DR KEVWE'S BLOG

With groups such as the American Academy of Pediatrics (AAP) and the World Health Organization (WHO) recommending that infants be exclusively breastfed for the first six months or longer, it’s no wonder the rates of breastfed babies have risen dramatically in the last 16 years. Statistics shows that in 2002, 37.9% of babies were breastfed for at least six months and 71.9% were breastfed for some time.  The latest available statistics, representing babies born, indicate that 57.6% are breastfed for six months and 83.2% at least for some time. Not all mothers are able to breastfeed their babies all the time, and so have to pump milk for storage to be used later. This is especially true for working mothers;


Pumping breast milk can be inconvenient, as most systems require a bulky system with lots of parts. The situation is improving, however, as companies are developing pumping systems that a woman can wear under her clothing. There are popular devices like the Willow Wearable Breast Pump shown above, a device that fits inside a woman’s bra while it collects milk in one-time-use bags. Chiaro Technology is the company that founded the Elvie Trainer, which is a mobile kegel exercise feedback device.


The same company recently announced the Elvie Pump. Described as “the world’s first silent wearable breast pump,” the Evie Pump is currently available on a waitlist status only. Designed to be worn inside a standard nursing bra, the Elvie Pump has five parts for easy assembly and cleaning. An associated iOS or Android app monitors milk volume in real-time, tracks pumping history for each breast and can control the pump remotely, although the app isn’t required to use the pump.



While the percentage of infants ever breastfed has increased ahead of the Health Promotion’s Healthy People 2020 Objectives, only about 25% of babies are breastfed exclusively for their first six months. Considering the busy lives of average mothers, systems to make pumping more comfortable and convenient could help to increase these percentages.

References

• Health Promotion’s Healthy People 2020
• American Academy of Pediatrics (AAP)
• World Health Organization
• Elvie Chiaro Technology

This October like every other previous one is "Breast Cancer Awareness Month" but unlike others, this particular month floods my heart with grief from the loss of a friend and all I can think about with regards to this matter is the very pressing but unanswered question- Why do majority of victims wait till it is too late? "I'm not feeling too well Kevwe but I am believing God for a miracle", she told me. "What is the issue?", I asked with the voice of one eager to help;"I'll rather not discuss it but you will know in due time". These were her last words to me over a phone called I placed with the intention of inviting her to a planned University Class mini-reunion. Little did I know that, those words would be her last to me or any other friend/classmate we shared in common. She was barely over 35 years of age but it was far gone and it was breast cancer. How did my friend or the many other fallen victims get to that point of no return? If the answer is lack of awareness, then this month has been set aside to ensure that moving forwards, adequate information is circulated all around the world to prevent other ladies or even men from dying as a result of Breast Cancer.

If you still don't know, breast cancer is the uncontrolled multiplication of cells in the breast or abnormal growth of breast tissue. It is said to be the most common cancer in women and the number three cause of cancer deaths amongst women worldwide. The various types depend on what part of the breast is being affected. For reasons not very well understood by Medical Scientists yet, just like every other cancer, some of the cells that make up the affected part of the breast tissue just lose their normal programming and uncontrollably go haywire, even spreading to other parts of the body to cause havoc - in advanced cases. In the mist of all the frustration, Scientists have identified risk factors to include: a family history of breast cancer/genetic predisposition; alcohol abuse; obesity/ morbid over weight; tobacco smoking; the use of combined contraceptive medications; old age; early onset of menstruation and late onset of menopause; radiation therapy for other chest conditions etc. Even women who choose not to breast feed after child birth have been identified as having a higher risk of developing breast cancer. Whilst there is nothing anyone can do about some of these risk factors but to be on the lookout vigilantly, luckily there's a lot that can be done about others (modifiable risk factors). Before we enumerate these preventive measures, permit me to however touch on what  the symptoms/ red flag signs are that indicate the need for quick action to be taken towards early diagnosis of perhaps pre-cancerous or even cancerous lesions and prompt treatment in the early stages.

Normal Breast tissue - 👀: free vector images

"Doctor, first I thought the nipple discharge was normal but then I began to notice that the particular breast was growing bigger from the growth of what felt like a seed(lump) with my changing skin beginning to drag the nipple to one side". "I noticed something like a pimple on my breast so I pierced and squeezed it out but it is refusing to heal and now I have swellings in my armpit; well my attempts at weight loss are beginning to pay off very well so I'll take that as a consolation- 20 kg/ approximately 3 stones in one month, fantastic". "I hate to visit the hospital, so I'll just pray, try to eat healthy, drink alkaline water and I'm sure my breast will spontaneously return to normal". If you know anyone in this shoe, tell them to visit their primary healthcare provider as a matter of urgency. You are making a big mistake. Your breast might only get worse. Anyone presenting with these symptoms are showing classical red flags for breast cancer. Might not be eventually until proven otherwise but whatever it is, best to sort it out medically sooner than "as soon as possible. Any life lost is one too many.

