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You Won’t Get Sued If You Do CPR, Review Suggests

By Alan Mozes
HealthDay Reporter

TUESDAY, Nov. 12, 2019 (HealthDay News) — Are you worried about getting sued if you provide bystander CPR in a public place?

Don’t be, surprising new research suggests: You’re more likely to get sued if you don’t intervene.

Dr. Travis Murphy undertook the most comprehensive review to date of jury verdicts, settlements, and appellate opinions focused on lawsuits involving cardiopulmonary resuscitation (CPR). His team analyzed 170 cases launched between 1989 and 2019 across all 50 states.

And, Murphy said, the data shows that “no non-medical person has been successfully sued for providing bystander CPR” to those who appear to be in cardiac arrest or trouble.

“There have been far more cases brought due to delays in [providing] CPR rather than for providing CPR,” he added.

Murphy, who is an emergency medicine attending physician and a fellow in surgical critical care at the University of Florida in Gainesville, said nearly all the CPR cases (167 out of 170) involved an allegation of negligence, namely not providing CPR when it might’ve helped. In sum, those cases generated punitive damages of roughly $ 620 million.

Of the three cases in which defendants were charged with battery assault because they did administer CPR, only one was convicted. And that was because “the patient already had a signed ‘Do Not Resuscitate’ order and received CPR anyway in their nursing home,” Murphy explained. The nursing home paid more than $ 121,000 in damages.

The other two cases were ruled in favor of the bystanders. And that, said Murphy, suggests that bystanders are very well protected by “Good Samaritan” laws.

“The laws vary from state to state,” he explained, and some states do have limitations in place. For example, Kentucky statutes only protect bystanders who offer CPR assistance if they are medically trained.

But most states fully protect bystanders who sincerely try to help, Murphy stressed. Some states even have “Duty to Act” laws that establish fines specifically for bystanders who are medically trained to provide CPR but choose not to help when an emergency unfolds. (Minnesota, Rhode Island and Vermont are three such examples.)

Continued

The findings come as little surprise to Dr. Michael Kurz, an associate professor in the department of emergency medicine with UAB Medicine and the Alabama Resuscitation Center in Birmingham.

“There is good scientific literature that suggests that the risk of liability when you stand up in this regard is miniscule, if it exists at all,” Kurz said.

But what should a bystander do if he/she is not trained in CPR?

Murphy said, “Ideally, we would like to see more people trained in CPR. But understanding that not everyone will be trained, calling 911 immediately would be the best course of action, since this is so time-sensitive.”

That thought was seconded by Kurz, who also serves as chair of the American Heart Association’s task force for telecommunicator CPR.

“In general, we encourage the lay public to render aid that they feel comfortable with,” he said. “But any assistance is better than no assistance. Because the alternative in the face of a cardiac arrest is the patient dies if no assistance is given,” Kurz added.

“So you can call 911, and the dispatcher can send appropriate help. But then, in addition, [they] can also provide ‘just in time’ simple CPR instructions over the phone within 20 seconds. That’s all you need to be instructed on how to do it in an emergency, with absolutely no prior training,” Kurz explained.

Murphy’s findings are scheduled for presentation at the American Heart Association meeting, in Philadelphia, Nov. 16 to 18.

Research presented at medical meetings should be considered preliminary until published in a peer-reviewed journal.

WebMD News from HealthDay

Sources

SOURCES: Travis Murphy, M.D., emergency medicine attending physician, and fellow, surgical critical care, University of Florida, Gainesville; Michael Christopher Kurz, M.D., M.S., associate professor, department of emergency medicine, UAB Medicine, Alabama Resuscitation Center, Birmingham,  and chair, Task Force for Telecommunicator CPR, American Heart Association; American Heart Association meeting, Philadelphia, Nov. 16-18, 2019

Copyright © 2013-2018 HealthDay. All rights reserved.

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Don’t Delay Surgery for Very Early-Stage Breast Cancer, Study Suggests

THURSDAY, Oct. 24, 2019 — Delaying surgery for a noninvasive breast cancer can have dire consequences, a new study shows.

Longer delays in surgery for ductal carcinoma in situ (DCIS) breast cancer lead to a higher risk of invasive ductal carcinoma and a slightly lower survival rate, researchers found.

