27 Sep

Medical News Today: Are statins the best cholesterol-lowering drug? Study investigates

Statins should remain the first-line therapy for lowering cholesterol and reducing the risk of cardiovascular disease, but if they cannot be tolerated, nonstatin therapies may be just as beneficial. This is the conclusion of a new study published in JAMA.
[A pack of statins and a stethoscope]
Researchers say some nonstatin therapies may be just as effective as statins for reducing LDL cholesterol and cardiovascular risk.

Statins are drugs that block a cholesterol-producing enzyme in the liver called HMG-CoA reductase. This lowers the production of low-density lipoprotein (LDL) cholesterol – the “bad” cholesterol that can increase the risk of heart attack, stroke, and heart disease.

Study co-author Dr. Marc S. Sabatine, of Brigham and Women’s Hospital at Harvard Medical School in Boston, MA, and colleagues note that the clinical benefits of using statins to lower LDL cholesterol are widely accepted, largely due to the high-quality evidence of their safety and efficacy in clinical trials.

According to the American Heart Association, statins are the only class of cholesterol-lowering medication that has been shown to directly reduce the risk of heart attack and stroke, so it is often the first choice of drug therapy for patients with high LDL cholesterol.

When it comes to nonstatin cholesterol-lowering therapies, however, the benefits are less clear.

Nonstatin therapies just as effective as statins for lowering cholesterol

For their study, Dr. Sabatine and team set out to assess the effects of statin and nonstatin therapies on LDL cholesterol levels and the risk of cardiovascular diseases.

The researchers conducted a review and meta-analysis of 49 randomized trials conducted between 1966-2016. The trials included 312,175 participants of an average age of 62 years.

Fast facts about cholesterol

  • Around 73.5 million adults in the United States have high LDL cholesterol
  • Less than half of adults with high LDL cholesterol are receiving treatment
  • Individuals with high LDL cholesterol are at twice the risk of heart disease than those with normal levels.

Learn more about cholesterol

A total of 39,645 major cardiovascular events – including heart attack, stroke, and cardiovascular death – occurred among the participants, and the trials assessed the outcomes of nine different cholesterol-lowering therapies.

In order to compare these therapies, the team divided them into four groups:

  • Statins
  • Nonstatin therapies that primarily lower cholesterol by increasing expression of LDL receptors, such as diet, bile acid sequestrants, and ileal bypass
  • Therapies that do not increase LDL receptor expression, such as fibrates, niacin, and cholesteryl ester transfer protein (CETP) inhibitors
  • PCSK9 inhibitors – a new class of drugs that reduce LDL cholesterol by blocking PCSK9 protein activity the liver.

The team notes that trials specifically investigating how PCSK9 inhibitors affect cardiovascular outcomes have yet to be completed, so data for these drugs to date were assessed separately and compared with data for therapies that increase LDL receptor expression.

The results of the analysis revealed that statins and nonstatin therapies that increase LDL receptor expression were both similarly effective for reducing LDL cholesterol and reducing the risk of major cardiovascular events.

With both types of therapies, every 1 millimole per liter (39 milligrams per deciliter) reduction in LDL cholesterol represented a 23 percent decrease in the risk of major cardiovascular events, the team reports.

According to Dr. Sabatine and colleagues, their results “deserve careful consideration in light of the strength of the available trial evidence for different types of therapies.”

The authors add:

“As per current guidelines, when tolerated, statins should be the first-line therapy given the large reductions observed for LDL-C [LDL cholesterol], the excellent safety profile, the demonstrated clinical benefit, and low cost (now that most are generic).

However, the data in the present meta-regression analysis raise the possibility that other interventions, especially those that ultimately act predominantly through upregulation of LDL receptor expression, may provide additional options and may potentially be associated with the same relative clinical benefit per each 1 millimole per liter reduction in LDL-C.”

Read about a study that suggests the harms of statins have been overestimated.

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Source: medicalnewstoday

27 Sep

Medical News Today: Manuka honey could stave off catheter-associated UTIs

Manuka honey has long been hailed as a health food, with a number of studies reporting its antibacterial and anti-inflammatory properties. Now, a new study provides further evidence of such benefits, after finding it can halt the development of bacterial biofilms – groups of microorganisms that can adhere to surfaces and facilitate transmission of infections.
[Manuka honey]
Manuka honey could help combat catheter-associated urinary tract infections, say researchers.

Study co-author Bashir Lwaleed, of the Faculty of Health Sciences at the University of Southampton in the United Kingdom, and colleagues report their findings in the Journal of Clinical Pathology.

Manuka honey is produced by bees that pollinate the Manuka tree, native to New Zealand. While a delicious, albeit expensive food, previous research has suggested Manuka honey also offers health benefits.

The strongest evidence is for its antibacterial properties; a 2012 study, for example, suggested Manuka honey may be effective against chronic wound infections caused by Streptococcus pyogenes.

For their study, Lwaleed and team set out to determine whether Manuka honey has the potential to prevent the development of bacterial biofilms.

Testing Manuka honey’s effects on bacteria in lab dishes

The researchers cultured two strains of bacteria on 96 plastic dishes in the laboratory: Escherichia coli and Proteus mirabilis. Both bacteria are key causes of urinary tract infections (UTIs) that can arise with long-term catheter use.

