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Men's hearts age differently from women's

Here is one more way men and women are different: research published online Oct. 20, 2015 in Radiology found that male and female hearts do not age the same way.

For the study, researchers reviewed MRI heart scans performed on almost 3,000 older adults, ages 54 to 94, without existing heart disease. (Scans were given 10 years apart.) The scans showed that in both sexes, the main heart chamber鈥攖he left ventricle, which fills with and then forces out blood鈥攇ets smaller with time. As a result, less blood enters the heart, and less gets pumped out to the rest of the body.

How can I tell if I'm sleeping enough?

Ask the doctor

Q: I have always had difficulty sleeping. Since I have taken to heart the advice for good sleep habits, I think I'm sleeping better, but I'm not sure. I'm in bed about 8.5 hours, but am often restless and get up to go to the bathroom a couple of times during the night. Is there a way to compute how much sleep I'm actually getting?

A: Adequate sleep is an important part of health. While the exact amount needed to maximize health and wellness is not totally clear, many experts recommend around seven to nine hours per night. Adequate sleep is associated with memory, improved mood, better weight control, improved diabetes control, greater resistance to colds, and fewer accidents.

Breast cancer: The good news

Personalizing breast cancer diagnosis and treatment has resulted in therapies that are more effective and less toxic than in the past.


Image: Thinkstock

The federal government's "Cancer Moonshot," with the expressed goal of curing cancer, is getting a lot of press lately. While the initiative's stated goal may be overly ambitious because cancer is actually 200 or more individual diseases, it promises to increase research funding and speed the availability of new treatments.

Amid the excitement, it's easy to overlook the fact that there has already been great progress in treating many cancers. Patients are enduring fewer side effects and living longer. Breast cancer is a prime example. "There's no question that breast cancer treatment is improving," says Dr. Ann Partridge, senior physician at the Susan F. Smith Center for Women's Cancers at Harvard-affiliated Dana-Farber Cancer Institute.

Atrial fibrillation carries a greater risk of stroke and death for women

Men are more likely than women to develop atrial fibrillation (afib)鈥攁 rapid, erratic beat in which the heart's upper chamber doesn't contract forcefully, allowing blood to pool and increasing the risk of clotting. However, some鈥攂ut not all鈥攕tudies have indicated that afib poses a greater stroke risk in women than in men. To settle the question, an international team of researchers looked at 30 studies with 4.4 million participants. They found that compared with men who have afib, women with afib have a 12% higher risk of death from all causes and almost double the risk of having a stroke or dying from one. The results were published online Jan. 20, 2016, by the journal BMJ.

Women notoriously neglect the symptoms of afib鈥攆eeling weak, breathless, or unusually fatigued. If you have afib symptoms, get medical attention, even if you think it's only a virus. There are several successful treatments for afib as well as for preventing stroke in women who have afib.

Getting out of the chair boosts metabolism in postmenopausal women

There's mounting evidence that sitting for long periods can have health risks. However, little is known about how the effects of sitting can be countered by standing occasionally. A team of researchers from the United Kingdom and Australia designed a two-day study involving 22 overweight or obese postmenopausal women with high blood sugar who were at risk for diabetes. On the first day, the women were assigned to one of three groups. One group sat for 7.5 hours straight. The other two sat over a 7.5-hour period, but one group was told to stand in place for five minutes every half-hour, and the other was told to walk for five minutes every half-hour. The second day, all the groups sat for 7.5 hours straight.

On both days, the researchers tested each participant's blood levels of glucose, insulin, fatty acids, and triglycerides鈥攁ll indicators of metabolism. They found that both walking and standing reduced glucose, insulin, and fatty acids鈥攕igns of a higher metabolic rate鈥攊n women who either stood or walked compared with those who sat the entire time. Moreover, in the two active groups, some of the beneficial effects persisted into the next day, when everyone sat for the entire session.

