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                                               Rasool Simjee

 
 

 

 
 

 

Contaminated Gloves a No-No in Hospitals
Not changing them between patients raises risk of spreading infection via hospital surfaces, study shows
By Robert Preidt

Health care workers who wear contaminated gloves can transfer bacteria onto hospital surfaces, a new study warns.

"Infection control is a priority for all hospitals to reduce the spread of [bacteria]," said study author Sae Otani, a master course student at Bunkyo Gakuin University in Japan.

"Gloving is recommended as a barrier protection for health care workers to reduce the risk of contamination during contact with infectious sputum [saliva], urine and body fluids," but not changing or removing contaminated gloves carries a high risk of transmitting harmful germs, she noted in a news release from the American Society for Microbiology (ASM).

For the study, Otani and her colleagues contaminated examination gloves with certain types of bacteria found in hospitals and other health care facilities. They then touched the gloves to a sterilized polypropylene surface. The amount of bacteria on the surface was then measured.

"This study shows that contaminated gloves increase risks of cross-transmission of health care-associated pathogens among health care workers and in the environment," Otani said.

"Proper glove use may decrease the risk of health care-associated infections and gloves should be carefully used and removed after use depending on the types of bacteria," she concluded.

The study was presented recently at an ASM meeting in Boston. Research presented at meetings should be considered preliminary until published in a peer-reviewed medical journal.

SOURCE: American Society for Microbiology, news release, June 19, 2016



Flint's Lead Crisis 'Entirely Preventable'
CDC looks at kids' blood levels before, during and after city's switch to local water
By Margaret Farley Steele

Analysis of blood samples from young children of Flint, Mich., shows they had much more lead in their blood when the city used local drinking water in an effort to cut costs, a new U.S. government study reveals.

A series of blood samples showed kids younger than 6 were nearly 50 percent more likely to have elevated blood lead levels when the city used the Flint River for drinking water instead of the Detroit water system, researchers from the U.S. Centers for Disease Control and Prevention concluded.

The percentage of kids with high lead content returned to previous levels once the city switched back to the Detroit system. The reason for the lead contamination? Inappropriate corrosion control measures, investigators said.

"This crisis was entirely preventable, and a startling reminder of the critical need to eliminate all sources of lead from our children's environment," Patrick Breysse, director of CDC's National Center for Environmental Health, said in an agency news release.

Even low levels of lead in children's blood can affect intelligence, ability to pay attention and academic achievement, the agency noted.

The blood lead level of concern is 5 or more micrograms of lead per deciliter of blood. During the period that the Flint River water was used (April 25, 2014 to Oct. 15, 2015), lead levels in local tap water increased over time, as did lead content in children's blood, the CDC said.

The CDC has advised that all children under age 6 in Flint have their blood tested for lead by a health care provider.

According to Dr. Nicole Lurie, U.S. Department of Health and Human Services' Assistant Secretary for Preparedness and Response, "Parents and teachers can do a lot to help children grow up healthy and strong, even if they were exposed to lead."

She said the city's children are getting developmental assessments and needed services. "We have also expanded Medicaid and strongly urge parents to enroll their children and schedule appointments for them to be seen by a health provider, who can follow their health as they grow and develop," Lurie said.

CDC looks at kids' blood levels before, during and after city's switch to local water

Taking advantage of healthy-foods programs and enrolling kids in programs that stimulate their brains such as Head Start are also important, she added.

The Flint crisis has raised concerns about the potential for lead contamination nationwide. Public health experts advise blood-lead testing for children living at or below the poverty level and kids enrolled in Medicaid, the government funded insurance program for the poor. The CDC generally recommends testing at age 1 or 2 years.

In Flint, residents have been advised to use filtered water for drinking, brushing their teeth and cooking.

"It's very important that Flint residents use lead-certified water filters, which are carefully installed on their faucets," said Dr. Robert Glatter, emergency physician at Lenox Hill Hospital in New York City.

"It should be pointed out that regular household tap water can be used for showering and bathing since lead is not absorbed through the skin. But it's still so important that parents guard against young children drinking water from the bath," he explained.

