18 September 2018
TUESDAY, Sept. 18, 2018 (American Heart Association) — Will Treinen has never been one to sit on the sidelines. The 51-year-old entrepreneur sacrificed many nights and weekends building a successful consulting company in Olympia, Washington. When he’s off the clock, Will and his wife, Denise, enjoy spending time with their two grown daughters and two young grandchildren, as well as hiking, rock climbing and biking. “My energy has always been forward,” Will said. “As a business person, I’m always thinking six to 12 months in the future.” In 2017, the couple embarked on the STP, a two-day ride from Seattle to Portland. On the first day, Will felt great. But the next morning, shortly into their ride, he was overcome by exhaustion and couldn’t catch his breath. This had happened before while training; he suspected sports-induced asthma and urged Denise to ride ahead. But when she went back for him a few minutes later, Will was lying on the ground surrounded by a group of bikers. His skin was blue, and he was gasping for breath. Fortunately, Madeline Dahl, a then-24-year-old cardiac nurse from Seattle who was riding the STP with her father, arrived upon the scene. When she couldn’t find Will’s pulse, she began giving chest compressions. Approximately 90 percent of people who experience a cardiac arrest outside of the hospital die, according to the American Heart Association. But performed immediately, CPR can double or triple the odds of survival. By the time the paramedics arrived, Madeline had performed several rounds of CPR. Will’s pulse returned briefly before fading again. Paramedics took over from Madeline and were still performing CPR when the ambulance departed for the hospital, shocking Will with a defibrillator between compressions. Later that day, Madeline was disappointed to hear from another rider that he had not survived. “I felt sad for Denise that he hadn’t made it despite my best efforts,” Madeline said. The rumors of Will’s death were exaggerated. The first thing he remembers clearly is waking up in the hospital in Tacoma, eight days later, having undergone open-heart surgery to correct an 80 to 90 percent blockage in his main coronary artery. Tubes were coming out of his abdomen, and he felt disoriented by the medications. Although his father had died of heart disease, Will had few obvious risk factors. Unlike his father, he did not smoke, and his cholesterol and blood pressure were not considered by doctors to be cause for concern. Alone at night, he contemplated his mortality. “I was on the edge a couple of times,” Will said. “In every sense, I was dead, and they revived me. Why? What’s my purpose?” One of Will’s first actions was to email the top management at his company, asking them to handle the business in his absence. He didn’t return to work for months; even now, more than a year later, he only checks in two or three days a week. He’d always planned to retire in his 50s, he said, although perhaps not as young as 51. “I realized that I was valuing my progress in the business world over my relationships with my children and my experiences with them,” Will said. Madeline learned that Will survived several days after the race. A co-worker saw a story on the evening news about Will’s cardiac event and the mystery nurse who saved him. The mystery was solved, and Will and Denise eventually invited Madeline to their house for dinner. “I see plenty of bad outcomes, so seeing somebody who is doing so well is renewing,” Madeline said. Motivated by his experience, Will is working to raise awareness about the importance of CPR. He spoke at an annual executive breakfast sponsored by the Tacoma chapter of the AHA earlier this year, and he formed a team for the 2018 South Sound Heart & Stroke Walk on Sept. 22. “I’m a very passionate person, and when I put my energy into something, it’s 100 percent,” Will said. Indeed, less than four months after Will had his cardiac arrest, he and Denise hiked to the 4,000-foot summit of Mount Rose in Washington state — a longtime item on their bucket list. And the year after Will’s life nearly ended during the STP race, he and Denise did the STP again. Knee pain prompted Will to stop after the first day, but Denise pressed on and finished, pausing for an emotional moment near mile 115, where the life-changing incident occurred. “It was extremely therapeutic for us (riding the first day together),” Will said. “We had a blast.”
