Skin Cancer Check? Do Some Sole-Searching

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, June 15, 2016 (HealthDay News) — Sunlight is considered the leading cause of melanoma, but daily wear-and-tear appears to promote the deadly skin cancer in at least one place where the sun rarely shines, researchers say.

Stress and damage caused by walking or running could be a risk factor for melanoma on the soles of the feet, the Japanese researchers contended.

Worse, because people don’t think to check for melanoma on their soles, when the cancer is found it’s often very advanced, the investigators reported.

Cases of melanoma on the soles of the feet seem to occur in places that receive the most stress when people walk or run, said senior researcher Dr. Ryuhei Okuyama. He is a professor of dermatology at the Shinshu University School of Medicine in Matsumoto, Japan.

These places (the “plantar surface”) include the ball of the foot, the side of the foot’s arch, and especially the heel, the researchers said.

“Our clinical observation suggests that mechanical stress — such as plantar pressure and shear stress — is involved in the development of melanoma on the sole,” Okuyama said.

Melanoma occurs in the skin’s melanocytes, which are cells that produce brown pigment called melanin, according to the American Cancer Society (ACS).

It’s a relatively rare, but very serious form of cancer. Melanoma accounts for only 1 percent of all skin cancers, but it causes the most deaths from skin cancer. More than 76,000 new melanomas are expected to be diagnosed in the United States in 2016, and approximately 10,000 people will die from the cancer, the ACS says.

Melanoma on the soles of the foot is even rarer than that, Okuyama said — about 2.2 cases for every million black people and about 2.4 cases for every million white people in the United States.

Melanoma is generally caused when ultraviolet rays — from the sun, or from artificial sources, such as tanning beds — damage the DNA of melanocytes, according to the cancer society.

But a review of medical data between January 1990 and December 2014 revealed 123 patients at Shinshu University Hospital who had been diagnosed with melanoma on the soles of their feet. The average age of people diagnosed with melanoma on their feet was 73.5 years, the study reported.

Charting the location of the melanomas, researchers found they most often occur on locations where pressure is regularly placed on the sole. Only a couple of cases occurred in the arch, which receives little direct pressure while walking, the study authors said.

When diagnosed, many already had advanced melanoma, the researchers noted.

Only 40 people — about one-third of all the patients — had cancer that was 1 millimeter or less thick. That thickness is usually classified as stage I melanoma. The rest had melanomas that were thicker and further developed, the study revealed.

Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society, pointed out that “once you get above that 1 millimeter level, you can be in serious trouble.”

Dr. Lynn Schuchter is chief of hematology and oncology at Penn Medicine’s Abramson Cancer Center in Philadelphia. She said that the finding is intriguing, but doesn’t completely line up with what we already know about melanoma in other locations on the body.

“Chronic damage or pressure or chronic inflammation has not been linked to other areas of the body and melanoma, but it is linked to squamous cell skin cancer,” said Schuchter, who also serves as an expert for the American Society of Clinical Oncology.

Lichtenfeld concurred. “The authors have provided us with useful and thought-provoking information, but whether stress is the cause of melanoma in these locations is unknown,” he said. “It’s unlikely this is the complete story about why these melanomas happened in the first place. There may well be other factors involved.”

Both U.S. cancer specialists agreed with the Japanese researchers that the soles should be part of any skin check.

Okuyama said, “In our view, a foot check should be considered as a part of skin cancer exam, especially in elder persons. Lesions on the sole are hardly noticed in daily life.”

People who want to check their own soles should look for the same signs of melanoma as other parts of the body, Lichtenfeld and Schuchter said.

Look for moles or spots on the skin that are asymmetric, have irregular or ragged borders, have different shades of coloration, are larger than 6 millimeters across, and are changing in size, shape or color, the ACS says.

On the soles, people also should be on the lookout for melanomas that contain no coloration, Schuchter added.

“A non-healing wound or ulcer should also raise clinical suspicion that one is dealing with a cancer,” she said. “People think, ‘oh it’s a corn, oh it’s a blister.’ The concern is if some of these things really persist or are associated with bleeding, that raises the issue that something else might be going on.”

The report was published June 16 in the New England Journal of Medicine.

More information

For more on melanoma, visit the American Cancer Society.