"Often there are no obvious symptoms early on after lead exposure," Glatter said, noting it can take years to show up as behavioral issues, learning disabilities and poor school performance. "Some children may also develop chronic abdominal pain and constipation," he added.

CDC officials said the study can't prove that the Flint River water directly caused the blood lead elevation. They cited limitations, such as not knowing about lead paint exposure in the children's homes or whether greater use of bottled water contributed to the decline in lead levels.

Still, this crisis shows "we must continue to screen all children who are at risk for lead exposure -- even in the absence of obvious symptoms," Glatter said.

SOURCE: U.S. Centers for Disease Control and Prevention, news release, June 24, 2016; Robert Glatter, M.D., emergency physician, Lenox Hill Hospital, New York City.



How Acupuncture Works Total Knee Replacement
New Treatment Shows Promise for Knee Arthritis
Small study found single shot of patient's own stem cells improved pain, mobility.
By Alan Mozes

For those who suffer debilitating arthritis in their knees, researchers report in a small study that just one injection of stem cells can reduce pain and inflammation.

The idea is experimental: Extract stem cells from a patient's own body fat -- cells known for their ability to differentiate and perform any number of regenerative functions -- and inject them directly into the damaged knee joint.

"While the goal of this small study was to evaluate the safety of using a patient's own stem cells to treat osteoarthritis of the knee, it also showed that one group of patients experienced improvements in pain and function," noted Dr. Anthony Atala, director of the Wake Forest Institute for Regenerative Medicine, in Winston-Salem, N.C. He was not involved in the study.

"In fact, most of the patients who had previously scheduled total knee replacement surgery decided to cancel the surgery," Atala noted.

"These results are encouraging, and it will be interesting to see if these improvements are seen in larger groups of study participants," he added.

Atala is editor-in-chief of STEM CELLS Translational Medicine, the journal that recently published the results of the 18-patient study.

The French and German researchers point out that osteoarthritis is the most common musculoskeletal disease among adults, a so-called "wear-and-tear" chronic condition that often affects the knee joint.

Typified by the ongoing breakdown of the cartilage that connect joints and bones, the progressively degenerative disorder ultimately gives rise to severe inflammation, significant pain and often crippling disability.

According to the Arthritis Foundation, osteoarthritis risk is driven by genetics; obesity; injury and joint overuse; other forms of arthritis; and metabolic disorders that can throw a person's iron or growth hormone levels out of whack.

No treatment can halt osteoarthritis' progress, and "no therapy is able to restore [damaged] cartilage tissue," noted study author Dr. Christian Jorgensen, head of the clinical unit for osteoarticular diseases at Lapeyronie University Hospital, in Montpellier, France.

To explore the potential of stem cell therapy, the study authors focused on 18 French and German men and women, aged 50 to 75, all of whom had struggled with severe knee osteoarthritis for at least a year before joining the study.

Between April 2012 and December 2013, all of the patients first underwent liposuction to extract fat-derived samples of a specific type of stem cell. The researchers noted that these particular stem cells have been shown to have immune-boosting and anti-scarring properties, as well as the ability to protect against cell "stress" and death.

A third of the patients received a single "low-dose" injection of their own stem cells directly into their knee. Another third received a "medium-dose" injection, involving a little more than four times the amount of stem cells, while the remaining group received a "high-dose" injection packed with roughly five times as many stem cells as the medium-dose group.

After six months, the study team found that all three groups showed improvements in terms of pain, function and mobility.

However, only those in the low-dose group were determined to have "statistically significant" improvements in terms of both knee pain and function recovery.

Apart from one case of chest pain (about three months after the injection), only a few patients experienced mild side effects.

The team concluded that the stem cell treatment results were "very encouraging." The opinion was echoed by Atala, who suggested that "the study shows yet another potential treatment using stem cells."

At the same time, Jorgensen and his colleagues stressed that more research with more patients will be needed before the approach can be considered a breakthrough.

That effort has already begun, with a second two-year trial now underway involving 150 patients at 10 different clinical centers across Europe.

