Back pain and remedies

Back pain is a common reason for absence from work and for seeking medical treatment. It can be uncomfortable and sometimes even debilitating.

Back pain can result from injury, activity, and some medical conditions. It can affect people of any age and for different reasons. As people get older, the likelihood of developing lower back pain increases due to factors such as previous occupation and degenerative disk disease.

Lower back pain may be relating to the bony lumbar spine, disks between the vertebrae, ligaments around the spine and disks, spinal cord and nerves, lower back muscles, abdominal and pelvic internal organs, or the skin around the lumbar area.

Pain in the upper back may be due to disorders of the aorta, tumors in the chest, or spine inflammation.

Causes

The human back consists of a complex structure of muscles, ligaments, tendons, disks, and bones that work together to support the body and enable movement.

The segments of the spine are cushioned with cartilage-like pads called disks.

Problems with any of these components can lead to back pain. In some cases of back pain, however, the cause remains unclear.

Damage can result from strain, medical conditions, or poor posture, among other things.

Back pain commonly stems from strain, tension, or injury. Frequent causes of back pain are:

  • strained muscles or ligaments
  • a muscle spasm
  • muscle tension
  • damaged disks
  • injuries, fractures, or falls

Strain

Activities that can lead to strains or spasms include:

  • lifting something improperly
  • lifting something that is too heavy
  • making an abrupt, awkward movement

Structural problems

A number of structural problems may also result in back pain:

  • Ruptured disks: Each vertebra in the spine is cushioned by disks. If the disk ruptures, there will be more pressure on a nerve, resulting in back pain.
  • Bulging disks: Much in the same way as ruptured disks, a bulging disk can lead to more pressure on a nerve.
  • Sciatica: A sharp and shooting pain travels through the buttock and down the back of the leg. This may occur when a bulging or herniated disk presses on a nerve or when a muscle pushes specifically on the sciatic nerve.
  • Arthritis: Osteoarthritis can cause problems with the joints in the hips, lower back, and other areas in the body. In some cases, the space around the spinal cord narrows. Health experts call this spinal stenosis.
  • Unusual curvature of the spine: If the spine curves in an unusual way, back pain can occur. An example of this is scoliosis, in which the spine curves to the side.
  • Osteoporosis: Bones, including the vertebrae of the spine, become brittle and porous, making compression fractures more likely.
  • Kidney problems: Kidney stones or kidney infection can cause back pain.

Movement and posture

Adopting a hunched sitting position when using a computer can lead to increased back and shoulder problems over time.

Back pain can also result from some everyday activities or poor posture.

Examples include:

  • twisting
  • coughing or sneezing
  • overstretching
  • bending awkwardly or for long periods
  • pushing, pulling, lifting, or carrying something
  • standing or sitting for long periods
  • straining the neck forward, such as when driving or using a computer
  • driving for lengthy periods without taking a break, even when not hunched
  • sleeping on a mattress that does not support the body or keep the spine straight

Other causes

Some medical conditions can lead to back pain:

  • Cauda equina syndrome: The cauda equina is a bundle of spinal nerve roots that arise from the lower end of the spinal cord. Symptoms of this syndrome include a dull pain in the lower back and upper buttocks, as well as numbness in the buttocks, genitalia, and thighs. Sometimes, bowel and bladder function disturbances occur.
  • Cancer of the spine: A tumor on the spine may press against a nerve, resulting in back pain. The structural damage to the bone itself can also be painful when there are tumors or metastasis to the bone.
  • Infection of the spine: A fever and a tender, warm area on the back could be due to an infection of the spine.
  • Other infections: Pelvic inflammatory disease and kidney or bladder infection may also lead to back pain.
  • Sleep disorders: Individuals with sleep disorders are more likely to experience back pain than others.
  • Shingles: An infection that can affect the nerves may lead to back pain. This depends on which nerves have become affected. A rash will follow the back pain.

Symptoms

The main symptom of back pain is an ache anywhere in the back and sometimes all the way down to the buttocks and legs.

Some back issues can cause pain in other parts of the body, depending on the nerves affected.

The pain often goes away without treatment. However, if it occurs with any of the following, a person should contact a doctor:

  • unexplained weight loss
  • fever
  • inflammation or swelling on the back
  • persistent back pain where lying down or resting does not help
  • pain down the legs
  • pain that reaches below the knees
  • a recent injury, blow, or trauma to the back
  • urinary incontinence
  • difficulty urinating
  • fecal incontinence, or loss of control over bowel movements
  • numbness around the genitals
  • numbness around the anus
  • numbness around the buttocks

When to contact a specialist

A person should seek medical help if they experience any numbness or tingling or if they have back pain:

  • that does not improve with rest
  • after an injury or fall
  • with numbness in the legs
  • with weakness
  • with fever
  • with unexplained weight loss

Treatment

Back pain usually resolves with rest and home remedies, but sometimes, medical treatment is necessary.

Home treatments

Over-the-counter (OTC) pain relief medication — usually, nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen — can relieve discomfort. Applying a hot compress or an ice pack to the painful area may also reduce pain.

Resting from strenuous activity can help, but moving around will ease stiffness, alleviate pain, and prevent muscles from weakening.

Medical treatment

If home treatments do not relieve back pain, a doctor may recommend the following medication, physical therapy, or both:

Medication

Back pain that does not respond well to OTC pain relief medication may require a prescription NSAID.

Codeine or hydrocodone, which are narcotics, may be prescribed for short periods. These require close monitoring by a doctor. In some cases, doctors may also recommend muscle relaxants.

Antidepressants, such as amitriptyline, may be prescribed, but research into their effectiveness is ongoing, and the existing evidence is conflicting.

Physical therapy

Applying heat, ice, ultrasound, and electrical stimulation, as well as some muscle release techniques, to the back muscles and soft tissues may help alleviate pain.

As the pain improves, a physical therapist may introduce some flexibility and strength exercises for the back and abdominal muscles. Techniques for improving posture may also help.

It is advisable to practice the techniques regularly, even after the pain has gone, to prevent back pain recurrence.

Cortisone injections

If other options are not effective, these may be injected into the epidural space, around the spinal cord.

Cortisone is an anti-inflammatory drug. It helps reduce inflammation around the nerve roots. Injections may also be used to numb areas thought to be causing the pain.

Botox

According to research, botox reduces pain by paralyzing sprained muscles in spasm. These injections are effective for about 3–4 months.

Traction

Pulleys and weights are used to stretch the back. This may result in a herniated disk moving back into position. It can also relieve pain but only while traction is applied.

Cognitive behavioral therapy

Cognitive behavioral therapy (CBT) can help manage chronic back pain by encouraging new ways of thinking. It may include relaxation techniques and ways of maintaining a positive attitude.

Studies have found that people receiving CBT tend to become more active and do exercise, which lowers the risk of back pain recurrence.

Surgery

Surgery for back pain is very rare. If an individual has a herniated disk, surgery may be an option, especially if there is persistent pain and nerve compression, which can lead to muscle weakness.

Examples of surgical procedures include:

  • Fusion: A surgeon joins two vertebrae and inserts a bone graft between them. The vertebrae are splinted together with metal plates, screws, or cages. There is a significantly greater risk of arthritis to subsequently develop in the adjoining vertebrae.
  • Artificial disk: A surgeon inserts an artificial disk that replaces the cushion between two vertebrae.
  • Diskectomy: Surgeons may remove a portion of a disk if it is irritating or pressing against a nerve.
  • Partially removing a vertebra: A surgeon may remove a small section of a vertebra if it is pinching the spinal cord or nerves.

Injecting cells to regenerate spinal disks: Scientists from Duke University in Durham, NC, developed new biomaterials that can deliver a booster shot of reparative cells to the nucleus pulposus, effectively eliminating pain resulting from degenerative disk disease.

Complementary therapies

Complementary therapies may be used alongside conventional therapies or on their own.

Chiropractic, osteopathy, shiatsu, and acupuncture may help relieve back pain and encourage a person to feel relaxed.

  • An osteopath is a physician who specializes in treating the skeleton and muscles.
  • A chiropractor treats joint, muscle, and bone problems. The main focus is the spine.
  • Shiatsu, or finger pressure therapy, is a type of massage where pressure is applied along energy lines in the body. The shiatsu therapist applies pressure with the fingers, thumbs, and elbows.
  • Acupuncture, which originated in China, involves inserting fine needles into specific points in the body. Acupuncture can help the body release its natural pain relievers — endorphins — and stimulate nerve and muscle tissue.
  • Yoga involves specific physical poses, movements, and breathing exercises. Some of these may help strengthen the back muscles and improve posture. Care must be taken that exercises do not make back pain worse.

Studies on complementary therapies have given mixed results. Some people have experienced significant benefits, while others have not. When considering alternative therapies, it is important to seek guidance from a qualified and registered therapist.

Transcutaneous electrical nerve stimulation (TENS) is a popular therapy for individuals with chronic back pain. The TENS machine delivers small electric pulses into the body through electrodes placed on the skin.

Experts believe TENS encourages the body to produce endorphins and may block pain signals returning to the brain. Studies on TENS have provided mixed results. Some showed no benefits, while others indicate that it could be helpful for some people.

A TENS machine should be used under the direction of a healthcare professional.