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Timing of Zika Infection in Pregnancy May Be Key to Birth Defect Risk

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, June 15, 2016 (HealthDay News) — The danger of Zika-related birth defects may be confined to maternal infections that occur during the first two trimesters of a pregnancy, a new study suggests.

Colombian and U.S. researchers studied almost 12,000 pregnancies occurring in 2015 among women in Colombia, a country that is endemic for the mosquito that spreads the Zika virus.

The study detected no cases of infant abnormalities among women who contracted Zika during the last three months of their pregnancy, the researchers said.

They stressed that at the time of the study’s publication, 10 percent of the 1,850 women infected late in pregnancy had not yet given birth — so the data remains incomplete and “preliminary.”

Still, data on the other 90 percent of women suggest that “maternal infection with the Zika virus during the third trimester of pregnancy is not linked to structural abnormalities in the fetus,” the researchers concluded.

Those Zika-linked abnormalities most commonly involve microcephaly — a devastating birth defect where infants are born with abnormally small heads and associated neurological issues.

The study was published June 15 in the New England Journal of Medicine and led by Margaret Honein, of the U.S. Centers for Disease Control and Prevention.

In other Zika news, the CDC on Tuesday announced a plan to respond in a targeted and rapid way to any outbreaks of Zika infection in the United States, as the summer mosquito season heats up.

According to the Associated Press, if local infections occur, the affected state can reach out to expert teams from the CDC that will travel to the area. Part of the plan also involves detailed steps on destroying mosquitoes and their breeding sites within 150 yards of the infected person’s property.

Such efforts would continue for at least 45 days after the last reported Zika illness in the area, the AP said.

The vast majority of Zika infections so far have occurred in Latin America, and Brazil has been the epicenter with an estimated 5,000 cases of microcephaly. There have been no reports of Zika-induced microcephaly contracted in the United States, although Zika is now circulating in Puerto Rico, the U.S. Virgin Islands and American Samoa.

U.S. health officials have said they expect to see mild Zika outbreaks in Gulf Coast states such as Florida, Louisiana and Texas as mosquito season picks up.

Last Friday, the World Health Organization issued a recommendation that couples who are trying to have children and live in Zika-affected areas should consider delaying pregnancy to avoid having babies born with birth defects.

In the United States, the CDC has refrained from recommending that couples delay pregnancy in Zika-affected areas. However, Puerto Rico’s health secretary has issued advice that is similar to the new World Health Organization (WHO) guideline, The New York Times reported.

Mosquito bites remain the most common way Zika is spread, but transmission of the virus through sex is more common than previously thought, WHO officials have said.

Although the new WHO guideline doesn’t specify how long couples should delay pregnancy, the recommendation “means delaying until we have more answers, more evidence, more science,” WHO spokeswoman Nyka Alexander told the Times.

Last month, U.S. health officials reported that the number of pregnant women in the United States infected with the Zika virus had tripled because cases were now being counted in a more comprehensive way.

So far, an estimated 280 infected women are being followed in the United States and its territories, according to two registries that have been created by the CDC.

Previously, only cases of pregnant women who had Zika-related symptoms or pregnancy complications were being tallied, CDC officials said. But recently published reports have found that some pregnant women show no symptoms of Zika infection, yet still give birth to babies with microcephaly.

Women of child-bearing age who live in an active Zika region should protect themselves from mosquito bites by wearing long-sleeved shirts and long pants, using mosquito repellent when outside, and staying indoors as much as possible, according to the CDC.

President Barack Obama has asked Congress to allocate $1.9 billion to combat the Zika threat, but lawmakers have yet to agree on a spending package.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on the Zika virus.

This Q&A will tell you what you need to know about Zika.

To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.

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Timing of Zika Infection in Pregnancy May Be Key to Birth Defect Risk

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, June 15, 2016 (HealthDay News) — The danger of Zika-related birth defects may be confined to maternal infections that occur during the first two trimesters of a pregnancy, a new study suggests.

Colombian and U.S. researchers studied almost 12,000 pregnancies occurring in 2015 among women in Colombia, a country that is endemic for the mosquito that spreads the Zika virus.

The study detected no cases of infant abnormalities among women who contracted Zika during the last three months of their pregnancy, the researchers said.

