Rule Changes Might Lead to More Lung Transplants for Kids

THURSDAY, Nov. 5, 2015 (HealthDay News) — Twice as many young people in the United States could get lung transplants if donor lungs were available from a wider geographic area, a new study contends.

“Children are dying while waiting for an organ. Geography should be one less barrier to pediatric patients receiving a potentially lifesaving transplant,” said senior study author Dr. Maryam Valapour. She is a senior lung investigator at the Cleveland Clinic’s Scientific Registry of Transplant Recipients and director of Lung Transplant Outcomes.

Currently, donor lungs are first offered to transplant candidates near the donor hospital. If there are no local candidates, the lungs are offered beyond the local area in 500-mile radius increments. Child candidates are given priority for child donor lungs within a 1,000-mile radius of the donor hospital, followed by teens and then adults. Teen candidates get priority for teen donor lungs, followed by children and then adults, the researchers explained.

Using data from almost 6,000 lung and 141 heart-lung candidates listed for transplant between July 2009 and June 2011, the researchers created computer models of alternative allocation of lungs from child donors.

Two scenarios led to significantly more lung transplants for children. One focused on broader geographic sharing of teen and child donor lungs by offering teen donor lungs to teens, then to children from the local region up to a 1,000-mile radius before offering them to local adults.

This scenario also offers child donor lungs to child candidates and then to adolescents within a 1,000-mile radius before adults are considered. This model more than doubled the number of teen transplants, to 461 adolescent transplants per 100 patient-years on the waiting list, compared with 206 under current rules, the computer model showed.

The other model gave priority to children over teens for lungs from teen donors, and widened children’s access to teen donor lungs from the local region to a 1,000-mile radius. This change led to the potential for 388 teen transplants per 100 patient-years on the waiting list, and likely increased transplant rates for children, the researchers said.

“We believe these changes will give young patients more access to transplants and will result in organs getting to the sickest patients first,” Valapour said in a clinic news release.

Adult transplant rates were not affected by either model, according to the study published Nov. 2 in the American Journal of Transplantation.

The Organ Procurement and Transplantation Network is reviewing the simulations and will choose one to be the new national policy for allocating children’s lungs for transplantation.

More information

The U.S. National Heart, Lung, and Blood Institute has more about lung transplantation.

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Many U.S. Women Gain Too Much Weight While Pregnant: Study

By Steven Reinberg
HealthDay Reporter

THURSDAY, Nov. 5, 2015 (HealthDay News) — A large number of American mothers-to-be gain more weight than is good for them or their baby, federal health officials reported Thursday.

Just 32 percent of pregnant women across the United States gained the recommended amount of weight during their pregnancy, the analysis from the U.S. Centers for Disease Control and Prevention found.

The study looked at 2013 data for women delivering full-term, singleton infants in 41 states, New York City and the District of Columbia, and additional 2012 pregnancy risk data for another five states.

While gestational weight gain varied by states, at least 50 percent of pregnant women in 17 states gained above the recommended amount, the report said.

“Eating for two shouldn’t translate to eating without limits,” said the report’s co-author, CDC epidemiologist Andrea Sharma. “It should translate to eating twice as healthy.”

“A large proportion of women enter pregnancy not at a healthy weight,” she added. “Entering pregnancy at a healthy weight is extremely important.”

The number of women gaining too much gestational weight ranged from 54.2 percent in Alaska to 43 percent in Colorado, the researchers said.

The proportion of women who gained less than their recommended amount of weight also varied by state: in 20 states and New York City, 20 percent or more gained less than their recommended limit.

In virtually every state, women who were overweight before their pregnancy had the highest prevalence of excessive weight gain, the study found.

The findings were published in the Nov. 6 issue of the CDC’s Morbidity and Mortality Weekly Report.

Sharma said a pregnant woman should know her recommended weight gain to have a benchmark. Gaining too much is a concern because dieting during pregnancy is not recommended, she said.

According to the March of Dimes, the recommended weight gain for women of normal weight is 25 to 35 pounds, for underweight women 28 to 40 pounds, for overweight women 15 to 25 pounds and for obese women 11 to 20 pounds.

“The amount of extra calories needed during pregnancy [per day] is relatively small,” Sharma said. “It’s only about an additional 340 to 450 calories in the second and third trimester only. An apple, a cup of yogurt, a handful of almonds might be about 350 calories.”