15 September 2018
SATURDAY, Sept. 15, 2018 (HealthDay News) — Cases of thyroid cancer are on the rise in the United States, and experts want you to know how people at high risk for the disease can detect it early. According to the American Cancer Society, 54,000 new cases will be diagnosed in the United States in 2018. And three out of four of these cases will be women. But anyone can get the disease. Symptoms can occur earlier in women, who are typically diagnosed in their 40s or 50s, while men commonly are diagnosed in their 60s or 70s. “While the majority of thyroid cancers arise without a family history, if you have a family history of thyroid cancer, you should have any new lump or mass in your neck evaluated by your physician,” said Dr. Brett Miles. He is co-chief of the division of head and neck oncology at the Icahn School of Medicine at Mount Sinai in New York City. Also, people with a history of Hashimoto’s thyroiditis, radiation exposure to the neck, or familial colon polyps are at increased risk, he added. “A good rule of thumb is that swollen lymph nodes or lumps in your neck that do not go away after about three to four weeks should be evaluated,” Miles said in a Mount Sinai news release. Thyroid cancer facts: Thyroid cancer is a tumor or growth in the thyroid gland in the front of the neck. Several types of thyroid cancer exist. The most common is papillary carcinoma, which is curable, especially if caught early. Important risk factors include: A family history of thyroid cancer; a history of radiation exposure to the head, neck or chest; or a diet low in iodine. Regular follow-up care is an essential part of treatment. Symptoms of thyroid cancer include: A lump or enlarged lymph nodes in the neck. Neck pain or tightness. Hoarseness, persistent cough. Difficulty swallowing or breathing. Prevention includes: A thyroid exam every three years if you are 20 to 39 years of age. A thyroid exam every year if you are 40 or older. Avoid unnecessary exposure to radiation. Have checks often if you’ve been exposed to radiation of the head, neck or chest, and have a family history of thyroid cancer. Do a thyroid neck self-exam, looking for asymmetries or protrusions below the Adam’s apple. Most thyroid cancer patients do not have any symptoms when they are diagnosed, said Dr. Raymond Chai, an assistant professor of otolaryngology at the Icahn School of Medicine at Mount Sinai. “These cancers are often only identified during routine physical examination by a physician,” Chai said. “It’s important to note the vast majority of early stage thyroid cancers can be successfully treated, and that’s why early detection is critical,” he added. More information For more on thyroid cancer, visit the American Cancer Society.
12 September 2018
WEDNESDAY, Sept. 12, 2018 (HealthDay News) — Instead of visiting the doctor each fall, sitting in a waiting room filled with the sniffling, sneezing masses — what if you could just slap on a flu vaccine “patch” sent in the mail? That’s the vision of researchers who’ve developed and conducted early tests on an injection-free vaccine that looks like a Band-Aid you place on your arm. Their initial hope is to create such a vaccine that would allow for a rapid public health response in case of a pandemic flu. “If there’s a pandemic flu, the last thing you want is for people to be coughing on each other while they’re waiting for a flu shot,” said the study’s lead author, Darrick Carter. “The new vaccine uses a combination of three technologies, and was designed quite specifically to be used by the person receiving the vaccine. It could be sent through the mail, and you could put it on and protect yourself,” said Carter. He’s vice president of the Infectious Diseases Research Institute in Seattle. Microneedles on the patch deliver the vaccine. “Mostly, when we get injured, we scrape ourselves or get a superficial wound, and much of the immune system lays on the surface of the skin to respond,” Carter said, explaining why it isn’t necessary to have an intramuscular injection. Another component of the vaccine is a new type of antigen — the substance that causes the immune system to produce protective antibodies. Carter said another company provided this component. It uses reprogrammed plant cells to produce virus-like particles. The final component is an adjuvant — a substance to boost the effectiveness of the vaccine. The researchers tested a liquid form of the vaccine and the adjuvant on ferrets. A single vaccine fully protected the animals, they said. They also gave the liquid form of the adjuvant and vaccine to 100 humans to test the vaccine’s safety. There were no significant side effects. In addition, those given the vaccine showed a stronger immune response. However, this study wasn’t designed to test how effective the vaccine was in humans. “This is a clinical proof of concept study,” Carter said. The researchers hope to get additional funding to move forward with the next phase of human trials. If all goes well, Carter said it might be possible to have this vaccine approved in five years or so. Dr. David Davenport, director of infection prevention at Borgess Medical Center in Kalamazoo, Mich., said this could be a “game-changer.” He was not involved with the study. “Egg-based vaccines are incredibly antiquated and we have to move away from that,” Davenport said. “The egg-based vaccine takes way too long [to manufacture], sometimes six months or longer. If we had a major epidemic, we need the ability to rapidly scale up, and a plant-based vaccine could take three months or less.” Plus, Davenport said, sending a vaccine through the mail for people to self-administer “could get high numbers of people vaccinated.” Currently, fewer than half of Americans get an annual flu shot, the U.S. Centers for Disease Control and Prevention estimates. Results of the ferret and early human trials were published Sept. 12 in the journal Science Advances. More information The U.S. Centers for Disease Control and Prevention has more advice on preventing the flu.
