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Thursday, November 30, 2017
Man says he contracted eye-eating parasite on water ride
From: http://www.cbsnews.com/news/eye-eating-parasite-water-ride-kennywood-pennsylvania/
Infectious Diseases A-Z: Does your child have ear pain?
From: Mayo Clinic https://www.youtube.com/watch?v=mShYxkS0VQo
Mayo Clinic Minute: Hyperbaric solutions
From: Mayo Clinic https://www.youtube.com/watch?v=_WmVfpu-VmI
Mayo Clinic Minute: Advancing technology making Type 1 diabetes management easier
From: Mayo Clinic https://www.youtube.com/watch?v=3CAQ0ydXatM
Naloxone: An important tool, but not the solution to the opioid crisis
Every once in a while, I’ll have a terrible shift in the emergency department (ED) in which I have to pronounce yet another young person dead from an opioid overdose. I typically have to call their parents, who usually express sorrow but not surprise at the horrific news, as we all know how deadly opioid use disorder can be. But more frequently, the overdose patients I care for survive. Typically, they were found unresponsive by a friend or family member — 911 is called, the person is given the reversal agent naloxone, and is brought to the ED where my colleagues and I take over.
How naloxone works
Here’s the problemNaloxone is, in many respects, a wonder drug. It inhibits the opioid receptor in the brain (so it blocks the effect of an opioid) and, if there is an opioid already present, naloxone can knock it off a receptor. So, if a person overdoses on an opioid such as heroin, the naloxone pushes the heroin away and blocks the receptor but does not activate it, so the person can recover from their overdose. However, since its time of action is fairly short — shorter than the effect of many of the opioids people use — we watch patients for a few hours in the ED until we’re sure the opioids have completely cleared their system. Basically, we want to make sure that they don’t overdose again. After they sober, we offer to have them speak to a social worker (most refuse), or provide a list of detox facilities, and then they quietly leave the ED.
This status quo bothers me. In particular, I’m concerned that although naloxone is now readily available — carried by police, firefighters, basic life support ambulances, and even bystanders —overdose deaths continue to clim
b. I want to talk frankly with the patient who overdoses and survives, and specifically let them know their risk of dying should they not get treatment. I also want to make the case that better treatment options after an overdose are needed.
Our group at Brigham and Women’s Hospital therefore conducted a study, recently presented at the American College of Emergency Physicians national meeting in Washington, DC. In this study, we aimed to define how many patients who were treated with naloxone by an ambulance crew and initially survived were still alive after one year. Even though these patients are typically just observed in the ED hallway, allowed to sober while the ED staff is busy taking care of other patients with life-threatening emergencies like heart attacks, trauma, and strokes, our team hypothesized that the individual sobering in the hallway bed has perhaps one of the highest one-year mortality rates of anyone seen in the department.
Here’s how the study worked — and what we found
To perform the study, we took advantage of a special project in Massachusetts called the “Chapter 55” legislation which, for the first time, linked many previously separate state databases. We connected the Emergency Medical Services (EMS) database with the all-payer claims database and death records database for our study. In brief, we evaluated patients who received naloxone by EMS over a 30-month period. We then looked at death records one year beyond the first time they received naloxone.
During the study period, there were 12,192 naloxone administrations by EMS, which equals over 400 per month. Of these, 6.5% of patients died that same day and 9.3% died within one year. Excluding those who died the same day, about 10% of the patients who initially survived were dead at one year. Even more significant was that 51.4% of those patients died within one month. Also, apart from those who died the same day, about 40% of those who died within one year died outside of the hospital, highlighting the danger of overdosing before medical personnel can reach the victim and the need for bystander naloxone.
What does this mean about preventing deaths from opioid use disorder?
These results are disheartening: an opioid overdose patient who sobers in the hallway, is offered a detox list, and then is discharged has a one-in-10 chance of being dead within a year. And the highest risk is within one month. Naloxone is an important tool in fighting the opioid crisis, but is no solution. Patients who survive opioid overdose should be considered extremely high-risk. I believe that as a society, we should talk seriously about the resources that are available for people who overdose. We should counsel these patients and offer them buprenorphine (a medication used to help treat opioid use disorder) directly from the ED, provide recovery coaches, and create easily accessible treatment sites where they can go for ongoing care.
