Scans May Spare Some Hodgkin Lymphoma Patients From Chemo

THURSDAY, June 23, 2016 (HealthDay News) — A certain type of medical scan can be used to help spare some Hodgkin lymphoma patients from the severe side effects of chemotherapy, a new study suggests.

Researchers found that PET imaging can identify patients whose Hodgkin lymphoma will likely respond better to treatment, and therefore require less intensive chemotherapy.

“The good news is that the majority of people diagnosed with Hodgkin lymphoma can be cured — in this trial more than 95 percent of patients are alive after three years. But we worry about the long-term side effects from the treatments we use,” study leader Peter Johnson, a professor of medical oncology at the University of Southampton in England, said in a university news release.

“As we’ve done in this trial, personalizing treatment based on how well it works is a major development for patients with Hodgkin lymphoma, and sets a new standard of care,” he noted.

PET scans were given to more than 1,200 patients with advanced Hodgkin lymphoma who had undergone two cycles of standard chemotherapy. Those with a clear scan continued chemotherapy without the drug bleomycin. Those who didn’t have a clear scan — suggesting a more resistant form of the blood cancer — continued chemotherapy with bleomycin.

Bleomycin has been used to treat Hodgkin lymphoma for 30 years, researchers said. But, the drug can lead to scarring of the lungs that can cause serious breathing problems.

Patients with clear PET scans who stopped receiving bleomycin had the same survival rate as those who continued receiving the drug, according to the study.

“Knowing which patients have a more difficult-to-treat form of the disease means we can select those who need stronger chemotherapy, while sparing everyone else the severe side effects such as infertility,” Johnson said.

“This approach, along with a reduction in the need for radiotherapy, should substantially reduce damage to healthy tissues and the risk of second cancers caused by treatments,” he added.

The study was published in the June 22 issue of the New England Journal of Medicine.

More information

Lymphoma Canada has more about Hodgkin lymphoma.

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U.K. Case of Throat Gonorrhea Resists Antibiotics

By Alan Mozes
HealthDay Reporter

THURSDAY, June 23, 2016 (HealthDay News) — In an alarming development, British public health experts have confirmed a case of throat gonorrhea that proved untreatable with the standard antibiotic regimen.

The patient, a heterosexual man who had just returned to the United Kingdom from Japan, wasn’t cured by a pair of antibiotics used as the first-line gonorrhea treatment in many countries, including the United States.

“This case highlights that gonorrhea may become untreatable due to antimicrobial resistance,” warned Gwenda Hughes, section head of sexually transmitted infections at Public Health England.

“Despite successful treatment of this case with higher doses of antibiotics, this approach to treatment would only be an interim solution,” noted Hughes, who was not involved with the new study.

“Higher-dose treatments are not suitable for all patients, and resistance to higher doses is likely to develop eventually,” she added.

The case reflects different challenges in treating gonorrhea of the throat, as compared with genital gonorrhea. It also underscores the need to test all potential places of infection, the study authors explained.

U.S. health officials watch cases like this closely. “Gonorrhea antibiotic resistance and treatment failure in other countries underscores the importance of continuing to monitor for drug resistance in the U.S., and adhering to CDC’s treatment recommendations for gonorrhea,” said Dr. Robert Kirkcaldy. He is an epidemiologist with the U.S. Centers for Disease Control and Prevention (CDC).

In the past 30 years, “we have seen gonorrhea develop resistance to an extensive roster of antibiotics,” Kirkcaldy said. “While we have not seen confirmed failures of treatment with the current recommended dual therapy of azithromycin and ceftriaxone in the United States, history shows us that it’s only a matter of time before resistance to these antibiotics emerge.”

Both genital and oral forms of gonorrhea have demonstrated antibiotic resistance in recent years.

Untreated gonorrhea in women can cause pelvic inflammatory disease and infertility. In rare cases in men, it can lead to sterility, the CDC says.

According to the case report, the patient had had sexual relations in Japan with a woman who herself had been treated for gonorrhea.

