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Why people overuse antibiotics

The overuse of antibiotics occurs due to the mistaken widespread belief that they are beneficial for a broad array of conditions and because many physicians are willing to prescribe antibiotics if patients ask for the medication, according to a Rutgers study.

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The overuse of antibiotics occurs due to the mistaken widespread belief that they are beneficial for a broad array of conditions and because many physicians are willing to prescribe antibiotics if patients ask for the medication, according to a Rutgers study.

The study, published in the journal BioEssays, reviewed more than 200 peer-reviewed studies to examine the causes behind antibiotic overuse, which can lead harmful bacteria to become drug-resistant and cause harmful effects on the microbiome, the collection of beneficial germs that live in and on our bodies.

Martin Blaser, director of the Center for Advanced Biotechnology and Medicine at Rutgers and lead author, said the global use of antibiotics between 2000 and 2015 increased 39 percent, with a 77 percent increase in low- and middle-income countries. He discusses the study’s findings.

What health concerns result from the disruption of the microbiome by antibiotics?

In children, improper antibiotic use can alter the microbiome while their immunological, metabolic and neural systems are developing. Epidemiological studies associate antibiotic exposure with an increased risk of disease of allergic, metabolic and cognitive disorders that have grown more common in children during the antibiotic era.

In adults, there is increasing evidence that antibiotics may enhance risk for metabolic and neoplastic diseases, including diabetes, kidney stones and growths in the colon and rectum that can lead to cancer.

What are the trends you found in antibiotic use?

Studies in the United States, United Kingdom and China found numerous online pharmacies selling antibiotics without a prescription. This problem also is large in Iow- to middle-income countries, where 60 percent of antibiotics are sold without prescriptions, often by untrained medical practitioners.

Perhaps of special concern during the COVID-19 pandemic is the finding that telemedicine services are another potential source of questionable antibiotic sales in the United States. A recent analysis found that patients with acute respiratory infections were more often prescribed broad-spectrum antibiotics if they had a tele-health doctor visit, compared to an in-person visit.

Worldwide, antibiotic use is highest in young children, especially in low-income areas. This is often in response to the fact that young children are prone to have four to six upper respiratory tract infections each year. Although most of these infections are treated by antibiotics, 80 percent are not caused by bacteria and would therefore derive no benefit from antibiotics.

Are some practitioners more likely to prescribe antibiotics?

Our findings are consistent with the hypothesis that older physicians are more likely than their younger colleagues to prescribe antibiotics. For example, one study found that physicians over 30 were several times more likely to prescribe antibiotics for common respiratory conditions that do not necessarily require them. Another study found that physicians with over 25 years in practice were disproportionately likely to issue prescriptions of more than eight days.

What misinformation did you find among the public?

Many people believe that antibiotics are effective against bacterial and viral illnesses, lumping all types of pathogens together and adopting a “germs are germs” attitude. Others believe that taking antibiotics can’t hurt. Across Europe, for example, 57 percent of people surveyed were unaware that antibiotics were ineffective against viruses, and 44 percent did not know that antibiotics have no effect against colds or influenza.

What other reasons did you find for inappropriate prescription of antibiotics?

Antibiotics are commonly used across the world to self-treat health problems for which they were never intended, such as in Nigeria, where women are increasingly using antibiotics to reduce menstrual cramps. In low- to middle-income countries, antibiotics are often seen as strong, magical medicines, capable of both curing and preventing a range of illness. In many countries people also take them to return to work or school when ill. One of the studies found that 63 percent of Chinese university students kept a personal antibiotic stock at home.

Parents may appeal for an antibiotic for their children so that they can go to work or for the children to return to school or daycare. A U.S. study found that 43 percent of parents of a child with cold symptoms believed that antibiotics were necessary.

