Posted on

As Melanoma Rises, Doctors Challenge Some Early Testing

May 6, 2019 — As melanoma cases continue to rise sharply, Americans are being urged to get screened early for this deadliest of skin cancers. But some dermatologists question whether screening people without symptoms has resulted in overdiagnosing melanoma, bringing unnecessary anxiety and treatments.

They note that while the number of invasive melanoma cases diagnosed in the U.S. doubled from 1982 to 2011 and continue to rise, death rates have only dropped slightly. From 2007 to 2016, deaths from melanoma decreased by 2% in adults 50 and older and by 4% in people younger than 50.

“A huge increase in diagnosed melanomas should be associated with a steep decline in mortality,” says Ade Adamson, MD, a dermatologist and assistant professor at Dell Medical School at the University of Texas at Austin. “This is a very delicate discussion in my field because we want to believe so badly that screening healthy people and early detection is going to save lives, regardless of the cancer.”

Adamson says advances in technology contribute to overdiagnoses, including skin scanning tools that pick up tiny changes the eye can’t see. He says it is difficult, sometimes impossible, for a doctor or pathologist to tell a malignant melanoma lesion from a benign mole in the earliest stages of skin cancer.

He says the United States Preventive Services Task Force — a group of independent experts that use evidence to guide decision making — cites overdiagnosis as one of the reasons it doesn’t endorse routine skin cancer screening. The task force said it didn’t have enough data to determine if screening helps save lives. This recommendation is for people without a history or skin cancer who do not have any suspicious moles or other spots.

“The potential for harm clearly exists,” according to a statement the task force released in 2016, although “current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults.”

It says potential harms include misdiagnosis, overdiagnosis, cosmetic effects from biopsy (where a doctor removes a small amount of tissue to examine it for cancer cells), and overtreatment. For instance, surgical removal of moles can leave scars, and medications can have side effects.

A Controversial Topic

Overdiagnosis is controversial in the field of dermatology, where the prevailing wisdom is that greater exposure to ultraviolet (UV) radiation from the sun and tanning salons has led to higher melanoma rates over the years. Dermatology organizations urge Americans to use sunscreen, avoid tanning salons, and regularly get screened for skin cancer, especially if they sunburn easily or have a family history of the disease.

Since 1985, the American Academy of Dermatology has offered free skin cancer screening clinics around the country in May, which is melanoma awareness month.

A spokesman for the academy, Joel Cohen, MD, says the rise in melanoma cases may be related to better technology in the field that helps detect cancer early, screening programs that find melanoma early, and public education campaigns about how to recognize the early signs of skin cancer. When caught early, melanoma doesn’t have to be a death sentence, he says.

“Early diagnosis is absolutely essential when it comes to melanoma,” says Cohen, director of AboutSkin Dermatology in Greenwood Village, CO. “When we catch something tiny, believe me, it’s something to celebrate about. You’ve actually given this person a chance at life.”

Five-year survival rates for people whose melanoma is detected early is 92%, according to data provided by the American Society of Clinical Oncology. If the cancer has spread to other part of the body, that rate drops to 23%.

A recent study examined the American Academy of Dermatology’s SPOTme skin cancer screening program from 1986 to 2014. It said the data suggest that the program “detected thousands of skin cancers that may have gone undetected or experienced a delay in detection.”

It also said that people who went on to be diagnosed with skin cancer were more likely to be uninsured.

‘We’re Ramping Up Health Anxiety’

David J. Elpern, MD, a dermatologist in Williamstown, MA., says that overdiagnosis — not exposure to the sun — has contributed to rising melanoma rates. He believes dermatologists are finding more cases of melanoma early because of “diagnostic drift,” a growing tendency to diagnose and treat benign lesions as malignant cancers.

“You’re picking up tumors that probably never would have amounted to anything,” says Elpern, who has spoken out about changes in the field of dermatology that promote care that’s wasteful and not needed.

Overdiagnosis is not without consequences, he says. Once a patient is labeled with cancer, they’re launched into the health care system, where they’re subjected to excessive and expensive treatments, including biopsies, that are profitable for dermatologists.

“We’re ramping up health anxiety,” he says. Some dermatologists argue that these lowest-risk conditions shouldn’t be labeled as cancers at all. Instead, they should be watched.