Ten days after his return to the United Kingdom, he sought medical care following two weeks of “urogenital” symptoms.

After a urine analysis confirmed gonorrhea, the patient was treated with a single 500 milligram injectable dose of the antibiotic ceftriaxone (Rocephin) and a 1-gram pill of the antibiotic azithromycin (Zithromax).

This drug combination is used to treat upwards of 97 percent of all gonorrhea cases in the United States, according to the CDC.

But 15 days after treatment, while tests showed no infection in his urine, the patient still had gonorrhea in his throat, the findings showed.

Nearly three months later, the throat infection was still present. Shortly thereafter the patient was given a double-dose of the same dual therapy.

This time, testing two weeks later confirmed that the double-dose dual therapy had worked, the researchers said.

The report authors call it a clear example of “treatment failure,” given that the therapy couldn’t clear the infection at the dose normally prescribed.

Antimicrobial testing revealed that while the strain of gonorrhea at hand was susceptible to one antibiotic known as spectinomycin (Trobicin), it was effectively resistant to a wide range of often used antibiotics.

But Kirkcaldy stressed that the dual-therapy regimen “is still highly effective in the United States.”

“The highest priority is to ensure doctors continue treating with a combination of ceftriaxone and azithromycin right away to fully cure infection and prevent transmission,” he said. And patients with persistent symptoms following treatment should immediately contact their doctors, he added.

Although gonorrhea infections are often symptomless, some men experience a burning sensation while urinating, discolored penile discharge, and/or painful or swollen testicles, according to the CDC. A sore throat could be a sign of oral gonorrhea.

Gonorrhea can be spread by having vaginal, anal, or oral sex with someone who has the infection, the agency notes.

According to the study, the patient had a type of gonorrhea that’s spreading in Japan and associated with poor response to cephalosporins and azithromycin.

The case review, led by Helen Fifer of Public Health England, is detailed in a letter published June 23 in the New England Journal of Medicine.

More information

There’s more on gonorrhea treatment at the U.S. Centers for Disease Control and Prevention.

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CDC Panel Says FluMist Nasal Flu Vaccine Ineffective

THURSDAY, June 23, 2016 (HealthDay News) — Americans may have to do without the easier, nasal spray form of flu vaccine next flu season, a panel of experts decided Wednesday.

That’s because the medicine, called FluMist, has been largely ineffective in children in recent years and should not be used in the United States during the 2016-17 flu season, the panel of experts said.

“We could find no evidence [the spray] was effective,” Dr. Joseph Bresee, a flu expert at the U.S. Centers for Disease Control and Prevention, told the Associated Press. The decision was announced late Wednesday by the CDC’s Advisory Panel on Immunization Practices (ACIP).

The traditional flu shot is effective, however, and recommended for everyone aged 6 months and older, the panel concluded.

The ACIP panel’s advisories are adopted by federal government, which then issues guidance to the nation’s doctors.

FluMist differs from the traditional shot in that it is not made from dead virus, but from a weakened form of the influenza virus.

The decision is a reversal of fortune for FluMist, which is made by AstraZeneca and was first licensed in 2003. Early studies that showed it outperformed the traditional flu shot in protecting kids.

In fact, in 2014, the ACIP recommended FluMIst over needle-based flu vaccines for children, the AP noted.

But more recent trials have shown less impressive results. ACIP said it reviewed data from 2013 through 2016 to assess the effectiveness of the nasal spray for children aged 2 to 17. These new studies found that FluMist offered kids virtually no protection against the flu.

In the 2015-16 flu season, the nasal flu vaccine’s protection rate was only 3 percent, which means that no protective benefit could be measured, the panel explained. It’s effectiveness in the previous two flu seasons was also low.

In comparison, the traditional flu shot was 63 percent effective among children aged 2 to 17 during the 2015-16 flu season, ACIP said.

Why has FluMIst seemingly lost its effectiveness? Speaking with the AP, Breese theorized that when a fourth strain of influenza was added to the vaccine a few years ago, that may have weakened the body’s response to another strain.

The American Academy of Pediatrics supported the panel’s move.