Dr. Jennifer Wu is an obstetrician, gynecologist at Lenox Hill Hospital in New York City who was not involved with the study. “This report is disappointing,” she said. “The most concerning fact is that too many women are gaining excessively during pregnancy, and a large percentage of these women are starting pregnancy already overweight or obese.”

Women who put on too much weight during pregnancy are doing harm to themselves and their babies, Wu said.

“Patients who gain excessive weight have a very hard time losing their pregnancy weight, thus increasing the risk for high blood pressure, diabetes and heart disease,” she said.

Children of obese mothers are also more likely to be overweight or obese themselves, Wu added.

“You really need to follow the weight gain guidelines during pregnancy,” she said. “I advise my patients to buy a scale and weigh themselves every day.”

Sharma added that women should also remain physically active during pregnancy. “Most women should do 150 minutes of moderate exercise a week,” she said.

More information

For more on weight gain during pregnancy, visit the March of Dimes.

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Scarlet Fever Resurfacing in Some Parts of the World

THURSDAY, Nov. 5, 2015 (HealthDay News) — Scarlet fever, a childhood disease that had been largely relegated to the history books, is reappearing in some parts of the world, researchers warn.

Outbreaks have been reported in the United Kingdom and Asia, said scientists at the Australian Infectious Diseases Center at the University of Queensland.

“We have not yet had an outbreak in Australia, but over the past five years there have been more than 5,000 cases in Hong Kong [a 10-fold increase] and more than 100,000 cases in China,” Mark Walker, a professor in the School of Chemistry and Molecular Biosciences, said in a university news release.

“An outbreak in the U.K. has resulted in 12,000 cases since last year,” he added.

The research team used genetic sequencing to investigate the rise in scarlet fever-causing bacteria and its increasing resistance to antibiotics.

The study was published online Nov. 2 in the journal Scientific Reports.

Scarlet fever, which mainly affects children younger than 10, is spread by the same bacteria that cause strep throat, the researchers said.
Symptoms include a red skin rash, sore throat, fever, headache and nausea. Antibiotics are used to treat serious cases.

The findings are “deeply concerning,” said Nouri Ben Zakour, a researcher in the School of Chemistry and Molecular Biosciences.

“We now have a situation which may change the nature of the disease and make it resistant to broad-spectrum treatments normally prescribed for respiratory tract infections, such as in scarlet fever,” she said in the news release.

Untreated, scarlet fever can lead to rheumatic fever, which can permanently damage the heart.

The re-emergence of scarlet fever could be due to a number of factors, and further research is needed to pinpoint them, the study authors said.

More information

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

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Early Warning Sign for Kidney Disease Identified in Study

THURSDAY, Nov. 5, 2015 (HealthDay News) — Researchers say they’ve discovered an early warning sign of chronic kidney disease.

They found that levels of a common protein in the blood rise in the months or years before the disease develops.

Levels of the protein suPAR (soluble urokinase-type plasminogen activator receptor) can be checked using a simple blood test. And the results can reliably predict a person’s risk of developing chronic kidney disease up to five years before it begins causing damage, the researchers report.

The researchers assessed suPAR levels and kidney function in nearly 2,300 people, and followed them for five years. Over that time, they found that 40 percent of participants with high suPAR levels but no known kidney disease developed chronic kidney disease, compared with 10 percent of those with low suPAR levels.

The researchers also found that suPAR levels predicted kidney function decline in people with known early stage kidney disease.

The study was published online Nov. 5 in the New England Journal of Medicine, to coincide with a planned presentation Thursday at the annual meeting of the American Society of Nephrology, in San Diego.

“SuPAR promises to do for kidney disease what cholesterol has done for cardiovascular disease,” study senior author Dr. Jochen Reiser said in a Rush University Medical Center news release. Reiser, a nephrologist, is chairman of internal medicine at the Chicago medical center.

People with high suPAR levels can be counseled about steps they need to take to prevent kidney disease, much like people with high cholesterol levels are told to make lifestyle changes and are prescribed drugs to lower their risk of heart attack and stroke, he explained.

More than 15 percent of Americans have chronic kidney disease, and about 4 percent require dialysis and/or a transplant because of kidney failure. Chronic kidney disease causes about 47,000 deaths a year in the United States, according to the news release.

More information

The American Academy of Family Physicians has more about chronic kidney disease.

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Poor Sleep Might Harm Kidneys, Study Suggests

By Steven Reinberg
HealthDay Reporter

THURSDAY, Nov. 5, 2015 (HealthDay News) — Lack of sleep may be a gateway to kidney disease, at least for women, a new study suggests.