The post Naloxone: An important tool, but not the solution to the opioid crisis appeared first on Harvard Health Blog.
From: Scott Weiner, MD https://www.health.harvard.edu/blog/naloxone-tool-not-solution-opioid-crisis-2017113012800
Real-life healthy dinners (for real people with real busy lives)
At the end of a long workday, my husband and I will often trade texts figuring out who will pick up the kids at my mother’s, and who will deal with dinner. Thankfully, we’re equal partners in all responsibilities (except spider-killing, which is strictly Hubby’s job) and dietary preferences. We’re both health-conscious foodie types. We want good food that’s good for us.
An unvarnished look at family dinner
The kids, on the other hand… I’m not sure how this happened, but we somehow raised creatures with tastes vastly different from ours, and each other. We’ve never tried to cook an evening family meal that everyone would eat, because such a meal does not exist. Instead, we stock up on parent-approved kids’ faves that they can essentially get for themselves, or that can be prepared with minimal time and fuss, on a moment’s notice. And we try to all eat in the same room, at sort of the same time.
Do our kids eat as healthfully as we do, or we would like them to? No, but they eat healthfully enough, they’re developing well, and that’s fine. On a “good” night, their dinners may consist of: an apple with cinnamon/a yogurt/a bag of pea puffs for my five-year-old daughter, and scrambled eggs with cheddar/pita bread/a fresh peach for my seven-year-old son. On a “bad” night, it may be a warmed-up blueberry pancake with extra blueberries and extra butter for my daughter, and bacon (lots of bacon) for my son. This is entirely okay with us. As a matter of fact, it’s incredibly liberating to let go of the idea that we always need to eat exactly the same thing, and that it has to be perfectly healthy. After all, Hubby and I enjoy pizza and wings sometimes, too!
Here’s a practical approach to striking a balance
What matters is what we all eat most of the time, and most of the time, we’re eating a healthy combo of fruits and veggies (we eat mostly fruits and veggies, all week), lean protein, and healthy fats.
So, dinner.
Hubby and I rely heavily on frozen foods. Not pre-prepared, store-bought frozen meals, but rather frozen veggies galore, veggie burgers, and tofu “chik’n.” The pantry is stocked with quick-cooking quinoa and brown rice, canned and bottled accompaniments for different-themed meals (like Kalamata olives, sundried tomatoes, and hearts of palm for a Greek salad; sliced water chestnuts and baby corn for a stir-fry; salsa for a southwestern meal). We always keep various nuts and seeds on hand (cashews, almonds, pine nuts, pepitas, sesame and sunflower seeds, for example), as these can be added to a salad or stir-fry for extra healthy fiber/protein/fat. We make sure we’re always stocked up on condiments like sesame oil, soy sauce, ground ginger and cilantro, olive oil, various vinegars, broths, and wines for cooking. In the fridge, there’s almost always romaine lettuce, onions, peppers, lemons, limes, and cherry tomatoes (all of which last awhile and can be used in many types of recipes). And of course, tons and tons of fruit, yogurts, and cheeses of all kinds.
Thus prepared, we always have ingredients for our go-to, quick and easy dinner repertoire.
Here are some basic healthy dinners we really do eat on a regular basis
So-Quick Southwestern Salad
- Two or three black-bean veggie burgers (there are several brands, usually in the frozen foods aisle)
- A heart or two of romaine lettuce
- Tomatoes (a bunch of cherry tomatoes, or a regular tomato or two)
- A lemon and/or a lime
- Salt/pepper to taste
- Olive oil
- Pepitas (toasted, or not), a good handful or two
How we do it: Get home from work, drop various and sundry backpacks and bags, ask kids to feed cats.
- Grab veggie burgers from freezer and throw in toaster oven to bake or broil.
