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Mosquito-Borne Brain Infection Found in Florida

July 29, 2019 — There’s an increased risk of a mosquito-borne virus that causes brain infection and swelling, Florida health officials warn.

Eastern equine encephalitis (EEE) has been detected in several sentinel chickens, according to the Florida Department of Health in Orange County, CNN reported.

Sentinel chickens are tested regularly for the West Nile virus and EEE.

After the positive tests for EEE virus in the sentinel chickens in Orange Couty, the health department said “the risk of transmission to humans has increased,” CNN reported.

Only about seven human cases of the EEE virus reported in the US each year. However, about one-third of people who contract it die, and many survivors have long-term neurological problems, according to the Centers for Disease Control and Prevention.

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Could Alzheimer’s Spread Like Infection Throughout the Brain?

WEDNESDAY, May 1, 2019 — With findings that might alter the path of Alzheimer’s research, scientists say misfolded forms of two proteins appear to spread through patients’ brains similar to an infection.

The findings suggest that Alzheimer’s is a “double-prion” disorder. This discovery could help lead to new treatments that focus directly on prions, according to researchers from the University of California, San Francisco.

A prion is a misshapen protein that can force other copies of that protein into the same misfolded shape and spread in the brain. It’s best known for its role in bovine spongiform encephalopathy — “mad cow” disease — and Creutzfeldt-Jakob disease (CJD), a degenerative brain disorder.

In the new research, the university team analyzed the brains of 75 Alzheimer’s patients after death and found self-propagating prion forms of the proteins amyloid beta and tau. Higher amounts of these prions were associated with early-onset Alzheimer’s and younger age at death.

Alzheimer’s patients have amyloid plaques and tau tangles in the brain, but efforts to treat the disease by clearing out these inactive proteins have failed.

These new findings suggest that active amyloid beta and tau prions could drive Alzheimer’s and offer targets for effective treatment, according to the researchers.

“I believe this shows beyond a shadow of a doubt that amyloid beta and tau are both prions, and that Alzheimer’s disease is a double-prion disorder in which these two rogue proteins together destroy the brain,” said study senior author Dr. Stanley Prusiner, director of the UCSF Institute for Neurodegenerative Diseases. Prusiner won a Nobel Prize in 1997 for discovering that prions were responsible for mad cow disease and CJD.

Prion levels also appear linked to patient longevity, he noted.

“We need a sea change in Alzheimer’s disease research, and that is what this paper does. This paper might catalyze a major change in AD research,” Prusiner said in a university news release.

For this study, the researchers used recently developed laboratory tests to rapidly measure prions in human tissue samples. They can reveal infectious prion levels in just days.

These tests “are a game-changer,” said study co-author William DeGrado, a UCSF professor of pharmaceutical chemistry.

In order to develop effective therapies and diagnostics, scientists must target the active prion forms, rather than the large amount of protein in plaques and tangles, DeGrado said.

The researchers hope that measuring the prion forms of amyloid beta and tau might lead to the development of drugs that either prevent them from forming or spreading, or help remove them before they cause damage.

The study was published May 1 in the journal Science Translational Medicine.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on Alzheimer’s disease.

© 2019 HealthDay. All rights reserved.

Posted: May 2019

Drugs.com – Daily MedNews

Severe ‘Mono’ Infection May Raise Risk for Chronic Fatigue Syndrome

TUESDAY, April 2, 2019 — As if having the exhausting “kissing disease” — also known as mononucleosis, or “mono” — isn’t bad enough, about 1 in 10 people with this infection will develop chronic fatigue syndrome in six months, researchers report.

To better predict which people with mono might end up with debilitating chronic fatigue syndrome, investigators at Lurie Children’s Hospital of Chicago developed a new scale to rate how severe a mononucleosis infection is. They then tested it in 126 college students diagnosed with mono.

“We looked at what factors correlated with bad outcomes and then tried to validate these measures,” said Dr. Ben Katz, an attending pediatric infectious diseases specialist.

People with the most severe mononucleosis infections based on the new scale were more than three times as likely to meet the diagnostic criteria for chronic fatigue syndrome, Katz explained.

And three factors in particular often showed up in people with more severe mono. These included:

  • Being unable to leave home when symptoms were worst.
  • Having trouble breathing.
  • Experiencing digestive symptoms, such as nausea and vomiting.

Mononucleosis is a contagious infection, commonly caused by the Epstein-Barr virus, according to the U.S. Centers for Disease Control and Prevention. It often occurs in younger people — especially those in high school and college. Symptoms include extreme fatigue, fever and sore throat. Between 1% and 5% of college students are diagnosed with mono, according to the study authors.

Chronic fatigue syndrome (CFS) is also called myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). The CDC says it causes extreme fatigue, sleep problems, thinking and memory issues, dizziness and pain. Symptoms can get worse after exercise. The exact cause is unknown, and it’s difficult to diagnose, the CDC noted.

