Monthly Archives: October 2013

Pneumonia Still A Mystery

A drug trial intended to determine if statin drugs improve outcomes in pneumonia patients found that it doesn’t work. Doctors at a French hospital gave 300 volunteers with pneumonia either statin drugs—drugs used to lower cholesterol—or an inert placebo in addition to standard treatment. What they found was that there was no evidence of any significant improvement in outcomes between the two groups, and that the addition of statins to the treatment regimen has no effect on the effectiveness of that treatment.

There had been previous studies suggesting that the drugs were beneficial for patients with pneumonia, but that had been patients taking statins for high cholesterol or other conditions for which the drugs are currently used. While statins do have anti-inflammatory properties, they did not prove useful against pneumonia.

That leaves antibiotics or antiviral medications—depending on whether the cause is bacteria or a virus—as the primary treatment for the lung disease. Patients who are old, who are young, or who have severe symptoms may need to be hospitalized. Hospitalization is also necessary in some cases in which there are complications, such as bacteria in the blood. Treatment can take as long as a month to show signs of completely clearing the infection.

Some vaccines help prevent pneumonia. Most forms of flu vaccine can keep it at bay, which is one reason it’s important to get flu shots every year. There is also a vaccine specifically for bacterial pneumonia, which only needs to be administered once. Several routine childhood vaccinations, such as for pertussis, varicella, and measles, are effective against pneumonia as well.

Another important preventative measure is avoiding indoor air pollution. That means not smoking, being careful about cooking and making sure there is adequate ventilation, and keeping down mold and dust. Hygiene in general is also important, washing your hands regularly and using hand sanitizer when needed. Keeping healthy generally—with a balanced diet, regular exercise, and enough sleep—will help you avoid opportunistic infections such as pneumonia.

The effects of Sandy remain visible a year later

Today, Hurricane Sandy seems like a distant memory. That is, unless you were in the wake of the devastation that flew across the East Coast. Even in the weeks that followed the storm, reports of serious health complications were reported. Then, there was the repair to flooded properties and rebuilding of destroyed homes and buildings. To date, a number of people living in the flood zones are dealing with respiratory problems.

Effects of Sandy
On October 28, 2012, mandatory evacuations were put in place due to the coming of Hurricane Sandy, and the following day the storm hit. Due to massive rainfall, there were 7 million to 8 million residents throughout the affected areas who were without power. According the the Centers for Disease Control and Prevention, the American Red Cross reported 117 people perished as a result of Sandy. The most common cause was drowning, and 45 percent of these cases took place in homes located in New York City's Evacuation Zone A.1 However, the effects of the hurricane go far beyond destruction of homes and buildings along the coast, many victims are still struggling with health issues today.

After effects
The New York City Poison Control Center investigated reported cases of carbon monoxide (CO) exposure two weeks after Hurricane Sandy struck.2 Data was collected using standardized and de-identified information sets that underwent a retrospective review. During this 12-day period, researchers noticed a spike in the number of suspected carbon monoxide poisonings reported. Emergency rooms and hospitals across the city indicated that there were 437 such cases. During the same two-week timeframe in 2008, the greater New York area only saw 116 reportings of CO poisoning.3

Respiratory effects
Today, Fox News reports that irritants left behind from the flooding are leading to respiratory repercussions for many individuals. Symptoms range from coughs to asthma to respiratory distress.

"Allergic-type symptoms, hay fever symptoms, congestion of the sinuses and nose, sore throat, rashes – these are things that people frequently complain of when they've had to either live for prolonged periods of time in a water-damaged environment or have had to move out because of it," Dr. Neil Schachter, a pulmonary specialist, told the source.4

This can be due to mold and other bacteria that is growing due to the damages sustained by properties. Those who suffer from cystic fibrosis or diabetes are at a greater risk for having more severe reactions to these contaminants. These issues were first noticed by the Deborah Heart and Lung Center in Browns Mills, N.J., when medical experts expressed concern of future health complications during the storm. The facility estimates that 14 to 30 percent of patients who come in for their Respiratory Evaluation for Sandy Program are referred to a primary care physician or specialist for further care.

