Medical News Today, 8/14/08 (http://www.medicalnewstoday.com/articles/118245.php)

Twenty-two percent of respondents to a survey have reduced the number of times they visit their physician because of the current economic climate in the U.S., according to the National Association of Insurance Commissioners, the San Francisco Chronicle reports. The poll of 686 consumers, released on Tuesday and conducted in July, also found that 11% of respondents said they had reduced the amount of prescription drugs they take or the dosage of those medications to make them last longer. The survey found that 85% of respondents had not made any change to their health insurance policies, while 2% had canceled their coverage entirely.

Over the past several years, U.S. residents have been paying more of their health care costs, primarily because employers are requiring employees to contribute a greater share of health insurance premiums and copayments, or they are changing or reducing benefits, the Chronicle reports. Michael Potter, a family physician and head of the San Francisco chapter of the California Academy of Family Physicians, said, “There’s a lot of evidence that the more patients are required to pay more for their care, the more that they make economic decisions about what to get or what not,” adding, “While some of that may be perfectly reasonable and acceptable, what I worry about is people not getting care that is really essential for their health.”

Chris Ohman, CEO of the California Association of Health Plans, said, “We know from past economic downturns that employers and individuals tighten their budgets as a whole, but they certainly tighten their health budgets,” adding that although health care costs have increased at rates often double or triple the rate of inflation for years, the squeeze feels more significant as the economy worsens.

The survey did not examine details behind consumers’ decisions, and it does not track any changes in consumer behavior because NAIC has not conducted similar surveys in the past (Colliver, San Francisco Chronicle, 8/13).

Medical News Today, 8/14/08 (http://www.medicalnewstoday.com/articles/118204.php)

“Flesh-eating” or “Strep” bacteria are able to survive and spread in the body by degrading a key immune defense molecule, according to researchers at the University of California, San Diego, School of Medicine and Skaggs School of Pharmacy and Pharmaceutical Sciences. The finding, which could aid in development of new treatments for serious infections in human patients, will be reported in the August 14 issue of the journal Cell Host & Microbe.

Led by senior author Victor Nizet, M.D., UC San Diego professor of pediatrics and pharmacy and an infectious diseases physician at Rady Children’s Hospital, San Diego, the researchers showed that a protease known as SpyCEP (Strep. pyogenes cell envelope protease) produced in large amounts by the most dangerous strains of Strep inactivates an immune system molecule that controls the body’s white blood cells ability to fight bacteria. Without signals from this molecule, white blood cells become slower and weaker, and infections can spread out of control.

“These findings may suggest a new approach to treating serious Strep infections by supporting our body’s natural defense system,” said Nizet.

The research focuses on the major human pathogen group A Streptococcus. Among the most important of all bacterial pathogens, Strep is responsible for a wide range of diseases from simple strep throat to life-threatening conditions such as necrotizing fasciitis (”flesh-eating disease”) and toxic shock syndrome.

The UC San Diego investigators examined the interaction of Strep bacteria with neutrophils, specialized white blood cells that play a front-line role in humans’ immune defense against pathogenic microbes. Previous research had shown that Strep bacteria change their pattern of gene expression dramatically during the course of infection, including a massive increase in production of SpyCEP, which has the unique ability to inactivate an immune defense molecule known as interleukin-8 (IL-8). IL-8 is produced at sites of infection and serves as a signal for neutrophils to migrate out of the bloodstream and into the tissues to clear the infection.

The UC San Diego team used a molecular genetic approach for their studies, knocking out the gene encoding the SpyCEP from a pathogenic strep strain that was originally isolated from a patient suffering from necrotizing fasciitis.

“Lacking this single protease, the mutant Strep strain was easily killed by human neutrophils,” said lead author Annelies Zinkernagel, M.D., a postgraduate researcher in the UCSD department of pediatrics. “In addition, the mutant Strep bacteria no longer produced a spreading infection when injected into the skin of experimental mice.”

The critical role of the Strep protease was confirmed by cloning the corresponding gene into a normally non-pathogenic bacterial strain, which then became resistant to neutrophil killing. More detailed analysis demonstrated that by inactivating IL-8, SpyCEP blocked neutrophil migration across blood vessels as well as neutrophil production of “extracellular traps” used to ensnare bacteria.

