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					                                                                                                                                                                                                                                 ARAB TIMES, WEDNESDAY, JUNE 22, 2011
HEALTH                                                                                                                                                                                                                                                                             33


        ‘No vit D screening in pregnancy’

Obesity, lack of exercise
linked to ‘chronic pain’
NEW YORK, June 21, (RTRS): It may not be surprising, but people who exer-
cise at least one hour per week have a lower risk of troublesome back, neck, and
shoulder pain, a new study shows.
    The new evidence supports the possibility that obesity and physical inactivity
play a role in a person’s risk of developing chronic pain in those areas, said study
co-author Dr Paul Mork, of Norwegian University of Science and Technology in
an email to Reuters Health.
    Mork and colleagues followed more than 30,000 adults who participated in a
large Norwegian health study. They recorded participants’ body mass index
(BMI) - a measure of weight related to height - at the start of the study, as well
as how often they exercised, and then tracked them over the next 11 years.
    The authors divided the participants into four categories based on how often
they exercised, and four categories based on their BMI. They also looked at how
many people in each category devel-
oped chronic neck, shoulder, and                 ‘Buying insurance’
lower back pain.
    Overall, 1 of every 10 people in the
study developed lower back pain, and
nearly 2 of every 10 developed shoul-
                                              Docs reaffirm
der or neck pain.
    After taking into account partici-        ‘responsibility’
pants’ age, BMI, whether or not they
smoked, and whether they did manu-             CHICAGO, June 21, (RTRS):
al labor at work, the research team            The       American        Medical
found that men who were exercising             Association on Monday reaf-
                                               firmed its position that individ-
2 hours or more per week at the start          uals should be responsible for
of the study were 25 percent less like-        buying health insurance, a              Health and Human Services Secretary Kathleen Sebelius gives brief remarks at the beginning of a news conference about Medicare at HHS June 20, 2011 in
ly to have lower back pain 11 years            contentious provision of US                                                                             Washington, DC. (AFP)
later, and 20 percent less like to have        healthcare reform.
neck or shoulder pain, compared men
who didn’t exercise at all. And
                                                  The health reform law’s
                                               requirement that everyone
                                                                                                                   Medicare preventive care use still spotty
women who exercised at least 2 hours           buy insurance is facing a legal
per week were 8 percent less likely to         challenge by 26 states that             More than five million Medicare recip-            and prostate cancer screenings, in               Democrats and Republicans trying to            it is about the same; and for a few
develop lower back pain than women             contend the government can-             ients have used preventive health-                the hopes that early diagnosis and               tame spiraling US debt.                        services there is a slight drop,” said
who were inactive, and 9 percent less          not compel citizens to engage           care services to date in 2011, and US             treatment will help save significant                But the uptake of services has              Ellen Griffith, a CMS spokeswoman.
likely to develop neck and shoulder            in commerce.                            health officials are trying to acceler-           costs for the system.                            been uneven, with one in six                   “All of this supports the need for the
                                                  At the AMA’s annual meet-            ate that trend to combat crippling                   The     Obama       administration’s          Medicare beneficiaries using at least          multi-pronged public awareness cam-
pain.                                                                                  healthcare costs.                                 healthcare overhaul, passed in early             one free service from Jan 1 through            paign we launched today.”
    Weight, not surprisingly, also             ing in Chicago, two-thirds of
                                               delegates voted to uphold the             The US Department of Health and                 2010, eliminated out-of-pocket costs             June 10, according to the Centers for             CMS estimates the US could save
affected the risk of chronic pain later                                                Human Services is launching a cam-                for recommended preventive servic-               Medicare and Medicaid Services                 two-thirds of the $2 trillion it spends
on. Obese men were almost 21 per-              group’s policy supporting indi-
                                               vidual responsibility for pur-          paign to encourage Medicare recipi-               es and annual checkups at the begin-             (CMS).                                         on preventable long-term illness by
cent more likely to develop chronic            chasing health insurance.               ents to take advantage of preventive              ning of this year. Healthcare costs are             “For some services, utilization is          preventing chronic illnesses in
lower back pain than men of normal                Key      insurance      market       services, including mammograms                    a central point of negotiation between           slightly higher than in 2010; for some,        Medicare beneficiaries. (RTRS)
weight, and 22 percent more likely to          reforms, such as ending
develop neck or shoulder pain. Obese           denials of coverage based on
women were also 21 percent more
likely to develop lower back pain
                                               pre-existing conditions, are
                                               only possible through broad                                                                                                ‘Docs, clinics not following guidelines’
than women of normal weight, and 19            participation in the health
percent more likely to develop neck            insurance market, said AMA
and shoulder pain.