Researchers from Boston’s Brigham and Women’s Hospital evaluated the sleep habits of thousands of women and found too little shuteye was tied to a more rapid decline in kidney function.

Women who slept five hours or less a night had a 65 percent greater risk of rapid decline in kidney function, compared with women sleeping seven to eight hours a night, the investigators discovered.

“This is concerning because as a general population the amount of sleep we are getting has decreased over the last 20 years,” said lead researcher Dr. Ciaran McMullan, an instructor in medicine.

Americans used to sleep an average of eight hours a night, but now it’s about 6.5 hours and decreasing, he said.

It’s not known whether sleeping longer improves kidney function or reverses damage caused by shortened sleep, he said.

McMullan cautioned that this study can only show that decreased kidney function is associated with less sleep, not that less sleep causes the decline in kidney function. For that, more research is needed, he said.

A connection between disrupted sleep and heart disease has been studied before.

A link between reduced sleep and diminished kidney function might be the result of medical conditions that affect kidney function, such as diabetes and high blood pressure, McMullan said.

“Diabetes occurs more often in people who sleep less, as does high blood pressure,” he said. “We know that two of the greatest factors that decrease kidney function are diabetes and high blood pressure.”

The body’s natural rhythms, or so-called circadian clock, might also play a role, McMullan said. The kidney is timed to work differently during the night than during the day because the demands on the body are different, he explained.

“Maybe short sleep changes the physiology of the kidney over the daily cycle, and these changes might damage the kidney,” McMullan suggested.

As the U.S. population ages and as more people suffer from diabetes and high blood pressure, the number of people with kidney disease will increase, and too little sleep may play a part, he added.

“We are a sleep-deprived society,” McMullan said. “The concern is that sleep deprivation will lead to a decline in kidney function.”

He said it’s likely the findings would also apply to men, but noted that would need to be studied.

The results of the study are scheduled for presentation Thursday at a meeting of the American Society of Nephrology in San Diego. The data and conclusions should be considered preliminary until published in a peer-reviewed medical journal.

For the study, McMullan’s team collected data on more than 4,200 women who took part in the Nurses’ Health Study. Over 11 years, the women’s kidney function was measured at least twice.

Dr. Kenar Jhaveri, a nephrologist at North Shore-LIJ Health System in Great Neck, N.Y., said the connection between sleep and kidney disease is new to him.

“At this point I would be very cautious about giving advice to patients based on this study,” he said. “I certainly wouldn’t change any sleep habits.”

Jhaveri said seven hours of sleep is good for health. “People who sleep too little or too much are at risk for certain disorders,” he added. “In terms of kidney disease, this is something that is going to be interesting in how it pans out.”

More information

For more on kidney health, visit the U.S. National Institutes of Health.

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Watch ‘Superhero’ Serena Williams Chase Down the Thief Who Swiped Her Phone

Credit: Getty Images

Superwoman’s identity has finally been revealed as none other than Serena Williams. The tennis star let the secret slip on Instagram Wednesday night after an unknown man attempted to steal her phone while she ate Chinese food in San Francisco.

And after seeing the footage, we totally believe her.

She also shared the full story in an epic caption.

“So this guy is standing next to me and something (I have now dubbed it my SUPERHERO sense) told me to watch him, ” she wrote. “My phone was sitting in the chair but I just didn’t feel right. He was there too long.”

She tried to shake the feeling, she wrote, but “kept watching him from the corner of my eye.”

Until, “this common petty thief grabbed my phone and swiftly left. I looked at the chair, than [sic] shouted “Omg that dude took my phone!!” Not thinking I reacted (hence the superwoman photo) I jumped up, weaved my way in and out of the cozy restaurant (leaping over a chair or two) and chased him down. He began to run but I was too fast. (Those sprints came in handy) I was upon him in a flash!”

RELATED: Serena Williams to Body-Shaming Critics: ‘I Have Grand Slams to Win’

Ultimately, she got her phone back from the guy after simply asking him to return it. (Though it seems like he tried to brush it off like it was an accident.)

But most importantly, she goes on to encourage other women to always trust their instincts and listen to their inner superhero. “Just because you are a lady don’t be afraid to step up to any challenge and not be a victim but a hero!”

RELATED: J.K. Rowling’s Awesome Response to a Mean Tweet About Serena Williams

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Illegal Toad Venom ‘Aphrodisiac’ Linked to NYC Man’s Death

THURSDAY, Nov. 5, 2015 (HealthDay News) — “Stone,” an illegal aphrodisiac that contains substances derived from toad venom, may have claimed the life of a New York City man and should be avoided, city health officials warned.