The immune-blocking effects of SpyCEP produced by Strep were strong enough to allow other bacterial species to survive at the site of infection, which may contribute to mixed infections that require complex antibiotic regimens. The researchers also showed that a pathogen of fish, Streptococcus iniae, produces its own version of SpyCEP that may contribute to recent reports of severe skin infections caused by this bacterium in fish handlers.

Nizet explained that the researchers’ findings could lead to novel treatments for Strep-related diseases. “In addition to attempting to kill the bacteria directly with standard antibiotics, new treatment strategies could be targeted to inhibit the Strep protease and thereby disarm the pathogen, making it susceptible to clearance by our normal immune defenses,” he said.

Medical News Today, 8/14/08 (http://www.medicalnewstoday.com/articles/118175.php): 

With more than half of all U.S. households affected by snoring, there is new hope for the enormous number of sleep-deprived snorers and their loved ones. Coming from Australia in the unexpected form of a sterling silver ring called the “Therapeutic Snore Ring.”

As an alternative to surgery and other invasive, uncomfortable or burdensome treatments, the Snore Ring has been proven to work for the vast majority who try it in Australia – and is making its long-awaited formal US launch this month.

The human body requires about 7-8 hours of undisturbed sleep each night to allow optimal alertness and the physical and mental regeneration required for general good health. Those awakened continually by snoring can suffer from unnatural drowsiness, irritability, lack of focus or attentiveness, low libido, dry or sore throat, and a number of other maladies.

The Snore Ring requires no medicines or sprays, no surgery, and no large uncomfortable devices placed into the mouth. It’s a sterling silver ring carefully designed to apply firm but gentle pressure to a specific area of the little finger which, through principles of acupressure, create a relaxed, calming effect to areas of the nose and throat.

The Snore Ring is based on the proven ancient technique of Chinese acupressure, an ancient practice that has helped people for over 3500 years. By applying pressure to the pressure point located on the left hand, it clears a flow of energy, aiding in the prevention of snoring.

Since the first development of the Snore Ring in Australia, companies around the world have attempted to copy the principle and concept but have only received mixed results. Now, the original is available in the United States for direct purchase via the website http://www.thesnorring.com.

Intro:  Do you know how many Americans have a hearing problem?  32 million.  Do you know how many of them use a hearing aid?  25%.  Meanwhile, over-the-counter hearing aids may not only not help, they may also worsen whatever hearing you have left.

Medical News Today, 8/14/08 (http://www.medicalnewstoday.com/articles/118220.php):  “…’These low-cost amplifying devices can look tempting to individuals with hearing impairment because of the significant cost differences,” Punch said. “But our research found that the low-cost aids generally don’t meet the fitting requirements to help a hearing-impaired person and could potentially damage a person’s hearing.’

The research is important to consumers, Callaway said. ‘Aside from being of extremely poor quality, very low-cost hearing aids – those under $100 – have the potential to damage your hearing because they send very loud sounds into the ear. The study’s mid-range hearing aids ($100-500) were of higher quality and were not considered a safety hazard….’ “ 

Medical News Today, 8/14/08 (http://www.medicalnewstoday.com/articles/118229.php):  In the span of 12 dramatic hours, Hadassah doctors raced to war-torn Georgia, rescued a critically injured Israeli reporter and flew him back to Hadassah Medical Center’s intensive care unit at Ein Kerem, Jerusalem.

While standing in the main city square in the town of Gori, Georgia, journalists from around the world were caught in heavy fire. A Dutch cameraman was killed and Zadok Yehezkeli, a senior reporter from Yedioth Aharonoth, Israel’s largest circulation daily newspaper, was severely wounded. Lying in the street and unable to move, Yehezkeli was driven by colleagues to a hospital in Tibilsi, some 40 miles away. Yehezkeli was given 16 units of blood and underwent two surgeries.

Yehezkeli’s newspaper decided to send Israeli doctors to Georgia to assess their reporter’s condition, and they turned to Hadassah for help.

At 9:00 pm Israeli time on Tuesday, August 12, Professor Avi Rivkind, Head of Hadassah’s renowned Trauma Unit, along with Dr. Micha Shamir, a senior physician from the Department of Anesthesiology and Critical Care, and a paramedic from Magen David Adom flew to Tibilsi. They took basic equipment and medication.