“We do understand this change will be difficult for pediatric practices who were planning to give the intranasal spray to their patients, and to patients who prefer that route of administration,” Dr. Karen Remley, CEO and executive director of the AAP.

“However, the science is compelling that the inactivated [needle-based] vaccine is the best way to protect children from what can be an unpredictable and dangerous virus,” she said in an AAP news release.

The panel’s recommendation could have a significant impact since data suggests that nasal flu vaccine now accounts for about one-third of all flu vaccines given to children, according to the CDC.

The agency said it will work with vaccine makers throughout the summer to ensure there is enough of the traditional flu vaccine to meet demand for the upcoming season.

Remley said that, “the AAP will be working with CDC and vaccine manufacturers to make sure pediatricians and families have access to appropriate vaccines, and to help pediatricians who have already ordered intranasal vaccines.”

The CDC director must review and approve the ACIP recommendation before it becomes policy. A decision is expected in late summer or early fall.

More information

The U.S. Centers for Disease Control and Prevention has more about seasonal flu vaccine.

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Tighter Opioid Laws in U.S. Haven’t Eased Misuse

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, June 22, 2016 (HealthDay News) — U.S. laws designed to curb abuse of opioid painkillers haven’t reduced misuse or overdoses by disabled Medicare beneficiaries, a new study suggests.

Between 2006 and 2012, states enacted 81 laws to control use of powerful opioids such as Oxycontin and Vicodin. But even with these new prescription-drug monitoring programs and other regulations, researchers found that 45 percent of disabled Medicare beneficiaries were still using opioids in 2012.

And 8 percent got their opioids from four or more doctors.

“There is no evidence yet that these laws prevent misuse of prescription opioids,” said lead researcher Ellen Meara, a professor at the Dartmouth Institute for Health Policy and Clinical Practice in Lebanon, N.H.

“In this vulnerable population of disabled workers, legal remedies to the opioid epidemic are too weak and too slow,” she added.

Disabled workers are at risk of opioid abuse, she said, because they “have complex medical and social needs, high rates of poverty, and they are more likely to have diagnoses of mental illness like depression compared with other Americans.”

Widespread availability of powerful painkillers has caused an epidemic of addiction, injury and death, said Dr. G. Caleb Alexander, co-director of the John Hopkins Center of Drug Safety and Effectiveness.

“The United States accounts for 5 percent of the world’s population, but consumes 80 percent of the opioids — you know we’ve got a problem,” said Alexander, who wasn’t involved in the study.

According to the U.S. Centers for Disease Control and Prevention, 78 Americans die every day from an overdose of opioids, including heroin.

Tighter regulations have a role in curbing the epidemic, Alexander said.

The problem with the laws enacted between 2006 and 2012 is that none addressed the “underlying pain and disenfranchisement that has led so many Americans to seek relief of pain with opioids,” Meara said.

Eventually, though, Meara believes new and/or tougher legislation will start to turn the epidemic around.

“Over a five-year horizon, I am optimistic that legal remedies may help slow the misuse, abuse and overdose deaths related to prescription opioids,” Meara said. “Unfortunately, the epidemic is spreading and changing rapidly, while the legal response is slow and blunt.”

Progress has been made since 2012, when the study ended, she noted. For instance, it’s now easier to gain access to naloxone, a prescription drug that can reverse opioid overdose. Addicts have greater access to medication-assisted treatment for addiction, and newer laws help prevent fraudulent prescribing, Meara said.

For the study, Meara and her colleagues used Medicare data to assess the volume of opioid painkiller use among disabled beneficiaries, aged 21 to 64, from 2006 to 2012.

They found no discernible difference in opioid use or overdose as a result of tighter regulations. For example, 5 percent still had prescriptions for high doses of opioid painkillers — more than 120 milligrams — in 2012.

They found that 0.3 percent of these patients were treated for a nonfatal overdose in 2012, about the same as before tougher laws were enacted, Meara said.

Alexander is cautious about drawing broad conclusions from a single study, however. “A lot has happened since 2012, this is a rapidly evolving area,” he said.