11 September 2018
11 September 2018
TUESDAY, Sept. 11, 2018 (HealthDay News) — As if the start of a new school year isn’t stressful enough, many teens may find their acne worsens when classes start, a skin doctor says. During summer vacation, teens’ acne often eases because they have less stress and more sun exposure, but it could flare up now that they’re back in school, explained Dr. David Shupp. He’s a dermatologist at Penn State Health Medical Group. “A teen often feels alone in suffering from embarrassing pimples,” Shupp said in a Penn State news release. “Because acne is caused primarily by hormone levels, the condition often begins at puberty and clears up by the late 20s,” he added. “Girls are more susceptible than boys to hormone-related acne.” For teens with mild acne, the first step is to try over-the-counter creams, gels or lotions applied directly to affected areas. Teens with other skin conditions — such as eczema or psoriasis — should consult their doctor before using over-the-counter acne medications, Shupp advised. The most common over-the-counter acne medications contain: Benzoyl peroxide, which kills bacteria, helps remove excess oil from the skin and reduces inflammation. Salicylic acid, which dries excess oils and works best for blackheads and whiteheads. Adapalene, which prevents plugging of hair follicles and is available over-the-counter in 0.1 percent strength. “If over-the-counter medications don’t provide enough relief from acne, it’s time to discuss prescription medications with a dermatologist or family physician,” Shupp suggested. Prescription acne treatments include: Stronger retinoids, such as Retin-A. These are among the most effective topical medications but can be more drying than over-the-counter options. Antibiotics, which can be administered orally or via a topical gel or cream to kill excess bacteria. Topical antibiotics are often combined with benzoyl peroxide to maximize effectiveness while lowering the risk of antibiotic resistance. Hormonal treatments, which impact the balance of hormones that cause acne and are usually prescribed to supplement topical medications or antibiotics in young women. Isotretinoin (Accutane) is a powerful vitamin A derivative used to treat severe acne that does not respond to other medications. Potential side effects include birth defects, so teenage and adult women taking this oral medication must undergo monthly pregnancy tests. Don’t use acne medications prescribed for someone else, Shupp said. Along with treatment, there are a number of things teens can do to reduce acne, he added. Gently clean affected skin twice a day. Avoid scrubbing, which can damage the skin and aggravate an acne problem. Do not use abrasive products. Use oil-free cosmetics, sunscreen, moisturizer and hair products. They’re labeled “noncomedogenic.” Keep hands and hair away from the face to reduce the transfer of oil. Don’t squeeze pimples. This can cause permanent scarring. The most common skin condition in the United States, acne strikes close to 85 percent of people between the ages of 12 and 24, according to the American Academy of Dermatology. More information The American Academy of Family Physicians has more on acne.