The doctors and paramedic arrived in Tibilsi about midnight, shortly after Yehezkeli’s surgery. They found the reporter fully conscious. They introduced themselves to him and he nodded in recognition. Without delay they anesthetized him and performed fluid resuscitation, assisted by the local Georgian hospital team. Prof. Rivkind decided that the best thing for Yehezkeli was to fly him to Israel for critical care.

Dozens of reporters, photographers and TV camera crews were waiting at Hadassah for the arrival of the ambulance from Ben Gurion Airport. At 9:00 am Wednesday morning, August 13, the patient and his rescuers arrived at Ein Kerem, where Yehezkeli was immediately admitted to the General Intensive Care Unit. He remains in the ICU, ventilated and anesthetized, in serious but stable condition.

Israelis and Georgian Jews also Rescued

While Hadassah physicians were treating Yehezkeli, the State of Israel arranged to evacuate hundreds of Israeli citizens and Georgian Jews from the battle zone; they provided three special flights from Tibilsi to Israel. All have arrived safely.

Medical News Today, 8/15/08 (http://www.medicalnewstoday.com/articles/118322.php)

West Nile virus is present in almost every corner of our country and this is the peak season. A new analysis from the Centers for Disease Control and Prevention on U.S. West Nile virus cases in 2007 found that most (89%) of the 3,630 cases were reported during July, August and September. All but six states reported cases of WNV infections in humans last year. The CDC says the mosquito-borne disease is underreported and under-diagnosed and estimates that approximately 175,000 Americans may have been infected with West Nile last year. There are at least 44 confirmed cases of WNV across 15 states so far this year.

The CDC and state and local public health agencies nationwide recommend the use of EPA-registered insect repellents to help protect against West Nile virus. The most popular of these recommended repellents is DEET, which is used by at least one-third of Americans every year. Despite its popularity, or perhaps because if it, many myths persist about DEET.

Myth: No more than 10% DEET should be used on children. Fact: Federal regulators say that all concentrations can be used by people of all ages when label directions are followed. The American Academy of Pediatrics says products containing up to and including 30 percent DEET can be used on children two months of age and older. The AAP also says that products containing DEET are among the most effective repellents available and should be used when necessary to protect against bites from insects and ticks that may carry disease.

Myth: Some popular skin creams and “natural” repellent products are safer than DEET. Fact: “DEET has been shown to be an extremely safe and effective repellent,” said Lyle R. Petersen, M.D., director of the CDC’s division of vector-borne infectious diseases. University of Florida scientists Jonathan Day and Roxanne Rutledge wrote: “Natural is a word that is sometimes used to promote ’safe’ products. Unfortunately, the wording can be misleading for the uninformed individual. ‘Natural’ products are usually essential oils distilled from plants… These oils can be toxic and irritating in high concentrations. ‘Natural’ repellents are not necessarily safe repellents.” DEET is one of the most widely tested consumer products of any type and has been used reliably by consumers for more than 50 years. According to a New England Journal of Medicine article (Fradin & Day, 2002), DEET “has a remarkable safety profile.”

Myth: Garlic, bananas and vitamin-B ward off mosquitoes. Fact: “There is no scientific evidence that eating garlic, vitamins, onions, or any other food will make a person repellent to mosquitoes,” said Day and Rutledge of the University of Florida. “It is also unlikely that B-1 skin patches will work either,” Day says. DEET is regarded as the “gold standard” against which other repellents are tested.

Myth: New devices are effective against mosquitoes. Fact: “There is no evidence that wearing devices that emit sound will repel mosquitoes,” say Day and Rutledge. “Bug zappers do not control mosquitoes and can reduce the populations of beneficial insects,” says Ken Gioeli, University of Florida natural resource agent. Some experts suggest that zappers actually attract mosquitoes to your property.

Myth: Dryer sheets and other home remedies repel bugs. Fact: “The truth is although many home remedies and oddball uses of everyday products do serve to repel mosquitoes somewhat, they don’t work very effectively for very long,” writes Barbara Mikkelson on the popular Web site, www.snopes.com.

Myth: DEET is smelly and oily. Fact: Fifty years of product development has yielded DEET-based products that are pleasant to use they have a pleasant “feel” on the skin and fresh fragrances. Some even go on as a dry formulation similar to spray deodorant that is powder-like.

Myth: Higher concentrations mean better protection. Fact: Higher concentrations of DEET mean longer protection, not better. A 5% product will provide about 90 minutes of protection and a 100 % product protects for about 10 hours. Protection time increases as the concentration increases. So, the longer you are outside, the higher the concentration you should use. However, protecting against ticks requires at least 20% DEET, and no other repellent works as well against ticks.