A person should avoid TENS if they:

  • are pregnant
  • have a history of epilepsy
  • have a pacemaker

TENS is considered “safe, noninvasive, inexpensive, and patient friendly,” and it appears to reduce pain. However, more evidence is necessary to confirm its effectiveness in improving activity levels.

Risk factors

The following factors are linked to a higher risk of developing low back pain:

  • occupational activities
  • pregnancy
  • a sedentary lifestyle
  • not enough exercise
  • older age
  • obesity
  • smoking
  • strenuous physical exercise or work, especially if done incorrectly
  • genetic factors
  • medical conditions, such as arthritis and cancer

Lower back pain also tends to be more common in females than in males, possibly due to hormonal factors. Additionally, health experts associate back pain with stress, anxiety, and mood disorders.

Diagnosis

A doctor will usually be able to diagnose back pain after asking about symptoms and carrying out a physical examination.

An imaging scan and other tests may be necessary if:

  • back pain appears to result from an injury
  • there is an underlying cause that requires treatment
  • the pain persists over a long period

An X-ray, an MRI scan, or a CT scan can give information about the state of the soft tissues in the back:

  • X-rays can show the alignment of the bones and reveal signs of arthritis or broken bones, but they cannot reveal damage in the muscles, spinal cord, nerves, or disks.
  • MRI or CT scans can reveal herniated disks or problems with tissue, tendons, nerves, ligaments, blood vessels, muscles, and bones.
  • Bone scans can detect bone tumors or compression fractures resulting from osteoporosis. A radioactive substance, or tracer, is injected into a vein. The tracer collects in the bones and helps the doctor detect bone problems with the aid of a special camera. Doctors use these for bone conditions and difficult-to-detect fractures.
  • Electromyography measures the electrical impulses produced by nerves in response to muscles. This can confirm nerve compression, which may occur with a herniated disk or spinal stenosis.

A doctor may also order a blood test if they suspect an infection.

Other types of diagnosis

  • A chiropractor will diagnose through touch, or palpation, and a visual examination. Chiropractic is known as a direct approach, with a strong focus on adjusting the spinal joints. A chiropractor may also want to see the results of imaging scans and any blood and urine tests.
  • An osteopath also diagnoses through palpation and visual inspection. Osteopathy involves slow and rhythmic stretching, known as mobilization, pressure or indirect techniques, and manipulation of joints and muscles.
  • A physical therapist focuses on diagnosing problems in the joints and soft tissues of the body.

Chronic or acute pain?

Health experts distinguish two types of back pain: acute and chronic.

Acute pain starts suddenly and lasts for up to 6 weeks.

Chronic, or long-term, pain develops over a longer period, lasts for over 3 months, and causes ongoing problems.

If a person has both occasional bouts of more intense pain and fairly continuous mild back pain, it can be hard for a doctor to determine whether they have acute or chronic back pain.

Prevention

Steps to lower the risk of developing back pain consist mainly of addressing some of the risk factors.

Exercise

Regular exercise helps build strength and manage body weight. Guided, low impact aerobic activities can boost heart health without straining or jerking the back.

Before starting any exercise program, a person should consult a healthcare professional.

There are two main types of exercise that people can do to reduce the risk of back pain:

  • Core-strengthening exercises work the abdominal and back muscles, helping strengthen muscles that protect the back.
  • Flexibility training aims at improving core flexibility, including the spine, hips, and upper legs.

Diet

A person’s diet should include sufficient amounts of calcium and vitamin D, as these are crucial for bone health.

A balanced diet also helps manage body weight.

Smoking

A significantly higher percentage of people who smoke have back pain incidences, compared with individuals who do not smoke and who are of the same age, height, and weight.

Body weight

The weight people carry and where they carry it affects the risk of developing back pain.

People with obesity are at considerably higher risk of experiencing back pain than those with a moderate body weight.

Moreover, people who carry excessive weight in the abdominal area rather than in the buttocks and hip area are also at greater risk.

Posture when standing

Make sure you have a neutral pelvic position. Stand upright, with the head facing forward and a straight back, and balance your weight evenly on both feet. Keep your legs straight and your neck in line with the rest of the spine.

Posture when sitting

A good seat for working should have good back support, arm rests, and a swivel base.

When sitting, try to keep your knees and hips level and keep your feet flat on the floor or use a footstool. You should be able to sit upright with support in the small of your back.

If you are using a keyboard, make sure that there is a 90-degree angle between the upper arm and forearm.

Lifting

When lifting things, use your legs, not your back, to do the lifting.

Maintain a long spine and keep your feet apart, with one leg slightly forward so that you can maintain balance. Bend only at the knees, hold the weight close to your body, and straighten the legs while changing the position of your back as little as possible.

Bending your back initially is unavoidable, but when you bend your back, try not to stoop and be sure to draw your low belly in so that your pelvis stays neutral and supported. Most importantly, do not straighten your legs before lifting, or you will be using your back for most of the work.

Avoid lifting and twisting at the same time

If something is particularly heavy, see whether you can lift it with someone else. While you are lifting it, keep looking straight ahead, not up or down, so that the neck is in alignment with the rest of the spine.

Moving things

It is safer for the back to push, not pull, things across the floor, as that way, you will be using your leg strength.

Shoes

Shoes with a low heel place less of a strain on the back. However, some flat shoes with minimal support, such as flip-flops, can also contribute to back pain.

Driving

It is important to have proper support for your back when driving.

Make sure the wing mirrors are properly positioned so that you do not need to twist. The pedals should be squarely in front of your feet.

If you are driving for a long time, have many breaks. Get out of the car and walk around.

Bed

You should use a mattress that keeps the spine properly aligned and supports the weight of the shoulders and buttocks. Also, use a pillow that does not force your neck into a steep angle.

Senior couple at home. Handsome old man is having back pain and his attractive old woman supports him.

What to know about cancer

Cancer causes cells to divide uncontrollably. This can result in tumors, damage to the immune system, and other impairment that can be fatal.

In the United States, an estimated 15.5 million people with a history of cancer were living as of January 1, 2016, according to a 2018 report from the American Cancer Society.

In this article, we examine types of cancer, how the disease develops, and the many treatments that help improve the quality of life and survival rates.

What is cancer?

Cancer is a broad term. It describes the disease that results when cellular changes cause the uncontrolled growth and division of cells.

Some types of cancer cause rapid cell growth, while others cause cells to grow and divide at a slower rate.

Certain forms of cancer result in visible growths called tumors, while others, such as leukemia, do not.

Most of the body’s cells have specific functions and fixed lifespans. While it may sound like a bad thing, cell death is part of a natural and beneficial phenomenon called apoptosis.

A cell receives instructions to die so that the body can replace it with a newer cell that functions better. Cancerous cells lack the components that instruct them to stop dividing and to die.

As a result, they build up in the body, using oxygen and nutrients that would usually nourish other cells. Cancerous cells can form tumors, impair the immune system and cause other changes that prevent the body from functioning regularly.

Cancerous cells may appear in one area, then spread via the lymph nodes. These are clusters of immune cells located throughout the body.

Causes

There are many causes of cancer, and some are preventable.

For example, over 480,000 peopleTrusted Source die in the U.S. each year from smoking cigarettes, according to data reported in 2014.

In addition to smoking, risk factors for cancer include:

  • heavy alcohol consumption
  • excess body weight
  • physical inactivity
  • poor nutrition

Other causes of cancer are not preventable. Currently, the most significant unpreventable risk factor is age. According to the American Cancer Society, doctors in the U.S. diagnose 87 percent of cancer cases in people ages 50 years or older.

Is cancer genetic?

Genetic factors can contribute to the development of cancer.

A person’s genetic code tells their cells when to divide and expire. Changes in the genes can lead to faulty instructions, and cancer can result.

Genes also influence the cells’ production of proteins, and proteins carry many of the instructions for cellular growth and division.

Some genes change proteins that would usually repair damaged cells. This can lead to cancer. If a parent has these genes, they may pass on the altered instructions to their offspring.

Some genetic changes occur after birth, and factors such as smoking and sun exposure can increase the risk.

Other changes that can result in cancer take place in the chemical signals that determine how the body deploys, or “expresses” specific genes.

Finally, a person can inherit a predisposition for a type of cancer. A doctor may refer to this as having a hereditary cancer syndrome. Inherited genetic mutations significantly contribute to the development of 5–10 percent of cancer cases.

Treatments

The side effects of chemotherapy include hair loss. However, advances in treatment are improving the outlook for people with cancer.

Innovative research has fueled the development of new medications and treatment technologies.

Doctors usually prescribe treatments based on the type of cancer, its stage at diagnosis, and the person’s overall health.

