The service at Belfast City Hospital aims to identify and support those at risk of heart problems.

If you get gonorrhoea, you might not be able to get rid of it, world health experts warn.

More than 14,000 women attending clinics in 2016 had become pregnant despite using contraception.

Survey of mental health leaders suggests rising demand and staff shortages are major problems.

Internet-based messaging apps are a key way for doctors to send patient information, the BBC has learned.

South Africans are increasingly becoming obese, with two-thirds of women and a third of men being overweight, according to a previous Health24 article.

Did you know that eating an extra 50 calories a day can sneak on more than two kilograms a year? But trimming the same number calories will put the trend in reverse.

Cutting out 50 (or more) calories a day isn’t as hard as you think, says registered dietitian Rachel Begun.

Here are seven ways you can cut down on your calorie-intake throughout the day:

1. Start with your daily coffee. Skip the sugar, and flavour your java with vanilla extract or cinnamon instead.

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2. Replace that pat of butter on your morning toast with a teaspoon of jam.

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3. At lunch, make tuna or salmon salad with low-fat vinaigrette instead of full-fat mayo.

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4. When ordering a salad, ask for a non-creamy dressing on the side, but resist the temptation to use it all – about half is all you really need.

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5. Downsize that glass of wine before dinner from 150ml to 100ml. Add a splash of seltzer to extend it.

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6. Cooking with olive or sesame oil is healthy, but go easy – every tablespoon has 120 calories. Measure out a half-tablespoon instead so that you won’t use too much of a good thing. Save even more by switching to an oil spritzer instead of pouring from the bottle, Begun says.

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7. At 30 calories a tablespoon, barbecue sauce adds unwanted calories to meat. Instead, grill or roast meats with fresh herbs and spices for flavour. Use fat-free (and low-salt) broth when you need to baste.

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Tip: And don’t forget to drink plenty of water. Water keeps you feeling full and your metabolism running in tip-top shape.

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Most of us have chicken pox as children and assume that’s the end of it. But many years later the disease can become reactivated as herpes zoster or shingles, caused by the varicella zoster virus (VZV).   

Shingles is also called herpes “zoster”, meaning “girdle” or “belt”, which describes the appearance of the rash. Small blisters, resembling chickenpox, appear on the “girdle line”. Eventually they fill with clear fluid, break and crust, before finally disappearing.

South Korean researchers recently found that besides the uncomfortable rash on the girdle line, those affected had an increased risk of cardiovascular problems such as heart attack and stroke.

Health24 previously reported that when VZV first enters the body, as it does in the case of 90% of all children, it leads to chickenpox. But the body is never totally rid of VZV, which belongs to a family of viruses known as the “herpes viruses” that become latent in their host after causing the first infection.

Ballooning risk for heart problems

Their study found that people with shingles saw an overall 41% higher risk of cardiovascular events, such as heart attack or stroke, when compared to an age-matched control group that did not develop shingles.

The risk of stroke was 35% higher and heart attack 59% higher, said the report published in the Journal of the American College of Cardiology.

The riskiest period was the first year after infection, and the dangers appeared to decline after that.

Researchers also found the risk for stroke was highest in those under 40 years old.

The study was based on a medical database of 519 880 patients whose records were tracked from 2003–2013.

Link still unclear

Researchers are unclear why shingles would boost the risk of cardiovascular problems, and said more study is needed.

“While these findings require further study into the mechanism that causes shingles patients to have an increased risk of heart attack and stroke, it is important that physicians treating these patients make them aware of their increased risk,” said study author Sung-Han Kim, a physician in the department of infectious diseases at Asan Medical Center in Seoul.

Prevalence of shingles

Nearly one in three people in the United States will develop shingles in their lifetime, according to the US Centers for Disease Control and Prevention.

The infection, which may cause blisters, rash and shooting pain, can affect anyone who has had chickenpox.

Shingles can be spread through direct contact with the rash, but not by air.

A vaccine against shingles is available and is recommended for people 60 and older.

Read more:

Approximately 90% of adults are at risk for shingles

Shingles vaccine is safe

People with shingles have a higher stroke risk

People with autism have difficulties with behaviour, communication, social interaction and dealing with sensory input. However, not everyone on the “autism spectrum” displays all these characteristics and to the same degree.

Parents of autistic children have problems with the fact that their kids rarely look people in the eye. Now, new research is suggesting reasons for this phenomenon.

“Contrary to what has been thought, the apparent lack of interpersonal interest among people with autism is not due to a lack of concern,” said study co-author Dr Nouchine Hadjikhani.

“Rather, our results show that this behaviour is a way to decrease an unpleasant excessive arousal stemming from overactivation in a particular part of the brain,” she said.

Hadjikhani is director of neurolimbic research at Massachusetts General Hospital’s Center for Biomedical Imaging.

According to the South African Medical Journal (SAMJ)The United States Department of Health estimates that cases of autism have increased 500% over the past five years.

Toxic environmental “trigger”

While avoiding eye contact is often regarded as a sign of social or personal indifference, many people with autism say eye contact causes them discomfort or stress, the study authors noted.