👀: slideshare.net

Just like with any other cancer or avoidable disease condition, PREVENTION IS ALWAYS BETTER THAN CURE! In this regard, life saving prevention strategies will include but are not limited to:

• tobacco smoking cessation 
• drastic reduction of alcohol intake to the medically accepted limits per week and well spaced out....
• eating a healthy diet and leading an active life with compulsory periods of exercise
• avoiding unnecessary use of implicated contraceptives or Hormone Replacement Therapy; if possible...
• considering to breast feed as much as possible instead of breast preservation and substitution with formula feeds...
• having an annual mammogram (special imaging) of your breast done for those over 50...
• and very importantly, making it a habit to do your self-breast examination as illustrated below... so on and so forth

Breast Self Examination- 👀: Royalty Free

You can access more information from the references below and from other sources as well.  Take advantage of the month and get adequately informed. Whatever you choose to do moving forwards, never forget that.....↓↓↓.

Do well to keep a tab with us but most importantly, never lose sight of your wellness goals. Health is certainly wealth....all day,everyday. Cheers.

REFERENCES:
* CDC|What Is Breast Cancer

* NHS|Breast Cancer In Women

* UICC|Breast Cancer Awareness Month 2018

A research team, Rory Myers College of Nursing, published a study showing the relative accuracy of five machine learning algorithms in detecting lymphedema in breast cancer surgery survivors. I know you may be wondering what all these jargon means; "Machine Learning", "Algorithms", "Artificial Intelligence or AI", "Lymphedema", and whatnot! Don't Worry, we'll explain further! ;)

Basically, an Algorithm is a sequence of steps, plans or formulas that solve a mathematical or computational problem. When a computer is programmed to build upon its pre-programmed basic steps or formulas (or algorithm) in order to by itself create more complex formulas that solve complex problems, its called machine learning as the computer learns from past solutions on how-to or how-not-to solve problems. A machine is said to be Artificially Intelligent (AI) when it can design algorithms and techniques that allow it to learn autonomously.

On the other hand, Lymphedema is a condition in which impaired lymph fluid flow causes swelling, usually in the arms or legs. Breast cancer treatment is the most common cause of lymphedema. Lymphedema occurs in 6% to 70% of breast cancer surgery survivors, the variation depending on the type of cancer and type of treatment. Lymphedema may occur anytime from shortly after treatment to as long as 20 years later. Lymphedema is one of the most feared side effects of breast cancer treatment, with more than 20 symptoms that range from a mild feeling of heaviness to swelling that is both disfiguring and disabling.

The researchers used five different machine learning algorithms to analyze data from 355 patients from 45 different regions; the Data analysed included, demographic and clinical information, lymphedema status, and symptoms. Of the five machine learning systems, the artificial neural network (ANN) produced the best results; it accurately detected lymphedema in 93.75% of the cases.

The implications of the Rory Myers College of Nursing test for detecting lymphedema in breast cancer survivors are clear, though with some reservations. More studies are needed to test the validity and reliability of the artificial neural networks. Also, the ANN system that works well at detecting lymphedema may not be as accurate with other breast cancer side effects or other types of cancer. The prospect of testing a multitude of conditions and treatments against a panel of machine learning algorithms may reveal a single strongest approach for many or most diseases.

Reference:

• Rory Myers College of Nursing test for detecting lymphedema

We may be overemphasizing happiness.

We're doing a good job preventing some types of sexually transmitted cancers, suggests a new CDC report, but there's room for improvement.

Most women know by now that the human papillomavirus (HPV), the most common sexually transmitted infection in the United States, can cause cervical cancer. That's why we get Pap or HPV tests every few years, and why the HPV vaccine is now recommended for adolescents and young adults.

Thanks to those efforts, the conversation around HPV is shifting: According to data published this week by the Centers for Disease Control and Prevention (CDC), throat cancer has now dethroned cervical cancer as the most common HPV-related cancer.

The new analysis, published in the CDC’s Morbidity and Mortality Weekly, found that cervical cancer rates decreased 1.6% per year between 1999 and 2015. At the same time, however, rates of oropharyngeal squamous cell carcinoma—the most common type of head, neck, and throat cancer—increased by 2.7% per year among men and 0.8% per year among women. In 2015, more than 15,000 cases of throat cancer were diagnosed in men, and more than 3,400 were diagnosed in women.

These numbers come from cancer registries across the United States, and they cover more than 97% of cancers diagnosed during the study period. While those registries did not typically determine whether HPV had caused individual cases of cancer, statistics suggest that the virus was to blame in many of them: Research shows that HPV DNA is found in 91% of cervical, 91% of anal, 75% of vaginal, 70% of oropharyngeal, 69% of vulvar, and 63% of penile cancers in the United States.