They stressed that at the time of the study’s publication, 10 percent of the 1,850 women infected late in pregnancy had not yet given birth — so the data remains incomplete and “preliminary.”

Still, data on the other 90 percent of women suggest that “maternal infection with the Zika virus during the third trimester of pregnancy is not linked to structural abnormalities in the fetus,” the researchers concluded.

Those Zika-linked abnormalities most commonly involve microcephaly — a devastating birth defect where infants are born with abnormally small heads and associated neurological issues.

The study was published June 15 in the New England Journal of Medicine and led by Margaret Honein, of the U.S. Centers for Disease Control and Prevention.

In other Zika news, the CDC on Tuesday announced a plan to respond in a targeted and rapid way to any outbreaks of Zika infection in the United States, as the summer mosquito season heats up.

According to the Associated Press, if local infections occur, the affected state can reach out to expert teams from the CDC that will travel to the area. Part of the plan also involves detailed steps on destroying mosquitoes and their breeding sites within 150 yards of the infected person’s property.

Such efforts would continue for at least 45 days after the last reported Zika illness in the area, the AP said.

The vast majority of Zika infections so far have occurred in Latin America, and Brazil has been the epicenter with an estimated 5,000 cases of microcephaly. There have been no reports of Zika-induced microcephaly contracted in the United States, although Zika is now circulating in Puerto Rico, the U.S. Virgin Islands and American Samoa.

U.S. health officials have said they expect to see mild Zika outbreaks in Gulf Coast states such as Florida, Louisiana and Texas as mosquito season picks up.

Last Friday, the World Health Organization issued a recommendation that couples who are trying to have children and live in Zika-affected areas should consider delaying pregnancy to avoid having babies born with birth defects.

In the United States, the CDC has refrained from recommending that couples delay pregnancy in Zika-affected areas. However, Puerto Rico’s health secretary has issued advice that is similar to the new World Health Organization (WHO) guideline, The New York Times reported.

Mosquito bites remain the most common way Zika is spread, but transmission of the virus through sex is more common than previously thought, WHO officials have said.

Although the new WHO guideline doesn’t specify how long couples should delay pregnancy, the recommendation “means delaying until we have more answers, more evidence, more science,” WHO spokeswoman Nyka Alexander told the Times.

Last month, U.S. health officials reported that the number of pregnant women in the United States infected with the Zika virus had tripled because cases were now being counted in a more comprehensive way.

So far, an estimated 280 infected women are being followed in the United States and its territories, according to two registries that have been created by the CDC.

Previously, only cases of pregnant women who had Zika-related symptoms or pregnancy complications were being tallied, CDC officials said. But recently published reports have found that some pregnant women show no symptoms of Zika infection, yet still give birth to babies with microcephaly.

Women of child-bearing age who live in an active Zika region should protect themselves from mosquito bites by wearing long-sleeved shirts and long pants, using mosquito repellent when outside, and staying indoors as much as possible, according to the CDC.

President Barack Obama has asked Congress to allocate $1.9 billion to combat the Zika threat, but lawmakers have yet to agree on a spending package.

More information

Visit the U.S. Centers for Disease Control and Prevention for more on the Zika virus.

This Q&A will tell you what you need to know about Zika.

To see the CDC list of sites where Zika virus is active and may pose a threat to pregnant women, click here.

---

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Indoor Pollution From Fuels May Threaten Heart

WEDNESDAY, June 15, 2016 (HealthDay News) — Regularly using kerosene or diesel for cooking, heating or lighting may increase the risk of heart attack and early death, a new study warns.

Researchers followed more than 50,000 people in Iran, to assess the effects of indoor air pollution caused by burning kerosene, wood, diesel, cow dung and natural gas. The participants’ average age at the start of the study was 52, and 80 percent lived in rural areas.

Over 10 years, those who burned kerosene or diesel had a 6 percent higher risk of dying from all causes, an 11 percent higher risk of heart-related death, and a 14 percent higher risk of heart disease, the study found.

Compared to those who used other fuels, people who used natural gas had a 6 percent lower risk of heart-related death, according to the study.

“We know that smoking tobacco products and outside air pollution are linked to heart disease death,” said lead researcher Dr. Sumeet Mitter, a cardiovascular disease fellow at Northwestern University in Chicago.

