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Why Are Cardiac Arrests More Deadly on Weekends?

WEDNESDAY, Nov. 13, 2019 — Your odds of surviving a cardiac arrest long enough to be admitted to the hospital are lower on the weekend than on a weekday, researchers say.

For the study, the investigators analyzed data from nearly 3,000 patients worldwide who suffered an out-of-hospital cardiac arrest and were treated with a publicly accessible automated external defibrillator (AED).

Overall, 27% of the patients survived to hospital admission, a rate that matches previous studies.

But those whose cardiac arrest occurred between 12 a.m. Saturday and 11:59 p.m. Sunday were about 20% less likely to survive to hospital admission than those who were stricken between Monday and Friday.

The odds were also lower for older patients and those whose cardiac arrest occurred at home, the findings showed.

“It is often said that sudden cardiac arrest can happen to anyone, anytime, anywhere. These results suggest that there is an opportunity to address sudden cardiac arrests that occur during the weekend by improving AED awareness, availability and training, and quick response by rescuers,” lead author Hannah Torney said in an American Heart Association (AHA) news release. Torney is a doctoral student at Ulster University in Northern Ireland.

Weekend survival odds may be lower because people could be less likely to be near a publicly accessible AED, and others may not witness the event, the study authors suggested.

The researchers said their findings could help guide placement of AEDs to improve accessibility.

The preliminary research is to be presented at the American Heart Association annual meeting, in Philadelphia, Nov. 16 to 18. Research presented at meetings should be considered preliminary until published in a peer-reviewed journal.

More information

The American Heart Association has more on cardiac arrest.

© 2019 HealthDay. All rights reserved.

Posted: November 2019

Drugs.com – Daily MedNews

Study Links Asbestos in Talcum Powder to Deadly Cancer

MONDAY, Oct. 21, 2019 — As concerns about baby powder being contaminated with asbestos mount, a new study finds a link between such contamination and a rare and deadly cancer.

A group of 33 people developed mesothelioma after long-term use of talcum powder and no exposure to other sources of asbestos, the report stated.

“All of them had significant exposure to talcum powder,” said lead researcher Dr. Jacqueline Moline, a professor with Northwell Health’s Feinstein Institutes for Medical Research in Manhasset, N.Y.

“It wasn’t like they sprinkled it on once a month. These were people who used it daily or many times a day for many, many years. They all used the powders, and then over time they developed the cancers,” Moline said.

Just last week, Johnson & Johnson recalled a shipment of baby powder after U.S. authorities found it had been contaminated with asbestos — the first such recall in the company’s history, a spokesman said.

Johnson & Johnson did not respond to a request for comment on Moline’s study, but said in its recall announcement that it has rigorous testing standards in place to ensure the safety of its baby powder.

“Thousands of tests over the past 40 years repeatedly confirm that our consumer talc products do not contain asbestos,” the company’s statement said.

Mesothelioma is a cancer of the lining that covers the outer surface of most internal organs, according to the American Cancer Society. It most often occurs in the lining around the lungs or the abdomen.

Asbestos is the main risk factor for mesothelioma, the cancer society says. It’s fairly rare in the United States, with about 3,000 new cases diagnosed each year. But it has an average five-year relative survival rate of just 9%.

People usually inhale asbestos fibers, which are so small that 200,000 fibers fit on Abraham Lincoln’s nose on a penny, Moline said. The inhaled asbestos makes its way into the lining around the lungs and abdomen, where it causes DNA damage that triggers cancer.

Although most mesotheliomas can be tracked back to asbestos exposure, there always have been a number of cases that couldn’t be explained that way, Moline said.

Researchers have suspected that talcum powder could be one potential source of asbestos exposure, Moline said. Both minerals are mined from the earth, and sometimes asbestos and talc deposits overlap.

“The talc, when it’s mined, can be contaminated with asbestos when both minerals are present,” Moline said.

There’s no way to remove asbestos from talc, so the only way to protect consumers is to test what’s coming out of the mine, she said.

To examine the possible link between mesothelioma and talcum powder, Moline and her colleagues gathered information on 33 different people with the deadly cancer who’d not been exposed to asbestos in any other way.

They determined that talcum powder use was the only possible source of asbestos exposure among all 33 cases.

Further, a closer examination of six specific cases revealed the presence of asbestos in their tissues after decades-long use of talcum powder.