Between 1999 and 2015, rates of anal and vulvar cancers also increased, while rates of penile cancers remained stable. Overall, more than 43,000 HPV-associated cancers were reported in 2015, compared to just over 30,000 in 1999.

In other words, there’s some good news and some bad news. On the plus side, the drop in cervical cancers “represents a continued trend since the 1950s as a result of cancer screening,” the authors wrote in their report.

Cervical cancer rates also decreased more among traditionally underserved populations (Hispanics, American Indian and Alaska Natives, and African-Americans) than among white women, suggesting that advances have been made to narrow screening and treatment disparities between these groups. Rates were still highest among Hispanics and African-Americans in 2015, however, indicating that health-care needs of some groups still “are not fully met,” the authors wrote.

The bad news, then, is that other types of HPV-associated cancer are on the rise. This could be due to “changing sexual behaviors,” the authors wrote—namely, an increase in unprotected oral and anal sex, which are both risk factors for HPV infection.

White men have a higher rate of HPV-related throat cancer compared to other racial and ethnic groups. That may be related to the fact that they also tend to have more lifetime oral-sex partners, and to first engage in oral sex at an earlier age, the authors wrote. (The authors note that smoking is also a risk factor for oropharyngeal cancers, but that smoking rates have declined in recent years. Studies have also shown the increase in these cancers “is attributable to HPV,” they wrote.)

Currently, U.S. health organizations only recommend regular screenings for one type of HPV-associated cancer: cervical cancer, in the form of Pap tests and/or HPV tests for women 21 to 65. The authors of the new report don’t suggest that this should change, but they do say it’s important for researchers to continue tracking trends—and changes—in rates of different types of cancer.

They also point out the importance of HPV vaccination, which is recommended for both girls and boys at age 11 or 12; it’s also available to adult women who didn’t get it when they were younger.

Although it might be too soon to see how vaccination has affected actual cancer rates, the authors write, studies have reported reductions in HPV infection, genital warts, and cervical precancers. (In related news, another new CDC report shows that more teenagers are getting the vaccine now than ever before.)

This isn’t the first report to show an increase in oropharyngeal cancers, especially among men, in recent years. A 2017 study in the Annals of Oncology came to a similar conclusion, although the authors stressed that the overall risk of developing such a cancer was still very low for most people.

Amber D’Souza, PhD, lead author of that paper and associate professor of epidemiology at the Johns Hopkins Bloomberg School of Public Health, spoke with Health after her study was published. Despite her team’s findings, she said that most people who test positive for HPV will never actually develop cancer—and that routine screenings for throat cancer would likely do more harm than good.

“Most people perform oral sex in their lives,” she said, “and this study really suggests that the risk remains low for oropharyngeal cancer and for oral HPV infection.”

That being said, any unusual symptoms that last longer than two weeks—including a sore throat that doesn’t go away, trouble swallowing or moving the tongue, ear pain, or a lump in the mouth or neck—should be checked out by a doctor, Abie Mendelsohn, MD, assistant professor-in-residence at the David Geffen School of Medicine at UCLA, previously told Health. “If we can identify [throat] cancer within about 6 to 8 weeks of when somebody first feels something, prognosis is usually excellent,” he said.

As the U.S. opioid addiction epidemic widened, the federal Drug Enforcement Agency (DEA) placed the prescription painkillers in a tougher-to-refill category.

Many states also mandated monitoring programs to spot overprescribing by doctors.

But two new studies suggest these steps, while well-intentioned, may have led to more opioids -- not fewer -- being given to patients by surgeons after routine operations.

In the case of the DEA's 2014 action to move opioid painkillers to a more restricted class, this "may inadvertently motivate surgeons to prescribe greater amounts to ensure adequate pain treatment," said Dr. Jennifer Waljee, lead author of one of the studies. She codirects the Michigan Opioid Prescribing Engagement Network.

Her team believes that once prescription refills became tougher under the new DEA rules, surgeons who worried about a patient's longer-term pain control simply ordered a larger number of pills so the patient had a "stockpile" of opioids to use at home.

Opioid use for postoperative pain control is thought to be a major "gateway" to addiction, experts note.

The findings made sense to one physician.

While more prescribing after a tightening of rules seems "counterintuitive," Dr. Joseph Conigliaro said he "agrees with the findings.

"In the case of someone having surgery, they are in acute pain, meaning it shouldn't last long," said Conigliaro, who is chief of internal medicine at Northwell Health in Lake Success, N.Y.

"But because there are limits on prescriptions postsurgery, sometimes physicians can prescribe someone twice to four times as much to ensure they will ultimately have what they need," explained Conigliaro, who wasn't involved in the new study.

