Entries in Medicine (10)


Tuberculosis in US Hits Lowest Levels Ever

Comstock/Thinkstock(NEW YORK) -- The rate of tuberculosis hit an all-time low in the United States in 2012, with fewer than 10,000 new cases reported.

With World Tuberculosis Day on Sunday, the Center for Disease Control's National Tuberculosis Surveillance System reported that the rate of Tuberculosis dropped 6.1 percent from 2011. The CDC's statistics mark the 20th consecutive year of decreasing occurrence of the deadly disease.

The statistics, published in the journal Morbidity and Mortality Weekly Report, found that out of the 3,413 counties in the U.S., 44.2 percent reported zero new cases of TB between 2010 and 2012.

Tuberculosis is a bacterial infection that most often affects the lungs. It is spread by caughing and sneezing, and can be fatal.

While the frequency of the disease is at it's lowest ever in the United States, there is still work to be done. Foreign-born people have higher rates of TB than U.S.-born citizens. Additionally, racial and ethnic minorities have higher rates of contraction than whites.

The study is based on provisional TB data provided by the 50 states and the District of Columbia, and case rates are based on estimated population numbers. Final statistics will be reported by the CDC later in the year.

Copyright 2013 ABC News Radio


'Zoobiquity': 7 Diseases Animals Share With Humans

Stockbyte/Thinkstock(LOS ANGELES) -- Dr. Barbara Natterson-Horowitz is a sort of modern day Dr. Dolittle.

For the past six years, the UCLA cardiologist has been consulting with the Los Angeles Zoo to help treat diseases found in animals. Natterson-Horowitz said she was surprised to learn how much human and veterinary medicine have in common.

"Animals suffer from almost all of the diseases that human beings do, but veterinarians and physicians never talk about this," she said. "Physicians have not typically, traditionally, seen veterinarians as their clinical peers and that's unfortunate."

Her work became the focus of her new book, Zoobiquity: What Animals Can Teach Us about Health and the Science of Healing, which she co-wrote with science writer Kathryn Bowers. The book calls for an approach to medicine that crosses the species barrier. It argues that studying diseases found in both a human and an animal could save both lives.

Natterson-Horowitz's work at the zoo began after she attended a sleepover at the LA Zoo with her young daughter. She struck up a conversation with some of the veterinarians who ended up enlisting her help in cardiac cases.

Here are just seven examples of diseases shared by humans and animals:

1. Heart Disease

One of her first experiences dealing with animal patients came when she examined Cookie the lioness. The big cat had been diagnosed with fluid in the sac around heart -- a potentially fatal condition.

Natterson-Horowitz said what amazed her most was that the zoo veterinarians made Cookie's diagnosis not with a battery of expensive tests -- as they would at UCLA. Instead it was old-fashioned observation, like they used to teach in medical school.

Veterinarians, she said, are the ultimate general practitioners,dealing with a wide range of species including mammals, reptiles and insects. Also, unlike human patients, the animals can't describe their symptoms to their doctors. The vets have to be keen observers.

After that experience, Natterson-Horowitz said she began looking at her human patients differently.

In Zoobiquity, the authors note that animals can experience heart attacks and many species can be frightened to death. Sudden cardiac death, a leading cause of death in humans, can also have "a fear trigger," Natterson-Horowitz and Bowers wrote. However, they also acknowledged that physicians have been "skeptical of linking high emotion and cardiac death in humans."

2. Breast Cancer

According to Natterson-Horowitz and Bowers, certain types of breast cancer have been found a number of mammals.

Their list includes jaguars, cougars, tigers, sea lions, kangaroos, wallabies, beluga whales, alpacas and llamas.

Natterson-Horowitz and Bowers note that the only group of mammals in which breast cancer is rarely found are with the "professional lactators," meaning dairy cows and goats.

3. Skin Cancer

Dr. Curtis Eng, the Los Angeles Zoo's chief veterinarian, said the zoo has come to rely on human specialists like Natterson to help treat its animals.

"There are a lot of medical conditions that we just don't know enough about to treat the animal fully," he told ABC'S Nightline.

So when Rhonda the rhino was diagnosed with squamous cell carcinoma, a common type of skin cancer, on her horn, the zoo brought in one of UCLA's top oncologists. Rhonda even underwent surgery to remove it and is now cancer free.

4. Osteosarcoma

Osteosarcoma, a common type of bone cancer that forced Ted Kennedy Jr. to undergo a leg amputation in 1973, is the leading cause of death in golden retrievers, Natterson-Horowitz and Bowers wrote in their book Zoobiquity.

