31 May 2018
THURSDAY, May 31, 2018 (HealthDay News) — Where fear of skin cancer has little effect, vanity may succeed. In a new study, sun worshippers who were shown computer images of how their face would age after years of ultraviolet (UV) light exposure often decided to quit the tanning habit. In fact, “a single, 10-minute exposure to one’s own face, digitally aged, with and without excessive UV exposure, reduced indoor and outdoor tanning behaviors over the next one month,” said study author Aaron Blashill. Blashill is an assistant professor in the San Diego joint doctoral program in clinical psychology at San Diego State University/University of California. The new study included just over 200 college students. The researchers enlisted a computer program called “APRIL Age Progression Software,” which was developed over the course of a five-year facial analysis involving 7,000 people representing various races, ages and lifestyles. First, a photo is taken of a person’s face as they stand in front of a blank white wall with an emotionless expression. The software then processes the image on the basis of exposure to various conditions before generating a series of images that illustrate how that face will likely change as the person grows older (up to the age of 72). Prior investigations have already explored how the software might be useful as an intervention to help smokers kick their habit, showing them their future appearance following years of smoking. Focusing on tanning’s impact, the researchers in this latest study asked all participants to review sun safety and protection material compiled by the U.S. Centers for Disease Control and Prevention. All had indicated that they had tanned indoors or outdoors at least once during the prior month, and all said they planned to do so again in the coming month. The participants were then randomly assigned to three groups: the face-morphing group; a CDC material-only group; and a group given both the CDC material and a 10-minute audio class on how to practice mindful sitting meditation. After having their picture taken, those in the face-morphing group viewed two side-by-side computerized images of their face as they aged, in two-year increments, following regular UV exposure. After repeating the UV-aging process a second time (until the age of 72), both images were dialed back to 10 years older than the individual’s actual age. The right image was then reset to a 10-year-older face not exposed to UV. That image then toggled back and forth between “tanned” and “untanned” while aging in 10-year increments. The whole process was repeated in 3D mode. The result? During the following month, those exposed to facial-morphing engaged in “significantly fewer” outdoor tanning sessions compared to those in the safety material group, and in “significantly fewer” indoor tanning sessions relative to those in the meditation group. The researchers determined that indoor tanning among the facial-morphing group plummeted by 60 percent. And, outdoor tanning fell by 12 percent in the face-morphing group, compared to the other participants. “That said, because it was so brief we don’t expect a single ‘dose’ would continue to work in the long-term,” said Blashill. “Additional ‘booster’ sessions would be one way to allow the benefits to last longer.” Still, he noted that as a practical matter, “the technology is developed and ready to go.” Placing photo-morphing kiosks in pharmacies or doctors’ offices would be one way to deploy the software as a tool to discourage tanning, he said, alongside the release of smartphone morphing apps. The findings were published in the June issue of the journal Body Image. Dr. Elizabeth Hale is senior vice president of the Skin Cancer Foundation in New York City. The foundation “supports efforts that discourage people from engaging in dangerous and potentially deadly indoor and outdoor tanning,” she explained. “Ultraviolet radiation emitted by the sun and by tanning beds is a proven human carcinogen,” Hale said. “We know there is no such thing as a safe UV tan. Tanning both indoors and out can lead to premature skin aging — wrinkles, lax skin, brown spots and more — and the development of dangerous skin cancers. Any tool that helps deter people from tanning is a step in the right direction.” More information The U.S. Food and Drug Administration has more about the risks of tanning.
