‘Friends and Family’ OD-Reversal Kits Are Saving Addicts’ Lives

By Steven Reinberg
HealthDay Reporter

THURSDAY, June 18, 2015 (HealthDay News) — Friends and family members have saved the lives of tens of thousands of narcotic drug users from overdoses by using emergency injection kits containing naloxone (Narcan) — a medication that can potentially reverse the effects of some narcotic drugs, a new federal report says.

Almost 27,000 drug-overdose reversals using Narcan kits were reported to U.S. health officials between 1996 and 2014, according to the report.

“Overdoses are often witnessed by other drug users and family members of drug users,” said lead researcher Eliza Wheeler, DOPE Project Manager at the Harm Reduction Coalition in Oakland, Calif.

That’s why more than 600 organizations have programs in place to provide Narcan kits to friends and family of narcotic drug users. From 1996 through June 2014, these groups have provided Narcan kits to more than 150,000 people, according to the researchers.

The goal of these programs is to put the tools to reverse overdoses in the hands of people most likely to witness an overdose, Wheeler said.

These programs started because drug users were dying before help could arrive or before they could get to a hospital, she said.

In 2013 alone, almost 44,000 people died from drug overdoses, including more than 16,000 deaths from prescription painkillers, such as oxycodone (Oxycontin), and more than 8,200 deaths from heroin, the researchers reported.

The findings were published in the June 19 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

“There is a reluctance to call 911 among people who use drugs, so people were managing overdoses on their own — unsuccessfully in many ways. So programs started educating people who are likely to witness overdoses in how to deal with them,” Wheeler said.

These programs have taken off in the last few years as the fear of putting the drug into the hands of laypeople has subsided, Wheeler explained. “The number of organizations doing this has increased rapidly since 2013,” she said.

Since 1996, growing numbers of organizations have been supplying training kits containing Narcan to drug users and their families and friends, Wheeler said. Currently, 30 states and the District of Columbia have at least one organization that provides kits, she said.

Narcan acts against narcotics and quickly reverses their effects and restores breathing after an overdose, Wheeler said. The drug is commonly used in emergency rooms to treat overdoses and is often carried by police, fire and emergency medical services.

People can search the Internet for the closest program, Wheeler said. People can also get prescriptions from their doctor or, in some areas, from clinics or pharmacists who supply kits and training, she said.

Daniel Wolfe is director of the New York City-based Open Society International Harm Reduction Development Program. He said the new report is “confirmation of what many community groups in the U.S. and across the world have long known — that use of naloxone by people who use drugs is possible, practical, and lifesaving.”

Expanding availability of this safe, easy-to-use antidote is common sense, and should be a policy priority across the country, he said.

“Unfortunately, access is becoming more difficult as pharmaceutical companies raise the price of this essential medication,” Wolfe said. “Naloxone is less than a dollar a dose in many countries, but is $25 a dose or more in the U.S.,” he said.

More information

For more about naloxone, visit Stop Overdose.

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How to Avoid the ‘Flesh-Eating Bacteria’ Lurking at Florida Beaches

Photo: Getty Images

Take caution if you’re headed to the Florida beaches this summer: A potentially deadly species of bacteria found in saltwater has infected at least eight people and killed two people so far this year, according to state officials.

The bacterium, Vibrio vulnificus, blooms in Florida’s warm May to October climate. ABC News reported that there were 32 recorded cases of infection in that state last year, and seven deaths.

RELATED: Beat 16 Summer Health Hazards

The good news: Most of us are at a low risk of death, or even harm, from the bug, which some people are calling “flesh-eating” but is rarely that dangerous to watergoers, unless you have an underlying immune problem, like liver disease, and/or an open cut or wound. In that case, coming into contact Vibrio vulnificus could lead to inflammation, ulcers, and, if the infection worsens, amputation and even death.

Even if you’re not immunocomprised, note that the bacterium does proliferate in raw shellfish caught in Florida—particularly in oysters, according to the Centers for Disease Control and Prevention (CDC)—so “if you don’t cook your shellfish properly, you’re setting yourself up for trouble,” says Aileen Marty, MD, professor of infectious diseases at Florida International University. Think gastrointestinal issues like vomiting and stomach pain at best, and at worst, septicemia, a.k.a an infection the blood.

