Study Casts Doubt on Effectiveness of COPD Drug

TUESDAY, Feb. 2, 2016 (HealthDay News) — A widely used drug may not significantly reduce the amount of time that patients with the lung condition COPD require mechanical help to breathe, a new study suggests.

COPD (chronic obstructive pulmonary disease) — which is often related to smoking — includes emphysema, chronic bronchitis or a combination of the two. Common symptoms include difficulty breathing, chronic cough, wheezing and phlegm production. Over time, the condition can prove fatal.

The drug acetazolamide has been used for decades to help COPD patients breathe when they develop a dangerous condition called metabolic alkalosis.

However, the French study authors said that, until now, there’s been no clinical trial to prove that the drug is actually effective in such cases.

To try to remedy that situation, the new study included 380 French COPD patients who were expected to receive mechanical ventilation (help with breathing) for more than 24 hours.

The findings were published in the Feb. 2 issue of the Journal of the American Medical Association.

For the study, each patient was given either acetazolamide or an inactive placebo. Treatment began within 48 hours of the patients being admitted to an intensive care unit (ICU) and continued for a maximum of 28 days, the authors said in a journal news release.

According to the team, led by Dr. Christophe Faisy of the European Georges Pompidou Hospital in Paris, there were no “significant” differences between the two groups in how long they spent on mechanical ventilation, the length of their ICU stay, or their death rates while in the ICU.

One expert in the United States said that the study could be an important one for COPD patients.

“It’s important to look at treatment protocols in this fashion, so that treatments that offer no advantage — but could have a downside as well — are not routinely used,” said Dr. Len Horovitz, a pulmonary specialist at Lenox Hill Hospital in New York City.

However, another U.S. expert differed with the French investigators on their definition of what “significant” improvements might mean for a patient.

Dr. Alan Mensch is chief of pulmonary medicine at Northwell Health’s Plainview Hospital in Plainview, N.Y. He noted that, according to the French research team, people who received acetazolamide required 16 fewer hours on the ventilator compared to those who received the placebo.

“In addition, the treated group had improved oxygen levels,” Mensch said.

“This suggests that a larger study is needed to obtain statistical significance in order to establish a beneficial effect of acetazolamide for patients on respirators,” he said, and “this study should be considered preliminary.”

More information

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

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Text Messages May Prompt People to Take Their Meds

By Kathleen Doheny
HealthDay Reporter

TUESDAY, Feb. 2, 2016 (HealthDay News) – When patients with chronic diseases get text reminders from their doctor’s office to take their medicines, it doubles the chances they will take those drugs as prescribed, a new analysis finds.

“Text messaging support programs have immense potential in health care,” said lead researcher Clara Chow, director of the cardiovascular division at The George Institute for Global Health, in Sydney, Australia.

Chow and her team reviewed the results of 16 randomized clinical trials that assessed the effect of text messaging on the adherence of taking medication by those with chronic diseases.

The problem of medication adherence is well known, Chow said, with many patients not sticking to the schedule. As a result, their disease may not be under good control.

“It is difficult to remain committed to long-term medication therapy for patients with chronic disease, and as many as half of patients can be non-adherent in a year,” she said.

The studies evaluated by Chow’s team used various methods and frequency of messaging to remind patients about taking medication. Some used two-way communication, some used daily reminders to smartphones.

Overall, however, the messages doubled the chances that people followed their medication schedule, the researchers found.

The studies involved more than 2,700 patients with a median age of about 39.

The results were published online Feb. 1 in the journal JAMA Internal Medicine

Chow added a caveat to the findings: The median length of the studies was 12 weeks (half longer, half shorter), so they don’t document long-term effectiveness. Larger studies with longer duration are needed, she said.

Chow can’t yet explain what it is about the messaging that seems to help. “We still need to better understand what feature of the text message programs make them most effective,” she said.

Also, “we don’t know yet whether greater personalization of the program will make them more effective,” Chow said.

When patients gave feedback, they said they found the messages useful and felt as if they were being supported, she said.

