Monthly Archives: June 2013

Lightning Safety Tips

Summer is thunderstorm season in most of the United States. Scientists still aren’t entirely sure how clouds become electrically charged in cold weather, but in general, the cold temperatures—as low as 13 degrees below zero—and rapidly moving air create small ice crystals, which become electrically charged when they jostle each other. The positively charged crystals tend to move upward while the negatively charged ones move downward, so the entire cloud is electrically polarized. The positively charged top spreads out, leaving a massive, negatively charged core. This creates a positive charge on the ground below, with results similar to a static shock, only on a larger scale.

That doesn’t mean it’s harmless, however. So far, four men and three women have been killed by lightning in 2013, most recently a man fishing on Lake Okeechobee in Florida on June 8th—and lightning strike fatalities typically peak in July, according to the National Oceanographic and Atmospheric Association. Here are some tips to keep you safe:

  • All seven fatalities happened outside. Being near buildings may be safer than an open field or on the water, but nowhere outside is truly safe from lightning. When thunder roars, go indoors
  • Seek shelter in an enclosed vehicle with a metal roof or a building with electricity or plumbing. Under a tree is not only unsafe, it is the second leading cause of lightning deaths
  • Your house is pretty safe, but stay away from electrical appliances and metal fixtures.
  • Don’t lean against or lie down on concrete.
  • If you’re caught outside during a storm, avoid high places, bodies of water, and anything conductive such as barbed wire. Don’t lie flat and don’t stand under anything that could fall on you.

Thunderstorms can be dangerous, but it’s a danger that can be managed if you know how. Just be aware of your surroundings and get inside when you hear the thunder.

Preventing HIV Infection In Vulnerable Populations

An antiretroviral pill used to prevent HIV infection has been shown to be effective in intravenous drug users, cutting their risk of contracting the virus in half compared to people who did not take the medication, according to a study published in The Lancet earlier this month. Trans,mission by intravenous drug use appears to account for around one in ten new HIV infections globally and around one in 12 in the United States. The same medication, called tenofovir, has also been found to prevent sexual and mother-child transmission; with this newest study, tenofovir has been shown to protect every major population at risk for HIV infection.

The study, performed in Thailand, also included blood tests performed on subjects, to determine how consistently they took the tenofovir. Intravenous drug users who took the prophylactic medication regularly—at least two-thirds of the time—and so maintained consistent levels of it in their blood found their risk of contracting HIV drop by 74 percent.

HIV, which stands for human immunodeficiency virus, is a retrovirus, which means once it infects a person (or other host), it spreads throughout the body by hijacking cell growth mechanisms. HIV causes AIDS when it infects and deactivates immune system cells; when the immune system is depleted beyond the point at which it is effective at protecting the body from infection, the patient is considered to have AIDS. Weakening the immune system prevents it from attacking HIV, and it also prevents it from attacking anything else, meaning HIV-positive people are susceptible to opportunistic infections by microbes that are common in the environment—or common but dormant in people—but that healthy immune systems successfully fight off as a matter of course.

The virus is usually transmitted through blood or sexual fluids. The most common means of transmission are sexual activities with an infected person without a barrier such as a condom, injecting drugs such as heroin with a syringe used by an infected person, or from an infected mother to her child through the placenta or breastfeeding. Transmission by all these means can be reduced with tenofovir. It is possible for HIV to be transmitted through blood transfusions, but the blood supply in the United States is screened for the virus.

New Treatment Possible For Cushing’s Disease

It may soon be possible for doctors to better treat a condition called Cushing’s disease, in which the body has too much exposure to the hormone cortisol. Researchers have identified one of the proteins behind the development of pituitary tumors, a common effect of the disease. The protein is one of a type called nuclear receptors, which are responsible for identifying and responding to hormone activity.

The nuclear receptor involved, called TR4, activates the production of a chemical called adrenocorticotropic hormone. Overproduction of this chemical is a characteristic of the pituitary tumors that trigger Cushing’s disease, and produces the excess cortisol which leads to the condition. The discovery is the first indication of a link between TR4 and adrenocorticotropic hormone. This discovery could help give health care practitioners a new route by which to address the disorder.

Cushing’s disease is a specific type of the condition called Cushing’s syndrome. Also called endogenous Cushing’s syndrome, because the excess cortisol is produced in the body, it is one of the two main causes the syndrome, the other being the corticosteroids often prescribed for inflammatory disease. Whatever the cause, Cushing patients tend to gain weight and develop fat deposits in the face and shoulders. Other symptoms include bruising easily and cuts healing slowly, thin and fragile, skin, and acne. Women often develop more body hair and have irregular periods; men exhibit reduced libido and erectile dysfunction. Left untreated, the condition can lead to loss of bone and muscle mass, heightened vulnerability to infection, diabetes, and high blood pressure.

