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by Mary Elizabeth Dallas

Statins Might Reduce Complications After Major Lung Surgery

But it's too soon to change standard practice, researchers say
FRIDAY, June 26, 2015 (HealthDay News) -- Widely used cholesterol-lowering drugs known as statins might help reduce major complications after lung surgery, new research suggests.
Statins have been linked to fewer complications after heart surgery, and researchers at Memorial Sloan Kettering Cancer Center in New York City theorized they might also benefit patients undergoing major lung surgery.
The researchers randomly assigned more than 160 study participants to receive the statin Lipitor (atorvastatin) or an inactive placebo before and after lung resection -- removal of part of the lung. Complications -- such as pneumonia, heart attack and acute respiratory failure -- were reported in 22 percent of patients receiving placebo, compared with 12 percent taking statins.
Statins were also linked to a nearly 50 percent reduction in post-surgery rates of atrial fibrillation (abnormal heart rhythm), the researchers said.
While the results are encouraging, they were not statistically significant. However, a subsequent analysis revealed an encouraging trend. The combined rates of major lung and heart complications in those undergoing surgery were three times higher in the placebo group than in the statin group, according to the study published in the June issue of the Journal of Thoracic and Cardiovascular Surgery.
The study originally called for the enrollment of 480 patients. Due to difficulty finding people who had never taken statins, however, the study only included 164 participants and ended early, the authors noted in a news release from the American Association for Thoracic Surgery.
"Imagine all the people who could potentially have benefited from the knowledge gained by this trial had it accrued as originally intended," said Dr. Betty Tong, a cardiovascular and thoracic surgeon at Duke University Medical Center in Durham, N.C., and author of an editorial accompanying the report.
With continued clinical trials at multiple centers, "we will be able to elucidate further the role of therapies such as this in preventing complications after lung resection," Tong said in the news release.
The study authors said a larger controlled study is needed to further investigate the potential benefits of statins for lung surgery patients before recommending them as standard clinical practice.
More information
The U.S. National Institutes of Health provides more information on statins (http://www.nlm.nih.gov/medlineplus/statins.html ).
SOURCE: American Association for Thoracic Surgery, news release, June 22, 2015
by Mary Elizabeth Dallas

Health Tip: Swimming Safely

Make sure pool is enclosed
(HealthDay News) -- Having a swimming pool or hot tub in the back yard can pose a drowning danger for young children.
The American Red Cross offers these safety tips:
Protect your pool with a barrier, ideally a 4-foot-high fence with a self-latching gate. Ladders and steps should be removed when the pool is not in use. An adult should always be no more than arm's length from a child in the pool. Inexperienced little ones should wear a life jacket approved by the U.S. Coast Guard. All supervising adults should know how to swim well, and should take an instructional swimming class. Everyone in the home should know first aid and CPR taught by the Red Cross. Properly maintain the pool and chemicals to keep the pool clean and safe. Create and enforce rules for the pool, such as no diving, no running, only swimming with a buddy and staying away from the drain.
by Mary Elizabeth Dallas