“Our study, using exposure history and time, is the first to find a significant and independent increased risk for all-cause, total cardiovascular disease and heart attack deaths due to increasing lifetime exposures to household air pollution from kerosene or diesel burning,” Mitter added.

The study only found an association, however, not a cause-and-effect relationship between these fuels and heart disease and deaths.

The findings were published June 13 in the journal Circulation.

Half the world’s population burns fuels for lighting, cooking and heating, according to the World Health Organization.

“Since heart disease is the leading cause of death worldwide, it is important for physicians to assess for a number of modifiable risk factors for heart disease, including household air pollution,” Mitter said in a journal news release.

More information

The World Health Organization has more about indoor air pollution.

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Sleep Apnea Tied to Complications After Angioplasty

WEDNESDAY, June 15, 2016 (HealthDay News) — Sleep apnea may increase the risk of serious complications in people who have undergone angioplasty to clear blocked heart arteries, researchers say.

In angioplasty, also called percutaneous coronary intervention (PCI), blocked heart arteries are re-opened using a thin catheter inserted through the groin or wrist.

The new study included 241 patients who underwent angioplasty. Their average age was 64 years, and the patients were followed for about six years.

Of those patients, slightly more than half had sleep-disordered breathing, which includes sleep apnea and snoring. Sleep apnea is a common and chronic condition, according to the U.S. National Heart, Lung, and Blood Institute (NHLBI). In sleep apnea, breathing stops or becomes shallow during sleep. Breathing pauses can last from a few seconds to minutes, the NHLBI says.

Sleep-disordered breathing was detected through heart and respiratory monitors used overnight after the procedure, the researchers said.

During the follow-up, 21 percent of patients with sleep-disordered breathing had major heart events, including heart attack, stroke and heart failure. In people who didn’t have sleep-disordered breathing troubles, the heart complication rate was just 8 percent, the study found.

People with sleep-disordered breathing were also more likely to die during the follow-up, the findings showed. However, the study can only show an association between these factors, not a direct cause-and effect link.

The findings were published online June 15 in the Journal of the American Heart Association.

“Sleep-disordered breathing, which includes snoring and sleep apnea, has long been recognized as an important risk factor for heart disease,” study author Dr. Toru Mazaki said in a journal news release.

“However, there is limited awareness of sleep-disordered breathing among cardiologists who care for PCI patients,” said Mazaki, who is chief physician in the department of cardiology at Kobe Central Hospital in Japan.

Mazaki said the study results suggest that sleep-disordered breathing problems are an important risk factor for stroke, heart failure and more after angioplasty.

“Doctors and patients should consider sleep studies [after an angioplasty] to rule out sleep-disordered breathing or take necessary precautions to restore healthy breathing during sleep,” Mazaki said.

The standard treatment for sleep apnea is continuous positive airway pressure, or CPAP. A CPAP mask pushes air into the person’s airways while asleep. Additional options include dental devices and surgery.

More information

The U.S. National Heart, Lung, and Blood Institute has more on heart angioplasty.

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Novel Brain Cancer Treatment Taps Into Sound Waves

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, June 15, 2016 (HealthDay News) — Brain cancer patients might benefit from an implantable ultrasound device that appears to enhance chemotherapy treatment, a small study says.

Researchers from the Pitie-Salpetriere Hospital in Paris and other French institutions tested the experimental device on 15 patients with recurrent glioblastoma, a particularly deadly brain cancer. When the so-called SonoCloud was activated, sound waves opened the blood-brain barrier, letting in more chemotherapy, they said.

“The walls of the blood vessels in the brain are very difficult to cross for certain molecules,” said Frederic Sottilini, CEO of Paris-based CarThera, the company developing SonoCloud.

While this blood-brain barrier protects the brain from toxins, “it means a challenge for treating brain diseases and disorders, as 99 percent of potential therapeutic drugs are blocked by it,” he said.

“Scientists have been researching ways to bypass this barrier for over 50 years,” Sottilini said.

A U.S. cancer specialist said this experimental technique could prove to be an important achievement.

“This is significant,” said Dr. Ekokobe Fonkem, a neuro-oncologist at Baylor Scott and White’s Vasicek Cancer Treatment Center, in Temple, Texas. “One of the reasons glioblastoma, which is one of the most aggressive forms of brain cancer, is very difficult to treat is because the blood-brain barrier prevents medications from getting across.”