SOURCES: Christian Jorgensen, M.D., Ph.D., head, clinical unit for osteoarticular diseases and department for biotherapy, Lapeyronie University Hospital, Montpellier, France; Anthony Atala, M.D., director, Wake Forest Institute for Regenerative Medicine, Winston-Salem, N.C., and editor-in-chief, STEM CELLS Translational Medicine; May 23, 2016, STEM CELLS Translational Medicine.



Diabetes Ups Risk of Heart Attack Death
Study points to need for better coordinated care, more effective use of medications, cardiology specialist says
By Robert Preidt

People with diabetes are much more likely to die after a heart attack than people without the blood sugar condition, a new study finds.

Researchers included 700,000 people in the study. All of them were hospitalized with a heart attack between January 2003 and June 2013. About 121,000 had diabetes.

Compared to people who didn't have diabetes, those with the disease were 56 percent more likely to die if they had a heart attack caused by a completely blocked coronary artery. If their heart attack was the result of a partially blocked coronary artery, people with diabetes were 39 percent more likely to die, the study found.

"These results provide robust evidence that diabetes is a significant long-term population burden among patients who have had a heart attack," said lead researcher Dr. Chris Gale, a consultant cardiologist and associate professor in the School of Medicine at the University of Leeds in the United Kingdom.

"Although these days people are more likely than ever to survive a heart attack, we need to place greater focus on the long-term effects of diabetes in heart attack survivors," he added in a university news release.

An important step is to strengthen the partnership between primary care doctors, doctors who treat heart problems (cardiologists), and doctors who treat diabetes (endocrinologists), Gale said. He added that doctors need to make sure that high-risk patients are getting established medications as effectively as possible.

This study couldn't show a cause-and-effect relationship. So, researchers now want to figure out exactly why people with diabetes have a higher risk of death after a heart attack.

"We knew that following a heart attack, you are less likely to survive if you also have diabetes. However, we did not know if this observation was due to having diabetes or having other conditions which are commonly seen in people with diabetes," Dr. Mike Knapton said. He's an associate medical director at the British Heart Foundation, which funded the study.

The findings highlight the need to find better ways to prevent heart disease in people with diabetes, he said. The study also shows the need to develop new treatments to improve survival after a heart attack for folks with diabetes, Knapton added.

The study was published recently in the Journal of Epidemiology and Community Health.

SOURCE: University of Leeds, news release, June 22, 2016.



Smoking May Hinder Common Breast Cancer Treatment
Cigarettes and drugs called aromatase inhibitors appear to be a bad mix, researchers say
By Steven Reinberg

Smoking may blunt the effectiveness of a certain kind of breast cancer treatment, new research suggests.

Among breast cancer patients taking a class of drugs called aromatase inhibitors, smokers had a three times greater risk of their cancer returning than nonsmokers, the investigators found. However, the study could not prove a cause-and-effect link.

Smoking had little or no effect on the benefit of other drugs, such as chemotherapy or tamoxifen, or radiation treatment, the study authors added.

"These findings need confirmation. If confirmed, smoking status should be taken into consideration when selecting the type of [breast cancer] therapy," said lead researcher Helena Jernstrom. She is an associate professor of experimental oncology at Lund University Cancer Center in Sweden.

Common aromatase inhibitors include Arimidex (anastrozole), Aromasin (exemestane) and Femara (letrozole).

These drugs stop production of the hormone estrogen in postmenopausal women. This reduces the estrogen available to stimulate growth of hormone receptor-positive breast cancer cells.

Hormone receptor-positive breast cancer is the most common type of breast cancer, accounting for about two of every three cases. If caught and treated early, 100 percent of patients survive five years or more, according to the American Cancer Society.

It's not clear why smoking makes aromatase inhibitors less effective, Jernstrom said. Perhaps something in cigarettes makes breast cancer cells resistant to these drugs, she suggested.

In light of these findings, aromatase inhibitors may not be the best choice for women with hormone receptor-positive breast cancer who smoke, since alternative treatments are available that aren't affected by smoking, Jernstrom said.

Of course, "it is always a good idea to quit smoking," Jernstrom said. Breast cancer patients who smoke should seek help to quit and doctors should encourage it, she added.