- Wash lettuce and tomatoes, shred/cut, and throw in a salad bowl.
- Juice lemon/lime over the mix.
- Then sprinkle olive oil, salt and pepper, and pepitas over, and toss.
- Tell partner to set table and get drinks (water, wine, whatever).
- Help the kids get their dinners together and move salad bowl, kids, and all food to table.
- Pull burgers out of toaster oven (don’t forget to turn it off, as we have) and either serve mixed in, alongside, or on top of salad.
You can obviously vary this as much as you like. You can top with some salsa, shredded cheddar, and plain Greek yogurt if you want, too. The point is, this meal is fast (we can get this prepared and on the table in under 10 minutes) and it hits all the high points: vegetables, healthy protein, healthy fats, no processed carbs.
Here’s another idea to try:
Really Fast Asian Stir-Fry
- A bag of soy-based chik’n (many forms and brands, usually found in the frozen foods aisle)
- A bag or two of frozen veggies of your choice
- A can or two of Asian-style veggies like sliced water chestnuts
- Sesame oil
- Soy sauce
- Ground ginger if you have it
- Cashews or sesame seeds
Directions: See above about getting home and getting kids together.
- Pull out a wok or a large frying pan, set on stove, and turn on heat. Let it heat while you get other ingredients out.
- When hot, add about a tablespoon or two of sesame oil, then soy chik’n.
- Cook and stir until hot and browned, then dump your veggies right on top, soy sauce (a teaspoon or two), ginger (a teaspoon or so), stir it all up, and cover.
- Let it heat up for a few minutes, stirring occasionally.
- When hot, throw in cashews or sesame seeds (a handful or so, toasted or not), and serve.
Again, you can vary this to suit your taste. You can always use fresh veggies. You can add spicy sriracha sauce or teriyaki sauce. If you like rice with your stir-fry, there is microwave brown rice that is very fast. (Pro tip: we will often simply reheat brown rice that we’ve made earlier and frozen.) The point is, again, that this is a recipe that’s fast as well as healthful. Make extra and have it the next night, or take it to work for lunch!
Looking for a healthy breakfast recipe? Check out my other blog post.
The post Real-life healthy dinners (for real people with real busy lives) appeared first on Harvard Health Blog.
From: Monique Tello, MD, MPH https://www.health.harvard.edu/blog/real-healthy-dinners-busy-people-2017112912794
Infectious Diseases A-Z: Does your child have ear pain?
From: Mayo Clinic https://www.youtube.com/watch?v=mShYxkS0VQo
Mayo Clinic Minute: Hyperbaric solutions
From: Mayo Clinic https://www.youtube.com/watch?v=_WmVfpu-VmI
Tips for surviving this cold and flu season
From: http://www.cbsnews.com/news/cold-and-flu-medicine-risks-natural-remedies-that-work/
Newborns in Pain Might Not Show It
Newborns display a stronger brain response to pain when they're under stress, but it isn't reflected in their behavior, British researchers found.
From: https://www.webmd.com/children/news/20171130/newborns-in-pain-might-not-show-it?src=RSS_PUBLIC
Another Opioid Scourge: Dangerous Infections
ERs are seeing an increasing number of patients seeking care for severe infections resulting from injected use of heroin, fentanyl, oxycodone and the like, new research shows.
From: https://www.webmd.com/mental-health/addiction/news/20171130/another-opioid-scourge-dangerous-infections?src=RSS_PUBLIC
Changes to School Lunch Rules Slammed by Experts
The U.S. Agriculture Department announced the proposed new rule on Wednesday and said it would be introduced during the 2018-19 school year.
From: https://www.webmd.com/children/news/20171130/changes-to-school-lunch-rules-slammed-by-experts?src=RSS_PUBLIC
Dentist stresses prescriber education, shares personal story during Senate opioids hearing
From: By Jennifer Garvin
http://www.ada.org/en/publications/ada-news/2017-archive/november/dentist-stresses-importance-of-safe-prescribing-shares-personal-story-during-senate-opioids-hearing
Science Says Dogs Are Smarter Than Cats
Dogs are smarter than cats, according to a new study that may settle a debate that's long had the fur flying between dog and cat lovers.