This disease has also been found in the bones of wolves, grizzly bears, camels, polar bears, some reptiles, fish and birds, according to the authors.

5. Obesity and Diabetes

Zoo animals not only can suffer from obesity, but diabetes is fairly common, in part because the animals eat food that has been genetically modified for human consumption.

In their book, Natterson-Horowitz and Bowers wrote that various animals in the wild will experience binge-eating, secret-eating, nocturnal-eating and food-hoarding, which could suggest a link between humans and "ancestral eating strategies."

6. STDs

Atlantic bottlenose dolphins suffer genital warts, baboons can get herpes, syphilis is rampant among rabbits, just to name a few sexually-transmitted diseases affecting animals that Natterson-Horowitz and Bowers note in their book.

"Wild animals don't practice safe sex," Natterson-Horowitz said. "Of course they get STDs."

In fact, an epidemic of sexually transmitted Chlamydia has devastated koala populations in Australia. Wildlife biologists Down Under are so concerned about it, they are working on a vaccine for Chlamydia in koalas. There is currently no Chlamydia vaccine for humans.

At the same time, Natterson-Horowitz and Bowers wrote that 1 in 4 humans worldwide will die of an STD.

7. Erectile Dysfunction

Horses can experience erectile dysfunction, the authors said. But there's no Viagra for them. Instead vets take a more holistic approach.

"I found that veterinarians are more comfortable talking about the sexuality of their animals then physicians sometimes are," Natterson said. "We are told in medical school to talk with our patients about their sexuality, but sometimes it's easier to talk to a patient about whether they have chest pain walking up a flight of stairs or not, then immediately getting into their sexual life."

Through her research, Natterson-Horowitz said stallions not only have been found to experience erectile dysfunction, they can have sexual dysfunction if they were bred too young or have an upsetting first sexual experience with a mare.

But acknowledging the similarities between humans and animals from a medical perspective does have bigger implications. How does the Zoobiquity approach apply, for instance, to the controversial issue of animal testing?

One could argue Zoobiquity is an argument for more animal testing, because of the similarities among different species, or Zoobiquity could be the basis for a moral argument against animal testing, because we share more in common than we think with the animal kingdom.

Should the Hippocratic Oath -- to do no harm -- apply to hippos? Natterson-Horowitz couldn't say.

"I can't give you a simple answer," she said, "because it's a very complicated, nuanced question."

But, she argued, doctors and veterinarians should have a lot to teach each other.

Copyright 2012 ABC News Radio


University of Chicago Student, 21, to Become Youngest to Attain M.D.

ABC News(CHICAGO) -- Sho Yano says that even though the reference to the popular ’90s show Doogie Howser M.D. amuses him and makes him feel “pretty good,” he doesn’t want to be known as a “whiz kid.”

“I kind of want to be the doctor,” he said. “I got through training early [but] my dream is to have a real achievement. Finding anything that would be helpful to people in general. Just knowing that I’m gonna help someone. That would be great.”

A doctor is just what Yano will become Saturday when the 21-year-old becomes the youngest student to attain an M.D. from the University of Chicago.

In 2000, when ABC News interviewed him as a 9-year-old college freshman at Loyola University, he said he eschewed the word “genius.”

“I’m not a genius. I’m gifted,” he told ABC News. “I got a gift from God and I may be accountable to God for using it wisely. Besides, I have to work for it.”

When he was 12 — having already graduated in three years from Loyola University — Yano entered the University of Chicago’s Pritzker School of Medicine, participating in a program where students get both their doctorate and medical degrees.

He completed his first year of medical school, got his Ph.D. in molecular genetics and cell biology and then pursued the rest of medical school so that he’d be at least 18 when it came time to work with patients.

Yano was reading by the age of 2, writing by the age of 3 and composing music by 5. At the age of 8, he scored a 1,500 out of 1,600 on the SAT.

He said Monday that despite a lot of flak from psychologists, he was not socially stunted and that he appreciated his parents for allowing him to follow his own path and molding him into a well-rounded person.

Yano is now an accomplished pianist with a black belt in tae kwon do. He said for fun he played the piano and worked with computer and electronic hardware, calling himself a “hand-radio enthusiast.”

He’s not the only prodigy in the family, though. His only sister, Sayuri Yano, 15, is working on her second bachelor’s degree in violin performance at Johns Hopkins University.

