Kidney Failure Can Isolate Young Patients

Kidney failure takes an especially tough toll on young adults, affecting their employment and relationships. Young people with kidney failure are less likely to have jobs or be in long-term relationships than others their age. It is vital to understand how kidney failure affects social goals, because by defining these we can seek interventions to improve areas of deficit. They were either on dialysis or had received a kidney transplant. Compared to their healthy peers, these young people had a worse quality of life and were more likely to be unemployed and to live in their parents' home. They also were less likely to be married or have a romantic partner. These social, employment and lifestyle issues were worse among those on dialysis than among those who'd had a kidney transplant. There were no differences between kidney failure patients and their healthy peers in terms of education levels or rates of smoking and drinking. Most young people with end-stage kidney disease have a kidney transplant, but they are high-risk for the transplanted kidney to fail. While much attention has been paid to the transition between pediatric and adult care for kidney patients. it's also essential to look at the social ramifications among this younger adult age group.

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Arthritis Can Strike Children

While arthritis is typically thought of as an older person's disease, more than 300,000 American children have chronic juvenile idiopathic arthritis (JIA). Unlike age-related arthritis caused by cartilage and bone wear and tear, JIA has more to do with joint inflammation, but it's not clear what triggers this inflammation. Symptoms of JIA include joints that are consistently swollen, stiff or inflamed. In some cases, the disease also affects the eyes and can threaten vision if not diagnosed and treated promptly. All children with JIA should be monitored by an ophthalmologist. The youngest children with JIA often don't complain about their pain. Signs that they may have JIA include wanting to be carried for the first couple of hours a day due to morning stiffness, or a persistently swollen knee or limp. In many cases, children just work around the problem and do function with minor adjustments in how they use the affected joints. But the older kids tend to perceive their arthritis differently and may have more discomfort. For children with JIA who have inflammation in one or two joints, cortisone shots may offer relief for up to two years. Also, low doses of the medication methotrexate can help ease symptoms and inflammation in many patients. If inflammation persists, doctors may prescribe biologic drugs to dampen an overactive immune response. We are fortunate to have medications to control this inflammation. Children tend to do well on them, with fewer side effects than adults. The outlook for children with JIA is much better now than it was decades ago. In the 1980s and 90s we had kids who needed hips, knees and other joints replaced with new joints said by lead researcher. But now, having JIA is more about taking medication safely, monitoring symptoms and living well with arthritis.

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Obesity Linked to 13 Types of Cancer

There's a link between obesity and 40 percent of all the cancers diagnosed. That doesn't mean too much weight is causing all these cancer cases, just that there's some kind of still-to-be explained association. Still, the study findings suggest that being obese or overweight was associated with cancer cases involving more than 630,000 Americans in 2014, and this includes 13 types of cancer. That obesity and overweight are affecting cancers may be surprising to many Americans. The awareness of some cancers being associated with obesity and overweight is not yet widespread, said by lead researcher. The 13 cancers include: brain cancer; multiple myeloma; cancer of the esophagus; postmenopausal breast cancer; cancers of the thyroid, gallbladder, stomach, liver, pancreas, kidney, ovaries, uterus and colon, the lead researchers said. Early evidence indicates that losing weight can lower the risk for some cancers. According to the new report from the CDC and the U.S. National Cancer Institute, these 13 obesity-related cancers made up about 40 percent of all cancers diagnosed in the United States in 2014. Although the rate of new cancer cases has decreased since the 1990s, increases in overweight and obesity-related cancers are likely slowing this progress, the lead researcher said. Of the 630,000 Americans diagnosed with a cancer associated with overweight or obesity in 2014, about two out of three occurred in adults aged 50 to 74, the top researcher found. The World Cancer Research Fund estimates that 20 percent of all cancers in the United States are caused by a combination of excess body weight, physical inactivity, excess alcohol, and poor nutrition. The American Cancer Society is currently doing its own extensive calculation of the numbers and proportions of cancer cases attributable to excess body weight, the results of which will be published soon, the lead researcher quoted.

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High-Fat Diets Could Pose Danger to Young MS Patients

A fatty diet may up the risk of relapse in children with multiple sclerosis(MS), according to a new study. But eating a diet rich in vegetables could cut relapse risk in half, the lead researcher said. The findings may provide early evidence that dietary changes could help some patients with MS manage their condition, said lead researcher. Multiple sclerosis is a disease of the central nervous system thought to affect more than 2.3 million people worldwide. Symptoms, which often affect movement and vision, can be disabling. Since young people with MS have a higher rate of relapse than adults, said, lead researcher. Food questionnaires were filled out by 219 young patients treated at 11 different MS centers across the United States. All were diagnosed with the relapsing-remitting form of multiple sclerosis or clinically isolated syndrome (CIS) before their 18th birthday. CIS is the first episode of neurological symptoms, usually lasting at least 24 hours. Relapsing-remitting MS means patients have attacks, then are symptom-free for periods of time. The lead researcher analyzed the patients' dietary data and monitored their health for almost two years on average. During this time, roughly 43 percent suffered a relapse of their disease. The lead researchers found that every 10 percent increase in calorie intake that came from fat was linked with a 56 percent higher risk of relapse. Most of this risk increase was tied to consumption of saturated fat, found in many baked goods and beef, cheese and butter. Every 10 percent increase in these calories was associated with a tripling of the risk for relapse, according to the study. But every additional cup of vegetables was linked with a 50 percent reduction in risk for relapse, regardless of how much fat the children ate, the study found. It's possible that excess fat intake may be triggering the release of inflammatory chemicals and affecting the composition of bacteria in the gut, the lead researcher said. Animal fat is also associated with a number of chronic inflammatory conditions, while a vegetable-rich diet has the opposite effect, the lead researcher said.