From: https://pets.webmd.com/news/20171130/science-says-dogs-are-smarter-than-cats?src=RSS_PUBLIC
More than half of U.S. kids could be obese by age 35
From: http://www.cbsnews.com/news/more-than-half-of-us-children-could-be-obese-by-age-65/
Do Teens' Brains Show 'Smartphone Addiction'?
Teens fixated on their smartphones experience changes to their brain chemistry that mirror those prompted by addiction, a new study suggests.
From: https://www.webmd.com/children/news/20171130/do-teens-brains-show-smartphone-addiction?src=RSS_PUBLIC
What You Don't Know About Drug Interactions Could Hurt You
Many older Americans take multiple medications -- but only about one-third ever discuss possible interactions between drugs, a new poll finds.
From: https://www.webmd.com/healthy-aging/news/20171129/too-few-seniors-know-risks-of-multiple-medications?src=RSS_PUBLIC
U.S. troops get freeze-dried plasma for use on the battlefield
From: http://www.cbsnews.com/news/u-s-troops-get-freeze-dried-blood-plasma-for-use-on-the-battlefield/
Drug studies offer hope for migraine sufferers
From: http://www.cbsnews.com/news/migraine-headaches-long-acting-drugs-erenumab-fremanezumab/
Naloxone: An important tool, but not the solution to the opioid crisis
Every once in a while, I’ll have a terrible shift in the emergency department (ED) in which I have to pronounce yet another young person dead from an opioid overdose. I typically have to call their parents, who usually express sorrow but not surprise at the horrific news, as we all know how deadly opioid use disorder can be. But more frequently, the overdose patients I care for survive. Typically, they were found unresponsive by a friend or family member — 911 is called, the person is given the reversal agent naloxone, and is brought to the ED where my colleagues and I take over.
How naloxone works
Naloxone is, in many respects, a wonder drug. It inhibits the opioid receptor in the brain (so it blocks the effect of an opioid) and, if there is an opioid already present, naloxone can knock it off a receptor. So, if a person overdoses on an opioid such as heroin, the naloxone pushes the heroin away and blocks the receptor but does not activate it, so the person can recover from their overdose. However, since its time of action is fairly short — shorter than the effect of many of the opioids people use — we watch patients for a few hours in the ED until we’re sure the opioids have completely cleared their system. Basically, we want to make sure that they don’t overdose again. After they sober, we offer to have them speak to a social worker (most refuse), or provide a list of detox facilities, and then they quietly leave the ED.
Here’s the problem
This status quo bothers me. In particular, I’m concerned that although naloxone is now readily available — carried by police, firefighters, basic life support ambulances, and even bystanders —overdose deaths continue to climb. I want to talk frankly with the patient who overdoses and survives, and specifically let them know their risk of dying should they not get treatment. I also want to make the case that better treatment options after an overdose are needed.
Our group at Brigham and Women’s Hospital therefore conducted a study, recently presented at the American College of Emergency Physicians national meeting in Washington, DC. In this study, we aimed to define how many patients who were treated with naloxone by an ambulance crew and initially survived were still alive after one year. Even though these patients are typically just observed in the ED hallway, allowed to sober while the ED staff is busy taking care of other patients with life-threatening emergencies like heart attacks, trauma, and strokes, our team hypothesized that the individual sobering in the hallway bed has perhaps one of the highest one-year mortality rates of anyone seen in the department.
Here’s how the study worked — and what we found
To perform the study, we took advantage of a special project in Massachusetts called the “Chapter 55” legislation which, for the first time, linked many previously separate state databases. We connected the Emergency Medical Services (EMS) database with the all-payer claims database and death records database for our study. In brief, we evaluated patients who received naloxone by EMS over a 30-month period. We then looked at death records one year beyond the first time they received naloxone.
