Monthly Archives: February 2014

Early Alzheimer’s Detection

The risk of Alzheimer’s disease and other forms of dementia increases with age. That means that as medical science makes it possible for people to live longer, it is expected that the number of people with dementia will go up. In fact, over the past 35 years, the number of people living with Alzheimer’s disease has doubled. Unfortunately, it usually goes undetected until symptoms start to appear. Because they are often gradual, dementia and related conditions are not always easy to detect at first. Fortunately, scientists are starting to develop a better understanding of what dementia looks like in the brain before it starts to affect cognition and behavior.

In one study, researchers found that people who think they have Alzheimer’s are often right. When men over 60 were asked about noticing changes in memory, the ones who reported significant and worsening impairment—as opposed to the lapses that are an ordinary part of life, and of aging particularly—were often confirmed to be suffering the condition. That means that people are capable of noticing early signs of Alzheimer’s disease in themselves, providing an indicator for screening. Similarly, people whose mothers had Alzheimer’s and who will have it themselves show indications in brain MRIs long before any symptoms develop, especially if their fathers had it as well.

These are important breakthroughs, because ordinarily, by the time symptoms appear, significant amounts or irreversible damage have already taken place. That’s why it’s important to get a handle on risk. Risk of developing Alzheimer’s increases sharply after age 65, and by 85 is nearly half. Diabetics are prone to Alzheimer’s disease, as are people who have had head trauma. Screening is available for people in high-risk groups.

Unfortunately, no cure for Alzheimer’s exists, but there are steps that can reduce someone’s risk or suffering. Research has found benefits from doing crossword puzzles, Sudoku, and a host of other mental exercises. Physical activity and staying fit can also help preserve cognitive functioning. There are some medications that can have a beneficial effect. Blood pressure medication fights dementia because high blood pressure is a risk factor, but there’s also some evidence that some kinds of anti-hypertension drugs have a direct influence on Alzheimer’s risk.

Genes And High Blood Pressure

Someone’s blood pressure can be very high, and they might never know it. That’s because even the initial symptoms of chronic hypertension—headaches, nosebleeds, and dizzy spells—rarely appear until a lot of damage has been done, if at all. Often, the first indicator of elevated blood pressure is a sign of the coronary and other health problems that it leads to, such as heart attack, stroke, or kidney failure, or diabetes or precursors to diabetes.

High blood pressure tends to develop gradually and silently over the course of decades, but doctors aren’t clear as to why. Risk factors include being middle-aged or older, being African-American, smoking, stress, a diet too low in potassium or vitamin D, and a sedentary lifestyle. People are also at articular risk for chronic hypertension if the have a family history of the condition, pointing to a genetic link. A number of genes have been identified as having some influence in cases of hereditary high blood pressure, including 11 in a study published last week.

"Discovering these new genetic variants provides vital insight into how the body regulates blood pressure," said Patricia Munroe, a researcher, in a statement. "With further research, we are hopeful it could lead to the development of new treatments for treating blood pressure and heart disease—a leading cause of death worldwide."

Someone with a genetic predisposition to high blood pressure isn’t doomed. There are risk factors a person can do directly. High blood pressure prevention means maintaining a healthy body weight, keeping up on regular physical activity such as brisk walking, being judicious abut drinking, and eating a diet low in salt but with plenty of fruits and vegetables. Trading a high-stress lifestyle for a calmer one may not always be possible or practical, but there are things, such as mindfulness meditation, that can reduce stress enough to lower hypertension risk.

Stress can also have an indirect effect, leading people who have been prescribed blood pressure medications to briefly, but dangerously, forgo them. Medications for high blood pressure include beta blockers and other drugs that relax the blood vessels, allowing the heart to work normally.

Raising a child with Type 1 diabetes

Type 1 diabetes, also known as juvenile diabetes, is a blood glucose disease that prevents the body from using glucose for energy.1 This lifelong, and sometimes chronic, disease can be difficult for both parents and children to deal with. However, there are a number of books that have been published on the matter, and you can likely find a support group in your area.

For the parent
Jean Betschart Roemer, a diabetes educator, wrote "Guide to Raising a Child with Diabetes," which was published by the American Diabetes Association. In the text, Roemer provides a number of fundamental tips to parents, according to Diabetes Forecast magazine.2 The book urges parents to remain involved in their children's diabetes care, even once they are able to manage the condition independently. Roemer also points out that it's important for parents to be forgiving of themselves and remain positive when discussing diabetes with their children.