Unfortunately, there are no good treatments that get to the root of either mono or CFS, according to Katz. There are supportive treatments that may make people feel better, he said, but no cures for either illness.

“This is a big problem on college campuses, and it could help to have a tool to predict who might have trouble,” Katz said.

Dr. Jane Swedler, chief of adolescent medicine at NYU Winthrop Hospital in Mineola, N.Y., reviewed the findings.

“We know there is an association with CFS and a certain history of specific infections, like mononucleosis,” she said.

Swedler said the new, validated measure should be helpful for guidance and planning. “There’s a predictive value to it, and it may be used to standardize care and possibly for earlier treatment of CFS,” she said.

So what can you do to ensure you don’t get mono, and then possibly CFS?

There’s no vaccine for mononucleosis. To help prevent it, the CDC recommends that you do not share certain items, such as: drinks and food; eating utensils; and personal items, like toothbrushes.

And, if you think someone might have an infection, don’t kiss them, because the disease can be transmitted through kissing, the CDC warns.

The study was recently published in The Journal of Pediatrics.

More information

Learn more about chronic fatigue syndrome from the U.S. Centers for Disease Control and Prevention.

© 2019 HealthDay. All rights reserved.

Posted: April 2019

Drugs.com – Daily MedNews

Wear Contacts 24/7? You Risk Infection, Blindness

By Alan Mozes

HealthDay Reporter

WEDNESDAY, Dec. 19, 2018 (HealthDay News) — Dangerous infections, blinding ulcers in the eyes: These are just some of the troubles that can come from wearing your contacts for too long.

Contact lenses are generally considered safe, but wearing them while asleep significantly raises the risk of developing serious complications that can cause permanent visual loss, the U.S. Centers for Disease Control and Prevention warns.

In one instance, a 34-year-old man who both swam while wearing his contact lenses and wore them overnight three to four days a week developed a rare but potentially blinding form of keratitis caused by a microscopic organism.

Keratitis — an inflammation of the cornea — is responsible for an estimated one million outpatient and emergency department visits each year, according to the CDC.

Another case involved a teenage girl who developed a corneal ulcer and scarring after wearing unprescribed lenses to bed.

Yet another involved a 57-year-old man who nearly lost vision in one eye after wearing his soft lenses nonstop for two weeks without daily cleaning.

In that case, the patient ultimately required a corneal transplant in his right eye after suffering a bacterial infection and a perforated cornea.

“The excess risks of developing corneal infection with overnight wear of contact lenses has been recognized for many years,” explained Dr. Oliver Schein. He is a professor of ophthalmology, and vice-chair for quality and safety with the Wilmer Eye Institute at Johns Hopkins University in Baltimore. Schein was not involved in the current case study report.

With an eye toward the 45 million Americans who regularly wear contacts, the CDC is highlighting the concern in collaboration with the Eye and Contact Lens Association and the disease surveillance network EMERGEncy ID NET.

Together, the organizations published a new report in the January issue of the Annals of Emergency Medicine that outlines the experiences of six patients who recently developed corneal infections after routinely wearing their contact lenses to bed. The report was led by Dr. Jon Femling of the University of New Mexico’s School of Medicine.

Continued

Despite the introduction of silicone hydrogels in the 1990s, overall corneal infection risk has held steady over decades, Schein said, affecting about one in every 2,500 lens wearers.

But that risk is “at least 10-fold greater for those choosing to sleep with lenses in. So I discourage that practice whenever I can,” he added.

As to why the risk is greater, Schein cited a number of factors that “favor microbial [germ] growth” whenever the eyes are closed, including “microtrauma to the surface of the cornea,” a drop in tear production, and a rise in temperature and humidity.

Amy Watts, director of optometry and contact lens service, and director of the vision rehabilitation service at Massachusetts Eye and Ear in Boston, said corneal function also plays a role.

“Our cornea is the only part of the body that receives its oxygen from the atmosphere and not our blood supply,” she noted.

So, “when we close our eyes at night, we reduce the amount of oxygen to our cornea by cutting the corneas off from the oxygen-rich atmosphere,” Watts explained.

“Wearing a contact lens further reduces the oxygen while asleep, and may put us just past the tipping point for keeping our corneas in optimal condition to fight off microbes,” she said.

Another issue is that people who sleep with their lenses also tend to shower with them in place. And “tap water — just like water in lakes, pools, ponds, oceans — can have microbes that may cause a serious eye infection,” Watts said. “In extreme cases, these infections can cause a severe loss in vision.”

Both Watts and Schein said preventing corneal infection is best achieved by wearing single-day disposable lenses.

Schein said, “This approach also removes the need for solution use and, most importantly, obviates the need for a contact lens case, an important advantage, since contamination of the case is certainly a risk factor for infection. However, if the user tries to save money by not discarding the lens daily, then the safety advantage is entirely lost.”

Meanwhile, he advises any wearer who develops a painful red eye to remove their lenses and see an eye care specialist within 24 hours.