During the study period, there were 12,192 naloxone administrations by EMS, which equals over 400 per month. Of these, 6.5% of patients died that same day and 9.3% died within one year. Excluding those who died the same day, about 10% of the patients who initially survived were dead at one year. Even more significant was that 51.4% of those patients died within one month. Also, apart from those who died the same day, about 40% of those who died within one year died outside of the hospital, highlighting the danger of overdosing before medical personnel can reach the victim and the need for bystander naloxone.
What does this mean about preventing deaths from opioid use disorder?
These results are disheartening: an opioid overdose patient who sobers in the hallway, is offered a detox list, and then is discharged has a one-in-10 chance of being dead within a year. And the highest risk is within one month. Naloxone is an important tool in fighting the opioid crisis, but is no solution. Patients who survive opioid overdose should be considered extremely high-risk. I believe that as a society, we should talk seriously about the resources that are available for people who overdose. We should counsel these patients and offer them buprenorphine (a medication used to help treat opioid use disorder) directly from the ED, provide recovery coaches, and create easily accessible treatment sites where they can go for ongoing care.
The post Naloxone: An important tool, but not the solution to the opioid crisis appeared first on Harvard Health Blog.
From: Scott Weiner, MD https://www.health.harvard.edu/blog/naloxone-tool-not-solution-opioid-crisis-2017113012800
Stronger Gun Laws Reduce Domestic Violence Deaths
Thirteen states and federal law prohibit people convicted of domestic violence from buying guns. But the study found that states that extended this ban to people convicted of any violent crime had 23 percent fewer domestic violence murders.
From: https://www.webmd.com/a-to-z-guides/news/20171130/stronger-gun-laws-reduce-domestic-violence-deaths?src=RSS_PUBLIC
Institute for Diversity in Leadership 2017-18 class announced
From: By Kimber Solana
http://www.ada.org/en/publications/ada-news/2017-archive/november/institute-for-diversity-in-leadership-2017-18-class-announced
Risks to watch for when taking cold and flu remedies
From: http://www.cbsnews.com/videos/risks-to-watch-for-when-taking-cold-and-flu-remedies/
Autoworkers collaborate to build fellow employee a new limb
From: http://www.cbsnews.com/news/a-more-perfect-union-autoworkers-build-prosthetic-hand-for-coworker/
60 Percent of U.S. Kids Could Be Obese by Age 35
The majority of children growing up in America today will be obese by age 35, a new computer analysis predicts.
From: https://www.webmd.com/children/news/20171129/60-percent-of-us-kids-could-be-obese-by-age-35?src=RSS_PUBLIC
New Migraine Drugs Show Promise
The drugs were designed specifically to target a pathway believed to be important in these headaches.
From: https://www.webmd.com/migraines-headaches/news/20171129/new-migraine-drugs-show-promise?src=RSS_PUBLIC
Trump budget cuts could result in millions of new AIDS-related infections, says new report
From: http://www.cbsnews.com/news/trump-budget-cuts-could-result-in-millions-of-new-aids-related-infections-says-new-report/
Recall: Chocolate Protein Bar Sold at ALDI
Fit & Active bars were distributed to 21 states.
From: https://www.webmd.com/a-to-z-guides/news/20171129/recall-chocolate-protein-bar-sold-at-aldi?src=RSS_PUBLIC
AG Jeff Sessions announces new tools to address opioid epidemic
From: http://www.cbsnews.com/news/ag-jeff-sessions-holds-press-conference-on-combatting-opioid-epidemic-live-stream/
"Bone treats" blamed for dog deaths, illnesses
From: http://www.cbsnews.com/news/fda-bone-treats-causing-dog-deaths-and-illnesses/
Does Marriage Help Preserve Your Brain?
A new research review suggests there's something about marriage -- or people who get and stay married -- that significantly lowers the risk of mental decline in old age.
From: https://www.webmd.com/alzheimers/news/20171129/does-marriage-help-preserve-your-brain?src=RSS_PUBLIC
Retired admiral on "most shocking call" of his life
From: http://www.cbsnews.com/news/opioid-epidemic-retired-admiral-sandy-winnefeld-sons-death/
FDA Warns Biotin Can Distort Lab Tests
The FDA is warning that high doses of the vitamin B7, or biotin, in dietary supplements can interfere with hundreds of common lab tests—including some relied on by ER doctors to diagnose a heart attack.