Patients with any form of Cushing’s syndrome who are taking corticosteroids need to be tapered off the drugs, since they can be dangerous if stopped abruptly. The possibility of treating Cushing’s disease by suppressing the activity of TR4 is being investigated. Current medications for the condition, such as mifepristone and ketoconazole, block the production or effects of cortisol. Often, however, the pituitary tumors in which the excess cortisol is produced are either treated with radiation or are removed surgically. Surgery is also a common option when the tumor is on the adrenal glands, lungs, or pancreas; in extreme cases, the adrenal glands themselves may be removed.

Advances In Cancer Radiotherapy

An emerging cancer treatment uses what are called monoclonal antibodies to destroy certain types of tumors. These molecules are carefully constructed in laboratories to look and behave like ordinary immune cells, and are designed and programmed to attack the cancer cells directly. They do this in one or more of several ways. Some mark tumors as harmful so that the immune system recognizes the tumor and attacks it, some prevent the growth of blood vessels in the tumor and cut off its oxygen supply, some interfere with the signals that tell the tumor to grow.

Another use of monoclonal antibodies is as the delivery mechanism for radiation treatment. Radiotherapy for cancer works by damaging the cancer cells so that they die off—slowly on cellular time scales, but in a relatively brief time from the patient’s point of view. Though effective, both on its own and in combination with surgery or chemotherapy, the radiation treatments have a high risk of affecting healthy cells as well. While part of the basis for radiation therapy is that healthy tissue is better able to recover from the radiation, it is nonetheless important to minimize the damage to cells not part of the tumor.

With monoclonal antibodies, however, this damage can be avoided. After being introduced into the body, the antibodies go to the site of the tumor and attach to those cells. Because they’re designed, these molecules can be built to deliver a low dose of radiation on an ongoing basis, as opposed to a high dose for a short time—more effective as well as safer—with less inconvenience to the patient and with a reduced risk of harm. The low-dose approach allows the cancer to be attacked relentlessly and completely destroyed. Radioactive particles become inert after a time, and the treatment is administered in such a way that the particles reach this point when the tumor is neutralized or destroyed.

A study in Alabama recently found that combining monoclonal antibodies with safe amounts of radioactive lead was able to destroy tumors without accumulating in the body or damaging ordinary functioning. Further research will look at adjusting the dose to produce the optimal level of radiation.

Acoustic Neuroma

Brain tumors are worrisome and can cause distressing symptoms even when they’re benign from a medical standpoint. For example, one type, called an acoustic neuroma or vestibular schwannoma, is not cancerous but can affect your balance and hearing, causing dizziness and vertigo, tinnitus, and hearing loss. About 3,000 acoustic neuromas are found every year in the United States, though depending on where precisely the tumor is, it may have no noticeable effects on functioning and so go undiagnosed. Neuromas don’t always grow, but if they do it could result in pressure buildup in the skull, causing convulsions and cognitive impairment; in rare cases acoustic neuroma may even be fatal.

Acoustic neuroma can be traced to a flaw in a gene on the 22nd chromosome. The gene, called neurofibramin 2, is ordinarily responsible for directing the production of a protein called merlin that helps build the Schwann cells that form the protective covering around nerve structures. In some people, problems with this gene are hereditary, leading to a condition called neurofibromatosis type 2, which can lead to acoustic neuroma, but in the vast majority of cases there’s no clear cause of the error. People with NF type 2 generally have tumors on both sides of the brain, in the auditory nerves of both ears.

Treatment is available for acoustic neuroma, though it can be dangerous. That’s why it’s important to talk to your health care provider, to figure out what your treatment options are and balance their risks versus the risks of doing nothing. Acoustic neuromas are benign, and the symptoms are the result of pressure on nerves in the brain; if there are no symptoms, there is likely no immediate need to take action, though the patient should be closely monitored.

If treatment is needed, the current options are surgical removal of some or all of the tumor, or a procedure called stereotactic radiosurgery in which gamma radiation is used to stop the tumor’s growth. Radiosurgery is not always effective at preserving hearing. Recently researchers have started studying a possible medication for NF type 2 which would be useful in treating bilateral acoustic neuroma resulting from that condition.