“Most emergency rooms are not equipped with eye specialists or the equipment — [such as a] slit lamp biomicroscope — necessary to distinguish a simple abrasion from an infection,” Schein cautioned. “Therefore, those who go to emergency departments initially should be seen in follow up as soon as possible by an eye care professional.”

WebMD News from HealthDay

Sources

SOURCES: Amy Watts, O.D., director, optometry & contact lens service, and director, vision rehabilitation service, Massachusetts Eye and Ear, Boston; Oliver Schein, M.D., M.P.H.,  professor, ophthalmology, and vice chair, quality & safety, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore; January 2019,Annals of Emergency Medicine

Copyright © 2013-2018 HealthDay. All rights reserved.

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WebMD Health

Your Gut May Be to Blame for Your Blood Infection

By Steven Reinberg

HealthDay Reporter

MONDAY, Oct. 15, 2018 (HealthDay News) — Bloodstream infections contracted during a hospital stay are usually caused by a patient’s own digestive tract, not a doctor’s dirty hands or another patient’s cough, a small new study suggests.

Stanford University researchers used new computer software to quickly identify the source of bloodstream infections among 30 patients. The findings showed that the infections mostly started in patients’ own bodies — often in the large intestine.

Being able to trace these infections to their source, rather than guessing, is a big step toward addressing the risk factors, said Dr. Ami Bhatt, an assistant professor of hematology and genetics at Stanford.

“Until now, we couldn’t pinpoint those sources with high confidence,” Bhatt said in a university news release. “That’s a problem because when a patient has a bloodstream infection, it’s not enough simply to administer broad-spectrum antibiotics. You need to treat the source, or the infection will come back.”

The new program could help doctors rapidly learn if the germ responsible for a bloodstream infection came from a break in the skin, leaked through the intestinal wall, or was on the surface of a catheter or bed rail. This, in turn, would mean better steps toward eradicating the infection, she said.

Bhatt’s team focused on the gut for the study because it’s the home of 1,000 to 2,000 different germs.

These bugs usually don’t cause any problem, Bhatt said. “They’re perfectly well-behaved in the gut. It’s only when they show up in the wrong place — due, for example, to leaking through a disrupted intestinal barrier into the bloodstream — that they cause trouble,” she explained.

In the study, the researchers analyzed blood and stool samples from patients who developed bloodstream infections when they had bone-marrow transplants between October 2015 and June 2017 at Stanford Hospital. In addition, each patient’s entire gene sequence was also analyzed.

The researchers didn’t find much evidence that any patient’s bloodstream germ matched strains in other patients’ blood or stool.

“I don’t think we’re passing around active infections among one another as often as has been assumed,” Bhatt said.

The report was published online Oct. 15 in the journal Nature Medicine.

WebMD News from HealthDay

Sources

SOURCE: Stanford University, news release, Oct. 15, 2018

Copyright © 2013-2018 HealthDay. All rights reserved.


WebMD Health

Half of Antibiotics Given With No Infection Noted

By Amy Norton

HealthDay Reporter

FRIDAY, Oct. 5, 2018 (HealthDay News) — After years of public health warnings about antibiotic misuse, a new study suggests the problem is far from being solved.

Researchers found that of more than 500,000 antibiotic prescriptions they analyzed, nearly half were written without an infection-related diagnosis. And about 20 percent were given without an office visit — usually over the phone.

It’s not clear how many of those prescriptions were actually inappropriate, said lead researcher Dr. Jeffrey Linder, of Northwestern University’s Feinberg School of Medicine in Chicago.

His team looked at patient records, and “bad coding” could be part of the problem, Linder explained. He was referring to the system doctors use for recording diagnoses.

Still, the findings are concerning, Linder said.

They suggest that some doctors are still doling out antibiotics too readily — probably, in part, because they assume patients want them, according to Linder.

But such indiscriminate antibiotic use is a driving force behind the widespread problem of antibiotic-resistant infections. Antibiotics are effective only against bacterial infections — not the common cold or other ills caused by viruses. When people use antibiotics unnecessarily, that exposes bacteria to the drugs and gives them a chance to mutate and become resistant.

So for years, public health experts have been warning doctors and patients against indiscriminate antibiotic use.

For the current study, Linder’s team looked at nearly 510,000 antibiotic prescriptions doled out at 514 medical clinics over two years. The prescribers included doctors, nurse practitioners and physician assistants in primary care and specialties such as gastroenterology and dermatology.

Overall, 46 percent of prescriptions were given with no documented diagnosis of an infection. In 29 percent of cases, another diagnosis — such as high blood pressure — was recorded; 17 percent of prescriptions had no diagnosis given.

In addition, 1 in 5 prescriptions was made with no in-person visit.

There are times when prescribing by phone is fine, Linder noted. If a woman with a history of urinary tract infections develops those symptoms, he said, it may be “perfectly appropriate” to prescribe an antibiotic without a visit.