The team diluted Manuka honey with distilled water before applying it to the bacteria, in order to test the effects of five different strengths: 3.3 percent, 6.6 percent, 10 percent, 13.3 percent, and 16.7 percent.

The researchers added the various concentrations of honey to two wells of each “growth” dish, while plain medium honey or artificial half-strength Manuka honey was added to the remaining two wells of each dish.

Each dish was sealed and incubated for 24, 48, and 72 hours, enabling the team to monitor how the honey impacted the development of biofilms.

In a separate experiment, the researchers added the honey to the growth dishes 24 hours after incubation, before incubating them for a further 4 or 24 hours. This was to assess how the honey affected biofilm growth following development.

Diluted Manuka honey reduced bacterial ‘stickiness’ by up to 77 percent

After 48 hours, the team found the lowest concentration of Manuka honey reduced the “stickiness” of E. coli and P. mirabilis bacteria by 35 percent – an indicator of reduced biofilm development – compared with plain medium honey or artificial half-strength Manuka honey.

After 72 hours, the team found the highest dilution of honey – 16. 7 percent – had reduced the stickiness of bacteria by 77 percent, and all other dilutions had reduced stickiness by at least 70 percent by that point.

In terms of biofilm growth, the researchers found all concentrations of Manuka honey had reduced growth after 4 hours; the highest concentration decreased growth by 38 percent after 4 hours, increasing to 46 percent after 24 hours.

The higher concentrations had an even stronger effect on biofilm growth after 48 hours, the team reports, but this was not the case with the 3.3 percent and 6.6 percent concentrations.

The researchers caution that their study has only shown how Manuka honey can reduce biofilm development or growth in laboratory conditions, so further studies are warranted to determine how the honey fares against bacteria in real-world settings.

“However, the model used demonstrates a capability of honey to inhibit the formation and early development of biofilms on solid plastic surfaces at concentrations that are not unduly viscous,” they add.

Adding honey to diet is ‘unlikely’ to help fight infection

Talking to Medical News Today, Lwaleed said the results could be beneficial for patients fitted with urinary catheters; according to the Centers for Disease Control and Prevention (CDC), of all hospital-acquired urinary tract infections, 75 percent are related to a urinary catheter.

“Honey may, subject to tolerability studies, be an effective antibacterial and biofilm inhibiting agent in catheter management – probably not prone to the induction of resistant pathogens as are many current antibiotics.”

Bashir Lwaleed

Asked whether adding Manuka honey to the diet may help fight infection, Lwaleed told MNT that it is unlikely.

“One of the reasons for using it in the bladder is that it is essentially a topical application, almost, if you will, an ‘external’ use comparable to current cutaneous use (impregnated in wound dressings, for example),” he explained. “The bladder wall structure and physiology is geared to preventing passage of substances from the urine into the body or the blood circulation, and the bladder lumen essentially is more or less in direct communication with the environment.”

“The caveat here is that bladder wall integrity may be partially compromised in disease states, so tolerability studies will need to include patients with some degree of bladder irritation or dysfunction,” added Lwaleed.

Learn about the health benefits and risks of honey.

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27 Sep

Medical News Today: What Does It Feel Like to Have High Blood Sugar Levels?

The human body naturally has sugar, or glucose, in the blood. The right amount of blood sugar gives the body’s cells and organs energy. The liver and muscles produce some blood sugar, but most of it comes from food and drinks that contain carbohydrates.

In order to keep blood sugar levels within a normal range, the body needs insulin. Insulin is a hormone that takes blood sugar and delivers it to the body’s cells.

What does it feel like to have high blood sugar levels?

[Blood sugar monitor]
In type 2 diabetes, the body can produce insulin but unable to use it properly.

Blood sugar is fuel for the body’s organs and functions. But having high blood sugar doesn’t provide a boost in energy. In fact, it’s often the opposite.

Because the body’s cells can’t access the blood sugar for energy, a person may feel tiredness, hunger, or exhaustion frequently.

In addition, high sugar in the blood goes into the kidneys and urine, which attracts more water, causing frequent urination. This can also lead to increased thirst, despite drinking enough liquids.

High blood sugar can cause sudden or unexplained weight loss. This occurs because the body’s cells aren’t getting the glucose they need, so the body burns muscle and fat for energy instead.

High blood sugar can also cause numbness, burning, or tingling in the hands, legs, and feet. This is caused by diabetic neuropathy, a complication of diabetes that often occurs after many years of high blood sugar levels.

What does high blood sugar mean for the rest of the body?

Over time, the body’s organs and systems can be harmed by high blood sugar. Blood vessels become damaged, and this can lead to complications, including:

  • Heart attack or stroke
  • Damage to the eye and loss of vision
  • Kidney disease or failure
  • Nerve problems in the skin, especially the feet, leading to sores, infections, and wound healing problems

Causes of high blood sugar

In type 1 diabetes, the immune system attacks the cells in the pancreas that produce insulin. As a result, the body lacks insulin and blood sugar levels rise. People with type 1 diabetes must take insulin through a needle, pen, or insulin pump to keep blood sugar levels under control.