It’s possible that this ultrasound approach could pave the way for more effective treatments, Fonkem said. “There are some medications that have potential but can’t cross the blood-brain barrier,” he noted.

But Fonkem said larger trials are needed before this device can be used in cancer treatment. “We have to see if there is any clinical benefit,” he said. “They have to show it works without increasing side effects.”

One concern, he added, is that by breaching the blood-brain barrier, you may open the door to brain infections.

“They have to make sure there is no room for bacteria to get into the brain and cause meningitis, which can be fatal,” Fonkem said.

Sottilini explained how the ultrasound device works: It’s implanted in the skull, over the area of the tumor. When activated, sound waves cause tiny beads — called microbubbles — to vibrate, temporarily opening the blood-brain barrier. This permits more of the chemo drug to reach the tumor, he said.

According to Sottilini, the device appeared safe to use in areas of the brain that control speech, movement and other senses.

“This could mean major therapeutic possibilities, not only for brain cancers, but also for neurodegenerative diseases such as Alzheimer’s,” he said.

The device is activated before each round of chemotherapy, Sottilini said. Two minutes of low-intensity ultrasound is enough to open the blood-brain barrier for about six hours and increase the concentration of medication five to seven times, he said.

The researchers used the chemo drug carboplatin for the study. Carboplatin is commonly used to treat recurrent glioblastoma, they said, and has been shown to control tumors, but does not easily pass the blood-brain barrier.

The experimental treatments were conducted monthly for six months at most or until evidence of tumor progression was detected.

This phase 1 trial was not designed to test whether the higher doses of chemotherapy that passed into the brain were effective. However, tumor growth did not progress in nine patients, the researchers said.

Sottilini said he hopes for a larger trial next year.

The report was published June 15 in the journal Science Translational Medicine.

More information

For more on brain cancer, visit the U.S. National Cancer Institute.

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Expert Panel Reaffirms Need for Colon Cancer Screen Beginning at Age 50

WEDNESDAY, June 15, 2016 (HealthDay News) — Reiterating a recommendation last made in 2008, an influential U.S. panel of health experts is advocating that regular colon cancer screening begin at age 50 and continue until at least age 75.

However, the U.S. Preventive Services Task Force stopped short of saying any one screening method was better than another.

“There are multiple screening options for colorectal cancer that reduce the risk of dying from the disease. We encourage people to choose the best option for them, in consultation with their clinician,” former Task Force member Dr. Douglas Owens said Wednesday in a USPSTF news release.

The panel’s reticence to choose one option over another may be at odds with the preference of many doctors, who often advise colonoscopy as the “gold standard” test.

Dr. Arun Swaminath is one of them.

“There is only one test — colonoscopy — that can both diagnose a polyp/cancer and remove or sample it at the same time,” said Swaminath, who directs the inflammatory bowel disease program at Lenox Hill Hospital in New York City.

“This is key, because a positive stool test plus stool DNA test (such as Cologuard), or a positive imaging test (such as CT colonoscopy) will still require a follow up colonoscopy to confirm and treat the problem,” he explained.

For its part, the American Cancer Society recommends colonoscopy screening once every 10 years, beginning at age 50, or one of a number of other tests at more frequent intervals.

In drafting its updated colon cancer screening guidelines, the USPSTF reviewed data on several screening strategies. Besides colonoscopy, these included flexible sigmoidoscopy (an invasive procedure that penetrates less far than colonoscopy); CT colonography (a scan of the colon); traditional fecal occult blood tests (looking for blood in stool); and the recently approved Cologuard DNA-based stool test.

The panel said there were no comparison studies that suggested that any of the screening methods were any more effective than others. There are varying amounts of proof supporting the effectiveness of each, and each method has its advantages and limitations, the panelists said.

And what about colon cancer screening for the elderly?

In its statement, the panel said that “for some adults ages 76 to 85, the benefits of screening are smaller, and the potential for harm greater. However, some people in this age group may benefit, especially if they have never been screened before and are healthy enough to undergo treatment if cancer is found.”

For this older group, the USPSTF recommends that decisions on screening be made during consultations between the patient and his or her doctor.

