Too Much Red Meat Might Harm Kidneys, Study Suggests

By Karen Pallarito
HealthDay Reporter

THURSDAY, July 14, 2016 (HealthDay News) — Eating red meat may boost the risk for kidney failure, but swapping even one daily serving of red meat for another protein may reduce the risk, a large study from Singapore suggests.

Red meat intake — in this case, mostly pork — was strongly associated with an increased risk of end-stage renal disease, the loss of normal kidney function. The relationship was also “dose dependent” — meaning the higher the consumption, the greater the risk.

The association held up even after compensating for factors that could skew the results, such as lifestyle and other health conditions, the study authors noted.

“Our findings suggest that patients with chronic kidney disease or the general population worried about their kidney health can still maintain protein intake but consider switching to plant-based sources,” said Dr. Woon-Puay Koh, professor in the Office of Clinical Sciences at Duke-NUS Graduate Medical School in Singapore.

“However, if they still choose to eat meat, fish/shellfish and poultry are better alternatives to red meat,” said Koh, one of the study’s authors.

The study adds new data to a conflicting body of evidence on the relationship between protein intake, particularly red meat, and kidney disease, experts noted.

“It adds useful and additional information to our knowledge base, but I’m not sure if it necessarily tips the scale one way or another,” said Dr. Allon Friedman, a nephrologist and associate professor of medicine at Indiana University School of Medicine in Indianapolis.

“My opinion is that it’s still perfectly fine for individuals who are otherwise healthy to consume red meat in moderation,” he said.

Dr. William Mitch, professor of nephrology at Baylor College of Medicine in Houston, said plenty of studies have shown that low-protein diets may benefit people who already have kidney damage.

However, “in the general population, there’s no persuasive evidence that eating a lot of protein causes kidney damage,” he said.

About 20 million Americans have chronic kidney disease, according to the U.S. Centers for Disease Control and Prevention.

Between 2000 and 2008, the number of new cases among people 65 and older more than doubled, says the U.S. National Institute of Diabetes and Digestive and Kidney Diseases. And while new cases have leveled off, recent data from a federal registry show the number of people requiring kidney dialysis continues to rise.

Red meat has been implicated in recent reports and studies as potentially harmful to human health. The World Health Organization last year warned of a possible link between red meat and cancer. And a November 2015 study in the journal Cancer found that meat cooked at high temperatures could potentially affect kidney cancer risk.

For the new study, researchers followed more than 63,000 Chinese adults in Singapore for an average of 15.5 years.

Food questionnaires were used to gather data on people’s daily protein consumption. Records on the incidence of end-stage renal disease came from a nationwide renal registry.

Ninety-seven percent of red meat intake in the study population consisted of pork. Other protein sources included poultry, fish/shellfish, eggs, dairy products, soy and legumes.

Although pork may appear white after being cooked, it’s still considered red meat, says the U.S. Department of Agriculture.

People consuming the highest amounts of red meat had a 40 percent increased risk of developing end-stage kidney disease, compared with people who ate the lowest amounts, the study found.

No association was found with poultry, fish, eggs or dairy products, while soy and legumes appeared to be slightly protective.

The study also found that replacing one serving of red meat with another protein reduced the risk of kidney failure — up to 62 percent for poultry.

Betsy Booreni is vice president of scientific affairs at the North American Meat Institute in Washington, D.C., which represents U.S. meat packers and processors. She noted that the study, by design, does not establish cause and effect.

What’s more, the results should be viewed with caution due to differences between Chinese and American diets, meat production practices, ethnic backgrounds and genetics, Booren said.

“It is inappropriate and premature to attempt to apply these findings to the North American population as the cause of a medical condition,” she said.

The study, published July 14 in the Journal of the American Society of Nephrology, was supported by funding from the U.S. National Institutes of Health.

More information

The U.S. National Kidney Foundation has more on kidney disease prevention.

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It Turns Out Using Homemade Sunscreen Isn’t as Wacky as It Sounds

Photo: Getty Images

Jennifer Farley, aka JWoww from MTV’s The Jersey Shore, is famous for her love of tanning. But this week, the former reality star made headlines for her recipe for DIY sunscreen (?!).