School Coaches Often Ill-Equipped to Spot, Manage Concussions

Better education recommended, especially at youth and middle school levels
FRIDAY, June 26, 2015 (HealthDay News) -- U.S. middle school and high school coaches may not be sufficiently trained and equipped to quickly recognize concussions in student athletes, two new studies suggest.
Without solid concussion training, coaches may mishandle a student's head injury, experts said.
"High school coaches are the primary responders on the field when head injuries occur, and every state now has some sort of mandate when it comes to the handling of student athlete concussions, which is great," said Meredith Madden, a resident in athletic training at Boston College and lead author of one of the new studies.
Her survey of Massachusetts coaches revealed some shortcomings.
"What we found is that although high school coaches do generally have an excellent knowledge of signs and symptoms, when they are given management scenarios involving concussion situations that are a little bit atypical, it can become difficult for them to quickly identify the situation," Madden said.
The other study, involving football coaches in Wisconsin, found some of them also lacked sufficient awareness of concussion guidelines.
Both studies were to be presented at this week's meeting of the National Athletic Trainers' Association, in St. Louis. Research presented at meetings is often considered preliminary until published in a peer-reviewed medical journal.
Youth concussion laws vary by state. The good news: In 2009 Washington state enacted the first sport-related concussion laws governing student athletes, and by 2014 all 50 states and the District of Columbia had some type of youth concussion law.
But the National Federation of State High School Associations notes that while most state laws address when to remove an injured player from the field and when to allow an athlete's return to play, some states -- such as Mississippi -- do not require high school coaches to take any concussion training.
In states where training is required, Madden said, its effect hasn't been evaluated. So, she and her colleagues set out to assess the impact of concussion training for high school coach in Massachusetts. There, student coaches working under the aegis of the Massachusetts Interscholastic Athletic Association must take an online concussion-education course within the first year of hire.
The goal is to provide basic first aid instruction and to help coaches recognize signs of head injury or concussion.
Madden's team conducted an online survey of 104 coaches. Twelve coaches also participated in face-to-face interviews.
Most coaches had basic information on concussion symptoms, the researchers found.
Confusion, headache, dizziness and blurred vision were correctly identified as signs of concussion by more than 90 percent of coaches. Loss of consciousness, nausea and amnesia were also correctly identified as symptoms more than 75 percent of the time.
But only about four in 10 coaches knew that poor sleep is also a symptom, while about 10 percent incorrectly highlighted symptoms that are not concussion-related, the researchers said.
Also, although more than 90 percent of the coaches could properly handle a concussion when presented with a straightforward injury scenario, that number plummeted to less than 60 percent in the face of a less-typical scenario.
The Wisconsin study of more than 700 coaches found that high school coaches were generally well-informed about concussion and related state guidelines, regardless of education level or experience.
But youth and middle school coaches were significantly less able to spot concussions, and the researchers said educational programs are needed for coaches at this younger level.
"We are not saying coaches should have to diagnose or treat concussions," Madden said. "But we do want them to be able to quickly identify them so treatment happens quickly."
Steven Broglio, an associate professor and athletic trainer, is also director of the NeuroSport Research Laboratory at the University of Michigan in Ann Arbor. In a perfect world, "all medical decisions need to be taken out of the coaches' hands," he said.
"That's not why they're there," Broglio added. "That's not really what they've trained for."
But, school budgets are often tight, so hiring personnel trained to spot and respond to concussions isn't always feasible. "In the meantime," Broglio said, "we do have to improve our education of coaches."
More information
There's more on head safety and concussion risk at the U.S. Centers for Disease Control and Prevention (http://www.cdc.gov/headsup/ ).
SOURCES: Meredith Madden, A.T.C., Ed.D., resident in athletic training, Boston College, Boston; Steven Broglio, Ph.D., athletic trainer, associate professor, director, NeuroSport Research Laboratory, School of Kinesiology, University of Michigan, Ann Arbor; presentation abstracts, National Athletic Trainers' Association meeting, June 23-26, 2015, St. Louis
by Mary Elizabeth Dallas

'Overwhelming' Evidence That Same-Sex Parenting Won't Harm Kids

Review of thousands of studies on the issue finds broad consensus among experts
FRIDAY, June 26, 2015 (HealthDay News) -- There is no evidence that having same-sex parents harms children in any way, a new comprehensive review finds.
The well-being of children of same-sex couples was an issue the U.S. Supreme Court addressed in its landmark 5-4 ruling on Friday that upheld the legality of gay marriage.
"Without the recognition, stability and predictability marriage offers, children suffer the stigma of knowing their families are somehow lesser," Justice Anthony Kennedy wrote in the majority opinion. "They also suffer the significant material costs of being raised by unmarried parents, relegated to a more difficult and uncertain family life. The marriage laws at issue thus harm and humiliate the children of same-sex couples."
In the new review, Jimi Adams, associate professor of health and behavioral studies at the University of Colorado Denver, said he wanted to find out if children suffered any disadvantages simply because their parents were of the same sex.
"As same-sex marriage has been debated in courts across the country, there has been the lingering question about the effects of same-sex parenting on children," Adams said in a university news release.
"I found overwhelming evidence that scientists agree that there is not a negative impact to children of same-sex couples," he said.
Adams' team analyzed data from thousands of studies on the issue. The data overwhelming found that children of same-sex parents do not differ from those of heterosexual or single parents on a range of social and behavioral outcomes.
According to the research, by 1990 a consensus between researchers on the issue began to emerge, and by 2000 "overwhelming" consensus had been reached that same-sex parenting does not harm children.
One expert in child mental health "applauded" the new research.
The issue "has been studied and the overwhelming evidence has supported this finding for the past 25 years," said Dr. Victor Fornari, who directs the division of child and adolescent psychiatry at the Zucker Hillside Hospital in Glen Oaks, N.Y., and Cohen Children's Medical Center in New Hyde Park, N.Y.
The study findings were reported online recently in Social Science Research.
More information
The American Association for Marriage and Family Therapy has more about same-sex parents and their children (http://www.aamft.org/iMIS15/AAMFT/Content/Consumer_Updates/Same-sex_Parents_and_Their_Children.aspx ).
SOURCES: Victor Fornari, M.D., director, division of child and adolescent psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. and Cohen Children's Medical Center, New Hyde Park, N.Y.; University of Colorado Denver, news release, June 15, 2015
by Mary Elizabeth Dallas