Below are examples of approaches to cancer treatment:

  • Chemotherapy aims to kill cancerous cells with medications that target rapidly dividing cells. The drugs can also help shrink tumors, but the side effects can be severe.
  • Hormone therapy involves taking medications that change how certain hormones work or interfere with the body’s ability to produce them. When hormones play a significant role, as with prostate and breast cancers, this is a common approach.
  • Immunotherapy uses medications and other treatments to boost the immune system and encourage it to fight cancerous cells. Two examples of these treatments are checkpoint inhibitors and adoptive cell transfer.
  • Precision medicine, or personalized medicine, is a newer, developing approach. It involves using genetic testing to determine the best treatments for a person’s particular presentation of cancer. Researchers have yet to show that it can effectively treat all types of cancer, however.
  • Radiation therapy uses high-dose radiation to kill cancerous cells. Also, a doctor may recommend using radiation to shrink a tumor before surgery or reduce tumor-related symptoms.
  • Stem cell transplant can be especially beneficial for people with blood-related cancers, such as leukemia or lymphoma. It involves removing cells, such as red or white blood cells, that chemotherapy or radiation has destroyed. Lab technicians then strengthen the cells and put them back into the body.
  • Surgery is often a part of a treatment plan when a person has a cancerous tumor. Also, a surgeon may remove lymph nodes to reduce or prevent the disease’s spread.
  • Targeted therapies perform functions within cancerous cells to prevent them from multiplying. They can also boost the immune system. Two examples of these therapies are small-molecule drugs and monoclonal antibodies.

Doctors will often employ more than one type of treatment to maximize effectiveness.

Types

The most common type  of cancer in the U.S. is breast cancer, followed by lung and prostate cancers, according to the National Cancer Institute, which excluded nonmelanoma skin cancers from these findings.

Each year, more than 40,000 people in the country receive a diagnosis of one of the following types of cancer:

  • bladder
  • colon and rectal
  • endometrial
  • kidney
  • leukemia
  • liver
  • melanoma
  • non-Hodgkin’s lymphoma
  • pancreatic
  • thyroid

Other forms are less common. According to the National Cancer Institute, there are over 100 types of cancer.

Cancer development and cell division

Doctors classify cancer by:

  • its location in the body
  • the tissues that it forms in

For example, sarcomas develop in bones or soft tissues, while carcinomas form in cells that cover internal or external surfaces in the body. Basal cell carcinomas develop in the skin, while adenocarcinomas can form in the breast.

When cancerous cells spread to other parts of the body, the medical term for this is metastasis.

A person can also have more than one type of cancer at a time.

Outlook

Improvements in cancer detection, increased awareness of the risks of smoking, and a drop in tobacco use have all contributed to a year-on-year decrease in the number of cancer diagnoses and deaths.

According to the American Cancer Society, the overall cancer death rate declined by 26 percent between 1991 and 2015.

When a person has cancer, the outlook will depend on whether the disease has spread and on its type, severity, and location.

Takeaway

Cancer causes cells to divide uncontrollably. It also prevents them from dying at the natural point in their life cycle.

Genetic factors and lifestyle choices, such as smoking, can contribute to the development of the disease. Several elements affect the ways that DNA communicates with cells and directs their division and death.

After nonmelanoma skin cancer, breast cancer is the most common type in the U.S. However, lung cancer is the leading cause of cancer-related death.

Treatments are constantly improving. Examples of current methods include chemotherapy, radiation therapy, and surgery. Some people benefit from newer options, such as stem cell transplantation and precision medicine.

The diagnosis and death rates of cancer are dropping yearly.

Pink ribbon for breast cancer awareness. Female patient listening to doctor in medical office. Support people living with tumor illness.

COVID-19 vaccines for children: What are the side effects?

Vaccines undergo particularly rigorous safety tests before receiving approval for use in the general population. However, no drug is guaranteed to be free from side effects, so what are the side effects that children receiving the COVID-19 vaccine may face?

The Food and Drug Administration (FDA) approved the Pfizer vaccine for children aged 5–11 years on October 29, 2021. According to a recent survey by KFF COVID-19 Vaccine Monitor, just over one-quarter of parents of children in this age group are eager for their child to be vaccinated as soon as possible.

Although this may be surprising, other survey findings shed some light on the reasons behind this hesitancy: a fear of side effects.

Two-thirds of parents of children of this age said that they were worried that the COVID-19 vaccine would affect their children’s future fertility. So significant are these concerns that the American Academy of Pediatrics recently put out a video disputing any potential impact of the vaccine on puberty or fertility.

Vaccine hesitancy is not just over fears of an impact on fertility, however. Over three-quarters of parents reported that they were “very” or “somewhat” concerned that their child might experience serious side effects or that not enough is known about long-term effects from the COVID-19 vaccine.

So, what are the possible side effects?

What are children going to get?

In the same way that pharmaceutical companies raced to get the vaccine approved for adults, those companies have carried out trials to see if their vaccines are safe and effective in adolescents and children.

Speaking at an Independent SAGE briefing on November 5, 2021, Prof. Deenan Pillay — a professor of virology at University College London (UCL) in the United Kingdom — said:

“There have been a number of trials. We are always concerned about the untoward effect of all medicines in children, and, of course, we can’t just extrapolate from data that [come] from adults to children. We have got to wait to ensure there is safety in children. And now that has happened.”

So far, mRNA vaccines from Pfizer and Moderna have received approval in the U.S. for children over 12 years of age, with the Pfizer vaccine approved for 5–12-year-olds at the end of October 2021.

The European Medicines Agency announced that it would start investigating the safety of the vaccine in that age group on October 18, 2021.

Most countries offering vaccination to those over 12 years of age are offering the Pfizer or Moderna vaccine, Reuters recently reported. A single dose of the Pfizer vaccine is available for those over 12 years old in the U.K., where the Moderna vaccine also has approval for this age group.

Pfizer has plans to trial the vaccine in children aged 6 months to 5 years, and Moderna has ongoing trials to test the safety and efficacy of vaccines in children under 12 years old.

Novavax is about to start a study of up to 3,000 adolescents aged 12–17 years across up to 75 sites in the United States. Johnson & Johnson has enrolled children as young as 12 years into existing trials, and AstraZeneca is planning on conducting trials of its vaccine in children as young as 6 years.

The vaccine with the most evidence to support its use so far is Pfizer’s mRNA vaccine against SARS-CoV-2, which is the virus that causes COVID-19.

However, the vaccine doses given to children over the age of 12 years and those under the age of 12 years differ. Pfizer released data from its phase 2 and 3 trials at the end of September 2021. The data suggest that the vaccine was safe in children aged 5–11 years.

Children under the age of 12 years will be offered 10 micrograms (mcg) of the vaccine. This is compared with 30 mcg of the vaccine, which is the amount given to children over the age of 12 years and adults. Experts hope that this lower dose could result in fewer side effects, as lower doses generally should.

Minor adverse reactions

Senior vice president of Pfizer Vaccine Clinical Research and Development, Dr. Bill Gruber, broke down the drug company’s data from its phase 2 and 3 trials at the FDA’s Vaccines and Related Biological Products Advisory Committee Meeting on October 26, 2021.

He revealed that there were very few serious adverse events and no deaths during the phase 2 and 3 trials of children aged 5–12 years. He also explained that the side effects were similar to those that adults experience.

The most common side effects in children after their second dose of the vaccine — first dose reactions were less frequent — were fatigue and headache, with 39.4% and 28% of 5–12-year-olds experiencing those symptoms, respectively.

This is compared with 65.6% and 60.9% of adults. Of note were data showing that fever and chills experienced after the vaccine were lower among 5–12-year-olds than among 12–65-year-olds.

Just 6.5% of children aged 5–12 years experienced fever after vaccination, compared with 17.2% of those over 12 years. Also, just 9.8% of those aged 5–12 years experienced chills, compared with 40% of those over 12 years.

Due to existing concerns about the risk of myocarditis and pericarditis among adolescent and young adult males, the scientists took specific precautions during this trial, Dr. Gruber explained to the committee.

He said: “To enhance possible detection of the rare events of myocarditis in adolescents and young adults, should [they] occur, specific instructions were provided to be vigilant with symptoms and signs of myocarditis […]. No anaphylaxis, no myocarditis, and no appendicitis were reported.”

Myocarditis

The Centers for Disease Control and Prevention (CDC) and others are currently monitoring rates of myocarditis, which is inflammation of the heart muscle. This comes following reports in July 2021 that some teenage boys had received diagnoses of this condition after receiving the Pfizer vaccine, which those over 12 years of age have been able to receive since May 2021.

The CDC  reports that males aged 12–29 years are most at risk of developing myocarditis.

It also states that although 687 cases of myocarditis following vaccination had been reported in under-30s in the U.S. between December 29, 2020, and June 11, 2021, healthcare professionals had given more than 52 million doses of the vaccine to people aged 12–30 years in total. So, this represents a very small risk.

However, there was still a discussion to be had over whether or not the risks of the vaccine, which were very small, outweighed the risks of developing COVID-19, which were also smaller for this section of the population than older adults.

One study, which has not yet undergone peer review, claimed that the risk of experiencing an adverse cardiac event following mRNA vaccination in males aged 16–17 years without any comorbidities was actually 3.5 times higher than the risk of hospitalization due to COVID-19. This was widely reported in August 2021.

Conversely, a study in the New England Journal of Medicine from October 6, 2021, reported findings from the Israeli Ministry of Health surveillance of the issue that seemed to prove a link between receipt of the Pfizer vaccine and myocarditis.

Data collected between December 20, 2020, and May 31, 2021, confirmed 136 cases of myocarditis after receipt of the Pfizer vaccine out of 5.12 million Israelis who had received two doses. Analysis suggests that the risk is highest after the second dose in male recipients aged 16–19 years, with a risk ratio of 1 in 6,637.