31 May 2018
THURSDAY, May 31, 2018 (HealthDay News) — A computer can beat even highly experienced dermatologists in spotting deadly melanomas, researchers report. The study is the latest to test the idea that “artificial intelligence” can improve medical diagnoses. Typically, it works like this: Researchers develop an algorithm using “deep learning” — where the computer system essentially mimics the brain’s neural networks. It’s exposed to a large number of images — of breast tumors, for example — and it teaches itself to recognize key features. The new study pitted a well-honed computer algorithm against 58 dermatologists, to see whether machine or humans were better at differentiating melanomas from moles. It turned out the algorithm was usually more accurate. It missed fewer melanomas, and was less likely to misdiagnose a benign mole as cancer. That does not mean computers will someday be diagnosing skin cancer, said lead researcher Dr. Holger Haenssle, of the University of Heidelberg in Germany. “I don’t think physicians will be replaced,” Haenssle said. Instead, he explained, doctors could use artificial intelligence (AI) as a tool. “In the future, AI may help physicians focus on the most suspicious skin lesions,” Haenssle said. A patient might, for instance, undergo whole-body photography (a technology that’s already available), then have those images “interpreted” by a computer algorithm. “In the next step,” Haenssle explained, “the physician may examine only those lesions labeled as ‘suspicious’ by the computer.” Doctors already do skin exams with the help of a technology called dermoscopy — where a hand-held device is used to light and magnify the skin. Haenssle said AI could again be used to help analyze those images. Dr. Mary Stevenson is an assistant professor of dermatology at NYU Langone Medical Center in New York City. She agreed that the technology is not going to replace doctors, but could serve as an “aid.” There are still questions to be answered, according to Stevenson, who was not involved in the research. For one, she said, this study focused only on differentiating melanoma from benign moles — and there is more to skin cancer diagnosis than that. For the study, Haenssle’s team recruited 58 dermatologists from 17 countries. Over half had more than five years of experience and were considered “expert” level. First, the doctors examined 100 dermoscopic images of either melanomas or harmless moles. Four weeks later, they viewed those images and were given more information about the patients — such as their age and position of the lesion on the body. That more closely reflected what doctors work with in the “real world.” In the first phase, the doctors accurately caught melanomas nearly 87 percent of the time, on average; they correctly identified moles about 71 percent of the time. The computer, however, did better: When it was tuned to have the same level of accuracy as doctors in detecting benign moles, the computer caught 95 percent of melanomas. The doctors boosted their accuracy when they also had information about the patients. They caught 89 percent of melanomas, and accurately identified benign moles about 76 percent of the time. The computer still outperformed them, though: At that same level of accuracy for catching melanoma, the computer correctly diagnosed about 83 percent of moles. Haenssle said that in some parts of Germany, doctors are already using the algorithm tested in this study — in software sold by the company FotoFinder Systems GmbH. He has received fees from the company and others that market devices for skin cancer screening. For now, traditional skin exams remain the standard of care. Stevenson said she suggests people get one head-to-toe exam to inspect the skin for suspicious growths — and then talk to their doctor about how to follow up. “I also recommend getting in front of a mirror once a month to do a self-exam,” Stevenson said. The point is to spot any changes in the size, shape or color of a mole or other dark spot on the skin. According to Stevenson, some warning signs of melanoma include asymmetry in a growth, as well as irregular borders, uneven coloring and a large diameter (larger than a pencil eraser). “When melanoma is caught early,” Stevenson said, “it is highly curable.” More information The Skin Cancer Foundation has a guide on melanoma skin cancer.
30 May 2018
WEDNESDAY, May 30, 2018 (HealthDay News) — The U.S. Food and Drug Administration on Wednesday gave its OK to the first artificial iris — the colored part of the eye that surrounds the pupil. The surgically implanted device can be used on adults and children whose iris is missing, has been damaged by a congenital condition called aniridia, or has been injured, the agency said in a news release. “Patients with iris defects may experience severe vision problems, as well as dissatisfaction with the appearance of their eye,” said Dr. Malvina Eydelman, who directs the division of ophthalmic, and ear, nose and throat devices at the FDA’s Center for Devices and Radiological Health. “Today’s approval of the first artificial iris provides a novel method to treat iris defects that reduces sensitivity to bright light and glare. It also improves the cosmetic appearance of the eye in patients with aniridia,” she said. Aniridia is a rare genetic disorder that leaves the iris completely or partially gone. It affects an estimated one in 50,000 to 100,000 people in the United States. Since the iris controls the amount of light entering the eye, those with aniridia are sensitive to light and have other severe vision problems. In addition to congenital aniridia, the CustomFlex Artificial Iris can be used to treat iris defects due to conditions such as albinism, traumatic injury or surgical removal due to melanoma, the FDA said. The artificial iris is made of thin, foldable silicone and is custom-fitted and colored for each patient. To insert it, a surgeon makes a small incision, places the device under the incision, then unfolds it and smoothes out the edges using surgical instruments. The safety and effectiveness of the CustomFlex Artificial Iris was primarily shown in a non-randomized clinical trial of 389 adult and pediatric patients with aniridia or other iris defects. More than 70 percent of these patients said they experienced significant decreases in light sensitivity and glare, as well as an improvement in quality of life. Ninety-four percent of the patients said they were pleased with the device’s appearance, the FDA added. Patients reported low rates of adverse events due to the device or the operation to insert it, the agency said. The CustomFlex Artificial Iris is marketed by HumanOptics AG, in Erlangen, Germany. More information For more on this approval, click here.