“They all had the same type of asbestos that is seen in talc in their tissues and in their mesothelioma,” Moline said. “The type of asbestos we found is not the type typically seen in commercial applications. It’s the type of asbestos you’d find in talc.”

In one case, a 65-year-old woman was diagnosed with mesothelioma around her left lung after she complained of a dry cough and short-windedness. She started using talc around age 8 or 9, and regularly used it throughout her life. Researchers found asbestos fibers in the tissue of her lungs and lymph nodes.

In another case, a 44-year-old man developed chest pain after playing hockey in 2012. Doctors found mesothelioma in the lining around his lungs. The man regularly used talcum powder after showering, as well as dousing his hockey gear with talc before donning it.

It’s hard for consumers to judge on their own whether a specific brand of talcum powder is safe, Moline said.

“The question is where does it come from and how rigorously has it been tested,” she said. “There are some mines that don’t have any asbestos, but it’s unclear whether those are being used by different manufacturers.

“The most prudent thing for folks is either to use talc-free powders, which are on the market, or cornstarch-based products,” Moline concluded.

The new study was published Oct. 17 in the Journal of Occupational and Environmental Medicine.

More information

The American Cancer Society has more about mesothelioma.

© 2019 HealthDay. All rights reserved.

Posted: October 2019

Drugs.com – Daily MedNews

Hospitals Work to Better Spot Deadly Sepsis in Kids

Marnie Doubek, MD, primary care doctor, Maplewood, NJ.

Niranjan Kissoon, MD, professor of pediatrics and emergency medicine, University of British Columbia; vice chair,  Global Alliance for Sepsis; Sepsis Alliance advisory board member, Vancouver, Canada.

Lauren Hess, MD, pediatric counselor, Texas Children’s Hospital; co-lead, Sepsis Quality Improvement Project, Houston.

Terri Brown, registered nurse; clinical specialist, quality & safety, Texas Children’s Hospital, Houston.

Michael Bell, MD, chief of critical care medicine, Children’s National Hospital, Washington, D.C.

Charles Macias, MD, chief, division of pediatric emergency medicine, University Hospitals Rainbow Babies & Children’s Hospital, Cleveland, OH.

Sepsis Alliance.

Children’s Hospital Association.

Children’s Hospital of Philadelphia.

CDC.

National Institute of General Medical Sciences.

Health Affairs: “Preventing Sepsis By Reimagining Systems And Engaging Patients.”

JAMA Pediatrics: “Cost of Pediatric Severe Sepsis Hospitalizations.”

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Train Tracks Deadly for Kids, But Many Parents Underestimate the Danger

TUESDAY, Sept. 24, 2019 — Think the chances that your kid could be hit by a train are slim to none?

New research suggests you should think again.

Issued to coincide with “Rail Safety Week,” the Sept. 23 report finds that, on average, a child dies of a train-related injury somewhere in the United States every five days. And for every death, another three children are injured.

The finding indicates that many parents may not realize the importance of addressing railroad safety, said Torine Creppy, president of Safe Kids Worldwide.

“In fact, fewer than half of parents we surveyed say they have talked with their children about it, and half of parents admit to taking risks around railroads,” Creppy added.

“We want to help parents get the little-known, but lifesaving information they need to protect themselves and their kids,” she added in a Safe Kids news release.

The Safe Kids Worldwide report highlights two key reasons people get hit by trains: car collisions and trespassing.

The report warns that collisions occur when drivers aren’t paying attention, ignore track safety barriers, or race to cross over the tracks before an oncoming train. The latter is a big mistake, Creppy and her colleagues noted, because even if a conductor spots a problem it’s impossible to stop a hurtling train on a dime. It can take upwards of a mile of advanced warning to bring a moving train to a full stop.

Trespassing on foot alongside tracks is both illegal and dangerous, they added. For one, modern trains aren’t as loud as one might expect. And they’re also considerably wider than the track itself — at least three feet wider on either side — which means being near, but not on, a track is no guarantee of safety.

In concert with Union Pacific Railroad, Safe Kids Worldwide offers some safety tips:

  • Only cross at designated track crossings.
  • Never try to beat a train across the tracks.
  • Always wait for trains to completely clear the crossing.
  • Don’t play, stroll or take photos anywhere near a train track.
  • Avoid distractions, such as cellphones or music, when preparing to cross a railroad track.

More information

There’s more on railroad track safety at Safe Kids Worldwide.

© 2019 HealthDay. All rights reserved.