All of the recommendations are specific to symptom-free people 50 years of age or older with an average risk colorectal cancer, the panel stressed. People with disorders or medical histories that raise their odds for colon cancer may need more rigorous screening, the USPSTF said.

The updated recommendation was published online June 16 in the Journal of the American Medical Association.

“Evidence convincingly shows screening for colorectal cancer works, but not enough people are taking advantage of this highly effective service,” said Owens, a general internist at the Veterans Affairs Palo Alto Health Care System and a professor at Stanford University.

The USPSTF notes that only one-third of eligible adults in the United States are screened for colon cancer, and more need to take advantage of this effective method of prevention.

Colorectal cancer remains the second leading cause of cancer death in the United States. This year about 134,000 people in the country will be diagnosed with the disease, and about 49,000 will die from it., the panel said

The USPSTF is an independent, volunteer panel of experts that makes recommendations about the effectiveness of specific preventive health services.

More information

The U.S. Centers for Disease Control and Prevention has more on colon cancer screening.

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Antibiotics, Formula Feeding Might Change Baby’s ‘Microbiome’

By Randy Dotinga
HealthDay Reporter

WEDNESDAY, June 15, 2016 (HealthDay News) — When babies are born, the birth process covers their bodies with countless microbes that play crucial roles in their future health. But a new study suggests that these “microbiomes” are altered by cesarean births, antibiotics and formula feeding.

“The microbiome is really important in how a baby develops normally. We are doing things that are disrupting them,” said Dr. Martin Blaser, director of the Human Microbiome Program at New York University Langone Medical Center.

What do these microbiomes do?

Microbiomes evolved with humans and are mostly helpful, explained Annie Gatewood Hoen. She’s an assistant professor of epidemiology and biomedical data science at the Geisel School of Medicine at Dartmouth, in New Hampshire.

“These organisms help digest our food, train our immune system and out-compete disease-causing microbes,” she said.

But, there’s still a lot of mystery about how they work.

“They’re very complex and everyone’s is slightly different,” Hoen said, and it’s not entirely clear what healthy ones should look like.

“There is a lot left to discover about how subtle variations in the makeup of these communities might be more or less optimal for health and, importantly, how we can manipulate them so they’re most beneficial to us,” she added.

The new study examined the microbiomes of newborns after they left the sterile environment of the womb.

Blaser and his colleagues used stool samples to track the intestinal germ makeup of 43 U.S. infants during the first two years of life. The researchers also analyzed the microbiomes of their mothers.

The investigators found that antibiotic use, cesarean birth and formula feeding all threw off the makeup of the microbiomes from levels considered normal. In essence, their make-up became less diverse, Blaser said.

“We didn’t measure health effects, so we can’t say whether that’s good or bad,” he added.

However, previous research has linked C-sections and antibiotics to higher rates of digestive illness, obesity and asthma, Blaser noted. And doctors recommend breast-feeding over the use of formula for similar reasons.

A second study followed 39 Finnish infants to the age of 3 years, and found that antibiotics were linked to less-diverse microbiomes in the children.

The study, led by Moran Yassour, a postdoctoral fellow at the Broad Institute and Harvard Medical School in Boston, also found a temporary rise in the number of antibiotic resistance genes when antibiotics were given.

What should parents of newborns do? Blaser said antibiotics are important medicines but they shouldn’t be overused.

“We’ve known for a long time that we’re overtreating kids with antibiotics, and we’re beginning to find evidence that it will hurt them,” he said.

Dr. Alexander Khoruts, a professor of medicine at the University of Minnesota, agreed. “Antibiotics early in life may well have serious consequences that may not manifest for years,” he said.

“Both the microbiome and the baby go through developmental stages, and there is a lot of cross-talk between the microbes and the host,” he added. “A disrupted conversation due to antibiotics can lead to hardwiring of the immune system, for example.”

This, he said, can lead to allergies and other conditions linked to overactive immune systems.

As for cesarean births, study co-author Blaser said they should only be performed if medically necessary. He also recommends breast milk over formula.

What’s next for research? In the future, it may be possible to counteract things that disrupt the microbiome, Blaser said. For now, “we’re continuing to follow these children.”

The studies were published June 15 in the journal Science Translational Medicine.

More information

The University of Utah has more about changing microbiomes.

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Heart Disease Down Among Over-40 Americans

WEDNESDAY, June 15, 2016 (HealthDay News) — America’s heart health seems to be improving, a new study reports.