Dr. Brian Haynes, a professor of clinical epidemiology and medicine at McMaster University, in Hamilton, Canada, is the author of a commentary that accompanied the study. He wrote that while texting has the potential to overcome the medication adherence problem, it is too soon to say if it has “real, enduring and patient-important benefits that are worth the investment.

“Our main message is that text messages to promote adherence in patients have not been tested properly, so it is not possible to tell whether they do anything useful,” he said. The studies in the new review were brief, he noted, and some used self-reporting, which he said is not always valid.

The best one could say, Haynes said, is that “some studies showed some promise that text messaging might be helpful.” To work effectively, he said, a patient must want to adhere to the medication schedule and have a cellphone (with a text plan) that they keep with them.

He said such a text program should not be pursued by doctors, hospitals or institutes until it has been documented to improve outcomes.

More information

To learn more about taking medications properly, see the American Heart Association.

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The Lead Poisoning Symptoms Everyone Should Know

Photo: Getty Images

 

The water crisis in Flint, Michigan, has all eyes on the dangers of lead poisoning. But until President Obama declared a state of emergency in Flint last month, many of us had stopped thinking of lead exposure as a major health concern. The toxic metal was phased out of plumbing materials, gasoline and household paint way back in the 1970s and 1980s.

Still, lead is something to be wary of, says Maida Galvez, MD, an associate professor of preventive medicine and pediatrics at the Icahn School of Medicine at Mount Sinai in New York City. “The biggest misconception about lead is the notion that this is a problem that has gone away.”

When lead gets absorbed into the body—often via contaminated water or food, or when lead dust or fumes are inhaled—it damages vital organs, such as the kidneys, liver, and brain; and spotting early signs of poisoning before physiological and psychological impairments occur can be tricky, says Dr. Galvez.

What to look for

After high levels of exposure, the symptoms of lead poisoning can be similar in children and adults, and range from anemia to abdominal pain to seizures. They may even be flu-like, and include constipation, nausea, stomachaches, and fatigue.

Low levels of lead in the blood typically don’t produce any noticeable symptoms, Dr. Galvez says; or the symptoms may be less distinct, such as behavioral issues or difficulties with learning (trouble thinking straight, for example, or memory blips). “Population-based studies have demonstrated the potential for subtle IQ deficits at [blood lead] levels as low as five micrograms per deciliter,” Dr. Galvez says. In other words, even a tiny amount of lead can have a cognitive effect.

RELATED: 18 Reasons Why Your Stomach Hurts

How lead poisoning is diagnosed

Having your blood lead level checked requires a blood test. But if you are worried that you’ve been exposed—or your child has been exposed—a doctor can get immediate results with a rapid screening test on a finger stick.

Why an early diagnosis is crucial for kids

Children absorb lead more easily than adults do, and it can interfere with their brain and nervous system development, especially if they are under the age of six. (Lead can also interfere with the development of a fetus, and increases a pregnant woman’s risk of miscarriage or stillbirth.)

Parents and caregivers should have their kids screened at ages one and two, says Dr. Galvez, even if there are no symptoms present. But many people fail to take this safety measure, she says. “Too often, the way [lead poisoning] is identified is through screening children for elevated lead levels after the exposure has already occurred, rather than preventing the exposure in the first place,” she says.

RELATED: 19 Medical Tests Everyone Needs

How it’s treated

“Medical treatment is generally required at [blood lead] levels greater than 45 micrograms per deciliter,” days Dr. Galvez. In extreme cases, chemical injections can be used to remove heavy metals and minerals from the bloodstream. But the unfortunate truth is that if lead exposure goes undetected for years, it can cause irreversible developmental or neurological damage.

There are some lifestyle measures that can prevent blood lead level from increasing, says Dr. Galvez. For example, eating healthy foods full of iron, vitamin C, and calcium may help keep the body from absorbing more lead. “A well-balanced diet, quality early childhood education, and early intervention for developmental delays are supportive therapies,” she explains.

The most important intervention, says Dr. Galvez, is preventing any further exposure to lead: “Contact your physician or local department of health if you have concerns about lead hazards in the home or workplace.”

 

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Scientists Find Stem Cells That Might Repair Skull, Face Bones

TUESDAY, Feb. 2, 2016 (HealthDay News) — Scientists report they may be one step closer to using stem cells to replace damaged skull and facial bones in people who experience a head trauma or undergo cancer surgery.