Diagnosing And Treating Sepsis

One thing that makes severe infections so deadly is the massive inflammatory response from the body. When infectious agents get into the blood—a condition called septicemia—it leads to high fever, flushed skin, fast heart rate, low blood pressure, delirium, and swelling, known as sepsis. Not all infected people get sepsis, though there are about a million cases a year. The condition is difficult to predict; one of the biggest dangers is that it is often not recognized until it has developed. As a result, sepsis kills more people than prostate cancer, breast cancer, and AIDS put together.

Some patients are more prone to sepsis than others. Pneumonia and kidney and abdominal infections are more likely to lead to sepsis than other kinds of infections are. Regardless of location in the body, infections are more likely to result in sepsis in patients who are young, who are old, or who have weakened immune systems. Sepsis is often iatrogenic, meaning it is caused or worsened by otherwise needed and helpful medical interventions—it’s particularly common in hospital intensive care units and in patients who have breathing tubes or similar devices. People with burns or serious wounds in addition to infection are also more likely to develop sepsis. Incidence of the condition varies in different parts of the country, according to researchers at the University of Pennsylvania, with concentrations in the Midwest, mid-Atlantic, and the South, though it’s not clear what it is about these areas that causes this concentration.

Now scientists are learning how health care professionals can see sepsis early and provide prompt treatment. Sepsis patients show poor mobility of white blood cells called neutrophils; be observing the cells and measuring their movement, doctors can determine which patients are starting to develop sepsis, and by using a compound called resolvin known to increase the mobility of the cells, doctors may be able to treat sepsis at the root rather than simply addressing the symptoms.

In addition, close monitoring of patients in health care settings is a key part of treating sepsis quickly or preventing it from developing. Nurses and doctors should be on alert to look for warning signs and early symptoms of sepsis, and be ready to administer tests and take action quickly.

Preventing Tooth Decay

Cheese makes many people smile, and now scientists have learned that eating cheese can help protect your teeth. Casein, a chemical found in dairy, helps shield teeth from decay, and one component of casein is calcium, which helps strengthen and restore tooth enamel. In addition to these benefits of dairy, cheese in particular can change the chemistry of the mouth, making it less acidic. That means there’s less acid eating away at tooth enamel. In a study comparing the effects of various dairy products teenagers assigned to drink milk or eat yogurt showed no change in mouth acidity, whereas in teenagers who ate cheese, their mouths were less acidic. Cheese also has a particularly high concentration of casein.

Dental caries, or cavities, are caused by bacteria. The bacteria are drawn to accumulated food debris, particularly sugar, on the teeth, and form a film on the teeth called plaque. This plaque thrives in an acidic environment and is acidic itself. This acid eats away at the minerals in tooth enamel, weakening it and creating little pits in the surface. the bacteria and plaque get inside these pits, making them wider and deeper. The widened and deepened holes are cavities. Left to develop untreated, the plaque can get to the root of the tooth, where the nerves are, causing pain and abscess, and eventually tooth loss.

In addition to cheese, other foods can help prevent or slow tooth decay. Cocoa—without too much sugar—has polyphenols that reduce plaque coverage on teeth and fight the erosion of tooth enamel. Black tea has similar polyphenols, and it has fluoride, which is found in many toothpaste formulas and is known to be an important component of a healthy dental regimen. Tea also has flavanols such as epigallocatechin that reduce bacterial growth. Apples and cranberries have flavonoids, and the apple’s crunchy texture helps provide abrasive action to clean teeth.

Brushing your teeth also helps. Brush before bedtime and after eating sticky or sugary foods. Also floss, to avoid plaque buildup between your teeth. use antimicrobial mouthwash to help further clear out bacteria, and chew sugarless gum to help encourage saliva production, washing plaque away.

A New Test For Colon Cancer May Save Lives

Given the benefits of early detection and diagnosis, it is recommended that people over 50 get tested regularly for signs of colon cancer, which is the second leading cause of cancer deaths in the United States. Unfortunately, the testing is often unpleasant, invasive, and time-consuming. The best way to detect colon cancer is with a colonoscopy, a difficult. involved, and costly procedure that generally involves giving the patient anesthesia.

Now doctors may soon have a less unpleasant, less intrusive way of looking for colon cancer. The technique involves looking at a blood sample for certain genetic changes that are indicative of the presence of cancer. Called methylation, the change is found far more frequently in tumor cells than in healthy tissue, and its presence appears to be a largely—thought not entirely—reliable indicator of whether someone has cancer or a per-cancerous condition likely to develop into cancer.

Blood tests are already part of the diagnostic process. The current use of blood tests is to looking for signs of organs not working properly. However, by that time the cancer may be quite advanced already and far less tractable than if it had been caught sooner.