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Taking a multivitamin during pregnancy may reduce a child's risk of developing autism, a new study suggests. Analyzing more than a quarter-million mother-child pairs in lead researcher found a link -- but not cause and effect proof -- between multivitamin use and risk of the neurological disorder. Multivitamin use with or without added iron or folic acid was associated with a lower likelihood of child autism with intellectual disability, compared with mothers who did not use supplements, said lead researcher . The odds of autism in the multivitamin group were 30 percent lower. Since mothers-to-be are already advised to take prenatal vitamins to prevent some birth defects, this may be an added benefit, the lead researcher said. Autism spectrum disorder includes a range of conditions that affect social interaction, communication, interests and behavior. It's estimated that about 1 in every 68 people in the United States has some form of autism, boys more often than girls. Experts believe autism is caused by genetic and environmental factors. It most likely starts in the womb, and the mother's diet during pregnancy might have an influence, lead researcher said. The finding of multivitamin use associated with lower risk of autism spectrum disorder with intellectual disability is consistent with previous studies, said lead researcher. Those trying to conceive may benefit from starting multivitamin supplementation before getting pregnant, lead researcher said. However, it's too early to recommend multivitamins specifically for lowering autism risk. From a single study, we can't make any definitive statement or policy recommendations, because the results of other studies have been inconsistent, lead researcher said. Because the study was observational, it's possible that women who take a multivitamin during pregnancy might engage in other healthy behaviors that account for the reduced autism risk, lead researcher said. Ideally, a trial that randomly assigns women to multivitamins or no supplements could pin down whether vitamins really reduce autism risk. The children were born between 1996 and 2007 and were followed at least to age 4 and to 15 in some cases. Mothers reported their use of folic acid, iron and multivitamin supplements at their first prenatal visit. Cases of child autism spectrum disorder were identified using national registers. Evidence that iron or folic acid lowered the risk of autism was not consistent, lead researcher said. In addition, women should continue to take their vitamins after pregnancy while they are breast-feeding.

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Blood Thinners Can Come With Dangerous Side Effects

Blood-thinning drugs can save life by preventing a heart attack or stroke caused by artery-blocking blood clots. But these are powerful drugs, and a pair of new studies detail side effects people need to understand before taking them. The effectiveness of a class of blood thinners called non vitamin K oral anticoagulants (NOACs) can be significantly altered through interaction with other drugs, the first study reveals. In some cases, these drug interactions increase a person's risk of life-threatening bleeding in locations such as the brain and gastrointestinal tract. In other cases, the NOACs' effectiveness is reduced, robbing patients of some protection against stroke and heart attack. Meanwhile, a second study found that blood thinners can greatly increase a person's risk of finding blood in their urine. As a result, patients might unnecessarily wind up in the hospital or emergency room, or undergo an unneeded invasive procedure, said lead researcher.The first study looked at the bleeding risk associated with NOAC drugs dabigatran (Pradaxa), rivaroxaban (Xarelto) and apixaban (Eliquis). These drugs are primarily used to prevent risk of stroke in people with atrial fibrillation, an abnormal heart rhythm that can cause blood to pool and clot inside the heart, said lead researcher. NOACs are being used more frequently because they're easier to use and produce fewer side effects than warfarin, an older anticoagulant that has many food and drug interactions. The lead researcher found that bleeding risk increased significantly when NOACs were used in combination with amiodarone, fluconazole, rifampin and phenytoin -- four drugs that treat widely different conditions. The lead researcher also found that other drugs dampened the effectiveness of NOACs, including atorvastatin, digoxin, and erythromycin or clarithromycin. That's a very commonly prescribed cholesterol-lowering drug, especially now that it's generic. The second study found that people are much more likely to go to the hospital for blood in their urine if they're taking blood thinners. During an average follow-up period of 7 years, people on blood thinners were six to 10 times more likely to wind up hospitalized or in the ER complaining of blood in their urine compared with others not taking the drugs, the lead researcher said. The lead researchers found that rates of bladder cancer detection were twice as high in people taking blood thinners compared to the general population. The drugs made the tumor produce more blood.

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