It all started when Farley posted a photo on Instagram of her infant son in the pool—which triggered some critical comments suggesting it was unsafe for the baby to be in the pool, and that he wasn’t well enough protected from the sun.

The 30-year-old mom quickly clapped back: “Not even sure why I am even doing this but I feel like schooling people on my previous post. First off, my son is two months and in a salt water pool up to his belly… Probably for a total of three minutes.” Then Farley goes on to say (and with some not-so-nice words) that her little boy is wearing sunscreen she whipped up herself—a mix of coconut oil, carrot seed oil, and zinc oxide.

RELATED: These Are the Best Sunscreens for Your Face, According to Dermatologists

Farley even estimated the SPF of each ingredient. But is homemade sunscreen really a good idea, we wondered. And if so, are these the right ingredients to protect your skin from harmful UV rays?

According to Mary Gail Mercurio, MD, a professor in the department of dermatology at the University of Rochester Medical Center, Farley’s concoction is, in theory, safe to use.

“From a dermatology stand point, this combination of ingredients is nothing that would be deemed harmful,” she explains. “What [Farley’s] basically doing is taking [zinc oxide], something that is already used as a sunscreen, and adding oils to make it more spreadable. There’s nothing wrong with that.”

In fact, says Dr. Mercurio, whether you make your own sunscreen at home or purchase it at a drugstore is a matter of personal preference: “It’s like choosing between buying a head of lettuce to make a salad, or buying [salad] in a bag.”

“What really determines if a product works is whether or not you get any color,” she points out.

RELATED: 10 Surprising Beauty Uses for Coconut Oil

Dr. Mercurio’s one qualm? Farley’s SPF claims. “The only way to know the SPF of a product is to do very elaborate testing in a laboratory,” she says. “It’s not something one can determine in the privacy of their home.”

Regardless, Farley’s recipe should offer some sun protection, says Dr. Mercurio: “We know that zinc oxide is used in common sunscreens on the market, so theoretically this combination of ingredients that she has put together appears to be safe, and likely to be effective.”

But to best shield your skin from UV rays, what you really need is a holistic protection strategy, Dr. Mercurio says, including sunscreen, protective clothing, and avoiding direct sunlight in the middle of the day.

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Health Before a Stroke Is Big Predictor of Second Attack

THURSDAY, July 14, 2016 (HealthDay News) — Stroke survivors who had high blood pressure or other heart risk factors before their stroke may be at greater risk for another stroke and dementia years later, a new Dutch study finds.

“We already know that stroke patients have an increased risk of recurrent stroke and dementia,” explained study senior author Dr. M. Arfan Ikram.

“What we didn’t know was whether this increased risk persists for a long time after stroke, and whether heart disease risk factors present before the first stroke influenced the risk of recurrent strokes or dementia,” he added.

“Our study found these risk factors influence future stroke and dementia, and the risks persist for an extended period in some patients,” Ikram said in an American Heart Association news release. He’s associate professor in the department of epidemiology, neurology and radiology at Erasmus University Medical Center in Rotterdam.

In the study, Ikram’s group compared data from a long-term study on more than 1,200 stroke survivors against data from about 5,000 people who hadn’t had a stroke.

The investigators found that one year after having a stroke, survivors remained at high risk for another stroke over at least the next five years.

A year after their first stroke, survivors had triple the odds for another stroke compared to people without a prior stroke history, the researchers said. Stroke survivors were also nearly twice as likely to develop dementia as those who didn’t have a stroke.

Poor heart health seems key. For example, among the stroke survivors, 39 percent of future strokes and 10 percent of dementia cases were linked to heart-related risk factors the patients had already been diagnosed with before their first stroke.

Those health issues included high blood pressure (hypertension), diabetes, low levels of HDL (“good”) cholesterol, smoking or a history of “mini-strokes” — what doctors call transient ischemic attacks, or TIAs, the researchers explained.

The findings weren’t a big surprise to the study authors. “We found in a previous study that 27 percent of all deaths after stroke can be attributed to risk factors already present before stroke,” Ikram said.

U.S. experts in brain health weren’t surprised by the findings, either, but said there’s much patients can do to lower their risk.

“What does this really mean? Put simply, it emphasizes once again the importance of controlling or treating one’s vascular risk factors,” such as giving up smoking and controlling blood pressure, said Dr. Richard Libman, a neurologist at Long Island Jewish Medical Center in New Hyde Park, N.Y.