Next up for Sho Yano? A five-year residency in pediatric neurology.

“I really don’t regret anything I did,” he told ABC News on Monday. “I have a good idea of how kids and teenagers act. I’m not sure that I would’ve enjoyed that. I don’t think I missed all that much. ”

Copyright 2012 ABC News Radio


How Do Docs Prescribe Kids’ Meds? Guess 

Comstock/Jupiterimages/Thinkstock(BOSTON) -- The last time your doctor gave you a prescription, it likely came with specific information on the correct and safe dosage to take, determined from years of clinical trials. But when kids need certain prescription drugs, such as statins, morphine, anesthetic or the asthma drug prednisone, doctors sometimes have to guess how much to give them based on the child’s weight.

The reason, described in a report published Tuesday in the Journal of the American Medical Association, is that about half the prescription drugs commonly given to children have no information on appropriate pediatric doses on their labels.

Researchers from the U.S. Food and Drug Administration studied drugs listed in the Physicians’ Desk Reference, the bible of FDA-approved drug labeling, and counted the number of drugs that came with guidance for use in children, including the appropriate dosage.  Of 461 drugs in the PDR that were for children, 231 had the adequate information doctors would need to prescribe the drug to a child.

For the 105 brand-new drugs approved by FDA between 2002 and 2008 that could potentially be used in children, 43 had pediatric information on the labels.

“You can’t get a product approved in adults without studying how it affects them first,” said Dr. Dianne Murphy, one of the study’s authors. “But children are routinely being given products that are not studied in them.”

The study is part of an effort to increase awareness that prescription drugs are often not tailored to kids’ unique biology. In April, Harvard researchers reported that four out of every five children hospitalized in the U.S. are treated with drugs that have never been tested in children and are FDA-approved only for adults.

For newborns, the picture is even grimmer.  About 90 percent of drugs have never been tested for use in infants.

Dr. Florence Bourgeois, the author of that study and an assistant professor of pediatrics at Harvard, said that about 60 percent of common conditions such as asthma and lower respiratory infections occur in children, but only 12 percent of the clinical trials currently testing drugs look at how they work in children specifically.

So when kids need these drugs, their doctors usually just have to guess how much to give them, usually gauging it against their weight. But kids are not just little adults. The way the liver, kidneys and other organs work to metabolize drugs is far different in early life.

“In some instances, extrapolating adult drug dosage to children might be appropriate, but again, without specific trials to assess that, we simply don’t know,” Bourgeois said.

Experts said testing drugs in children is simply more complicated and costly for drug companies. Clinical trials of children have their own ethical issues and often the science used to study adults doesn’t apply to children. For example, it’s difficult or impossible to get infants and children to breathe into a spirometer to study their asthma.

But alarming as it may seem to parents with sick kids, the situation used to be a lot worse. Dr. Daniel Frattarelli, chairman of the American Academy of Pediatrics’ Committee on Drugs, said even though half of drugs have dosage information for children, it used to be that only about 20 percent did.

The improvements are largely the result of two laws, passed in the late 1990s and early 2000s. The Pediatric Research Equity Act allows the FDA to require drug companies to do additional testing of their products on children if the drug is likely to be used widely in pediatrics. The Best Pharmaceuticals for Children Act gives incentives for drug companies to test their products on children, such as giving them an additional six months of marketing exclusivity.

Both laws are up for congressional reauthorization in 2012, and experts say they are essential to getting more information about appropriate dosage of drugs in children.

Copyright 2012 ABC News Radio


After 200 Years of Surgery: Cutting to Cure Has Come a Long Way

Keith Brofsky/Thinkstock(NEW YORK) -- The 3.5-inch tumor in Cynthia Miller's throat threatened to choke her, leaving her no choice but to have it removed.

"I had no idea I was even sick," said Miller, 55, who lives in Maitland, Fla. "I woke up in the middle of the night coughing. … The next thing I knew they were booking emergency surgery."

Instead of radical surgery—which would involved cutting her face, pulling teeth and breaking her jaw—Miller had her tumor removed through her mouth by a miniature robotic arm guided by the surgeon.

"With the robot, there are no cuts anywhere. No breathing tube, no broken bones," said Dr. Bert O'Malley, who pioneered the procedure at the University of Pennsylvania's Head and Neck Cancer Center in Philadelphia. "We go in through the mouth with a high-magnification 3-D camera and very small instruments, like a surgeon's fingers but very tiny, and we're able to remove the tumor without the side effects of traditional surgery."