He also stressed that limiting use of opioid painkillers doesn’t mean shortchanging patients in pain as some have feared, he added. There are many non-narcotic painkillers and non-drug treatments for chronic pain, he said.

These drugs do have a role for people in acute pain and those suffering at the end of life, Alexander said. “But that’s not where we’ve seen the soaring increase. In the past two decades, it’s been in the treatment of chronic, non-cancer pain,” he said.

The report appears in the June 23 issue of the New England Journal of Medicine.

More information

For more on opioid painkillers, see the U.S. National Institute on Drug Abuse.

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Doing This at Bedtime Could Temporarily Rob Your Sight

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, June 22, 2016 (HealthDay News) — A short-lived optical sensation can lead some smartphone users to mistakenly believe they’ve lost sight in one eye, British doctors report.

The temporary vision loss can affect people who read their smartphone in the dark while lying on their side, explained Dr. Gordon Plant, an ophthalmologist with Moorfields Eye Hospital in London.

When they stop reading and get up to do something else, they might suddenly lose vision in the eye they’ve been using to read their smartphone, said Plant, senior author of a paper on the phenomenon.

Luckily, it’s a temporary condition that lasts for several minutes, with no risk of permanent damage, he added.

Plant said he wrote the paper because these people might think they’ve suffered a stroke or some other medical emergency.

“I have seen a dozen or so similar cases,” Plant said. “The reason I wish to make this known is because it leads to anxiety and unnecessary investigation because the patients — and their doctors — think they have had a transient ischemic attack.” A TIA is a temporary loss of blood circulation in the brain that can serve as a warning sign for stroke.

The optical trick results from the eye’s ability to adapt to dark conditions, Plant said. It’s similar to how your vision may become dim when you move from a very bright space to a very dark location.

“The patients are looking at their phone in the dark lying on their side,” he said. “If on their left side, the left eye is occluded by the pillow and they are viewing the phone with the right eye. The left eye is adapted to the dark and the right eye is adapted to the light.”

When they switch off the phone, Plant said, they can’t see with the light-adapted eye in the dark, as it takes several minutes to adjust to the dark. However, they can see with the dark-adapted left eye, and so they think that they have lost vision in the right eye, he explained.

The paper cites two case studies — a 22-year-old woman who’d suffered recurring bouts of nighttime vision loss in her right eye for several months, and a 40-year-old woman who would wake up with a loss of vision in one eye that lasted as long as 15 minutes.

Both women went through a battery of tests, including MRIs and echocardiograms, before doctors figured out it was a trick of the eyes caused by reading a smartphone in the dark while lying in bed.

Plant figures the effect could be caused by any device that generates a bright light, but adds that the solution is “easy — look at the phone with both eyes.”

That way, both eyes will maintain the same adaptation to light, he said.

Another eye specialist agreed.

“If you look at your smartphone or your e-reader with both eyes you won’t have this surprise of losing your vision, which obviously is very scary for anyone, even if it’s temporary,” said Dr. Rahul Khurana, an ophthalmologist in Mountain View, Calif.

Khurana said this information can help doctors avoid ordering expensive brain scans and other testing. Instead, they can start their investigation by simply asking patients a few questions about their smartphone use.

“A lot of times when people have temporary loss of vision, there are so many potential causes of it that we aren’t always thinking of something as simple” as light adaptation, said Khurana, an expert with the American Academy of Ophthalmology.

The report was published in the June 23 issue of the New England Journal of Medicine.

More information

The U.S. National Eye Institute talks about healthy eyes.

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Zika Can Also Strike Eyes of Adults: Report

By Randy Dotinga
HealthDay Reporter

WEDNESDAY, June 22, 2016 (HealthDay News) — Doctors in Brazil report that a man infected with Zika developed a potentially severe eye condition, in another sign that the dreaded virus can harm vision in both babies and adults.

“Zika patients should report every single symptom to their doctors, especially if they present with any kind of eye symptoms,” said report co-author Dr. Benedito Antonio Lopes da Fonseca, an associate professor at the University of Sao Paulo.