Common Antidepressants Linked to Higher Fracture Odds in Menopausal Women

Drugs like Celexa, Prozac could undermine bone, research suggests
FRIDAY, June 26, 2015 (HealthDay News) -- Women prescribed a common class of antidepressants to ease menopausal symptoms may face a long-term rise in their risk for bone fracture, a new study suggests.
The antidepressants in question are selective serotonin reuptake inhibitors (SSRI) medications such as Celexa, Paxil, Prozac and Zoloft.
Besides being used to treat depression, these drugs are often prescribed as an alternative to hormone replacement therapy (HRT) to tackle hot flashes, night sweats and other problems that can accompany menopause.
However, "SSRIs appear to increase fracture risk among middle aged women without psychiatric disorders," wrote a team led by Dr. Matthew Miller of Northeastern University in Boston.
The team added that the effect seems to be "sustained over time, suggesting that shorter duration of treatment may decrease [this effect]."
The study authors acknowledged that their work did not establish a direct cause-and-effect link between SSRIs and a boost in fracture risk. However, they point out that prior research has highlighted bone-thinning as a possible side effect of antidepressants.
Findings from the study were published June 25 in the journal Injury Prevention.
For the study, researchers sifted through data from the PharMetrics Claims Database, which collects information on drug treatments involving roughly 61 million patients nationally.
In this case, investigators specifically focused on more than 137,000 women between the ages of 40 and 64, all of whom began SSRI treatment at some point between 1998 and 2010.
The SSRIs in question included citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Sarafem, Prozac), fluvoxamine (Luvox), paroxetine (Paxil) and sertraline (Zoloft).
The SSRI group was compared with more than 236,000 other women who had been prescribed indigestion medications instead of an SSRI.
They found that women in the SSRI group faced a 76 percent higher risk for fracture after a single year of SSRI use, compared with the non-SSRI group. That figure fell slightly, to 73 percent after two years and 67 percent after five years, the study said.
One expert in bone health said a relationship between SSRIs and bone weakening does have some basis in biology.
"The authors speculate that the mechanism of action involves the activation of osteoclasts, cells which break down bone, by the SSRIs," explained Dr. Caroline Messer, an endocrinologist at Lenox Hill Hospital in New York City.
She said that, "While more studies are needed, the trial does suggest that women might want to limit the duration of treatment with SSRIs and perhaps consider taking the lowest effective dose to minimize bone loss."
More information
For more information on menopause and treatment options U.S. National Institute on Aging (https://www.nia.nih.gov/health/publication/menopause ).
SOURCE: Caroline Messer, M.D., endocrinologist, Lenox Hill Hospital, New York City ; Injury Prevention, news release, June 25, 2015
by Mary Elizabeth Dallas

Could Brain Scans Help Guide Treatment for OCD?