For the study, investigators followed 1,065 women diagnosed with breast cancer between 2002 and 2012. One in five smoked prior
to breast cancer surgery.

The researchers found that women 50 or older who were treated with aromatase inhibitors fared considerably worse during the
follow-up period if they smoked than if they didn't.

Smoking May Hinder Common Breast Cancer Treatment

Cigarettes and drugs called aromatase inhibitors appear to be a bad mix, researchers say

Only a small percentage of smokers quit during treatment, Jernstrom said. So it isn't known whether giving up smoking while taking
aromatase inhibitors increases the drug's effectiveness.

The smokers were also more likely to die from their cancer or other illnesses during the roughly five-year follow-up period, the
findings showed.

Dr. Stephanie Bernik, another cancer specialist, said smoking increases the risk of many cancers for decades.

Now evidence exists that smoking could shorten the lives of patients with breast cancer taking aromatase inhibitors, she said. Exactly
how this happens needs to be made clear, suggested Bernik. She is chief of surgical oncology at Lenox Hill Hospital in New York City.

"What we do know is that more than ever, patients who smoke, even if just socially, need to make an effort to try to kick the habit
in order to optimize their chance for survival," she said.

The study by Jernstrom and colleagues was recently published online in the British Journal of Cancer.

SOURCES: Helena Jernstrom, Ph.D., associate professor, experimental oncology, Lund University Cancer Center, Sweden; Stephanie Bernik, M.D., chief, surgical oncology, Lenox Hill Hospital, New York City; June 9, 2016, British Journal of Cancer.



Painkiller Misuse in U.S. Doubled in Decade
Over 4 percent of adults reported nonmedical use of drugs like OxyContin in 2012-2013
By Robert Preidt

More bad news from the U.S. drug wars: Misuse of prescription opioid painkillers by American adults more than doubled from the early 2000s to 2013, a new government study says.

Rates of addiction to powerful painkillers such as OxyContin and Vicodin also swelled during that time, according to the U.S. National Institute on Alcohol Abuse and Alcoholism (NIAAA).

"The increasing misuse of prescription opioid pain relievers poses a myriad of serious public health consequences," said Dr. Nora Volkow, director of the U.S. National Institute on Drug Abuse, which contributed funding for the study. These consequences range from addiction and overdose deaths to use of heroin, an illicit opioid, she said.

Survey results indicated more than 4 percent of adults reported no medical use of addictive opioids in 2012-2013. This means they took the drug without a prescription or more of the drug than prescribed or for longer periods or more often. Ten years earlier, less
than 2 percent of adults reported such risky behavior.

Moreover, the proportion of adults who reported no medical use of opioids at some point in their lives rose from 4.7 percent to more than 11 percent during the study period.

And 2.1 million Americans met the criteria for prescription opioid use disorder, or opioid addiction, in 2012-2013.

The consequence are wide-ranging, Volkow pointed out. "These include increases in opioid use disorders and related fatalities from overdoses, as well as the rising incidence of newborns who experience neonatal abstinence syndrome," she said in a government news release.

In addition, Volkow said prescription opioid misuse can progress to intravenous heroin use. This in turn raises the risk for HIV, hepatitis C and other infections among people sharing needles, she explained.

According to the report, rates of prescription opioid misuse were highest among: men; people with annual incomes less than $70,000; those previously married; and people with a high school education or less.

Misuse was also higher among whites and Native Americans and those living in the Midwest and West, the study found.

NIAAA director George Koob said, "Given the dramatic increase in nonmedical use of prescription opioids, it is important that clinicians and patients also recognize the potent interaction of opioids with alcohol and other sedative-hypnotic drugs -- an interaction that can be lethal."

People who've had an alcohol use disorder are nearly twice as likely to also develop an opioid addiction, government data shows.

Treatment for misuse and abuse of prescription painkillers lags far behind the need, the study suggests.

Only about 5 percent of adults who misused prescription opioids in the past year and 17 percent of those with prescription opioid addiction ever receive treatment, researchers found. Recommended treatment includes medication and behavioral counseling.

