First U.S. Uterus Transplant Has Failed

(WASHINGTON) — The Cleveland Clinic says the nation’s first uterus transplant has failed.

A 26-year-old woman received the transplant there on Feb. 24 and had appeared to be recovering well, even appearing briefly at a news conference on Monday. But according to a hospital statement Wednesday, the patient experienced a sudden complication.

Doctors surgically removed the organ on Tuesday.

The hospital is exploring what went wrong, but said its clinical trial that aims to do 10 uterus transplants is continuing.

Other countries have attempted uterus transplants, with some reported failures, although Sweden has succeeded in five healthy births. The experimental treatment might eventually offer an option for women born without a uterus or who lost it to disease.

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Lead Found in Drinking Water at Newark Schools

But lead levels are nowhere near those found in Flint, Mich.

A school district in Newark, N.J. is shutting off its water fountains after testing found lead in building drinking water, according to state health officials.

Drinking water at 30 schools in Newark tested positive for levels of lead higher than the federal standard, according to a joint announcement from the New Jersey Department of Environmental Protection and the Newark Public Schools. The Environmental Protection Agency’s action level for lead, the threshold requiring additional action, is 15 parts per billion and drinking water in Newark’s schools ranged from 16-558 ppb.

Of the some 300 water samples taken from the Newark school buildings, 59 were above the EPA’s action levels for testing and no building had more than four samples above the action level. The water in Newark’s schools is nowhere near some of the high levels of lead in Flint, Michigan—one home there tested as high as 13,200 ppb.

Schools remains in session and New Jersey officials are urging parents not to worry, adding in the release: “Parents should have no concerns about students’ water and food consumption at the school while the situation is addressed.”

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Weight Loss Drug Doesn’t Deliver On Claims: Study

A recently approved weight loss drug was touted to also lower risk of heart problems. But the latest study shows that may not be the case

In September 2014, the Food and Drug Administration (FDA) approved the weight loss drug Contrave. It’s a combination of naltrexone and bupropion, an antidepressant, that together work to lower appetite. But bupropion is also linked to high blood pressure and increased heart rate, and two previous weight loss drugs with similar effects on the heart had already been removed from the market. That’s why, even though it approved the drug, the FDA required Contrave’s maker, Orexigen, to conduct a trial investigating its possible side effects.

In a study published in JAMA, scientists detail how the release of early results—before the study was completed, and before the results should have been made public—skewed the picture. Early research about Contrave suggested the drug was good for heart health, a message that made its way to the public. The problem, according to the new study, is that as the trial continued, that benefit didn’t hold up. When more data was analyzed, the heart benefit disappeared. In fact, there was almost no significant difference in heart events among the people taking the drug and those taking a placebo.
MORE: This Pill Can Trick the Body Into Losing Weight, Study Finds

“Morally and ethically we could not allow that situation to continue,” says lead author Dr. Steven Nissen, chair of cardiovascular medicine at Cleveland Clinic, of his and his colleagues’ decision to release all of the available data on the trial. “We didn’t believe that the early data accurately reflected the benefits. And sure enough it turned out not to be reliable evidence of benefit.”

Orexigen did not respond to multiple requests for comment.

The JAMA study sheds light on some of the potential issues wrought by a new approval process adopted by the FDA in recent years. The new process is intended to bring new drugs to market sooner. Normally, accumulating data about side effects like heart attacks, strokes, even death can take five years or more. Now, in order to speed drugs to patients faster, the agency can approve drugs before the full study on its side effects is complete—as long as certain criteria are met. The FDA, the drug maker and the scientists doing the trial must agree on a pre-specified threshold of safety that the drug has to meet. In this case, all parties agreed that the study would have to show that the drug didn’t more than double the number of negative heart-related outcomes.

MORE: Weight Loss Supplements Don’t Work for Most People, Study Finds

The FDA also requires that trials for approval be blinded, so that researchers and the people in the studies are not aware of whether they are taking the drug or a placebo. Of course, some people at the drug manufacturer and at the FDA are privy to—and are required to keep confidential—the results of a trial before it is final. In Contrave’s case, the early finding that the drug was linked to a 41% lower risk of heart events was shared with more than 100 people. And because the results meant it met that agreed-upon threshold for safety, the FDA approved the drug.

It also requested an entirely new study to continue evaluating the drug’s heart safety and shut down the existing trial.

Given the widespread publicity over the preliminary results that showed benefit, however, doctors began prescribing the drug and many people participating in the trial dropped out so they could get the medication from their own physicians.