But Stephanie Gardner, MD, a dermatologist in suburban Atlanta, says they are vigilant for a reason.

“Patient education and self-exams, appropriate timing of skin exams by dermatologists, and removal and surveillance of suspicious lesions all help to prevent advanced disease,” she says. “I would much rather be overdiagnosed than have a cancer missed, along with all of those ramifications.”

Prevention Tips

Prevention is the first step to avoid skin cancer. The American Academy of Dermatology urges everyone to take these steps:

  • Seek shade when needed. The sun’s strongest rays are between 10 a.m. and 2 p.m.
  • Wear protective clothing when possible: a wide-brimmed hat, sunglasses, long pants, and long-sleeved shirts.
  • Generously apply a broad-spectrum, water-resistant sunscreen with SPF 30 or higher. Use it whenever you are outside, even on cloudy days.
  • Reapply sunscreen every 2 hours.
  • Avoid tanning beds.
  • Do regular skin self-exams to look for new or suspicious spots on your skin.

People at higher risk of skin cancer include those who have:

  • Light skin
  • Skin that burns or freckles easily
  • Blue or green eyes
  • Blond or red hair
  • Certain types and a large number of moles
  • A family history of skin cancer
  • A personal history of skin cancer
Posted on

Do Adults Need a Measles Booster Shot?

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, May 8, 2019 (HealthDay News) — New York’s ongoing measles epidemic alarmed midtown Manhattan resident Deb Ivanhoe, who couldn’t remember whether she’d ever been vaccinated as a child.

So Ivanhoe, 60, sought out her long-time primary care doctor, who performed an antibody test to see whether she had any protection against measles.

To her surprise, the test revealed that Ivanhoe had no immunity to measles. Her doctor quickly gave her a measles booster shot.

“I’m a New Yorker. I’m out and about. I take the subway every day,” Ivanhoe said of her concerns. “One of the outbreak areas is in Williamsburg, Brooklyn. I have friends in Williamsburg. I go to there to visit, for dinner. It all becomes local.”

Ivanhoe is one of a growing number of adults who are worried that their immunity against measles might have lapsed, if they even received a vaccination.

The U.S. Centers for Disease Control and Prevention has downplayed these concerns, saying that only adults in high-risk groups should talk with their doctor about a measles vaccination.

But experts are divided on whether the CDC is underestimating the threat posed by possibly waning immunity in adults.

New outbreaks, new dangers

There’s good reason adults are worried. At least 764 cases of measles across 23 states have been reported so far this year, the CDC says. Most cases have occurred in unvaccinated groups living in communities located on either side of the nation, in the areas surrounding New York City and Portland, Ore.

The high-risk groups of adults who should discuss measles vaccination with their doctor include international travelers, health care workers, and folks living in communities that are in the throes of an outbreak, Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said in a media briefing last week.

“Most adults are protected against measles. That’s what the science says,” Messonnier said. “That includes people who were born before measles vaccine was recommended, and even folks who only got a single dose.”

Ivanhoe’s physician, Dr. Len Horovitz, said her antibody test “clearly proves that is not the case.”

Horovitz recommends his adult patients get a blood test that shows the level of antibodies they have against measles and other infectious diseases.

“By the time you reach your [childhood] pediatrician it’ll be weeks, if he’s still even alive and hasn’t retired or moved,” said Horovitz, an internist with Lenox Hill Hospital in New York City. “It’s impossible to get vaccination records for my patients. They’re tearing their hair out.”

But, Horovitz noted, “In a 24-hour turn-around time, I can offer them a blood test and have an answer.”

Waning effectiveness of early vaccine

Besides people at high risk due to their circumstances, there’s only one group of adults that really should talk with their doctor about getting the measles shot, the CDC says.

One of the first measles vaccines used a killed version of virus, and was administered between 1963 and 1967. That vaccine did not provide lasting immunity, and for decades the CDC has urged that generation of folks to undergo vaccination with the better live version of the measles vaccine.

“If you happen to be someone 50 years ago that got this killed measles vaccine, then you’d have to get re-vaccinated with the live virus vaccine,” said Dr. Sandra Fryhofer, an internal medicine specialist in Atlanta.

People born in the United States earlier than 1957 are presumed to be immune to measles because the virus is so contagious everyone caught measles in those days.

Pediatric infectious disease specialist Dr. Matthew Zahn says the CDC is right that most adults are protected against measles.