“For each month of delay, there was well under a 1% difference in survival. But for each month of delay, there was an approximate 1% increase in the finding of invasive cancer,” said study author Dr. Richard Bleicher, a professor of surgical oncology at Fox Chase Cancer Center, in Philadelphia.

“The survival difference with a delay is small,” Bleicher noted in a center news release. “While it’s not an emergency to get treated immediately, delays do have an effect and long delays should be avoided.”

DCIS occurs when abnormal cells form in the milk duct of the breast and is the earliest stage of breast cancer. When cancerous cells spread beyond the milk duct, it becomes invasive ductal carcinoma.

Standard treatment for DCIS is surgery and radiotherapy, along with endocrine therapy. But research suggests that some DCIS may never progress to invasive disease, and clinical trials are being conducted to determine whether DCIS can be observed, rather than surgically removed.

This study “suggests that delays in operative management of DCIS are associated with invasion and slightly worse short-term outcomes,” Bleicher said. “Since observation represents infinite delay, it suggests that observation should not yet be pursued outside of a clinical trial in patients who will tolerate excision.”

The study included more than 140,600 U.S. women (123,947 with DCIS, 16,668 with invasive ductal carcinoma). They were diagnosed between 2004 and 2014.

Survival was compared with five time intervals in delays to have surgery: less than 30 days, 31-60 days, 61-90 days, 91-120 days, or 121-365 days.

Overall survival was 95.8%, with a median time from diagnosis to surgery of 38 days. However, each increase in diagnosis-to-surgery interval was associated with a 7.4% increase in the risk of death.

The study was published Oct. 21 in the Annals of Surgical Oncology.

More information

The American Cancer Society has more on treatment of DCIS.

© 2019 HealthDay. All rights reserved.

Posted: October 2019

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A Drink a Day Might Be Good for Diabetics’ Health, Study Suggests

By Serena Gordon
HealthDay Reporter

TUESDAY, Sept. 17, 2019 (HealthDay News) — Chinese researchers may deserve a toast for their new findings that suggest light to moderate drinking may be beneficial for people with type 2 diabetes.

The review found that people who had a bit of alcohol daily had lower levels of a type of blood fat called triglycerides. But alcohol didn’t seem to lower blood sugar levels in people who already had type 2 diabetes, the review found.

The research did show lower levels of insulin and improved insulin resistance in people who drank light to moderate amounts of alcohol, study lead author Yuling Chen said. Chen is a medical student at Southeast University in Nanjing, China.

That finding suggests that “light to moderate alcohol consumption might protect against type 2 diabetes,” Chen said.

But Chen cautioned that you can have too much of a good thing: “High alcohol consumption is reported to be a risk factor for diabetes.”

The authors said light to moderate drinking is about 20 grams of alcohol daily. That’s about 1.5 cans of beer, a large glass of wine (almost 7 ounces), or a generous shot (1.7 ounces) of distilled spirits.

The American Diabetes Association recommends that people who drink alcohol do so in moderation — no more than one drink per day for adult women and no more than two drinks per day for adult men.

Dr. Joel Zonszein, director of the Clinical Diabetes Center at Montefiore Medical Center in New York City, said those are the levels he recommends to his patients with type 2 diabetes.

“A little alcohol can be good for you, and that’s no different in patients with type 2 diabetes,” he said.

One caveat, Zonszein said, is that people with type 1 diabetes and anyone with type 2 who is taking insulin or other medications that can cause low blood sugar levels must be more cautious with alcohol. It can sometimes lead to dangerously low levels of blood sugar (hypoglycemia).

But not all type 2 diabetes medications are a concern with alcohol. For example, he said, it’s OK to have a drink if you’re taking a commonly used type 2 diabetes drug called metformin.

Continued

Zonszein shared Chen’s concern about too much alcohol.

“Excessive drinking is a problem,” he said, noting that too much alcohol can raise triglycerides and lead to serious health concerns, such as pancreatitis.

For the new research, Chen and colleagues reviewed 10 previous randomized controlled trials on people with type 2 diabetes. Those studies had a total of 575 volunteers.

A number of factors related to diabetes and health were measured, including blood sugar control, insulin levels, insulin resistance, cholesterol and triglycerides.

Across the studies, researchers found a drop of nearly 9 milligrams per deciliter (mg/dL) in average triglyceride levels. A normal triglyceride level is less than 150 mg/dL, according to the U.S. National Institutes of Health. A high level of triglycerides is associated with a higher risk of heart disease.