The study was published online June 22 in the Journal of Clinical Psychiatry.

SOURCE: U.S. National Institute on Alcohol Abuse and Alcoholism, news release, June 22, 2016.



Southern States Lagging in Tough Smoking Bans
Only 6 in 10 Americans covered by state or local laws banning smoking in public places
By Robert Preidt
 

Smokers in southern states can still find plenty of places to spread secondhand smoke to others, a new report finds.

In fact, no states in the U.S. Southeast have comprehensive smoke-free laws to protect nonsmokers from tobacco fumes, a federal government report says.

This type of law bans smoking in all indoor areas of workplaces, restaurants and bars.

Dr. Tom Frieden directs the U.S. Centers for Disease Control and Prevention. "We've made great progress in protecting many Americans from secondhand smoke exposure," he said, "but millions of Americans, especially those living in southeastern states, are still unprotected from this completely preventable health hazard."

The number of states with comprehensive smoke-free laws rose from zero in 2000 to 26 by 2010, including the District of Columbia.


But progress has stalled: Only two more states were added to that list between 2010 and 2016, the CDC noted.

"The lack of comprehensive statewide smoke-free laws in some U.S. states represents a key policy failure," added Dr. Ernest Hawk, head of cancer prevention & population sciences at the University of Texas MD Anderson Cancer Center in Houston.

But progress has been made. Overall, the CDC report finds that nearly 60 percent of Americans are covered by comprehensive smoke-free laws at the state or local level, compared with less than 3 percent in 2000.

Local anti-smoking laws also protect some residents living in 14 of the 23 states without comprehensive smoke-free laws. However, nine states have no such laws at either the local or state level, and eight states even forbid local officials from passing smoke-free laws, the CDC researchers said.

Local anti-smoking regulations also vary widely in the 14 states without comprehensive smoke-free laws, the report found. For example, local laws protect 60 percent of people in West Virginia. In Kentucky, South Carolina and Texas smoking laws cover about 30 percent of people. However, only 2.4 percent of people in Georgia, and less than 1 percent of people in Arkansas and Wyoming are protected by smoking laws, the findings showed.

"Ten years ago, the Surgeon General concluded there is no risk-free level of secondhand smoke exposure," Frieden noted in an agency news release.

Exposure to secondhand smoke causes heart disease and lung cancer. Together, the two diseases kill more than 41,000 nonsmokers every year in the United States. Even brief exposure to secondhand smoke is a health threat, and completely eliminating indoor smoking is the only way to fully protect nonsmokers, according to the CDC.

"Smoke-free laws provide a low-cost, high-impact benefit to the public's health," said Corinne Graffunder, director of the CDC's Office on Smoking and Health.

"These laws substantially improve indoor air quality, help smokers quit, prevent youth and young adults from starting to smoke, change social norms about the acceptability of smoking, and reduce heart attack and asthma hospitalizations among non-smokers," she explained.

The CDC also noted that smoke-free laws can be extended to other types of tobacco products, such as e-cigarettes. Currently, seven states -- California, Delaware, Hawaii, New Jersey, North Dakota, Oregon and Utah -- include e-cigarettes in their comprehensive smoke-free laws.

SOURCES: Ernest Hawk, M.D., vice president and head, division of cancer prevention & population sciences, University of Texas MD Anderson Cancer Center, Houston; U.S. Centers for Disease Control and Prevention, news release, June 23, 2016.



Southern States Lagging in Tough Smoking Bans
Only 6 in 10 Americans covered by state or local laws banning smoking in public places
By Robert Preidt

Smokers in southern states can still find plenty of places to spread secondhand smoke to others, a new report finds.

In fact, no states in the U.S. Southeast have comprehensive smoke-free laws to protect nonsmokers from tobacco fumes, a federal government report says.

This type of law bans smoking in all indoor areas of workplaces, restaurants and bars.

Dr. Tom Frieden directs the U.S. Centers for Disease Control and Prevention. "We've made great progress in protecting many Americans from secondhand smoke exposure," he said, "but millions of Americans, especially those living in southeastern states, are still unprotected from this completely preventable health hazard."