Continued

Another example would be a prescription refill for someone taking antibiotics for acne, Linder said. But for the most part, he added, patients should be seen in the office before getting an antibiotic.

Linder was to present the findings Friday at IDWeek 2018, an annual meeting of infectious disease specialists, in San Francisco. In general, studies presented at meetings are considered preliminary until they are published in a peer-reviewed journal.

Dr. Ebbing Lautenbach, chief of the infectious diseases division at the University of Pennsylvania, agreed the study can’t show whether all of the prescriptions were actually inappropriate. “But this certainly raises concerns that antibiotics are often prescribed for reasons that are unclear,” he added.

Lautenbach said patients should feel free to ask questions when an antibiotic is prescribed. “Sometimes an antibiotic is an appropriate choice, and sometimes it’s not. Providers should explain, ‘Here’s why I think an antibiotic is necessary.’ And there should be a discussion of the pros and cons of taking one,” he suggested.

Besides the public health issue of antibiotic resistance, the drugs can also have side effects for any one person, like nausea and diarrhea, and interactions with other medications, Lautenbach noted.

Linder said his team plans to take a “deeper dive” into their data, to learn more about the conditions doctors were treating with antibiotics.

For now, Linder said there could be multiple reasons that doctors would prescribe an antibiotic even if there is no definite diagnosis of a bacterial infection. Time demands, for example, may push some doctors to throw an antibiotic at a sore throat.

In some cases, Linder said, a patient might insist on an antibiotic, and the doctor gives in.

“But I think that more often, the problem is the doctor’s perception that patients want antibiotics,” he said.

Linder suggested that patients take a more proactive role when it comes to the medications.

“You can tell your doctor that you only want an antibiotic if it’s really necessary,” he said. “That will automatically shift the doctor’s default position on it.”

WebMD News from HealthDay

Sources

SOURCES: Jeffrey Linder, M.D., M.P.H., Northwestern University, Feinberg School of Medicine, Chicago; Ebbing Lautenbach, M.D., chief, infectious diseases division, University of Pennsylvania/Penn Medicine, Philadelphia; Oct. 5, 2018, presentation, IDWeek 2018, San Francisco

Copyright © 2013-2018 HealthDay. All rights reserved.

WebMD Health

Half of Antibiotics Given Without Infection Diagnosis

FRIDAY, Oct. 5, 2018 — After years of public health warnings about antibiotic misuse, a new study suggests the problem is far from being solved.

Researchers found that of more than 500,000 antibiotic prescriptions they analyzed, nearly half were written without an infection-related diagnosis. And about 20 percent were given without an office visit — usually over the phone.

It’s not clear how many of those prescriptions were actually inappropriate, said lead researcher Dr. Jeffrey Linder, of Northwestern University’s Feinberg School of Medicine in Chicago.

His team looked at patient records, and “bad coding” could be part of the problem, Linder explained. He was referring to the system doctors use for recording diagnoses.

Still, the findings are concerning, Linder said.

They suggest that some doctors are still doling out antibiotics too readily — probably, in part, because they assume patients want them, according to Linder.

But such indiscriminate antibiotic use is a driving force behind the widespread problem of antibiotic-resistant infections. Antibiotics are effective only against bacterial infections — not the common cold or other ills caused by viruses. When people use antibiotics unnecessarily, that exposes bacteria to the drugs and gives them a chance to mutate and become resistant.

So for years, public health experts have been warning doctors and patients against indiscriminate antibiotic use.

For the current study, Linder’s team looked at nearly 510,000 antibiotic prescriptions doled out at 514 medical clinics over two years. The prescribers included doctors, nurse practitioners and physician assistants in primary care and specialties such as gastroenterology and dermatology.

Overall, 46 percent of prescriptions were given with no documented diagnosis of an infection. In 29 percent of cases, another diagnosis — such as high blood pressure — was recorded; 17 percent of prescriptions had no diagnosis given.

In addition, 1 in 5 prescriptions was made with no in-person visit.

There are times when prescribing by phone is fine, Linder noted. If a woman with a history of urinary tract infections develops those symptoms, he said, it may be “perfectly appropriate” to prescribe an antibiotic without a visit.

Another example would be a prescription refill for someone taking antibiotics for acne, Linder said. But for the most part, he added, patients should be seen in the office before getting an antibiotic.

Linder was to present the findings Friday at IDWeek 2018, an annual meeting of infectious disease specialists, in San Francisco. In general, studies presented at meetings are considered preliminary until they are published in a peer-reviewed journal.

Dr. Ebbing Lautenbach, chief of the infectious diseases division at the University of Pennsylvania, agreed the study can’t show whether all of the prescriptions were actually inappropriate. “But this certainly raises concerns that antibiotics are often prescribed for reasons that are unclear,” he added.

Lautenbach said patients should feel free to ask questions when an antibiotic is prescribed. “Sometimes an antibiotic is an appropriate choice, and sometimes it’s not. Providers should explain, ‘Here’s why I think an antibiotic is necessary.’ And there should be a discussion of the pros and cons of taking one,” he suggested.