The patient, who was in his early 40s, recovered from the condition called uveitis, a kind of inflammation in the eye. But the condition can lead to cataracts and high blood pressure in the eye, said report lead author Dr. Joao Furtado, an infectious disease specialist and professor at the University of Sao Paulo.

The mosquito-borne Zika virus has struck countries around the world, and travelers have brought it to the U.S. mainland. The American territory of Puerto Rico is facing an especially high risk, potentially placing hundreds of pregnant women in jeopardy of delivering babies with debilitating birth defects.

But no nation has been more affected than Brazil. As a result of the Zika epidemic there, almost 5,000 babies have been born with a devastating birth defect known as microcephaly after their mothers were infected with Zika early in pregnancy.

The virus is typically mild in adults, according to the U.S. Centers for Disease Control and Prevention. The most frequent symptoms are fever, rash, joint pain, and red eyes, possibly caused by conjunctivitis.

In addition to the cases of conjunctivitis, many children born with microcephaly are also blind, Fonseca added. But until now, only conjunctivitis has been seen in adults with Zika virus, Furtado noted.

The new case, reported in the June 22 issue of The New England Journal of Medicine, describes a man who was infected with Zika and developed uveitis. Based on tests and observation of the patient, it’s clear that Zika was the cause of the condition, Fonseca said.

“We cured this patient,” Fonseca said, and he hasn’t had any further eye problems.

Will other Zika patients with this kind of eye problem have a similar good prognosis?

“These are questions to be answered with time. Zika is a new disease, and many aspects of it are still unclear,” Fonseca said. However, he said, patients seen by his team have done well so far after treatment.

People with the condition can be treated in a variety of ways, such as drops to the eye, injections of medications in or around the eyes, and medications taken by mouth, via injection or intravenously, said Dr. Debra Goldstein, director of the Uveitis Fellowship Program at Northwestern University Feinberg School of Medicine, in Chicago. Mild cases like this one tend to have a good prognosis, she said.

Both Fonseca and Furtado believe that Zika may cause eye problems — both conjunctivitis and the more severe uveitis — because the virus affects the central nervous system. The eye is closely linked to that system, they explained.

Matthew Aliota, a professor who studies viruses at the University of Wisconsin, pointed out that the eye doesn’t have a strong immune system, meaning that viruses may more easily replicate there.

“This has been documented among survivors of Ebola virus disease,” he said, although it’s not clear how widespread the phenomenon is.

What now?

“Ophthalmologists who see patients with uveitis should be aware that Zika is a potential cause of it,” Furtado said. “And general doctors should know that a red eye associated with Zika is not necessarily only conjunctivitis. It can be more severe than it looks.”

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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Abortion Rates Rising in Zika-Affected Countries, Study Shows

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, June 22, 2016 (HealthDay News) — Fears over birth defects from mosquito-borne Zika may be driving up abortion rates in Latin American countries affected by the virus, a new study finds.

In Brazil and Ecuador — where governments have issued health warnings on the danger to the fetus from maternal Zika infection — requests for abortion in 2016 have doubled from 2010 rates, researchers say.

The other 17 Latin American countries covered by the new study had their rates rise by more than a third during that time, according to the June 22 report in the New England Journal of Medicine.

The researchers noted that because data on family planning in Latin America is often hard to come by, their numbers may underestimate the surge in abortions since Zika’s emergence.

Their study relied on data from Women on Web, a widely used nonprofit online resource for women seeking abortions in Latin America. The group provides medical abortions for women in countries where safe abortions are not widely available.

“The World Health Organization predicts as many as 4 million Zika cases across the Americas over the next year, and the virus will inevitably spread to other countries,” noted study senior author Dr. Catherine Aiken, of the University of Cambridge in England.

“It isn’t enough for health officials just to warn women about the risks associated with Zika — they must also make efforts to ensure that women are offered safe, legal, and accessible reproductive choices,” Aiken said in a university news release.