Only 5 percent of all people with diabetes have type 1, according to the American Diabetes Association.

With type 2 diabetes, the body does produce insulin but is unable to use it properly. The pancreas tries to make more insulin, but often cannot make enough to keep blood sugar levels under control. This is known as insulin resistance. People with type 2 diabetes may need to take insulin, pills, or make diet or exercise changes to help control blood sugar levels.

Many pregnant women develop insulin resistance and high blood sugar levels during pregnancy. This is known as gestational diabetes. Gestational diabetes must be monitored by a woman’s obstetrician throughout her pregnancy, as it can lead to complications for mother and baby. Gestational diabetes usually goes away after the woman gives birth.

A higher than normal blood sugar level is known as hyperglycemia. Although diabetes is the main cause, people who take beta blockers and certain steroids may also experience high blood sugar.

Risk factors for high blood sugar

The exact cause of type 1 or type 2 diabetes is not known. Some factors may make a person more likely to develop these conditions, however.

Researchers believe certain genetic or environmental factors may make people more likely to get type 1 diabetes. The National Institute of Diabetes and Digestive and Kidney Diseases say certain genes play a role, and other factors such as viruses and infections may also be involved.

The Juvenile Diabetes Research Foundation say that there is nothing a person can do to prevent type 1 diabetes, and it is not related to eating, exercise, or other lifestyle choices. Type 1 diabetes usually begins during childhood or early adulthood.

[exhausted woman]
Having high blood sugar can cause a person to feel frequently tired and exhausted.

Although no single factor has been identified, the following risk factors make a person more likely to develop type 2 diabetes:

  • Having certain genes that are linked to diabetes
  • Being overweight or inactive
  • Having a parent or sibling with type 2 diabetes
  • Having African-American, Alaska Native, American Indian, Asian-American, Hispanic, or Pacific Islander ethnicity
  • Being over the age of 45
  • Being treated for high blood pressure, or having blood pressure of 140/90 or higher
  • Having low levels of “good” HDL cholesterol or high levels of triglycerides

What is a healthy blood sugar level?

People who have high blood sugar should discuss their target levels with their doctor. Regular testing may be needed to find out if the patient is within a healthy range. Each individual is different and levels can vary from person to person.

To determine a person’s blood sugar levels, blood tests may be taken after not eating for 8 hours, 2 hours after a meal, or at both times. Some people may also take a glucose tolerance test, which requires the patient to drink a sugary liquid and get blood tests afterward.

The American Diabetes Association recommend a pre-meal blood sugar level of 80-130 milligrams per deciliter. Around 1 to 2 hours after the beginning of a meal, blood sugar should be less than 180 milligrams per deciliter.

The American Association of Clinical Endocrinologists (AACE) state that blood sugar should be below 110 milligrams per deciliter after fasting. Around 2 hours after eating a meal, the AACE recommend a blood sugar target of fewer than 180 milligrams per deciliter.

Controlling blood sugar levels

Many people with diabetes must check their blood sugar levels daily with a glucose meter. This device takes a drop of blood, usually from a finger, and displays the sugar level within a few seconds.

People with type 1 diabetes will need to take insulin as directed, usually several times a day. Those with type 2 diabetes or gestational diabetes may need to change their diet and exercise habits. They may also need to take oral medications or insulin.

Blood sugar is only one part of a healthy lifestyle with diabetes. A person should also have their cholesterol and blood pressure checked regularly to help avoid heart disease. In addition, people with diabetes should check their feet regularly for sores or other problems and should receive regular eye exams.

What does it feel like to have low blood sugar?

Low blood sugar is often a side effect of diabetes medicines. If a person takes too much insulin, the blood sugar may become too low. Low blood sugar can also be caused by certain medications, health conditions, or skipping meals.

[Apples, water and weights]
People with type 2 diabetes or gestational diabetes may need to change their diet and exercise habits.

Symptoms of low blood sugar, also known as hypoglycemia, may include:

  • Feeling weak or shaky
  • Sudden nervousness, anxiety, or irritability
  • Sweating or chills
  • Extreme hunger
  • Confusion
  • Fast heart rate, or palpitations

Low blood sugar can often be corrected by drinking a beverage that contains carbohydrates. Frequent episodes of low blood sugar should be discussed with a doctor. Diabetes medications may need to be changed or reduced in order to correct the problem.

When to see a doctor

Symptoms such as tiredness, increased thirst, frequent urination, or weight loss should be discussed with a doctor. These could be signs of diabetes or other health problems.

Most checkups will involve blood sugar testing, even if the person has no symptoms. The U.S. Preventive Services Task Force recommend that adults age 40 to 70 who are overweight should be tested for diabetes. Those who have a family history of diabetes or who have other risk factors may need earlier or more frequent tests.

A person’s health and well-being depend upon proper management of blood sugar levels. Regular visits to the doctor and following diet, exercise, and medication guidelines can help control blood sugar for a better quality of life.