Besides the public health issue of antibiotic resistance, the drugs can also have side effects for any one person, like nausea and diarrhea, and interactions with other medications, Lautenbach noted.

Linder said his team plans to take a “deeper dive” into their data, to learn more about the conditions doctors were treating with antibiotics.

For now, Linder said there could be multiple reasons that doctors would prescribe an antibiotic even if there is no definite diagnosis of a bacterial infection. Time demands, for example, may push some doctors to throw an antibiotic at a sore throat.

In some cases, Linder said, a patient might insist on an antibiotic, and the doctor gives in.

“But I think that more often, the problem is the doctor’s perception that patients want antibiotics,” he said.

Linder suggested that patients take a more proactive role when it comes to the medications.

“You can tell your doctor that you only want an antibiotic if it’s really necessary,” he said. “That will automatically shift the doctor’s default position on it.”

More information

To learn more about proper antibiotic use, visit the U.S. Centers for Disease Control and Prevention.

© 2018 HealthDay. All rights reserved.

Posted: October 2018

Drugs.com – Daily MedNews

Contact Lenses May Harbor Serious, Blinding Infection

By Steven Reinberg

HealthDay Reporter

FRIDAY, Sept. 21, 2018 (HealthDay News) — Contact lens wearers everywhere need to be on the lookout for a rare, but potentially blinding, eye infection, British researchers warn.

In southeast England, cases of the infection, called Acanthamoeba keratitis, have tripled since 2011, a new study found.

The illness is typically tied to poor contact lens hygiene use.

The infection combines a tiny single-cell amoeba with the bacteria keratitis. Once the eye is infected, it causes the the cornea to become painful and inflamed due to this cyst-forming microorganism.

For one in every four of people infected, the disease results in a loss of most of their vision or blindness and they face prolonged treatment, the research team said.

While rare, outbreaks have also occurred in the United States, one ophthalmologist said.

“There have been a few outbreaks in the U.S., most notably from improper disinfection of contact lenses,” said Dr. Jules Winokur, who practices at Lenox Hill Hospital in New York City. He wasn’t involved in the new study.

“In clinical practice, we see cases of acanthamoeba on a regular basis, ” he said. “Most often, these cases present in patients wearing contact lenses who have been exposed to contaminated water, which could be from swimming pools, water parks or even showers at home.”

“The treatment of acanthamoeba can be prolonged and difficult,” Winokur explained. “Toxic medications and even corneal transplantation may be necessary treatments.”

The British study was led by Dr. John Dart, from University College London’s Institute of Ophthalmology. His team collected data on patients seen from 1985 to 2016 at Moorfields Eye Hospital.

They found an increase in cases of the disease from the eight to 10 a year seen in 2000 -2003, to 36 to 65 cases per year more recently.

Overall, 25 percent of those affected required corneal transplants to treat the disease or restore vision, the researchers said.

Dart’s team also conducted a second study, this time in people who wore reusable contact lenses daily. The study compared those 63 diagnosed with Acanthamoeba keratitis with 213 people who went to the eye hospital for any other reason.

Continued

Dart’s group found that the risk of developing the disease was more than three times greater among people with poor contact lens hygiene. This means people who didn’t always wash and dry their hands before handling their lenses, or those who used a now discontinued disinfectant product containing Oxipol.

In addition, people who wore their contacts in swimming pools or hot tubs were also at risk, as were those who showered or washed their face while wearing their lenses, the study found.

“People who wear reusable contact lenses need to make sure they thoroughly wash and dry their hands before handling contact lenses, and avoid wearing them while swimming, face washing or bathing,” Dart said.

“Daily disposable lenses, which eliminate the need for contact lens cases or solutions, may be safer and we are currently analyzing our data to establish the risk factors for these,” he added in a university news release.

Dart stressed that “this infection is still quite rare, usually affecting fewer than 3 in 100,000 contact lens users per year in South East England, but it’s largely preventable.”

“This increase in cases highlights the need for contact lens users to be aware of the risks,” he added.

Dr. Matthew Gorski is an ophthalmologist at Northwell Health in Great Neck, N.Y. He agreed that proper contact lens hygiene could prevent most cases of Acanthamoeba.

According to Gorski, that includes:

  • Washing your hands with soap and water before handling contacts.
  • Properly disinfecting, cleaning and storing your contacts, including never using tap water to clean contacts.
  • Removing contacts from your eyes before water exposures such as swimming, showering or bathing.
  • Removing contacts immediately and seeing your eye doctor if you have any eye pain, sensitivity to light, red eye or change in vision.

The study was published Sept. 21 in the British Journal of Ophthalmology.

WebMD News from HealthDay

Sources

SOURCES: Matthew Gorski, MD, Ophthalmologist, Northwell Health, Great Neck, NY; Jules Winokur, ophthalmologist, Lenox Hill Hospital,, New York CIty; Sept. 21, 2018, press release, University College London, U.K.