Another important factor when raising a child with diabetes is keeping the proper supplies on hand. This is one point that is highlighted in the book "Kids First Diabetes Second: Tips for Parenting a Child with Type 1 Diabetes," written by Leighann Calentine, a well-known author who is also the mother of a child with Type 1 diabetes.

Diabetic supplies can be purchased by health care professionals and individuals from Medex Supply, an online medical supply store.

1 National Institutes of Health, "Type 1 diabetes" June 18, 2013
2 Diabetes Forecast, "Tips on raising a child with diabetes" April 2011

Medical Error

Every year, an estimated 98,000 people lose their lives due to preventable medical error. In fact, some studies say this number is a massive underestimate; they say as many as 440,000 people who go to the hospital die due to an error on the part of the staff while they are there. Medical errors, then, are at least the sixth and possibly as high as the third leading cause of death. However, these numbers are subject to various definitions and reporting standards, as well as an understandable desire on the part of medical professionals not to attribute adverse outcomes to their own mistakes. On top of that, outcomes are less likely to be traceable to errors the longer after the error they happen, making accurate data difficult to determine.

There are a number of types of errors that can cause problems. The most common, and most fundamental, medical error is simple misdiagnosis. Either one or more symptoms are missed, or symptoms are misinterpreted, or a patient will have symptoms that have more than one explanation and the doctors get it wrong. Unfortunately, sometimes even though several conditions have similar or overlapping symptoms, they have different treatments—in extreme cases, the treatment for one of the conditions will make another one worse. In any event, a patient who has been given the wrong diagnosis is likely to be given a treatment that is not helpful.

Even with the correct diagnosis, medication errors can be dangerous, even fatal. Transcription errors or misreading can lead to patients being given the wrong dosage, or even the wrong medication entirely. Some medication errors are due to poor coordination—two or more medications, appropriate on their own, but dangerous when used together, and health care professionals don’t realize the problem.

In fact, medical error can often be traced to poor communication among doctors. Even with electronic record-keeping, professionals treating the same patient often communicate primarily through notes in charts, and may never meet in person or directly discuss the patient’s care. In one study, training designed to enhance communication by hospital staff across shift changes improved patient outcomes dramatically, and another study shown improvements by involving the patients in these handoffs.

Making Liver Transplants Work

For people facing liver failure, a liver transplant is the only option, and it’s far from a perfect one. Donor tissue has to be as close a match as possible to the recipient, and even them the patient will need anti-rejection drugs—medications that keep the recipient’s immune system from attacking the donated organ, at the cost of scaling back all other immune functions—for life, meaning he or she will be forever more prone to infection. What’s more, there’s a chronic shortage of donors, with nearly 20 people waiting for each donated organ.

In some cases, and increasingly, it is possible to solve both these problems with stem cells. Stem cells are pluripotent, meaning unlike most tissue cells, which are specialized and only function properly in certain parts of the body, stem cells have the potential to sere any function that may be needed. That means that when someone’s liver is badly malfunctioning, it would be possible to use their stem cells to grow a new liver that won’t be rejected, without the need for a donor. However, the procedures for doing so are only just starting to be developed, and stem cells are difficult to harvest from adults. Cord blood banking has become possible in recent years, but for most people who need liver transplants, their window for that closed years before the technology was viable.

Now researchers have found a way to use cells that aren’t quite pluripotent to make liver cells. Using genetic engineering, scientists were able to transform skin cells into viable liver tissue that continued to thrive after nine months. In previous efforts, the liver cells made from stem cells died shortly after development.

"The cells began to take on the shape of liver cells, and even started to perform regular liver-cell functions", said one of the researchers, Dr. Milad Rezvani of the University of California at San Francisco, in a statement. "They weren’t fully mature cells yet—but they were on their way."

The long time frame suggests that this may be a functioning method for creating a new liver from a patient’s own tissue. Although human trials are still down the road, scientists hope this technique will benefit not just liver patients, but people with several types of organ failure in the future.

Advice for at-home wound care

It's not uncommon for patients to conduct home wound care following a serious injury or surgical procedure. For some, this can present a lot of questions and concerns throughout the process. However, as long as you follow your doctor's directions and keep the proper wound care supplies on hand, you should have no problems.

Reasons for home care
Chronic wounds generally require home care for full recovery. These types of wounds occur when skin or deep tissue has been broken so severely that it requires an extended period of time to heal.1 Instead of keeping you at the hospital, your clinician will likely send you home with a plan in place – providing there's no sign of infection. To start, some doctors will recommend the services of a home care agency. Once you get into the swing of things, there's a good chance that you can take over the responsibilities.