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27 Sep

Medical News Today: HIV vaccine steps closer with new insights into broadly neutralizing antibodies

Scientists reveal new insights into the human body’s ability to produce broadly neutralizing antibodies to HIV that promise to open new avenues for vaccine development.
[HIV attacking a cell]
Scientists say their new information on broadly neutralizing antibodies may bring us closer to an HIV vaccine.

Once the HIV enters the body, the immune system starts to produce antibodies to fight the pathogen. Generally, the antibodies produced are specific to the particular strain of HIV.

However, research reveals that around 1 percent of HIV-infected people produce broadly neutralizing antibodies that attack different strains of HIV that circulate worldwide.

Broadly neutralizing antibodies bind to structures or “spikes” on the surface of the virus that arise from the virus itself and vary little among different strains.

Much of the search for an HIV vaccine focuses on better understanding how broadly neutralizing antibodies form and attach to the spikes.

In a paper published in the journal Nature Medicine, researchers from the University of Zurich and University Hospital Zurich (UZH) in Switzerland describe how they found disease-specific, host-specific, and virus-specific factors that appear to influence the body’s ability to make broadly neutralizing antibodies against HIV.

For the study, the team examined around 4,500 people infected with HIV – all participants of the Swiss HIV Cohort Study and the Zurich Primary HIV Infection Study. They found 239 of the participants formed broadly neutralizing antibodies.

Disease, virus, and host factors

The researchers found three important disease-specific features that appear key for the production of broadly neutralizing antibodies: the number of viruses present in the body, the diversity of virus types, and how long the HIV infection had gone untreated.

Huldrych Günthard, professor of clinical infectious diseases at UZH and one of the study’s corresponding authors, says their study is the first to identify these three disease-specific features.

He says they also found that the features influence the production of broadly neutralizing antibodies independently of each other, and explains:

“So we don’t necessarily have to consider all three parameters in designing an HIV vaccine. This is especially important with regard to the length of vaccine administration – it wouldn’t be possible to imitate a longer untreated HIV infection with a vaccine.”

The important host-specific feature concerns ethnicity. The team found black participants infected with HIV appear to make broadly neutralizing antibodies more frequently than white people – regardless of other factors the study analyzed.

Co-author Alexandra Trkola, a professor of medical virology at UZH, suggests this factor needs further investigation in order to better understand how ethnic origin affects production of broadly neutralizing HIV antibodies. Factors likely to play a role could be genetics, geographics, and socioeconomics.

Finally, the team found that different virus subtypes appear to affect the binding site the antibodies attach to. Subtype B viruses are more likely to spur the body to make HIV antibodies that bind to CD4 binding sites – through which the virus binds to host immune cells.

In contrast, non-subtype B viruses appear to encourage production of antibodies that bind to a sugar element of the virus spikes (V2 glycan).

“Our results show how different factors boost the formation of antibodies that broadly combat different viral strains. This will pave the way for us to systematically push ahead with the development of an effective vaccine against HIV.”

Prof. Alexandra Trkola

Learn how a new powerful technique finds dormant HIV hiding in rare cells.

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27 Sep

Medical News Today: Region of body fat affects heart disease risk

Some types of fat increase the risk factors for heart disease more than others, finds a new study published in the Journal of the American College of Cardiology. While belly fat and fat under the skin are both associated with new and worsening heart disease risk factors, the relationship was more pronounced in belly fat.
[Woman with fat around abdomen]
Heart disease risk factors are increased more by belly fat than fat found just under the skin.

Around 1 in every 4 deaths in the United States are a result of heart disease. The majority of cardiovascular disease risk factors – high blood pressure, cholesterol, overweight and obesity, tobacco use, lack of physical activity, and diabetes – can be controlled, treated, or modified.

While just over 70 percent of U.S. adults are overweight and more than one third are obese, the new study shows that the region of the body where fat is distributed is a major factor in a person’s risk of heart disease.

Previous research has found that individuals who carry excess abdominal fat – particularly around the waist – face a greater risk of heart disease, compared with people who have fat elsewhere.

This study confirms that regional fat deposits in the stomach are harmful and suggests that the density of stomach fat – measured by CT scan – is just as influential on the risk of heart disease as the amount of fat a person has.

From CT scans, investigators note that the more fat a person has, the lower the density of the fat.

Dr. Caroline Fox, a former senior investigator for the National Heart, Lung and Blood Institute and the study’s senior researcher, and colleagues aimed to identify whether there was a relationship between volume and density changes in abdominal fat and changes in cardiovascular risk factors over the 6-year course of the study data.

The team studied 1,106 participants – average age 45 years and 44 percent women – enrolled in the Framingham Heart Study, and they assessed their CT scans to measure coronary and abdominal aortic calcification. The amount of abdominal fat they had accumulated, its location, and the density of the body fat were analyzed.

During the study, participants had measurements taken of subcutaneous adipose fat – fat that lies just underneath the skin – and visceral adipose fat that is situated inside the abdominal cavity.

Heart disease risk factors more pronounced in belly fat

Over the course of the 6-year follow-up, on average, participants experienced a 22 percent increase in fat under the skin and a 45 percent increase in fat inside the abdominal cavity.