Autism is a behaviourally defined developmental disorder which appears to be caused in early development by the impact of the environment on a genetic predisposition.

Usually diagnosed before the age of three, a pattern of initial seemingly normal development, followed by a regression or loss of skills around 18 months, is common.

This is bolstering a growing body of opinion that genetically predisposed children are encountering a neurologically toxic environmental “trigger” that disables them and disconnects them from the world.

Brain activity monitored

The new research traces the problem to part of the brain that triggers babies’ natural attraction to faces and helps people perceive emotions in others. It’s called the subcortical system, and it’s activated by eye contact.

To learn more, the study authors monitored brain activity while people with and without autism looked at images of faces either freely or when restricted to seeing only the eye area.

Both groups showed similar levels of brain activity when viewing pictures of the entire face.

But when participants with autism were shown only the eye area, their subcortical brain system was overactivated, the findings showed. This was especially true when they saw fearful faces, but also with happy, angry and neutral ones.

Cascading effects

The study was published online in the journal Scientific Reports.

The findings could lead to more effective ways to engage people with autism, according to Hadjikhani.

“Forcing children with autism to look into someone’s eyes in behavioural therapy may create a lot of anxiety for them,” she said in a hospital news release.

“An approach involving slow habituation to eye contact may help them overcome this overreaction and be able to handle eye contact in the long run, thereby avoiding the cascading effects that this eye-avoidance has on the development of the social brain,” Hadjikhani suggested.

Read more:

Diagnosing autism

New autism treatment hope

Autism symptoms can fade

Tanya* has been experiencing severe mood swings and erratic emotions since her period started at the age of 15, but has always dismissed it as “normal” PMS.

Although a doctor put her on oral contraception that eased physical symptoms like bad cramps, her mood preceding her period would be filled with despair and suicidal thoughts – clearing up the moment her period started.

The week before each period would always be a nightmare. Seemingly minor problems at work would drive her to tears, she would struggle to complete a task at hand, have problems sleeping and would pick fights with her spouse and anyone else in her immediate vicinity.

It wasn’t until she was called in by her boss for some glaring errors in a very important presentation that she realised how much her symptoms affected her daily life.

Something so severe had to have a name, right? 

When is it not PMS?

PMDD (premenstrual dysphoric disorder) affects between 2 and 5% of women. Women experience extreme mood swings and depression at the time right before their menstrual cycle, which then clears up as soon as bleeding starts.

These symptoms can have an extreme impact on a person’s daily life or activities, and can easily be dismissed as PMS (premenstrual syndrome). The statistics for PMDD are therefore much lower, as diagnosis is harder.

Diagnosing PMDD

Just like PMS, PMDD starts around ten to seven days before the menstrual cycle and clears up as soon as bleeding starts, although it can last longer in some cases.

Both PMS and PMDD can cause bloating, breast tenderness and food cravings, but according to the American Family Physician, at least five of these eleven symptoms must be present before PMDD is diagnosed:

• Persistent and severe anger or irritability
• A noticeable lack of interest in usual interests or activities
• An extreme lack of concentration and difficulty with completing tasks
• Lethargy or fatigue not caused by any other pre-existing condition
• A change in appetite, marked by over- or undereating, or very specific food cravings
• A lack of sleep, or too much sleep
• Feeling overwhelmed by daily activities, or feeling out of control
• Physical symptoms similar to PMS such as bloating, a sensation of weight gain, headaches and breast tenderness

If severe depression is experienced, it is important to rule out other mental conditions before attributing the symptoms to PMDD. When mental conditions are ruled out, a physical and pelvic exam can be done by a doctor or gynaecologist. In order for a diagnosis, the above symptoms should cause a severe interruption of daily life.

New research could explain why women get PMDD

The exact cause of PMDD has never been clear in the past, but researchers are getting closer to finding an answer.

A recent study published in Molecular Psychiatry has shown that when oestrogen and progesterone were repressed with drugs in women with PMDD, their symptoms dissipated, but would flare up as soon as the hormones were released again.

The study showed that women who suffer from PMDD are more sensitive to hormones. The study also found that the specific gene network in women with PMDD causes cells to react differently to hormones, explaining their sensitivity.

Other factors such as alcohol and substance abuse, or thyroid conditions can trigger symptoms of PMDD.

Banish the blues and bloating

The following methods have been suggested by Harvard Medical School to help relieve the symptoms of PMDD and PMS:

1. Antidepressants that slow the reuptake of serotonin have been proven to alleviate the symptoms of PMDD. Consult your doctor about a prescription if you experience extreme mood swings or lows, and depression or other mental conditions have been ruled out.
2. Stick to healthy eating habits and mild exercise to relieve symptoms. Decreasing caffeine, alcohol or sugar intake and quitting smoking may relieve the symptoms. Mild exercise can also elevate one’s mood.
3. Hormone therapy such as oral contraceptives may offer a form of relief.

* Name has been changed.

Read more:

Pms treatment

Premenstrual dysphoric disorder

PMS symptoms improve with antidepressant

Marelize Wilke

Targeted treatment could be developed as human DNA and its effects on health are better understood.