“No one wants to have a stroke, but this study suggests that we all have some control in the form of preventing a second stroke and maintaining our mental faculties,” he said.

Dr. Ajay Misra practices neurology at Winthrop-University Hospital in Mineola, N.Y. He said that the “most important take-home message is that efforts should be directed towards primary prevention of cardiovascular risk factors — to prevent the stroke in the first place.”

The findings were published online July 14 in the journal Stroke.

More information

The American Stroke Association explains more about the risk factors for stroke.

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U.S. Cases of Drug-Resistant Gonorrhea Rise Fourfold in One Year

THURSDAY, July 14, 2016 (HealthDay News) — Antibiotic-resistant cases of the sexually transmitted illness gonorrhea have more than quadrupled in the United States.

This new data, from the U.S. Centers for Disease Control and Prevention, should serve as a warning that “the future of current treatment options may be in jeopardy,” the agency said in a news release issued Thursday.

“The confluence of emerging drug resistance and very limited alternative options for treatment creates a perfect storm for future gonorrhea treatment failure in the U.S.,” said Dr. Jonathan Mermin, who directs the CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and Tuberculosis Prevention.

“History shows us that bacteria will find a way to outlast the antibiotics we’re using to treat it,” Mermin said. “We are running just one step ahead in order to preserve the remaining treatment option for as long as possible.”

For now, the multidrug therapy that the CDC recommends for gonorrhea “still works,” the agency said, and there’s not yet been a U.S. case where treatment completely failed.

However, agency researchers report that the number of U.S. cases of gonorrhea where strains showed “decreased susceptibility” to a key antibiotic, azithromycin, jumped from 0.6 percent in 2013 to 2.5 percent a year later.

This suggests that azithromycin “will be next in the long line of antibiotics to which gonorrhea bacteria have become resistant — a list that includes penicillin, tetracycline and fluoroquinolones,” the CDC said.

Patients sometimes receive azithromycin in combination with another antibiotic, ceftriaxone.

“It is unclear how long the combination therapy of azithromycin and ceftriaxone will be effective if the increases in resistance persist,” said Dr. Gail Bolan, director of the CDC’s Division of STD Prevention.

One way to slow antibiotic resistance is to curb the number of new infections of gonorrhea affecting Americans, Mermin said. The CDC noted that more than 800,000 cases of gonorrhea are estimated to occur in the United States each year.

Because infection can often occur without symptoms, the CDC estimates that less than half of all cases are ever diagnosed. Gonorrhea seems to be especially on the rise among men, the agency said.

Symptoms of gonorrhea include a burning sensation upon urination or a green or whitish discharge. Left untreated, symptomatic or asymptomatic gonorrhea can lead to serious health issues, especially for women, because it is linked to chronic pelvic pain, potentially fatal ectopic pregnancy and infertility, the CDC said.

The study findings were published in the July 15 issue of the CDC journal Morbidity and Mortality Weekly Report.

More information

For more on gonorrhea, head to the American College of Obstetricians and Gynecologists.

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Synthetic Pot Overdoses on the Rise in U.S.

By Steven Reinberg
HealthDay Reporter

THURSDAY, July 14, 2016 (HealthDay News) — Synthetic marijuana is sending increasing numbers of U.S. users to hospitals, researchers report.

Sold under the names K2, Spice and others, synthetic marijuana is a combination of chemicals designed to mimic the high of pot. But, it can be two to 100 times more potent, the study authors explained.

“Synthetic agents are dangerous. They scare me,” said Dr. Scott Krakower, assistant unit chief of psychiatry at Zucker Hillside Hospital in Glen Oaks, N.Y.

“It really messes people up quickly,” said Krakower, who wasn’t involved with the new research. Users can become extremely irritable and very aggressive. They also can become sleepy and unable to stand, he said.

Just this week, 33 people in Brooklyn, N.Y., who used K2 were hospitalized after they staggered and collapsed on the street.

“It’s like a scene out of a zombie movie, a horrible scene,” bystander Brian Arthur told The New York Times. “This drug truly paralyzed people.”

Synthetic pot overdoses elsewhere in the country have resulted in heart and kidney damage, delirium, coma and even death, the new report said.