Anyone who was affected by Hurricane Sandy or flooding due to other conditions are urged by health care professionals to seek an evaluation of their respiratory functions to avoid future complications. Even if the water damage took place years ago, the exposure over time can build up to serious medical conditions. The sooner something like this is caught, the more effectively it can be treated.

Medex Supply provides respiratory equipment for oxygen therapy, asthma management and more to both individuals and doctors.

1 Centers for Disease Control and Prevention, "Deaths associated with Hurricane Sandy – October-November 2012" May 24, 2013
2 Clinical Toxicology, "Carbon monoxide exposures in New York City following Hurricane Sandy in 2012"
3 LiveScience, "Hurricane Sandy brought surge in carbon monoxide poisonings" October 28, 2013
4 Fox News, "Sanding survivors may be experiencing respiratory problems 1 year later" October 29, 2013

Halloween Safety Tips

Halloween is a night for fun, but for too many families, it can be a night of tragedy. While some of the traditional stories are exaggerated or false—no one has legitimately found a razor blade in an apple, for example—there are some scary facts about Halloween and kids, and not in the fun way. Twice as many children are hit by cars on Halloween than on any other night, mostly because more children are on the streets. Here are some safety tips for trick or treating:

  • Young children should be supervised as they make their rounds. Trick-or-treaters should be in groups whether there are adults with them or not; it’s not only safer, it’s more fun.
  • If you’re wearing a costume while serving as the adult, make sure it’s very visible and recognizable—homemade is better than store-bought to help keep the kids you’re supervising from wandering off with the wrong person.
  • If you’re not accompanying your kids—because they’re with a trusted neighbor or because they’re old enough to go in a group of kids—know their route, know when you can expect them back, and make sure cell phones are charged.
  • If you check in with your kids by phone, call rather than texting. They won’t be tempted to walk while texting when they respond, and you’ll be able to hear what’s going on around them.
  • Avoid dark or black costumes for kids, or put reflective tape on the costumes and bags. Costumes with lighted accessories are also good. Even the Grim Reaper can carry a reflective or light-up scythe.
  • Costumes shouldn’t impede movement, nor should they drag.
  • Masks can block peripheral vision and make even seeing straight ahead difficult. Non-toxic face paint is a better choice.
  • Turn your light out if your children are home alone. Halloween is no exception to the rule about kids opening the door to strangers.
  • Children should not carve pumpkins without an adult to watch them.
  • Don’t leave knives or lit candles around toddlers.

Don’t let the specter of danger haunt your Halloween. Using safety tricks can help make the night a treat.

Preventing infections in hospitals

Cleanliness is one of the top priorities in hospitals across the country. However, health care-associated infections (HAIs), those that develop during a hospital stay, can cause severe complications for some individuals. According to the Centers for Disease Control and Prevention, one out of every 20 patients develop an HAI.1 Although many precautions are taken in an attempt to avoid these types of situations, it still happens.

More on HAIs
Many of these infections occur due to devices that are used during medical procedures. Some of the most common types of HAIs that are experienced by patients include:2

  • catheter-associated urinary tract infections
  • central line-associated bloodstream infections
  • gastrointestinal infections
  • surgical site infections
  • ventilator- associated pneumonia

The CDC regularly monitors HAIs and is constantly working to prevent their occurrence, as a key to ensuring patient safety.

HAI prevention
Based on collected researcher, the CDC provides advice on new strategies for HAI prevention. These are generally improvements to medical procedures and infection control guidance used in health care facilities.3 A key to success in this area is to have infection prevention policies and procedures in place at hospitals and the like. When staff members are informed and kept up to date with the information, it can go a long way in avoiding HAIs.