Small study suggests neural activity can point to patients who'll benefit most from psychotherapy
FRIDAY, June 26, 2015 (HealthDay News) -- Psychotherapy can help some people avoid the disruptive behaviors linked to obsessive-compulsive disorder (OCD), and a new study suggests that brain scans can help spot those patients for whom the therapy will be most effective.
The treatment is called cognitive behavioral therapy (CBT). It works by placing patients in controlled situations where they are exposed to anxiety-causing stimuli, so that they gradually learn to deal better with these situations.
"Cognitive behavioral therapy is in many cases very effective, at least in the short term," said Dr. Jamie Feusner, an associate professor of psychiatry at University of California, Los Angeles, and director of the Semel Institute's Adult OCD Program.
However, the treatment is "costly, time-consuming, difficult for patients and, in many areas, not available," Feusner noted in a UCLA news release. So, "if someone will end up having their symptoms return [after treatment], it would be useful to know before they get treatment," he reasoned.
His team wondered if certain patterns on brain scans might point to those patients who have the most to gain from CBT.
The notion has some merit, said one expert, especially since more reliable treatment is needed for people suffering from OCD.
"OCD is an illness in which patients experience obsessions and then act on them by performing compulsions," explained Dr. Alan Manevitz, a clinical psychiatrist at Lenox Hill Hospital in New York City.
Even though "the patient realizes that these obsessions and compulsions are unwanted, unreasonable and excessive, he or she cannot stop listening to the thoughts and acting on them," he said.
According to Manevitz, one in every 40 Americans (2.5 percent) has clinical OCD, with symptoms bad enough to interfere with daily living, and another 10 percent have a lower-level form of the illness, where thoughts intrude but do not reach such a disruptive state.
"The past few decades, however, have seen the emergence of many effective treatments, both pharmacological and psychotherapeutic," including CBT, Manevitz said.
But who will gain the most from the psychotherapy? Feusner's team noted that although CBT may be very effective initially, not all patients see long-term benefits, and about 20 percent of patients suffer a relapse of their OCD symptoms.
In the UCLA study, brain scans known as fMRIs were used to study the brains of 17 people with OCD who ranged in age from 21 to 50.
The scans -- which measure brain activity in real time -- were performed before and after the patients completed intensive CBT.
The patients' symptoms were also monitored for one year.
According to Feusner, people with more efficient brain network "connectivity," as gauged by the brain scans, actually had worse long-term outcomes following CBT treatment.
The team also found that the intensity of OCD symptoms prior to treatment, or the patient's initial level of response to the therapy, was not a good predictor of long-term success.
Having a better understanding of which patients will not respond well to specific therapy long-term could help doctors develop a more effective treatment strategy.
The researchers were quick to point out that the study does not suggest that some patients with OCD are "beyond help" when it comes to psychotherapy. Instead, they believe that these patients may simply need longer CBT than the four weeks used in the study, or that they may be helped by medications as well.
"We are now starting to translate knowledge of the brain into useful information that in the future could be used by doctors and patients to make clinical decisions," Feusner said. "Although a brain scan may seem expensive, these scans only took about 15 minutes and thus the cost is not exceptionally high, particularly in comparison to medication or cognitive behavioral therapy treatments, which over time can cost many thousands of dollars."
However, Manevitz did have some reservations about the findings.
"The results are intriguing but this study has a very small sample size: 17 subjects," he said. Plus, those subjects appeared to be especially willing to undertake the rigors of CBT -- something not every person with OCD might be amenable to, he said.
All of that "makes it harder to generalize [the findings] to the overall OCD population," Manevitz said. He also believes that while brain network "connectivity" may play a role in the effectiveness of psychotherapy for OCD, that remains only a theory.
The bottom line, according to Manevitz: "It is important to follow up this study with a larger group of participants."
Dr. Emily Stern is assistant professor of psychiatry and neuroscience at the Mount Sinai School of Medicine in New York City. She said that brain scans may have potential "to predict which patients will relapse has the potential to identify those patients who may need further treatment or greater monitoring."
If the findings pan out, "brain network organization may provide a window into patient functioning that cannot be assessed through symptom measures alone," Stern said.
The study was funded by the U.S. National Institute of Mental Health and published recently in the journal Frontiers in Psychiatry.
More information
The U.S. National Institute of Mental Health provides more information on OCD (http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml ).
SOURCES: Alan Manevitz, M.D., clinical psychiatrist, Lenox Hill Hospital, New York City; Emily R. Stern, Ph.D. assistant professor, departments of psychiatry and neuroscience, Mount Sinai School of Medicine, New York City; University of California, Los Angeles, news release, June 23, 2015
by Mary Elizabeth Dallas