The mosquito-borne Zika virus has struck countries around the world, and travelers have brought it to the U.S. mainland. The American territory of Puerto Rico is facing an especially high risk, potentially placing hundreds of pregnant women in jeopardy of delivering babies with debilitating birth defects.

But no nation has been more affected than Brazil. As a result of the Zika epidemic there, almost 5,000 babies have been born with a devastating birth defect known as microcephaly after their mothers were infected with Zika early in pregnancy.

In microcephaly, a newborn’s head is smaller than normal, with the potential for long-term neurological damage.

Just last Friday, the U.S. Centers for Disease Control and Prevention warned that infection rates are rising in Puerto Rico. Testing of blood donations in the U.S. territory — “our most accurate real-time leading indicator of Zika activity” — suggest that more and more people on the island have been infected, according to CDC Director Dr. Tom Frieden.

“Based on the best information available, Zika infections appear to be increasing rapidly in Puerto Rico,” he said in a media briefing.

“The real importance of this information is that in coming months it’s possible that thousands of pregnant women in Puerto Rico could become infected with Zika,” he stressed. “This could lead to dozens or hundreds of infants being born with microcephaly in the coming year.”

For weeks now, the percentage of blood donations testing positive for Zika has been increasing in Puerto Rico, reaching as high as 1.1 percent for the latest week of reporting, June 5-11, the CDC’s Morbidity and Mortality Weekly Report indicates.

However, only one in every five people infected with Zika develops any symptoms, making the virus difficult to track.

Zika is typically transmitted via the bite of the Aedes aegypti mosquito.

“Controlling this mosquito is very difficult,” Frieden said. “It takes an entire community working together to protect a pregnant woman.”

Because the virus remains largely undetected, it will be months before affected babies begin to be born, Frieden said. Some will have microcephaly or other brain-related birth defects. But many will appear healthy and normal, and there’s no way to know how they might have been affected, he added.

“We simply don’t know, and may not know for years, if there will be long-term consequences on brain development,” Frieden said.

No places in the continental United States currently have local transmission of Zika, the CDC said. But one blood bank, the Gulf Coast Regional Blood Center in Houston, has already started screening donations for Zika under the FDA’s investigational approval for a screening test for the virus.

The CDC has said it expects to see Zika infections in Gulf Coast states like Florida, Louisiana and Texas as mosquito season heats up.

Mosquito bites remain the typical way Zika is spread. But, transmission of the virus through sex is more common than previously thought, World Health Organizations officials have said.

Women of child-bearing age who live in an active Zika region should protect themselves from mosquitoes 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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Hair Removal for a Beach-Ready Body? Do It Safely

WEDNESDAY, June 22, 2016 (HealthDay News) — If you’re plagued by patches of unwanted hair, waxing is one way to achieve a fuzz-free look — at least for a little while.

But, waxing needs to be done properly to prevent problems, a dermatologist says.

“At-home waxing can be an affordable method for hair removal, but it’s important to take precautions,” Dr. Jessica Krant said in an American Academy of Dermatology news release. She is assistant clinical professor of dermatology at SUNY Downstate Medical Center in New York City.

“Never wax sunburned or very sensitive skin, and don’t wax if you have taken [the acne medication] isotretinoin in the last six months. Also, it may be a good idea to leave Brazilian waxes to the professionals, since the skin in that area is particularly delicate,” she advised. (A Brazilian wax removes most or all of a woman’s pubic hair.)

Before waxing, make sure your hair is about one-fourth to three-fourths of an inch long. Longer hair can make waxing more messy and painful. Don’t use over-the-counter skin care products containing retinol and prescription retinoids two to five days before waxing your face. Otherwise, you could remove skin along with hair, Krant cautioned.

Taking over-the-counter pain medication or applying cold packs to the skin about 30 minutes before waxing may help reduce pain and discomfort. Before waxing, gently wash the area to remove dirt, dead skin cells and skin care products. Then dry your skin thoroughly. Clean, dry skin allows the wax to adhere properly, Krant said.

