And the Circumcision Debate Continues - More UTIs in Uncircumcised Boys?

It's difficult to think of many things more polarizing in the parenting world as breast feeding versus bottle feeding, cloth diapers versus disposable diapers, and stay-at-home moms versus work-outside-the-home moms, but there is: circumcision. Parents who aren't sure what to do are bombarded with "It's horrible!" and "You must do it!" - messages from both sides of the circumcision spectrum. What are parents to do? Well, if they decide to research medical issues involved in circumcision, they may not come out any further ahead because the debate is raging on over there too.

The latest study to enter the fray of to circumcise or not to circumcise is one just published today in the CMAJ (Canadian Medical Association Journal) regarding urinary tract infections (UTIs) and circumcisions. Researchers from the Montreal Children's Hospital looked at boys who developed UTIs, whether they were circumcised and if uncircumcised, if the meatus (where the urethra opens to the outside of the penis) was visible. It has been thought that uncircumcised boys with clearly visible urethras may not be as vulnerable to developing a UTI as those whose urethras could not be seen. Therefore, going along that train of thought, if the boy was not circumcised but had a visible urethra, his risk of developing a UTI was lower.

To see if this was true, the researchers assessed 393 boys who had visited the MCH emergency department with symptoms of a possible UTI. Eighty-four of the boys were circumcised. Of the remaining who were uncircumcised, 40 had a visible urethral meatus and 269 had only partial visible or nonvisible meatus. In other words, it didn't matter if the urethra was visible or not - more boys who had not been circumcised had infections than those who were not.

The researchers concluded, "We suggest that clinicians should consider circumcision status alone, not the degree of urethral visibility when stratifying risk for boys presenting to the emergency department with symptoms or signs suggesting a urinary tract infection."

UTIs are serious infections that should be treated. Untreated, the infection may go up into the kidneys. UTIs can also develop into a life-threatening illness called sepsis (Sepsis and Urinary Tract Infections).

Persistent Dizziness May Respond to a Few Simple Exercises

When we were kids, many of us had fun spinning on merry-go-rounds or just going in circles to get as dizzy as possible. As we got older, getting dizzy may have been more due to drinking a bit too much alcohol than anything else. But those are episodes where the dizziness faded away when the cause ended or was taken away and that's a good thing, because continuing dizziness - vertigo - is not only uncomfortable, it is very disruptive, and could cause serious injuries if people fall.

It isn't known how many adults experience dizziness, but it is common, particularly among older people. Dizziness can make you feel nauseous and can be isolating. After all, how can you go out if your world is spinning? Some people with vertigo must quit work, stop social activities - many can't even enjoy life in their home because reading, watching television, even cooking or baking, can become impossible to do. But what causes vertigo?

What causes vertigo?

Most often, vertigo is caused by a problem in your ear. There is fluid in your inner ear that acts like a level. When you move your head, the fluid moves and your brain gets information about your head's position. This is how your brain knows if you're on your side or even upside down. If this area of your ear is affected, it can cause dizziness.

Certain parts of your brain also control balance. These are the cerebellum and brain stem. Damage to these parts can throw you off balance.

Treatment of ear-related vertigo

Treating or managing vertigo will depend on what is causing it. If it is caused by labyrinthitis, irritation and inflammation of the inner ear, which is very common, it has to be determined why you have labyrinthitis in the first place. Do you have an inner ear infection? Is it from allergies? Is it a side effect from a medication? Once the cause has been determined, your doctor will suggest a treatment.

If your vertigo is caused by benign paroxysmal positional vertigo (BPPV) or Meniere's disease, your doctor may recommend something called vestibular rehabilitation exercises. A recent study, presented yesterday at the international WONCA conference yesterday (World Organization of Family Doctors), found that simple exercises are effective in helping reduce dizziness in many patients. The study was also published in the British Medical Journal.

Lucy Yardly, a professor at the University of Southampton, found that exercises that involved turning your head right to left and back again, or nodding your head up and down, "lead to reduced dizziness within a matter of weeks of starting, and the benefits lasted for at least a year."

Professor Yardly's study involved 300 patients who were randomly assigned to one of three groups: one received routine medical care, which may include medications to reduce symptoms; the second received a booklet based on exercises only; and the third group received the booklet, as well as telephone support from a healthcare professional.

The researchers found that the two groups that had the exercise book felt "much better" than those who received routine medical care. Only 5% of patients in the exercise book groups reported feeling worse at the end of the study, compared with 15% of those who felt worse after only receiving medical care.

So, if you go to the doctor about recurring dizziness and he or she recommends exercises to help - be sure to do them. They may be more helpful than you think they may.

Parental Drug Use Ups Foster Care Use - Duh Study?

A Duh Study is one that tells us something that is common sense - that we likely don't need to spend money and resources on to officially prove. This study, "Child Abuse and Foster Care Admissions Increase When Parents Use Methamphetamines," may be a candidate.