The researchers discovered and isolated stem cells capable of repairing these bones in mice. One day, this discovery might be used in human reconstructive surgeries, the scientists added.

Led by Takamitsu Maruyama at the University of Rochester Medical Center in Rochester, N.Y., the research team said its findings could also help those born with a skull deformity known as craniosynostosis, which can lead to developmental delays and pressure on the brain.

In the study, the scientists investigated the role of the Axin2 gene in bone formation and regeneration. They also examined a specific mutation that causes craniosynostosis in mice.

They found that stem cells involved in skull formation are contained within this cell population. These cells are specific to the bones in the head and are very different from other stem cells involved in the formation of the bones in the legs and other parts of the body.

Tests to uncover these cells could also help doctors detect bone diseases caused by stem cell abnormalities, the researchers added.

The research was published Feb. 1 in the journal Nature Communications.

Research involving animals often fails to provide similar results in humans.

More information

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

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Study Pits Antiperspirants Against Underarm Bacteria

By Amy Norton
HealthDay Reporter

TUESDAY, Feb. 2, 2016 (HealthDay News) — That antiperspirant may keep you dry, but it might also disrupt the bacterial “community” that resides in your armpits, a new, small study suggests.

Researchers said it’s not clear whether that disruption has any dire effects — or whether it could even be beneficial. But the findings, published online Feb. 2 in the journal Peer J, add to questions about the ways in which modern lifestyles could be altering the human “microbiome.”

The term refers to the trillions of bacteria and other microbes that inhabit the human body, inside and out. The skin is covered in a range of microbes — most of which are either harmless or beneficial, according to the U.S. National Institutes of Health (NIH).

Some microbes, the NIH says, protect the skin from invasion by harmful bugs, and may also play a role in “educating” the immune system cells that dwell in the skin.

“We know that these skin microbes interact with the immune system,” said lead researcher Julie Horvath. “So it’s important to consider what our daily habits do to the skin’s microbiome.”

The point of this study was not to demonize deodorant, according to Horvath, who heads the genomics and microbiology research lab at the North Carolina Museum of Natural Sciences, in Raleigh.

For starters, anything put on the skin — from lotion to makeup to soap and water — might change the microbial community. There are other factors, too, according to the NIH — such as age, gender and sun exposure.

Horvath became interested in antiperspirants’ effects after she and her lab colleagues ran an experiment among themselves: They took swabs of their armpits, then cultured the samples to see what microbes were dwelling there.

At the time, Horvath was dealing with some public-speaking jitters, with the help of a clinical-strength antiperspirant. And it turned out that her armpit swab was free of microscopic organisms.

“I thought, ‘Where are my microbes?’ ” she said. “And then I remembered the clinical-strength antiperspirant.”

To dig deeper, Horvath’s team recruited 17 volunteers for an eight-day experiment. Seven of the men and women regularly used antiperspirant, five used deodorant, and five used neither product.

On day one, all volunteers followed their normal hygiene routine. On days two through six, they refrained from all underarm products. On the final two days, all used antiperspirant.

On the first day, the researchers found, armpit swabs from the antiperspirant users tended to show far fewer bacteria, compared with both nonusers and deodorant users. Deodorant users actually had the most bacteria.

Horvath said it’s not surprising that antiperspirant and deodorant users would differ from each other: Deodorants do have antimicrobial ingredients that fight odor, but antiperspirants actually prevent sweating — and bacteria like to feed on sweat.

Things got more complicated when the whole study group stopped using all underarm products: By day six, all volunteers showed similar amounts of bacteria in their armpit swabs — but the type and diversity of those bacteria varied widely.

Among the people who usually used no products, the most common bacteria belonged to a group called corynebacteria — accounting for 62 percent of the microbes in their armpit swabs. Staphylococcaceae bacteria made up another 21 percent.

That pattern was reversed among people who normally wore antiperspirant or deodorant, with staph bacteria dominating.

Corynebacteria are partly responsible for body odor, Horvath said, but they also help defend the body from harmful bacteria. Staph bacteria have a bad reputation, but most strains are beneficial. Horvath said her team did not determine the types of staph study participants carried.

