Women who are heavier or older may take longer to heal after surgery to reduce the size of their breasts, new research indicates. Body weight and age can affect complication risk after breast reduction, according to a report in the April 2023 edition of Plastic and Reconstructive Surgery. “While reduction mammaplasty is a safe procedure, our study suggests that patients in higher BMI categories may take longer to heal, with increased risk of wound healing times longer than two months,” lead author Dr. Jesse Payton said in a journal news release. Payton is a researcher at Baylor Scott & White Medical Center in Temple, Texas. Reduction mammaplasty is used to reduce back and neck pain and to improve body image and low self-esteem in women with breasts considered overlarge. For the study, researchers reviewed data on 277 patients who underwent reduction mammaplasty between 2014 and 2018. Patients’ average age was 36. Average BMI (body mass index) was 30 — the low end of obesity. Despite being at this high-BMI cutoff point, the patients were generally healthy, with low rates of other health problems, according to the study. About 49% of patients whose cases were reviewed had minor complications, such as superficial wound-healing problems. Major complications were uncommon, occurring in a little more than 4% of patients. On initial analysis, BMI was unrelated to the risk…  read on >  read on >

Parents who harshly discipline their young children may be putting them on a path toward lasting mental health symptoms, a new study suggests. Researchers found that among 7,500 children followed from age 3 to 9, about 10% fell into a “high risk” group where mental health symptoms — ranging from persistent sadness to acting out — worsened over the years. And children whose parents often used harsh discipline, including yelling or physical punishment, were about 50% more likely than their peers to end up in that group. Experts said the findings, published March 30 in the journal Epidemiology and Psychiatric Sciences, underscore an important reality: Some parents need to learn better strategies for managing young children’s behavior. That might mean a “timeout” to nip a tantrum in the bud, according to study leader Ioannis Katsantonis, a doctoral researcher at the University of Cambridge in the United Kingdom. But it also means setting up clear and consistent behavior rules that young kids can understand. In this study, “consistent” parenting styles seemed to have benefits for children’s mental well-being. For those families, kids’ early-childhood behavior and emotional issues typically improved over time. “This could be because consistent parenting provides children with a sense of predictability and security, which can act as a buffer against worsening mental health,” Katsantonis said. When parents are consistent, he said, it suggests…  read on >  read on >

Children should feel safe at school, but learning of a mass shooting — like this week’s tragedy at Covenant School in Nashville — can threaten their sense of security. For parents, it can be challenging to know what to tell them. Two children’s mental health experts from UT Southwestern Medical Center in Dallas offer some advice. Just as important as what’s said is what not to say, according to Dr. Beth (Betsy) Kennard, a professor of psychiatry and member of the Peter O’Donnell Jr. Brain Institute, and Dr. James Norcross, chief of child and adolescent psychiatry. “The first thing to consider is the developmental level of the children so that you can provide answers and information at their level of understanding,” Norcross said in a medical center news release. “All children, regardless of their age, should be encouraged to express their reactions to the event, and parents should feel free to talk about their emotions.” Kids are typically worried about their personal safety after experiencing a traumatic event, Norcross continued. “As parents, you should provide reassurance that they are safe and that you are there to protect them from harm,” he said. The Nashville shooting on Monday took the lives of three children and three adults. Police killed the shooter at the scene and are trying to piece together a motive for the attack. Gun…  read on >  read on >

Drug overdose deaths — both accidental and intentional — have quadrupled over the past 20 years among older adults in the United States, a new study finds. This increase in people ages 65 and older suggests the need for greater mental health and substance use policies, the authors said. “The dramatic rise in overdose fatalities among adults over 65 years of age in the past two decades underscores how important it is for clinicians and policymakers to think of overdose as a problem across the life span,” said co-author Chelsea Shover, an assistant professor of medicine at the University of California, Los Angeles David Geffen School of Medicine. “Updating Medicare to cover evidence-based treatment for substance use disorders is crucial, as is providing harm reduction supplies such as naloxone to older adults,” Shover said in a school news release. About three-fourths of those who died accidentally were using illicit drugs, including synthetic opioids such as fentanyl, heroin, cocaine and methamphetamine. In 67% of intentional overdoses, seniors used prescription medication, including opioids, antidepressants, benzodiazepines, antiepileptics and sedatives. The researchers calculated overdose deaths among seniors from 2002 to 2021, using a database from the U.S. Centers for Disease Control and Prevention. The investigators compared demographics, specific drugs, and whether the deaths were intentional, unintentional or undetermined. They found that fatal overdoses quadrupled from 1,060 in 2002, which…  read on >  read on >

