Category: Health

Children prescribed antibiotics twice as often as needed

Pediatricians prescribe antibiotics about twice as often as they’re actually needed for children with ear and throat infections, a new study indicates.

More than 11 million antibiotic prescriptions written each year for children and teens may be unnecessary, according to researchers from University of Washington and Seattle Children’s Hospital. This excess antibiotic use not only fails to eradicate children’s viral illnesses, researchers said, but supports the dangerous evolution of bacteria toward antibiotic resistance…

Antibiotics, drugs that kill bacteria or stop them from reproducing, are effective only for bacterial infections, not viruses. But because doctors have few ways of distinguishing between viral or bacterial infections, antibiotics are often a default treatment.

Based on the prevalence of bacteria in ear and throat infections and the introduction of a pneumococcal vaccine that prevents many bacterial infections, the researchers estimated that about 27 percent of U.S. children with infections of the ear, sinus area, throat or upper respiratory tract had illnesses caused by bacteria.

But antibiotics were prescribed for nearly 57 percent of doctors’ visits for these infections, the study found.

Thousands die unnecessarily every year from illness caused by antibiotic-resistant bacteria. There are no legitimate reasons for over-prescription. Only marketing and social pressures which should have nothing to do with the practice of medicine.

Thanks, Mike

He gave his parents a present of genetic testing — and then a divorce

I’m a stem cell and reproductive biologist. I fell in love with biology when I was in high school. It was the realization that every cell in my body has the same genome and DNA, but each cell is different. A stomach cell is not a brain cell is not a skin cell. But they’re reading from the same book of instructions. With 23andMe, you get your personal genome book, your story. Unless you have an identical twin somewhere, that genetic makeup is unique to you…

I had spent many years looking at the genes of other animals — particularly mice — but I never looked at my own. Because I was so excited about it, I got two 23andMe kits for my mom and dad as gifts. It’s a lot more fun when you can incorporate your family because you can trace not just the chromosomes but individual alleles on the chromosome so you don’t just see them, but where they came from. Also, I felt I had a good handle on my family’s medical history so I was very interested in confirming any susceptibility to cancers that I heard had run in my family, like colon cancer. I wanted to know if I had a genetic risk.

I found out I don’t have any genetic predisposition to any kind of cancer, which was a great relief to me. But I also discovered through the 23andMe close relative finder program that I have a half brother, Thomas.

…We figured out that at the very bottom of your profile, there’s a little box that says “check this box if you want to see close family members in this search program.”…Dad checked it, and Thomas’ name appeared in his list. 23andMe said dad was 50 percent related with Thomas and that he was a predicted son

At first, I was thinking this is the coolest genetics story, my own personal genetics story. I wasn’t particularly upset about it initially, until the rest of the family found out. Their reaction was different. Years of repressed memories and emotions uncorked and resulted in tumultuous times that have torn my nuclear family apart. My parents divorced. No one is talking to my dad. We’re not anywhere close to being healed yet and I don’t know how long it will take to put the pieces back together.

Sometimes, the truth really can hurt.

RTFA, wander through the twists and turns of this very modern tale. It’s not all unhappy. The anonymous author’s half-brother, Thomas, was adopted and had searched years for either of his birth parents. He has a daughter of his own who wondered about her family’s medical history.

Still…

Transforming cancer cells into healthy cells

For almost thirty years, William Kuhens worked on Staten Island as a basketball referee for the Catholic Youth Organization and other amateur leagues. At seventy, he was physically fit, taking part in twenty games a month. But in July of 2013 he began to lose weight and feel exhausted; his wife told him he looked pale. He saw his doctor, and tests revealed that his blood contained below-normal numbers of platelets and red and white blood cells; these are critical for, respectively, preventing bleeding, supplying oxygen, and combatting infection.