This is good news for people at risk for colon cancer. Age is probably the biggest risk factor: 90 percent of cases are in people over 50. African Americans are also particularly vulnerable to the condition. As with many forms of cancer, a family history of the condition is a sign you’re likely to get it yourself. People with other diseases of the colon tend to be likely to get cancer as well, are are people who are out of shape, who smoke, and who lead generally sedentary lives.

In addition to colonoscopy, current diagnostic techniques include what is called a complete blood count, measuring the amount of iron in the blood. Serious illnesses, particularly involving digestion, are often associate with anemia. Imaging procedures may also be used that are less direct then colonoscopy, but these also are less exact and less reliable. For example, patients may be X-rated after drinking contrast die, a substance that shows up on X-rays, allowing the colon to be outlined and delineated. CAT scan images—with or without a contrast—can also be used to create what is called a virtual colonoscopy, providing almost as good a look as the genuine article.

When Children Take Adult Medicines

Advances in medical research are making it possible for people to live longer, more active lives. One of the results of that is that more and more people are having children later in life, or taking a substantive role in their grandchildrens’ lives. However, the medications that make these possible can be dangerous for those children.

In fact, thousands of children are harmed annually by taking prescription medications belonging to the adults in the house, and this number is rising. Over the past decade, prescriptions have increased, meaning more children have these medications in their homes, and curiosity is taking hold of more of them each year. A recent study found that, between 2001 and 2008, prescription poisonings at pediatric emergency rooms rose as much as 36 percent.

This isn’t always an accident. Teenagers, for example, who find Vicodin or other opioid drugs sometimes experiment—nearly one in four teens have, according to a different survey. Often, however, a toddler will discover or seek Mommy’s or Daddy’s pills, such as statins, heart medications called beta blockers, or diabetes medication, and take them like the grow-ups do. Unfortunately, while these medicines are beneficial for those who need them, the same effects can be dangerous to younger or healthier bodies. Moreover, while people for whom medicine was prescribed take only the prescribed dose, curious exploring children, particularly toddlers, are likely to accidentally overdose, a danger that increases if the medicine is packaged in a bottle rather than in single-dose packaging or if pills are bright or sweet.

While it’s generally easy for people who have young children living in their homes to store medicines safely, other people may be tempted to overlook this if they only need to do it occasionally. Grandparents and non-custodial parents, for example, may be used to keeping medications, particularly daily ones, where they are easily accessible, making them also easily accessible for children they are likely to host for extended periods of time. If a child in your care does take medicines that aren’t intended for them, treat it as a poisoning. Call 911 or Poison Control (1-800-222-1222) immediately, and be ready to go to the emergency room, if possible with the medicine container and a best guess as to how much medicine the child took. The more information you can give medical personnel, the faster they will be able to provide proper treatment.

Maintaining Cognitive Function After Surgery

Surgeons have long recognized that patients display signs of confusion and mental fog in the days after an operation is performed. This postoperative cognitive dysfunction is very common after heart surgery, but also happens after other sorts of surgery. The impairment almost always clears up in a matter of weeks, though patients over 60 occasionally have long-term issues.

Incidence of dysfunction increases with age and with the complexity and length of the surgery, but there is otherwise no difference between the risk in patients who were under general anesthetic and those who received local. There are some lifestyle connections, as patients who drink a lot or have a lower educational level are at greater risk, though there’s no clear reason educational level should be relevant. The health of the person undergoing an operation—beyond the immediate reason the operation is being performed—also makes a difference; chronically ill patients and people who have had strokes, even if they’ve made a complete recovery, are at greater risk.

It’s not entirely clear what causes this condition. An inflammatory reaction to the operation appears to be partly to blame, particularly in the brain as a result of molecules activated in the body by many surgical procedures. The stress hormone cortisol, produced as a response to surgery, is known to affect a part of the brain that is important in the formation of long-term memory, and fluctuations in cortisol levels have been observed to affect the severity of postoperative cognitive dysfunction, suggesting that the condition is related in some way to cortisol levels.

With the cause being elusive, no successful treatment has been found. However, a team of Swedish researchers think they may have found a possible solution. Compounds called resolvins, which the body manufactures out of omega-3 fatty acids, are known to reduce inflammation, and now there is evidence that they, like anti-inflammatory medications, can lower the incidence of postoperative cognitive dysfunction. In addition, one thing that can increase resolvin production is aspirin—resolvins are part of the process by which aspirin reduces pain. The researchers found that as little as one dose of aspirin helped protect memory in patients after surgery.