“Follow the directions on the package, and always test the temperature of the wax by applying a small amount to the inside of your wrist. It should be warm, but not hurt or burn,” she said. “Apply the wax to a small section of your skin with unwanted hair. For the best results, always spread the wax in the direction of hair growth.”

After the wax is applied, place the cloth strip over the wax, press down firmly, and leave the cloth on for two to three seconds. When removing the cloth, hold your skin taut with one hand and use the other hand to quickly pull off the cloth in the opposite direction of hair growth.

“If you’re waxing a tricky spot to reach, such as the underarms, consider asking a friend or relative to help you,” Krant suggested.

“After waxing, soothe your skin by applying cold packs if you have pain, avoiding hot baths and showers, wearing loose clothing and applying moisturizer that won’t clog your pores. Look for moisturizers labeled ‘oil-free’ or ‘non-comedogenic,’ ” she said.

“If you follow the instructions, at-home waxing is a safe and effective way to remove unwanted body hair. However, if you experience redness or swelling after waxing that lasts more than two days, see a board-certified dermatologist,” Krant said.

More information

The U.S. Food and Drug Administration has more about hair removal.

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Women Get Worse Cardiac Arrest Care Than Men: Study

By Steven Reinberg
HealthDay Reporter

WEDNESDAY, June 22, 2016 (HealthDay News) — Women who survive cardiac arrest are less likely than men to get aggressive, lifesaving care at the hospital, researchers report.

“Although we have made a lot of improvement in treating patients with cardiac arrest over the last decade, there is room for improvement, especially in women,” said lead researcher Dr. Luke Kim, an assistant professor of medicine at Weill Cornell Medical College, in New York City.

Cardiac arrest occurs when the heart stops beating. In 2014, more than 350,000 people in the United States suffered cardiac arrests and only 12 percent survived, Kim noted.

In his study, women treated for cardiac arrest were 25 percent less likely to have an angiography, which is imaging to look for blocked heart arteries. Women were also 29 percent less likely to undergo angioplasty, a technique to open blocked arteries, the study found.

Moreover, women were 19 percent less likely to be treated with hypothermia to lower body temperature, which increases the odds of survival without brain damage, the researchers added.

The reasons for the disparity in care are not clear, Kim said, but “we are not as aggressively treating women as men.”

Women tend to do worse than men after cardiac arrest, Kim said. So, it’s possible that doctors don’t think some of these procedures are worthwhile in women, he said.

Kim said the public can help by learning about cardiac arrest and how to give “hands-only CPR.”

And treatment for cardiac arrest is improving as doctors are learning to treat women as aggressively as men, he noted. “The gap is still there, but it’s closing,” Kim said.

The report was published online June 22 in the Journal of the American Heart Association.

For the study, Kim and his colleagues collected data on cardiac arrests from more than 1,000 hospitals across the United States. Over 10 years, death rates from cardiac arrest dropped for both men and women, but were still higher for women.

Of those treated in hospitals for cardiac arrest, 64 percent of women died, compared with 61 percent of men, the researchers found.

Using a national database that tracks hospital discharges, the study team analyzed more than 1.4 million cases of cardiac arrest patients who reached the hospital alive. From 2003 through 2012, cardiac arrests increased 14 percent.

Women in the study were older than men and less likely to have been diagnosed with heart disease. They were also more likely to have other conditions, such as high blood pressure or obesity. They were also more likely to have a cardiac arrest caused by problems other than a blocked blood vessel, such as a clot in the lung, researchers found.

Dr. Suzanne Steinbaum, director of Women’s Heart Health at Lenox Hill Hospital, in New York City, said, “We are seeing another area where health disparities still exist for women.”

She is concerned that women with cardiac arrest are less likely to receive the most lifesaving procedure, which is an angiogram. “Why that’s the case is not clear,” Steinbaum said.

“We need a paradigm shift,” she said. “There has to be an understanding that women need to be treated as aggressively as men when it comes to heart issues.”

More information

Visit the American Heart Association for more on cardiac arrest.