Last week, a hospital told the New York Poison Control Center about a 39-year-old man who died after taking the product, also known as Piedra China, Jamaican Stone, Love Stone, Black Stone or China Rock.

Similar products caused poisonings and deaths in the 1990s, the New York City Department of Health and Mental Hygiene said in a news release. Since 2000, there have been seven such cases, including the most recent one and one earlier this year.

These supposed aphrodisiacs are banned by the U.S. Food and Drug Administration but are imported illegally. Stone is a hard, dark brown substance typically sold as a solid chunk less than a square inch in size.

Stone’s active ingredients include chemicals known as bufadienolides, which are derived from toad venom and some trees. These chemicals can disrupt heart rhythm, city health officials said. The products pose the greatest risk when ingested, but can also cause harm when applied to the skin, the typical use.

Symptoms of poisoning include chest pain, abdominal pain and vomiting. People should call the Poison Control Center immediately if poisoning from stone is suspected.

People with these products should immediately stop using them and wrap them and put them in the garbage. Do not flush them down the toilet, the health department said.

City officials are working with federal authorities to halt sales of these product, the health department said.

More information

The American Academy of Family Physicians has information about erectile dysfunction.

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Think You’re Allergic to Penicillin? Maybe Not, Researchers Say

THURSDAY, Nov. 5, 2015 (HealthDay News) — Many people who’ve been told they’re allergic to penicillin may be able to safely take the drug, a small study suggests.

Most people who believe they are allergic to penicillin have been told so by a doctor after having a reaction to the antibiotic. Most never take penicillin again, even if they are never tested for the allergy, the researchers said.

The researchers examined the medical records of 15 people who tested negative for penicillin allergy after being told they were allergic. They were then treated with intravenous penicillin multiple times.

The study was to be presented Thursday at the annual meeting of the American College of Allergy, Asthma and Immunology, in San Antonio.

“Of the patients whose records we examined, there were no adverse drug reactions or evidence of recurrence of their penicillin allergy,” study author and allergist Dr. David Khan said in a college news release. “There is often thought to be a higher risk in patients who get intravenous penicillin, but we did not find this to be the case.”

Previous reported reactions included rash, hives and swollen lips, Khan said. But the study found none of those reactions after allergy testing and treatment with multiple courses of intravenous penicillins.

About 10 percent of Americans believe they are allergic to penicillin. As a result, they’re prescribed more risky and expensive antibiotics, according to the news release.

“Recent research has shown that patients who are labeled penicillin-allergic and take other antibiotics are more likely to have poor outcomes, such as development of colitis, longer hospital stays and greater numbers of antibiotic-resistant infections,” allergist Dr. Roland Solensky said in the news release.

Khan said patients who’ve been told they’re allergic to penicillin should get tested to be sure.

“An allergist will work with you to find out if you’re truly allergic to penicillin, and to determine what your options are for treatment if you are. If you’re not, you’ll be able to use medications that are safer, often more effective and less expensive,” he explained.

Research presented at meetings has not been subject to the same scrutiny as published studies and is typically considered preliminary.

More information

National Jewish Health has more about drug allergies.

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Your DNA May Explain High-Calorie Food Cravings

THURSDAY, Nov. 5, 2015 (HealthDay News) — Can’t resist high-fat, sugary foods? Your genetic makeup may be to blame.

Researchers say they’ve identified a pair of genetic variants that interact to boost the brain’s reward responses to foods high in fat and sugar.

They believe the findings might lead to new treatments for obesity.

The two genetic variants are located near the FTO gene, which is associated with increased risk of obesity, and the DRD2 gene, the researchers said.

The study, by researchers at Imperial College London, was to be presented Thursday at Obesity Week, a meeting in Los Angeles hosted by the American Society for Metabolic and Bariatric Surgery and the Obesity Society.

“For the first time, we also found that the activation in a part of the brain called the striatum was increased when those with the variant in FTO looked at high-calorie foods, but this depended on which variant of the other gene DRD2 they possessed,” research team leader Dr. Tony Goldstone said in an Obesity Society news release. “The DRD2 variant alters how the dopamine system works in the brain.”

The findings suggest that one reason people with the FTO variant are more likely to be obese may be because dopamine signals in their brain boost cravings when they see foods high in fat and sugar, leading them to eat more of those foods, Goldstone said.