Living with a lot of transportation noise can increase your risk of suicide, new research suggests. A study from Switzerland found that with every 10-decibel increase of average road traffic noise at home, risk for suicides rose by 4%. An association between railway noise and suicide was less pronounced. “We used suicides as an indicator for mental health disorders as we do not have robust Swiss data on mental health diagnoses such as depression or anxiety,” said study co-author Benedikt Wicki, a PhD student at the Swiss Tropical and Public Health Institute. “Noise increases the mental load, contributing to the development of mental disorders or worsening of preexisting conditions,” he said in an institute news release. Mental health disorders affect nearly 1 billion people worldwide, including about 1.4 million people in Switzerland. They are a leading cause of suicide, the authors noted. In Switzerland, about 1,000 people die by suicide each year. Past research has linked environmental factors like air pollution or noise to adverse health effects such as cardiovascular diseases and general well-being, but robust evidence on the effects of transportation noise on mental health disorders remains scarce, according to the study. Biological mechanisms explaining why noise impacts mental health include sleep disturbance, increased levels of stress hormones, changes in brain function or a sense of loss of control. “Our brain registers noise as…  read on >  read on >

A new report from the U.S. Consumer Product Safety Commission (CPSC) reveals deaths from carbon monoxide poisoning are increasing in the United States. The report looked at carbon monoxide (CO) deaths from 2009 to 2019, finding 250 consumer product-related CO deaths in 2019, more than any other year. Generators and other engine-driven tools accounted for the largest percentage of deaths. Since 2009, portable generators alone have been associated with 765 CO-poisoning deaths not related to fires. That’s 40% of all CO deaths related to consumer products, a CPSC news release noted. Heating systems were associated with the second largest percentage of CO poisoning deaths not involving fires for 2019, with 69 deaths, or 28% of the total associated with products in this category. More than half of all CO deaths occur in the colder months of November, December, January and February. CO is an invisible killer because it is colorless and odorless. It can kill in minutes. Someone exposed to it may become unconscious before recognizing the symptoms of nausea, dizziness or weakness. The CPSC warns that portable generators should only be used outside. They should be at least 20 feet from the home with exhaust pointed away from any nearby building. The commission also offers these other safety precautions: Never operate a portable generator inside a home, garage, basement, crawlspace or shed, the commission…  read on >  read on >

Giving patients who have septic shock a combo of two steroids could potentially be a lifesaver, according to a new study. Researchers found that patients receiving a combination of hydrocortisone and fludrocortisone had lower death rates and discharge to hospice compared to those who received hydrocortisone alone. “Our results provide robust evidence that one steroid regimen is superior to the other regimen and, in absence of further clinical trials, directly inform the choice of steroids in patients with septic shock,” said study co-author Dr. Nicholas Bosch, an assistant professor at Boston University’s Chobanian & Avedisian School of Medicine. For the study, published March 27 in JAMA Internal Medicine, researchers compared treatment options using a multicenter database that included about 25% of U.S. hospitalizations. The study was designed to mimic a randomized clinical trial. The team compared the outcome of death or discharge to hospice between patients who received the regimen of hydrocortisone and fludrocortisone to those who received hydrocortisone alone. On average, patients who received the combined regimen died or were discharged to hospice about 4% less of the time than patients who received hydrocortisone alone. More than a third of the estimated 1.7 million U.S. hospitalizations involving sepsis — an extreme response to infection — each year end in death. These findings may change clinical practice, the authors said. “It is possible that guideline…  read on >  read on >

If you’re one of the millions of people with allergic asthma or eczema, you may be more likely to develop the wear-and-tear form of arthritis as you age. This is the main finding from a new study that examined the risk of developing osteoarthritis among people with the two allergic conditions. The study wasn’t designed to say how, or even if, these allergic diseases increase osteoarthritis risk, but the researchers do have a theory. “Our group has done work showing that mast cells [a type of allergic cell] are increased in numbers in the joints of people with osteoarthritis, and their activity contributes to the development of osteoarthritis,” said study author Dr. Matthew Baker, clinical chief in the division of immunology and rheumatology at Stanford University in Stanford, Calif. And asthma and eczema may be the tip of the iceberg, he said. “It is possible that other atopic conditions such as seasonal allergies, food allergies and/or allergic rhinitis [hay fever] may provide a similar risk,” Baker noted. These researchers did not look at these conditions in the new study. For the study, they reviewed insurance claims from two databases. The first set included more than 117,000 people with asthma or eczema and 1.2 million people without these conditions. After eight years of follow-up, the risk of developing osteoarthritis was 58% higher among folks with allergic…  read on >  read on >