How long should you take a bisphosphonate for osteoporosis?

Millions of postmenopausal women are taking a bisphosphonate like oral alendronate (Fosamax) or intravenous (IV) zoledronic acid (Reclast) to increase bone density. But because long-term use of these drugs has been associated with an increased risk of bone death in the jaw and unusual thighbone fractures, experts have debated how long women should stay on the drugs to minimize the risk of hip or vertebral fractures without raising their risk for these rare but serious complications.

After considering major randomized controlled clinical trials, a task force of the American Society for Bone and Mineral Research has released guidelines on the optimal duration of bisphosphonate therapy for osteoporosis. The guidelines, published in the January 2016 issue of the Journal of Bone and Mineral Research, recommend reassessing a woman's fracture risk after five years of oral bisphosphonates or three years of IV therapy. They advise that women whose risk is still high should continue to take oral bisphosphonates for up to 10 years or IV therapy for up to six years. However, fracture risk should be reassessed every two to three years during extended therapy.

New depression screening guidelines benefit pregnant women and new moms鈥揳nd everyone

The U.S. Preventive Services Task Force has recently updated their guidelines on depression screening to include pregnant and postpartum women, which will be a great help to the many new moms who experience mood changes that go beyond the “baby blues.” The updated guidelines offer other benefits, too, that help improve everyone’s access to mental health care 鈥� especially those who can’t currently afford it.

Zika, pregnancy, and winter travel: Many unknowns, and a cautious message

If you’re planning an escape from the dreary winter weather, and you’re pregnant or trying to get pregnant, you may want to plan your destination carefully. There’s still a lot we don’t know about Zika virus 鈥� which is now widespread in several favorite tropical destinations, such as the Caribbean 鈥� and its potential pregnancy-related complications. Until we know more, it’s better to be safe and follow the precautions we’ve listed here.

Should you use a retail health clinic?

They're convenient and affordable, but they don't replace a relationship with a primary care physician.

Walk into a drugstore, supermarket, or "big box" store these days, and you'll find more than prescriptions, food, and household goods. Many now feature health clinics. They're part of the big trend of making health care more convenient. "Twenty years ago you had to go to an emergency department if you got sick and needed immediate care. Now we have an explosion of options, such as retail health clinics," says Dr. Ateev Mehrotra, a researcher on the topic and an associate professor of health care policy at Harvard Medical School.

The clinics

Retail health clinics began showing up about 15 years ago. Today, there are about 2,000 clinics across the United States, mostly in large retail chain settings. A typical clinic is open from 7 a.m. to 7 p.m., seven days a week, and is staffed by a nurse practitioner or a physician assistant. Clinics offer all kinds of health services鈥攅verything from treating minor illness like a cold, pinkeye, or a urinary tract infection to providing physicals, health screenings, lab work, smoking cessation help, and vaccinations.

The health benefits and risks of pet ownership

They're cute, cuddly, and loving, but dogs and cats aren't always appropriate for older adults.

There's a reason dogs are dubbed man's best friend. Dogs鈥攁nd cats, too鈥攎ake wonderful companions and provide many emotional and physical benefits. "I'm a believer in the beneficial effects of having a pet, and I'm impressed with the ability of dogs in particular to form bonds with human beings. I think the science is starting to support their special ability to do that," says psychiatrist Dr. Greg Fricchione, director of the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine. However, there are a number of considerations to mull over before adding a pet to your household.

Benefits

The most obvious benefits of pet ownership are love and companionship. "We do best medically and emotionally when we feel securely attached to another, because we're mammals and that's the way we've evolved," says Dr. Fricchione. He points out that we feel especially secure with dogs and cats because of the unconditional love they provide. "No matter what you do or say, your dog or cat accepts you and is attached to you," says Dr. Fricchione. Taking care of a dog or a cat can provide a sense of purpose and a feeling of validation when you wake up or come home and there's someone who's happy to see you.

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