16 January 2019
WEDNESDAY, Jan. 16, 2019 (HealthDay News) — U.S. dermatologists are prescribing fewer antibiotics overall but are writing more short-term orders for the drugs, a new study finds. Dermatologists prescribe more antibiotics per doctor than any other medical specialty — more than 7.1 million prescriptions per year, the University of Pennsylvania researchers said. According to their analysis of 2008-2016 data from privately insured patients, antibiotic prescriptions by dermatologists fell from 3.36 to 2.13 per 100 visits. That works out to about 500,000 fewer antibiotic prescriptions a year. The drop was significant among patients taking extended courses of antibiotics — down 53 percent over the study period. That includes a 28 percent reduction in antibiotic prescriptions for acne, the study authors said. But the investigators found a nearly 70 percent surge in short-term use of antibiotics, especially for skin-surgery patients. Those prescriptions rose from 3.92 to 6.65 per 100 visits. In addition, antibiotic prescriptions associated with cysts increased 35 percent, according to the study published Jan. 16 in JAMA Dermatology. Many dermatological patients, including those taking antibiotics for inflammatory skin conditions such as acne and rosacea, may stay on antibiotics for long periods. That’s an issue, because overuse of antibiotics can lead to reduced effectiveness, the researchers explained. “Overall, our findings are hopefully a sign that we’re making progress, but we need to evaluate how we can optimize the use of antibiotics in dermatologic surgery,” lead study author Dr. John Barbieri said in a university news release. That includes more studies to determine which skin surgery patients benefit most from antibiotics, he said. Barbieri is a dermatology research fellow at Penn. While prescription rates were down overall, the types of antibiotics used and length of treatment remained the same, the findings showed. “This may be a sign that treatment guidelines have raised awareness about overuse, though it’s also noteworthy that there are biologic and other alternate treatments that give patients more options than they’ve ever had before,” Barbieri added. More information The American Academy of Family Physicians has more on antibiotics.
12 January 2019
SATURDAY, Jan. 12, 2019 (HealthDay News) — If you pledged to hit the gym this year, take some steps to prevent skin infections, an expert says. “While skin infections are not a reason to cancel your gym membership, it’s important to follow a few simple steps to avoid germs while you’re at the gym,” said Dr. Brian Burke Adams, professor and chair of dermatology at the University of Cincinnati. “The bacteria, viruses and fungi that cause skin infections to develop thrive in warm, moist places like sweaty exercise equipment and locker room showers. If you’re not careful, you could end up with an infection like ringworm, plantar warts or impetigo,” he said in an American Academy of Dermatology news release. Here’s what Adams recommends: At the gym, wear loose-fitting, moisture-wicking clothes that will help keep your skin dry and prevent germs from growing. Wash your gym clothes after a workout. Always wear shoes, especially around pools, and in locker rooms and showers. Keep shower shoes, flip-flops or sandals in your gym bag. If you have cuts, keep them clean and covered. Don’t use saunas, steam rooms or hot tubs until the wound is healed, Adams said. Wash or sanitize your hands immediately after working out, and shower as soon as possible. After showering, put on clean clothes, including clean socks and underwear. Never share towels, razors or other personal items. Use disinfectant wipes or sprays to clean gym equipment before and after you use it. It’s also a good idea to place a barrier, such as a towel, between your skin and shared surfaces such as workout benches and bicycle seats. Use your own equipment, such as yoga mats, when possible. “Without treatment, skin infections can worsen,” Adams said. “Keep an eye on your skin, and if you notice signs of an infection, such as increased pain or swelling, pus or persistent redness, make an appointment to see a board-certified dermatologist.” More information The U.S. National Library of Medicine has more on skin infections.