The number of states with comprehensive smoke-free laws rose from zero in 2000 to 26 by 2010, including the District of Columbia. But progress has stalled: Only two more states were added to that list between 2010 and 2016, the CDC noted.

"The lack of comprehensive statewide smoke-free laws in some U.S. states represents a key policy failure," added Dr. Ernest Hawk, head of cancer prevention & population sciences at the University of Texas MD Anderson Cancer Center in Houston.

But progress has been made. Overall, the CDC report finds that nearly 60 percent of Americans are covered by comprehensive smoke-free laws at the state or local level, compared with less than 3 percent in 2000.

Local anti-smoking laws also protect some residents living in 14 of the 23 states without comprehensive smoke-free laws. However, nine states have no such laws at either the local or state level, and eight states even forbid local officials from passing smoke-free laws, the CDC researchers said.

Local anti-smoking regulations also vary widely in the 14 states without comprehensive smoke-free laws, the report found. For example, local laws protect 60 percent of people in West Virginia. In Kentucky, South Carolina and Texas smoking laws cover about 30 percent of people. However, only 2.4 percent of people in Georgia, and less than 1 percent of people in Arkansas and Wyoming are protected by smoking laws, the findings showed.

"Ten years ago, the Surgeon General concluded there is no risk-free level of secondhand smoke exposure," Frieden noted in an agency news release.

Exposure to secondhand smoke causes heart disease and lung cancer. Together, the two diseases kill more than 41,000 nonsmokers every year in the United States. Even brief exposure to secondhand smoke is a health threat, and completely eliminating indoor smoking is the only way to fully protect nonsmokers, according to the CDC.

"Smoke-free laws provide a low-cost, high-impact benefit to the public's health," said Corinne Graffunder, director of the CDC's Office on Smoking and Health.

"These laws substantially improve indoor air quality, help smokers quit, prevent youth and young adults from starting to smoke, change social norms about the acceptability of smoking, and reduce heart attack and asthma hospitalizations among non-smokers," she explained.

The CDC also noted that smoke-free laws can be extended to other types of tobacco products, such as e-cigarettes. Currently, seven states -- California, Delaware, Hawaii, New Jersey, North Dakota, Oregon and Utah -- include e-cigarettes in their comprehensive smoke-free laws.

The report was published June 23 in the CDC's Morbidity and Mortality Weekly Report.

SOURCES: Ernest Hawk, M.D., vice president and head, division of cancer prevention & population sciences, University of Texas MD Anderson Cancer Center, Houston; U.S. Centers for Disease Control and Prevention, news release, June 23, 2016.



Sprained Ankle May Have Longer-Term Health Effects
Study finds link between adult injury, more heart and lung problems later
By E.J. Mundell

Many Americans have suffered through an ankle break or sprain, but new research suggests these injuries might have a larger effect on health.

The study, based on a survey of thousands of adults, found that people with injured ankles tend to have higher rates of disability and arthritis, heart or respiratory issues going forward.

The study can't prove cause-and-effect, but it points to the importance of proper rehabilitation after such injuries, the researchers said.

"What is concerning is these differences are presenting across the life span -- especially during the critical middle age years when our risk for these diseases begins to increase," said study author Phillip Gribble. He's an associate professor in the department of rehabilitation sciences at the University of Kentucky, in Lexington.

In the study, Gribble's team conducted an online survey of over 3,500 adults. More than 1,800 of them said they had sustained some kind of ankle injury at some point in their lives.

Those who'd had such injuries were more likely to say they were "somewhat" to "completely" limited in their daily activities compared to people without such histories, at 46 percent vs. 36 percent, respectively. Rates of moderate to severe body pain were also higher (38 percent vs. about 27 percent).

The study also found higher rates of heart or respiratory ailments in people who'd injured their ankle versus those who hadn't (about 31 percent vs. 24.5 percent, respectively).

Not surprisingly, arthritis of the ankle was also much more likely among those who previously injured the joint (9.4 percent) compared to those who hadn't (1.8 percent), Gribble's team found.