    Based on the results, Mork
believes that even moderate physical
                                               President Dr Cecil Wilson.
                                                  “The AMA’s policy support-
                                               ing individual responsibility
                                               has bipartisan roots, helps
                                                                                                                                         Cervical cancer virus overtested
exercise — just one hour or more per                                                                                                     WASHINGTON, June 21, (AP): Too
                                               Americans get the care they
week — “can, to some extent, com-
pensate for the adverse effect of being        need when they need it and
                                                                                                                                         many doctors are testing the wrong
                                                                                                                                         women, or using the wrong test, for a
                                                                                                                                                                                                            ‘Poor, disadvantaged people’
overweight and obese on future risk            ends cost shifting from those
                                               who are uninsured to those                                                                virus that causes cervical cancer.
of chronic pain.”
    “Chronic neck and back pain are
important to public health due to their
                                               who are insured,” Wilson said.
                                                  President Barack Obama in
                                                                                       In this frame grab taken from twitpic
                                                                                       and released by Epic Records, on
                                                                                       June 20, singer Sean Kingston ges-
                                                                                                                                            The days of one-size-fits-all screening
                                                                                                                                         for cervical cancer are long gone. How
                                                                                                                                         often to get a Pap smear — and whether
                                                                                                                                                                                          Lung cancer patients less managed
                                               2009 took his healthcare cam-                                                                                                              NEW YORK, June 21, (RTRS): Lung                between the types of hospitals are “very
substantial influence on quality of            paign to the annual meeting of          tures to his fans. Kingston says he’s             to be tested for the cancer-causing HPV
life, disability, and health care                                                      felling better almost a month after               virus at the same time — now depend on           cancer patients at public hospitals, which     complex,” Cleeland said. “I don’t think it’s
                                               the influential AMA, which rep-                                                                                                            serve a greater proportion of poor and         the intention of those caring for those
resources,” Dr. Adam Goode from                resents 250,000 doctors and             crashing his watercraft into a Miami              your age and other circumstances.
                                                                                       Beach bridge over the Memorial Day                                                                 disadvantaged people, are less likely to       folks.”
Duke University in Durham, North               has historically been opposed                                                                But a government study reports                receive adequate treatment for pain and           Rather, patients’ access to resources
Carolina told Reuters Health by                to a bigger government role in          weekend. The singer famous for his                Monday that a surprising number of doc-
                                                                                       2007 hit ‘Beautiful Girls’ has been hos-                                                           other symptoms than patients treated at        within the hospital and beyond it could
email. Goode, a physical therapist,            healthcare.                                                                               tors and clinics aren’t following guide-         a cancer center, according to a new            explain why underserved patients tended
                                                                                       pitalized in Miami since the May 29
was not involved in the study by                          ❑ ❑ ❑                        crash. His publicist, Joseph Carozza,             lines from major medical groups on how           study.                                         to experience worsening symptoms.
Mork’s group.                                                                                                                            to perform HPV checks, suggesting a lot             Patients at public hospitals were nine         Cleeland said patients at public hospi-
                                                  Providers of bare-bones              said Kingston walked on his own June                                                               times more likely than the cancer center       tals might be less likely to get referrals to
    Back in the mid-1990s, a study             health insurance plans have             6 for the first time since the accident.          of women are getting unnecessary tests.
from the Netherlands estimated that                                                                                                         That wastes money and could harm              patients to come in with more-severe           specialists for behavioral health services
                                               until September to seek                 On his Twitter page Monday, Kingston                                                               symptoms to begin with.                        or for the treatment of bone pain.
low back pain cost that country near-          exemption from certain cover-           posted a message to his fans. He                  women who wind up getting extra med-                “I think it’s been noted...for the last        Additionally, the patients at a cancer
ly 2 percent of its gross national prod-       age requirements set under              wrote: ‘Feeling a lot better! God is              ical care they didn’t need, says Dr Mona         couple of decades” that cancer “is less        clinic might be more able to afford spe-
uct. In their new paper Mork and col-          the 2010 health care reform             great! Thanks for all the prayers and             Saraiya of the Centers for Disease               well managed in what we consider               cialty care when it’s offered.
leagues write that “just a small reduc-        law, according to the Centers                  support! Love you all!’ (AP)               Control and Prevention, who led the              underserved patients,” said Dr Charles            The patients in the study did receive
tion in the incidence of chronic lower         for Medicare and Medicaid                                                                 research.                                        Cleeland from MD Anderson Cancer               equal treatment for the cancer itself.
back pain would have a profound                Services.                                                                                    Even she wasn’t protected from the            Center in Houston, who led the study.             Sixty-two out of every 100,000 adults
economic impact.”                                 The agency said on Friday                                                              confusion. Saraiya was stunned to get a             Underserved patients tend to be poor,       in the United States are diagnosed with
                                                                                                                                                                                          single, unemployed, non-white, and             lung cancer each year.