10 January 2019
THURSDAY, Jan. 10, 2019 (HealthDay News) — Regular exercise before and after a cancer diagnosis significantly improves odds of survival, a new study finds. Among more than 5,800 U.S. patients with a range of early- to late-stage cancers, those who exercised three or four times a week before and after their diagnosis had a 40 percent lower risk of death than inactive patients, researchers reported. But survival gains were strong even for patients who began exercising only after their cancer diagnosis. “Patients who reported never doing any type of exercise until they were faced with a cancer diagnosis cut their risk of death by 25 percent to 28 percent compared to those who remained inactive,” said first author Rikki Cannioto. She’s an assistant professor of oncology at Roswell Park Comprehensive Cancer Center in Buffalo, N.Y. Patients who exercised once or twice a week also had a much lower risk of death than inactive patients, suggesting that any amount of regular, weekly activity is better than no activity, according to the researchers. Study participants had blood or head and neck cancers, as well as breast, prostate, lung, colon, kidney, esophageal, bladder, ovarian, endometrial, pancreatic, liver or stomach cancers. Others had sarcoma or cervical, thyroid, testicular, brain or skin cancers. The strongest link between exercise and reduced risk of death was seen with eight types: breast, colon, prostate, ovarian, bladder, endometrial, esophageal and skin cancer, the research team said. The results “solidify the importance of the message that when it comes to exercise, some weekly activity is better than inactivity,” Cannioto said in a Roswell news release. The finding that low-to-moderate weekly exercise is associated with improved survival is particularly encouraging, Cannioto said, given that cancer patients and survivors can be overwhelmed by the current recommendations of at least 30 minutes of daily moderate-to-intense physical activity. The study was published recently in the journal Cancer Causes & Control. More information The American Cancer Society has more on cancer patients and exercise.
09 January 2019
WEDNESDAY, Jan. 9, 2019 (HealthDay News) — Newly diagnosed cancer patients may be at increased risk for the painful skin condition shingles, a new study finds. Experts say development of new vaccines might help prevent shingles in cancer patients. The study, of about 240,000 cancer patients in Australia from 2006 to 2015, found that any type of cancer was associated with a 40 percent increased risk of developing shingles, compared with not having cancer. Patients with a blood-related cancer had the greatest shingles risk — more than three times that of people without cancer, according to the recent study in the Journal of Infectious Diseases. And those with a solid tumor — such as cancer in the lung, breast, prostate or other organ — had a 30 percent higher risk of shingles than people without cancer, study first author Jiahui Qian and colleagues said in a journal news release. Qian is with the University of New South Wales in Sydney, Australia. The higher shingles risk among blood cancer patients was present in the two years before their cancer diagnosis. But among patients with solid tumors, the greater risk was largely associated with receiving chemotherapy treatment, rather than with the cancer itself, the researchers said. Shingles (herpes zoster), marked by painful rashes and skin blisters, is caused by the varicella zoster virus, the same virus that causes chickenpox. The virus remains dormant in the body, but causes shingles if it reactivates later in life. “These findings have important implications in view of recent advances in development of zoster vaccines,” wrote Kosuke Kawai, of Harvard Medical School, and Dr. Barbara Yawn, of the University of Minnesota, in a commentary accompanying the study. A shingles vaccine approved for U.S. use in 2017 does not use a live form of the virus and may be safe for people with weakened immune systems, including those receiving chemotherapy, the commentary authors said. However, due to a lack of data, this vaccine is not yet recommended for use in that group of patients. Also in development is a shingles vaccine that uses an inactivated form of the virus. These advances suggest that vaccines show promise as a way to prevent shingles and its complications in cancer patients, according to the researchers and commentary authors. Nearly one-third of Americans people in the United States will develop shingles, and about 1 million cases occur in the country each year, the U.S. Centers for Disease Control and Prevention says. More information The U.S. National Institute of Neurological Disorders and Stroke has more on shingles.