RELATED: What You Need to Know About Summer Car Travel

Again, Dr. Marty stresses, most people have nothing to fear from wandering into the Florida waters this summer. But if you think you may have been infected, head to your doctor ASAP for antibiotics, and to make sure you’re protected, follow these tips from the CDC and the Florida Department of Health:

• Do not eat raw oysters or other raw shellfish.
• Wear protective clothing (e.g., gloves) when handling raw shellfish.
• Cook shellfish (oysters, clams, mussels) thoroughly.
• Eat shellfish promptly after cooking and refrigerate leftovers.
• Avoid exposure of open wounds or broken skin to warm salt or brackish water, or to raw shellfish harvested from such waters.
• Individuals who are immunocompromised should wear proper foot protection to prevent cuts and injury caused by rocks and shells on the beach.

RELATED: How to Enjoy a Less-Stressful Summer

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FDA Seizes Counterfeit Drugs, Devices Sold Online

THURSDAY, June 18, 2015 (HealthDay News) — The U.S. Food and Drug Administration, along with international partners, moved this week against more than 1,050 websites that sell potentially dangerous counterfeit medicines and medical devices, the agency said Thursday.

Illegal medicines and medical devices were seized worldwide, and warnings were sent to the operators of offending websites, the FDA said in a news release.

“Our efforts to protect the health of American patients by preventing the online sale of potentially dangerous illegal medical products will not cease,” said George Karavetsos, director of the FDA’s Office of Criminal Investigations.

Counterfeit prescription drugs that claim to be generic versions of brand-name drugs that are sold illegally on the websites include generic Nolvadex, generic Meridia, generic Valium, generic Truvada and generic Advair Diskus, according to the FDA.

Mail screenings in Chicago, Miami and New York found that some of these counterfeit drugs — which included antidepressants, hormone replacement therapies, sleep aids and drugs to treat erectile dysfunction, high cholesterol and seizures — were on their way to American consumers, the FDA said.

Bogus medical devices sold on websites that were targeted include hyaluronic acid and other dermal fillers and “colon hydrotherapy” products. Dermal fillers are used for concealing facial wrinkles.

As part of the international effort led by Interpol, the FDA said it sent warning letters to the operators of nearly 400 websites selling unapproved or misbranded prescription medicines to U.S. consumers, and to nine companies distributing unapproved medical devices online.

This operation “provides yet another avenue for the FDA to engage with our international law enforcement partners on these critical issues,” Karavetsos said.

“We are not only pleased to be a part of this strong international enforcement effort, but resolved to do everything we can to ensure that the global problem of illegal Internet drug and device sales is deterred as a result,” he added.

Potential health risks are one obvious danger posed by illegal online pharmacies and medical device sellers, the agency said. Other threats to consumers include credit card fraud, identity theft and computer viruses, the FDA added.

More information

The U.S. Food and Drug Administration has more about buying medicines online.

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New Drugs Might Prevent Migraines Before They Start

By Dennis Thompson
HealthDay Reporter

THURSDAY, June 18, 2015 (HealthDay News) — Competing teams of researchers are closing in on a new class of drugs that can prevent chronic migraines by interrupting the chain of events thought to create the headaches.

The drugs target a biochemical called calcitonin gene-related peptide (CGRP). The results from phase 2 clinical trials show that these drugs can effectively prevent migraine in a substantial portion of headache sufferers, according to the studies.

“It’s very exciting, because this would be a form of prevention that might not have a lot of side effects and would be highly effective for people who have not had good treatment,” said Dr. Thomas Ward, a professor of neurology at Geisel School of Medicine at Dartmouth in New Hampshire. “The hope is these drugs will be clean, reduce the number of headaches people get, and won’t carry a lot of baggage.”

Findings from these studies were to be presented this week at the annual meeting of the American Headache Society, in Washington D.C.

Researchers have known for more than two decades that CGRP plays an important role in migraine headaches, said Dr. Peter Goadsby, chair of the scientific program of the American Headache Society’s annual meeting and chief of the University of California, San Francisco Headache Center.

The body uses CGRP to control the opening of blood vessels, and it also is thought to play a role in the transmission of pain signals, Ward said.