Necessary home care supplies
Depending on the type of injury or surgery a patient has experienced, there are a variety of medical supplies that may be necessary for recovery at home. However, you will be given specific instructions and a list of required equipment prior to starting your treatment. If this information is not provided, it is in your best interest to request it. Open wounds are at risk of developing bacteria, which can lead to infection or extend the recovery time. So, you'll want to make sure that you are properly caring for the wound.

Other tips for home care
Once you've obtained instructions for your clinician, it's important that you keep track of all your wound care responsibilities at home. For instance, if you are taking medications to prevent infection and lessen pain, you'll want to track the times each dose is administered. Following a serious injury, you may experience excruciating pain if your prescription isn't taken at the appropriate times. Some other things to keep in mind during your home care include:

  • Tracking the amount of supplies you have remaining – you don't want to run out.2
  • Knowing what to look for in terms of a healthy wound – it's best to contact your doctor at the first sign of infection.
  • Keeping up with any physical therapy exercises that have been prescribed to ensure an overall successful recovery.

If you are in need of wound care supplies to treat an injury or surgical site following discharge from the hospital, contact Medex Supply. This online medical supply store will provide you with all of the necessary equipment for a full and healthy recovery.

1 Intermountain Healthcare, "Wound care: Homes instructions" February 2012
2 Wound Care Advisor, "Providing wound care in the home: An option to explore" August 6, 2012

Cats And Mental Health

A parasite called Toxoplasma gondii gets into rats, and makes them utterly fearless around cats. This is as disastrous for the rats as might be expected. The parasite can also spread to humans, and while the consequences aren’t nearly as dire, it is still harmful. In fact, the same mechanism that causes infected rats to walk right into the feline jaws of death produces risk-taking behavior in people. The rat risk taking is actually how the disease spreads; the parasite is spread through cat waste. If you have cats, toxo lurks in the litter box; if you don’t, feral cats are probably leaving it in your garden. Unwashed fruits and vegetables that have come into contact with cat feces can also be vectors.

The good news is that the parasite is more common—it’s estimated to infect one in three people—than the actual disease. In people with healthy immune symptoms, it’s largely asymptomatic. At risk are people with compromised immune systems due to diseases such as AIDS or to immune-suppressant medications, children, and pregnant women and fetuses. If a woman becomes infected while pregnant, the parasite can cross the placental barrier. When this happens, the baby is often stillborn, or else can develop cerebral palsy, jaundice, seizure disorders, or developmental or cognitive disabilities.

If people get infected as adults, they too may get seizures, or there may be other symptoms. In some people, toxoplasmosis can look like flu, with achiness, swollen lymph nodes, fever, and fatigue. In people with immune problems, toxoplasmosis can cause vision problems, specifically blurry vision, as well as seizures. The parasite also effects the brain. Most often, it stimulates the production of a neurochemical called gamma aminobutyric acid, which suppresses fear and encourages risky behavior. However, there is some evidence that, in people with a genetic predisposition, toxoplasmosis can lead to schizophrenia.

Treating toxoplasmosis is not always necessary, because usually there are no symptoms. When treatment is needed, anti-malarial medication is administered. Malaria, like toxoplasmosis, is a parasitic illness, so medications that prevents parasite-caused conditions works on it. Recent research has shown indications that statin drugs, used to fight high cholesterol, in combination with osteoporosis medication, can stop the toxoplasma parasite from infecting people without the side effects of the malaria drugs.

This year’s flu season is not over

As February comes to an end, many may think flu season is behind us. However, that doesn't seem to be the case this year. In fact, the flu seems to be worse than usual. According to CNN Health, young people are having an especially hard time overcoming the virus.1 While generally infants and seniors seem to struggle the most when it comes to the flu, those ages 18 to 64 make up 61 percent of all influenza-related hospitalizations this season – this is up from 35 percent in years past.

Flu activity
The source reported that flu levels are listed as high, according to the Centers of Disease Control and Prevention, in the following states:

  • New York
  • Connecticut
  • Kansas
  • Oklahoma
  • Arkansas
  • Texas

CBS Baltimore also reported on the current flu strain hitting teens and young adults hard.

"Even though the recommendation is that everybody should get the flu shot, most likely children and the elderly are more likely to get vaccinated, whereas young adults often don't get vaccinated," Dr. Melissa Denham, a physician at Patient First, explained to the source.2

Most years, nearly 50 percent of children and 60 percent of seniors are vaccinated for influenza. However, only 33 percent of those age 18 to 64 are administered a flu shot. It is likely that this is the main cause of their falling ill this year.