Study co-author Prof. Manfred Green, from the Department of Epidemiology at the University of Haifa in Israel, told Medical News Today in an interview:

“Myocarditis is more common in males and females, [and] there are all kinds of theories why […]. [In the study, we found that] it generally was a mild illness, a mild infection and a minor event requiring hospitalization, as people with myocarditis are almost always hospitalized for observation. They required […] very basic anti-inflammatory treatment to treat the inflammation. All were fine, they recovered well.”

Dr. Green sits on the committee due to decide whether or not to proceed with licensing vaccines for 5–12-year-olds in Israel on November 10, 2021. He pointed out that as the dose given to 5–12-year-olds is one-third that of the dose given to older children and adults, “it is expected [that] there will be [fewer] side effects and [fewer] adverse events.”

Medically vulnerable children

Much of the concern voiced about side effects from COVID-19 vaccines is over the risk they may pose to healthy children.

Meanwhile, children who have some preexisting conditions will be particularly vulnerable to COVID-19 and will benefit more from vaccination. So, what about them?

There have been few studies into these children, as children in these groups are few in number. However, one study that appears in the journal Archives of Disease in Childhood found no problematic side effects in a group of 20 adolescents aged 12–15 years with neurological conditions.

Risk-benefit analysis

When evaluating the risks posed by possible side effects of the COVID-19 vaccine, it is impossible to do so without considering the possible benefits — though these may be hard to discern for the individual.

An analysis that appeared in the Journal of the Royal Society of Medicine on November 1, 2021, suggests that the vaccination of 12–17-year-olds is most beneficial while infection rates remain high — which, of course, they do in many parts of the world.

The analysis suggests that if SARS-CoV-2 infections are as high as 1,000 per 100,000 people per week over 16 weeks, vaccination could avert 4,430 hospital admissions and 36 deaths over 16 weeks. It also suggests that thousands of cases of long COVID could be avoided, even if the rate of long COVID was as low as 4% in teenagers.

Speaking at an Independent SAGE briefing on November 5, 2021, author Prof. Christina Pagel — a professor of operational research at UCL — said:

“It became really clear that if you got to really high case rates, then it is massively beneficial, and so even though children of 5–11 are less likely than adolescents to get really sick at the current rates of infection, with 6% [with the infection] at the end of October [in the U.K.], it is almost certain to be beneficial… I would be really surprised if there [weren’t] a benefit to vaccinating 5–11-year-olds, and I am a bit concerned that some members of [Joint Committee on Vaccination and Immunisation] are already saying ‘it’s too soon.’”

Medical Myths: Sexual health

Sexually transmitted infections (STIs) have been on the rise in the United States. In April 2021, the Centers for Disease Control and Prevention (CDC) announced that, in 2019, STIs had reached an all-time high for the sixth consecutive year.

In 2019, the CDC received reports of over 2.5 million cases of chlamydia, gonorrhea, and syphilis.

The World Health Organization (WHO) estimates that 1 million STIs are acquired worldwide each day.

Despite rising rates, there is still significant stigma attached to STIs. For some, this might mean individuals are less willing to speak about sexual health concerns or raise questions with a doctor.

This unwillingness to speak openly about sexual health can breed misinformation.

Of course, the internet is a convenient first port of call when someone has a question they would like to ask anonymously. Sadly, not all information that appears on the web can be trusted.

Here, Medical News Today approached some common myths associated with sexual health and asked for input from an expert:

Dr. Sue Mann, a consultant in sexual and reproductive health and a medical expert in reproductive health at Public Health England.

Increasing understanding of sexual health helps people make informed, safe decisions. Although one article cannot brush away deeply ingrained falsehoods, the more trustworthy information that is available, the better.

1. When someone is taking ‘the pill,’ they cannot contract an STI

This is a myth. Oral contraception cannot protect against contracting an STI.

As Dr. Mann explained to MNT, “oral contraception only works to prevent pregnancy. The only way to protect yourself from getting an STI when using oral contraception is by wearing a condom.”

Mirroring this, the CDC states: “Birth control methods like the pill, patch, ring, and intrauterine device (IUD) are very effective at preventing pregnancy, but they do not protect against [STIs] and HIV.”

2. The ‘withdrawal method’ prevents pregnancy

The so-called withdrawal method, also called coitus interruptus or the pull-out method, is when the penis is pulled out of the vagina before ejaculation. Although it may reduce the chance of pregnancy, “the withdrawal method is not a reliable way to prevent pregnancy,” said Dr. Mann.

When used accurately, it can reduce the risk of pregnancy, but accuracy can be difficult in the heat of the moment.

Additionally, the penis releases pre-ejaculate, or pre-cum, before ejaculation. In some cases, sperm can be present in this fluid.

In one study, for instance, scientists examined samples of pre-ejaculate from 27 participants. The scientists identified viable sperm in 10 of the participant’s pre-ejaculate.

Each volunteer provided a maximum of five samples. Interestingly, the researchers found sperm in either all or none of their samples. In other words, some people tend to have sperm in their pre-ejaculate, while others do not. The authors concluded:

“Condoms should continue to be used from the first moment of genital contact, although it may be that some men, less likely to leak spermatozoa in their pre-ejaculatory fluid, are able to practice coitus interruptus more successfully than others.”

3. The ‘withdrawal method’ prevents STIs

Using the withdrawal method, “you can still get an STI, such as HIV, herpes, syphilis, gonorrhea, or chlamydia,” explained Dr. Mann.

4. Using two condoms doubles the protection

It is understandable why people might assume two condoms would provide twice the protection, but this is a myth.

“It is actually more risky to use two or more condoms when having sex,” said Dr. Mann. “The likelihood of the condom breaking is higher due to the amount of friction the condom is enduring. A single condom is the best option.”

5. You can contract STIs from a toilet seat

This is perhaps one of the most persistent myths associated with STIs. Yet, despite being repeatedly debunked, it remains a myth. Dr. Mann told MNT:

“STIs are spread through unprotected vaginal, anal, or oral sex, and by genital contact and sharing sex toys.”

She also explained that the viruses that cause “STIs cannot survive for long outside the human body, so they generally die quickly on surfaces like toilet seats.”

Similarly, the bacteria responsible for STIs, such as chlamydia, gonorrhea, and syphilis, cannot survive outside the body’s mucous membranes for a significant amount of time. For that reason, they would not survive on a toilet seat.

6. There are no treatments for STIs

This is not true. However, although they can be treated, not all can be cured. The Medical Myths: Sexual health

Sexually transmitted infections (STIs) have been on the rise in the United States. In April 2021, the Centers for Disease Control and Prevention (CDC) announced that, in 2019, STIs had reached an all-time high for the sixth consecutive year.

In 2019, the CDC received reports of over 2.5 million cases of chlamydia, gonorrhea, and syphilis.

The World Health Organization (WHO) estimates that 1 million STIs are acquired worldwide each day.

Despite rising rates, there is still significant stigma attached to STIs. For some, this might mean individuals are less willing to speak about sexual health concerns or raise questions with a doctor.

This unwillingness to speak openly about sexual health can breed misinformation.

Of course, the internet is a convenient first port of call when someone has a question they would like to ask anonymously. Sadly, not all information that appears on the web can be trusted.

Here, Medical News Today approached some common myths associated with sexual health and asked for input from an expert:

Dr. Sue Mann, a consultant in sexual and reproductive health and a medical expert in reproductive health at Public Health England.

Increasing understanding of sexual health helps people make informed, safe decisions. Although one article cannot brush away deeply ingrained falsehoods, the more trustworthy information that is available, the better.

7. You can’t contract an STI unless you have penetrative sex

“Penetrative sex isn’t the only way someone can contract an STI. Oral sex, genital contact, and sharing sex toys are other ways that STIs can be spread,” Dr. Mann told MNT.

Beyond sexual contact, it is also possible to contract an STI from exposure to blood that contains the infectious pathogen, including through sharing needles.

8. Only gay males contract HIV

This is another longstanding and entirely incorrect assumption. According to Dr. Mann:

“Anyone, regardless of sexual orientation, race, ethnicity, age, or gender, can contract HIV. If you have HIV and don’t know it, you’re more likely to pass it on. But if you know your status, you can make sure you and your partner(s) are taking steps to stay healthy.”

Dr. Mann underscores the importance of testing, explaining that in many countries, “testing is free, easy, and confidential. You can even do a test in the comfort of your own home.”

9. You can only transmit an STI if you have symptoms

“A lot of people pass on STIs to others without even knowing,” said Dr. Mann. “STIs can be spread with symptoms or without.”

Indeed, the WHO explains that “[t]he majority of STIs have no symptoms or only mild symptoms that may not be recognized as an STI.”

“That is why,” Dr. Mann explained, “it is important to be tested regularly and to use a condom to prevent STIs as much as possible.”

To summarize, STIs are common but preventable. Regular testing and understanding how to keep yourself safe are key to remaining STI-free. explains that eight pathogens make up the vast majority of STIs.

Four of the eight are curable: the bacterial infections syphilis, gonorrhea, and chlamydia, and the parasitic infection trichomoniasis.

The remaining four are viral: hepatitis B, herpes simplex virus (HSV), HIV, and human papillomavirus (HPV). These cannot yet be cured. However, it is worth noting that HPV infections are often cleared by the body naturally.