08 January 2019
TUESDAY, Jan. 8, 2019 (American Heart Association) — On a Monday in August, Steve Regier came home early from his office to prepare for a conference call later at home in Wichita, Kan. Needing a break from a day of meetings, he decided to squeeze in a run. With the thermometer past 95 degrees, Steve normally would have logged miles on his treadmill. But a remodeling of the kitchen forced the major appliances into the room where he exercised. Soon into his run, he began coughing. He’d been coughing for days, enough to take pills containing epinephrine to combat congestion. The next thing he remembers is waking up in the hospital three days later. What Steve later learned was that after a couple miles, he passed a home with someone working in the yard. That person, Cooper Phillips, gave him a neighborly wave, and Steve waved back. A few seconds later, Amanda Carrillo, driving with her daughter in the car, had stopped at a nearby intersection to wait for traffic when they noticed a man lying in the middle of the street. As Amanda jumped out of her car to help, Cooper noticed the commotion and raced over to also lend a hand. They found a man whose skin was turning purple, the only sound he made was raspy gurgles. Steve had gone into cardiac arrest. Amanda called 911, and she and Cooper took turns administering Hands-Only CPR until EMS personnel arrived and took over. About 90 percent of people who experience an out-of-hospital cardiac arrest die. But nearly 45 percent of out-of-hospital cardiac arrest victims survive when bystander CPR is administered, according to 2014 data. “Everything worked out so unbelievably perfect,” Steve said. “Cooper said he’d come home early and wanted to mow the lawn. Amanda said she’d been talking to someone and was running late. The ambulance was nearby, on its way to pick up a non-emergency patient. My bad luck was also my good luck.” Thanks to Steve having filled out the emergency medical information in the health app on his iPhone, medical personnel immediately located his emergency contact — his wife, Marilyn, who happens to be a nurse in the neonatal intensive care unit of the same hospital Steve was taken to, Wesley Medical Center. Marilyn was so shaken by the news that she had to have a friend walk her to the emergency room. “Of course, I’d been there before, but I didn’t think I’d be able to find it,” she said. “I couldn’t even use my phone.” The couple’s son, then a senior in high school, and daughter, then in college, joined her later at the hospital. Initially, Marilyn assumed Steve’s heart problem was related to a six-way bypass he’d had 10 years earlier. But doctors determined the cardiac arrest was a freak occurrence caused by a combination of circumstances — the epinephrine he’d taken, physical exertion in extreme heat and an undiagnosed case of fungal pneumonia from dust he’d inhaled during the kitchen remodeling. When Steve arrived at the hospital, doctors put him into a medically induced coma and lowered his body temperature to help reduce the possibility — or severity — of brain damage. Three days later, they brought him out of it. For Marilyn, that was the scariest part — how would he respond? “When he came off the ventilator, he was obsessed with half a tooth he’d lost,” she said. Thankfully, most of the short-term memory loss faded within 24 hours. Doctors discussed whether Steve needed an implantable cardioverter defibrillator, a device that can detect when the heartbeat is too fast or chaotic and gives electric shocks to stop the abnormal rhythm. While one cardiologist thought it may not be necessary, Marilyn insisted. “Had he not had it put in, I couldn’t have functioned,” she said. “Having that has given us both a huge peace of mind.” Steve is back to jogging (albeit slower), which Marilyn is trying to accept. “Every time he tells me he wants to go for a run, I tell him, ‘Can’t you just walk fast?'” she said. “But I do want to get beyond that.” Steve and Marilyn both sing the praises of Cooper and Amanda. They gave them each heart-shaped cookies after Steve was back home. In 2018, less than a year after Steve’s cardiac arrest, the foursome walked together as a team in the Wichita Heart Walk. Steve will be chairman of the 2019 event on June 8. He said it’s a great platform to spread the word about the importance of knowing Hands-Only CPR. “I understand that people get nervous about mouth-to-mouth CPR, and I want them to know that it’s not necessary,” he said. “Even with your hands, you can make a huge difference in somebody’s life. When you start thinking about the ripple effect in someone’s life — their work, their friends, their family — it’s pretty staggering.”