Most folks who are going outside for a backyard barbecue should choose a product that protects them for up to two hours, a repellent in the 10% range. It’s often fine to use a concentration below 30% for most outdoor activities. When you are exposed for long periods to hoards of mosquitoes, though, a 100% product is advisable.

Myth: I don’t need repellent unless I’m headed out into a wooded or waterfront location. Fact: Mosquitoes can be anywhere, even in a city, and many carry disease. Most people who have contracted WNV were bitten by mosquitoes lurking in their own yards. Cases of malaria have occurred in recent years in Washington, D.C. And other mosquito-borne diseases sometimes occur elsewhere in the United States.

Myth: DEET is an insecticide. Fact: DEET does not kill mosquitoes, as insecticides do. It repels them by confusing their ability to locate humans.

Myth: DEET causes seizures in children. Fact: Scientific reviews do not show a causal relationship between DEET and seizures (Murphy, et al, 1997; Bell, et al, 2002). This myth stems from a handful of isolated reports in both adults and children that cannot be definitively linked to DEET. Experts report that two percent of typical children have one or more seizures from unknown causes by age 10. A multi-year review of adverse events yielded a handful of neurological cases (given millions of product uses per year) that could not be tied to use of DEET-based repellents. These neurological adverse events were not more common in children than in other age groups and were not tied to concentration of DEET in the products.

Myth: Some popular skin creams and “natural” repellents work as well as DEET. Fact: Scientifically controlled studies show very few repellents are effective as DEET (Fradin & Day, 2002). The CDC urges consumers to pick only repellents with EPA registrations to assure appropriate efficacy. The most effective, according to the CDC, are DEET, picaridin, oil of lemon eucalyptus (recommended with limitations) and IR3535 (http://www.cdc.gov).

Medical News Today, 8/15/08 (http://www.medicalnewstoday.com/articles/118325.php)

Chemical Engineers in Switzerland have created a plastic film that’s up to 1000 times more effective at killing E. coli bacteria cells than conventional methods.

The team from the Swiss Federal Institute of Technology, Zurich have discovered that coating the film with a mix of silver and calcium phosphate nano-particles proves deadly to bacteria.

Wendelin Stark, a chemical engineer and leader of the project explained that it had been previously impossible to apply silver in a targeted and measured way. However, by using a film and applying the silver to the calcium phosphate, he believes the problem has been overcome: “Within 24 hours of the plastic film being applied to a surface, less than 1 bacterium out of 1 million bacteria will survive.”

Because bacteria rely on calcium for their metabolism, the 20-50 nanometer calcium phosphate particles are used by the micro-organisms as nutrition. When the bacteria consume the calcium phosphate, this releases thousands of small silver 1-2 nanometer particles. It’s these tiny silver particles that kill the bacteria and prevent germs from growing and spreading.

The polymer film only emits silver if bacteria are growing in the vicinity. This can be assessed by the quantity of calcium phosphate that is taken up by the bacterium. “It saves money and is much more efficient,” said Stark.

“It also reduces the environmental impact of the process and we have developed a method that is easy to apply and could bring great benefits to patients in hospitals, as well as the food industry.”

Silver has been used as an antiseptic and disinfectant for thousands of years. Wealthy households would commonly use silver tableware in the belief it could fend off germs, whilst poorer people would put silver coins into their milk jug.

Silver was also used in medical treatments before being replaced by antibiotics but nanotechnology has allowed the metal something of a medical renaissance. The project is now being up scaled by a Swiss Company.

Medical News Today, 8/15/08 (http://www.medicalnewstoday.com/articles/118409.php)

Scientists in the UK are hoping to develop a new vaccine using patients’ own blood cells to suppress the effects of rheumatoid arthritis; if successful the work will signal a major breakthrough in the treatment of the auto-immune disease.

Newcastle University’s Musculoskeletal Research Group is to carry out the research, which is being funded by a 216,000 pound grant from the medical research charity the Arthritis Research Campaign. Leading the team is John Isaacs, Professor of Clinical Rheumatology at the University; in a press statement he called the work, which is currently at a very early experimental stage, “hugely exciting”.