New developments
According to The Wichita Eagle, Wesley Medical Center in Kansas has developed a new robot – Johnny Five – to help the staff prevent the spread of infection in the facility.4 The device works to help kill infectious spores and bacteria that may lead to HAIs in patients. This is in addition to current cleaning policies in place at the hospital. While Johnny Five is at work, the room is evacuated to ensure the safety of patients and personnel.

"We're going to see what kind of effect it has," Valerie Creswell, Wesley's infectious disease medical director, told the source.

In particular, the center is looking to see how the equipment effects of C. diff rates in patients. Creswell believes that the results will be available next year.

Medex Supply provides health care facilities with supplies to help control and prevent infection.

1 Centers for Disease Control and Prevention, "Health care-associated infections (HAIs): the burden" December 13, 2010
2 Centers for Disease Control and Prevention, "Types of health care-associated infections" January 30, 2012
3 Centers for Disease Control and Prevention, "Preventing health care-associated infections" April 17, 2012
4 The Wichita Eagle, "Wesley using robot to help in preventing spread of infection" October 30, 2013

Psoriasis And Other Diseases

The skin disease psoriasis affects more than 7.5 million Americans. The most common variety is plaque psoriasis, in which patches of skin become inflamed, with silver-white scales covering the lesions. Beyond the physical discomfort, more than half of people with psoriasis report the condition being a significant problem in their day-to-day lives, particularly women and younger patients. Patients report anxiety and low self-esteem due to embarrassment from psoriasis.

There’s a sliver lining to the silver scales. Psoriasis patients are resistant to viral infection. Proteins in the skin of people with psoriasis have an effect on viruses that lessens their ability to grow and replicate. Psoriasis is an autoimmune disease, in which the immune system attacks healthy skin tissue, and so the skin of patients has high levels of an immune messenger called interleukin-29, which fights viruses.

Unfortunately, the viral resistance doesn’t translate into resistance to non-viral illnesses. In fact, people with psoriasis are especially prone to diseases of the lungs, heart, kidneys, liver and pancreas, including chronic pulmonary disease, type 2 diabetes, mild liver disease, and peptic ulcers. In addition, these and other conditions are more severe in psoriasis patients. That means people with psoriasis need to be particularly vigilant about these conditions, and take what steps they can to lower controllable risk. In addition, people with psoriasis are more prone to developing other autoimmune diseases, such as multiple sclerosis and lupus.

Treatments for psoriasis is with anti-inflammatory drugs, corticosteroids, and topical medication for the symptoms. Synthetic vitamin D and acne medication called retinoids are also administered topically. Ultraviolet light, natural or artificial, can also help alleviate psoriasis. Some natural remedies may also be helpful. Aloe vera’s soothing properties alleviate the discomfort of psoriasis lesions, and there is some evidence omega-3 fatty acids, taken orally, can reduce inflammation. Taking a bath is a good way to soothe the skin, at least 15 minutes with therapeutic salts or oatmeal. Use moisturizer immediately after drying from the bath and whenever your skin seems dry—possibly several times a day in cold weather. If your treatment interacts with alcohol, keep that in mind, and remember it can be drying.

Children working against juvenile diabetes

Willoughby Middle School, located in Ohio, recently held a dance-a-thon to raise funds for fighting juvenile diabetes, according to area newspaper The News-Herald.1 This was the first event of its kind at the school, and 120 junior high students participated to raise a total of $7,500 to help find a cure for the disease. Currently, six students attending the school are diabetic. This event offered a chance for classmates to show support for their friends, and they also raised awareness of a need for further research on putting an end to Type 1 diabetes in children.

At the school
Kids who participated in the fundraising did much more than dance. There were other activities planned throughout the evening, including a Halloween hour in which participants were able to dress up and get on their feet to the popular song "Thriller."

"I came because I wanted to make a difference," Skylar Bertolette told the source.

