If you or a loved one has a latex allergy or sensitivity, think twice before reaching for a product that says “latex free” or “does not contain latex.” That’s the latest advice from the FDA, which says no existing tests can show that a product is completely free from latex. Labeling that suggests a product doesn’t contain the substance could cause trouble for individuals with a latex allergy or sensitivity.

The original latex came from the sap of the rubber tree (Hevea brasiliensis), earning it the designation of “natural rubber latex.” It is used to make a host of stretchy products, including adhesive bandages, condoms, gloves used in health care and dishwashing, balloons, rubber band, elastic used in waistbands and socks, baby bottle nipples, pillows, and more. Natural rubber latex contains proteins that set off some people’s immune systems, leading to an allergic reaction. An alternative, synthetic latex, doesn’t contain these proteins and so doesn’t provoke allergies.

Although anyone can develop a latex allergy, it usually occurs in people with repeated exposure to the rubber proteins. Allergies to latex skyrocketed in the 1990s as a more and more people (mostly in healthcare and associated professions) were required to use gloves to avoid getting and spreading infections. Although the use of alternatives has decreased latex allergies, up to 12% of healthcare workers and up to 6% of the general population may have a latex allergy or sensitivity. “The most common patient is a healthcare worker or frequent surgical patient,” says Dr. Peter Schalock, assistant professor of dermatology at Harvard-affiliated Massachusetts General Hospital.

According to the American Latex Allergy Association, the signs of a latex allergy, which is really a system-wide immune reaction, include

• hives or welts
• swelling of the affected area
• a runny nose
• sneezing
• reddened, itchy, or teary eyes
• headache
• sore throat, hoarse voice
• abdominal cramps
• chest tightness, wheezing, or shortness of breath (asthma)

Sometimes the reaction is so powerful it can put a person into anaphylactic shock, which can be deadly.

There’s no cure for a latex allergy. That makes avoiding latex a must. More →

Americans drive while talking on a cellphone or texting more than their counterparts in seven European countries. A report published yesterday showed that 69% of American drivers surveyed said they had talked on a cellphone while driving at least once in the previous month (31% said they did it “regularly or fairly often”), and 31% said they had read or sent text messages while driving. The least distracted drivers were in the United Kingdom.

Percentage of adults aged 18–64 years who reported that they had talked on their cell phone while driving regularly or fairly often, at least once, or never in the past 30 days

As you might expect, younger drivers were more likely to have reported talking on a cellphone or texting while driving.

More →

New guidelines for recognizing and managing sports-related concussions could help protect the brains of millions of athletes at all levels of play, from professional football to youth soccer.

The guidelines, released today by the American Academy of Neurology (AAN), replace a now-outdated set published in 1997.

“The new guidelines are a huge step forward,” said Dr. William P. Meehan III, director of the Sports Concussion Clinic at Harvard-affiliated Boston Children’s Hospital, who was not involved creating the new guidelines. “They summarize the best of what we now know about concussion.”

The guidelines step away from trying to “grade” concussions or diagnose them on the field or sidelines. Instead, they focus on immediately removing from play athletes who are suspected of having a concussion until they can be evaluated.

The AAN estimates that concussions cause between 1.6 million and 3.8 million mild brain injuries each year. Concussions happen when something makes the head and brain move quickly back and forth. This can be a jolt to the head, a fall, or a blow to the body. The injury changes how the brain functions. Many athletes don’t get medical attention for these injuries, often because they or their coaches don’t recognize the warning signs or take them seriously.