Kuhens was sent to the Memorial Sloan Kettering Cancer Center, in Manhattan, to meet with Eytan Stein, an expert in blood disorders. Stein found that as much as fifteen per cent of Kuhens’s bone marrow was made up of primitive, cancerous blood cells. “Mr. Kuhens was on the cusp of leukemia,” Stein told me recently. “It seemed that his disease was rapidly advancing…”

The only options were experimental. Stein had sent a sample of Kuhens’s bone marrow to be analyzed for the presence of thirty or so gene mutations that are known to be associated with blood cancers. The tests revealed one notable mutation, in a gene that produces an enzyme called IDH-2. Normally, the enzyme helps to break down nutrients and generate energy for cells. When mutated, it creates a molecule that alters the cells’ genetic programming. Instead of maturing, the cells remain primitive, proliferate wildly, and wreak havoc…

This past spring, Kuhens entered the AG-221 drug trial and received his first dose. Within weeks, the leukemic-cell count in his bone marrow had fallen from fifteen per cent to four per cent, and his counts of healthy blood cells improved markedly; he has been in complete remission for four months. The most noticeable side effect has been a metallic taste in his mouth. “For some reason, I can’t stand mayonnaise,” Kuhens told me recently. He just celebrated his fiftieth wedding anniversary. “I want to be around for a while,” he said, “and I don’t know how long this drug will last…”

The Agios drug, instead of killing the leukemic cells—immature blood cells gone haywire—coaxes them into maturing into functioning blood cells. Cancerous cells traditionally have been viewed as a lost cause, fit only for destruction. The emerging research on A.M.L. suggests that at least some cancer cells might be redeemable: they still carry their original programming and can be pressed back onto a pathway to health.

Most cancers, once they spread, are incurable. Cancer researchers are desperate to raise the number of patients who go into remission, to prolong those remissions, and to ultimately prevent relapse. So when a new way of attacking cancer comes along, it is often greeted with incautious euphoria and an assumption that the new paradigm can be quickly converted into a cure for all cancers…

Cancer does not have one fatal flaw. It advances along many paths, sometimes incrementally, often unpredictably, like the science arrayed against it. Nonetheless, these latest findings offer an unanticipated opportunity for scientists to reëxamine what many of us took for granted: that cancer cells must be destroyed if the patient is to improve. These discoveries could enable researchers to target cancers that were previously beyond treatment. For patients, they offer evidence that it is possible to live longer, and better, with cancer—and they provide hope that scientists are advancing on a cure.

The big CA scares all of us. Shuffling off this mortal coil is nothing any sentient rational human being looks forward to. Adding all the negatives of death by cancer increases anxiety and fear by an order of magnitude.

RTFA for an analysis of the treatment and research involved in this particular approach. Someday, it may help you through a difficult time.

Thanks, Mike

Enterovirus D-68 (HEV-D68) Update

Although lab confirmation is still awaited in some areas, the outbreak of severe respiratory illness in kids that we saw pop up N.W. Missouri a little over a week ago…and then a few days later in St. Louis…has now been reported in at least four more states.

This week we’ve seen media reports of hospitals being slammed with (mostly young) patients with respiratory infections in Ohio, Illinois, Kansas, Missouri, and most recently Colorado. While test results haven’t come back for all of these locations, local doctors are pointing their fingers at the emerging EV 68 virus.

Click through to the article updating reports around the United States and the world. About 4 days old.

Thanks, Mike

Infection, death risk increases with every day of hospital stay

Infection risk in patients increases by 1 percent each day of hospitalization, a new research reveals.

Researchers from the Medical University of South Carolina examined 949 documented cases of Gram-negative infection at their academic medical center. This study is the first to quantify the risks for patients over time.

The team noted that in the first few days of hospitalization the percentage of infections from Gram-negative bacteria (a multidrug-resistant one) was around 20 percent and the rate constantly went up as days passed and reached 35 percent at 10 days.

Researchers stated that the infections developed in hospitals represent a large and possibly preventable segment of hospital-related deaths. These infections are on the rise year by year. According to one European study, Gram-negative infections comprise of two thirds of the 25,000 hospital-acquired infection deaths each year.

The CDC says that around 722,000 hospital-acquired infections resulted in 75,000 deaths. A death rate greater than 10%. And folks wonder why we call our local hospital, “Saint Victims”?

Thanks, Mike

Sleeping on animal skins may be good for babies — and other baby animals. eh?