There was a great deal of support from students and parents at the school. Those who put on the event were thrilled with the turnout.

"It's nice to know that there are people out in the community who care," Kim Miozzi, a lead parent coordinator, explained to The News-Herald.

And the funds raised by the participants were much higher than the $35 goal those who organized the activity anticipated.

About juvenile diabetes
While many children suffer from Type 1 diabetes, it is also referred to as juvenile diabetes. This is a medical condition in which a child's pancreas is no longer able to produce insulin to the body. As a result, kids need to obtain the hormone in other ways.2 Parents with children who are insulin dependent need to monitor their blood sugar levels, count their carbohydrates and learn how to give them injections.

Parents in need of medical supplies for caring for kids with juvenile diabetes can turn to Medex Supply for insulin syringes and other diabetic supplies.

1 The News-Herald, "Willoughby Middle School dances to end juvenile diabetes" October 28, 2013
2 Mayo Clinic, "Type 1 diabetes in children" March 3, 2011

A few chemicals worth avoiding

We all use chemicals or cleaning agents around the house to keep it free of germs. This can be especially important during cold and flu season, when viruses can run rampant. However, the Environment Working Group has released a list of 12 chemicals that are found in everyday items that we use and even eat that may have less-than-desirable effects on the body.1

The worst of the worst
It's surprising how many chemicals we come into contact with in our daily lives. Based on information collected by EWG, some of the ones that should be on top of the concern list include:2

  1. Glycol ethers: These are found in paints and cleaning products. They have been found to lower sperm counts in painters who work with them on a regular basis, according the EWG. Parents should refrain from purchasing cleaning products that have 2-butoxyethanol and methoxydiglycol listed as ingredients, as children may have an increased risk for asthma and allergies when exposed to these chemicals.
  2. Organophosphate pesticides: Many fruits and vegetables are treated with this type of chemical. However, organic varieties may reduce your exposure. The problem? These pesticides can affect brain development, behavior and fertility – specifically as it can change testosterone levels in the body.
  3. Arsenic: This product occurs naturally in the environment, but can be more prevalent in pesticides that make their way to food and the water we consume. According to EWG, the chemical can lead to an increased risk of bladder, lung and skin cancers. It is important to note that although rice has been found to contain arsenic, the levels are low enough so as not to cause short-term health effects.

Medex Supply provides health care professionals and individuals with medical supplies for the treatment of a variety of conditions.

1 Environmental Working Group, "EWG's 'Dirty Dozen' list of hormone-disrupting chemicals" October 28, 2013
2 LiveScience, "12 worst hormone-disrupting chemicals & their health effects" October 28, 2013

Epstein-Barr Virus

Almost everyone has been infected with the Epstein-Barr virus. When doctors look for evidence of infection with Epstein-Barr—such as an immune response to it—they find it more than 90 percent of the time in adults. The good news is that immune response is so routine for the body that infected people, particularly if they’re not immunocompromised, shrug it right off, and almost no one who has the virus actually shows symptoms of illness due to it. This is especially true in children, half of whom pick up the virus by age five, but even people who catch it during or after adolescence become ill, usually with mononucleosis, less than half the time.

Unfortunately, not all Epstein-Barr diseases are so benign. Along with the "kissing disease," the virus is linked with some strains of herpes. Some types of lymphoma are caused by Epstein-Barr, as well as the kind of throat cancer that affects the top of the throat behind the nose. Furthermore, Epstein-Barr infection raises the risk of multiple sclerosis, particularly later in life. However, these complications are rare, which, combined with the ubiquitous nature and easy transmission of the virus—in saliva, though it is not airborne—means that developing an effective vaccine has been both difficult, while at the same time it has not been a goal widely pursued by medical researchers.

Now, however, scientists think they have an unprecedented grasp on how the virus functions, how it does so well, and possibly how to stop it. Epstein-Barr achieves its infectious success by attacking the immune system as well as the throat, destroying the signals that alert the immune system to it’s presence. Under laboratory conditions, researchers were able to get the immune cells that deal with Epstein-Barr to find the virus despite this.