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Heart Attack Help? There’s an App for That

By Amy Norton
HealthDay Reporter

WEDNESDAY, June 22, 2016 (HealthDay News) — Smartphones, apps and other digital technology could speed emergency care to people suffering a heart complication or stroke, says a new report from the American Heart Association.

When someone is suffering a heart attack, stroke or cardiac arrest, quick action can be the difference between life and death, said Dr. Raina Merchant, who co-wrote the American Heart Association (AHA) scientific statement.

In theory, Merchant said, digital technology could boost those survival odds — partly by helping bystanders respond swiftly.

“The public can really make a difference in saving someone’s life,” said Merchant. She is director of the social media lab at Penn Medicine Center for Health Care Innovation, in Philadelphia.

“In an emergency, the first step is always to call 911,” Merchant stressed. But, she added, digital technology can help — if, for example, a bystander uses a smartphone app to get “just in time” instructions in CPR.

Apps like that already exist, she pointed out: The AHA, for instance, has an app that guides people through “hands-only CPR” (chest compressions, with no mouth-to-mouth breathing).

But the full potential of digital technology is still largely untapped, Merchant said.

The new report was published June 22 in the journal Circulation. It summarizes the state of the science right now.

It’s also a “call to action” for more research, according to Merchant.

In general, researchers have been looking at whether digital technology could be useful in two ways: helping laypeople respond in a crisis; and helping medical professionals communicate and get patients the care they need more quickly.

Some research has focused on automated external defibrillators, or AEDs — portable devices that can be used on a person in cardiac arrest to “shock” the heart back into a normal rhythm. Even laypeople can use an AED, because the device automatically analyzes the heart’s rhythm and delivers a shock only if it’s appropriate.

One of the problems with AEDs is that, although they are available in public places and private businesses, most people don’t know how to find one.

“We don’t have good systems for locating an AED in an emergency,” Merchant said. So some apps, such as PulsePoint, have been developed that help people find the nearest AED.

Other apps, Merchant said, are designed to alert layperson volunteers within 500 meters (nearly one-third of a mile) of a cardiac arrest victim, so they can jump into action and perform CPR. A Swedish study found that the technology helped. Almost two-thirds of nearby volunteers with the app started CPR in an emergency, versus 48 percent of bystanders who lacked the app.

Smartphones and other digital technology could also be useful to medical professionals, according to the AHA.

For example, some studies have looked at whether apps can help diagnose a heart attack before the patient gets to the hospital — by allowing paramedics to send EKG readings to the on-call cardiologist’s smartphone.

Right now, most emergency medical service (EMS) systems allow paramedics to “call in” a probable heart attack before they get to the hospital, said Dr. Kevin Rodgers, president of the American Academy of Emergency Medicine.

“But,” he added, “an app where you can send the EKG directly to the cardiologist could be valuable in smaller, less sophisticated systems.”

Other research has focused on speeding up stroke diagnosis: Videoconferencing apps, for example, might allow doctors at community hospitals to consult with stroke specialists at larger centers.

Again, Rodgers said, hospitals have already been using “telemedicine” technology to help diagnose strokes: Often, that means using a bedside “robot” that allows the off-site doctor to monitor the patient remotely.

But in hospital systems with fewer resources, Rodgers said, a smartphone app could be a nice alternative to a robot.

There would, however, be a number of technical issues to overcome, Rodgers pointed out. For one, he said, any system used for transmitting medical information would have to be reliable and secure enough to protect patients’ privacy.

For now, Rodgers encouraged people to use the resources that are already out there.

“There are so many online resources now,” he said. “You can educate yourself on what a heart attack looks like, what a stroke looks like. You can watch a video to see what hands-only CPR looks like.”

As far as AEDs, Rodgers said that some cities have maps to help people find local devices. “But we need a bigger push on that,” he added.

Merchant agreed, and said that’s true of the bigger picture, too.

“Looking to the future,” she said, “there’s a lot of possibility for digital technology to improve emergency heart and stroke care.”

More information

The American Heart Association has resources for responding to cardiovascular emergencies.

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