    Because of the way it was                  that insurers will need to file
                                               by September 22 for waivers
                                                                                                 Health                                  bill showing that her own doctor had
                                                                                                                                         ordered testing for HPV strains not con-
                                                                                                                                                                                          receiving public assistance health insur-         Previous studies have uncovered dis-
designed, the Norwegian study can’t                                                                                                                                                       ance. They also tend to have low levels        parities among lung cancer patients for
prove that lack of exercise and being          regarding annual coverage                                                                 nected to cervical cancer.                       of formal education.                           treatment and survival as well.
overweight actually caused people’s            limits under such “mini-med”            US unveils tobacco warning labels:                   The findings, reported in the journal            Previous work, Cleeland said, had              African Americans and patients of
chronic pain, or that regular exercise         health plans.                           Dead bodies, diseased lungs and a man on a        Obstetrics & Gynecology, show women              only analyzed patients’ symptom treat-         lower socioeconomic status are less like-
and a more healthy weight prevented               The       plans,      generally      ventilator were among the graphic images for      have to be savvy to ensure they’re get-          ment at a specific point in time. His study,   ly to survive lung cancer.
it. It could be that the people who did        designed for low-wage restau-           revamped tobacco labels unveiled on               ting the right checkups — enough, but            published in the Journal of Clinical              And an earlier study led by Dr Samuel
                                               rant and retail workers, pro-           Tuesday by US health officials.                   not too much.                                    Oncology, monitored patients for more          Cykert, a professor of medicine at the
or didn’t have chronic pain are differ-        vide lower benefits than the                                                                                                               than two months.                               University of North Carolina, found that
ent in ways the study did not measure.                                                    Proposed in November under a law that             “It’s extremely discouraging,” says
                                               average health insurance                put the multibillion-dollar tobacco industry                                                          Eighty patients were receiving treat-       African Americans are more likely than
    However, given the known bene-             plan.                                                                                     Debbie Saslow, gynecologic cancer                ment for their lung cancer at one of three     whites to forego surgery for early stage
fits of exercise and maintaining a                                                     under the control of the Food and Drug            director at the American Cancer Society,
                                                  As the health law required,                                                                                                             public hospitals — two in Houston and          lung cancer - the best treatment for the
healthy weight, Mork believes that                                                     Administration, the new labels must be on         who’s had to argue with her doctor               one in Miami. Another 101 were receiv-         disease.
                                               in September 2010 insurance             cigarette packages and in advertisements
“community based measures aimed at             plans began phasing out their                                                             against testing too often. “We have not          ing care at MD Anderson Cancer                    “There were probably unintended
                                                                                       starting in October 2012.                         been able to get that message across.”           Center.                                        biases in physicians,” Cykert suggested.
reducing the incidence of chronic              annual limits. Today, most                 Health and Human Services Secretary
pain...should aim at promoting regu-           plans cannot impose an annu-                                                                 Cervical cancer grows so slowly that             Roughly one-third of the MD Anderson        “When they looked at a sick patient who
                                                                                       Kathleen Sebelius and FDA Commissioner                                                             patients and two-thirds of the public hos-     had less resources in a really difficult sit-
lar physical exercise and the mainte-          al limit that is lower than             Margaret Hamburg were to announce the             Pap smears — which examine cells
                                                                                                                                         scraped from the cervix — usually find it        pital patients had very severe symptoms        uation, they would be less apt to recom-
nance of normal body weight.”                  $750,000.        Beginning        in    nine new warnings at the White House, but                                                          before they started on chemotherapy for        mend surgery than to someone in a sim-
              ❑ ❑ ❑                            September 2011, that allow-             the labels were released early Tuesday at         in time to treat, or even to prevent when        their cancer. These included pain,             ilar situation who had good resources.”
