Drug, Alcohol Abuse More Likely Among High School Dropouts

TUESDAY, Feb. 19 (HealthDay News) -- The link between poor academic performance and substance abuse just got stronger, with a new U.S. government report showing ties between the two.

High school seniors who dropped out of school before graduating were more likely to drink, smoke cigarettes and use marijuana and other illegal drugs, according to a new report from the U.S. Substance Abuse and Mental Health Services Administration.

The researchers said their findings should prompt communities to develop strategies to keep teens in school and prevent problems with substance abuse.

"The fact that nearly one in seven students drops out of high school has enormous public health implications for our nation," SAMHSA Administrator Pamela Hyde said in an agency news release. "Dropouts are at increased risk of substance abuse, which is particularly troubling given that they are also at greater risk of poverty, not having health insurance, and other health problems. We have to do everything we can to keep youth in school so they can go on to lead healthy, productive lives, free from substance abuse."

The study revealed high school seniors (typically between 16 and 18 years of age) who dropped out of school were more than twice as likely to be smokers, or have smoked in the past month, than students who stayed in school. The study also found that more than 31 percent of seniors who didn't receive their diploma used drugs, compared with about 18 percent of students who had finished high school.

The researchers also noted that about 27 percent of high school dropouts smoked marijuana, while close to one in every 10 abused prescription drugs. Meanwhile, only about 15 percent of those who completed high school used marijuana and just 5 percent abused prescription drugs.

Dropouts were also more likely to drink -- the study showed that nearly 42 percent of seniors who didn't finish high school drank and about a third engaged in binge drinking.

In contrast, about 35 percent of those students who stayed in school drank and only about one-quarter said they binged on alcohol.

-- Mary Elizabeth Dallas
Copyright © 2013 HealthDay. All rights reserved. SOURCE: U.S. Substance Abuse and Mental Health Administration, news release, Feb. 14, 2013

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Health Tip: Using a Food Thermometer

(HealthDay News) -- Using a food thermometer can help ensure that food is cooked properly, reducing your risk of a food-borne illness.

The U.S. Food Safety and Inspection Service offers these suggestions:

Test food with an instant-read thermometer toward the end of its cooking time, but before you expect it to be fully cooked. Place the thermometer in the thickest area of the food, and make sure it is not touching any bone, gristle or fat.Use the U.S. Department of Agriculture's recommended guidelines to make sure your food is cooked to a safe temperature.Always use hot water and soap to wash your thermometer before and after each use.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

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As Economy Rebounds, More Folks Try Turning Back Hands of Time

TUESDAY, Feb. 19 (HealthDay News) -- Evidence of the economic upturn can be found in more than housing starts and auto sales: A new report shows that the number of cosmetic procedures grew 5 percent in 2012.

Botox injections and other types of minimally invasive treatments led the way as more people opted for these types of facial rejuvenation procedures, while the number who chose to "go under the knife" remained relatively stable, the findings revealed.

In total, there were 14.6 million minimally invasive and surgical plastic surgery procedures in 2012. There were also 5.6 million reconstructive plastic surgery procedures last year, an increase of 1 percent from 2011, according to annual statistics from the American Society of Plastic Surgeons (ASPS).

Minimally invasive procedures increased 6 percent, with more than 13 million procedures in 2012. The top five were:

There were nearly 1.6 million cosmetic surgical procedures in 2012, a 2 percent decrease from 2011. The top five surgical procedures last year were:

Breast augmentation (286,000 procedures, down 7 percent)Nose reshaping (243,000 procedures, no change)Liposuction (202,000 procedures, down 1 percent)Eyelid surgery (204,000 procedures, up 4 percent)Facelift (126,000 procedures, up 6 percent).

While cosmetic breast surgeries among women decreased 2 percent between 2011 and 2012, male breast reduction surgeries increased 5 percent, to nearly 21,000 in 2012, the report said.

"For the third consecutive year, the overall growth in cosmetic surgery continues to be driven by a significant rise in minimally invasive procedures, while surgical procedures remain relatively stable. We are aware, however, that patients who begin with less-invasive treatments with a plastic surgeon may opt for more invasive, surgical procedures once required," Dr. Gregory Evans, ASPS president, said in a society news release.

Reconstructive plastic surgery increased by 1 percent in 2012 and the top five procedures were:

Tumor removal (4.2 million, up 1 percent)Laceration repair (291,000, down 4 percent)Maxillofacial surgery (209,000, up 7 percent)Scar revision (171,000, down 2 percent)Hand surgery (123,000, up 3 percent).

Reconstructive breast reduction increased 8 percent, with 68,000 procedures performed in 2012, the report noted.