The U.S. Drug Enforcement Administration (DEA) reported 20 deaths from fake pot between 2011 and 2015. And calls to poison control centers related to synthetic marijuana jumped 330 percent the first four months of 2015, the agency said.

In 2011, the DEA made five chemicals used in fake pot illegal. But dealers try to skirt the law by continually tinkering with the formula and labeling the products as not fit for human consumption, Krakower said.

“They are coming out with agents almost faster than we can detect them,” he explained.

In addition, these drugs are cheap and easy to get. They’re sold in head shops and convenience stores, usually under the counter, he said. “They try to hide them,” Krakower added.

For the new report, the researchers analyzed data from the Toxicology Investigators Consortium, a registry established by the American College of Medical Toxicology. From 2010 to 2015, the study authors found, U.S. toxicologists treated nearly 500 cases of synthetic marijuana intoxication. Sixty-one percent of the patients said it was the only drug they had used.

Three of these patients died, one of whom had used synthetic marijuana exclusively. The other two used fake pot along with other drugs, the researchers said.

“The increase in acute synthetic cannabinoid poisonings underscores the importance of targeted prevention interventions and the need for education about the potentially life-threatening consequences of synthetic cannabinoid use,” the authors wrote in the report.

The findings were published in the July 15 issue of the U.S. Centers for Disease Control and Prevention’s Morbidity and Mortality Weekly Report.

More information

For more about synthetic marijuana, visit the American Association of Poison Control Centers.

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Research Sees Potential to Make Bone, Muscle From Human Stem Cells

THURSDAY, July 14, 2016 (HealthDay News) — Scientists say they’ve mapped the biological and chemical signals needed to make bone, heart muscle and 10 other cells types from human stem cells within a matter of days.

The researchers from Stanford University School of Medicine say the ability to quickly coax human embryonic (pluripotent) stem cells to generate such cell types as skeletal muscle, bone and blood vessels would be a major advance in regenerative medicine. Pluripotent means the cells can develop into any type of cell in the body.

The researchers said the findings could potentially enable scientists to repair heart tissue after a heart attack, make cartilage to repair painful joints or produce bone to help people recover from accidents or other trauma.

“Regenerative medicine relies on the ability to turn pluripotent human stem cells into specialized tissue stem cells that can engraft and function in patients,” said study co-senior author Dr. Irving Weissman. He directs Stanford’s Institute for Stem Cell Biology and Regenerative Medicine, and its Ludwig Cancer Center.

“It took us years to be able to isolate blood-forming and brain-forming stem cells. Here we used our knowledge of the developmental biology of many other animal models to provide the positive and negative signaling factors to guide the developmental choices of these tissue and organ stem cells. Within five to nine days we can generate virtually all the pure cell populations that we need,” he said in a university news release.

Embryonic stem cells can become any type of cell by responding to cues within the developing embryo. These cues direct the cells to become specific cell types.

For the study, the researchers experimented with different combinations of known signaling molecules to prompt the stem cells to become more specialized precursor, or progenitor, cells.

“We learned during this process that it is equally important to understand how unwanted cell types develop and find a way to block that process while encouraging the developmental path we do want,” said co-lead author Kyle Loh. Loh is a graduate student at Stanford’s medical school.

After carefully guiding the stem cells’ choices, the scientists said they were able to generate bone cell precursors that formed human bone within mice, according to the study published July 14 in Cell. They also produced beating heart muscle cells along with 10 other specific cell types.

“Previously, making these cell types took weeks to months, primarily because it wasn’t possible to accurately control cell fate,” Loh said. “As a result, researchers would end up with a hodgepodge of cell types.”

At each stage of development, the researchers examined the activity of genes within single cells. This allowed them to identify brief, previously unknown patterns that occur as cells become increasingly specialized. They said the process reflects what happens in other animals.

The study authors said their findings could shed new light on how and when birth defects arise.

“Next, we’d like to show that these different human progenitor cells can regenerate their respective tissues and perhaps even ameliorate disease in animal models,” Loh said.

More information

The U.S. National Institutes of Health provides more on stem cells.

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1 in 5 Americans Uses a Tobacco Product

THURSDAY, July 14, 2016 (HealthDay News) — Despite decades of declines in smoking rates in the United States, one in five Americans still smokes or uses hookahs, e-cigarettes or other tobacco products, U.S. health officials reported Thursday.