Here are some of the AAN’s findings and recommendations:

• Concussions are most common in males playing American football or rugby (Dr. Meehan says ice hockey also tops the list) and in females playing soccer or basketball. However, concussions can happen in any sport.
• Concussion is a clinical diagnosis. It isn’t something that can always be identified on the field using one of the numerous symptom checklists or scoring systems that are currently available.
• Athletes who seem to have suffered a concussion should be immediately removed from play and evaluated.
• Athletes who have sustained concussions should not return to play or activity that has a risk of contact activity until a licensed healthcare provider “had judged that the concussion has resolved.” Light exercise may be started beforehand as long as there is no contact risk. The AAN did not set a timeline for safe return to play.
• Athletes who have had one concussion are at greater risk of having another. The first 10 days after a concussion is a period of special danger.
• Athletes with multiple concussions and lingering symptoms should undergo testing. Some should be counseled to retire from play. More →

Tiny shock absorbers in the knee (each one is called a meniscus) provide a key cushion between the thighbone and the shinbone. They are prone to tearing, and sometimes just wear out. A torn meniscus can cause pain or other symptoms, like a knee that locks. But sometimes they don’t cause any symptoms.

In a youngish person, when a knee-wrenching activity like skiing, ultimate Frisbee, or slipping on the ice tears a meniscus, the damage is often repaired surgically. But a torn meniscus is often seen in the 9 million Americans with knee osteoarthritis, and for them the best course of action hasn’t been crystal clear. Results of the Meniscal Tear in Osteoarthritis Research (MeTeOR) trial published yesterday in the New England Journal of Medicine indicate that physical therapy may be just as good as surgery.

Surgeons at Harvard-affiliated Brigham and Women’s Hospital and six other large hospitals recruited 351 men and women with symptom-causing knee osteoarthritis and a meniscal tear. Half completed a six-week physical therapy program aimed at easing inflammation, strengthening muscles supporting the knee, and improving the knee’s range of motion. The other half underwent a procedure called arthroscopic partial meniscectomy, in which unstable pieces of the meniscus are removed and the remaining edges are smoothed, followed by the same physical therapy program.

Participants in both groups reported similar improvements in knee function and pain at six and 12 months. About one-third of those who received only physical therapy “crossed over” during the course of the trial and had surgery.

“We did this trial because surgeons really haven’t been sure what’s best for these patients,” said Dr. Jeffrey N. Katz, professor of medicine and orthopedic surgery at Harvard Medical School, who was one of the leaders of the trial. “Now we have a better picture, and can advise people with knee osteoarthritis and a torn meniscus that physical therapy and surgery are both good options.” More →

It always takes me a few days to get used to Daylight Saving Time. While I love the extra hour of light at the end of the day, I’m not so wild about the extra hour of darkness in the morning or waking up an hour earlier than I need to. And I sure miss the hour of sleep I lost yesterday.

That lost hour seems to be a big deal. A report in this month’s American Journal of Cardiology details the jump in heart attacks seen in a large Michigan hospital the first week after the start of Daylight Saving Time, and the small decline after it ends in the fall. A few years back, researchers showed a similar pattern in Sweden. The number of traffic accidents are similarly affected. In a Canadian study, there were more accidents on the Monday after the start of Daylight Saving Time than there were on the Monday the week before the change.

No one knows for sure why losing one hour of sleep might generate more heart attacks or accidents. It could be a disruption in the body’s circadian rhythm, which controls hormone levels and many other physiologic underpinnings of health, as well as alertness.

Catching up

If ever there was a perfect day for a nap, today would be it. A single nap won’t fully reset your body clock or make up for a lost hour of sleep, but it can help. It’s also a good way to stay sharp, especially in the afternoon.

A few years back, nap champion William A. Anthony, then professor of rehabilitation counseling at Boston University, proclaimed the Monday after the start of Daylight Saving Time as “National Napping Day.” It was part publicity stunt to promote The Napping Company, a business he founded with his wife, Camille Anthony to bring napping into business world to improve productivity.

But napping does make sense, not just today, but almost any day. Although the effects of napping on physical health are all over the map, it’s clear that napping can help improve learning and creativity. More →

All-you-can-eat buffets are a boon for hungry, thrift diners and a nightmare for dieters or those trying to maintain a healthy weight. If you are in the latter camp, here are two tips from Brian Wansink, the master of mindful eating:

• Take a walk around the entire buffet to scope out your options before serving yourself.
• Put your food on a small plate instead of a big one.