Researchers also saw decreases in insulin levels and in a measure called HOMA-IR that assesses insulin resistance. Chen said these findings suggest “relieved insulin resistance in type 2 diabetes patients.”

The authors are scheduled to present the findings Tuesday at a meeting of the European Association for the Study of Diabetes, in Barcelona, Spain. Findings presented at meetings are typically viewed as preliminary until they’ve been published in a peer-reviewed journal.

WebMD News from HealthDay

Sources

SOURCES: Yuling Chen, medical student, Southeast University, Nanjing, China; Joel Zonszein, M.D., director, Clinical Diabetes Center, Montefiore Medical Center, New York City; Sept. 17, 2019, presentation, European Association for the Study of Diabetes, Barcelona, Spain

Copyright © 2013-2018 HealthDay. All rights reserved.

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Curbing a Skin Oil Might Help Curb Acne, Study Suggests

WEDNESDAY, May 15, 2019 — Acne is the bane of many teens, and even some adults. Now, researchers say they might have hit on a new approach to easing the condition.

The key lies in a naturally produced skin oil called sebum, explained a research team led by William Esler, a researcher with drug giant Pfizer in Cambridge, Mass.

Sebum is important to the skin’s health because it helps regulate temperature and repel microbes, the team said. But an excess of sebum production has also long been thought to be a contributor to acne.

“Too much sebum can get trapped in glands, which cause it to swell and cause a bump under the skin,” explained Dr. Raman Madan, a dermatologist with Northwell Health’s Huntington Hospital in Huntington, N.Y.

So, it stands to reason that identifying “a target to decrease sebum production would be a novel approach to treating acne,” said Madan, who wasn’t involved in the new study.

The research involved a microscopic examination of the skin of 22 healthy volunteers. Esler’s team discovered that skin sebum production relies on a specific molecular mechanism known as the de novo lipogenesis (DNL) pathway.

Most sebum was found to be produced by cells called sebocytes, which secreted the oil based on the ebb and flow of the DNL pathway, the researchers explained.

But nine people with acne showed one major difference: Compared to people with normal skin, they had a 20% higher rate of sebum production and a related rise in fluctuations of the DNL pathway, the findings showed.

Going a step further, Esler’s group designed a compound that targeted an enzyme involved in the pathway. In healthy volunteers, application of the treatment cut sebum production by nearly half, according to the report published in the May 15 issue of Science Translational Medicine.

Of course, these experiments are early and it remains to be seen if such a compound might curb sebum — and acne — in a larger, more rigorous trial.

In the meantime, Madan said that the approach “has potential.” But he cautioned that “this may be a treatment for acne, but not a cure, because the cause of acne is more than just sebum production. It has potential to be an addition to current treatments.”

Dr. Michele Green is a dermatologist at Lenox Hill Hospital in New York City. She agreed that the findings “may offer promise to patients suffering with acne vulgaris.”

More information

There’s more on acne and acne treatment at the U.S. National Institute of Arthritis and Musculoskeletal and Skin Diseases.

© 2019 HealthDay. All rights reserved.

Posted: May 2019

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Exercise May Boost Brain Power in Alzheimer’s, Mouse Study Suggests

THURSDAY, Sept. 6, 2018 — There are plenty of reasons to work out, and this may be another: Exercise promotes the growth of new brain cells that improve thinking in mice with a form of Alzheimer’s disease, a new study finds.

Massachusetts General Hospital (MGH) researchers reported that it may be possible to develop drug and gene therapies that trigger the same beneficial effects in people with the brain disease.

“While we do not yet have the means for safely achieving the same effects in patients, we determined the precise protein and gene targets for developing ways to do so in the future,” study lead author Se Hoon Choi said in an MGH news release. Choi is in the hospital’s genetics and aging research unit.

In mice, Choi’s team said exercise triggered the production of new neurons (neurogenesis) in the brain regions where memories are encoded.

The study’s senior author, Rudolph Tanzi, is director of the genetics and aging research unit at MGH. He said that the research team “showed that exercise is one of the best ways to turn on neurogenesis. And then, by figuring out the molecular and genetic events involved, we determined how to mimic the beneficial effects of exercise through gene therapy and pharmacological agents.”

Results of animal studies aren’t always replicated in people, but Tanzi is optimistic.