“The last step in the pathway we think to setting off headache is this substance called CGRP,” Ward said. “This material is released by nerves, and when released it causes inflammation in the nervous system.”

Headache drugs called triptans currently are used to stop migraines in progress, and they work by blocking CGRP, Ward said. But until now, researchers have been unable to come up with a way to prevent onset of migraines by targeting CGRP.

Traditional pharmaceuticals have not panned out in heading off migraines by blocking CGRP, Goadsby said. CGRP is widely used throughout the body, and blocking its function entirely can cause serious side effects in a number of organs.

This latest class of drugs reduces levels of CGRP through the use of monoclonal antibodies — laboratory-created antibodies that can be engineered to target any substance in the body.

These are the first drugs specifically developed for prevention of migraines, Goadsby said. Up to now, doctors have repurposed drugs developed for other health problems — for example, high blood pressure — to treat migraine.

“This is the first time that migraine patients will get migraine drugs for prevention,” Goadsby said.

Four drug manufacturers — Alder Pharmaceuticals, Amgen, Eli Lilly and Company, and Teva Pharmaceuticals — currently are testing their own versions of CGRP monoclonal antibodies. Goadsby is helping test Amgen’s CGRP monoclonal antibody.

A drug that effectively prevents migraine could prove lucrative. More than 36 million Americans have migraines, more than have asthma or diabetes combined, according to the American Headache Society. About 4 million have chronic migraine, experiencing more than 15 migraine days a month, according to the society.

In results presented at the American Headache Society meeting:

• Teva reported that its drug achieved a significant reduction in the number of headache hours after one week, with more than half of patients in each arm experiencing a 50 percent or greater reduction in headache frequency.
• Amgen reported that its drug reduced the number of migraine days by 50 percent in about half the treated patients after 12 weeks.
• Lilly showed that its drug could help prevent migraine headaches, compared against placebo.

Alder Pharmaceuticals didn’t present any new findings at the meeting, but has previously published promising phase 2 study results, according to an American Headache Society news release.

The drugs are all administered via injection, said Goadsby.

If the drugs prove successful, migraine patients could get a monthly injection to prevent some or all of their headaches, he said.

“They clearly work for a substantial proportion of people,” Goadsby said. “About half of patients will get 50 percent response, and a fifth will get 100 percent response.”

CGRP monoclonal antibodies so far have shown limited side effects, with only 3 percent of patients dropping out of trials due to adverse events, Ward said.

However, there is some concern about the long-term use of these drugs, given how CGRP is used throughout the body for many different purposes, he said.

“CGRP is so widespread, it’s hard to tell whether it could cause consequences throughout the body,” Ward said.

The data and conclusions of research presented at medical meetings should be viewed as preliminary until published in a peer-reviewed journal.

More information

For more about migraine, visit the U.S. National Institute of Neurological Disorders and Stroke.

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Vaccinate Puppies Against Parvovirus Before They Meet Other Dogs

THURSDAY, June 18, 2015 (HealthDay News) — It’s important to have your puppy fully vaccinated against parvovirus before going to the dog park or anywhere else your pup might encounter other dogs, an expert says.

Failure to take this precaution could prove deadly for your pet, according to Susan Nelson, clinical an associate professor of clinical sciences at the Veterinary Health Center at Kansas State University.

“Parvovirus — parvo — is a highly contagious virus that is something we do see year-round because it is always in the environment, but the Veterinary Health Center has been seeing more cases recently,” she said in a university news release.

“We usually see cases in young dogs, primarily puppies, that have had one vaccine as a puppy but didn’t complete the series or had no vaccines at all,” Nelson noted.

She emphasized that this is “a preventable disease, so it’s important when you have puppies to get them into your veterinarian starting around 6 to 8 weeks of age for their first vaccine of what is commonly known as their ‘puppy series.’

“Then they will need to get that vaccine every three to four weeks and receive their last booster around 14 to 16 weeks of age for the best chance of avoiding parvo and other diseases included in this vaccine series. They aren’t considered fully protected until a few weeks after that final dose at 14 to 16 weeks of age,” Nelson said.

During the vaccination period, you should avoid taking your puppy to city parks, dog parks, pet stores that allow animals inside, or any other place where there may be unvaccinated dogs.