30 May 2018
WEDNESDAY, May 30, 2018 (HealthDay News) — Exposure to triclosan — a chemical in some shampoos and toothpastes — might raise the risk for colon inflammation and colon cancer, at least in mice, researchers say. New study results “suggest that triclosan could have adverse effects on gut health,” said study leader Guodong Zhang, a food scientist at the University of Massachusetts Amherst. Triclosan is a common antibacterial agent. It’s often used in hygiene and cosmetic products. Triclosan is also found in some clothing and kitchenware, according to the U.S. Food and Drug Administration. The FDA no longer allows triclosan in hand soaps, but it’s still present in other household products, such as dish soap. Working with laboratory mice, Zhang and his colleagues concluded that triclosan could alter gut microbiota, or the types of bacteria living in the intestines. These changes could lead to inflammation, more severe colitis symptoms and colitis-associated colon cancer cell growth in mice, the study authors said in a university news release. Colitis refers to colon inflammation. The team warned that triclosan should be monitored more closely. Study co-first author, Haixia Yang, a postdoctoral fellow at UMass Amherst, said, “Because this compound is so widely used, our study suggests that there is an urgent need to further evaluate the impact of triclosan exposure on gut health.” It’s important to note, however, that the results of animal studies aren’t always applicable to humans. In several mouse models, the researchers found that triclosan triggered inflammation and tumor formation in the colon. Triclosan also increased development of inflammatory bowel disease (IBD) in the mice, suggesting that IBD patients may need to reduce exposure to this compound, the researchers said. Triclosan had no effect, however, in models involving germ-free mice or mice that were genetically engineered to lack a specific receptor that is critical for gut bacteria communications, the investigators found. According to Zhang, “This is strong evidence that gut microbiota is required for the biological effects of triclosan.” Just how common is triclosan? It’s in more than 2,000 consumer products. And the chemical was detected in roughly 75 percent of urine samples tested in a U.S. National Health and Nutrition Examination Survey, the study authors noted. It’s also one of the leading pollutants in rivers in the United States. The study was published May 30 in the journal Science Translational Medicine. More information The U.S. Food and Drug Administration has more on triclosan.
30 May 2018
WEDNESDAY, May 30, 2018 (HealthDay News) — When it comes to kids and medical procedures like needles, expectation is everything. If they think the shot will hurt, it probably will, a new study finds. On the flip side, if they’re coaxed not to expect a lot of pain, they may feel it less. “We know that expectation affects pain experience in adults; we don’t know whether this is also true for children,” said study author Kalina Michalska, a psychologist at the University of California, Riverside. In real-life terms, distracting children beforehand has value, the researchers said. For example, telling them, “This is going to feel like a branch scraping against your skin” may be less frightening than saying, “This is going to hurt.” The study involved 48 children (27 of whom had an anxiety disorder) and 25 adults. Michalska’s team applied heat to the participants and asked them to rate levels of pain as low, medium or high. High was about the temperature of very warm tap water. The experiment, however, used only one temperature, the one rated as medium. The difference was the cues participants heard before the heat was applied. One tone meant low heat, the other high. Surprisingly, all three groups had a similar relationship between pain expectation and feeling — for example, if they heard cues for high pain, they reported it, even though the actual pain level was only medium. Michalska’s group had expected the strongest reaction among the anxious children, followed by healthy children, then adults. “We took great care to reassure children and make them feel comfortable. There were always two experimenters in the room with them and a nurse who saw them before and after to ensure they were OK,” Michalska said in a university news release. “We did not take as great a precaution with adults.” Despite this reassurance, the study showed that pain expectation significantly affects pain experience, she said. “What we learn is that both healthy and anxious children’s experience of pain is influenced by what they are told about it. If we tell them they will experience a lot of pain — or they tell themselves this — they will actually experience more pain and greater negative emotions as a consequence,” Michalska said. The report was published online May 30 in the journal Psychosomatic Medicine. More information The American Academy of Pediatrics recommends ways to make vaccines less painful.