“We will next explore whether safely promoting neurogenesis in Alzheimer’s patients will help alleviate the symptoms of the disease, and whether doing so in currently healthy individuals earlier in life can help prevent symptoms later on,” Tanzi said.

The study was published Sept. 6 in the journal Science.

More information

The U.S. National Institute on Aging has more about Alzheimer’s disease.

© 2018 HealthDay. All rights reserved.

Posted: September 2018

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New Research Suggests Glaucoma May Be an Autoimmune Disease

FRIDAY, Aug. 10, 2018 — The eye disease glaucoma may be an autoimmune disorder, a new study suggests.

Glaucoma affects nearly 70 million people worldwide. It damages the retina and optic nerve and can lead to blindness.

In research with mice, scientists found that immune system T-cells cause the retinal damage that occurs in glaucoma, and that previous interactions with bacteria normally found in the body trigger the T-cell attacks on the retina.

“This opens a new approach to prevent and treat glaucoma,” senior co-author Jianzhu Chen said in a Massachusetts Institute of Technology news release. He is a professor of biology at MIT.

Most glaucoma treatments today aim to lower pressure in the eye, but the disease gets worse in many people even after pressure is normalized. Researchers found the same thing in mice, although research in animals doesn’t always produce the same results in humans.

“That led us to the thought that this pressure change must be triggering something progressive, and the first thing that came to mind is that it has to be an immune response,” senior co-author Dr. Dong Feng Chen said in the release.

She is an associate professor of ophthalmology at Harvard Medical School and the Schepens Eye Research Institute of Massachusetts Eye and Ear in Boston.

The discovery suggests blocking the autoimmune activity could offer a new approach to treating glaucoma.

Further research will try to determine whether other parts of the immune system play a role in glaucoma, and whether autoimmunity is a factor in degenerative brain diseases, the researchers said.

“What we learn from the eye can be applied to the brain diseases, and may eventually help develop new methods of treatment and diagnosis,” Chen said.

The findings were published Aug. 10 in the journal Nature Communications.

More information

The U.S. National Eye Institute has more on glaucoma.

© 2018 HealthDay. All rights reserved.

Posted: August 2018

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Nicotine in E-Cigarettes Might Cause Cancers, Mouse Study Suggests

MONDAY, Jan. 29, 2018 — The nicotine in e-cigarettes seems to damage DNA in ways that may increase cancer risk, a new study in mice suggests.

The damage was seen both to DNA and its ability to repair itself, making cells more likely to mutate and develop into cancer, said lead researcher Moon-shong Tang, a professor of environmental medicine at New York University School of Medicine.

If confirmed in future studies, the finding could mean that e-cigarettes carry their own cancer risk through the nicotine they deliver, said Dr. Roy Herbst, chief of medical oncology at Yale Cancer Center.

“It’s the first evidence we have that nicotine can be carcinogenic in and of itself,” said Herbst, chair of the American Association for Cancer Research’s Tobacco and Cancer Subcommittee. “It’s certainly concerning, and certainly gives pause if one were to say e-cigarettes were safe and could be used by all people without consequences.”

However, not all animal research produces similar results in humans.

For their experiment, Tang and his colleagues exposed laboratory mice to e-cigarette vapor, which contains both nicotine and liquid solvents. They also exposed mice to the nicotine and the solvents separately.

The vapors were produced using 4.2 volts of electricity, at or below the level at which most commercial e-cigarettes function, Tang noted.

Prior studies have shown that e-liquid heated using higher levels of electricity could produce harmful chemicals. This research team wanted to investigate the risk posed to people using a typical e-cigarette.

“We found the solvent alone does not cause DNA damage,” Tang said. “Nicotine with e-cigarette solvent caused the same damage as nicotine alone.”

The researchers also exposed cultured human lung and bladder cells to nicotine, and found the same effects — DNA damage and suppressed DNA repair.

The next step of the research is underway, in which mice are exposed to nicotine and e-cigarette vapor long-term to see if they actually develop cancer or heart disease, Tang added.

Tang could not say whether e-cigarettes are still safer than traditional cigarettes, which contain thousands of harmful chemicals produced by burning tobacco.

“We just cannot guess with the data we have,” Tang said.

One scientist not involved with the research pointed to what he considered a shortcoming in the study.