“Our experience overwhelmingly has been that it becomes a numbers game,” said Zahn, who is on staff at the Children’s Hospital Orange County in Orange, Calif. “The vaccine seems to be about 99% effective in keeping you from getting sick, but if you have hundreds and hundreds of people who are exposed, then you will see occasional cases of persons who’ve been vaccinated previously who are getting sick anyway.”

Best use of resources

Zahn figures people who are worried about the status of their measles immunity should just go ahead and get the vaccine, rather than go through an antibody test.

“If you’re not sure you’ve had your two doses before and you want to be up to date, there’s nothing wrong with getting that additional dose,” Zahn said, noting that a person who undergoes the antibody test pays extra and faces getting stuck with a needle twice.

There’s plenty of measles vaccine on hand so there’s no concern about shortages, Zahn said. Doctors are simply trying to focus their attention on the most critical weaknesses in America’s immune protection, and waning adult immunity doesn’t seem to be contributing to the ongoing outbreaks.

“It’s more of an issue where you want to best use everybody’s time and resources,” Zahn said. “We certainly are seeing outbreaks, but those outbreaks are so weighted towards unvaccinated persons, that’s where the community is by far at risk.”

Posted on

Genetic therapy heals damage caused by heart attack

Researchers from King’s College London have found that therapy that can induce heart cells to regenerate after a heart attack.

Myocardial infarction, more commonly known as a heart attack, caused by the sudden blocking of one of the cardiac coronary arteries, is the main cause of heart failure, a condition that now affects over 23 million population in the world, according to the World Health Organisation.

At present, when a patient survives a heart attack, they are left with permanent structural damage to their heart through the formation of a scar, which can lead to heart failure in the future. In contrast to fish and salamander, which can regenerate the heart throughout life.

In this study, published today in Nature, the team of investigators delivered a small piece of genetic material, called microRNA-199, to the heart of pigs, after a myocardial infarction which resulted in the almost complete recovery of cardiac function at one month later.

Lead author Professor Mauro Giacca, from King’s College London said: “It is a very exciting moment for the field. After so many unsuccessful attempts at regenerating the heart using stem cells, which all have failed so far, for the first time we see real cardiac repair in a large animal.”

This is the first demonstration that cardiac regeneration can be achieved by administering an effective genetic drug that stimulates cardiac regeneration in a large animal, with heart anatomy and physiology like that of humans.

“It will take some time before we can proceed to clinical trials” explained Professor Giacca.

“We still need to learn how to administer the RNA as a synthetic molecule in large animals and then in patients, but we already know this works well in mice.”

Posted on

Americans Sit Way Too Much, But Exercise May Help

April 23, 2019 — Tethered to our televisions and computers, Americans are sitting even more than in years past, according to a new study.

And while prolonged sitting has long been linked with a higher risk of obesity, heart disease, cancer, diabetes, and death, another new study found that exercise may blunt some of the risks.

While researchers say it’s no surprise that we’re all sitting more, they don’t all agree about how much exercise can help.

Sitting Study Details

In the U.S., total sitting time from 2007 to 2016 rose by about an hour a day, to 8.2 hours for teens and 6.4 hours for adults, says Yin Cao, ScD, assistant professor of surgery in the Division of Public Health Sciences at Washington University School of Medicine in St. Louis. She is the senior author of the study that tracked Americans’ sitting habits. (Data on children’s total sitting time was not collected.)

Cao’s team used data from the National Health and Nutrition Examination Survey (NHANES) from 2001 through 2016 to track the sitting behaviors of nearly 52,000 children, teens, and adults.

The survey had separate questions on time spent sitting to watch TV or videos and time spent sitting for computer use outside of school or work needs.

By age group, the percentage of people who watched at least 2 hours a day of TV or videos in 2015-2016 included:

  • 62% of children
  • 59% of teens, and
  • 65% of adults (84% of those 65 and above).

Those times are averages. Overall, across all the age groups, up to 38% watched 3 hours a day or more, and up to 23% watched for 4 hours or more daily.

While these daily TV and video viewing times remained fairly stable over the 15-year period, leisure time computer use rose, driving the overall increase in sedentary behavior, Cao says.