In addition, some doctors are inclined to prescribe an antibiotic to maintain a good relationship with patients who expect to receive medication. Patients may not demand antibiotics outright, but rather infer their need for them by how they describe the severity of their illness or note that they worked in the past for a similar issue. People have become less willing to wait and let an illness run its course. The perception that there is a pill for ills of all kinds leads the public to demand immediate relief for symptoms from practitioners and to self-medicate.

Every time an antibiotic is given, money changes hands. This is especially a problem in low- and middle-income countries, where pharmacists are happy to dispense without a prescription to their customers. The rural health practitioners in China are paid every time they dispense an antibiotic as well. Such monetary incentives favor the wide use of antibiotics.

How can antibiotic overuse be addressed?

Clinicians need to be better educated about the long-term effects on the microbiome and learn about better ways to speak with their patients about antibiotic risks and benefits. They also need to improve their communication about the consequences of antibiotic treatments and identify antibiotic alternatives.

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5 Steps for women to reduce their risk of COPD

Women tend to develop COPD earlier in life than men and are more likely to have severe symptoms and be hospitalized with the disease. The good news? According to the National Heart, Lung, and Blood Institute, there are steps you can take to reduce your risk for COPD.

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If you’re a woman who tries to stay healthy, you may exercise several times per week, watch what you eat and get 7-9 hours of sleep each night. But are you listening to your lungs?

Chronic obstructive pulmonary disease (COPD), a leading cause of disability and death in the United States, takes an especially heavy toll on women. You may think problems like shortness of breath, frequent coughs or wheezing are just signs of getting older, but it’s important to pay attention to these symptoms and discuss them with your doctor.

COPD is a serious lung disease that causes breathing problems and worsens over time. It has often been considered a man’s disease. Yet more women than men have been diagnosed with COPD in the past decade, and over the past 20 years more women have died from it, according to the US Centers for Disease Control and Prevention.

Women tend to develop COPD earlier in life than men and are more likely to have severe symptoms and be hospitalized with the disease. The good news? According to the National Heart, Lung, and Blood Institute, there are steps you can take to reduce your risk for COPD.

Don’t Smoke

You probably already know cigarette smoking is harmful  but did you know that women may be more vulnerable to the effects of smoking? Women who smoke tend to get COPD at younger ages and with less cigarettes smoked than men. COPD is the leading cause of death among U.S. women smokers.

If you do smoke, it’s never too late to quit.

If you thought vaping was a healthy alternative to smoking, think again. Researchers are still learning about the long-term health effects of e-cigarettes, but they may contain as many, if not more, harmful chemicals than tobacco cigarettes.

Avoid Pollutants

Among people with COPD who have never smoked, most are women. Women may be more vulnerable to indoor and outdoor air pollution. Women’s smaller lungs and airways mean the same amount of inhaled pollutants may cause more damage.

Working in places like nail salons, hair salons or dry cleaners can expose you to harmful chemicals. If you’re exposed to chemical fumes at your job, talk to your employer about ways to limit exposure. Better ventilation and wearing a mask can help.

Stay Current on Vaccines

People at risk for COPD are more likely to have serious problems resulting from some vaccine-preventable diseases. Ask a health care provider about getting vaccinated against the flu, pneumococcal disease and COVID-19.

Talk to Your Doctor About COPD

Women with COPD tend to be diagnosed later than men when the disease is more severe and treatments are less effective. If you think you could be at risk, or you are having symptoms, bring it up with your health care provider. Treatment can ease symptoms and improve your ability to exercise.

Learn More to Breathe Better

Find more information on COPD from NHLBI’s Learn More Breathe Better program at copd.nhlbi.nih.gov.

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2 Steps to save a life

“By equipping people with Hands-Only CPR training, we are empowering them to spring into action if a loved one needs help, as the majority of cardiac arrests occur at home.”

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More than 350,000 sudden cardiac arrests occur annually outside hospital settings. However, a hands-on emergency intervention like cardiopulmonary resuscitation (CPR), especially if performed immediately, can double or triple a cardiac arrest victim’s chance of survival.