It would have been nice if this study had taken the extra step of exposing mice to tobacco smoke as well, and then compared them head-to-head against the mice that inhaled e-cigarette vapor, said Anthony Alberg. He’s chair of epidemiology at the University of South Carolina’s Arnold School of Public Health.

“Here we’ve got e-cigarettes versus nothing at all, and that’s where it gets tricky to talk about the broader public health impact,” said Alberg. He also chairs the American Society of Clinical Oncology’s Cancer Prevention Committee.

“It would seem clear based on the number of toxic substances and the lack of combustion that e-cigarettes should be lower risk than tobacco cigarettes. The magnitude of how much a reduction in risk that would be is unknown,” he said.

Nicotine’s potentially cancer-causing effects likely have been overlooked because prior to e-cigarettes the only folks who ever used nicotine on its own were former smokers trying to beat their habit, Alberg said.

“The way you would conduct such research would be to compare nicotine replacement therapy users versus cigarette smokers, and those people are the ones who have a heavy history of smoking already,” Alberg said.

If Tang’s findings are verified, they would add more impetus for public policies to require lower nicotine levels in tobacco cigarettes and to increase regulation of e-cigarettes, said Herbst, who was not involved with the current research.

The study was published Jan. 29 in the Proceedings of the National Academy of Sciences.

Earlier this month, a report from the National Academies of Sciences, Engineering and Medicine that reviewed the findings of 800 studies found e-cigarettes may lead young people to smoke conventional tobacco, but they also appear to help adults quit smoking.

Still, the report’s authors acknowledged that little is known about the long-term health effects of e-cigarettes.

More information

For more on nicotine, visit the U.S. National Institute on Drug Abuse.

© 2018 HealthDay. All rights reserved.

Posted: January 2018

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Diet Study Suggests It’s Carbs, Not Fats, That Are Bad for You

TUESDAY, Aug. 29, 2017 — A large, 18-country study may turn current nutritional thinking on its head.

The new research suggests that it’s not the fat in your diet that’s raising your risk of premature death, it’s too many carbohydrates — especially the refined, processed kinds of carbs — that may be the real killer.

The research also found that eating fruits, vegetables and legumes can lower your risk of dying prematurely. But three or four servings a day seemed to be plenty. Any additional servings didn’t appear to provide more benefit.

What does all this mean to you? Well, a cheeseburger may be OK to eat, and adding lettuce and tomato to the burger is still good for you, but an excess of white flour burger buns may boost your risk of dying early.

People with a high fat intake — about 35 percent of their daily diet — had a 23 percent lower risk of early death and 18 percent lower risk of stroke compared to people who ate less fat, said lead author Mahshid Dehghan. She’s an investigator with the Population Health Research Institute at McMaster University in Ontario.

The researchers also noted that a very low intake of saturated fats (below 3 percent of daily diet) was associated with a higher risk of death in the study, compared to diets containing up to 13 percent daily.

At the same time, high-carb diets — containing an average 77 percent carbohydrates — were associated with a 28 percent increased risk of death versus low-carb diets, Dehghan said.

“The study showed that contrary to popular belief, increased consumption of dietary fats is associated with a lower risk of death,” Dehghan said.

“We found no evidence that below 10 percent of energy by saturated fat is beneficial, and going below 7 percent may even be harmful. Moderate amounts, particularly when accompanied with lower carbohydrate intake, are probably optimal,” she said.

These results suggest that leading health organizations might need to reconsider their dietary guidelines, Dehghan noted.

But not everyone is ready to throw out current dietary guidelines.

Dr. Christopher Ramsden is a clinical investigator with the U.S. National Institute on Aging. “There’s a lot more information that’s needed. They did a great job and they’re going to have a lot more coming out of it for years to come, but it’s hard to get it down to recommendations regarding food at this point,” he said.

“It really highlights the need for well-designed randomized controlled trials to answer some of these questions,” Ramsden added.

The researchers noted that their study did not look at the specific types of food from which nutrients were derived. And, that, said Bethany O’Dea, constitutes a “major flaw from a nutrition standpoint.” O’Dea is a cardiothoracic dietitian with Lenox Hill Hospital in New York City.

“For example, eating a healthy carb like an apple is more nutrient dense and better for you than eating a bag of processed potato chips,” O’Dea said.