Results indicated that increases in the amount of fat and decreases in the density of the fat were associated with adverse changes in heart disease risk. Additionally, each extra pound of fat gained from the start of the study through follow-up was linked to new-onset high blood pressure, high triglycerides, and metabolic syndrome.

While increases in both subcutaneous and visceral adipose fats were linked with initiating new and exacerbated cardiovascular disease risk factors, the relationship was more noticeable in fat inside the abdominal cavity than fat under the skin.

Participants who had the highest increases in belly fat also showed substantial increases in metabolic risk factors, such as high blood sugar, high triglycerides, and low high-density lipoprotein cholesterol, or “good” cholesterol.

Higher levels of fat under the skin may have a protective effect to serve as a “metabolic sink for storing excess fat particles,” Dr. Fox hypothesizes. However, in contrast, fat stored in the abdominal cavity is considered to be hazardous.

The researchers indicate that after adjusting for changes in body mass index (BMI) and waist circumference – two identifiers of whether a person is a healthy weight – their findings remained significant.

Increased fat volume with decreased density heightens heart disease risk

To examine abdominal adipose tissue volume and density change, the team divided the participants into three groups for assessment. They discovered that individuals who had greater increases in fat volume and a bigger reduction in fat density had a relatively higher incidence of heart disease risk factors.

Dr. James A. de Lemos states in an accompanying editorial that the study findings back up other studies that suggest the location and type of fat deposits provide essential information about heart disease risk that cannot be identified with simple measures like BMI.

“What’s really interesting is that we show that an increase in the amount of stomach fat and a lower density fat is associated with worse heart disease risk factors – even after accounting for how much weight was gained. This hasn’t been shown before.”

Dr. Caroline Fox

Dr. Fox continues to say that the correlation between fat density and worsening heart disease risk is significant. “Measuring fat density is a new measure that we are still working to understand and warrants further investigation,” she adds. “We used it as an indirect measure of fat quality and found that lower numbers were linked to greater heart disease risk.”

Future work of Dr. Fox and co-workers will target why and how fat density is associated with metabolic consequences – hypertension, abnormal cholesterol, diabetes, inflammation, insulin resistance – of obesity. They also hope to unravel how synchronized decreased density of fat and increased fat volume escalates the occurrence of damaging cardiometabolic changes.

Read about how compiling a person’s genetic risk score may improve heart disease prediction.

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27 Sep

Medical News Today: Roller coasters could help pass kidney stones

Medical research is full of twists and turns, but a new study has taken a more literal approach. Researchers report how riding moderate-intensity roller coasters might aid the natural passing of small kidney stones, reducing the need for surgical treatment.
[Big Thunder Mountain Railroad at Walt Disney World in Florida]
Using a 3-D-printed kidney model, researchers found riding the Big Thunder Mountain Railroad at Walt Disney World may aid the passing of small kidney stones.
Image credit: Disney.wikia.com

Study co-author Dr. David D. Wartinger, a professor of neurology at the College of Osteopathic Medicine at Michigan State University, and colleagues publish their findings in The Journal of the American Osteopathic Association.

Kidney stones are one of the most common urinary tract disorders in the United States. They accumulate from substances found in the urine – such as calcium, oxalate, and phosphorus – which can become highly concentrated and form solid masses.

According to the National Institute of Diabetes and Digestive Kidney Disease (NIDDK), kidney stones are the cause of more than 1 million visits to healthcare providers in the U.S. every year, as well as around 300,000 emergency department visits.

Kidney stones vary greatly in size, and they can either remain in the kidney or travel through the urinary tract. Small kidney stones may naturally pass through the urine, often causing little or no pain. Larger stones, however, may become stuck in the urinary tract, which can obstruct urinary flow and cause pain or bleeding.

If kidney stones do not pass naturally, they can grow in size, causing more pain and increasing the need for surgical removal.

Patients with small kidney stones are normally told to drink plenty of water to encourage natural passing, though this does not always work. The new study suggests there may be an alternative for patients who can stomach roller coasters.

Movements, forces of roller coasters jar kidney stones loose

Inspiration for the study came from patient reports that a certain ride at Walt Disney World in Orlando, FL – the Big Thunder Mountain Railroad – facilitated the passing of small kidney stones.

According to Dr. Wartinger and team, one patient said he passed a kidney stone after each of his three successive turns on the roller coaster.

To test whether the roller coaster does encourage the natural passing of kidney stones, the researchers used 3-D printing to create a model kidney, which they filled with urine and three kidney stones of different sizes.

After getting permission from Walt Disney World, the researchers placed the kidney model in a backpack and wore it during 20 rides on the Big Thunder Mountain Railroad. They assessed how the roller coaster affected the movement of the kidney stones after each turn.

Sitting at the back of the roller coaster resulted in a 63.89 percent passage rate, the researchers found, while sitting at the front of the roller coaster led to a 16.67 percent passage rate, regardless of size and location. Passage rate refers to the natural passing of kidney stones through the urinary tract.

Explaining the mechanism by which roller coasters may encourage the passing of kidney stones, Dr. Wartinger told Medical News Today that the “significant and random forces jar the stone loose, thus guiding the stone through the passage way.”