Wansink, professor of consumer behavior at Cornell University, and colleague Mitsuru Shimizu led a team of 30 trained observers to watch more than 300 men and women in two dozen all-you-can-eat Chinese restaurant buffets and unobtrusively record six specific activities: how quickly the diners served themselves; choice of plate size; location of table; whether they faced the buffet; eating utensils used; and where they placed their napkin. Diners who surveyed the buffet before serving themselves and those who used smaller plates made fewer trips to the buffet, and so likely ate less.

“Consistent with the idea that small changes might lessen one’s tendency to overeat, deliberative thought about what to serve oneself, and using a smaller plate, may reduce overeating in buffets,” they write in the April 2013 American Journal of Preventive Medicine.

In an earlier study, the Cornell team showed that buffet diners with higher body-mass index (a measure of weight) tended to serve before surveying, used larger plates, sat facing the buffet, and used forks instead of chopsticks. More →

Type 2 diabetes doesn’t usually appear all of a sudden. Many people have a long, slow, invisible lead-in to it called prediabetes. During this period, blood sugar levels are higher than normal. However, they’re not high enough to cause symptoms or to be classified as diabetes. It’s still possible at this stage to prevent the slide into full-blown diabetes. Think of prediabetes as a wake-up call.

Unfortunately, few people ever hear the alarm. A new report from the Centers for Disease Control and Prevention shows that among Americans age 20 and older, only 10% of those with prediabetes know they have it. Given that as many as 73 million Americans have prediabetes, that’s a lot of missed opportunities to prevent the ravages of diabetes.

One reason many people don’t know that they may be headed toward diabetes is they’ve never had their blood sugar tested. This simple test isn’t part of routine preventive care. The U.S. Preventive Services Task Force recommends blood sugar “screening” only in individuals with high blood pressure. (Screening means hunting for hidden disease in the absence of any outward signs or symptoms.) That’s important, because recommendations from the Task Force, an independent panel of experts, are used by many health-care organizations to determine preventive care. In addition, Task Force recommendations will help determine what services are covered under the Affordable Care Act.

Expanding the net

The American Diabetes Association and other organizations recommend routine blood sugar testing in people at high risk for developing diabetes. These include:

• everyone over age 45
• younger people who are overweight and who also have one of these diabetes risk factors:
  • little or no physical activity
  • family history of diabetes
  • high blood pressure or high cholesterol
  • previous diagnosis of heart disease or polycystic ovary syndrome
  • diabetes during pregnancy (gestational diabetes) or having delivered a baby weighing more than nine pounds

More →

“Is Heavy Metal Holding You Back?” So asks an online ad for a wellness clinic offering chelation therapy—an alternative treatment touted to cure heart disease and other ailments. Chelation therapy removes metals that have built up in the body. Its proponents claim that this can rejuvenate the heart and blood vessels, improve liver and kidney function, increase blood flow to the brain, and more.

Chelation therapy is an FDA-approved therapy—for treating mercury, lead, and other types of heavy-metal poisoning, as well as for iron overload (hemochromatosis) and some types of anemia. A chelating agent infused into the bloodstream binds to these toxins. The kidneys filter out the chelating agent and bound metals, which are then urinated away.

How might chelation therapy work for heart disease? The theory is that the chelating agent (usually ethylenediaminetetraacetic acid [EDTA]) binds to calcium in fatty plaques lining arteries. When it pulls out the calcium, plaque is supposedly swept away too, clearing arteries in much the same way that a drain cleaner opens clogged pipes. It’s a wonderful analogy, but one that hasn’t been backed by solid science. More →

If you are worried about your weight, paying more attention to what you eat, not less, could help keep you from overeating. Multitasking—like eating while watching television or working—and distracted or hurried eating can prompt you to eat more. Slowing down and savoring your food can help you control your intake.