From: https://www.webmd.com/vitamins-and-supplements/news/20171129/fda-warns-biotin-can-distort-lab-tests?src=RSS_PUBLIC
Retired Adm. Winnefeld on son's opioid-overdose death
From: http://www.cbsnews.com/videos/retired-adm-winnefeld-on-sons-opioid-overdose-death/
Electrical Pulses May Ease Pain From 'Slipped' Disc
A new treatment that aims electrical pulses at irritated nerves around the spinal cord appears effective at relieving chronic lower back pain and sciatica, a preliminary study suggests.
From: https://www.webmd.com/back-pain/news/20171129/electrical-pulse-may-ease-pain-from-slipped-disc?src=RSS_PUBLIC
What You Don't Know About Drug Interactions Could Hurt You
Many older Americans take multiple medications -- but only about one-third ever discuss possible interactions between drugs, a new poll finds.
From: https://www.webmd.com/a-to-z-guides/news/20171129/too-few-seniors-know-risks-of-multiple-medications?src=RSS_PUBLIC
Many NFL Players Found to Have Enlarged Aortas
The aorta, the largest artery in the body, carries blood from the heart to the rest of the body.
From: https://www.webmd.com/heart-disease/news/20171129/many-nfl-players-found-to-have-enlarged-aortas?src=RSS_PUBLIC
Arkansas again cuts off Medicaid funds to Planned Parenthood
From: http://www.cbsnews.com/news/arkansas-again-cuts-off-medicaid-funds-to-planned-parenthood/
Global response to malaria at crossroads
From: http://www.who.int/entity/mediacentre/news/releases/2017/malaria-report-response/en/index.html
"Encouraging signs" seen in fight against HIV
From: http://www.cbsnews.com/news/hiv-being-caught-sooner-in-more-people-cdc-says/
Doctor who doesn't use computer can't regain license
From: http://www.cbsnews.com/news/doctor-who-doesnt-use-computer-cant-regain-license-judge-says/
HIV Diagnoses Occurring More Quickly, CDC Says
The average time between HIV infection and diagnosis was three years in 2015, seven months earlier than it had been in 2011, according to researchers from the U.S. Centers for Disease Control and Prevention.
From: https://www.webmd.com/hiv-aids/news/20171128/hiv-diagnoses-occurring-more-quickly-cdc-says?src=RSS_PUBLIC
Doctors seek new hope for patients with eye stroke
From: http://www.cbsnews.com/news/new-hope-for-patients-with-eye-stroke/
Don't Delay Hip Fracture Surgery. Here's Why
Having surgery within 24 hours decreases the risk of hip fracture-related death
From: https://www.webmd.com/osteoarthritis/news/20171128/dont-delay-hip-fracture-surgery-heres-why?src=RSS_PUBLIC
FDA: Beware of Bone Treats for Dogs
Ninety dogs have been sickened, including 15 who died, from bone treats, federal agency says.
From: https://pets.webmd.com/news/20171128/fda-beware-of-one-treats-for-dogs?src=RSS_PUBLIC
Facebook turns to AI to help prevent suicides
From: http://www.cbsnews.com/news/facebook-artificial-intelligence-suicide-prevention/
Contaminated raw milk may have been sold in 4 states
From: http://www.cbsnews.com/news/contaminated-raw-milk-may-have-been-sold-in-4-states/
Bullied teens more likely to bring weapons to school
From: http://www.cbsnews.com/news/bullied-teens-more-likely-to-bring-weapons-to-school/
1 in 10 medical products in developing countries is substandard or falsified
This means that people are taking medicines that fail to treat or prevent disease. Not only is this a waste of money for individuals and health systems that purchase these products, but substandard or falsified medical products can cause serious illness or even death.
From: http://www.who.int/entity/mediacentre/news/releases/2017/substandard-falsified-products/en/index.html