Overall, the findings suggest that ankle breaks and strains should be taken more seriously, the researchers said.

"In isolation, ankle injuries are seen as relatively benign and inconsequential injuries," noted Gribble, who is also co-director of the International Ankle Consortium, a specialist research group.

"This is not just a problem for athletes, as a large percentage of the population reports chronic ankle issues," he noted. "Better efforts are needed to prevent the initial injuries, and also to introduce improved interventions post-injury, to reduce the high rate of chronicity we see in ankle injury patients."

Another expert in athletic injury agreed.

The study "supports other research reporting the negative long-term effects of an ankle sprain," said Tricia Hubbard-Turner, an associate professor at the Center for Biomedical Engineering Systems at the University of North Carolina at Charlotte.

"The take-home message should be there is no such thing as 'just an ankle sprain,'" she said.

Hubbard-Turner offered advice on proper recovery from an ankle injury:

Give the ankle adequate time to rest and heal.


Use crutches if possible during the healing process, and begin a rehab exercise regimen once healing occurs.


Exercise could include: "motion exercises [pointing toes up and down, writing the alphabet with your feet], strengthening [tubing exercises, cuff weight around the foot], balance exercises [standing on one leg] and more functional activities [light jogging, zigzags, figure eights] before returning to activity," she said.

"Enabling healing and rehabilitation is key to preventing the negative consequences reported in the Gribble study," Hubbard-Turner said.

"This may mean missing sports activity or modifying exercise [for example, trying non-weight bearing exercise] for a few weeks, depending on the severity of injury," she acknowledged. "But those few weeks are well worth it based on the long-term problems people are developing."

The study was to be presented Thursday at the annual meeting of the National Athletic Trainers' Association in Baltimore. Experts note that research presented at medical meetings is typically considered preliminary until published in a peer-reviewed journal.

SOURCES: Phillip Gribble, Ph.D., associate professor, department of rehabilitation, division of athletic training sciences, College of Health Sciences, University of Kentucky, Lexington, and co-director, International Ankle Consortium; Tricia Hubbard-Turner, Ph.D., ATC, associate professor, Center for Biomedical Engineering Systems, University of North Carolina at Charlotte; June 23, 2016.



Scans May Spare These Patients From Chemo
Test finds those who might respond well, may spare others treatment side effects
By Robert Preidt

A certain type of medical scan can be used to help spare some Hodgkin lymphoma patients from the severe side effects of chemotherapy, a new study suggests.

Researchers found that PET imaging can identify patients whose Hodgkin lymphoma will likely respond better to treatment, and therefore require less intensive chemotherapy.

"The good news is that the majority of people diagnosed with Hodgkin lymphoma can be cured -- in this trial more than 95 percent of patients are alive after three years. But we worry about the long-term side effects from the treatments we use," study leader Peter Johnson, a professor of medical oncology at the University of Southampton in England, said in a university news release.

"As we've done in this trial, personalizing treatment based on how well it works is a major development for patients with Hodgkin lymphoma, and sets a new standard of care," he noted.

PET scans were given to more than 1,200 patients with advanced Hodgkin lymphoma who had undergone two cycles of standard chemotherapy. Those with a clear scan continued chemotherapy without the drug bleomycin. Those who didn't have a clear scan -- suggesting a more resistant form of the blood cancer -- continued chemotherapy with bleomycin.

Bleomycin has been used to treat Hodgkin lymphoma for 30 years, researchers said. But, the drug can lead to scarring of the lungs that can cause serious breathing problems.

Patients with clear PET scans who stopped receiving bleomycin had the same survival rate as those who continued receiving the drug, according to the study.

"Knowing which patients have a more difficult-to-treat form of the disease means we can select those who need stronger chemotherapy, while sparing everyone else the severe side effects such as infertility," Johnson said.

"This approach, along with a reduction in the need for radiotherapy, should substantially reduce damage to healthy tissues and the risk of second cancers caused by treatments," he added.

The study was published in the June 22 issue of the New England Journal of Medicine.

SOURCE: University of Southampton, news release, June 22, 2016.


This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.

Courtesy: Rasool Simjee