Time spent on computers — meaning traditional desktop computers or laptops — outside of school or work increased in all age groups over the 15-year period. Comparing 2015-2016 to 2001:

56% of children spent an hour or more on computers, up from 43%.
57% of teens did, up from 53%.
50% of adults did, up from 29%.
And these numbers don’t capture all sedentary behavior. “A missing component is how much time is spent sitting and using handheld devices,” Cao says. That data is not collected in the NHANES survey.

“The findings on computer use are not surprising as we know technology changes,” she says. “We were surprised that time on TV and video [viewing] was stable, as we thought it would be decreased with the increase in computer time.”

Some groups are more likely to sit too much, Cao found, including non-Hispanic black people, overweight people, and boys.

Exercise Study Details

In the other study, researchers looked at the sitting and exercise habits of nearly 150,000 Australians ages 45 and older, from 2006-2009, to see if higher levels of exercise could eliminate the health risks of sitting.

As exercise levels rose, risks declined, says lead author Emmanuel Stamatakis, PhD, a professor of physical activity, lifestyle, and population health at the University of Sydney. He calls 150 minutes of activity a week ”the magic threshold” when risks start to decline.

The participants reported how many hours a day they spent sitting, standing, and sleeping, as well as how much time they took part in moderate to vigorous physical activity.

The researchers tracked deaths from any cause until June 2017, nearly 9 years after the original survey, and death from heart disease through December 2015, a follow-up of more than 7 years. During that period, more than 8,600 of the 150,000 study participants died (more than 1,600 from heart-related causes).

Sitting more than 6 hours daily was linked with a higher risk of death and was strongest in people who did not meet the recommendation of at least 150 minutes of activity a week, Stamatakis says.

Among people who reported no physical activity, those who sat more than 8 hours a day were 1.5 times more likely to die during the follow-up than those who sat less than 4 hours a day.

While risks began to decline with 150 minutes of activity a week, people taking part in the study needed to get more than 300 minutes a week to eliminate the risk, Stamatakis says.

Replacing sitting time with standing ”doesn’t seem to do much,” he says, but replacing sitting with physical activity was consistently linked with less risk.

“Moderate to vigorous activity includes walking, sports, and exercise such as running or playing tennis, hiking, strenuous work in the garden, or vigorous housework,” Stamatakis says.

U.S. guidelines say adults should get at least 150 minutes (2.5 hours) to 300 minutes (5 hours) a week of moderate-intensity activity; 75 minutes to 150 minutes of vigorous-intensity activity; or an equal combination of both.

Few Americans get the recommended amount of activity, with 65% reporting doing less than the minimum.

‘Just the Tip of the Iceberg’

Not everyone agrees that exercise can combat the effects of hours of sitting.

In its 2016 scientific statement, the American Heart Association says that being sedentary could make you more likely to have heart disease and stroke, and that moderate to vigorous physical activity does not cancel out the impact of being sedentary.

Nieca Goldberg, MD, medical director of the Joan H. Tisch Center for Women’s Health at NYU Langone Health in New York City, calls the exercise study results promising, but she says more research is needed.

Both studies show the unhealthy downside of technology, she says, and Stamatakis agrees.

“The health risks of excessive screen media use go well beyond the increase in sedentary behavior they impose; sitting is just the tip of the iceberg,” he says. He cites social isolation, screen addiction, and other mental health issues. Figuring out how to moderate screen media use is an ongoing challenge for health professionals, he says.

Posted on

13 Easy Ways to Eat More Greens

Sautéed Kale and White Beans
For decades, Italian country cooks have simmered greens and buttery white beans together. A quick version from cookbook author Holly Clegg starts with Canadian bacon browned in a pan. Next, sauté an onion in olive oil. Add chopped kale, a can of white beans, chicken broth, and stir until the greens are tender. Canadian bacon adds meaty flavor with less fat than regular bacon.

Bok Choy Salad
Bok choy, a mild Chinese cabbage, gives this salad a crunchy texture. Combine chopped baby bok choy, green onions, toasted sliced almonds, and drained mandarin oranges. For dressing, whisk together olive oil, rice vinegar, sugar, and low-sodium soy sauce. Bok choy has the disease-fighting powers of cabbage and is packed with vitamins and minerals.

Beets, Greens, and Black Licorice
Want to serve leafy greens like a top chef? Try a salad of sliced beets and beet greens, the creation of Top Chef All-Stars winner Richard Blais. He tames the bite of the greens with shavings of black licorice. It adds a kick and a false sense of sweetness, like using cinnamon or vanilla. At his newest restaurant, The Spence, he adds a little horseradish as a final touch.