The only exception is obedience classes. Socialization is critical for puppies and the risk of parvovirus is much lower in obedience classes because dogs must be vaccinated to attend. You can start taking your puppy to obedience classes one week after the first set of puppy shots, Nelson said.

You can also allow your puppy to get socialized by playing with friends’ or family members’ dogs that you know are up to date on their vaccines.

Parvo often begins with a fever and severe lethargy and depression. The dog then stops eating and begins vomiting, usually several times daily, Nelson said.

Profuse diarrhea, which is often bloody, then develops. The dog ends up extremely dehydrated. The virus destroys the lining of the intestinal tract, allowing bacteria to settle in and release toxins, according to Nelson.

“The only treatment is supportive care and intensive therapy. They are put in strict isolation because it is highly contagious to other dogs. Without any type of treatment, most infected dogs will die from the disease. And even with aggressive therapy, some dogs won’t make it. It can be very costly to treat them. Your best bet is prevention and keeping up with the vaccine series,” Nelson said.

More information

The ASPCA has more about parvovirus.

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Gene Mapping Yields Clues to Recent Ebola Outbreak

THURSDAY, June 18, 2015 (HealthDay News) — New insight into the Ebola outbreak in West Africa has been gained by scientists who analyzed the genetic blueprint — or genome — of hundreds of specimens of the deadly virus.

Health officials believe the worst of the epidemic that began in late 2013 is past, but the outbreak is not over.

“Our early work tracked the virus’s movements over just three weeks as the outbreak emerged in Sierra Leone. Now with a view of the virus over seven months, we can understand how it has been moving and changing over the long term,” study senior author Pardis Sabeti said in a Harvard University news release.

One insight gained is that later in the outbreak, there was very little cross-border exchange of the virus, lead author Danny Park said in the news release.

“That’s important, because the three main affected countries — Sierra Leone, Liberia, and Guinea — are often described as having ‘porous borders’ which allowed people to travel back and forth,” Park explained.

Cross-border movement may have helped fuel the outbreak in its early stages, but once the epidemic was underway, the virus did not migrate in the ways many had predicted.

“This is very reassuring to know that measures to contain the outbreak at borders can work and allows attention to be focused on within-country movement,” Park said.

The study was published June 18 in the journal Cell.

The team also gained insight into how Ebola evolved over the outbreak. Early in the epidemic, it spread rapidly and accumulated many mutations. But as the outbreak continued, the number of mutations slowed.

“Ebola has never been exposed to humans for so long, and through so many transmissions, it has begun to weed out mutations that do not benefit it,” Park said.

The many mutations seen early in the outbreak and the evolution documented over the long-term have been observed for other viruses, and the genetic data helps illuminate known evolutionary trends, Sabeti said. “The data just remind us what we have always known, that we must get this viral lineage to zero,” he said.

More information

The U.S. Centers for Disease Control and Prevention has more about Ebola.

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Using Same Hospital for Complications After Surgery Lowers Death Risk: Study

THURSDAY, June 18, 2015 (HealthDay News) — Surgery patients who suffer complications after discharge from a hospital are more likely to die if they’re readmitted to a different hospital than where they had their original operation, a new study finds.

University of Utah researchers reviewed information on millions of Medicare patients who underwent one of 12 major surgical procedures between 2001 and 2011. They found that up to one-fifth of the patients were readmitted to a hospital within 30 days due to complications.

Up to 83 percent of patients with complications were readmitted to the same hospital where they had their initial surgery. Overall, readmission to the same hospital was associated with a 26 percent lower risk of death within 90 days, the study revealed.

For specific types of surgeries, the risk of death associated with readmission to the same hospital ranged from 44 percent lower for those who had all or part of their pancreas removed to 13 percent lower for those who had heart bypass surgery.

Patients also did slightly better if they were treated by the same surgical team, according to the study.

It’s important to note, however, the study only found an association between readmission to the same hospital and the risk of death. It did not prove a cause-and-effect relationship or point to the reasons why such an association exists.

The study was published online June 18 in The Lancet.

“This is not a small issue. Between 5 to 22 percent of patients were readmitted in our study, depending on the type of surgery,” lead author Dr. Benjamin Brooke, an assistant professor of surgery at the University of Utah, said in a university news release.