“A kidney looks like a tree with branches. The forces move the stone from being positioned where a leaf is located, down through the branches and out through the trunk – and onward to the bladder,” he added. “It’s not surprising that the model we used passed kidney stones on this coaster because it’s based on a gentleman that passed three stones on this exact roller coaster.”

‘Not everyone will respond to the same ride’

Dr. Wartinger says these early results suggest a moderate-intensity roller coaster ride has the potential to benefit some patients with small kidney stones, but it may not be the right approach for everyone.

“We believe this can be replicated but not everyone will respond to the same ride,” he told MNT. “What’s important to understand is kidney passage patterns are like fingerprints, so each person is going to have their own ideal roller coaster ride.”

Still, he and his team believe their findings certainly warrant further investigation, and they plan to test more kidney models and different sizes of kidney stones on a variety of roller coasters.

“Passing a kidney stone before it reaches an obstructive size can prevent surgeries and emergency room visits. Roller coaster riding after treatments like lithotripsy and before planned pregnancies may prevent stone enlargement and the complications of ureteral obstruction.

The osteopathic philosophy of medicine emphasizes prevention and the body’s natural ability to heal. What could be more osteopathic than finding a relatively low-cost, noninvasive treatment that could prevent suffering for hundreds of thousands of patients?”

Dr. David D. Wartinger

Learn about the causes, symptoms, and treatments for kidney stones.

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27 Sep

Medical News Today: Respiratory Acidosis: Causes, Symptoms, and Treatment

Respiratory acidosis develops when air exhaled out of the lungs does not adequately exchange the carbon dioxide formed in the body for the inhaled oxygen in air. There are many conditions or situations that may lead to this.

One of the conditions that can reduce the ability to adequately exhale carbon dioxide (CO2) is chronic obstructive pulmonary disease or COPD.

CO2 that is not exhaled can shift the normal balance of acids and bases in the body toward acidic. The CO2 mixes with water in the body to form carbonic acid.

With chronic respiratory acidosis, the body partially makes up for the retained CO2 and maintains acid-base balance near normal. The body’s main response is an increase in excretion of carbonic acid and retention of bicarbonate base in the kidneys.

Medical treatment for chronic respiratory acidosis is mainly treatment of the underlying illness which has hindered breathing. Treatment may also be applied to improve breathing directly.

Respiratory acidosis can also be acute rather than chronic, developing suddenly from respiratory failure. Emergency medical treatment is required for acute respiratory acidosis to:

  • Regain healthful respiration
  • Restore acid-base balance
  • Treat the causes of the respiratory failure

Fast facts on respiratory acidosis

Here are some key points about respiratory acidosis. More detail and supporting information is in the main article.

  • Respiratory acidosis develops when decreased breathing fails to get rid of CO2 formed in the body adequately
  • The pH of blood, as a measure of acid-base balance, is maintained near normal in chronic respiratory acidosis by compensating responses in the body mainly in the kidney
  • Acute respiratory acidosis requires emergency treatment
  • Factors that could worsen respiratory acidosis include smoking, sedatives, and obesity

Tipping acid-base balance to acidosis

When acid levels in the body are in balance with the base levels in the body, the pH measure of blood is 7.4. A lower pH number reflects higher levels of acid, and a higher pH number represents higher base levels.

[lungs diagram]
Acidosis occurs when gas exchange in the lungs does not work as it should.

The narrow pH range for healthy functioning is between 7.35-7.45.

Acidemia is defined when pH of the blood is lower than 7.35. Alkalemia, or blood with high levels of base, is when blood pH is higher than 7.45.

Respiratory acidosis

Acidosis is excess acidity. It is classified as either metabolic or respiratory, depending on the main cause of the acid-base imbalance.

Metabolic acidosis does not arise from increased CO2, but from increased production of acids. It can occur in conditions such as diabetic ketoacidosis and kidney disease, as well as many other diseases.

Respiratory acidosis occurs when respiration does not adequately get rid of CO2. The increased CO2 results in an increase in acid and an acidic state.

The increased CO2 that occurs in respiratory acidosis is called hypercapnia when it rises above the normal range.

Hypercapnia in chronic respiratory acidosis can persist without dangerously acidic blood because of the body’s responses to compensate. The kidneys get rid of more acid and reabsorb more base to try and create a balance.

Immediate medical attention is needed if this kidney function is no longer enough to maintain the balance of acids and bases. It is also needed in the event of acute respiratory acidosis from respiratory failure.

Symptoms of respiratory acidosis

The symptoms of respiratory acidosis are generally the effects of raised CO2. In chronic respiratory acidosis, these symptoms are less noticeable than in acute respiratory acidosis. This is because compensating responses in the body keep blood pH near normal.

The acidifying effect of raised CO2 in chronic respiratory acidosis can be lessened in the blood. However, it is not lessened as effectively in the brain.