Fat No Longer the Focus of New U.S. Dietary Guidelines

Nutrition experts endorse decision to drop restrictions, focus on quality of food instead
FRIDAY, June 26, 2015 (HealthDay News) -- Nutrition experts are hailing a federal decision to drop recommended restrictions on total fat consumption in the forthcoming 2015 Dietary Guidelines for Americans.
Over the past decade, research has shown that a diet rich in healthy fats can be better for people, particularly if those fats help offset consumption of foods containing high levels of salt, sugar and refined grains, Dr. Dariush Mozaffarian, dean of Tufts University's Friedman School of Nutrition Science and Policy in Boston, wrote in a viewpoint article on the federal decision.
The report appears in the June 23/30 issue of the Journal of the American Medical Association.
That research prompted independent scientists on the federally funded 2015 Dietary Guidelines for Americans Committee to quietly abandon current recommended restrictions on dietary fat, he said.
For the first time since 1980, the committee did not propose restricting total fat consumption in its technical report, which was released earlier this year.
Low-fat diets have had unintended consequences, turning people away from healthy high-fat foods and toward foods rich in added sugars, starches and refined grains. This has helped fuel the twin epidemics of obesity and diabetes in America, Mozaffarian said.
"We really need to sing it from the rooftops that the low-fat diet concept is dead," Mozaffarian said. "There are no health benefits to it."
Current dietary guidelines hold that only up to 35 percent of daily calories should come from fat. The committee's recommendation drops the entire concept, Mozaffarian noted.
"What's really noticeable is not they came out with a dramatic statement that we should drop the limit on total fat, but that they really quietly ignored the whole thing," he said. "There's no chapter on fat. There's no statement on fats."
Based on the committee's recommendation, the U.S. Department of Agriculture and the U.S. Department of Health and Human Services are expected to issue an updated set of dietary guidelines later this year that omits any limits on total fat consumption, Mozaffarian said.
Sotiria Everett, a registered dietitian at the Katz Institute for Women's Health in Lake Success, N.Y., said, "This seems to follow increasing scientific evidence that reducing total fat intake may not benefit heart health and cholesterol levels, especially since consumers' response to the initial limitations on fat led to increased consumption of refined carbohydrates and added sugar."
Dropping restrictions on healthy fats will allow Americans to adopt eating habits like the Mediterranean diet, which has been shown to improve heart health even though it includes high-fat items, Everett said.
"Many eating patterns that support heart health, such as the Mediterranean diet, consist of a fat intake that is above 35 percent fat, largely due to the emphasis of foods high in unsaturated fat such as olive oil, nuts and fatty fish," she said.
Most dietary fats still should come from plant-based unsaturated fats, which have been shown to improve blood cholesterol levels and reduce a person's risk of heart disease and type 2 diabetes, Everett said.
But even limited amounts of saturated fats are fine, particularly if they come from plant sources like nuts or avocados, Mozaffarian said.
Mozaffarian argued that these new guidelines should offer more clarity than confusion, because now people can choose foods based on their overall quality rather than individual nutrients they contain.
"This doesn't mean that butter is good for you or that bacon is good for you. It means we have to really think about the overall quality of our food," he said.
For example, high-fat foods like vegetable oil, nuts and whole-milk dairy products can be very healthy, while low-fat foods like bagels, white rice, crackers and low-fat potato chips are terrible, Mozaffarian said.
Dr. Suzanne Steinbaum, director of Women's Heart Health at Lenox Hill Hospital in New York City, said, "These new guidelines are intended to bring health back to the American diet, by encouraging fruits, vegetables and healthy fats. Hopefully, this will help in reducing the obesity epidemic."
Mozaffarian hopes that other federal programs will follow suit. For example, the Nutrition Facts label on food products currently uses a 30 percent dietary limit to calculate what an average person's daily fat intake should be, and the National School Lunch Program recently banned whole milk while keeping sugar-sweetened nonfat milk on cafeteria menus, he said.
"I think the public and doctors should really push the government to cause all of its programs to get up to date with the modern science," he said.
Both Mozaffarian and his viewpoint co-author, Dr. David Ludwig, director of the New Balance Foundation Obesity Prevention Center at Boston Children's Hospital, were supported in part by grants from the U.S. National Institutes of Health.
More information
Visit the Mayo Clinic (http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/mediterranean-diet/art-20047801 ) for more on the Mediterranean diet.
SOURCES: Dariush Mozaffarian, M.D., Dr.P.H., dean, Tufts University's Friedman School of Nutrition Science and Policy, Boston; Sotiria Everett, R.D., registered dietitian, Katz Institute for Women's Health, Lake Success, N.Y.; Suzanne Steinbaum, M.D., director, Women's Heart Health, Lenox Hill Hospital, New York City; June 23/30, 2015, Journal of the American Medical Association
by Mary Elizabeth Dallas