"Although breast reduction has many physical and psychological benefits for women with overly large breasts, obstacles remain in acquiring insurance coverage," Evans said. "It's promising to see gains in this and other beneficial, medically necessary surgeries."

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: American Society of Plastic Surgeons, news release, Feb. 19, 2012

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Health Tip: Eating for Healthier Teeth

(HealthDay News) -- Most parents know the importance of brushing and flossing, but what you eat also is crucial to maintaining good dental health.

The Academy of Nutrition and Dietetics offers this advice to help preserve a child's dental health:

Kids should eat foods rich in calcium, such as dairy foods, dark and leafy green vegetables, and almonds.They should also eat phosphorous-rich foods, such as eggs, fish and lean meats.And they should eat vitamin C-rich foods, such as citrus fruits, potatoes, tomatoes, spinach and broccoli.

-- Diana Kohnle
Copyright © 2013 HealthDay. All rights reserved.

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Tips to Avoid Return Trip to the Hospital

TUESDAY, Feb. 19 (HealthDay News) --More than 1 million Americans end up back in the hospital just weeks after they're discharged, and many of those readmissions are preventable, according to an expert from Columbia University School of Nursing in New York City.

Patients can do their part to avoid return trips to the hospital by simply paying attention and speaking up when it's time to go home, advised Mary Donovan-Johnson, program director of the Acute Care Nurse Practitioner Program.

"Discharges are often rushed and patients may be overwhelmed during this stressful time," Donovan-Johnson said in a Columbia news release. "If you don't understand something a medical provider said, don't be afraid to ask your doctor or nurse to repeat the instructions... Ask the person accompanying you home to listen and take notes when instructions are being explained by your medical team."

Other steps you can take to reduce the odds of readmission after discharge include:

Get all discharge instructions and information in writing, including directions for wound care, medications and food restrictions. Keep these instructions in a place where they are easily accessed. After discharge, follow through on your treatment by filling prescriptions and taking medications as directed. If you have questions about your medications or other instructions, call your doctor. Schedule follow-up visits with your doctor and blood tests or other procedures as directed, and keep those appointments.

"Ideally, the same team of doctors and nurses who worked with the patient would discharge them since they know the protocol in their medications, wound care, and how to set up the safest environment at home for them. But unfortunately, that doesn't always happen," Donovan-Johnson said. "So the patient needs to be vigilant about being an active participant in their recovery."

-- Mary Elizabeth Dallas
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Columbia University School of Nursing, news release, Feb. 18, 2013

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Human Teeth Healthier in the Stone Age Than Today: Study

TUESDAY, Feb. 19 (HealthDay News) -- Something to think about next time you're in the dentist's chair: Ancient humans had healthier teeth than people do today, researchers say.

This decline in oral health over the past 7,500 years is the result of changes in oral bacteria due to human evolution and industrialization, the study authors said. These changes have led to chronic oral and other health problems, according to the report published Feb. 18 in Nature Genetics.

"The composition of oral bacteria changed markedly with the introduction of farming, and again around 150 years ago," explained study leader Alan Cooper, a professor and director of the University of Adelaide's Australian Centre for Ancient DNA, in a center news release. "With the introduction of processed sugar and flour in the Industrial Revolution, we can see a dramatically decreased diversity in our oral bacteria, allowing domination by caries [cavities]-causing strains. The modern mouth basically exists in a permanent disease state."

The international team of researchers examined DNA that had been preserved in tartar -- calcified dental plaque -- found on 34 prehistoric northern European human skeletons. They used these samples to analyze how oral bacteria changed from the Stone Age to the last hunter-gatherers, medieval times and later with the introduction of food manufacturing in the Industrial Revolution.

The evolution of human behavior and diet have had a negative impact on oral health, the investigators said.

"This is the first record of how our evolution over the last 7,500 years has impacted the bacteria we carry with us, and the important health consequences," Cooper said. "Oral bacteria in modern man are markedly less diverse than historic populations and this is thought to contribute to chronic oral and other disease in post-industrial lifestyles," he pointed out.

Study lead author Christina Adler, now at the University of Sydney, added that "dental plaque represents the only easily accessible source of preserved human bacteria." And, she said in the news release, "Genetic analysis of plaque can create a powerful new record of dietary impacts, health changes and oral pathogen genomic evolution, deep into the past."

The researchers said their research is being expanded to include other periods in time, other areas of the world and other species, such as Neanderthals.