Symptoms of raised CO2 levels and acidity in the brain may be overlooked in long-term illness, but can include:

[Man struggling to sleep]
Sleep disturbance is one of the symptoms of raised CO2 levels.
  • Headache
  • Memory loss
  • Sleep disturbance
  • Anxiety and personality changes

In acute respiratory acidosis, or if chronic respiratory acidosis worsens, the effects of raised CO2 in the brain are more prominent. Symptoms can include:

  • Confusion
  • Drowsiness
  • Stupor
  • Muscle jerking

In acute respiratory acidosis and worsening chronic respiratory acidosis, blood pH is lowered and is linked with higher rates of death. Effects of the lowered pH include:

  • The heart muscle working less
  • Heart rhythm is disturbed, producing arrhythmias
  • Blood pressure drops

Treating respiratory acidosis

[Woman with oxygen mask]
In acute respiratory acidosis, direct breathing assistance can be provided.

Medical treatment of chronic respiratory acidosis will focus on treating the underlying illness that hinders proper respiration.

Treatments may also be given to improve respiration, including drugs that help to open the passages to the lungs.

In acute respiratory acidosis, direct breathing assistance can be provided. Doctors may provide positive-pressure ventilation through a face mask.

In more severe conditions, breathing is mechanically assisted through a tube inserted into the airway.

Avoiding respiratory acidosis

Respiratory acidosis is avoided by maintaining healthy respiratory function. Long-term illness that affects respiration such as asthma and COPD should be well-monitored and medically managed.

If such illnesses are present, or if chronic respiratory acidosis develops from another condition, medications that can further reduce respiration should be avoided if possible. If patients do need to use them, they should be used in the smallest useful dose.

Behaviors such as smoking that reduce healthy respiration should be avoided. Since smoking has a strong association with developing COPD, quitting smoking is always encouraged.

Obesity can also reduce healthy respiration, as well as increase the risk of heart disease and diabetes. As a result, a healthy diet and physical activity benefit both heart and lungs.

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Source: medicalnewstoday

27 Sep

Gardening May Give Kids' Diets a Boost

News Picture: Gardening May Give Kids' Diets a Boost

Latest Healthy Kids News

FRIDAY, Sept. 23, 2016 (HealthDay News) — Letting kids help with gardening may sow the seeds of a lifelong healthy eating habit, according to new research.

College students who gardened as a kid, or were currently gardeners, ate more fruits and vegetables than their peers without a green thumb, researchers at the University of Florida found.

“This finding is particularly relevant, given the recent popularity of school gardens and farm-to-school projects,” the study’s lead author, Anne Mathews, said in a school news release. She is an assistant professor of food science and human nutrition at the University of Florida’s Institute of Food and Agricultural Sciences.

This study is part of a larger effort by researchers from several U.S. universities to get college students to eat healthier foods. The new program is dubbed the “Get Fruved” (Get Your Fruits and Vegetables) project. The investigators are analyzing which variables influence the eating habits of teens and young adults.

To explore how participation in school gardening projects affected students’ long-term eating habits, Mathews and her colleagues surveyed over 1,300 college students.

The participants were divided into four groups: those who gardened in childhood; those who currently gardened; those who gardened in childhood and still do; and, those who never gardened.

The study found that 30 percent of the students gardened as a child, and 38 percent currently gardened. These students ate 2.9 cups of fruits and vegetables daily — about a half a cup more than their peers who never gardened, the study showed.

“We found that if your parents gardened but you did not, just watching them did not make a difference in how much fruits and vegetables you eat in college. Hands-on experience seems to matter,” said Mathews.

The findings should encourage schools to offer gardening lessons or a group program that exposes young children to the activity. Doing so could encourage students to maintain healthy eating habits later in life and perhaps help curb rates of childhood obesity, the study authors suggested.

The findings were published in the September issue of the Journal of the Academy of Nutrition and Dietetics. The report is also expected to be presented next month at the annual Food and Nutrition Conference and Exhibition in Boston.

— Mary Elizabeth Dallas

MedicalNews
Copyright © 2016 HealthDay. All rights reserved.

SOURCE: University of Florida, news release, Sept. 19, 2016

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Source: MediciNet

27 Sep

New MRSA Strain Found in Denmark

News Picture: New MRSA Strain Found in Denmark

Latest Infectious Disease News

FRIDAY, Sept. 23, 2016 (HealthDay News) — Researchers in Denmark have identified a new form of the superbug known as MRSA (methicillin-resistant Staphylococcus aureus) that they suspect may be spread through eating contaminated poultry.

People who raise livestock are known to face a higher risk for MRSA, the researchers said. But, the new strain infected 10 urban-dwelling people who hadn’t been working on a farm and had no direct contact with live farm animals.

Instead, the researchers believe the MRSA patients were infected after eating or handling poultry that had been imported from other European countries.

“This is one of the first studies providing compelling evidence that everyday consumers are also potentially at risk,” study author Lance Price said in a news release from George Washington University (GWU), in Washington, D.C.

Price serves as director of the Antibiotic Resistance Action Center based at the Milken Institute School of Public Health at GWU, one of 25 institutions that participated in the current study. Price is also director of the Translational Genomics Research Institute in Flagstaff, Ariz., another institution involved in the study.

MRSA is a bacteria resistant to many antibiotics. MRSA can cause a host of health problems ranging from skin infections and sepsis to pneumonia to bloodstream infections, according to U.S. health officials.

Investigators said the new strain of MRSA isn’t found in Danish livestock.