08 January 2019
TUESDAY, Jan. 8, 2019 (HealthDay News) — Over the past 25 years, the number of Americans who have died from cancer has dropped dramatically, though racial and economic disparities persist, a new study reveals. Between 1991 and 2016, deaths from cancer dropped 27 percent. In real numbers, that’s almost 2.6 million fewer cancer deaths, according to the American Cancer Society. “The decline in deaths is largely driven by reductions in smoking and improved treatment, as well as earlier detection for some cancers,” said lead researcher Rebecca Siegel, scientific director of surveillance research at the cancer society. This is especially true for the most common cancers, including breast, colon, lung and prostate. But although the racial gap in cancer deaths is slowly narrowing, socioeconomic disparities are growing, she said. Poor counties in particular lag behind, and for some cancers the gap is widening, Siegel noted. “The largest gaps are for the most preventable cancers,” she said. For example, in the early 1970s, colon cancer death rates were 20 percent lower in poor counties, and today they are 35 percent higher, when compared with people living in richer counties, Siegel said. “Differences in wealth lead to differences in risk factors and less access to high-quality care for prevention, early detection and treatment,” she explained. In addition, poor people are less likely to be screened for cancer, and so cancer is likely to be diagnosed at an advanced stage that makes treatment problematic. Plus, care for the poor is not as good as that given to the rich, Siegel said. Where the poor have access to screening, these disparities can be eliminated, she suggested. “We have seen this in Massachusetts and Washington, D.C.,” she said. In addition, more education is called for to help people understand the steps they can take to lower their risk for cancer. “Health literacy is an issue,” Siegel said. The report was published online Jan. 8 in CA: A Cancer Journal for Clinicians. According to Electra Paskett, co-program leader of the cancer control program at Ohio State University’s Comprehensive Cancer Center, “The people who suffer the most are impacted by social determinants of health, which include where they live, their socioeconomic condition, their education, their income.” Poor people face so many problems just living day-to-day. And when they are confronted by cancer, they often don’t have the access to the latest treatments, Paskett explained. The new report noted that nearly 2 million Americans will be diagnosed with cancer this year, and more than 600,000 will die of the disease. But the cancer death rate has actually been dropping nearly 2 percent a year, from 215 deaths per 100,000 in 1991 to 156 per 100,000 in 2016. Between 1990 and 2016, deaths from lung cancer among men dropped 48 percent, and deaths from breast cancer among women decreased 40 percent. From 1993 to 2016, deaths from prostate cancer dropped 51 percent, and from 1970 to 2016, deaths from colon cancer plummeted 53 percent, the researchers reported. Siegel noted that “lung cancer still kills more Americans than breast, prostate and colon cancer combined.” Deaths from some cancers, however, rose. For example, deaths from liver cancer increased each year among men and women. Pancreatic cancer deaths rose slightly among men. Brain cancer deaths also rose each year. Other cancer deaths on the rise are soft-tissue cancers (such as heart) and oral cancers linked to the human papillomavirus (HPV). Although a vaccine for HPV is available, Paskett said, too few girls and boys are being vaccinated. The vaccine can prevent 70 percent of cervical cancers as well as many oral cancers and genital warts. Cancer is the second leading cause of death after heart disease, the researchers reported. But cancer is the leading cause of death in many states and among Hispanics, Asian Americans and people under 80 years of age. For cancers such as leukemia, non-Hodgkin lymphoma, pancreatic and ovarian cancers, death rates vary only slightly between the rich and poor, the investigators found. The study authors also said that cases of melanoma have been increasing, as well as cases of liver, thyroid, uterine and pancreatic cancer. Paskett pointed out that “we have made great strides. But we have a long way to go.” More information Visit the U.S. National Cancer Institute for more on cancer.