Health Tip: Dealing With a Bee Sting

Use tweezers to remove stinger
(HealthDay News) -- Most bee stings involve less-than-severe allergic reactions that don't require emergency medical care.
To treat most bee stings, the Mayo Clinic advises:
Use tweezers to remove the stinger from the skin as quickly as you can. The faster it's removed, the less venom is likely to enter the body. Use soap and water to gently cleanse the area. Sooth swelling and pain with a cold compress or ice pack. If the area is swollen, itchy or red, apply calamine lotion. Take an antihistamine containing diphenhydramine or chlorpheniramine if the itching or swelling is uncomfortable. Don't scratch the affected area. Doing so can lead to an infection.
by Mary Elizabeth Dallas

In Wake of High Court Ruling, What's Next for Obamacare

Insurers can begin making sound business decisions based on a stable Affordable Care Act, experts say
THURSDAY, June 25, 2015 (HealthDay News) -- The Affordable Care Act will grow stronger in the next few years, now that the U.S. Supreme Court has upheld the controversial health reform law for a second time.
That's the consensus from both supporters and detractors of the legislation.
John Graham, a senior fellow with the free-market National Center for Policy Analysis, said the Supreme Court's decision Thursday essentially brings to an end efforts to repeal the law through the legal system. The law, championed by President Barack Obama and fellow Democrats and denounced by Republicans as fatally flawed, is often called Obamacare.
"For opponents of Obamacare like myself, we can now let go of the fantasy that the judges are going to solve this problem for us," Graham said. "We are going to have to solve it ourselves, through the political process."
Ron Pollack, executive director of Families USA, a pro-Obamacare group, said the end of the legal battles will bring a sense of legitimacy to the Affordable Care Act. This will make it easier for the law to weave itself ever more firmly into the fabric of American life, he said.
The high court's ruling "means the Affordable Care Act is not just the law of the land, but that it will remain the law of the land," Pollack said. "It is a stable part of America's health care system."
Now that insurers know that Obamacare isn't going away, they can begin making business decisions based on the law, allowing it to become the "stable operating platform for insurance in this country," said Dan Mendelson, chief executive officer of Avalere Health, a health care advisory firm.
"It sends the message to insurance companies that they can invest in this system and it will be durable, at least for the next few years," Mendelson said.
Republicans, despite Thursday's ruling, reiterated their pledge to work for the repeal of the Affordable Care Act.
In its decision Thursday, the Supreme Court upheld the legality of tax subsidies for an estimated 6.4 million Americans who signed up for health insurance under the Affordable Care Act. The major point of contention in the case was whether people in states that failed to set up their own health marketplaces, or exchanges, to buy insurance under Obamacare could qualify for the tax credits if they used the federally run HealthCare.gov online exchange.
Opponents of Obamacare insisted that, as the 2010 law was written, the tax credits could only come with insurance purchased through online exchanges operated by individual states. But, only 13 states and the District of Columbia created their own exchanges. Most states that chose not to create exchanges are headed by Republicans.
In the run-up to Thursday's decision, the Obama administration insisted that Congress intended the tax credits to be available to all eligible buyers, whether they used the federally run HealthCare.gov exchange or a state-established exchange.
Thursday's ruling marks the second time the Supreme Court has decided in favor of the Affordable Care Act. In 2012, the court found the law constitutional.
Supporters of Obamacare said Republicans now will face mounting pressure to approve Medicaid expansion in their states, which would further strengthen the Affordable Care Act. Currently, 21 states have refused to accept federal funding available through Obamacare that would expand Medicaid down to low-income adults who make 138 percent of the federal poverty level.
In a Rose Garden speech following the Supreme Court's decision, Obama promised to continue urging GOP state leaders to accept the Medicaid expansion -- and the Affordable Care Act itself.
"The law is working and it's going to keep doing just that," said Obama, calling the Affordable Care Act a success story similar to Social Security and Medicare. "This is health care in America."