In their research, Waljee and her colleagues tracked opioid prescription patterns before and after the DEA's new rule, which moved the opioid hydrocodone (Vicodin) from schedule III to the more restrictive schedule II.

The change meant that doctors could now only prescribe a 90-day supply, and couldn't prescribe over the telephone or by fax.

Data on nearly 22,000 privately insured patients in Michigan -- all of whom underwent common elective surgeries -- found that far from hydrocodone prescription rates dropping, the number of prescriptions actually rose after the new rule.

Although there was a reduction in the prescription refill rate, there was an overall average 7-tablet-per-patient rise in hydrocodone prescribing after the DEA change, Waljee's group noted.

Why the unexpected trend?

"Our main thought was that since surgeons were more limited in their ability to prescribe extra pain medications after the patient left the hospital, they prescribed more up front to avoid the risk of patients running out," said study co-author Dr. Joe Habbouche. He's a surgery resident at Michigan Medicine, the academic medical center at the University of Michigan.

In a second study, researchers at Dartmouth-Hitchcock Medical Center in Lebanon, N.H., looked at changes in opioid prescribing after New Hampshire mandated "prescription drug monitoring programs." These programs exist in many states and track doctors' opioid prescribing patterns.

The New Hampshire program went into effect Jan. 1, 2017, and the Dartmouth team looked at opioid prescription patterns for more than 1,000 patients who'd undergone an elective surgery in the six months before or after the change.

Researchers led by the hospital's Dr. Richard Barth found that "the percentage of patients prescribed opioids after surgery did not decrease significantly" after the monitoring program came into effect.

In fact, the average number of opioid pills dispensed after surgery was already decreasing before the implementation of the new program, but that decline actually slowed "in the six months after the legislation," Barth's group reported.

Dr. Harshal Kirane directs addiction services at Staten Island University Hospital in New York City. Reading over both studies, he said they point out the hazards of well-intentioned policies implemented "in the absence of adequate physician and patient engagement."

There's no "one-size-fits-all" method to curbing excess opioid use, Kirane said.

"Physician prescribing practices are a major contributor to the ongoing opioid crisis," he said. "Yet, even the most well-intentioned prescriber is confronted by an increasingly complex calculus, in which the goals of pain management and patient satisfaction must be balanced with eliminating the risks of opioid misuse."

The real solution may lie in a more nuanced, "evidence-based" approach to opioid prescribing, and better education of doctors and patients alike, Kirane said.

Habbouche agreed.

"Different types of physicians and health professionals should be involved in the policymaking surrounding opioid prescribing -- especially for prescribing in different settings," he said. "Our work suggests patient and physician education about opioids is critical."

Both studies were published online Aug. 22 in JAMA Surgery.

More information

For more about opioids, visit the U.S. National Institute on Drug Abuse.

Whether you have some extra weight in your upper arms or rear end, it makes sense that targeting those areas with exercise—curls for your arms, lunges for your butt—would slim them down.

Weight-loss experts refer to this as “spot reduction.” But it turns out that in most cases, this kind of laser-focused weight loss isn’t possible. One study in the Journal of Strength and Conditioning Research found that six weeks of intensive ab workouts did nothing to slim the exercisers’ midsections. A related study found that 12-weeks of one-armed workouts resulted in less loose skin in the trained arm, but zero fat loss.



Working out just one part of your body probably won’t slim it down, but some body parts are more likely to shed fat when you exercise. Your stomach is one of them.

“Some fat deposits are more metabolically active than others, and those may be more responsive to exercise interventions,” says Arthur Weltman, a professor of medicine and chair of the department of kinesiology at the University of Virginia. “Abdominal fat in particular is one of the most metabolically active fats.”

When you exercise, your workouts trigger the release of hormones, Weltman explains. The higher the exercise intensity, the more of these hormones your body pumps out, and the more of that metabolically active fat you lose. (Some of Weltman’s research suggests that high intensity interval training (HIIT), in particular, may slim your midsection.)

If you have fat stored in your gut, arms and chest, a lot of your fat is metabolically active, so it will likely respond to exercise and diet changes, he says. That’s especially true of your abdominal fat. The bad news is that extra fat in these regions is also linked with a greater risk for diabetes, heart disease, cancer and other ailments.

On the other hand, if you store excess fat in the hips, butt and thighs, that fat is not metabolically active. You have a lower risk for many diseases, “but that fat is very hard to reduce,” he says.

What type of exercise is best for targeting the tummy? One study compared strength training to aerobic training in terms of fat reduction in different parts of the body and found that while aerobic training—running, swimming, cycling—led to greater whole-body fat loss, resistance training targeted abdominal fat in particular.

In a nutshell, spot-targeting fat isn’t very effective—in most cases. But if you’re trying to lose fat around your stomach, a mix of resistance training and high-intensity aerobic exercise, along with a healthy diet, may help reduce your belly fat.