Posted: September 2019

Drugs.com – Daily MedNews

FDA Approves Drug for Most Deadly Form of TB

By Robert Preidt
HealthDay Reporter

THURSDAY, Aug. 15, 2019 (HealthDay News) — A new drug has been approved as part of a powerful, three-pronged treatment regimen for the most deadly strain of tuberculosis, the U.S. Food and Drug Administration announced Wednesday.

Pretomanid tablets were approved to be used with bedaquiline and linezolid in adults with extensive multidrug-resistant tuberculosis (XDR-TB) of the lungs. Caused by a bacterium that attacks the lungs, TB can also wreak havoc on any part of the body including the kidney, spine and brain.

The FDA approval sprang from a groundbreaking trial of 107 patients in South Africa who had been diagnosed with XDR-TB. Six months after treatment, 89% of the patients were cured, which is far higher than typical success rates for treatment of this often lethal strain of TB, according to the FDA.

Tsholofelo Msimango was one of the patients in the South African trial. Sent off to a hospital in Johannesburg to participate in the trial, she weighed only 57 pounds at the time and was terrified.

“I cried the whole way in the ambulance,” Msimango told The New York Times recently. “They told my parents to fix the insurance because I would die.”

Instead, Msimango, now 25, is TB-free five years after her diagnosis. She weighs a healthy 103 pounds, and has since had a young son.

That’s not to say the new regimen wasn’t tough to take. Significant side effects were experienced by patients in the trial. They included nerve damage, acne, anemia, nausea, vomiting, headache, increased liver enzymes, indigestion, rash, increased pancreatic enzymes, visual impairment, low blood sugar and diarrhea.

But the disease is far worse than the side effects of treatment.

TB is now the leading cause of infectious deaths worldwide, according to the Times. While only a fraction of the 10 million people who get TB get this deadly strain, very few of the 30,000 people in 100 countries who get XDR-TB survive, the newspaper said. Three-quarters die before there is even a diagnosis, experts believe. And among those who get typical treatment, the cure rate is only 34% because the XDR strain is resistant to all four families of antibiotics typically used to fight the disease, the newspaper reported.

Continued

“The threat of antimicrobial-resistant infections is a key challenge we face as a public health agency,” FDA Principal Deputy Commissioner Dr. Amy Abernethy said in an agency news release.

“The bacterium that causes tuberculosis can develop resistance to the antibiotics used to treat it. Multidrug-resistant TB and extensively drug-resistant TB are public health threats due to limited treatment options. New treatments are important to meet patient national and global health needs,” Abernethy said.

The approval of pretomanid was granted to the Global Alliance for TB Drug Development (TB Alliance).

WebMD News from HealthDay

Sources

SOURCES: U.S. Food and Drug Administration, news release, Aug. 14, 2019;The New York Times

Copyright © 2013-2018 HealthDay. All rights reserved.

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Fentanyl Becoming a Deadly Accomplice in Cocaine, Meth Abuse

MONDAY, May 6, 2019 — As if using cocaine or methamphetamines isn’t risky enough, new research shows a sharp spike in urine drug tests that are positive for those drugs and the powerful synthetic opioid fentanyl.

The findings could provide insight into steeply rising rates of cocaine- and methamphetamine-related overdoses in the United States.

For the study, researchers analyzed data on one million urine drug tests taken in various medical settings. The investigators found that between January 2013 and September 2018, the presence of fentanyl in urine drug tests that were also positive for cocaine or methamphetamine rose 1,850% and 798%, respectively.

Those statistics suggest that increases in cocaine- and methamphetamine-related overdoses may be related to fentanyl either being added to those drugs or used at the same time, according to the authors of the study published online recently in JAMA Network Open.

Research published just last week came to similar conclusions, but from a different angle: Nearly three-quarters of cocaine-involved deaths in 2017 also involved opioids, as did about half of deaths involving psychostimulants such as meth. Synthetic opioids — fentanyl, most prominently — often played a key and deadly role, researchers from the U.S. Centers for Disease Control and Prevention found.

In the latest study, the urine tests were ordered by health care providers in numerous areas of medicine, including pain management, primary care, addiction treatment, behavioral health, obstetrics and gynecology, and multi-specialties.

Positive results for cocaine or methamphetamine with non-prescribed fentanyl were seen across all of them, suggesting abuse is happening in many care settings, the researchers noted.