Orexigen did not respond to requests from TIME and Takeda Pharmaceuticals, which is partnering with Orexigen on Contrave, did not respond to questions about the heart-related safety issues, but said in a statement: “Takeda was not involved in the decision to disclose the interim data… We remain confident in the therapeutic benefits of Contrave and its importance as a treatment option for chronic weight management as an adjunct to a reduced-calorie diet and increased physical activity.”

For now, the question of whether people taking Contrave are exposed to a higher risk of heart events is still unanswered. The only thing for certain is that it doesn’t double the risk of heart events compared to people taking placebo. Orexigen is now funding a new trial that will deliver a more definitive answer on the heart safety of its drug, which Nissen will lead. But it will take another five years, at least.

“We always hope that weight loss drugs would actually help heart disease,” says Nissen. “But it has to be done scientifically and in a rigorous fashion.”

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Meldonium Use Widespread in Elite Athletes, Researchers Say

A commission looked at the athletes from the 2015 European Games

Meldonium, the banned drug Maria Sharapova recently admitted to taking, may be used quite widely in the athletic community according to new research.

The research, performed by members of the European Olympic Committees Medical and Anti-Doping Commission and published online Tuesday, examined athletes at the 2015 European Games in Baku, which took place in June, before meldonium was banned by the World Anti-Doping Agency. They looked at three factors: athletes self-reporting of taking the drug; declarations from medical teams about what drugs they’d taken with them; and results from testing, which found 8.7% had tested positive (though only 3.5% had declared use). Of the medallists or other competition winners, 13 were taking meldonium during the games, as were athletes from 15 of the 21 participating countries.

The drug was banned effective Jan. 1, but Sharapova tested positive for it at the Australian Open later that month. She said she had not read an updated list that included the drug. Meldonium is meant to improve oxygen circulation for patients with heart conditions or vascular disease. Since it also makes users feel more active and improves motor function, it is thought to have performance-enhancing qualities.

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You Asked: How Do I Improve My Posture?

Change starts with your seat.

Experts call it “the turtle.” It’s that neck-bent, shoulders-forward, hunched-over position many people assume when sitting all day at work on their computers or texting on their phones.

Even if you begin the workday sitting ramrod straight—your chin held at an angle that would make Emily Post proud—hours of answering emails and reviewing work documents tend to pull you down into the turtle, says Dr. Alan Hedge, director of the Human Factors and Ergonomics Laboratory at Cornell University.

This cramped pose is bad for a lot of reasons, Hedge says. For one thing, it puts pressure on your neck, spine and lower back, which can lead to soreness and injury. This bent-forward posture also pinches nerves in your neck that run down to your arms and hands, which increases your risk for carpal tunnel syndrome and other painful conditions.
And unlike your mother’s warning that making a silly face might make it stay that way, that’s actually true of poor posture.

“Your head weighs 10 or 12 pounds,” says Dr. Mary Ann Wilmarth, former chief of physical therapy at Harvard University and now CEO of Back2Back Physical Therapy in Andover, Mass. Holding it straight engages lots of muscles in your neck and shoulders. But when you spend all day with your head hanging forward, then come home from the office and plop a tablet or phone into your lap, all of those support muscles languish and weaken, she explains.

It won’t happen overnight. But eventually you may find it difficult or uncomfortable to hold your head up and back over your shoulders, Wilmarth says. “You see people who have their heads bent forward, looking at the ground, even when they’re walking down the street,” she says. “This happens because we’re all conforming our bodies and our postures to accommodate our devices, rather than making our devices conform to our bodies.”

So what’s the fix? Both Wilmarth and Hedge stress the importance of a properly arranged workstation.

“The human body is not designed to stay in one position for a prolonged period,” says Dr. Benjamin Domb, an orthopedic surgeon and founder of the American Hip Institute. If you’re spending a big chunk of your day in front of a computer, even small misconfigurations will take a toll, he says. The aim is to be able to sit comfortably and work on your computer without having to crane forward. To do that, you need your monitor at the correct height. “When you’re sitting straight with your head back squarely over your neck and shoulders, the level of your eyes should be an inch or two below the top of your monitor,” Wilmarth says. At the same time, you want your forearms and hands to rest comfortably on your desktop, without having to flex or bend when you type.

People who use a laptop are probably thinking, “How the heck…” And they’re right. Unfortunately, a laptop just isn’t suitable for long stretches of work, Wilmarth says. Raise it up to the correct eye level, and you put your arms and hands in awkward positions that can lead to carpal tunnel and nerve pain. Lower it, and you’re dragging your head forward and down.