“Furthermore, the study did not take trans fats into account, which hold heavy evidence of being unhealthy and contributing to cardiovascular disease,” she pointed out.

Current global guidelines recommend that 50 percent to 65 percent of a person’s daily calories come from carbohydrates, and less than 10 percent from saturated fats, the researchers said.

Dehghan suggested that “the best diets will include a balance of carbohydrates and fats, approximately 50 to 55 percent carbohydrates and around 35 percent total fat, including both saturated and unsaturated fats.”

All foods contain three major macronutrients essential for life — fat, carbohydrate and protein. The optimum amounts a person should eat has been the focus of debate for decades, with the pendulum swinging from low-fat to low-carb diets over time.

For this study, Dehghan and her colleagues tracked the diet and health of more than 135,000 people, aged 35 to 70, from 18 countries around the world, to gain a global perspective on the health effects of diet.

Participants provided detailed information on their social and economic status, lifestyle, medical history and current health. They also completed a questionnaire on their regular diet, which researchers used to calculate their average daily calories from fats, carbohydrates and proteins.

The research team then tracked the participants’ health for about seven years on average, with follow-up visits at least every three years.

The investigators found that high-carbohydrate diets are common, with more than half of the people deriving 70 percent of their daily calories from carbs.

High-carbohydrate diets have been linked with increases in both blood cholesterol and in the chemical building blocks of cholesterol, Dehghan said.

While the experts continue debating what’s the best diet, what should you be eating?

O’Dea said, “Your diet should consist of healthy carbs, lean protein, and plenty of fruits and vegetables. Remember to avoid processed snacks that contain trans and saturated fats, and opt for a healthy carb source.”

The study was scheduled to be presented Tuesday at the European Society of Cardiology annual meeting in Barcelona, Spain. The research was being published online as two studies on Aug. 29 in The Lancet.

More information

For more on a healthy diet, visit the U.S. Department of Agriculture.

Posted: August 2017

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Undiagnosed Heart Condition ‘AFib’ May Be Common, Study Suggests

SATURDAY, Aug. 26, 2017 — Many people at risk for atrial fibrillation probably do have the irregular heart rhythm but have not been diagnosed, a new study reports.

Nearly 1 out of 3 patients in the study had undetected atrial fibrillation that was caught only through the use of long-term cardiac monitor implants, researchers say.

Based on these results, it’s likely there’s probably a lot more undetected atrial fibrillation among seniors, said lead researcher Dr. James Reiffel. He’s a cardiologist and professor at the Columbia University College of Physicians and Surgeons in New York City.

“Continuous monitoring of such patients, as we did, can detect otherwise unsuspected AF, which can lead to treatment before complications arise,” Reiffel said. “When monitored for 18 months, almost one in three patients had AF detected, as did 40 percent by 30 months.”

Atrial fibrillation involves irregular quivering in the upper chambers of the heart, which are called the atria. AFib doubles the risk of heart-related death and increases your risk of stroke fivefold, according to the American Heart Association.

Blood tends to pool and clot in the atria during this irregular heart rhythm, which can lead to a stroke if a clot breaks off and lodges in an artery feeding the brain.

Patients with AFib are often prescribed blood thinners to reduce their stroke risk.

To see whether long-term monitoring can help detect the heart rhythm irregularity, Reiffel and his colleagues recruited 385 people who did not seem to have atrial fibrillation but did have health problems associated with the heart condition.

About 90 percent of the participants had symptoms related to atrial fibrillation, such as fatigue, breathing problems or heart palpitations. Many were 75 or older with other risks, such as heart failure, high blood pressure, diabetes, prior stroke, coronary artery disease, failing kidneys, sleep apnea, or chronic obstructive pulmonary disease (COPD).

All were fitted with an insertable cardiac monitor, a tiny device implanted just beneath the skin of the chest. The monitor — about the size of a AAA battery –continuously records heart activity, and regularly uploads its data for review by cardiologists.

“These are so small I don’t like to use the word implanted,” said Dr. Kenneth Ellenbogen, chair of cardiology for the Virginia Commonwealth University’s Pauley Heart Center. “They’re actually injected under the skin.”

The monitors were provided by device maker Medtronic, which sponsored this study.

Patients underwent monitoring for 18 to 30 months. Researchers found the odds of detecting undiagnosed AFib increased the longer people carried around the implants. By 30 months, it had been detected in two out of five patients.