-- Mary Elizabeth Dallas
Copyright © 2013 HealthDay. All rights reserved. SOURCE: Australian Centre for Ancient DNA, news release, Feb. 18, 2013

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Sharp Rise Seen in Robotically Assisted Hysterectomies

By Serena Gordon
HealthDay Reporter

TUESDAY, Feb. 19 (HealthDay News) -- Nearly 10 percent of hysterectomies in the United States are performed robotically, say researchers who found the "robo" procedures jumped dramatically between 2007 and 2010.

But they question whether robotic surgery is preferable to another minimally invasive procedure, laparoscopic surgery, for women having their uterus removed for non-cancerous conditions. While the two procedures have similar complication rates, the robotically assisted hysterectomy costs roughly $2,200 more than the laparoscopic procedure, according to the new study.

"The robotically assisted procedure was substantially more expensive," said the study's lead author, Dr. Jason Wright, an assistant professor of obstetrics and gynecology at Columbia University College of Physicians and Surgeons, in New York City.

Wright said more work is needed to determine which women would benefit from robotic hysterectomy.

"This data also raises a lot of questions about surgical innovations and the need to find ways to better study them before they diffuse into practice," he added.

Results of the study are published in the Feb. 20 issue of the Journal of the American Medical Association.

Hysterectomy is a common treatment for non-cancerous gynecological conditions, such as fibroids, endometriosis and excessive bleeding. As many as one in nine U.S. women will undergo such a procedure, according to the study.

Different surgical techniques exist for performing a hysterectomy. One choice is traditional open surgery, where a surgeon removes the uterus through a 5- to 7-inch opening in the abdomen. Another is vaginal hysterectomy -- removal of the uterus through the vaginal opening. Laparoscopy is done with special tools that allow surgeons to perform the surgery using only small incisions. Robotically assisted surgery is similar to laparoscopic surgery, but the surgeon uses a robotic device instead of a laparoscope to do the procedure.

Dr. Michael Zinner, chief of surgery at Brigham and Women's Hospital in Boston, said there are advantages to robotically assisted surgery in certain situations.

"The robotic device is easy to learn," Zinner said. "The wrist on the machine gives you [greater flexibility] unlike a straight laparoscope that's more like a chopstick. If the surgeon has any slight tremor, the machine evens it out," he said. In cases such as prostate surgery, where the surgery must take place in a very confined space and there's a significant risk of nerve damage, the delicate, articulating robotic device can be ideal, he said.

But for larger areas of the body, a laparoscope generally works just as well. "Nobody talks about using robotic surgery for removing the gallbladder," noted Zinner, because it would be more expensive without providing an additional benefit. Zinner co-wrote an editorial in the same issue of the journal.

In the current study, Wright and his colleagues reviewed data from more than 264,000 women who had a hysterectomy for a non-cancerous condition.

Robotically assisted hysterectomies were performed 0.5 percent of the time in 2007. By 2010, that number had jumped to 9.5 percent. The rate of laparoscopic surgery also increased during this time period, from 24.3 percent to 30.5 percent, according to the study.

At hospitals that introduced robotically assisted hysterectomy, its use quickly rose, the study found. But at hospitals without the robotic option, use of laparoscopic hysterectomy increased during the same time period. Overall, abdominal and vaginal hysterectomies declined.

Robotically assisted hysterectomy was less likely to lead to a hospital stay of two days or more compared to laparoscopic surgery, but the two procedures were similar in all other measured complications.

Where the two procedures differed most significantly was in cost, with $6,679 the median fee for a laparoscopic hysterectomy versus $8,868 for the robotically assisted procedure.

Joel Weissman, deputy director and chief scientific officer at the Center for Surgery and Public Health at Brigham and Women's Hospital and co-author of the editorial, said the robotic machine costs about $1.5 million and requires extra personnel.

"It's a little bit unclear who's paying the extra cost," he said. "It seems like at this point in time, insurers are paying the same whether the surgery is robotically assisted or not. But hospitals have to somehow pay those extra costs."

If you're considering a robotically assisted procedure, Zinner and Weissman advised talking with your doctor about which procedure will deliver better results. If two procedures are similarly effective, they suggested comparing costs.

In the case of hysterectomy, because robotically assisted surgery and laparoscopic surgery have similar results but significantly different costs, Zinner said he'd like to see more surgeons training in the laparoscopic procedure.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: Jason Wright, M.D., Levine Family Assistant Professor of Women's Health, Columbia University College of Physicians and Surgeons, New York City; Joel Weissman, Ph.D., deputy director and chief scientific officer, Center for Surgery and Public Health, and associate professor of health policy, Brigham and Women's Hospital, Boston; Michael Zinner, M.D., chief of surgery, Brigham and Women's Hospital, and clinical director, Dana Farber-Brigham and Women's Cancer Center, Boston; Feb. 20, 2013, Journal of the American Medical Association

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