Nevertheless, all 10 Danish patients ended up with the same virtually identical strain. That strongly suggests a common source of infection imported from outside the country, the researchers said.

That source, the study team said, is likely poultry that has been raised on low doses of antibiotics, a common practice used to encourage animal growth and minimize their risk of disease when kept in unsanitary crowded conditions.

“Our findings implicate poultry meat as a source for these infections,” said study leader Dr. Robert Skov from the Statens Serum Institut — a Danish agency similar to the U.S. Centers for Disease Control and Prevention.

“At present, meat products represent only a minor transmission route for MRSA to humans,” Skov said. He added that these findings underscore the importance of reducing the use of antibiotics in food-producing animals.

Skov’s work was funded in part by the U.S. National Institute of Allergy and Infectious Diseases.

The findings were published online in the Sept. 21 issue of Clinical Infectious Diseases.

— Alan Mozes

MedicalNews
Copyright © 2016 HealthDay. All rights reserved.

SOURCE: George Washington University, news release, Sept. 21, 2016

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Source: MediciNet

27 Sep

'Medical Tattoos' Help Hide Surgical Scars

News Picture: 'Medical Tattoos' Help Hide Surgical ScarsBy Randy Dotinga
HealthDay Reporter

Latest Skin News

FRIDAY, Sept. 23, 2016 (HealthDay News) — Patients with unsightly scars from cancer surgeries may benefit from “medical tattoos” that can help restore some of the skin’s natural appearance, Dutch researchers report.

The researchers surveyed 56 patients who got medical tattoos on their head and neck, and found they were pleased with the results.

“The mystery until now was how well patients appreciated the technique,” said study co-author Dr. Rick van de Langenberg, an ear, nose and throat surgeon at Maastricht University in the Netherlands. In addition to saying their scars looked better, “patients were less stressed about the appearance of the scar and thought less about it,” he said.

U.S. experts noted that the procedure is common in the United States.

In a general sense, “medical tattooing had been performed in the U.S. for decades,” said Dr. Fred Fedok, president-elect of the American Academy of Facial Plastic and Reconstructive Surgery.

“It can be used anywhere where the application of pigment aids the appearance of a region. When an area or structure is too light, it can be made darker and vice versa. Many times, the normal pigment of the skin can be mimicked,” Fedok said.

Dr. Jessie Cheung, a dermatologist in Willowbrook, Ill., said medical tattooing is probably most often performed on patients after breast cancer surgery. Tattoos can improve appearance where there’s a mismatch of skin color around the areola, she explained.

The new study specifically looked at tattoos that were used to make skin look more natural after procedures related to tumors in the head and neck. The researchers focused on survey responses from 56 patients who underwent medical tattoo procedures at an Amsterdam hospital between 2007 and 2015. The patients had an average age of 57, and 75 percent were women.

In one case, tattooing techniques restored the redness to a woman’s lower lip after she underwent a procedure that robbed her lip of its color. In another case, tattooing helped remove much of the redness from a long scar down a woman’s neck, according to the report.

On a scale of 0-10, with 0 being worst, the study patients improved the average ranking of the appearance of their scars from 3.8 before the tattoo procedures to 7.8 after.

“In addition, all questions regarding patient satisfaction and quality of life improved significantly after treatment,” said van de Langenberg. “These are really nice results.”

Cheung praised the research. “It’s a simple and elegantly designed study,” she said.

Who should get medical tattooing?

“As long as there is no active skin inflammation, any sort of discoloration would be a candidate for medical tattooing,” Cheung said. “A scar can be softened prior to tattooing, to help the skin take up the ink.”

As for cost and side effects, “medical tattooing can be covered by insurance, if it is designated as part of reconstructive surgery,” Cheung said. “The anticipated side effects of tattooing are temporary redness, scabbing and crusting. Tattoos can get infected, but patients are instructed on wound care to avoid this complication.”

Fedok said most patients don’t know that medical tattooing is available. If they do want to explore the option, he said, most dermatologists and plastic surgeons wouldn’t have the knowledge to perform the tattoo procedures.

“To do this effectively, special training and experience is necessary,” he said.

But physicians may be able to make referrals. “In my career, I have had an association with a skilled medical tattoo practitioner who could do amazing work with scarring and nipple reconstruction,” Fedok said.

Dr. Terry Cronin, a dermatologist in Melbourne, Fla., agreed about referrals. “Many dermatologists and plastic surgeons employ or have a business relationship with cosmetic tattoo artists for permanent makeup and medical tattooing,” he said.

The study was published online Sept. 22 in the journal JAMA Facial Plastic Surgery.

MedicalNews
Copyright © 2016 HealthDay. All rights reserved.

SOURCES: Rick van de Langenberg, M.D., Ph.D., ear nose and throat surgeon, Maastricht University, the Netherlands; Fred Fedok, M.D., FACS, plastic surgeon, Foley, Ala., and president-elect, American Academy of Facial Plastic and Reconstructive Surgery; Jessie Cheung, M.D., dermatologist, Willowbrook, Ill.; Terry Cronin, M.D., dermatologist, Melbourne, Fla.; Sept. 22, 2016, JAMA Facial Plastic Surgery, online

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Source: MediciNet