Doctors prescribed blood thinners to 72 patients because of episodes of atrial fibrillation that lasted six or more minutes, which increase stroke risk, researchers noted.

However, only 13 patients had AFib episodes that lasted more than 24 hours. That duration “appears to be associated with a substantial increase in the absolute risk of stroke,” Dr. Jeff Healey wrote in an editorial. He’s a professor of cardiology at McMaster University in Ontario. Both study and editorial were published Aug. 26 in JAMA Cardiology.

Dr. Samuel Asirvatham is a professor of in the division of cardiovascular diseases at the Mayo Clinic in Rochester, Minn.

“Reiffel and colleagues have now reported important information that clearly demonstrates a very high incidence of atrial fibrillation in this high-risk population, and the incidence and prevalence of atrial fibrillation will likely be even higher with longer-term monitoring,” he said.

Asirvatham added the findings suggest a need for a large study to determine if all patients with stroke of unknown origin should receive blood thinners in the way they would if atrial fibrillation had been recognized.

Reiffel said cardiologists should give strong consideration to using these cardiac monitors, which appear to be much more effective than other forms of intermittent heart monitoring.

“Implantation and follow-up with monitoring devices such as the one we are now using has an incredibly low complication rate and high patient acceptance,” Reiffel said.

However, Ellenbogen noted that no studies have yet been conducted to determine what the best course of treatment might be for these patients.

“It would be premature to implant these in patients who have never had a stroke or who never had symptoms of AFib to look for AFib, because we don’t know what to do if we find it,” said Ellenbogen, a heart association expert. “The bottom line is we have to be doing studies to figure out what to do with these patients.”

The Medtronic devices used for the study cost less than $ 6,000, comparable to other implantable cardiac monitors, company officials said.

The study was also presented at the European Society of Cardiology’s annual meeting, in Barcelona, Spain.

More information

For more on implantable cardiac monitors, visit the University of Iowa.

Posted: August 2017

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FDA Suggests Limits on Lead in Cosmetics

FRIDAY, Dec. 23, 2016 (HealthDay News) — The U.S. Food and Drug Administration has suggested setting a limit on how much lead can be in cosmetics ranging from lipstick and eye shadow to blush and shampoo.

Although it does not have the authority to enforce such a limit, the FDA recommended in a draft guidance issued Thursday that cosmetics not contain more than 10 parts per million (ppm) of lead.

Lead occurs naturally in the environment, but high levels can harm almost every organ in the body. Children and pregnant women are particularly susceptible to its harmful health effects, according to the U.S. Environmental Protection Agency.

In crafting its guidance on lead limits in cosmetics, the FDA tested hundreds of products for lead.

“Although most cosmetics on the market in the United States generally already contain less than 10 ppm of lead, a small number contained higher amounts,” the FDA said.

Cosmetics or the ingredients in them, with the exception of color additives, do not need FDA approval before being sold on the market. And cosmetic companies don’t have to share safety data with the agency, according to the FDA.

“However, FDA can pursue enforcement action against products on the market that are not in compliance,” the agency added.

There will be a 30-day comment period before the guidance becomes final.

WebMD News from HealthDay

Sources

SOURCE: U.S. Food and Drug Adminstration, draft guidance, Dec. 22, 2016

Copyright © 2013-2016 HealthDay. All rights reserved.

WebMD Health

Craving Salt? Your Genes May Be the Reason, Study Suggests

SUNDAY, Nov. 13, 2016 — Some people carry a genetically driven “salt tooth” that could affect how heavily they season their food, potentially endangering their heart, a new study suggests.

Genetic variations cause some people to be more keenly aware of bitter flavors, said lead researcher Jennifer Smith, a doctoral student at the University of Kentucky College of Nursing.

These people are about twice as likely to exceed the daily limit of salt recommended by heart health specialists, according to study findings presented Sunday at the American Heart Association annual meeting in New Orleans.

The research centers on a gene called TAS2R38. Variations of this gene have been shown to enhance a person’s perception of bitter flavors.

“We were looking at a gene that codes for taste receptors,” Smith said. “People with one genotype will taste bitter more keenly than people who have the other genotype.”

Previous studies have shown that people carrying those genetic variations of TAS2R38 are more likely to avoid heart-healthy foods that can taste bitter, like broccoli or dark leafy greens, the researchers said.