Sexually transmitted diseases in marriage couple concept. Obstetricians and Gynecologists doctor with husband and wife consult about STD and STI, Genital Problems in Men and women.

Clean eating: What does the research say?

Food bloggers, social media influencers, and magazines commonly relied upon for nutrition information often promote so-called clean eating.

Many supporters of this concept promise benefits such as weight loss, radiant skin, and improved energy.

The fundamentals of clean eating involve choosing natural, nutrient-dense foods and avoiding processed and refined foods.

Taking a “clean” approach to eating can lead to an overall healthy lifestyle and weight management. However, some interpretations of clean eating may lead to unhealthy consequences.

In this Honest Nutrition feature, we explain what clean eating is, its potential benefits, and its risks. We will also take a look at the latest research surrounding clean eating.

What is clean eating?

Clean eating is a movement that has rapidly grown in popularity over the last decade. Despite many people committing to clean eating to get healthier and lose weight, there is no clear definition of clean eating.

Generally speaking, “clean eating” could be described as choosing foods that are natural and wholesome. This includes foods that are free from additives, preservatives, and refined and processed ingredients.

Although the term likely emerged with good intentions, the lack of clarity surrounding it leaves it open to interpretation, which may mean that some adherence could take it too far.

For example, some may choose a less restrictive approach and follow a clean eating pattern similar to those outlined in the Dietary Guidelines for Americans. This may include eating more whole fruits and vegetables, beans, and high-quality proteins while limiting processed foods.

However, others may be more restrictive and eliminate foods such as dairy, gluten, and sugar. They may also limit the number of food ingredients and avoid foods treated with antibiotics, pesticides, and growth hormones.

What do studies say?

One study published in the journal Nutrients examined perceptions of clean eating among a large, diverse sample of adolescents and emerging adults in the United States.

Although definitions varied among respondents, most of those surveyed classified clean eating as consuming whole or unprocessed foods, including raw foods, natural foods, and foods without artificial flavorings or additives.

Within those surveyed, 70.8% identified clean eating as healthy. In contrast, 18% identified both beneficial and harmful elements, meaning it could cause disordered eating patterns.

Another study published in Nutrients looked at 762 Australian women aged 17–55 years. They completed a self-report questionnaire on eating behaviors and beliefs about clean eating based on websites.

The study found that women who followed dietary advice from clean eating sites were more likely to meet dietary guidelines for fruit, meat, and meat alternatives — such as legumes, eggs, nuts, and seeds — compared to women who did not adhere to advice from the sites.

There were no statistical differences in vegetable, dairy, grains, or discretionary foods among the groups.

However, the study also found more dietary restraint among those who followed dietary advice from the sites, suggesting a potential for obsessive eating patterns. It is also uncertain if the advice given was from a credible source or followed evidence-based guidelines.

Additionally, a study published in the Journal of Eating Disorders found that clean eating is viewed favorably by U.S.-based college students, even when it is linked with emotional distress.

The potential benefits of clean eating

Focusing on a clean diet can be beneficial because it reduces sodium, sugary beverages, and ultra-processed foods.

A version of clean eating that includes a nutrient-dense diet filled with whole grains, fruits, vegetables, nuts, and healthy protein can nourish the body adequately while supporting an individual’s overall health and weight management.

While there are no scientific studies to link clean eating with health benefits, there is research to associate difficulties in eating a balanced diet, typically avoided by clean eaters, with chronic disease.

For example, one large study published in The BMJ found that eating 10% more ultra-processed foods increased the risk of coronary heart disease, cerebrovascular disease, and cardiovascular disease by at least 10%.

The ultra-processed foods in the study included reconstituted meat products, savory snacks, and frozen dinners.

Additionally, the Centers for Disease Control and Prevention (CDC) suggest that overall difficulties in following a balanced diet, including excessive consumption of sugary beverages, sodium, and processed foods, can increase the risk of chronic disease.

The potential risks of clean eating

Research suggests that clean eating may result in excessive food restriction, resulting in nutrient deficiencies and loss of social relationships. This can also lead to mental distress.

The clean eating movement’s lack of clarity surrounding dietary recommendations can result in people categorizing certain foods as “bad” and other foods as “good” without strong evidence to support this labeling.

This puts pressure on individuals to eat a certain way and can lead to a harmful obsession with healthy eating.

According to the National Eating Disorders Association, clean eating, similar to dieting, increases the risk for orthorexia nervosa (ON), the strict avoidance of foods a person perceives to be unhealthy. This may include additives, nonorganic foods, and processed foods.

The Diagnostic and Statistical Manual of Mental Disorders, 5th edition, does not recognize orthorexia as a separate eating disorder. However, many researchers believe ON should fall under the Avoidant/Restrictive Food Intake Disorder umbrella.

It is important to note there is a difference between orthorexia and dietary restrictions. While some people may avoid certain foods due to ethical, religious, or health-related reasons, those with orthorexia have obsessive thoughts about their eating habits.

Moreover, choosing grilled chicken over fried chicken or spaghetti squash over pasta does not mean clean eating has gone too far.

As long as a person’s dietary pattern includes food from all food groups, there may not be cause for concern. A healthy, balanced diet is the best approach, no matter which dietary pattern an individual follows.

Eating a healthy diet

While an obsession with clean eating is not healthy for the mind or body, it is important to eat a nutrient-dense, healthy diet. There are ways to find a healthy balance between clean eating and eating healthy without fear or restriction.

For example, a nutritious diet can include frozen and canned produce. However, when choosing canned or frozen foods, avoid added sodium, sugar, and syrups.

All processed foods are not necessarily bad, nor should they completely be eliminated. In fact, most of the foods sold in stores today are processed to some extent.

To ensure nutrient needs are met, follow evidence-based food and beverage recommendations such as those outlined in the 2020–2025 Dietary Guidelines for Americans, which states that a nutritious adult diet includes:

  • vegetables of all types and colors
  • fruits, with an emphasis on whole fruit
  • grains, with at least half being whole grains
  • diary, including low fat or fat-free milk and cheese or lactose-free versions
  • protein foods, including lean meats, poultry, eggs, seafood, nuts, seeds, soy products, beans, peas, and lentils
  • oils, including vegetable oils and oils in foods such as nuts

The guidelines also suggest limiting added sugars, saturated fat, sodium, and alcoholic beverages.

The bottom line

Since the definition of clean eating varies greatly by person, there is no research to prove it has more benefits than other dietary patterns.

While some may follow a clean eating pattern and allow for moderation leading to great success, others vulnerable to disordered eating may be at risk.

A harmful obsession with restricting certain foods or food groups can put a person at risk of malnutrition, social isolation, and overall mental distress.

It appears the existence of nonqualified individuals giving faulty advice on clean eating may further put individuals at risk for developing disordered eating patterns.

With this in mind, it’s important to always speak with a registered dietitian or qualified nutrition professional whenever questions arise about clean eating.

Organic food background and Copy space. Food photography different fruits and vegetables isolated white background. High resolution product

What can I do about an overactive bladder?

The bladder collects urine from the kidneys and expels it when it is full. If a bladder is overactive, a person cannot control when they choose to urinate, and the number of times they urinate during the day.

The condition occurs when a person’s bladder squeezes frequently or without warning. As a result, they may have to use the bathroom more frequently or urine may leak out.

The condition is usually the result of miscommunication between the brain and the bladder. The brain signals to the bladder that it is time to squeeze and empty, but the bladder isn’t full. As a result, the bladder starts to contract. This causes a strong urge to urinate.

While the condition may be common, it doesn’t have to mean a person has to live with the symptoms. Many treatments are available that can help people reduce their symptoms.

Symptoms

An overactive bladder will cause a group of symptoms, all of which can affect a person’s quality of life.

An overactive bladder may cause a number of different symptoms including urinating more than eight times a day and leaking urine when the need to urinate arises.

Examples of these symptoms include:

  • Frequency of urination: A person will urinate more than eight times a day.
  • Nocturia: A person cannot sleep through the night without waking up to urinate, usually one to two times.
  • Urinary urgency: A person will experience a sudden and uncontrollable urge to urinate.
  • Urge incontinence: A person will leak urine when they experience the urge to urinate.

A person with an overactive bladder may often feel like they can’t completely empty their bladder. They may use the restroom and then feel like they need to go again a very short time after.

Doctors divide overactive bladder into two types based on their symptoms. The first type is overactive bladder, dry. According to Cedars-Sinai Hospital, an estimated two-thirds of people with overactive bladder have the dry variety.

The second type is overactive bladder, wet. A person with this condition experiences a leaking bladder. Those with overactive bladder, dry, do not have the leaking symptoms.

Risk factors

Some patients may pass off their overactive bladder symptoms as a natural part of getting older. However, aging isn’t the only risk factor that could increase a person’s risk of experiencing an overactive bladder.

Additional risk factors include:

  • nerve damage due to a history of surgery
  • trauma to the upper body or pelvis that damages the bladder
  • having a condition known as normal pressure hydrocephalus, a cause of dementia
  • having a urinary tract infection
  • history of bladder or prostate cancer
  • history of bladder stones
  • history of conditions that affect neurological function, such as multiple sclerosis, Parkinson’s disease, or stroke
  • having gone through menopause
  • eating a diet high in foods that make the bladder more “irritable” or likely to be overactive

Examples of the types of foods that can make the bladder overactive include caffeine, alcohol, and spicy foods.