Salmon Steamed in Collards
Collards have big, wide leaves with a cabbage-like flavor. Chef Blais blanches them briefly in boiling water, then plunges them into ice water. Once soft, fold the leaf over uncooked salmon like a wrap. Steam the fish in the collard leaf until the salmon is tender.

Tip: Aim for 2 to 3 cups of veggies daily. Cooked greens like cabbage count as one cup of veggies. For salad greens, two cups are equal to one cup of vegetables.

Southern-style Greens
The true Southern way to cook collards — or the more peppery mustard greens shown here — is with chunks of ham or Andouille sausage. Recipe developer Clegg, who calls Louisiana home, creates a similar flavor with turkey sausage or Canadian bacon. This cuts the fat and sodium in this favorite side dish. After browning the meat, add olive oil, onion, broth, and leafy greens until wilted.

Read More…

Posted on

Inactive Lifestyle Begins as Early as Age 7: Study

By Robert Preidt

HealthDay Reporter

MONDAY, April 15, 2019 (HealthDay News) — Kids can start becoming couch potatoes as early as age 7, a new study reveals.

A review of 27 studies published between 2004 and 2018 in different countries found high rates of decreasing physical activity among children and teens.

While many teens quit playing sports, overall activity starts to decline during early school years among kids who were once active, said study author Irinja Lounassalo. She’s a doctoral student in sport and health sciences at the University of Jyvaskyla in Finland.

So, “being physically active in childhood and adolescence may be of high importance since it can postpone the time of becoming inactive later on,” Lounassalo said.

While the percentage of inactive people increases with age, certain groups actually increase their activity levels in adulthood and old age.

“In the future, special attention should be paid to these individuals who increase their physical activity, because it is important to understand how potential lifelong inactivity could be turned into activity,” Lounassalo said.

Among children and teens, parental support for an active lifestyle helped increase activity. For teens, less time in front of the television was associated with regular activity.

For adults, quitting smoking brought increased activity. And among older adults, regular activity was associated with a lack of chronic illnesses, a lower death rate and good physical functioning.

“Since physical activity behavior stabilizes with age and inactivity is more persistent behavior than activity, interventions should be targeted at children early in life before their habits become stable,” Lounassalo said.

Parents can help by supporting physical activity in the schools and extracurricular sports clubs for kids, she said.

“Building publicly available sport facilities and safe bicycling and walkways might help in increasing opportunities for being active regardless of age, nationality, gender or educational level,” Lounassalo said.

The study was recently published in the journal BMC Public Health.

Posted on

How does bereavement impact the immune system?

Losing a loved one is, of course, incredibly traumatic; it may also shorten lifespan. A recent paper reviews decades’ worth of research into bereavement and its effects on the immune system.

For years, researchers and laypeople alike have noted that when someone loses a partner, their risk of mortality increases significantly.

In days gone by, we might have referred to this as a death from a broken heart.

The phenomenon has been under investigation for decades.

For instance, researchers using data from a Finnish population published their findings in 1987. They found that “For all natural causes, mortality during the first week [following the death of a spouse] was over two-fold, compared to expected rates.”

Another study, published in 1995, concluded that, following the death of a spouse, mortality “was significantly elevated in both men and women.” This elevation was most pronounced 7–12 months after the bereavement.

Although scientists have collected a fair amount of evidence demonstrating this effect, there is less information about the biological mechanism that drives it.

Bereavement and the immune system

Now, a literature review has attempted to tie previous findings together to create a clearer picture of this phenomenon. Specifically, the authors were interested in how bereavement and grief might negatively influence the immune system, thereby increasing mortality risk.

The authors, from the University of Arizona, in Tucson, recently published their paper in the journal Psychosomatic Medicine.

The researchers conducted a systematic review of published research from 1977 to now. In all, 33 studies met the grade to be considered for analysis and the scientists focused on 13, which were of the highest quality.

When asked why they conducted the research, one of the authors, Lindsey Knowles, explained that “There is strong evidence that spousal bereavement increases morbidity and risk for early mortality in widows and widowers; however, we have yet to discover how the stress of bereavement impacts health.”