The National Center for Policy Analysis' Graham said he's hopeful that Republicans will work with Obama to amend and improve the Affordable Care Act over the next couple of years.
There's not much chance of major political movement on the matter, given that Obama has vowed to oppose any bill that would unravel the law. But Congress and the president might find common ground on some issues that would revise the law but not weaken it, observers said.
The House of Representatives already has approved repeal of a 2.3 percent sales tax on medical devices, such as artificial hips and pacemakers. The tax is designed to help fund the Affordable Care Act, but has been criticized as unfairly burdening device manufacturers. The bill has some Democratic support, mainly from states where the manufacturers are located, but its passage is still uncertain.
The two political parties also might be able to hammer out a compromise on a mandate that requires businesses with 50 or more employees to provide health insurance. Or there might be movement on an excise tax set to take effect in 2018 that would penalize employer-provided health plans that provide a too-rich array of benefits, health industry experts said.
"We have at least two years or more of Obamacare, and there are things that can be done," Graham said. "I don't think Republicans in Congress should be afraid of putting forward amendments to Obamacare and be accused of caving in to Obamacare," he added.
"Obama has said he will consider changes. The majority in Congress should give it a shot," Graham concluded.
Added Mendelson: "You've got still a majority in the Congress that believes the law should be repealed. Until there is some level of acceptance, you will not have an environment that is conducive for legislative calibrations."
The Affordable Care Act likely will serve as an issue in the 2016 presidential race, but in the meantime health care reform will continue to march forward, experts said.
Operators of the online health insurance exchanges likely will turn their attention toward practical policy matters that improve and expand coverage, industry experts said.
"Looking ahead, while this [the Supreme Court ruling] is a major victory for exchange markets, critical challenges remain for future years," said Caroline Pearson, senior vice president at Avalere, where she heads Health Reform and Policy Practice.
"Exchanges need to focus on increasing enrollment and attracting younger, healthier individuals in order to ensure that a variety of affordable health plan options participate in the market," Pearson said.
Younger participants are viewed as vital to the success of the Affordable Care Act. The reason: they tend to be healthier, and their premiums are designed to help counterbalance the expenses of older Americans, who are more likely to be sick.
More information
To learn more about the Affordable Care Act, visit HealthCare.gov (https://www.healthcare.gov/ ).
To read more about Thursday's Supreme Court decision, click here (http://consumer.healthday.com/public-health-information-30/government-health-news-339/supreme-court-upholds-subsidies-for-obamacare-700628.html ).
SOURCES: John Graham, senior fellow, National Center for Policy Analysis, Washington, D.C., and Dallas, Texas; Ron Pollack, executive director, Families USA, Washington, D.C.; Dan Mendelson, CEO, Avalere Health, Washington, D.C.; Caroline Pearson, senior vice president, Avalere Health
by Mary Elizabeth Dallas

Losing Weight May Ease Asthma in Obese People

Researchers also saw improvement in quality of life
FRIDAY, June 26, 2015 (HealthDay News) -- Losing weight may help reduce asthma severity in obese adults, a new Canadian study finds.
"We were pleased to see significant improvement in asthma symptoms, as well as quality of life for these individuals. This study further supports the need to manage [chronic disorders] to improve patient lives," said study author Dr. Smita Pakhale, from The Ottawa Hospital and the University of Ottawa.
People who are obese are about 1.5 times more likely to have asthma than those who aren't obese. A 3-unit increase in body mass index -- BMI, an estimate of body fat based on weight and height -- is associated with a 35 percent increase in the risk of asthma, the researchers said in a news release from the American College of Chest Physicians.
A BMI of 18.5 to 24.9 is considered normal weight. A BMI of 25 to 29.9 is overweight, while 30 and over is considered obese.
The study found that when obese people with asthma lost weight, they showed improvement in asthma severity, asthma control and quality of life.
The study appears in the June issue of the journal Chest.
More information
The American Lung Association has more about asthma (http://www.lung.org/lung-disease/asthma/ ).
SOURCE: American College of Chest Physicians, news release, June 2015

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