                                               able limit increases to $1.25           http://www.fda.gov/TobaccoProducts/Labelin        precancerous cells are spotted and               fatigue, nausea, vomiting, distress, and          The same hesitancy to treat a cancer
No vit D screening: Most pregnant              million and in September                g/CigaretteWarningLabels/default.htm.             removed.                                         problems with appetite and memory.             aggressively might extend to symptom
women do not need to be screened for           2012 it will rise to $2 million.           They show images that may disturb some,           For decades, Paps were the only way              Over the weeks, patients who started        treatment as well, Cykert told Reuters
vitamin D deficiency, nor given addi-             Such limited benefit plans           including one titled “WARNING: Cigarettes         to screen for cervical cancer. Now doc-          out with less severe symptoms found            Health.
tional supplements, according to an            are to be phased out when               are addictive,” illustrated with a photograph     tors know that certain strains of HPV, the       some relief over time — but that was              “Being passive is bad,” said Cykert,
official statement issued by the               subsidies and new coverage              of a man smoking a cigarette through a hole       human papillomavirus, cause most cervi-          generally not the case for those with          who was not involved in the current
American College of Obstetricians              options provided for in the             in his throat.                                    cal cancer. HPV testing isn’t a replace-         more severe symptoms to begin with.            study. “You have to say, ‘I have this
and Gynecologists.                             health law come on line in                 Others messages point out the dangers of                                                           “Even though these patients are expe-       symptom and I need help.’ And you have
                                               2014. The law prohibits plans                                                             ment for the Pap. But it can provide extra       riencing symptoms, they are not being          to say it over and over. Advocating for
    Vitamin D provided by the moth-                                                    secondhand smoke to children, tobacco’s           information to help determine if a               corrected,” Cleeland told Reuters Health,      oneself is very important.”
                                               from setting annual and life-           causal link to fatal lung disease, cancer,
er’s body helps build a baby’s bones           time spending limits after that                                                           woman is at higher or lower risk and thus        “and they tended to be treated at public          Cleeland said providers need to priori-
and teeth before it’s born. Vitamin D                                                  strokes, heart disease and death.                 guide her ongoing care — if it’s used            hospitals.”                                    tize the treatment of symptoms, and not
                                               point.                                     Sebelius said their goal is to stop children
is manufactured in the skin in                                                                                                           correctly.                                          The reasons for the differences             just the cancer.
response to sunlight and occurs natu-                                                  from starting to smoke and offer adults who          The new CDC study, part of a nation-
rally in some foods, as well as being                                                  want to quit some help.
                                            according to the ACOG report.                 “We have about 4,000 people under 18           al survey of medical practices that
added to others such as milk.                  In an interview with Reuters            who try their first cigarette and about 1,000     included 600 providers of cervical can-          to use. Only a few so-called high-risk         developed a consumer-friendly brochure
    Pregnant women do not generally         Health, Macones explained that             of them become permanent smokers. And             cer screening, examined how doctors are          strains of HPV cause cervical cancer, the      to help women understand their options
have tests to check their vitamin D         women can obtain extra amounts             that’s not good for our country,” she told the    using it.                                        strains doctors are supposed to test for.      for      cervical   cancer     screening:
levels. But many are asking if they         through sunlight and eating fish, as       CBS “Early Show.”                                    The study found 60 percent of doctors         Before scientists understood the different     http://tinyurl.com/6g8de6v
should, or whether they should take         well as through milk and juices that          “This is really aimed at making sure kids      and clinics say they give a routine Pap-         HPV types, a test already was on the              And guidelines from the American
supplements, said Dr George                 have been specially fortified with vita-   don’t start in the first place.”                  plus-HPV test to women who are too               market that detects strains that can cause     College       of    Obstetricians     and
Macones, chair of ACOG’s commit-            min D.                                        The 2009 Family Smoking Prevention and         young for that combination. Guidelines           genital warts, not cervical cancer. The        Gynecologists recommend that:
tee on obstetric practice. “And for the        “I have no problem with women           Tobacco Control Act called for cigarette          stress that so-called co-testing is only for     CDC’s Saraiya says there’s no reason to        ■ Routine Paps start at age 21.
most part, the answer is no.”               deciding to drink some extra fortified     packages to include warning statements in         women 30 and older. If both tests are            use that old test because learning you         ■ Most women in their 20s get a Pap
    Macones and his colleagues came         milk, or fortified juices,” he said. And   large type covering half of the front and back    negative, they can wait three years              have a probably transient warts-causing        every two years.
to that conclusion after reviewing          if a woman asked if she could take a       of each package and graphic images showing        before their next screening.                     strain doesn’t alter your care.                ■ Women 30 and older wait three years
available evidence about the value of       supplement with modest amounts of          adverse health effects from smoking.                 Why the age limit? Saslow says HPV               Yet her study found 28 percent of doc-      between screenings if they’ve had a neg-
screening for low vitamin D levels in       vitamin D, “I would be okay with              The warnings are also to occupy the top        is nearly as common as the common                tors and clinics say they order tests for      ative Pap and negative HPV test, or three
every woman who’s pregnant - and            that,” Macones added. “I just would-       20 percent of every tobacco advertisement of      cold, especially in younger women —              both the cancer-causing and warts-caus-        consecutive clear Paps.