Copyright © 2013-2018 HealthDay. All rights reserved.

WebMD Health

Blood Infection Sepsis Tied to Heart Attack, Stroke

MONDAY, Sept. 10, 2018 — Survivors of serious bloodstream infections called sepsis are at increased risk for stroke and heart attack for four weeks after leaving the hospital, a new study finds.

The study included roughly 42,300 sepsis patients in Taiwan. Of those, 22 percent died within 30 days of hospital admission.

Among the survivors, 1,012 had a cardiovascular event, 831 had a stroke and 184 had a heart attack within 180 days after leaving the hospital, the study found.

The risk was highest shortly after leaving the hospital, with more than one-quarter (26 percent) of heart attacks or strokes occurring during the first seven days, and 51 percent occurring within 35 days, the researchers reported.

Sepsis patients aged 20 to 45 had a higher risk of heart attack or stroke than those older than 75, according to the study published Sept. 10 in the CMAJ (Canadian Medical Association Journal).

Similar findings were made in a Danish study, the researchers said in a journal news release.

“Based on our study (Han Chinese) and the study in Denmark (European) that reported similar findings for two different ethnic groups, it is likely that these results are generalizable to different populations,” Dr. Chien-Chang Lee, who’s with the department of emergency medicine at National Taiwan University Hospital in Taipei, and colleagues wrote.

The investigators called for further research in different patient populations.

Sepsis causes about 8 million deaths worldwide each year, the study authors said.

More information

There’s more on sepsis at the U.S. National Institute of General Medical Sciences.

© 2018 HealthDay. All rights reserved.

Posted: September 2018

Drugs.com – Daily MedNews

FDA Warns of Serious Genital Infection With Diabetes Meds

Aug. 30, 2018 — The FDA is warning about rare cases of necrotizing fasciitis — sometimes called “flesh-eating bacteria” — of the genitals and genital area in patients taking type 2 diabetes drugs known as SGLT2 inhibitors.

The new warning will be added to the prescribing information and the patient medication guides for all types of the drugs and drug combinations approved to treat type 2 diabetes. They include:

  • Canagliflozin (Invokana, Invokamet, Invokamet XR)
  • Dapagliflozin (Farxiga, Xigduo XR, Qtern)
  • Empagliflozin (Jardiance, Glyxambi, Synjardy, Synjardy XR)
  • Ertugliflozin (Steglatro, Segluromet, Steglujan)

Necrotizing fasciitis of the genital area, also called Fournier’s gangrene, is a life-threatening bacterial infection of the tissues under the skin surrounding the muscles, nerves, fat, and blood vessel in the genital area. It is estimated to happen to about 1.6 of 100,000 men annually in the United States, most often among those ages 50 to 79.

But from March 2013 to May 2018, the FDA received reports of 12 cases of Fournier’s gangrene among patients taking SGLT2 inhibitors, of whom five were women and seven were men. The condition has rarely been reported among women. The patients ranged from 38 to 78 years old.

The condition developed an average of 9.2 months after the patients starting taking the drug. (Though the development time ranged from 7 days to 25 months.) Patients stopped taking the drug in most cases.

Multiple Surgeries, One Death

Reports included all SGLT2 drugs except ertugliflozin, but it “would be expected to have the same risk for this rare and serious infection as other SGLT2 inhibitors,” the FDA said in a statement.

All 12 patients were hospitalized and required surgery to remove infected tissue. Five required more than one surgery, and one required skin grafting. Four patients developed complications, including diabetic ketoacidosis, acute kidney injury, and septic shock. One patient died, and two were transferred to a rehabilitation hospital.

Because diabetes makes Fournier’s gangrene more likely, data were examined for patients taking other drugs that lower blood sugar. Between 1984 and 2018, just six cases of Fournier’s gangrene were identified, all in men.

Continued

In 2017, an estimated 1.7 million patients received a prescription for an SGLT2 inhibitor from U.S. outpatient retail pharmacies.

Patients taking the drugs should seek medical help immediately if they have tenderness, redness, or swelling of the genitals or the genital area and have a temperature higher than 100.4 F.

The infection can get worse quickly, so patients are advised to get help right away.

The condition is treated with broad-spectrum antibiotics and surgery if needed. Patients should stop taking the drug and take other medications to control their blood sugar while monitoring their glucose levels.

The FDA urges patients to report any side effects from taking these or other drugs to FDA MedWatch by calling 855-543-DRUG (3784) and pressing 4; emailing [email protected]; or completing an online form.

Medscape Medical News

Sources

FDA: “FDA warns about rare occurrences of a serious infection of the genital area with SGLT2 inhibitors for diabetes.”

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Man Loses Limbs After Infection From Dog’s Lick

A Wisconsin man had his lower legs and hands amputated after developing a rare blood infection caused by bacteria in dog saliva.

He first developed flu-like symptoms such as fever and vomiting. By the next morning, his temperature had soared and he was delirious. After his wife rushed him to the hospital, she noticed his body was covered in bruises, as if he’d been beaten with a baseball bat, the Washington Post reported.