A doctor may not be able to say why a person is experiencing overactive bladder symptoms. The symptoms can seem to occur spontaneously.

When to see a doctor

Although overactive bladder isn’t thought to be a life-threatening condition, the condition can greatly affect a person’s quality of life. Many treatments are available to lessen symptoms, although doctors can’t cure the condition.

Waking up at night to use the bathroom may be a sign of an overactive bladder. If symptoms persist, it may be advised to visit a healthcare professional.

Examples of signs that a person should seek treatment for an overactive bladder include when:

  • a person cannot sleep throughout the night without waking up to go to the bathroom
  • a person uses the restroom more than eight times per day
  • a person frequently experiences sudden urges to urinate and rarely makes it to the bathroom
  • a person experiences urine leakage regularly

A person may sometimes experience these symptoms and yet not realize the degree to which they have them. There are several tools that can help assess the likelihood that the symptoms may be related to overactive bladder.

Examples of these tools include:

  • An online quiz regarding overactive bladder symptoms and severity, which is offered by the American Urological Association.
  • A “bladder diary” that a person can keep of the foods and drinks they consume plus how often they go to the bathroom and have symptoms, such as urinary urgency and incontinence.
  • Smartphone apps, which a person can download that help them keep a bladder diary by tracking how much they drink, number of trips to the restroom, and urinary leakages that occur.

Using these tools can help track the regularity of someone’s symptoms and sometimes confirm that symptoms are cause for concern.

However, a person should always see their physician if they are having bladder symptoms they are worried about.

Lifestyle remedies

Some foods and drinks are known to contribute to bladder irritation. As a result, making lifestyle changes can help a person reduce the likelihood they will experience overactive bladder symptoms.

Limiting the intake of alcohol and caffeine as well as stopping smoking may be recommended lifestyle changes.

Examples of steps to take include:

  • Limiting intake of caffeine and alcohol, which can stimulate the bladder.
  • Maintaining a healthy weight. Excess weight can place too much pressure on a person’s bladder.
  • Increasing fiber intake, which can reduce the risk of constipation and the likelihood of an overactive bladder.
  • Adjusting fluid intake so that a person doesn’t drink as much fluid in the evening. This helps to decrease the likelihood of them waking up overnight with the need to urinate.
  • Stopping smoking, as smoke can be irritating to the bladder.

Medical treatment

A doctor can recommend many treatments for overactive bladder, including medications, dietary changes, and physical therapy. Rarely, a doctor may recommend more invasive measures to treat the condition.

Doctors can prescribe a number of medications to treat an overactive bladder. These medications are usually known as antispasmodics or anticholinergics. They reduce the incidence of muscle spasms, such as the spasms in the bladder.

Examples of these medications include:

  • oxybutynin (Ditropan)
  • solfienacin (Vesicare)
  • tolterodine (Detrol)
  • trospium (Sanctura)

These medications are not without their side effects, such as dry mouth and constipation. People should always talk to their doctor regarding potential side effects.

Therapy treatments

A number of therapy treatments exist for overactive bladder. One example is bladder training. This is a method used to strengthen the muscles of the bladder by delaying voiding. Bladder training should only be done with the advice and direction of a physician.

Pelvic floor exercises and vaginal weight training are also therapy methods used to strengthen the bladder muscles. Specialists, called pelvic floor therapists, can instruct a person through these exercises.

More invasive approaches

Doctors are using injections of botulinum toxin (such as BOTOX) to reduce muscle spasms to the bladder. However, this may require further injections after a few months as the toxin wears off.

If a person’s overactive bladder does not respond to medications, therapy, or other non-invasive treatments, a doctor may recommend surgery.

One example is the implantation of a sacral nerve stimulator. This stimulator can help to control the nerve impulses to the bladder, making the muscles less overactive.

Another option is a procedure known as augmentation cytoplasty. This involves replacing portions of a person’s bladder with bowel tissue. As a result, a person’s bladder is better able to tolerate a larger volume of urine.

How to stay safe while having fun this Halloween

Halloween is a favorite fall celebration in the United States and elsewhere in the world. This year, however, the COVID-19 pandemic poses some challenges for enthusiasts of this holiday. How can you have fun and still stay safe this Halloween?

Halloween is the time of the year when many fall enthusiasts drink pumpkin spice lattes, watch favorite horror flicks, and go trick-or-treating. Every year, people around the U.S. and the world throw costume parties to celebrate this holiday, taking the opportunity to spend some quality time with friends and family.

This year, however, the COVID-19 pandemic has made celebrating Halloween more complicated, as social gatherings can facilitate the spread of SARS-CoV-2, the virus that causes the disease.

Despite this, some data suggest that many people in the U.S. have not let the pandemic deter them from their yearly Halloween preparations.

According to a Statista projection from September 2021, planned nationwide expenses for Halloween costumes amount to $3.3 billion. Estimates also indicate another $3.2 billion on Halloween decorations and $3 billion on candy.

So how can people stay safe while still enjoying this favorite fall holiday? In this Special Feature, we look at some best practices and offer tips for health, safety, and fun.

We have based our suggestions on official guidelines from the Centers for Disease Control and Prevention (CDC).

Article highlights:

Handling and offering treats

Trick-or-treating and costume parties may be the best-loved Halloween activities, but they typically involve close contact with many people from different households. This can facilitate the transmission of the coronavirus.

For example, if someone who has unknowingly contracted SARS-CoV and has not experienced any symptoms engages in regular social activities, they might be putting others at risk.

The first and most important step to protect yourself and others against COVID-19 is by getting vaccinated, and the CDC advises everyone who is able to receive a COVID-19 vaccine to do so.

The best way to stay safe this Halloween is to avoid contact with people from other households, which might mean avoiding trick-or-treating and attending parties with individuals you do not share a living space with.

However, there are some ways people who want to make the most of this fall festivity can mitigate the risks.

If children go treat-or-tricking, they must avoid coming into direct contact with other treat-or-trickers or with any adults offering them treats.

They must also try to keep at least 6 feet away from other children and adults who do not live with them and carry hand sanitizer with at least 60% alcohol content to use frequently.

Adults may want to supervise children as they use hand sanitizer and use it frequently themselves.

Additionally, always wash hands before and after handling any treats or treat bags destined for children from other households.

Children must also wash their hands thoroughly before they eat any candy received while treat-or-tricking.

Costumes and face coverings

One of the most important aspects of Halloween is, of course, wearing costumes.

Both adults and children may want to incorporate a face covering — covering the nose and mouth — into their outfit during any treat-or-tricking activities or any other activities where they might encounter people who do not form part of their household, particularly in areas where the risk of viral transmission remains high.

Healthline’s former chief medical officer, Dr. Hanh Le, advises that: “For this Halloween, amidst the COVID-19 pandemic, costumes that have a mask that covers the mouth and nose area are likely the safest, and costumes that are either disposable or washable will most likely decrease your risk of contamination in the future.”

However, a regular costume mask may not provide the necessary protection against the transmission of SARS-CoV-2, so it is best to follow CDC guidelines on choosing an appropriate mask.

You may also want to avoid wearing a cloth face covering under a costume mask, because it could get in the way of breathing freely.

Organizing or attending festivities

The safest way to celebrate this Halloween is with people from your own household.

Pumpkin carving, wearing fun costumes, and participating in traditional Halloween games can be just as fun in smaller, more intimate circles as they are in larger social gatherings.

However, for those choosing to celebrate with individuals outside their households, here is some advice on staying safe and minimizing the risk of transmitting the virus.

According to medical experts, one way of minimizing transmission during a social gathering is by holding it in an outdoor space.

Dr. Hanh Le explains why:

“When organizing Halloween get-togethers, it is advisable to plan them outdoors if possible, because [spacing] people out in an open outdoor setting is the best way to prevent person-to-person transmission. Gathering a lot of people together in small confined spaces — especially if it’s loud and people [need] to lean in to hear each other — is a recipe for disaster for widespread [SARS-CoV-2] transmission among all your guests.”

Additionally, make sure to ventilate any indoor spaces used during a holiday gathering.

Hosts who wish to organize a get-together should limit the number of guests and ensure that everyone is familiar with and willing to follow current safety guidelines.

Some hosts may choose to provide disposable face masks, hand sanitizer, and tissues to their guests if they cannot bring their own.

For extra safety, you may want to place tables and chairs to allow for physical distancing between guests from different households. When it comes to cutlery, plates, and drinking cups, using disposable ones may be the safest option.

Providing individual sachets or pots of sauce, condiments, and salad dressings is also safer than passing around one container that everyone will handle.

Some hosts may suggest that guests bring their own food and drink to avoid sharing with others. Where this is not possible, limit contact with shared items or surfaces.

If people from different households cannot keep at least 6 feet apart from others, they should wear face coverings.

Hosts and guests alike must remember to wash their hands thoroughly before handling shared items or serving or eating food.

Finally, and most importantly, if you feel unwell or think you may have had exposure to a virus, please avoid all social gatherings to keep your friends and family safe.