finding a lack of data to prove a ben-                                                 companies such as Altria Group Inc’s Philip       but their bodies usually clear the infec-        ing strains, regardless of patient age. The    ■ If a Pap is inconclusive at any age,
                                            n’t routinely recommend it.”               Morris unit, Reynolds American Inc’s R.J.
efit to mother or baby.                        Although experts suspect that rela-                                                       tion on their own and only a years-long          study couldn’t tell why, although Saraiya      HPV testing may help rule out who needs
                                                                                       Reynolds Tobacco unit and Lorillard Inc’s                                                          says some doctors don’t know there’s a         further examination and who can just
    Performing an additional blood test     tively high levels of vitamin D are        Lorillard Tobacco Co. The anti-smoking            infection is risky. Learning that a 20-
that has no benefit would be a waste of     safe in pregnancy, there could be some     group Campaign for Tobacco Free-Kids said         something has HPV increases the odds             difference and some order forms for the        repeat a Pap in a year.
healthcare resources, said Macones.         risks to supplements that researchers      the images represent a dramatic change from       of more invasive testing that in turn can        lab tests don’t differentiate.                 ■ Anyone who’s been vaccinated against
“If there isn’t a reason to do it, you’re   haven’t uncovered yet, Macones said.       current health warnings. (RTRS)                   leave her cervix less able to handle preg-          An HPV test costs $80 to $100, on top       HPV, a relatively new vaccine, still must
just wasting money and time.”               “We think it’s safe, but sometimes                           ❑ ❑ ❑                           nancy later in life. Younger women are           of a $40 Pap. Saraiya says labs can bill       follow Pap screening guidelines for their
    The only pregnant women who             unexpected things turn up.”                                                                  supposed to get HPV testing only if a            for two HPV tests when doctors order           age group.
might benefit from a blood test for            Still, a study last year by             PPIN drops Medicaid patients:                     Pap signals a possible problem and doc-          testing for both kinds of strains.             ■ Higher-risk women, such as those with
vitamin D deficiency — and it’s not         researchers in the United States sug-      Planned Parenthood of Indiana will stop see-      tors really need the extra information.             So what does a woman need to know           HIV or previous cervical abnormalities,
clear even for them — are those who         gested that pregnant women should          ing Medicaid patients after Monday because           Then there’s the question of which test       before her next checkup? The CDC has           need more frequent screening.
are at high risk for the problem in the     dramatically increase their intake of      of an Indiana law that cut the provider’s
first place due to certain diseases or                                                 funding.
                                            vitamin D, in the form of supple-             PPIN went to court last month to prevent
other circumstances.                        ments, to as much as 4,000 IUs per         Indiana from cutting funding to the state’s
    Last November, the Institute of         day. The authors said there is little      largest reproductive health care provider. US     signed a law that restricts abortions and cuts                                                  ing Medicaid patients after the bill made
Medicine said the highest amount of         danger at that level. A review of previ-   District Judge Tanya Walton Pratt said she        federal funding to Planned Parenthood.                                                          national news.
vitamin D women could safely take           ous studies published earlier this year    would make a decision on whether to enjoin           Planned Parenthood performs abortions,                                                          Medicaid patients won’t be seen start
during pregnancy or breastfeeding           concluded that many women have low         the law by July 1.                                but even before the Indiana law passed, fed-                                                    Tuesday unless they can pay, two disease
was 4,000 international units (IU) per      blood levels of vitamin D early in            “Our 9,300 Medicaid patients, including        eral money could not be used to pay for                                                         intervention specialists will be laid off, and
day. For the average pregnant               pregnancy, but it’s unclear whether a      those who had appointments Tuesday, are           abortions. Indiana cut Medicaid funding to                                                      most employees around the state will be tak-
woman, the Institute recommends             deficiency stunts fetal growth or caus-    going to see their care disrupted,” Betty         Planned Parenthood that covers other repro-                                                     ing a day off without pay on Wednesday,
600 IU of vitamin D daily. Most pre-        es other pregnancy-related complica-       Cockrum, president and CEO of PPIN, said          ductive health services, including contracep-                                                   according to a statement from PPIN.
natal vitamins contain 400 IU,              tions.                                     in a statement.                                   tion and cancer screening.                                                                         If the judge doesn’t make a favorable rul-
                                                                                          The Medicaid funds stopped May 11, the            After Monday, PPIN said it will have run                                                     ing by July 1, PPIN said it will start closing
                                                                                       day Republican Governor Mitch Daniels             out of the donations it used to pay for exist-       Hamburg                    Pratt           health centers and reducing staff. (RTRS)

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