“Our work suggests that striving to maintain continuity of care in the same hospital, and by the same medical team when possible, is critical to achieve the best outcomes should complications arise after surgery,” he added.

The findings are important in light of the growing trend of “domestic medical tourism” in the United States, the researchers said.

Some large businesses negotiate lower prices for surgery at some of the nation’s leading hospitals and encourage their employees to have complex elective surgeries performed at these hospitals, the study authors said.

In many such cases, patients have to travel long distances from home to reach these hospitals, which means it might be difficult for them to return if they develop complications, the researchers explained.

“Most people do not think about the implications of traveling far for an operation,” study senior author Dr. Sam Finlayson, professor and chair of surgery at the University of Utah, said in the news release.

“As with many health care decisions, there are trade-offs to consider. Traveling may confer the best chance of a favorable outcome with surgery, but it may hinder access to optimal care in the event of a serious complication after discharge.”

More information

The U.S. National Library of Medicine has more about surgery.

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Lip Injections May Ease Challenges of Facial Paralysis

THURSDAY, June 18, 2015 (HealthDay News) — People with facial paralysis may benefit from cosmetic lip surgery, a preliminary study finds.

Facial paralysis is “a very large problem that can occur because of stroke, Bell’s palsy, muscular dystrophy, trauma and birth defects,” Dr. Kofi Boahene, a facial plastic and reconstructive surgeon at Johns Hopkins University School of Medicine in Baltimore, said in a university news release.

Poor lip control caused by facial paralysis can cause drooling, spillage of food and drink, and difficulty making sounds that require fully closing the lips, such as the letters “b” and “p.”

Many of these people are also self-conscious about their appearance, Boahene said.

He and his colleagues worked with 22 people who had facial paralysis on one side of the mouth and three people with muscular dystrophy who had lost control of both sides of the mouth.

The patients were given hyaluronic acid injections, a cosmetic procedure to make lips appear fuller. Hyaluronic acid injections are commonly used to reduce facial wrinkles and lines, and to ease and cushion the aching joints of people with arthritis, the researchers said.

The greatest improvement was seen in the three muscular dystrophy patients, who had a six- to seven-fold increase in lip strength. Among those with paralysis on one side of the mouth, lip strength improved an average of 1.4 times on the paralyzed side and 0.4 times on the non-paralyzed side, the study found.

All 25 patients showed notable improvement in their ability to speak and to eat and drink without spillage, according to the study published June 18 in the journal JAMA Facial Plastic Surgery.

A larger study with about 100 patients is being planned.

Hyaluronic acid lip injections cost between $500 and $2,000, the researchers say, and last about a year. If the patients in this study continue to show improvement without any significant side effects, Boahene said he may explore longer-lasting treatments, such as removing fat from elsewhere in the body and injecting it around the mouth.

More information

The U.S. National Institute of Neurological Disorders and Stroke talks about Bell’s palsy.

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Many Parents Who Smoke Expose Kids to Fumes at Home

THURSDAY, June 18, 2015 (HealthDay News) — In nearly 40 percent of U.S. homes with parents who smoke, those parents don’t have smoke-free rules in place for their kids, a new study finds.

Having a smoke-free home — where all smoking is done outside — shields children from exposure to secondhand smoke and also cuts the risk that they’ll begin smoking themselves later on, the researchers said.

One expert agreed.

“Smoke-free rules are such an important aspect of tobacco control, particularly for children since they, unlike adults, have less control over their environment,” said Patricia Folan, who directs the Center for Tobacco Control at North Shore-LIJ Health System in Great Neck, N.Y.

In the new study, a team led by Ana Martinez-Donate of the University of Wisconsin-Madison looked at data from a 2010-2011 federal government survey. The investigators found that about 60 percent of households with children, and at least one parent who smoked, had a voluntary smoke-free rule in the home.

Such rules were more likely in two-parent homes versus single-parent households, the researchers found. Rules were more likely if parents had a college education, and if household incomes equaled $50,000 or more. Homes with infants were more likely to have smoke-free rules than homes without babies, the study found.

Most parents agreed that smoking should never be allowed inside cars when children are present, including 72 percent of those who did not have a smoke-free rule in their home, the Wisconsin team found.