Smith decided to test whether this gene would lead people to use more salt in their daily diet. Eating too much salt can lead to high blood pressure, which increases a person’s risk for heart attack and stroke.

Her team analyzed the diets of 407 people in rural Kentucky who had two or more heart disease risk factors. The researchers also did genetic testing to see whether participants carried the gene variation that enhances bitter taste.

“We found people who tasted bitter more keenly were in fact 1.9 times more likely to be non-adherent to the sodium guidelines,” she said.

U.S dietary guidelines recommend no more than 2.3 grams of salt per day.

The researchers have different theories about why people with these genetic variants seem to eat more salt.

It could be that they taste salt more intensely and enjoy it more, causing them to prefer heavily salted foods, Smith said.

Or it could be that people use salt to mask the bitter taste of some foods, she added.

“There are alternatives you can use to flavor foods, and we need to begin investigating those,” Smith said. “We can start to look if there are different types of spices or seasonings we can add instead of salt to offset the bitter taste. For example, with bitter vegetables, you can use a little bit of sugar rather than salt to offset the bitter.”

The findings are fascinating but “very preliminary,” said Dr. Lawrence Appel. He’s a professor of medicine and director of the Welch Center for Prevention, Epidemiology and Clinical Research at Johns Hopkins Medical Institutions in Baltimore.

“Because bitterness is amplified, these people may need some other flavor alternative to mitigate the gene-induced bitterness,” said Appel, a spokesman for the American Heart Association. “But you always need replication [studies], because there are always a lot of chance findings in genetic research. It’s definitely what I like to call preliminary science.”

Another study presented at the AHA meeting found that most U.S. adults consume too much salt, based on 24-hour urinary tests.

Overall, adults excreted more than 3.6 grams of sodium in their urine on a given day, far higher than the 2.3-gram dietary limit, researchers found. Men excreted about 4.2 grams a day on average; women, 3.1 grams, according to the study.

“We still consume vastly more sodium than we need to, and it does adversely affect blood pressure. Especially as we age, it becomes increasingly important to cut back,” Appel said. “Whether or not you have this gene, sodium reduction is good for you.”

Research presented at medical meetings is typically considered preliminary, because it has not had the same scrutiny as studies in peer-reviewed journals.

More information

For more on sodium and heart health, visit the American Heart Association.

Posted: November 2016

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Legalizing Marijuana Reduces DEA Eradication Costs, Data Suggests

Newly released data from the U.S. Drug Enforcement Administration (DEA) appears to show that legalizing marijuana does what advocates have long promised: It reduces the unregulated cannabis market and cuts law enforcement costs. The DEA allocated exactly zero dollars and zero cents for marijuana eradication in Colorado for Fiscal Year 2016, which is down from the agency’s $ 80,000 […]
Marijuana

Mouse Study Suggests Brain Circuit Involved in Sleep-Wake Cycle

MONDAY Sept. 5, 2016, 2016 — Scientists say they’ve identified a brain circuit in mice that plays a key role in the sleep-wake cycle.

The circuit is a key component of the brain’s reward system, according to researchers from Stanford University in Palo Alto, Calif.

The investigators saw that as the mice ramped down for sleep, activity in this brain circuit decreased. The researchers also saw that activating this circuit could rouse the animals from sleep.

These findings could potentially lead to new treatments for sleep problems, the researchers said.

“This has potential huge clinical relevance,” senior author Luis de Lecea, professor of psychiatry and behavioral sciences, said in a university news release.

“Insomnia, a multibillion-dollar market for pharmaceutical companies, has traditionally been treated with drugs such as benzodiazepines that nonspecifically shut down the entire brain,” he explained.

“Now we see the possibility of developing therapies that, by narrowly targeting this newly identified circuit, could induce much higher-quality sleep,” de Lecea said.

Research on animals often fails to produce the same results in humans, though the researchers said the brain circuitry involving the reward system is similar in all vertebrates.

The study was published online Sept. 5 in the journal Nature Neuroscience.

Between 25 percent and 30 percent of Americans have sleep problems, according to the U.S. National Institutes of Health.

Also, sleep-wake cycle disturbances are common among people with conditions such as schizophrenia and bipolar disorder, the researchers said.

More information

The U.S. National Institute of Neurological Disorders and Stroke has more on sleep.

Posted: September 2016

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