06 September 2018
THURSDAY, Sept. 6, 2018 (HealthDay News) — Many patients who have nose surgery use far fewer opioid painkillers than they’re given, evidence that doctors are overprescribing the highly addictive drugs, a new study suggests. For the study, researchers reviewed 173 nose surgery (rhinoplasty) cases performed at Massachusetts Eye and Ear Infirmary. Of those, 168 patients were prescribed opioids (such as OxyContin) along with acetaminophen (Tylenol), at an average of 28 opioid pills per patient. Only two patients refilled their opioid prescriptions, and 11 percent did not fill their initial prescription, the study authors said. “When we looked at the number of patients who needed refills, we found this near-negligible number,” corresponding author Dr. David Shaye said in a hospital news release. Shaye is a facial plastic and reconstructive surgeon at Mass Eye and Ear in Boston. “This tells us that, as a field, we’re probably overprescribing in rhinoplasty,” he added. Study co-author Dr. Linda Lee said, “After analyzing our data, we were pleasantly surprised by the lack of opioids patients actually required after rhinoplasty, which is especially significant given the current opioid epidemic.” Lee is also a facial plastic and reconstructive surgeon at the hospital. “Understanding this data, we as surgeons have a duty to responsibly prescribe opioids and limit the potential for abuse, particularly for cosmetic or elective surgeries,” Lee said. As a result of their findings, the study authors have reduced by at least half the number of opioid tablets they prescribe. The study was published online Sept. 6 in JAMA Facial Plastic Surgery. The United States is facing an opioid epidemic, the study authors noted in the news release, with less than 5 percent of the world’s population using two-thirds of the world’s opioid painkiller supply. Opioid-related deaths in the United States have increased 200 percent since 2000. And studies have found that nearly 60 percent of the nation’s households have leftover prescription opioids. More information The U.S. Centers for Disease Control and Prevention has more on prescription opioids.
06 September 2018
THURSDAY, Sept. 6, 2018 (HealthDay News) — Though psoriasis is not contagious, many Americans shun people with the skin condition, new research indicates. The study included a cross-section of about 400 Americans who viewed images of people with visible psoriasis. Large numbers wrongly thought psoriasis was contagious or only affects the skin, and about one-third said they wouldn’t want to invite people with the condition into their homes. “People with psoriasis feel they can’t go to a public pool, go to a salon to get their hair done, or are worried about going on vacation with their families,” said study senior author Dr. Joel Gelfand, who called the burden on psoriasis patients “tremendous.” “This tells us how much work we need to do as a society to make sure people have good health literacy, and understand what these skin conditions are about and treat people with respect,” he said. Gelfand is a professor of dermatology and epidemiology at the University of Pennsylvania’s Perelman School of Medicine, in Philadelphia. A chronic autoimmune disease estimated to affect about 8 million Americans, psoriasis causes skin cells to grow too fast and accumulate, resulting in red, scaly patches. Lesions can come and go, and cover varying amounts of skin surface, triggering itching, pain and/or burning. In moderate-to-severe cases, psoriasis increases the risk of other health conditions related to inflammation, including heart attack and stroke. While the condition can be treated, there is no cure. Gelfand’s team surveyed 187 medical students and 198 laypeople about their perceptions of people with psoriasis. Participants in the online survey were shown eight images of people with psoriasis along with enlarged photos of psoriasis lesions. The survey participants’ reactions underscore the stigma and misconceptions associated with the disorder, the researchers said. More than 54 percent of lay participants said they didn’t want to date someone with psoriasis, and nearly 40 percent didn’t even want to shake hands with them. In addition, 32 percent didn’t want someone with psoriasis in their homes, and 45 percent said people with psoriasis were unattractive. The study also highlighted persistent myths: 27 percent of respondents thought psoriasis was contagious; and 53 percent considered psoriasis sufferers sick. About one-third of respondents thought psoriasis only affects the skin, and more than a quarter said psoriasis isn’t a serious disease, the findings showed. Notably, medical students who took the survey showed less stigmatizing views, which study lead author Rebecca Pearl called “encouraging.” “The trainees are going to become health care professionals who are not expressing as negative views as someone without as much medical knowledge or background,” said Pearl, an assistant professor of psychology at Perelman School of Medicine. Dr. Richard Fried is a dermatologist in private practice in Yardley, Pa., and wasn’t involved in the new research. Though he said the study was small, he called the findings “enormously important” and said they were consistent with what he sees in clinical practice. “I think it takes our breath away a little bit in terms of how truly burdened psoriasis sufferers are,” he said. “Psoriasis can be enormously capricious and can steal joy and involvement from people’s lives, but it’s often unrecognized,” said Fried, who is also a member of the medical board at the National Psoriasis Foundation. “The data from this study are enormously important.” The study authors said better education about the disease and contact with people who have it could help dispel myths and ease the stigma. Pearl said it might help if TV commercials for psoriasis medications — which are common — showed patients’ actual psoriasis lesions. This could educate the public about what psoriasis looks like to reduce misinformation, she said. “Could we test what would happen if we had commercials or educational campaigns of people with psoriasis shown with their lesions but still engaging in normal activities like playing outside with their kids?” she asked. “Just showing them as normal people — could those portrayals reduce stigma?” The study was published online recently in the Journal of the American Academy of Dermatology. More information Learn more about psoriasis from the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.