Safe Halloween 2020 during the Covid-19 pandemc. Halloween pumpkins with face mask

Cardiovascular health most important to reduce diabetes risk

  • A recent study investigated the effects of good cardiovascular health (CVH) in preventing type 2 diabetes (T2D) among middle-aged individuals.
  • The results suggest that middle-aged adults with a healthy heart have a reduced risk of developing T2D.
  • The study also notes that regardless of genetic predisposition, favorable CVH reduces the risk of developing T2D among middle-aged individuals.

The Centers for Disease Control and Prevention (CDC)Trusted Source estimate that more than 34 million people in the United States live with diabetes and that approximately 90–95% of these individuals have T2D.

T2D is characterized by peripheral resistance to insulin. This means that tissues such as the gut, liver, and muscles fail to respond to messages from insulin to take up glucose from the bloodstream.

It also means that the liver, which not only absorbs glucose but also produces it, does not respond to insulin to stop this production. In the early stages, the pancreas secretes additional insulin to overcome the problem, but this corrective process can eventually fail.

Insulin is a hormone that the pancreas produces. It regulates the transport of glucose into the cells of the body, where it serves as a source of energy. Blood glucose levels that remain too high for long periods can damage various organs and systems of the body.

Previous research has shown that multiple factors — both genetic and nongenetic — combine to increase a person’s risk of developing T2D. However, there is also evidence showing that people can significantly reduce this risk by adopting certain lifestyle measures.

Recently, scientists in the Netherlands embarked on a study to evaluate whether a favorable CVH score reduces the lifetime risk of developing T2D. They looked at middle-aged individuals with and without a genetic predisposition to T2D.

The results appear in the European Journal of Preventive Cardiology.

Measuring cardiovascular health

Lead study author Dr. Fariba Ahmadizar, Ph.D., a professor at the Erasmus University Medical Center in the Netherlands, explained the motivation behind the study to Medical News Today:

“Previous studies have shown that cardiovascular risk factors are largely associated with the risk for T2D.”

“However, data on the lifetime risk of incident T2D across different CVH categories was scarce,” she added. “More importantly, the impact of genetic predisposition on the lifetime risk of incident T2D associated with CVH was unknown, [so] this prompted our research into cardiovascular health, genetic predisposition, and lifetime risk of T2D.”

The new study included 5,993 participants without T2D at the start of the study. Data came from the Rotterdam Study — a prospective cohort study of a community-dwelling population aged 55 years and older in Rotterdam.

The average age of the participants was 69 years, and 58% were women. The study participants received CVH scores based on a range of parameters that the scientists measured at baseline. These included body mass index (BMI), smoking behavior, blood pressure, total cholesterol, physical activity, and diet.

The researchers summed up these parameters to create a CVH score between 0 and 12, with higher scores indicating better CVH. Based on the CVH score, they divided the participants into three groups: poor, intermediate, and ideal.

In addition, the team calculated biological CVH, which comprised blood pressure, total cholesterol, and smoking.

Each participant also received a behavioral CVH score, which took into account BMI, smoking, diet, and physical activity.

In assessing genetic predisposition to T2D, the researchers used 403 independent genetic variants associated with the disease to generate a genetic risk score. They used this score to classify the participants as having a low, intermediate, or high genetic risk.

Analyzing the study results

The researchers noted that at 55 years, the lifetime risk of developing T2D varied by CVH score:

  • ideal: 22.6%
  • intermediate: 28.3%
  • poor: 32.6%

When they accounted for genetic risk, the researchers observed that among those in the high genetic risk group, the lifetime risk of T2D was 23.5%, 33.7%, and 38.7% for the ideal, intermediate, and poor CVH groups, respectively.

In comparison with the poor and intermediate CVH groups, the ideal CVH group still had the lowest lifetime risk for T2D, although this pertained to those with an intermediate or low genetic risk.

The scientists also assessed the lifetime risk of T2D using behavioral and biological scores. They noted that for both the behavioral and biological assessments, the risk was lower in the ideal CVH groups than in the poor and intermediate groups.

These findings led the researchers to conclude that, regardless of genetic predisposition, favorable CVH health is most important in preventing T2D among middle-aged individuals.

This conclusion is similar to the sentiments that Dr. Francesca Cortese — a cardiologist in Bari University General Hospital, Italy — has shared. Dr. Cortese says:

“Through very simple tools, such as education for a correct lifestyle, we can significantly contribute to the prevention of T2D and its complications.”

Study limitations and controversy

The authors acknowledge that the study had limitations. Firstly, the team obtained individual CVH parameters at baseline, which was 20–27 years earlier. This could have led to misclassification of the participants across the different categories in the intervening time.

Secondly, some results from the genetic groups were based on relatively small sample sizes, which means that further information may be required.

Lastly, most of the participants were of European ancestry, limiting the generalizability of the results to other populations.

Also, in a potentially contentious twist, the scientists noted that participants decreased their lifetime T2D risk further by adhering to an ideal behavioral CVH rather than an ideal biological CVH. One of the components in the behavioral score was BMI.

As the authors explain, “This is controversial because it may suggest that obesity is a choice.” However, other research underlining the multifactorial nature of obesity concludes that people should consider obesity a health metric just as they would blood pressure or T2D.

Regardless of the study’s limitations and controversy, it has opened up interesting possibilities on which future studies can build.

Doctor using a stethoscope checking patient with examining, presenting results symptom and recommend treatment method, Healthcare and medical concept.

Medical Myths: 15 breast cancer misconceptions

In 2020, 685,000 people died from breast cancer, and 2.3 million received a diagnosis. It reported:

“As of the end of 2020, there were 7.8 million women alive who were diagnosed with breast cancer in the past 5 years, making it the world’s most prevalent cancer.”

Its prevalence might help explain why there is a wide range of myths attached to it. Here, we will tackle 15 of the most common misunderstandings.

To help us reach the truth, we enlisted the help of three experts:

  • Dr. Michael Zeidman: an assistant professor of breast surgery at Icahn School of Medicine at Mount Sinai in New York City.
  • Dr. Crystal Fancher: a surgical breast oncologist at the Margie Petersen Breast Center at Providence Saint John’s Health Center and assistant professor of surgery at the Saint John’s Cancer Institute in Santa Monica, CA.
  • Dr. Richard Reitherman, Ph.D.: the medical director of breast imaging at MemorialCare Breast Center at Orange Coast Medical Center in Fountain Valley, CA.

1. A breast injury can cause breast cancer

“Injury to the breast cannot cause breast cancer,” explained Dr. Zeidman, “however, it can cause changes in the breast that may mimic breast cancer on imaging.”

“This process is called ‘fat necrosis,” he continued, “and it can look like an irregular mass with jagged edges on a mammogram, much like the appearance of a new breast cancer. The best way to distinguish cancer from fat necrosis is with a needle biopsy.”

2. Underwire bras increase the risk of breast cancer

Although underwire bras do not increase breast cancer risk, Dr. Zeidman always recommends bras without a wire. He explains:

“The wire can irritate the skin under the breast, which can lead to skin breakdown. This breakdown may allow bacteria to enter the breast causing infection, [an] abscess, [or both].”

3. IVF increases the risk of breast cancer

As part of the in vitro fertilization (IVF) procedure, doctors often prescribe drugs that stimulate the ovaries to produce eggs. These drugs mimic the activity of estrogen.

Because of this, some experts wondered whether they might encourage the growth of estrogen receptor-positive breast cancer. As the name suggests, these cancer cells have estrogen receptors on their membranes.

“While there are no randomized controlled trials looking to answer this question,” explained Dr. Zeidman, “a recent meta-analysis of all observational studies over the past 30 years concluded that there is no increase in breast cancer risk for women who received ovarian stimulation drugs compared with the general population.”

4. No one in my family had breast cancer, so I won’t develop it

This is a myth that Dr. Zeidman is familiar with, he told Medical News Today: “It is very common for [people] with a new breast cancer diagnosis to tell me how shocked they are considering that they have no family history.”

“I then respond by stating that the vast majority of [people who] I see with a new breast cancer have no risk factors. In fact, the most significant risk factor for developing breast cancer is being a woman. In the United States, 1 in 8 women will develop breast cancer over their lifetime.”

As Dr. Fancher explained to us, “only about 5–10% of breast cancers are caused by a genetic mutation that is passed between family members. This means that the majority of breast cancers are sporadic or have no hereditary cause.”

Because family history is only one factor in the risk of breast cancer, screening is important. As Dr. Reitherman explained:

“The message is that every woman starting at 40 years of age should have a yearly mammogram regardless of a family history of breast cancer. Those women with a family history of breast or ovarian cancer should be evaluated by a genetics counselor by the age of 30. This group of women may need to begin breast cancer screening prior to the age of 40.”

Dr. Zeidman takes the opportunity to stress the importance of checkups:

“If you are a woman and at least 40 years old, please get your screening mammograms!”

5. Being stressed can cause breast cancer

With the ever-present stresses of modern life, it is no surprise that people are concerned about how stress might impact health.

However, as Dr. Zeidman told us, “There is absolutely no evidence to support a link between stress and breast cancer. In fact, there is evidence to support that stress does not increase breast cancer risk.”

That is not to say that stress cannot impact health at all, however. He goes on: “Part of being human is finding effective ways to deal with the stress we all will inevitably face. This can have profound health benefits both mentally and physically, but will do nothing to mitigate breast cancer risk.”