According to the study that was undertaken by researchers at Baylor University, "Methamphetamine abuse leads to an increase in child abuse and neglect, which causes an increase in foster-care admission." Of course it does. Addicts don't and can't think about their children and their needs. Addicts think and try to meet their own needs; this is what is most important for them, physically and psychologically.

Even today, in 2012, there is debate as to whether people believe addiction is a disease. To many, addiction isn't a disease. They may use the examples of Type 1 diabetes or cancer - where sheer will power could never cure them, making it so they no longer need to take insulin or chemotherapy. To others, this is nonsense and addiction is no less a disease than is asthma or multiple sclerosis. It needs to be diagnosed, treated, and managed - and that it takes much more than just will power to do this.

Regardless of how you feel about addiction, it can't be denied that it affects not just the addict, but the people around him or her, particularly their children. A child of an addict lives in a world unlike any other and must be cared for. But do we have the resources to do that? We need to.

A child of an addict who isn't cared for will not receive the medical, nutritional, social, and educational nurturing that he needs. Without these, his ability to learn how to function in our society is severely compromised, perhaps leading him directly to the lifestyle he knows and grew up with, perpetuating the cycle.

Exercise Your Hot Flashes Away?

It's the M word. Some women hate it, some women welcome it: menopause. However you feel about it, if you're a woman, it's going to happen to you at some point.

It's quite interesting to hear women talk about their experiences with perimenopause, the time when the menstrual flow is shutting down, and menopause, the period after menstruation has stopped. Some women breeze through this time without any noticeable discomfort, while others are hit with everything that their body can throw at them.

Among the most common complaints from women "of a certain age" are the hot flashes, or hot flushes. Again, not all women find them uncomfortable, but for many - these hot flashes are not only uncomfortable, they are nasty.

But what exactly is a hot flash? No one knows quite for sure, but the easiest way to explain it is that your body's thermostat has gone haywire for a while. One theory is that a woman's dropping level of estrogen may throw off the hypothalmus, the body's temperature regulator.

I love this definition of a hot flash, from WebMD: "A hot flash -- sometimes called a hot flush -- is a momentary sensation of heat that may be accompanied by a red, flushed face and sweating. The cause of hot flashes is not known, but may be related to changes in circulation."

Really? Momentary? Tell that to some women who minding their own business, doing their jobs, perhaps sitting in a board room meeting or driving a bus, and they are suddenly overwhelmed with a hot flash that just won't stop.

What to do?

So, if you do have hot flashes, what can you do to lessen their frequency and/or severity. Is there anything? The good news is that there are some things that help some women. The bad news is you may have to do a lot of trial and error to find something that works for you.

Here are some of the more common suggestions:

- Limit your alcohol intake and watch if certain alcoholic beverages trigger more hot flashes. Some Women find red wine is a big trigger, but they can drink white wine with few resulting hot flashes;

- Don't smoke; 

- Avoid meals that are heavy or spicy. Eat smaller meals throughout the day rather than three large ones;

- Drink cold drinks instead of hot drinks;

- Exercise;

- Dress in layers, preferably cotton fabrics.

That last point brings up a press release issued today by Penn State researchers, who undertook a study looking at menopause and exercise. The study was supported by the National Institute of Child Health and Human Development.

According to the researchers, "menopausal women who exercise may experience fewer hot flashes in the 24 hours following physical activity." They came to this conclusion after studying 92 menopausal women who were between 40 and 59 years old. They were not on any hormone therapy at the time of the study.

Over 15 days, the women wore accelerometers that monitored how much physical activity they performed and a monitor that measured the moisture on their skin. The women also recorded if and when they experienced hot flashes throughout the day.

Since exercise tends to make people feel warmer, it wouldn't be odd to suspect that exercise may make hot flashes worse, but the researchers found that this didn't happen. In fact, on average, the women in the study who exercised the most experienced fewer hot flashes after afterward. "The women who were classified as overweight, having a lower level of fitness, or were experiencing more frequent or more intense hot flashes,  noticed the smallest reduction in symptoms," the press release said. 

"For women with mild to moderate hot flashes, there is  no reason to avoid physical activity for the fear of making symptoms worse," said Steriani Elavsky, assistant professor of kinesiology at Penn State. "In fact, physical activity may be helpful, and is certainly the best way to maximize health as women age."

Some hot flash good news?

As uncomfortable as hot flashes may be, they may be good for something. According to a study published last year, researchers found - among the estimated 60,000 women they studied - that women who experienced hot flashes and night sweats while going into menopause had an 11 percent lower risk of developing heart disease later on in life. In addition, they had an eight percent lower chance of dying over the 10 years following the study. You can read more about it in this Time magazine article: The Hot Flashes of Menopause May Protect Women's Hearts, by Alice Park.

Do you have hot flashes? Do they bother you? How do you manage them?