Pieter Dorrestein is a professor at the University of California, San Diego’s Skaggs School of Pharmacy and Pharmaceutical Sciences. In a recent study, he found that “a lot of personal care products” — from deodorant to lotion to shampoo — remain on the skin, even after a few days’ break.

“The data also suggested that personal care and lifestyles may influence the microbes that reside on the skin surface,” said Dorrestein, who was not involved in the new study.

He said he was happy to see other researchers taking a “detailed” look at one personal care product. But he also pointed to some limitations of the study, including the small number of volunteers, and the “arbitrary” choice of an eight-day experiment.

Plus, Dorrestein said, it’s not certain that the changes in people’s armpit swabs actually reflect a dramatic shift in their skin bacteria. An alternative explanation, he noted, is that when people were using underarm products, the swabs just weren’t reaching as many bacteria through the barrier.

Dorrestein pointed to the dramatic drop in swabbed bacteria on day seven — just the first day that all volunteers starting using (or reusing) antiperspirant.

Still, he said, the study hypothesis was good, and he’d be “surprised” if personal care products did not change the skin’s microbial community.

The big question is what that means.

“We know a little bit about the skin microbiome,” study co-author Horvath said. “But we have so much left to learn.”

More information

The American Academy of Microbiology has more on the microbiome.

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Salted caramel post workout smoothie

 

Change up your post-gym snack with this salted caramel smoothie by @silverspies.

 

 

• 3 heaped tbsp (approx. 30g) of natural whey protein (WPI or WPC)
• 2-3 medjool dates (depending on desired sweetness)
• 1/8 tsp pink Himalayan salt
• 1 large frozen banana
• ¼ tsp cinnamon
• 1 cup rice milk

Simply place all ingredients into a blender & blend until smooth and creamy. Pour and enjoy.

NEXT: Choc chip banana protein ice cream... yum!

{nomultithumb}

 

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Less Than Half of U.S. Babies Receive Flu Vaccine: CDC

By Steven Reinberg
HealthDay Reporter

TUESDAY, Feb. 2, 2016 (HealthDay News) — Only about four out of 10 U.S. babies aged 6 months to 23 months are getting vaccinated against the flu, federal health officials reported Tuesday.

Between the 2002-2003 and 2011-2012 flu seasons, the number of infants who received flu shots increased from just under 5 percent to almost 45 percent, according to a new study. However, that falls far short of the recommendation from the U.S. Centers for Disease Control and Prevention that children 6 months and older get a flu shot every year.

“While flu vaccination for children has gone up, there is still a long way to go to protect every child,” said study lead researcher Tammy Santibanez, an epidemiologist with CDC’s National Immunization Program.

“We also know that more effort needs to be put into encouraging black parents and children, and Hispanic parents and children to get the flu vaccine,” she said.

Flu is a serious and potentially life-threatening illness. Each year an average of 20,000 children under 5 years of age are hospitalized because of complications from the flu. During last year’s flu season, more than 140 children died from flu, the CDC said.

Depending on age and vaccination history, children need either one or two doses of vaccine to be fully protected. Some children 6 months through 8 years of age need two doses, including those being vaccinated for the first time, the CDC says. The agency recommends that you check with your doctor to see if your child needs two doses.

In the 10 flu seasons studied, black and Hispanic children had lower rates of vaccination than white children, Santibanez said. Complete vaccination coverage was higher among children who needed only one dose, compared with those requiring two doses.

In the 2011-2012 flu season, 49 percent of white children were vaccinated compared with 40 percent of Hispanic children and 35 percent of black children, the researchers found.

“Vaccination is the first and most important step parents can take to protect their family against the flu,” Santibanez said. Vaccination can reduce flu illnesses, doctor visits, and missed work and school, and also prevent flu-related hospitalizations, she added.

“Both parents and doctors can work together to do a better job at ensuring that children are fully vaccinated and protected against the flu,” she said.

The report was published online Feb. 2 in the journal Pediatrics.

For the study, Santibanez and colleagues used data from the National Immunization Survey to estimate influenza vaccination among children aged 6 to 23 months based on doctors’ reports.