29 May 2018
TUESDAY, May 29, 2018 (HealthDay News) — May is Women’s Health Month. With that in mind, doctors are offering suggestions for steps that women can take to reduce their risk of diseases and safeguard their health, both physical and mental. Dr. Blanca Sckell is medical director of the Ambulatory Care Center and internal medicine program at NewYork-Presbyterian Queens, in New York City. She offered the following advice for women who are seeking ways to boost their health. For starters, manage stress. Try to take a few minutes each day to relax. Meditation is a great way to cope with daily pressures and can also help improve your mental health. Eat a healthy diet that includes fresh fruits and vegetables, whole grains, high-fiber foods and lean cuts of meat, poultry and fish. Cut back on processed foods. Healthy eating helps maintain proper weight, and lowers the risk of diabetes, high blood pressure, heart disease and problems during pregnancy. Talk to your doctor about when and how often to get screened for breast cancer. Get regular pelvic exams and Pap smear screenings to check for signs of vaginal and cervical cancers, and for sexually transmitted diseases, such as human papillomavirus (HPV) or genital warts. Women with a family history of certain diseases — including breast and ovarian cancer — may want to consider genetic testing. Protect your skin from the sun. And check regularly for signs of skin cancer. Ask your doctor about vaccinations for whooping cough, measles, mumps, HPV (the leading cause of cervical cancer), the flu, pneumonia and shingles. Screening tests are available for HIV and hepatitis. Get the recommended mix of cardio and resistance/weight-bearing exercise, which is at least 30 minutes a day, five days a week. Regular aerobic workouts such as walking, swimming, jogging, bicycling and dancing can help prevent heart disease, cancer, diabetes and osteoporosis. Limit your alcohol consumption, don’t smoke, and monitor your calcium intake. Too much absorbed calcium can increase the risk of kidney stones and may increase the risk of heart disease. Women under 50 should get 1,000 milligrams a day, and women over 50 should get 1,200 milligrams a day, mainly through diet. Calcium-rich foods such as low-fat milk, salmon and almonds are recommended, and can help prevent osteoporosis. About one in seven new mothers in the United States develops postpartum depression. If you are a new mom and have mood swings, trouble bonding with your baby or signs of depression that don’t ease after a few weeks, see your doctor. More information The U.S. National Library of Medicine has more on women’s health.