05 September 2018
05 September 2018
WEDNESDAY, Sept. 5, 2018 (American Heart Association) — Back when Charlie Wilson was an avid runner, the only flutter he ever felt in his chest came from indigestion. That changed on Sept. 11. The now-retired New York police sergeant spent nearly every day for the next six months at the World Trade Center. He helped with rescue and cleanup missions, all while breathing in the hazardous dust still settling over lower Manhattan. The work soon left Wilson with horrible sinus problems. Years later, he developed sleep apnea and asthma. And on Oct. 19, 2011, Wilson received a pacemaker after years of dealing with an irregular heartbeat. Wilson, 59, is among thousands of first responders, volunteers and New York residents with ailments and diseases linked to 9/11. More than 71,800 first responders and 16,600 survivors currently receive treatment through the World Trade Center Health Program. Yet, 17 years after the world’s deadliest terrorist attack, research has only started to uncover ways in which the aftermath has literally altered the hearts and minds of those affected. Respiratory illnesses were among the first widely reported health issues, usually characterized by chronic coughing and wheezing. Acid reflux was another common complaint, along with sleep apnea and sinus problems that often led to blocked upper airways. Many of the problems were linked to the fact that the collapse of the twin towers filled the air with numerous carcinogenic particles and chemicals, including asbestos and fiberglass, exposing anyone within reach of the colossal cloud. Only more recently has research shown a link between the dust and cardiovascular health. A study published last year in the journal Environment International found that New York children exposed to the dust because of where they lived in the wake of 9/11 may be at higher risk for heart disease. Blood tests of teens and young adults who were children when the twin towers fell showed high levels of artery-clogging cholesterol. Another study published this summer in the journal Circulation: Cardiovascular Quality and Outcomes showed a link between cardiovascular health and post-traumatic stress disorder, a common illness among 9/11 rescuers, volunteers and survivors. The research found that response crew workers who suffered from PTSD had more than double the risk for heart attacks or strokes than those without the disorder. Dr. Alfredo Morabia, the study’s lead author, noted that heart disease is not formally recognized as a World Trade Center-related condition, but substantial research has demonstrated the need for medical insurers to consider the connection as such. “I think the evidence is very strong,” said Morabia, a professor of epidemiology at both New York’s Columbia University and the City University of New York. Dr. Aaron Pinkhasov, a clinical professor of psychiatry at New York University School of Medicine, said he is not surprised to see research linking PTSD with cardiovascular health. PTSD affects the part of the brain that responds to fear, and the brain can overreact to even benign situations. This disrupts the immune system and triggers an inflammatory response known to harden arteries. It also affects social behavior, sometimes leading to a withdrawn, sedentary lifestyle and poor dietary choices that can elevate stroke and heart attack risk, he said. Other studies published this year in JAMA Oncology found that World Trade Center firefighters have a heightened risk of developing a type of blood cancer called multiple myeloma. It is expected that they also have a greater chance of being diagnosed with prostate cancer, thyroid cancer and melanoma in years to come. On Sept. 11, 2001, Wilson was a NYPD sergeant helping set up polls for a primary election when the first plane crashed into the World Trade Center. He immediately headed downtown and began evacuating people from the area. When the second tower collapsed, “it was like a wave just picked me up, like body surfing,” Wilson recalled. “It picked me up and threw me over the top of (a) van.” Wilson ended up breaking his back, but continued working until 3 a.m. the next morning. In an Injury Epidemiology study last year, people like Wilson who sustained significant injuries on 9/11 were twice as likely to develop heart disease as people who didn’t. Wilson’s back injuries eventually prompted him to retire from the police department in 2005. Other health problems followed, including the heart flutter that doctors failed to diagnose for years until shortly before he got his pacemaker. The device picked up another heart condition called atrial fibrillation. His heart problems have not officially been tied to 9/11, he said. “With all the research they’re doing now, it will happen,” he said. “It’s going to come out eventually, but I don’t know if I’ll be around to see it.”