Hedge and his team at Cornell have worked out a dozen guidelines for assembling the ideal workstation setup. But both he and Domb say the key to avoiding problems is to change postures frequently. A sit-stand desk configuration or some other arrangement that allows you to switch among a number of different seated or standing positions is one of the best ways to stay out of trouble.

Stretching also helps, Wilmarth says. She recommends taking a break from your computer every hour to slowly rotate your shoulders, squeeze their blades together, stretch your neck, and tuck your chin. All of these help increase blood flow and engage those muscles you neglect when you huddle over your keyboard.

If you spend all day in a car, you want your seat in an upright position that allows your head to sit comfortably and squarely over your neck and shoulders, Wilmarth says. She also stresses the necessity of lumbar support, especially during long drives. “Most people don’t pump that lumbar support up enough,” she says. “You want to feel some pressure on your lower back.”

Finally, what should you do about your phone and other handheld devices to avoid troubles like text neck? You can try to raise those devices up to eye level, but that’s not realistic for more than a few minutes. “Use them less,” Wilmarth says. “That’s about all I can say.”

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Pediatricians Should ‘Screen’ Kids for Poverty, Says Group

It’s not a direct medical condition, but experts say poverty can have a major impact on children’s health, and doctors should be asking families about their financial situation

The American Academy of Pediatrics (AAP) is recommending that pediatricians start assessing children for their poverty status. The screening begins with a single question — asking parents whether they have difficulty making ends meet at the end of the month.

One in five U.S. children live in poverty, and the academy says that there is growing evidence that the stress of not having safe and secure housing, regular meals and a stable home environment can lead to significant health problems.

“We know children living in poverty have more chronic disease, more severe chronic disease, and have poor early brain development which can impact them when they get to school, and lead to poor academic performance,” says Dr. Benard Dreyer, president of the AAP. “Pediatricians deal on a daily basis with the intersection between poverty and health and the well being of children. They understand that they actually aren’t separate.”
MORE: Why We Don’t Talk About Rural Poverty

The new recommendation, published in the academy’s journal Pediatrics, formalizes the process and make it easier for doctors who aren’t sure about how to address the issue. The screening doesn’t have to be performed by the doctor, but can be part of a checklist that parents fill out while waiting for their well child visit, or, in larger practices, could be conducted by a quick interview with office staff or social workers.

The recommendation also provides guidelines to help pediatricians connect families who might be struggling to the proper resources, from local housing bureaus to food pantries and job listings. The hope, says Dreyer, is to help the 50% of families who currently qualify for additional support but aren’t getting it to access the resources they are entitled to. “Many pediatricians are already doing this, and helping families who have been evicted or connecting them to local food pantries. What we want to do is to give them more resources,” says Dreyer.

MORE: We Are Measuring Childhood Poverty Wrong

With the recommendation, the academy is also urging state and federal lawmakers to expand existing housing, food and health programs. “In order for kids to thrive, we recognize that the community, family and social aspects of their existence may be even more important than many of the medical things they may be dealing with,” says Dreyer. “Poverty is the most serious non communicable disease that children have — and it’s the most common.”

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WHO: Sexual Transmission of Zika More Common Than Previously Thought

WHO says pregnant women shouldn't travel to countries with ongoing Zika outbreaks

(GENEVA) — The sexual transmission of the Zika virus is more common than previously thought, the World Health Organization said Tuesday, citing reports from several countries.

After a meeting of its emergency committee on Tuesday, the U.N. health agency also said there is increasing evidence that a spike in disturbing birth defects is caused by Zika, which is mostly spread by mosquito bites.

WHO Director-General Dr. Margaret Chan said “reports and investigations in several countries strongly suggest that sexual transmission of the virus is more common than previously assumed.”

She said nine countries have now reported increasing cases of Guillain-Barre syndrome, a rare condition that can cause temporary paralysis and death, in people beyond women of child-bearing age, including children, teenagers and older adults.

“All of this news is alarming,” Chan said.

Despite the lack of definitive evidence proving that Zika causes birth defects and neurological problems, Chan said officials shouldn’t wait for definitive scientific proof before making recommendations.

“Women who are pregnant in affected countries or travel to these countries are understandably deeply worried,” Chan said.

The U.S. is investigating more than a dozen possible cases of Zika in people who may have been infected through sex.

WHO recommends pregnant women avoid travel to areas with ongoing Zika outbreaks and that if their partners travel to affected countries, they should practice safe sex or abstain from sex for the duration of their pregnancy.

The agency last month said the explosive outbreak in the Americas constitutes a global emergency.

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