According to the American Heart Association, 70% of cardiac arrests – electrical malfunctions in the heart that cause an irregular heartbeat (arrhythmia) and disrupt the flow of blood to the brain, lungs and other organs – occur at home, but often family and friends who witness a child, spouse, parent or friend going into cardiac arrest hesitate to perform potentially lifesaving CPR for fear of making the situation worse.

“By equipping people with Hands-Only CPR training, we are empowering them to spring into action if a loved one needs help, as the majority of cardiac arrests occur at home,” said Dr. Anezi Uzendu, M.D., interventional cardiologist and American Heart Association volunteer.

As part of its Hands-Only CPR campaign, nationally supported by the Elevance Health Foundation, the American Heart Association aims to increase awareness about the importance of bystander CPR and offers these two simple steps:

1.      Call 911.
2.      Push hard and fast in the center of the chest of the individual experiencing cardiac arrest.

Using the beat of a familiar song with 100-120 beats per minute, such as “Stayin’ Alive” by the Bee Gees, can help you stay on pace with the necessary compressions.

“Being able to efficiently perform Hands-Only CPR in the moment can mean the difference between life and death, and by following these two simple steps we can increase someone’s chance of survival from cardiac arrest,” said Shantanu Agrawal, M.D., board certified emergency medicine doctor and chief health officer at Elevance Health. “As a longstanding supporter of the American Heart Association, we remain focused on working together to improve health inequities in our communities by expanding access to training and increasing the number of people who learn and feel confident performing Hands-Only CPR to save lives.”

To find more information, watch a livestream video demonstration of Hands-Only CPR or download a first aid smartphone app, visit heart.org/CPR.

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What you eat could contribute to your menstrual cramps

Roughly 90% of adolescent girls experience menstrual pain. Most use over-the-counter medicine to manage the pain but with limited positive results. Evidence has highlighted that diets high in omega-3 fatty acids and low in processed foods, oil, and sugar reduce inflammation, a key contributor to menstrual pain.

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Despite the fact that menstrual pain (dysmenorrhea) is the leading cause of school absences for adolescent girls, few girls seek treatment. An analysis of relevant studies suggests that diet may be a key contributor, specifically diets high in meat, oil, sugar, salt, and coffee, which have been shown to cause inflammation.

Roughly 90% of adolescent girls experience menstrual pain. Most use over-the-counter medicine to manage the pain but with limited positive results. Evidence has highlighted that diets high in omega-3 fatty acids and low in processed foods, oil, and sugar reduce inflammation, a key contributor to menstrual pain.

This analysis was designed to study the effect of diet on menstrual pain and identify which foods contribute to it and which can reduce it. Research was conducted through a literature review that found multiple studies that examined dietary patterns that resulted in menstrual pain. In general terms, these studies found that diets high in omega-6 fatty acids promote inflammation and foods high in omega-3 fatty acids reduce it. The muscles in the uterus contract because of prostaglandins, which are active in inflammatory responses. When measuring the Dietary Inflammatory Index, it was found that those on a vegan diet (that excluded animal fat) had the lowest rates of inflammation.

“Researching the effects of diet on menstrual pain started as a search to remedy the pain I personally experienced; I wanted to understand the science behind the association. Learning about different foods that increase and decrease inflammation, which subsequently increase or reduce menstrual pain, revealed that diet is one of the many contributors to health outcomes that is often overlooked. I am hopeful that this research can help those who menstruate reduce the pain they experience and shed light on the importance of holistic treatment options,” says Serah Sannoh, lead author of the poster presentation from Rutgers University.

“Since menstrual pain is a leading cause of school absenteeism for adolescent girls, it’s important to explore options that can minimize the pain. Something like diet modification could be a relatively simple solution that could provide substantial relief for them,” said Dr. Stephanie Faubion, NAMS medical director.

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