Within a week, Manteufel’s legs were amputated from the knees down. Then doctors had to remove his hands.

Doctors diagnosed Manteufel with a rare blood infection caused by bacteria called Capnocytophaga canimorsus that’s commonly found in the saliva of most healthy dogs and is usually not harmful to humans, the Post reported.

But in Manteufel’s case, the bacteria got into his bloodstream, triggering blood poisoning (sepsis). The bruises on his body were actually blood spots caused by the sepsis.

Manteufel was given antibiotics to fight the infection, but clots blocked blood flow to his extremities, resulting in tissue and muscle death and the need to amputate his legs and hands in order to save his life, the Post reported.

Greg Manteufel loves dogs and had been around eight of them about the time he became ill, according to his wife Dawn Manteufel. It’s not clear which dog was carrying the bacteria.

She told the Post that doctors said her husband’s case was a “crazy fluke.”

Greg Manteufel has been at Froedtert & the Medical College of Wisconsin in Milwaukee for about a month. He recently had surgery to remove dead tissue and muscle from his leg amputations. This week, he will have two more surgeries to remove dead tissue, the Post reported.

He may also require nose reconstruction surgery because lack of blood flow caused it to turn black, his wife said.

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Obesity Might Help When Infection Strikes

By Steven Reinberg

HealthDay Reporter

FRIDAY, May 25, 2018 (HealthDay News) — Obesity brings with it many health ills, but there could be one silver lining, new research shows.

If you’re in the hospital suffering from an infectious disease, you’re half as likely to die if you’re overweight or obese, Danish researchers report.

For the study, Sigrid Gribsholt, from Aarhus University Hospital’s department of clinical epidemiology, and colleagues collected data on more than 35,000 patients hospitalized for infections from 2011 to 2015.

Among these patients, the investigators looked at whether weight affected the risk of dying in the three months after discharge.

Gribsholt’s team found that for underweight patients, the risk of dying was two times higher than for patients of normal weight. That seemed tied, however, to recent weight loss due to some underlying disease. Deaths did not increase for underweight patients who had not recently lost weight.

The surprise finding was that overweight patients were 40 percent less likely to die and obese patients were 50 percent less likely to die, compared with normal-weight patients.

Among obese patients, whether they had recent changes in weight, other medical conditions or if they smoked had little effect on the risk of dying, the findings showed.

“Overweight and obesity were associated with substantially reduced 90-day mortality following incident hospital admission for infection,” the researchers wrote.

The results of the study were presented May 24 at the European Congress on Obesity in Vienna, Austria.

Similar findings arose in three other studies also presented at the meeting:

  • In a study jointly conducted by researchers in the United States and Taiwan, a look at the medical records from nearly 1.7 million Americans hospitalized with pneumonia found that the odds of dying fell by 20 to 30 percent if the patient was overweight or obese.
  • A study conducted by the same team, using the same database, found that hospitalized overweight or obese patients were also about 22 to 23 percent less likely to die from the blood infection sepsis, compared to normal-weight patients.
  • A study led by Dutch researchers at the Erasmus MC, University Medical Center Rotterdam found that, in a group of 26 seriously ill patients, the nine who were obese were less likely to undergo rapid muscle wasting compared to their normal-weight peers.

Continued

But obesity expert Dr. Mitchell Roslin said the so-called “obesity paradox” — where a normally unhealthy weight appears to have some health benefit — “has to be kept in perspective.”

Even though excess weight might somehow offer protection in dire circumstances, obesity is linked to a number of deadly diseases, including diabetes, heart disease and even some cancers.

“What is happening today is that the obesity epidemic is causing far more [ill health] than it is protecting,” said Roslin, who is chief of obesity surgery at Lenox Hill Hospital in New York City.

“Just because you are overweight does not mean you are unhealthy,” he said, but “if your obesity is severe, it is unlikely you are healthy.”

The new findings were all presented at a medical meeting, and as such should be considered preliminary until published in a peer-reviewed journal.

WebMD News from HealthDay

Sources

SOURCES: Mitchell Roslin, M.D., chief, obesity surgery, Lenox Hill Hospital, New York City; May 24, 2018, presentations, European Congress on Obesity, Vienna, Austria

Copyright © 2013-2018 HealthDay. All rights reserved.

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George H.W. Bush Hospitalized Due to Blood Infection

Former U.S. President George H.W. Bush is being treated for a blood infection in a Houston hospital.

Bush, 93, was admitted Sunday morning to Houston Methodist Hospital after an infection spread to his blood, spokesman Jim McGrath said on Twitter Monday, the Associated Press reported.

The former president and vice president is “responding to treatments and appears to be recovering,” according to McGrath.

On Saturday, Bush attended the funeral of his wife, Barbara, who died at age 92. They were married for 73 years, the longest presidential marriage in U.S. history.