Isaacs and his team will be testing the effectiveness of the experimental vaccine in 8 volunteer patients being treated for rheumatoid arthritis at the Freeman Hospital. The pilot trial will roll out to a larger trial eventually, depending on how successful the vaccine proves to be.

Healthy immune systems protect the body by fighting infection, but in some people the immune system goes too far and starts to attack healthy tissue as well, causing it to become inflamed and painful, the characteristic symptoms of rheumatoid arthritis.

Scientists believe that what stops a healthy immune system from becoming overactive and causing rheumatoid arthritis is having the right balance between mature dendritic cells that activate the immune system and tolerogenic dendritic cells that suppress it.

Isaacs and his team hope to increase immune system suppression in people with rheumatoid arthritis by causing some of their white cells to transform into tolerogenic dendritic cells. This can be done, they think, by mixing the white blood cells with chemicals, steroids and vitamin D and then reinjecting them back into the patient’s knee like a vaccine.

Isaacs said that previous research suggested this would lead to a suppression of the auto-immune response. The team will then take cell biopsies two weeks after the vaccine has been injected to check whether the desired response has taken place, and whether it only affected the injected joint or whether it has spread via lymph nodes to other parts of the body.

In the UK alone there are over 350,000 people living with rheumatoid arthritis. There is no cure for this painful condition, although the Arthritis Research Campaign said that new drugs such as one it pioneered and developed itself, called anti-TNF therapy, have revolutionized its treatment in the last 10 years. But the downside of current treatments is that they suppress the immune system too far, leaving the patient open to the risk of infection.

The new vaccine being explored by Isaacs and his team would have the benefit of switching off unwanted immune responses, without suppressing that part of the immune system that protects against infection by outside agents.

Medical News Today, 8/15/08 (http://www.medicalnewstoday.com/articles/118319.php)

Ear infections are a painful rite of passage for many children. New research suggests the damage caused by chronic ear infections could be linked to people’s preference for fatty foods, which increases their risk of being overweight as they age. Scientists from around the country presented their findings on this unexpected connection at the American Psychological Association’s 116th Annual Convention here Thursday.

“Middle ear infection is a common childhood disease and obesity is a growing problem worldwide,” said Linda Bartoshuk, PhD, of the University of Florida College of Dentistry. “Any potential association between these two public health issues is of considerable interest.” Bartoshuk presented some preliminary findings that a strong link between localized taste damage from chronic middle ear infections, or otitis media, and an increased preference for high-fat foods.

A series of studies address this issue. In one, 6,584 people who attended a lecture series responded to a series of health questions that determined their history of middle ear infections and their body mass index (BMI). The participants, mostly academics, were between 16 and 92 years old. The findings showed that those with a moderate to severe history of otitis media were 62 percent more likely to be obese. Bartoshuk noted that the overall rate of obesity in this sample was less than the general population.

John Hayes, PhD, of Brown University and his collaborators at the University of Connecticut, found associations between otitis media exposure, taste, food choice and obesity. Among middle-aged women, those with taste functioning consistent with taste nerve damage preferred sweet and high fat foods more and were more likely to have larger waists. In another study, they found preschoolers with a severe history of ear infections ate fewer vegetables and more sweets and tended to be heavier. “This suggests that taste damage from ear infections may alter food choice and thus lead to obesity risk.” said Hayes.

Scientists are also looking at the possibility that damage to other taste nerves may also be associated with weight gain. Having the tonsils removed also appears to have an effect on whether a child will be overweight. Epidemiologist Howard Hoffman, MA, in a re-examination of the National Health Examination survey, which was conducted in the 1960s, found that 13,887 children ages 6 to 17 who had had their tonsils removed were at an increased risk for being overweight. The recent analysis showed younger children, ages 6 to 11, who had had tonsillectomies were 40 percent more likely to be overweight at the time of the survey.

Another finding was that teen girls who had had their tonsils removed were 30 percent more likely to be overweight. Hoffman said tonsillectomies were a common treatment for chronic ear infections during the period of this survey. “This data suggests that there are lingering effects of tonsillectomies on taste nerves and that can affect eating habits,” said Hoffman.

Epidemiologist Kathleen Daly, PhD, of the University of Minnesota-Twin Cities, also spoke about recent findings that showed ear infections treated with tubes can also lead to higher BMIs in toddlers. “Obesity has doubled over the past 20 years among preschool children. The more data we collect on what contributes to this major public health problem, the greater likelihood that we can help prevent it,” said Daly.