Cigarettes remain the most popular, but the emergence of hookah and e-cigarette use, especially among younger adults, is cause for concern, the U.S. Centers for Disease Control and Prevention report said.

Findings from the 2013-2014 survey underscore the need “to educate the public about the potential harms of all tobacco product use, including risks associated with occasional use,” CDC researcher Dr. Sean Hu and colleagues wrote.

Noting that e-cigarettes were used most often by 18- to 24-year-olds, the study authors suggested advertising and misleading marketing claims are to blame.

Patricia Folan, director of the Center for Tobacco Control at Northwell Health in Great Neck, N.Y., agreed.

“There is a misperception, fostered by e-cigarette and hookah pipe industry advertising, that these products are not harmful,” Folan said. “These products contain nicotine and other hazardous chemicals.”

Because they’re perceived as a healthier alternative to smoking, Folan said e-cigarettes and hookahs have the potential to dissuade smokers from quitting.

For the report, researchers from the CDC and the U.S. Food and Drug Administration analyzed data from the 2013-2014 National Adult Tobacco Survey.

More than 49 million Americans (21 percent) reported using a tobacco product every day or some days. And more than one-quarter said they used a tobacco product daily, some days, or rarely, the researchers found.

Cigarettes were smoked by 17 percent of Americans; cigars and pipes by about 2 percent. More than 3 percent reported e-cigarette use, while almost 1 percent had tried hookahs (water pipes). And close to 6 million adults reported using smokeless tobacco, the findings showed.

Among the other findings:

• Males and adults up to age 44 were most likely to use a tobacco product.
• Midwesterners and southerners were more likely to use tobacco products than residents of other regions. So were people with less education; singles, including divorced and widowed individuals; poor people; and lesbians, gays and bisexuals.
• Asians and Hispanics were less likely than whites or blacks to use tobacco products.

Progress has been made over the past five decades to curb smoking, but more work is needed, the researchers said.

What will help?

“A combination of comprehensive smoke-free laws, high-impact media campaigns, tobacco price increases, and easy access to quitting assistance,” the study authors suggested.

Such strategies could help reduce tobacco-related disease, which causes smokers to die 10 years earlier than nonsmokers, the CDC said. Cigarettes alone lead to more than 480,000 deaths a year in the United States, including nearly 42,000 deaths from secondhand smoke exposure.

The FDA, which recently gained authority over all tobacco products, intends to ban sales of e-cigarettes and all other tobacco products to minors starting next month.

Hoping to prevent another surge of nicotine addiction, the agency will also require manufacturers to report ingredients and submit new or altered products for approval before bringing them to market.

Folan applauded the new rules.

Hopefully, with the FDA now having the authority to regulate these products, information about ingredients and manufacturing processes will be available to consumers,” she said.

The findings were published in the July 15 issue of the CDC’s Morbidity and Mortality Weekly Report.

More information

The U.S. Department of Health and Human Services tells how smoking hurts your health.

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Latin America Zika Outbreak Should ‘Burn Out’ Within 3 Years, Scientists Say

THURSDAY, July 14, 2016 (HealthDay News) — A team of British experts in disease outbreaks believes that the Zika epidemic afflicting Latin America will end within three years.

They based their estimate on modeling using available data on the outbreak, which has so far involved thousands of cases of Zika-linked birth defects, mainly in Brazil.

The Zika virus is typically spread by mosquito bites. For most people the health risks are mild. But, maternal infection in pregnancy can trigger microcephaly, a condition where babies are born with too-small heads and neurological issues.

The new analysis uses “all available data to provide an understanding of how the disease will unfold — and allows us to gauge the threat in the imminent future,” lead researcher Neil Ferguson said.

“Our analysis suggests that Zika spread is not containable, but that the epidemic will burn itself out within 2-3 years,” Ferguson, of Imperial College London’s School of Public Health, said in a college news release.

Reporting July 14 in the journal Science, Ferguson and his team pulled together all the existing data on Zika transmission throughout Latin America. They then used this data, along with information on outbreaks of similar viruses, such as dengue, to create a model that represented the current outbreak and future patterns of transmission.