29 May 2018
TUESDAY, May 29, 2018 (HealthDay News) — Alec Smith was diagnosed with type 1 diabetes shortly before his 24th birthday. When he turned 26, he lost his health insurance. Less than a month later, he lost his life because he couldn’t afford the exorbitant price of his life-saving insulin. “Alec had a full-time job that didn’t offer health insurance. But because he was working full-time, he didn’t qualify for subsidies under the Affordable Care Act. The insurance he could get, the premium and the deductible were so high, he couldn’t afford to pay for a policy. His deductible would’ve been $7,600,” his mother, Nicole Smith-Holt, said. When he was diagnosed with type 1 diabetes, Smith-Holt said, her son was determined not to let the disease change his life. Type 1 diabetes is an autoimmune disease that causes the body’s immune system to mistakenly attack healthy insulin-producing cells in the pancreas. Insulin is a hormone that helps transport the sugar from foods into cells for use as fuel. People with type 1 diabetes make little to no insulin, so they must replace the lost hormone through injections or a tiny tube inserted under the skin and attached to an insulin pump. But replacing that lost insulin doesn’t come cheaply. During the 2016 presidential campaign, Bernie Sanders pointed out that a vial of insulin cost about $21 in 1996. That same vial of insulin cost about $255 in 2016. The American Diabetes Association (ADA) has noted that Europeans pay about one-sixth of what Americans pay for insulin. It was the high price that led Smith to try to ration his insulin; he simply couldn’t afford to buy another vial. He didn’t realize that even if someone with type 1 diabetes eats a low-carbohydrate diet (carbohydrates are turned into glucose in the body), they cannot get by without insulin. On a Sunday night in late June 2017, Smith went to dinner with his girlfriend. He said he wasn’t feeling well and complained of abdominal pain. Abdominal pain is one of the symptoms of a serious and potentially deadly complication of diabetes called diabetic ketoacidosis, according to the ADA. This condition occurs when the body doesn’t have enough insulin. The next morning Smith called in sick to work. His girlfriend tried to reach him repeatedly on Monday, but had to work. She planned to check on him Tuesday morning. She did, but it was too late. As Smith-Holt recounted the story, she said her son never asked for help. “I wish he would’ve come to me,” the Richfield, Minn., woman said, but added that he was very independent. And although it’s hard for her to tell the story of her son’s death, she said, “I’m hoping the story gets out there. Somebody needs to make a change. This can’t continue. More people will die or end up in the hospital. I want to try to save other lives.” More than 7 million Americans require insulin Smith-Holt isn’t alone in trying to draw attention to this problem. Two years ago, the American Diabetes Association asked Congress to hold hearings to determine why the cost of insulin was skyrocketing. Congress recently did just that, and the ADA’s chief scientific, medical and mission officer, Dr. William Cefalu, testified before the U.S. Senate’s Special Committee on Aging. “Insulin is a life-sustaining medication for approximately 7.4 million Americans with diabetes, including approximately 1.5 million individuals with type 1 diabetes. There is no substitute,” Cefalu said. He told senators insulin costs about $15 billion a year in the United States. Between 2002 and 2013, its average price tripled, according to Cefalu. So, why has the price of insulin gone up so dramatically? Unfortunately, there are no easy answers. The ADA found there was little transparency in pricing along the insulin supply chain. It’s not clear how much each intermediary (wholesalers, pharmacy benefit managers and pharmacies) in the supply chain benefits from the sale of insulin. It’s also not clear how much manufacturers are paid as this information isn’t publicly available either. The ADA also noted that the current pricing and rebate system encourages high list prices (that’s what someone without insurance or who has a high deductible is often stuck paying). Pharmacy benefit managers (PBMs) have substantial market power and can control which insulins are approved to be on an insurer’s list of approved medications (formulary). PBMs receive rebates and administrative fees, but don’t have to disclose them. They can exclude insulins from a formulary if their rebate is too low, according to the diabetes association. People with diabetes — like Alec Smith — are the ones who end up harmed by high list prices, high out-of-pocket costs and formulary restrictions. “Insulin access and affordability are a matter of life and death,” Cefalu said. The ADA also had a number of recommendations that Cefalu passed on to Congress, including: Ensuring access to affordable insulin for those without insurance. Requiring greater transparency throughout the supply chain. Doctors prescribing the lowest price insulin to meet treatment goals effectively. Keeping rebates, discounts and fees to a minimum. More closely matching list price of insulin to the net price that’s paid. Smith-Holt has some advice for parents of children with type 1 diabetes and those who have type 1 diabetes themselves. “Speak out. Share your stories. This problem is outrageous and it’s only getting worse. People need to speak up,” she said. More information Learn more from the American Diabetes Association about the need for insulin affordability.