It was in the late 1970s that scientists started looking to the immune system’s role in increased mortality risk after bereavement.

A paper published in The Lancet in 1977 claims to be the first to measure an abnormality in immune function following bereavement.

A new review of the evidence

Knowles explains that she wanted to create a document that includes “all published data on the association between bereavement and immune function — to establish a knowledge base and suggest specific directions for future research.”

The paper outlines the primary findings from studies that have been carried out to date.

In particular, they identify that people who are bereaved have increased levels of inflammation, faulty immune cell gene expression, and reduced antibody responses to immune challenges.

These changes are all significant when trying to understand why people who are bereaved have a higher risk of death; for instance, scientists already know that chronic inflammation plays a part in a range of conditions, including obesity, heart disease, and diabetes.

The authors also conclude that there is a link between the psychological impacts of bereavement — such as grief and depression — and how severely bereavement impacts immune function.

A study published in 1994, for instance, found that, overall, individuals who had been bereaved did not have significant differences in their immune profiles. However, those who also met the diagnostic criteria for depression did have impaired immune function.

This type of research is important; there is still an air of mystery around the topic, so any new insight is vital. Scientists know that grief increases the risk of an earlier death, so understanding what is happening on a physiological basis could help guide how doctors treat these people in the future.

Another of the paper’s authors, associate professor Mary-Frances O’Connor, explains how, “Someday, clinicians may be able to track changes in patients’ immunity and prevent medical complications after this difficult experience.”

When asked about the contribution that this paper lends to the field, O’Connor says:

“This systematic review gives researchers a resource to read all that research in one place, with a modern perspective on how the field has changed and a visual model to help move the field forward in a more organized way.”

Although this line of inquiry has a long history, there are still many gaps that scientists need to fill with fresh research.

As the authors explain, there is a great need for large longitudinal studies; for instance, if researchers could assess an individual’s immune profile before bereavement occurs and throughout the aftermath, this would provide a much-needed depth of information. Of course, this approach would require a great many resources.

Hopefully, this review will ignite a fascination in the next generation of researchers who are destined to tackle this topic.

Posted on

2019 Measles Outbreak: What You Should Know

Note: This story was updated April 22, 2019, with additional cases reported and April 18, 2019, with statistics on reported measles cases worldwide.

April 11, 2019 — Measles cases have been skyrocketing in the U.S. this year, with 626 reported so far, according to the CDC. Worldwide, the number of reported cases jumped 300% in the first three months of 2019 compared to the same time period in 2018, according to the World Health Organization. Learn why it’s happening and how to protect your family from this potentially deadly disease.

What is measles?

Measles is a contagious disease spread by a virus. It’s so contagious that when someone has measles, 90% of the people around them who aren’t immune will also catch it. And it’s so serious that one in four people who get measles will need to be hospitalized.

What are the symptoms of measles?

Seven to 14 days after exposure, symptoms begin with a high fever, cough, runny nose, and red, watery eyes. Several days after that, the measles rash appears.

Why has measles come back?

Measles was declared eliminated in the U.S. in 2000, 3 decades after the vaccine was introduced. But in recent years, “A critical number of parents have chosen not to vaccinate their children,” says Paul Offit, MD, director of the Vaccine Education Center at Children’s Hospital of Philadelphia. “When that happens, measles — the most contagious of vaccine-preventable illnesses — is often the first to come back.”

Where have there been measles outbreaks 2019?

The CDC defines an outbreak as three or more cases . The largest outbreak this year has been in New York City, with nearly 300 cases concentrated in an Orthodox Jewish community in the Williamsburg area of Brooklyn. New York City Mayor Bill de Blasio declared a public health emergency April 9 and said unvaccinated residents living in certain ZIP codes that had been exposed to the virus must get the vaccine to help prevent further spread of the disease. Residents who refuse may face a violation and possible fine of $1,000. A group of parents is suing the city’s public health department to block the order.

Rockland County, north of the city, also had a sizable outbreak, as did counties in Washington state, Michigan, New Jersey, and California. Individual cases have been confirmed in 14 other states.

How dangerous is it?

For some people, measles brings far more than just a fever and a rash. There is no treatment, and it can cause serious health complications, especially in small children. Currently, five patients in New York City have been admitted to the intensive care unit. In general, one out of every 10 children with measles get an ear infection, which can lead to permanent hearing loss. And one or two out of every 1,000 will die.