Because people who have already been infected with Zika are unlikely to be re-infected, the epidemic should burn itself out within three years, the study authors estimated.

“The current explosive epidemic will burn itself out due to a phenomenon called herd immunity,” Ferguson explained. “Because the virus is unable to infect the same person twice — thanks to the immune system generating antibodies to kill it — the epidemic reaches a stage where there are too few people left to infect for transmission to be sustained.”

That will mean Zika can’t gain a foothold again in the Latin American population for at least a decade, when a new generation without exposure will emerge, the researchers said. “This mirrors other epidemics, such as chikungunia — a similar virus to Zika — where we have seen explosive epidemics followed by long periods with few new cases,” Ferguson said.

As for the current Zika outbreak, it may already be too late to do much to curb case numbers, he said.

“Efforts to contain the epidemic would have needed to have been implemented much earlier in the current Zika epidemic to have a major effect — but by the time we realized the scale of the problem it was too late,” Ferguson said.

He added that all of this means that efforts to find a vaccine should be encouraged, while Zika is still highly active.

Another study published in the same issue of Science looks to the future of epidemic control, as well. Researchers in the United States believe new strategies are needed to prepare for unexpected mosquito-borne epidemics, such as the recent outbreak of the Zika virus.

The history of Zika, which was discovered in Uganda in 1947, may provide valuable lessons for the current crisis in Brazil, Colombia, Puerto Rico and other parts of the Americas, said scientists from Johns Hopkins University Bloomberg School of Public Health in Baltimore.

“The rise of Zika after its long persistence as a disease of apparently little importance highlights how little we truly understand about the global spread of mosquito-borne viruses and other lesser-known diseases,” said the study’s co-leader, Justin Lessler, an associate professor of epidemiology.

“Over the past decades, dengue, chikungunya, West Nile virus and now Zika have emerged or re-emerged across the globe. Yet why these viruses have expanded their range and others have failed to invade areas potentially ripe for their spread remains a mystery,” Lessler said in a university news release.

Most people infected with Zika have few or minor symptoms. But since early 2015 thousands of women — largely in Brazil — exposed to the virus in pregnancy have had babies with serious birth defects. Many of the infants have smaller heads and brains associated with microcephaly.

The Hopkins researchers analyzed existing studies on Zika to assess its global threat. They came up with two main theories that could help explain why Zika has become such a risk.

One theory is that the virus mutated and became more dangerous and infectious.

The alternative theory is that the virus previously spread among just a small group of people, so its effects were less obvious. But once Zika spread to Brazil — a country with 200 million people having no immunity to the virus — the complications became more apparent.

“Despite knowing about this disease for nearly 70 years, we were completely surprised and rushing to discover the very basic things about it when it invaded the Americas,” Lessler said.

“We have been completely unable to stop its spread. That is a problem for how we approach public health,” he added.

Better preparation is essential, Lessler said. “We will always be in this situation when something new comes about or something little-known re-emerges unless we do a better job planning for threats more generally instead of always fighting the last battle,” he said.

There is currently no vaccine or cure for Zika. The Hopkins review called for more research to assess the effectiveness of mosquito-control methods.

More information

The U.S. Centers for Disease Control and Prevention provides more information on mosquito-borne diseases.

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

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Road Rage Rampant in America

THURSDAY, July 14, 2016 (HealthDay News) — Next time you’re ready to make a rude gesture when another driver cuts you off in traffic, take a deep breath.

America’s highways are already more than mean enough, according to a new study from the AAA Foundation for Traffic Safety.

Nearly 8 of 10 drivers demonstrated significant anger, aggression or road rage in the past year, the study found. They admitted to tailgating, confronting other motorists and even hitting other cars on purpose.

“Inconsiderate driving, bad traffic and the daily stresses of life can transform minor frustrations into dangerous road rage,” Jurek Grabowski, the foundation’s director of research, said in a AAA news release. “Far too many drivers are losing themselves in the heat of the moment and lashing out in ways that could turn deadly.”

Anger or road rage provokes a number of risky behaviors. The study found about half of drivers, or roughly 100 million people, have tailgated or yelled at another motorist.

About 45 percent honk their horn when they are mad; 33 percent make rude gestures; 24 percent block another car from changing lanes; 12 percent cut off other cars; and 4 percent have gotten out of their car to confront someone.