04 January 2019
FRIDAY, Jan. 4, 2019 (HealthDay News) — A program that maps out the genes of newborns has allowed researchers to identify risks for some inherited childhood conditions, many of which can be prevented. The so-called BabySeq Project discovered that slightly more than 9 percent of infants carry genes that put them at risk for medical conditions as they reach childhood. “The BabySeq Project is the first randomized trial of sequencing in newborns and the first study to fully examine the wealth of unanticipated genetic risk information in children,” said Dr. Robert Green, co-director of the study and a professor at Harvard Medical School. “We were stunned by the number of babies with unanticipated genetic findings that could lead to disease prevention in the future,” he said in a news release from Boston’s Brigham and Women’s Hospital. DNA sequencing can identify risks for a wide range of disorders that may not be detected otherwise, the study authors noted. Finding these mutations early may lead to helping newborns live better lives and ease the worries of their families. For the study, Green and his colleagues randomly assigned 128 healthy newborns and 31 ill infants to have their DNA sequenced. Among all the babies, 9.4 percent had a gene mutation that increased the risk of a disorder that arises or is manageable during childhood, or a mutation that conferred a moderate risk for a condition for which treatment during childhood might prevent devastating outcomes later in life. Mutations included those linked to several heart conditions that affect how the heart functions, according to the report. These conditions can be monitored, and families have been referred to cardiac specialists. One newborn had a risk for biotin deficiency, which can lead to skin rash, hair loss and seizures. That child’s diet is now being supplemented with biotin, which should prevent any symptoms, the researchers said. Senior study author Alan Beggs explained that “sequencing results have potential to raise questions that may be upsetting for parents, but could also lead to helpful or even lifesaving interventions.” Beggs is director of The Manton Center of Orphan Disease Research at Boston Children’s Hospital. “Only time will tell how the costs — both financial and in terms of extra medical testing and family stress — balance out against the benefits. That’s what we’re really trying to find out,” he said. The researchers also offered parents information about their child’s risk for adult-onset conditions. Three of 85 infants whose parents agreed to receive this information had these types of gene mutations. These variants were also found in the mothers of the three children. Green said, “Disclosing genetic risk for adult-onset conditions in children has been discouraged in traditional genetics in order to protect the child’s ‘right not to know,’ but our results demonstrate that many parents want access to this information about their child.” He added that the “findings suggest that thoroughly sequencing newborns reveals potentially lifesaving information in both infants and their parents far more commonly than was previously thought, and should encourage our entire field to re-evaluate the value of comprehensively analyzing and disclosing genomic information at any age.” The report was published Jan. 3 in the American Journal of Human Genetics. More information For more on genetic sequencing, visit the U.S. National Institutes of Health.
03 January 2019
THURSDAY, Jan. 3, 2019 (HealthDay News) — An old acne drug may hold the key to developing a new, safer treatment, a study suggests. Isotretinoin (Myorisan, formerly branded as Accutane), is a form of vitamin A, and has been prescribed for acne for decades. It works by reducing oil in the skin, thus helping prevent acne. An additional benefit of the drug has recently come to light. It alters the bacteria on the skin of acne patients to more closely resemble the skin of people without acne, researchers report. This discovery might lead the way to create bacteria-based treatments, said lead researchers Makedonka Mitreva, an associate professor of medicine, and Dr. William McCoy, a dermatologist and instructor of medicine, both at Washington University in St. Louis. Although isotretinoin is effective, it can cause severe birth defects, so it’s dangerous when used in women of childbearing age, which is why an alternative is needed, the researchers explained. Antibiotics are often prescribed to target the bacteria called Cutibacterium acnes, also called Propionibacterium acnes. These drugs, however, aid the development of resistant strains of bacteria and can kill off potentially beneficial microbes. Isotretinoin isn’t an antibiotic. It’s believed to treat acne by drying out the skin, which makes it a less inviting place for acne germs to flourish. It’s the only treatment that reliably clears acne over the long term, the researchers noted. For the study, the investigators sampled bacteria from the skin of 17 patients treated with isotretinoin. They compared this bacteria with samples from eight people who hadn’t been treated — four had normal skin and four had acne. In isotretinoin patients, an increase in the diversity of microbes was seen on the skin. DNA sequencing identified four types of bacteria that bloomed with isotretinoin. None of these had been associated with improved acne before. With isotretinoin, a reduced amount of Propionibacterium acnes bacteria was also seen, even though diversity of bacteria increased. By understanding how isotretinoin works, it might be possible to develop a similar drug that is more effective and doesn’t have negative side effects, the scientists said. “Women often will go without treatment for acne during their pregnancies because there just aren’t good therapies that are totally safe to use during that time,” McCoy said in a university news release. “They need other options. Our study suggests there could be a way to provide some type of microbial ‘fertilizer’ or ‘weed killer’ on the skin to help promote the growth of healthy microbes,” said McCoy. “We’re conducting a larger study to look more closely at these questions.” The report was published recently in the Journal of Investigative Dermatology. More information The American Academy of Dermatology has more on acne.