Bush has a form of Parkinson’s disease and uses a wheelchair and electric scooter. In recent years, he has been hospitalized several times for respiratory problems, the AP reported.

McGrath provided no details about Bush’s condition and said further updates would be provided “as events warrant.”

In his eulogy for his mother Saturday, former Florida Gov. Jeb Bush said his father was in the hospital at the same time Barbara Bush was in the hospital just before her death. At the time, those hospitalizations were not made public, the AP reported.

“I think Dad got sick on purpose so that he could be with her,” Jeb Bush said.

A year ago, Bush was hospitalized for two weeks due to pneumonia and chronic bronchitis. In January 2017, Bush spent 16 days in hospital for pneumonia. During that hospital stay, he spent time in intensive care and doctors inserted a breathing tube and connected him to a ventilator, the AP reported.

Bush also was hospitalized in 2015 after falling and breaking a bone in his neck, in December 2014 for shortness of breath, and at Christmas 2012 for bronchitis-related cough and other problems.

People in their 90s with Parkinson’s disease can be at higher risk for pneumonia and other infections due to swallowing problems, Dr. David Reuben, professor of geriatric medicine at the UCLA medical school in Los Angeles, told the AP.

“And the stress of losing a loved one can weaken the immune system,” he noted.

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That Ocean Swim May Come With Infection Risks

SUNDAY, March 18, 2018 — Frolicking in the sea may torpedo your health, new research suggests.

It found a twofold increased risk for general ear problems, a 77 percent increased risk for earaches and a 29 percent increased risk for diarrhea and other gastrointestinal illnesses among people who swam in the sea.

The findings came from an analysis of 19 studies, involving more than 120,000 people, from the United States, the United Kingdom, Australia, New Zealand, Denmark and Norway. The results were published recently in the International Journal of Epidemiology.

“In high-income countries like the U.K., there is a perception that there is little risk to health of spending time in the sea,” researcher Anne Leonard, from the University of Exeter Medical School in England, said in a news release from the school. “However, our paper shows that spending time in the sea does increase the probability of developing illnesses, such as ear ailments and problems involving the digestive system, such as stomach ache and diarrhea.

“We think that this indicates that pollution is still an issue affecting swimmers in some of the world’s richest countries,” Leonard added.

Despite major improvements in water quality, seawater is still polluted from sources such as industrial waste, sewage and run-off from farmland, the researchers noted.

“We don’t want to deter people from going into the sea, which has many health benefits — such as improving physical fitness, well-being and connecting with nature,” fellow researcher Will Gaze, also from the Exeter medical school, said in the news release. “However, it is important that people are aware of the risks so they can make informed decisions.

“Although most people will recover from infections with no medical treatment, they can prove more serious for vulnerable people, such as the very old or very young, or those with pre-existing health conditions,” he noted.

“We have come a long way in terms of cleaning up our waters, but our evidence shows there is still work to be done,” Gaze said. “We hope this research will contribute to further efforts to clean up our coastal waters.”

More information

The U.S. Environmental Protection Agency has more on human health at the beach.

© 2018 HealthDay. All rights reserved.

Posted: March 2018

Drugs.com – Daily MedNews

Repeat Infection Likely for Men With HPV

By Robert Preidt

HealthDay Reporter

FRIDAY, Dec. 8, 2017 (HealthDay News) — Men infected with genital human papillomavirus (HPV) are at high risk for reinfection with the same type of HPV, researchers say.

The investigators also found that the risk for reinfection after a year increased 20-fold for men who’ve been infected with HPV16 — the type responsible for most HPV-related cancers. And the risk was 14 times higher after two years.

This was true in both men who were sexually active and those who were celibate. That suggests that they are not re-acquiring the virus from another sexual partner, according to the study from the University of Chicago Medical Center.

The researchers analyzed data from more than 4,000 men who were not vaccinated against HPV. The men lived in Florida, Mexico and Brazil and were tracked from 2005 to 2009.

The findings show the importance of HPV vaccination in young males before they become sexually active, the study authors said.

“Vaccinating boys before HPV exposure could be a highly effective way to reduce the burden of HPV infection,” study leader Sylvia Ranjeva said in a university news release. “Vaccinating men who have already been infected might also be effective.” Ranjeva is a Ph.D. student in the university’s department of ecology and evolution.

HPV is the most common sexually transmitted infection. It’s a major cause of genital warts and cancers of the cervix, vulva, vagina, penis, anus, mouth and throat. About 40 percent of women and 45 percent of men in the United States are infected with HPV.

Among women, virtually all cases of cervical cancer are caused by HPV, and just two HPV types, 16 and 18, are responsible for about 70 percent of all cases, according to the U.S. National Cancer Institute.

There are more than 200 HPV types. Vaccines protect against four to nine of the most common, disease-causing types, the study authors noted.

The new report was published online Dec. 5 in the Proceedings of the National Academy of Sciences.

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Sources

SOURCE: University of Chicago, news release, Dec. 5, 2017

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