Federal researchers found that fewer Americans over 40 have coronary heart disease. The rate is down from just over 10 percent in 2001-2002 to 8 percent in 2011-2012, the study found.

Despite the overall decline, there wasn’t a significant change in heart disease rates for people from 40 to 59 years old. But the rate among those 60 and older fell from 19.5 percent to 15 percent, the researchers said.

The rate among women dropped more than 2 percent during the study period. There were also significant declines in coronary heart disease among whites and blacks, the study revealed.

Having health insurance was also linked to better heart disease rates, the study authors said.

The study was carried out by researchers at the U.S. Centers for Disease Control and Prevention’s National Center for Health Statistics.

So, what are older Americans doing that may be boosting their heart health?

The researchers suggested that better management and prevention of modifiable risk factors is likely why the rates of heart disease are coming down. These factors include high blood pressure, abnormal cholesterol, smoking, diabetes, overweight and obesity.

The rates of high blood pressure and abnormal cholesterol haven’t gone down. But people are controlling those risk factors, the researchers noted.

Diabetes and obesity rates are on the rise, but the study authors said that overall, management of blood sugar levels has greatly improved.

The study was published June 14 in the American Journal of Preventive Medicine.

The drop in heart disease rates “could relate to general trends in lifestyle changes, such as improved diet, increased level of physical activity, or other factors such as prophylactic aspirin use among U.S. adults,” said lead study author Sung Sug (Sarah) Yoon. She was with the National Center for Health Statistics at the time of the study.

“Furthermore, anti-smoking prevention efforts have resulted in a decreased prevalence of cigarette smoking, which may have contributed to the decrease in coronary heart disease prevalence,” she said in a journal news release.

More information

The U.S. National Heart, Lung, and Blood Institute has more on coronary heart disease.

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Pet Turtles Continue to Spread Salmonella

WEDNESDAY, June 15, 2016 (HealthDay News) — Kissing a turtle may be more than just yucky — sometimes it can literally be sickening.

U.S. health officials found that illegal small turtles caused 15 outbreaks of Salmonella in the United States over the past decade. Half of the cases were in children under 10.

Certain behaviors were likely to lead to infection, the new report said. Among those behaviors: “Kissing turtles, letting them roam on kitchen countertops and tabletops where food and drink is prepared or consumed, and cleaning turtle habitats in kitchen sinks,” researchers from the U.S. Centers for Disease Control and Prevention said.

Although banned since 1975, turtles less than 4 inches long remain popular as pets in the United States, according to the report.

“Exposure to small pet turtles has long been recognized as a source of human salmonellosis in the United States, and the public health risk may be increasing,” said researchers, led by the CDC’s Stacey Bosch. “These small reptiles are readily acquired through multiple venues and continue to be the main source of turtle-associated salmonellosis in children.”

Prevention will require “a comprehensive approach involving human, animal, and environmental health,” the researchers said in an agency news release.

The report is published in the July issue of Emerging Infectious Diseases.

Prior to the ban, salmonella illnesses linked to turtles sickened about 280,000 people each year, according to the CDC.

It’s possible to become infected without picking up the turtle, Maroya Walters, an epidemiologist with the CDC, said recently. “You don’t actually have to hold the turtle or touch its aquarium or water to get sick. Cross-contamination of surfaces can cause illness as well,” she said.

Salmonella symptoms include diarrhea, fever and abdominal cramps between 12 and 72 hours after infection. The illness usually lasts four to seven days, and most people recover without treatment, the CDC says.

But in severe cases, hospitalization may be required. In these patients, the salmonella infection may spread to the bloodstream and to other parts of the body. In such cases, salmonella can be fatal without antibiotic treatment, according to the CDC.

The elderly, infants, pregnant women and those with impaired immune systems are more likely to have a severe illness, the agency says.

All turtles can carry and transmit salmonella on their skin and shells, Walters said. “Turtles and other reptiles shouldn’t be kept at home or school or any other facilities where there are children under 5,” she said.

In homes with older children or where people choose to keep reptiles, it’s important to wash your hands after handling turtles or their environment or any area where they roam, Walters said.

More information

The U.S. Food and Drug Administration has more about pet turtles and salmonella.

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