Who’s most at risk of measles?

About 500,000 people in the U.S. can’t be vaccinated because of severe allergies or a weakened immune system, says. Offit. Those people rely on everyone else’s vaccinations to protect them, in a concept known as community (or herd) immunity. Community immunity also keeps infants safe, since the vaccine isn’t given until a child is a year old.

How is measles spread?

People with measles can spread the disease up to 4 days before their symptoms appear. When an infected person coughs or sneezes, the virus sprays into the air, where it lingers or lands on surfaces. The virus can live outside a human body for up to 2 hours — so even if you enter an empty room, if you don’t have immunity, you can become infected.

What is the chance that measles will spread more widely?

If more parents refuse to vaccinate their children, the disease could become a constant threat.

When is the measles vaccine given?

The vaccine is usually given to children between the ages of 1 and 6. To be most effective, they’ll get two doses: the first at 12 to 15 months, and the second between ages 4 and 6. That second dose can be given as soon as 28 days after the first dose, if necessary.

If every unvaccinated person got vaccinated, would it stop the spread?

Absolutely, says Offit. “Measles is back because we haven’t learned from history. And it’s the children who suffer for our ignorance.”

Are measles parties safe?

Before there was a vaccine for chickenpox, parents would bring children to the home of a child who had the pox to expose them on purpose. (Chickenpox can become more serious in adults.) Now, some parents who refuse vaccinations for their children are doing the same with measles. Offit says this is extremely dangerous. “Why risk a natural infection, knowing it could mean your life?”

Does the vaccination I got as a child still protect me?

In most cases, yes. Only about three people out of every 100 who get both doses of the vaccine will still get measles after exposure. One caveat: If you received the vaccine in its early days, between 1963 and 1967, you may need to be re-vaccinated. Certain vaccines given in those years were not effective.

What should you do if you think your child has been exposed?

Call your pediatrician right away, Offit says. The risk will depend on several things, which your doctor will assess. Do not wait for symptoms.

Posted on

16 Brilliant Beauty Tips That Solve Every Problem

Pump Up the Volume

When you don’t have time to wash and style, take second-day hair to new heights by blasting your roots with a texturizing spray, massaging the crown of your head and then winding your hair into a high bun. Try BlowPro Blow Back Time ($20, ulta.com), which boosts fullness. Before you walk into your office, undo the bun, shake it out and, voilà, textured waves!

Reduce Sallowness

Peach blush helps balance a sallow complexion, says Kristofer Buckle, a celebrity makeup artist. Try Benefit Majorette ($28, benefitcosmetics.com) or Dior Cheek & Lip Glow ($37, Sephora stores) on the apples of your cheeks.

Whiten Stained Teeth

You’re giving a presentation at work later in the day and your teeth look a bit dingy (let’s just say the Starbucks’ barista knows your name by heart). To the rescue: a fast-acting strip that you can apply before you shower. Try Crest 3D White 1 Hour Express Whitestrips ($55, drugstores). Remove the strip and brush your teeth after you get dressed to reveal a sparkly smile. Good morning, multitasker!

Look More Vibrant

To perk up tired skin pronto, slather on a face mask, get in the shower and let it work its magic for 10 minutes. The steam will open your pores and help the ingredients penetrate deeper. Nugg Beauty Revitalizing Face Mask ($3, nuggbeauty.com) comes in a single-use pod and packs peppermint oil, which smooths, firms and acts like a shot of espresso for your skin.

Zen Out

You probably sprint through your a.m. routine, but that doesn’t mean it can’t feel a little spalike. Sprinkle a few drops of eucalyptus oil (get it at a health-food store) directly under the showerhead as the warm water streams out. Not only will it smell amazing, but the zesty fragrance will also open your nasal pathways for deeper breathing, helping to fight mental sluggishness, explains Sara LaBree, the education manager for Jurlique. A eucalyptus shower gel works wonders, too. We like Malin + Goetz Eucalyptus Body Wash ($20, malinandgoetz.com).