Flu deaths
The Sacramento Bee reported on Friday, February 21, that there have been a number of deaths due to the flu this season. In fact, the source cited that 2 of every 100,000 Sacramento County residents younger than 65 have died from the virus so far.3 In total, there have been 278 deaths.

"The best way to prevent influenza is by getting vaccinated," Dr. Ron Chapman, director of the California Department of Public Health, told the source. "The influenza season continues and it's not too late for vaccination."

In order to prevent infection from spreading further, Medex Supply provides the necessary medical supplies to both individuals and professionals.

1 CNN Health, "Flu hitting young people harder this year" February 20, 2014
2 CBS Baltimore, "Flu hits Md. teens, young adults especially hard this year" February 23, 2014
3 The Sacramento Bee, "California reports another 35 flu deaths; Sacramento among hot spots" February 21, 2014

Is there a link between sleep apnea and diabetes?

Diabetes is a well-known medical condition that a large amount of Americans are familiar with; however, sleep apnea is not as greatly recognized. According to the National Institutes of Health, sleep apnea is actually a common disorder that disrupts an individual's sleep.1 In many cases, pauses in breathing can lead to sleep disruption as well as difficulty getting a quality night's rest. Most commonly, those who are obese suffer from the condition.

Now, how is sleep apnea linked to diabetes? Researchers from the University of Chicago aimed to find out whether or not disruptions to rapid eye movement sleep caused by sleep apnea were responsible for poor glycemic control in patients.2 This has been known to be an issue for Type 2 diabetes specifically. As explained in their findings, which were published in the journal Diabetes Care, authors of the research indicate that patients with Type 2 diabetes are at risk of having long-term glycemic control issues if they experience sleep apnea.

Diet and exercise are a great way to get your weight under control, especially if you suffer from diabetes or sleep apnea, both of which are worsened by obesity. If you need diabetic supplies to track your glucose levels, turn to Medex Supply, an online medical supply company.

1 National Institutes of Health, "What is sleep apnea?" July 10, 2012
2 American Diabetes Association, "Association of obstructive sleep apnea in rapid eye movement sleep with reduced glycemic control in Type 2 diabetes: therapeutic implications" February 2014

A New Understanding Of An Old Disease

The bacterium Yersinia pestis infects about one in 1.6 million people every year. However, while it isn’t especially prevalent today, researchers say this tiny microbe changed the course of human history—not just once, but twice. Yersinia pestis caused an outbreak of bubonic plague in the year 541, 15 centuries ago, in the Byzantine Empire that contemporary observes said killed 10,000 people each day. Carried by rats that had stowed away on ships carrying imported grain, the Plague of Justinian, so called by historians after the emperor reigning at the time, spread from that empire’s cosmopolitan capital to much of Europe, Asia, and Africa, killing around half the population, weakening the empire militarily and politically, and possibly contributing to the Anglo-Saxon conquest of Britain. The illness recurred, in milder forms, for a further 200 years.

This plague was 800 years before the Black Death struck in 1347, but in 2010 scientists discovered that different strains of the same bacterium were responsible for both. In fact, analysis of remains from those eras suggests that the strain that caused the Plague of Justinian had died out by the year 1000. There are no traces of the Justinian strain of the microbe more recently than that; the Black Death was caused by a different type that survives to this day, though it has become much more rare. Medical historians used DNA recovered from the teeth of victims of the Justinian Plague in Bavaria, a region of Germany, to look for the microbe likely to be responsible for the ancient pandemic. Comparing it to known strains of Y. pestis, they saw distinct similarities, but also crucial differences, indicating the bacteria are related, but not identical.

Although plague is very rare in humans nowadays—though there was a third, smaller epidemic in the 19th century in Asia and North America that resulted in the discovery of the bacterium responsible—it is still prevalent in rodent populations in certain parts of the world. Rodents of over 200 species that exist today have been found to be plague carriers. Fortunately, humanity has some things in our favor. People whose ancestors are from areas where a plague epidemic lasted a long time may have inherited a degree of evolved immunity. The Plague of Justinian lasted long enough that people from Europe and the Middle East, and their descendants, have a degree of natural resistance. Better sanitation than was standard 800 and 1600 years ago means humans are seldom infected by rats. In addition, plague bacteria have not developed antibiotic resistance.