“The increasingly common concurrent use of fentanyl with cocaine or methamphetamine may help explain the recent sharp increases in overdose deaths involving stimulants,” said study co-author Bob Twillman. He is a consultant with the drug testing company Millennium Health, based in San Diego.

“It is still undetermined if these combinations are created by dealers or users, and if by users, if this simply reflects a shift from heroin to fentanyl as the opioid being used,” he added in a company news release.

“Clinicians and patients both should be aware of the potential consequences of fentanyl exposure, knowingly or unknowingly, and take the necessary steps to maximize patient safety,” Twillman concluded.

More information

The U.S. Centers for Disease Control and Prevention has more on fentanyl.

© 2019 HealthDay. All rights reserved.

Posted: May 2019

Drugs.com – Daily MedNews

Deadly Meningitis B Targets College Students

By Alan Mozes

HealthDay Reporter

WEDNESDAY, Jan. 2, 2019 (HealthDay News) — College students face a much higher risk for the deadly bacterial infection meningitis B, a new analysis shows.

Investigators from the U.S. Centers for Disease Control and Prevention found that students who were aged 18 to 24 were 3.5 times more likely to contract meningitis B than their peers who were not in school.

The research team, led by Dr. Sarah Mbaeyi from the CDC’s National Center for Immunization and Respiratory Diseases, said the finding highlights the urgent need to ensure that all students get vaccinated against the disease before they head off to a university.

“Meningitis B is an uncommon but potentially deadly bacterial infection that leads to inflammation of the lining of the brain and spinal cord,” explained Dr. Robert Glatter, an emergency physician with Lenox Hill Hospital in New York City.

A meningitis B infection may “also may lead to meningococcal sepsis, or bacteria invading the bloodstream,” added Glatter, who was not part of the study. “The combination of these factors can make it lethal in less than 24 hours.”

The latest findings essentially confirm long-standing fears about college-related vulnerabilities, given that “the bacteria that leads to meningitis B lives in the nose and throat and can be spread by close contact from coughing, sneezing or kissing,” Glatter noted.

“The truth is that health care professionals have always been concerned about the heightened risk of meningitis among college students living in close quarters together and sharing drinks and utensils,” he explained.

That thought was seconded by Dr. Lucila Marquez, an assistant professor of pediatrics in the section of pediatric infectious diseases at Baylor College of Medicine and Texas Children’s Hospital, in Houston. She said that “college freshmen living in residence halls were previously known to have an increased risk for other forms of meningococcal disease.”

When the meningitis B vaccine first became available in 2015, college students were not recognized as a high-risk group and not recommended for routine vaccination.

But “it’s important for college attendees to be vaccinated, because vaccination is the only reliable means of preventing devastating meningococcal disease,” said Marquez, who co-authored an editorial that accompanied the study.

Continued

Vaccination could help protect both the 10 percent to 15 percent of meningitis B patients who ultimately die from their infection, and those who survive the disease only to endure serious long-term health consequences.

Given that over one-third of meningitis infections occur among young Americans aged 16 to 23, Marquez stressed that parents “should feel confident that MenB vaccines are safe.”

During their investigation, Mbaeyi and her team identified 166 cases of some form of meningococcal disease (including B, C and Y infections) between 2014 and 2016 among Americans aged 18 to 24. Of those, 83 were college students.

Among the student group, more than three-quarters of the infections were meningitis B, the investigators found. This compared with less than 40 percent of the meningitis cases cited among non-college patients.

The findings were published in the January issue of the journal Pediatrics.

Still, Glatter observed that the overall risk for contracting meningitis B remains “low,” even among college students. The CDC concurs, noting that in 2016 there was a total of about 370 cases of all forms of meningococcal disease across all age groups in the United States.

However, “the reality is that we need to better inform parents and health care providers about the importance of vaccinating college students against this potentially deadly illness,” said Glatter. “It’s simply not worth taking the risk, even in light of the low prevalence of this disease.”

WebMD News from HealthDay

Sources

SOURCES: Lucila Marquez, M.D., MPH, assistant professor, pediatrics, section of pediatric infectious diseases, Baylor College of Medicine and Texas Children’s Hospital, Houston, and associate medical director, infection control and prevention, Texas Children’s Hospital, Houston; Robert Glatter, M.D., emergency physician, Lenox Hill Hospital, New York City; January 2019,Pediatrics

Copyright © 2013-2018 HealthDay. All rights reserved.

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Kidney Disease More Deadly for Men