Read More…

Posted on

The Best Butt Exercises for Knee Pain—No Squats or Lunges Included

Let me tell you a secret: Squats and lunges are not the magic ingredients for getting a better butt. Yes, they’re both *great* lower-body exercises that recruit tons of muscles, but they aren’t the be-all and end-all of boosting your glutes. That’s great news if you have knee pain, because you can do all these booty-blasting moves without worrying about bugging your knees. (Must-read: 4 Reasons Why You Have Pain Behind Your Knee)

Just follow along with celeb trainer Jeanette Jenkins of the Hollywood Trainer Club for the ultimate butt workout that you can do if you have knee pain—or just want to build muscle in that booty. (Want to spread the burn beyond the booty? Try Jeanette’s total-body toning dumbbell workout too.)

How it works: Do each move for the number of reps indicated and then repeat the circuit two to three times. Watch the video for full move demos and form tips from Jeanette.

Butt Burner Toe Tap

A. Stand with feet together and sit back into a quarter squat.
B. Shift weight into left foot and tap the right foot backward, then back to center, then out to the side, then back to center, while keeping left leg bent and pumping arms as if running.

Do 16 to 20 reps per side.

Side Toe Tap

A. Stand with feet together and sit back into a quarter squat.
B. Staying in squat position, shift weight into left foot and tap the right foot out to the side, opening arms up to the side.
C. Tap the right foot back to center, lowering arms. Continue quickly tapping in and out.

Do 20 to 25 reps per side.

Single-Leg Deadlift

A. Stand with feet together, dumbbells in hands by sides. Shift weight into right foot, balancing on left toe.
B. Hinge forward at the hip, lifting straight left leg backward and reaching dumbbells toward right foot.
C. Keeping core tight, engage right glute to raise torso and return to starting position.
D. For a challenge, after doing 16 reps, hold the extended position (left foot lifted and torso parallel to the ground) and add a dumbbell row, drawing dumbbells up next to ribs, elbows in tight. Do 8 reps.

Do 16 reps per side.

Arabesque Pulse

A. Stand on the right leg, with left toes extended slightly backward to balance. Extend right arm straight overhead and left arm out to the side at shoulder height.
B. Maintaining the upper body position, lift back left leg and pulse up and down without touching toes to the floor.

Do 20 to 25 reps per side.

Kneeling Back Kick

A. Start in tabletop position, on all fours with hips over knees and shoulders over wrists, core engaged.
B. Lift right knee off the floor and kick diagonally backward and up, pressing heel toward the top back corner of the room.
C. Return knee to starting position without touching it to the ground and repeat.

Do 25 reps per side.

Kneeling Combo

A. Start in tabletop position, on all fours with hips over knees and shoulders over wrists, core engaged.
B. Lift right knee off the floor and kick diagonally backward and up, pressing heel toward the top back corner of the room.
C. Return knee to starting position without touching it to the ground, then lift knee out to the side, maintaining 90-degree bend.
D. Return knee to starting position without touching it to the ground.

Do 16 reps per side.

Kneeling Roundhouse

A. Start in tabletop position, on all fours with hips over knees and shoulders over wrists, core engaged.
B. Lift right knee out to the side, then extend leg to kick, leg parallel to the ground with knee pointing forward.
C. Reverse motion to return to starting position and repeat.

Do 16 reps per side.

Straight-Leg Pulse

A. Start in tabletop position, on all fours with hips over knees and shoulders over wrists, core engaged.
B. Lift and straighten right leg backward, knee pointing down. Pulse right leg up and down.

Do 16 reps per side.

Kneeling Bird-Dog Balance

A. Start in tabletop position, on all fours with hips over knees and shoulders over wrists, core engaged.
B. Lift and straighten right leg backward, knee pointing down. Extend left arm forward.

Hold for 15 seconds per side.

Leg Lift Hold

A. Start in tabletop position, on all fours with hips over knees and shoulders over wrists, core engaged.
B. Lift and straighten right leg backward, knee pointing down. Lift right leg as high as possible, and bend elbows to lower chest to the floor.

Hold for 15 seconds per side.

Shoulder Bridge

A. Lie faceup on the ground with feet planted and knees pointing up.
B. Engage core and tuck pelvis, then push into feet to press hips off the ground.
C. Pulse hips up and down, squeezing glutes at the top.

Do 20 reps.

Single-Leg Shoulder Bridge

A. Lie faceup on the ground with feet planted and knees pointing up.
B. Engage core and tuck pelvis, then push into feet to press hips off the ground. Lift the right leg straight into the air over hips.
C. Maintaining this position, pulse hips up and down.

Do 15 to 20 reps per side.