26 May 2018
SATURDAY, May 26, 2018 (HealthDay News) — Learning how to do a skin self-exam could save your life. “Skin cancer is one of the few cancers you can see with the naked eye,” said Dr. Ali Hendi, an assistant clinical professor of dermatology at Georgetown University Medical Center in Washington, D.C. “Yet sadly, many people don’t know how to be their own hero when it comes to skin cancer, including what to look for on their skin or when to see a board-certified dermatologist,” he added in an American Academy of Dermatology news release. Skin cancer is the most common cancer in the United States. One in five Americans develops skin cancer, and one person dies every hour from melanoma, the deadliest form of the disease. To check your skin, use a full-length mirror to examine your entire body, front and back. Then, raise your arms and look at your right and left sides, Hendi said. Bend your elbows and carefully check your forearms, underarms and palms. Look at the backs of your legs and feet, between your toes, and the soles of your feet. With nail polish removed, check your fingernails and toenails, as well. Use a hand mirror to check the back of your neck and scalp, and part your hair for a closer look. Finally, check your back and buttocks with a hand mirror. Ask a partner to help check your back and other hard-to-see areas. “While performing a skin self-exam, keep in mind that skin cancer can develop anywhere on the skin, not just in areas that are exposed to the sun,” Hendi said. “If you notice any new spots on your skin, scalp or nails, spots that look different from other spots on your body, or spots that are changing, itching or bleeding, make an appointment to see a board-certified dermatologist,” he advised. Hendi also explained the ABCDEs of checking for melanoma. A is for Asymmetry: One half of a spot is unlike the other half. B is for Border: The spot has an irregular, scalloped or poorly defined edge. C is for Color: Colors vary from one area of the spot to another, from shades of tan, brown or black, for instance, or areas of white, red or blue. D is for Diameter: When diagnosed, melanomas are usually larger than 6 millimeters (about the size of a pencil eraser), but can be smaller. E is for Evolving: The spot looks different or is changing in size, shape or color. See a medical professional if you have any of these signs or notice an existing mole start to change in any way. “When detected early, skin cancer, including melanoma, is highly treatable, making it imperative to check your skin regularly,” Hendi said. “It only takes a few minutes to check your skin, and it could save your life.” More information The U.S. National Cancer Institute has more on skin cancer.
25 May 2018
FRIDAY, May 25, 2018 (HealthDay News) — Summer sun brings childhood fun, but experts warn it also brings skin cancer dangers, even for kids. “Don’t assume children cannot get skin cancer because of their age,” said Dr. Alberto Pappo, director of the solid tumor division at St. Jude Children’s Research Hospital in Memphis, Tenn. “Unlike other cancers, the conventional melanoma that we see mostly in adolescents behaves the same as it does in adults.” His advice: “Children are not immune from extreme sun damage, and parents should start sun protection early and make it a habit for life.” So, this and every summer, parents should take steps to shield kids from the sun’s harmful UV rays. Those steps include: Avoid exposure. Infants and children younger than 6 months old should avoid sun exposure entirely, Pappo advised. If these babies are outside or on the beach this summer, they should be covered up with hats and appropriate clothing. It’s also a good idea to avoid being outside when UV rays are at their peak, between 10 a.m. and 2 p.m. Use sunscreen. It’s important to apply a broad-spectrum sunscreen to children’s exposed skin. Choose one with at least SPF15 that protects against both UVA and UVB rays. Pappo cautioned that sunscreen needs to be reapplied every couple of hours and after swimming — even if the label says it is “water-resistant.” However, sunscreen should not be used on infants younger than 6 months old because their exposure to the chemicals in these products would be too high, he noted. Keep kids away from tanning beds. Melanoma rates are rising among teenagers, partly due to their use of indoor tanning beds. Use of tanning beds by people younger than 30 boosts their risk for this deadly form of cancer by 75 percent, according to the International Agency for Research on Cancer. Get children screened. Early detection of melanoma is key to increasing patients’ odds of survival. Children with suspicious moles or skin lesions should be seen by a doctor as soon as possible, Pappo advised. Removing melanoma in its early stages also increases the chances of avoiding more invasive surgical procedures later on, he added. More information There are more sun-safety tips at the Skin Cancer Foundation.