“It is possible that people with these particular genetic variants may respond differently to certain treatments for obesity,” Goldstone said.

The researchers used functional MRI to evaluate the brain responses of participants as they viewed pictures of either high-calorie or low-calorie foods. Participants were also asked to rate how appealing they found the pictures. All had had their DNA analyzed.

The findings could help researchers better understand the biological basis of behaviors that may predispose some people to obesity, said Leah Whigham, executive director of Paso Del Norte Institute for Healthy Living, in the news release.

“It could help us better target treatments for obesity so particular people get the most effective treatment, as individualized approaches to obesity are necessary,” said Whigham, an Obesity Society spokeswoman.

Data and conclusions presented at meetings are usually considered preliminary until published in a peer-reviewed medical journal.

More information

The U.S. National Heart, Lung, and Blood Institute has more about obesity prevention.

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‘Balloon-in-a-Pill’ May Be New Weight-Loss Weapon

By Alan Mozes
HealthDay Reporter

THURSDAY, Nov. 5, 2015 (HealthDay News) — Could losing weight ever be as easy as swallowing a pill? Preliminary research suggests the answer may very well be yes.

Testing is underway to assess the potential of a gastric balloon that’s packed inside a standard-sized capsule attached to a tiny catheter.

Once swallowed, this capsule descends into the stomach, where its shell dissolves. The released balloon is then pumped up with buffered distilled water via the catheter, which is removed through the mouth.

If all goes as planned, the resulting grapefruit-sized (19-ounce) ball of water fills the stomach and significantly curbs the amount of food someone can eat before feeling satiated.

After about four months, the balloon automatically deflates, at which point its thin shell is naturally excreted.

The device, called Elipse and manufactured by Allurion Technologies of Wellesley, Mass., has yet to be tested in American patients for U.S. Food and Drug Administration approval. Researchers say that under the best of circumstances, it won’t be available in the United States for another two to three years.

However, early research involving 34 patients in the Czech Republic and Greece suggests that the noninvasive intervention seems safe and effective.

In four months time, patients lost an average of 37 percent of their excess weight (about 22 pounds each), the researchers report.

The device is considered an aid to weight loss, not a cure, experts noted.

“Because patients get used to feeling full so much quicker with the device, they learn portion control and get used to eating less,” said study author Dr. Ram Chuttani, director of interventional gastroenterology and endoscopy at Beth Israel Deaconess Medical Center in Boston. “We anticipate that the improved eating habits patients develop will mean that a significant amount of the weight will stay off, even when the balloon is no longer in place.”

The trial was funded by Allurion, and the results were scheduled for presentation Thursday in Los Angeles at Obesity Week. The annual meeting is hosted by the American Society for Metabolic and Bariatric Surgery and the Obesity Society. Because research presented at meetings hasn’t gone through the rigorous peer review required of published studies, it is usually considered preliminary.

Chuttani said thicker, silicon-based gastric balloons have been available for about 15 years outside the United States. This year, the FDA approved two traditional gastric balloon systems, which require an endoscopy — a minimally invasive procedure — for implantation in the stomach.

This is not the case with Elipse, which is described as “procedureless.”

Prior tracking of traditional gastric balloon patients suggests there are long-term benefits. For example, Chuttani said that after a year patients typically keep off about half the pounds lost while the balloon was in place. That figure dips to about 30 percent five years post-procedure, he said.

Typical side effects with traditional gastric balloons include nausea and vomiting, which was also the case among Elipse trial participants, the researchers said.

Dr. John Morton, chief of bariatric and minimally invasive surgery at Stanford University in Palo Alto, Calif., said a noninvasive approach might ultimately reach a wider pool of obese adults, given that invasive approaches are typically reserved for severely obese patients — those with a body-mass index (BMI) of 35 and up.

By contrast, Elipse is intended for patients with a BMI as low as 27, said Morton, who is also president of the society for metabolic and bariatric surgery. A BMI of 27 is overweight but not obese. BMI is an assessment of body fat based on height and weight.

“We know the risk for mortality, and disease starts to edge up with a BMI of around 30,” said Morton.

An approach that “affords the promise of earlier intervention to address the huge public health problem that is obesity” would be a great additional tool, he said.

However, noting that these new results stem from one small study, Morton said more research is needed. “But so far it looks to be quite safe and reasonably effective, so I think it’s quite promising,” he said.

More information

There’s more on bariatric surgery at the U.S. National Institute of Diabetes and Digestive and Kidney Diseases.

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