The researchers also found that 3 percent — nearly 6 million people — have bumped or rammed another car on purpose due to road rage.

Most motorists believe aggressive driving has gotten worse in recent years and threatens their personal safety.

Road rage is more common among men between the ages of 19 and 39. Drivers in the Northeast are also much more likely to yell, honk or gesture out of anger than those elsewhere in the United States.

Road rage is also more common among those who also speed or run red lights, according to the study published July 14.

“It’s completely normal for drivers to experience anger behind the wheel, but we must not let our emotions lead to destructive choices,” Jake Nelson, AAA’s director of traffic safety advocacy and research, said in the news release.

“Don’t risk escalating a frustrating situation because you never know what the other driver might do. Maintain a cool head, and focus on reaching your destination safely,” Nelson added.

AAA offers these tips for preventing road rage:

• Don’t offend. Never force another driver to hit the brakes or change direction.
• Be tolerant. Don’t take driving personally. Other drivers may be having a bad day as well.
• Do not respond. Avoid eye contact, don’t make gestures and keep adequate space between cars. If an emergency arises, call 911.

More information

The U.S. National Highway Traffic Safety Administration provides more information on aggressive driving.

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CDC Warns of Dangers of Plastic Surgery in Dominican Republic

By Randy Dotinga
HealthDay Reporter

THURSDAY, July 14, 2016 (HealthDay News) — U.S. health officials are warning about the dangers of “medical tourism” after at least 18 women from the East Coast became infected with a disfiguring bacteria following plastic surgery procedures they had in the Dominican Republic.

The infections, caused by a type of germ called mycobacteria, can be difficult to treat. At least several of the women had to be hospitalized, undergo surgery to treat the infection and take antibiotics for months, according to the report from the U.S. Centers for Disease Control and Prevention.

One expert said the effects can be devastating.

“It’s a very mutilating infection. They’re going for cosmetic surgery, and they will be scarred. It’s a terrible scenario for people to go down there, get surgery and come back worse than they imagined they could be,” said Dr. Charles Daley. He is a Denver infectious disease physician whose clinic has seen patients infected after undergoing these kinds of procedures in the Dominican Republic.

According to the CDC, 21 women from six Northeast and Mid-Atlantic states appear to have been affected by mycobacterial infections after visiting five plastic surgery clinics in the Dominican Republic, a nation in the Caribbean. (Eighteen of the cases are confirmed, and three are considered probable.)

Mycobacteria, which are found worldwide in the environment, “usually infect the skin or lungs, and are responsible for chronic and recurrent infections that are notoriously resistant to antibiotics and difficult to treat,” said report co-author Dr. Douglas Esposito. He is a medical officer and epidemiologist with the CDC’s Travelers’ Health Branch.

More than 80 percent of the infected women reported swelling, pain and scarring. Daley, who works at the National Jewish Health respiratory hospital in Denver, said infected people often need to undergo reconstructive surgery.

It’s not clear how the women were infected, although Daley said it’s possible the bacteria entered their plastic surgery wounds through tap water or instruments used in surgery. Most underwent liposuction and at least one other surgery, such as procedures to expand the size of the breasts and buttocks, or breast reduction.

Daley said his clinic has seen two patients infected after plastic surgery and consulted on a third case. It’s not clear how many, if any, are among those in the CDC report.

The risk of this kind of infection is higher in countries like the Dominican Republic and Brazil, he noted, but patients have become infected in the United States, too. “We are definitely seeing more of these postoperative infections, particularly ones that are related to cosmetic surgery,” Daley said.

The CDC report warns about the risks of medical tourism, a term that describes leaving the United States for medical procedures to save money. According to the report, many of the women — most of whom were born in the Dominican Republic — said they went to the country for plastic surgery to save money.

People who have undergone plastic surgery in the Dominican Republic should talk to their doctor about getting tested, Daley suggested. And, people who plan to go there for a procedure should ask the clinic whether they’ve had infections, he added.

“I would never go to one of those places,” he said. “I know too many stories about what’s happened to people. It has ruined people’s lives.”

The study was published online July 13 in Emerging Infectious Diseases.

More information

For more about mycobacterial infections, visit the U.S. National Library of Medicine.

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