Sleeping on animal skin may reduce a baby’s risk of developing asthma, research suggests…Germs in the hide and fur prime the immune system not to trigger allergies, scientists believe…The finding comes from a study of 2,441 healthy German infants whose progress was monitored until the age of 10.

More than half (55%) slept on animal skin during their first three months of life. They were 79% less likely to develop asthma by six years of age than children not exposed to animal skin.

The results, presented at the European Respiratory Society’s International Congress in Munich, lend support to the “hygiene hypothesis” that suggests too much cleanliness early in life can increase susceptibility to allergies.

Lead researcher Dr Christina Tischer, from the Helmholtz Zentrum Munchen Research Centre, said: “Previous studies have suggested that microbes found in rural settings can protect from asthma. An animal skin might also be a reservoir for various kinds of microbes, following similar mechanisms as has been observed in rural environments.

“Our findings have confirmed that it is crucial to study further the actual microbial environment within the animal fur to confirm these associations.”

Grandma was right. Of course, she only had to content with rural dirt, wild fur. Environments contaminated by industrial pollution probably still aren’t recommended sources for “natural”.

Thanks, Mike

Seals and sea lions probably distributed tuberculosis to humans around the globe


“You sneezed on me!”

Scientists who study tuberculosis have long debated its origins. New research shows that tuberculosis likely spread from humans in Africa to seals and sea lions that brought the disease to South America and transmitted it to Native people there before Europeans landed on the continent.

The paper, “Pre-Columbian Mycobacterial Genomes Reveal Seals as a Source of New World Human Tuberculosis,” was published in Nature…

Modern strains of tuberculosis currently circulating are most closely related to those found in Europe, and there was a complete replacement of the older strains when European disease reached the Americas during the age of exploration. Researchers found that genomes from humans in Peru dating from about 1,000 year ago provide unequivocal evidence that a member of the tuberculosis strain caused disease in South America before Europeans arrived, so the question among the scientists was, “What types of tuberculosis strains were present before contact..?”

In the study, researchers collected genetic samples from throughout the world and tested those for tuberculosis DNA while utilizing advances in technology during the past five years that enable more accurate genome capture from ancient samples. Of 76 DNA samples from New World pre- and post-contact sites, three from Peru around 750 to 1350 AD had tuberculosis DNA that could be used. The researchers then focused on these three samples and used array-based capture to obtain and map the complete genome.

These were compared against a larger dataset of modern genomes and animal strains. Research results showed the clear relationship to animal lineages, specifically seals and sea lions.

“Our results show unequivocal evidence of human infection caused by pinnipeds (sea lions and seals) in pre-Columbian South America. Within the past 2,500 years, the marine animals likely contracted the disease from an African host species and carried it across the ocean to coastal people in South America,” said Anne Stone, one of the principle investigators.

Don’t pet everything that looks cute. Don’t eat everything you can catch!

Thanks, Mike

Palliative care, end-of-life counseling moves forward even if politicians don’t

Pain

Five years after it exploded into a political conflagration over “death panels,” the issue of paying doctors to talk to patients about end-of-life care is making a comeback, and such sessions may be covered for the 50 million Americans on Medicare as early as next year.

Bypassing the political process, private insurers have begun reimbursing doctors for these “advance care planning” conversations as interest in them rises along with the number of aging Americans. People are living longer with illnesses, and many want more input into how they will spend their final days, including whether they want to die at home or in the hospital, and whether they want full-fledged life-sustaining treatment, just pain relief or something in between. Some states, including Colorado and Oregon, recently began covering the sessions for Medicaid patients.

But far more significant, Medicare may begin covering end-of-life discussions next year if it approves a recent request from the American Medical Association, the country’s largest association of physicians and medical students. One of the A.M.A.’s roles is to create billing codes for medical services, codes used by doctors, hospitals and insurers. It recently created codes for end-of-life conversations and submitted them to Medicare.

The Centers for Medicare and Medicaid Services, which runs Medicare, would not discuss whether it will agree to cover end-of-life discussions; its decision is expected this fall. But the agency often adopts A.M.A. recommendations, which are developed in meetings attended by its representatives…and discussion with bible-thumping populist idjits is useless as ever. Why waste the time?…

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