Dr. Jefry Biehler, chairman of pediatrics at Nicklaus Children’s Hospital in Miami, said people need to realize that “influenza is a serious infection, especially in children that are high-risk because of other health conditions, and it can be serious even in children who are otherwise healthy.”

Biehler recently treated a young girl who nearly died from heart complications brought on by the flu. “The parents didn’t realize how serious the flu can be,” he said. “Many parents still believe that the flu is a bad cold and it’s nothing to worry about.”

It’s important for all members of the family to get their flu shot every year, Biehler said.

More information

For more about the flu, visit the U.S. Centers for Disease Control and Prevention.

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Stress-Prone Teen Males May Be at Risk of High Blood Pressure Later

MONDAY, Feb. 1, 2016 (HealthDay News) — Young men who get stressed out easily appear to have a greater risk of high blood pressure later in life, a new study suggests.

The researchers found that, among 18-year-old men, those who had the lowest stress-resilience scores were 40 percent more likely to develop high blood pressure later than those with the greatest ability to cope with stress.

The investigators also found that being overweight was linked with an even greater risk of developing high blood pressure (or “hypertension”) in those who had a low threshold for stress.

However, it’s important to note that the study can only show an association between stress response and later high blood pressure; it cannot prove a cause-and-effect relationship.

The research was based on data from more than 1.5 million men conscripted into the Swedish army between 1969 and 1997 at age 18. Their health was followed until the end of 2012. None of them had high blood pressure when they entered the military. All of the young men were assessed for their ability to handle stress.

During the study period, about 93,000 of the men were diagnosed with high blood pressure. The average age at diagnosis was 49, the researchers said.

Weight also seemed to play a role in the men’s risk of developing high blood pressure. The investigators looked at each participant’s body mass index (BMI), which is an estimate of body fat based on height and weight.

Men who had low stress-resilience scores and a high BMI at age 18 had a more than tripled risk of high blood pressure later in life than those who had high stress-resilience scores and normal BMI at age 18, the findings showed.

The study was published online Feb. 1 in the journal Heart.

If confirmed, the findings “may help inform more effective prevention interventions by addressing psychosocial risk factors and stress management across the lifespan,” study author Dr. Casey Crump, from Icahn School of Medicine at Mount Sinai in New York City, and colleagues said in a journal news release.

More information

The U.S. National Institute of Mental Health has more about stress.

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Could That Bloody Scene on ‘Downton Abbey’ Really Happen?

Photo: PBS

Spoiler alert: If you’re a Downton Abbey addict and you missed Sunday’s episode—or if you’re just a little bit squeamish—this is your final warning to click away.

Last night on the British period drama, Lord Grantham’s health mystery came to graphic fruition when he vomited blood across the dinner table, a potentially life-threatening consequence of his stomach ulcer. (You can catch a clip from the scene here. A heads up: it isn’t pretty.)

The scene caused Health editors-slash-Downton fans to wonder: What the heck just happened—and can it happen to us?! We tapped our contributing medical editor, gastroenterologist Roshini Rajapaksa, MD, for the need-to-know facts on stomach ulcers.

The crater-like sores form when acid in the digestive tract eats away at the lining of the stomach or the duodenum (the first section of the small intestine), says Dr. Rajapaksa. “They’re potentially very dangerous if left untreated.”

The show’s blood-spewing scene wasn’t an unrealistic depiction of what can happen in an extreme case. “If the ulcer erodes deep enough into the lining of your stomach, two things can happen,” Dr. Rajapaksa explains. “It can erode into a blood vessel, which then can start bleeding very profusely, and that’s likely what happened in [Lord Grantham’s] case, because he began vomiting blood. Or, it can actually erode a hole all the way through your stomach, and stomach contents can then leak into the abdominal cavity,” a rare but potentially deadly scenario.

How do you get a stomach ulcer in the first place?

The primary cause is a bacteria known as Helicobacter pylori, which was just discovered in 1982. “Many people have the bacteria in their bodies, but may not realize it until later in life, if and when they develop gastritis, which is inflammation of the stomach, or an actual stomach ulcer,” says Dr. Rajapaksa. (An estimated two-thirds of the world’s population carries H. pylori.) Another possible cause of stomach ulcers is the long-term use of nonsteroidal anti-inflammatories, or NSAIDs, like ibuprofen and aspirin, she adds.