That’s the bottom line from a report published in the April issue of the American Journal of Clinical Nutrition. A team from the University of Birmingham in the United Kingdom scoured the medical literature for studies that have looked at how attention and memory affect food intake. All of these studies had at least two groups, such as one group that ate a particular meal while watching television and another that ate the same meal without television.

These studies point to two key conclusions: More →

Chronic pain in the muscles and joints can make life miserable. Standard treatments like ice and heat, anti-inflammatory medications,

The study isn’t the last word on the issue, but it is one of the best quality studies to date and has made an impression.

“I think the benefit of acupuncture is clear, and the complications and potential adverse effects of acupuncture are low compared with medication,” says Dr. Lucy Chen, a board-certified anesthesiologist, specialist in pain medicine, and practicing acupuncturist at Harvard-affiliated Massachusetts General Hospital.

How does it work?

Acupuncturists insert hair-thin needles into the skin at specific points around the body. It is virtually painless when done by an experienced practitioner. Inserting the needles is thought to correct imbalances in the flow of energy in the body, called qi (pronounced “chee”). As I write in the April issue of the Harvard Men’s Health Watch, in Western scientific terms acupuncture is thought to ease pain by affecting neurotransmitters, hormone levels, or the immune system.

For new pain, an acupuncturist should not always be your first stop. Dr. Chen recommends that individuals have clear diagnoses of what is causing their pain to rule out serious medical conditions that should be treated right away—and then seek out acupuncture if appropriate.

• How often is acupuncture needed? Plan on weekly treatments until you start to see a benefit, then gradually lengthen the time until the next visit.
• What does it cost? Acupuncture treatments range from $65 to $125 per session. Private insurers usually don’t pay for it, nor do Medicare or Medicaid. Some plans may cover the cost of a physician-acupuncturist.
• Who administers it? Ideally a trusted, certified provider. You can search for a trained acupuncturist at the National Certification Commission for Acupuncture and Oriental Medicine or by calling the organization at 904-598-1005.

physical therapy, and appropriate exercises can often ease the pain. But when they don’t, acupuncture is an option with a good track record that’s worth considering.

Over the years there has been substantial debate about whether acupuncture really works for chronic pain. Research from an international team of experts adds to the evidence that it does provide real relief from common forms of pain. The team pooled the results of 29 studies involving nearly 18,000 participants. Some had acupuncture, some had “sham” acupuncture, and some didn’t have acupuncture at all. Overall, acupuncture relieved pain by about 50%.

The study isn’t the last word on the issue, but it is one of the best quality studies to date and has made an impression.

“I think the benefit of acupuncture is clear, and the complications and potential adverse effects of acupuncture are low compared with medication,” says Dr. Lucy Chen, a board-certified anesthesiologist, specialist in pain medicine, and practicing acupuncturist at Harvard-affiliated Massachusetts General Hospital.

How does it work?

Acupuncturists insert hair-thin needles into the skin at specific points around the body. It is virtually painless when done by an experienced practitioner. Inserting the needles is thought to correct imbalances in the flow of energy in the body, called qi (pronounced “chee”). As I write in the April issue of the Harvard Men’s Health Watch, in Western scientific terms acupuncture is thought to ease pain by affecting neurotransmitters, hormone levels, or the immune system.

For new pain, an acupuncturist should not always be your first stop. Dr. Chen recommends that individuals have clear diagnoses of what is causing their pain to rule out serious medical conditions that should be treated right away—and then seek out acupuncture if appropriate.

• How often is acupuncture needed? Plan on weekly treatments until you start to see a benefit, then gradually lengthen the time until the next visit.
• What does it cost? Acupuncture treatments range from $65 to $125 per session. Private insurers usually don’t pay for it, nor do Medicare or Medicaid. Some plans may cover the cost of a physician-acupuncturist.
• Who administers it? Ideally a trusted, certified provider. You can search for a trained acupuncturist at the National Certification Commission for Acupuncture and Oriental Medicine or by calling the organization at 904-598-1005.