On the other hand, smoke-free outdoor children’s play areas were supported by only 61 percent of parents who did not have a smoke-free rule in their home.

Folan believes more must be done to get smoking parents to think twice about puffing away when kids are near.

“To increase smoke-free rules — particularly in homes — a nationwide anti-tobacco media campaign, highlighting the impact of second- and third-hand smoke on children, is needed,” Folan said. “An educational campaign in day care centers and schools may also be helpful.”

But one other expert believes the real problem is that any parents still smoke at all.

“Although it may sound encouraging that most adults support smoke-free homes, that does not address the role-modeling of the message conveyed by the parents who continue to smoke — be it inside the home or out,” said Dr. Howard Selinger, chair of family medicine at Quinnipiac University School of Medicine in Hamden, Conn.

“What matters is whether these children grow up to be smoking adults or not,” he said.

The findings were published June 18 in the journal Preventing Chronic Disease.

More information

The U.S. Centers for Disease Control and Prevention has more about how to protect children from secondhand smoke.

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Technology May Help Surgeons Tell Brain Cancer From Healthy Tissue

By Randy Dotinga
HealthDay Reporter

THURSDAY, June 18, 2015 (HealthDay News) — Researchers are making progress in developing an ultrasound-like technology that helps brain surgeons distinguish between brain tumors and normal tissue.

In the new study, researchers report how the technology worked on human brain tissue. But, the technology hasn’t yet been tested in living people.

“Hopefully this summer we’ll unroll the first preliminary studies, and we’ll begin to use it in patients,” said study co-author Dr. Alfredo Quinones-Hinojosa, professor of neurological surgery and oncology and director of the Brain Tumor Surgery Program at Johns Hopkins University School of Medicine in Baltimore. Currently, he said, “we agonize because many times we can’t tell what is tumor and what is normal brain.”

The study appears in the June 17 issue of Science Translational Medicine.

About 70,000 people are diagnosed with brain cancer in the United States each year, the American Brain Tumor Association says. Brain cancer kills about 14,000 Americans annually, the association reports.

Surgery is the recommended treatment in many cases. But it can be hard to tell where the tumor ends and healthy brain tissue begins.

“The more you take out of the cancer, the better for the patients,” said Quinones-Hinojosa.

However, removing the wrong kind of tissue can “potentially compromise things like speech or moving the arm or finger,” said study co-author Xingde Li, a professor of biomedical engineering at Johns Hopkins University School of Medicine. “You want to have a very precise guiding tool to tell you what to cut and not to cut.”

That’s where the new technology comes in. It relies on optical coherence tomography, which uses light to measure distance, somewhat like radar, the study authors explained.

“It works similarly to ultrasound, but has better resolution because light travels faster than sound,” said study lead author Carmen Kut, a Johns Hopkins University graduate student.

The technology produces color-coded maps that allow for better distinction between types of brain tissue, the researchers explained.

For the study, researchers tested the technology by analyzing human brain tissue — some of it cancerous — that had been removed from people. They analyzed the tissue in the laboratory and transplanted some into mice for more analysis.

If it works in people, “it will help by not only allowing us to see the tumor but also take more,” study co-author Quinones-Hinojosa said, “and extend the survival of patients.”

Other experts expressed some reservations. “Human brain tumors growing in the brains of animals do not fully reflect how they grow in human patients,” said Ruman Rahman, assistant professor in molecular neuro-oncology at the Children’s Brain Tumor Research Center at the University of Nottingham in England. “Therefore, it cannot be presumed that the technology will work just as well in patients as it has in the animals.”

Still, Rahman said, “This is potentially a breakthrough technology.”

Another brain tumor specialist, Peter Jarritt, deputy director of the NIHR Healthcare Technology Cooperative for Brain Injury in the United Kingdom, cautioned that the technology does not penetrate through a layer of blood, potentially limiting its use if there’s significant bleeding during an operation.

Study co-author Li expects the new technology to be cheaper in cost than some other forms of brain-scanning technology. In terms of side effects, he said the light doesn’t hurt the brain tissue.

In addition to brain cancers, Kut believes the new technology might prove useful in other cancers. It also might help surgeons avoid blood vessels during surgeries, she said.

More information

For more about brain tumors, see the U.S. National Cancer Institute.

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