RELATED: 18 Reasons Why Your Stomach Hurts

How do you know if an ulcer is developing?

You may not if the sore is just opening and you’re symptom-free, says Dr. Rajapaksa. But when an ulcer forms and deepens into the stomach lining, you’ll feel it, she says. Common symptoms include burning pain and nausea, even vomiting in some cases. “You may also feel a gnawing feeling of hunger,” Dr. Rajapaksa adds. “People with ulcers tend to feel a little bit better after they eat because food almost helps coat the stomach.”

If notice these signs, Dr. Rajapaksa recommends seeing your doctor a.s.a.p. “Certainly if you’re vomiting blood, I would hope that everyone knows to immediately go to the hospital,” she says. “But even if you’re having other symptoms at home and you suspect you have an ulcer, I would suggest you get it diagnosed instead of trying to wait it out, or seeing if the pain goes away.”

Ulcers can be diagnosed through with X-ray tests, an endoscopy (a nonsurgical procedure that involves inserting a flexible tube with a light and mini-camera through your mouth to look inside your digestive tract), or a simple breath test that detects whether you have the H. pylori bacteria.

RELATED: 13 Ways Inflammation Can Affect Your Health

Can you prevent stomach ulcers?

Unfortunately, if you have H. pylori in your body, there are few precautions you can take to avoid getting a stomach ulcer. Some people believe that avoiding spicy foods can help, or that stress triggers stomach ulcers—but those are myths, says Dr. Rajapaksa. She advises limiting your intake of NSAIDs (and not popping more than the recommended dose per day).

The key is to get checked out early, she says. “As soon as the ulcer is diagnosed, you can take an acid-blocking medication that will treat the erosion and prevent it from getting any worse in most cases. In more extreme cases, surgery may be required to repair the damage.”

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Study: Causes of Gulf War Illness Pinpointed

MONDAY, Feb. 1, 2016 (HealthDay News) — Exposure to pesticides and other toxins appears to be the cause of Gulf War illness in U.S. veterans, a new analysis states.

The Boston University researchers reviewed studies on Gulf War illness, and said their findings “clearly and consistently” show a link between the disorder and exposure to pesticides and taking pyridostigmine bromide (PB) pills, which were meant to protect troops against the effects of nerve gas.

There’s also evidence of a connection between Gulf War illness and exposure to the nerve gas agents sarin and cyclosarin, and to oil well fire emissions, according to the findings published in the January issue of the journal Cortex.

These toxins damaged troops’ nervous and immune systems, and reduced the amount of white and gray matter in veterans’ brains, said study leader Roberta White in a news release from the university. White is a professor of environmental health at Boston University’s School of Public Health.

The main causes of Gulf War illness are like so-called “friendly fire,” said study co-author James Binns. “We did it to ourselves,” he said in the news release.

“Pesticides, PB, nerve gas released by destroying Iraqi facilities — all are cases of friendly fire. That may explain why government and military leaders have been so reluctant to acknowledge what happened,” Binns said.

About 700,000 U.S. troops fought in the first Gulf War 25 years ago, and as many as 250,000 veterans of that conflict have Gulf War illness, the researchers said. It is a debilitating disorder that features symptoms such as fatigue, joint and muscle pain, headaches, concentration and memory difficulties, gastrointestinal problems and skin rashes.

For years, Gulf War veterans have claimed that the U.S. Department of Veterans Affairs did not take Gulf War illness seriously. In 2008, a committee created by Congress and directed by the White House released a report that said Gulf War illness is a real disorder that’s distinct from stress-related syndromes.

The report from the Research Advisory Committee on Gulf War Veterans’ Illnesses called for research into the causes and treatments of the illness. Binns was chairman of that committee.

Efforts to find effective treatments for Gulf War illness have been unsuccessful, but recent research has started to offer promising leads, the researchers added.

More information

The U.S. Centers for Disease Control and Prevention has more on Gulf War illness.

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