6. A healthy lifestyle eliminates breast cancer risk

“While it is true that postmenopausal women who are overweight are at an increased risk of developing breast cancer, there is nothing that a woman can do to eliminate breast cancer risk,” explained Dr. Zeidman.

“Even women who undergo bilateral mastectomy are still at risk of developing a new breast cancer.”

However, he is not suggesting anyone starts “smoking and eating fast food every day.”

More generally, he believes that “it is of the utmost importance to take care of your body because you only get one. But even world class athletes have been diagnosed with breast cancer.”

7. Breast cancer only happens to older adults

“While it is true that breast cancer risk increases as women age, and the average age of a new breast cancer diagnosis is 61 years, breast cancer can occur much earlier,” Dr. Zeidman told MNT.

“About 5% of new breast cancer diagnoses are in women under the age of 40 years. There, unfortunately, have been reports of women in their early 20s and even teens who were diagnosed. There is typically a strong family history in these young women.”

“If you have a significant lifetime breast cancer risk based on a strong family history, then you may qualify for genetic testing and early screening starting at age 25.”

Dr. Fancher explains that, although breast cancer is rarer in younger people, she encourages people to “bring any concerning findings in your breast to your doctor’s attention and follow their recommended screening guidelines.”

8. All lumps in the breast signal breast cancer

This is a myth — not all lumps in the breast are cancer. Dr. Zeidman explained that the majority

“of new breast lumps are benign. And, if you had a recent mammogram that was normal, then that percentage is likely even higher.”

However, Dr. Zeidman made it clear that any new lump should be “evaluated by a healthcare professional.”

9. Having an abortion increases the risk of breast cancer

“The reason this question comes up is because we know that breast cancer risk is directly related to estrogen exposure,” Dr. Zeidman told us, “and abortion interrupts the normal hormonal cycle of pregnancy.”

“While we can never perform a randomized controlled trial to address this question, there was a very large observational study

in Denmark that included 1.5 million women and found no link between abortion and breast cancer.”

Aside from this analysis, he explained that there have also “been several other large-scale studies that came to the same conclusion.”

10. Carrying a phone in your bra can cause cancer

According to Dr. Zeidman: “There is no evidence to support that cell phones cause cancer, period.”

“However, we do not have any long-term studies, so we may find this to be the case in the future. For now, why can’t you just put your phone in your pocket or bag?”

11. Nipple piercings increase breast cancer risk

Dr. Zeidman told MNT that this is a myth — nipple piercings do not increase breast cancer risk.

“However,” he elaborated, “they can lead to complications, such as infection, abscess, difficulty breastfeeding due to blocked ducts from scar tissue, nerve damage, keloids, cysts, and more rare but serious illness from HIV and hepatitis B and C.”

“For these reasons,” he said, “I always recommend against nipple piercing. If the deed is done, I recommend removing it.”

12. Sugar causes breast cancer

Dr. Zeidman maintains a firm stance on sugar: “Sugar should be avoided in general. It is addictive.”

“It can cause mood swings,” he continued, “It leads to spikes in insulin, which puts the body in a pro-inflammatory state. This, in turn, can lead to heart disease, diabetes, and other chronic inflammatory diseases.”

“Too much sugar can result in obesity, which is a risk factor for breast cancer.”

However, he explained that studies investigating links between sugar and breast cancer have been “mixed and inconsistent.”

While discussing sugar, it is worth busting a related myth: that sugar helps tumors grow. This myth arose because cancer cells divide rapidly and, therefore, need a lot of energy.

“While there is no concrete evidence to support this,” stated Dr. Zeidman, “I still recommend abstaining from added sugar as much as possible for overall well-being.”

13. Men do not get breast cancer

“Men have breasts… so yes, they too get breast cancer,” said Dr. Zeidman. “In fact, 1%

of all breast cancer diagnoses in the U.S. are in men.”

According to the Centers for Disease Control and Prevention (CDC), there were 2,300 new cases of male breast cancer in 2017 and 500 deaths.

“While breast cancer is more common in women than men, there are still men who get breast cancer,” explained Dr. Fancher, “It’s important for men also to be aware of any changes in their breast since there are no recommended screening guidelines for men.”

“Any lump, pain, or changes should be brought to your doctor’s attention, even if you don’t have a strong family history.”
– Dr. Fancher

Dr. Reitherman added, “Men are diagnosed with breast cancer rarely the most common risk factor is a family history of breast cancer. The BRCA2

genetic mutation markedly increased the risk of breast cancer in males who carry this gene.”

14. Mammograms cause breast cancer to spread

“This is a common misconception that I hear from my patients,” Dr. Zeidman told us.

“The thinking is that squeezing the cancer with compression during mammography, or performing a needle biopsy on the cancer, will cause the cancer to seed other parts of the breast.” However, he confirms:

“There is absolutely no evidence to support this.”

Dr. Reitherman agrees: “There is absolutely no evidence that mammograms cause breast cancer. The performance of a mammogram uses a very low dose of radiation and compression and has no documented or theoretical relationship to causing breast cancer.”

15. If there is no lump, there is no cancer

“If this were true, then we would not need mammograms,” said Dr. Zeidman. “Mammograms have been proven to save lives because they allow us to catch the cancer before it becomes palpable,”

In this context, “palpable” means that a person can feel the lump with their fingers.

“If we diagnose and treat a breast cancer while it is stage 1, survival approaches 100%. Survival drops as the stage advances. In fact, the cancer may never be palpable and still spread to other parts of the body,” Dr. Zeidman added.

According to Dr. Fancher, “Many breast cancers are found on screening mammograms and may not be felt. This is especially true for noninvasive breast cancer or ductal carcinoma in situ, which may only show up as calcifications on a screening mammogram.”

The take-home

Breast cancer is common, and while a healthy lifestyle might reduce the risk to a certain extent, vigilance is key. The earlier a doctor catches breast cancer, the higher the chances of surviving it.

Women Breast Cancer Support Charity Concept

What are the symptoms of type 2 diabetes?

Type 2 diabetes is the most common form of diabetes. It happens when blood sugar levels rise due to problems with the use or production of insulin.

It can appear at any age, but it is more likely to occur after the age of 45 years.

It affects over 30 million Americans, according to the United States Centers for Disease Control and Prevention (CDC), and it accounts for 90–95 percent of diabetes cases.

This article looks at the early signs and symptoms of type 2 diabetes, the risk factors, and potential complications.

What is type 2 diabetes?

People with type 2 diabetes do not make or use insulin correctly.

Insulin is a hormone that regulates the movement of blood glucose, or sugar, into cells, which use it as energy.

When sugar cannot enter cells, this means:

  • too much glucose collects in the blood
  • the body’s cells cannot use it for energy

A doctor may diagnose diabetes if a person’s blood sugar levels are 126 milligrams per deciliter (mg/dl) or above after fasting for 8 hours.

Symptoms

The symptoms of high blood sugar in type 2 diabetes tend to appear gradually. Not everyone with type 2 diabetes will notice symptoms in the early stages.

If a person does experience symptoms, they may notice the following:

  • Frequent urination and increased thirst: When excess glucose builds up in the bloodstream, the body will extract fluid from tissues. This can lead to excessive thirst and the need to drink and urinate more.
  • Increased hunger: In type 2 diabetes, the cells are not able to access glucose for energy. The muscles and organs will be low on energy, and the person may feel more hungry than usual.
  • Weight loss: When there is too little insulin, the body may start burning fat and muscle for energy. This causes weight loss.
  • Fatigue: When cells lack glucose, the body becomes tired. Fatigue can interfere with daily life when a person has type 2 diabetes.
  • Blurred vision: High blood glucose can cause fluid to be pulled from the lenses of the eyes, resulting in swelling, leading to temporarily blurred vision.
  • Infections and sores: It takes longer to recover from infections and sores because blood circulation is poor and there may be other nutritional deficits.

If people notice these symptoms, they should see a doctor. Diabetes can lead to a number of serious complications. The sooner a person starts to manage their glucose levels, the better chance they have of preventing complications.

Symptoms in children and teens

Type 2 diabetes is more likely to appear after the age of 45 years, but it can affect children and teens who:

  • have excess weight
  • do not do much physical activity
  • have high blood pressure
  • have a family history of type 2 diabetes
  • have an African American, Asian American, Hispanic American, or American Indian background

The following symptoms may occur:

  • weight loss, despite increased appetite and hunger
  • extreme thirst and dry mouth
  • frequent urination and urinary tract infections
  • fatigue
  • blurred vision
  • slow healing of cuts or wounds
  • numbness or tingling in hands and feet
  • itchy skin

If caregivers notice these symptoms, they should take the child to see a doctor. These are also symptoms of type 1 diabetes. Type 1 is less common but more likely to affect children and teenagers than adults. However, type 2 diabetes is becoming more common in young people than it was in the past.

Symptoms in older adults

At least 25.2 percent of people aged 65 and above have type 2 diabetes in the United States. They may have some or all the classic symptoms of type 2 diabetes.

They may also experience one or more of the following:

  • flu-like fatigue, which includes feeling lethargic and chronically weak
  • urinary tract infections
  • numbness and tingling in the hands, arms, legs, and feet due to circulation and nerve damage
  • dental problems, including infections of the mouth and red, inflamed gums