In a different study, researchers looked at how Epstein-Barr and related viruses infect cells. The viruses are under great pressure, and forcefully shoot their genes into host cells to infect them. The researchers hypothesize that they can weaken the infectious power of the virus by reducing the pressure—a treatment that won’t be vulnerable to mutations in the virus, because it is based on structural rather than biological features.

New device for leaking heart valve treatment

If you keep up with all the latest medical equipment being developed, you'll know it's rather impressive. A new product that has recently been approved by the U.S. Food and Drug Administration is the MitraClip, by Abbott Vascular.

About the device
Abbott's MitraClip has been created to aid patients who are suffering from mitral regurgitation (MR), which comes along with debilitating symptoms.1 This product is the first of its kind, and is a great new advancement in treatment options for those with MR. As it has been approved by the FDA, it is clear that this product maintains a positive safety profile. Other beneficial attributes include favorable left ventricular remodeling and reduction in mitral regurgitation. The MitraClip will improve symptoms being experienced by patients along with reducing the number of hospitalizations due to heart failure for those with MR. This is possible, because the MitraClip stops heart valve leaking in patients who are unable to have their valves repaired through surgery.

FDA approval
According to a statement released by Reuters, MitraClip could be a $500 million product. Nearly one in 10 people who are 75 years and older are affected by MR.2 With the aging population the U.S. is experiencing, there's a good chance that these numbers will increase as the Baby Boomer generation reaches their senior years. And although the device has just been approved in the U.S., it has been in use in Europe since 2008. Overseas, sales have increased about 50 percent since the MitraClip's introduction in the world of health care. Locally, 50 medical facilities have experience with the device thanks to clinical trials that have been conducted. John Capek, head of medical devices with Abbott, estimates that there are 20,000 to 30,000 patients in the U.S. who will qualify for implantation of the MitraClip.

Medex Supply provides health care professionals and individuals with all the necessary medical supplies.

1 Abbott Vascular, "MitraClip percutaneous mitral valve repair system"
2 Reuters, "FDA approves Abbott device for leaking heart valve" October 25, 2013

Men And Breast Cancer

Because breast cancer is presented as a woman’s health concern, it’s easy to forget that—while rare—it is a legitimate concern for men as well. In fact, experts believe over 400 men will die of breast cancer this year alone. Men as well as women have breasts, including lymph nodes and even the tissue that in women are the milk ducts, and that means that men can also get breast cancer; about one in 1000 do.

The risk factors in men are obviously different from women, but there is some overlap:

  • High levels of estrogen. All men have some estrogen, just as women have some testosterone, but because the levels are so low, it’s not entirely uncommon for men to have elevated testosterone levels. Meanwhile, most breast cancer in men is what is called estrogen receptor-positive, and grows in response to estrogen. Men with gynecomastia—literally, "womanly breasts"—are likely to have high estrogen.
  • Estrogen exposure. Some men naturally produce more estrogen than typical, but estrogen is also administered to men, such as to treat prostate cancer.
  • Obesity. Fat cells create estrogen, including in men.
  • Radiation exposure, especially in the chest area. Radiation treatment for Hodgkin’s lymphoma is a common source of this radiation.
  • Liver disease. The liver is an important center of hormonal metabolism, meaning liver function is part of the regulation of estrogen and testosterone levels in the body.
  • Family history of breast cancer. While this is more often a risk factor for women, male family members of someone—particularly a man—who has had breast cancer are more likely to develop it themselves.
    • Breast cancer in men is often treated with surgery. The aesthetic concerns with surgery, including mastectomy, on men are different from those involved in the surgery when performed on women, meaning mastectomy is a less fraught option. Hormone therapy is also used to deprive the tumor of the hormones it needs to grow.