Side effects include spasms, difficulty with swallowing and speech, not to mention chronic pain.

"The more you disrupt and injure tissue, the greater the risk of dysfunction and chronic problems," said O'Malley.

Today's minimally invasive surgery is far different from the procedures of 200 years ago, when surgeons hacked through skin, muscle and bone briskly and brutally without anesthesia or antisepsis.

"Pain and the always-looming problem of infection restricted the extent of a surgeon's reach," Dr. Atul Gawande, a surgeon at Brigham and Women's Hospital in Boston, wrote in a review published Wednesday in the New England Journal of Medicine's 200th anniversary issue.

Even after the advent of anesthesia in 1846, surgeons continued to "choose slashing speed over precision," Gawande wrote, describing a 19th century leg amputation in which the surgeon accidentally cut an assistant's finger along with the patient's limb. "The patient and the assistant both died of sepsis, and a spectator reportedly died of shock, resulting in the only known procedure with a 300 percent mortality," he wrote.

Unlike today's surgeons dressed in sterile scrubs, masks, caps and booties, surgeons of yore wore black Prince Albert coats speckled with pus and dried blood from procedures past. It would take decades for them to recognize the importance of sterility.

Soon after, however, the arsenal of surgical procedures and their success rates quickly grew. From heart procedures to organ transplants to joint replacements, the "invasion of people's bodies for cure" was becoming the norm, Gawande wrote.

American surgeons perform more than 50 million procedures a year, according to the review, meaning the average American can expect to undergo seven operations during his or her lifetime. Miller, who's had four surgeries so far, said she's amazed at how far the field has come.

"I went in on a Friday morning and came home on the Monday," she said, recalling her surprisingly quick and painless recovery. "I'm thoroughly amazed. I'm in awe. Technology and man are coming together to enrich our world in ways that we could never have imagined."

Copyright 2012 ABC News Radio


Medicine Cabinet Is Worst Place to Store Medications, Pharmacists Say

Comstock/Thinkstock(ALBANY, N.Y.) -- If there is one place you shouldn't store your medication, it's the exact place where you probably are: the medicine cabinet in your bathroom.

"The medicine cabinet in the bathroom is the worst place," said Selig Corman, director of Professional Affairs at the Pharmacists Society of the State of New York.

Most medicine should be stored at room temperature, between 68 and 77 degrees, and kept away from moisture. Because the bathroom is prone to high temperatures and humidity, it is a poor place to keep drugs.

"An egg kept at an extreme temperature of heat becomes cooked and that could happen with tablets, with certain gelatin capsules, and that could alter the chemistry of the product." Corman said. "Something as simple as aspirin...when aspirin reacts with moisture it becomes a different chemical...something that is sold as a corn remover. You wouldn't want to ingest a corn remover."

Storing medication in an area with temperatures between 58 and 86 degrees is usually acceptable, Corman said, but two things can happen if the temperature does not stay in the proper range. The first is that the drug might lose its effectiveness, and the second is that the medication could become harmful if its chemistry has changed.

Corman and Dr. Grant Fowler, professor of family medicine at the University of Texas Health Science Center at Houston, say travel is often when drugs are exposed to extreme conditions. Here are their tips on how to keep medications safe during transit.

-- Don't check drugs when flying. Put them in your carry-on luggage.

-- Don't put drugs in the trunk when driving. Keep them in the car when driving and take them with you when you park.

-- Choose overnight shipping for mail-order drugs. If you work, have the medication shipped to your office.

"If they [the drugs] sit out on your front porch for hours to even days, in some situations your pretty much are going to guarantee they are going to exceed those excursions," Fowler said.

An FDA study from 1995 found that the interior temperature of a black mailbox can reach as high as 136 degrees when the ambient air temperature was 101 degrees.

Insulins and other injectables, which are supposed to be refrigerated, are especially vulnerable to extreme temperatures.

"They could freeze, which would ruin it. They could overheat, which would ruin it," Fowler said.

When it comes to pills or tablets, Corman said, you can usually see a difference in their appearance if they have been adversely affected by severe temperatures or moisture. The color often changes and tablets that were once shiny might look dull.

If you have any doubts about the medication you're taking, he said, you should consult your pharmacist. Corman advised people to speak with their pharmacist about the proper way to store medication whenever they begin taking a new one.

Copyright 2011 ABC News Radio


Study: Millions of Americans with Artery Disease Not Taking Medicine

Medioimages/Photodisc/Thinkstock(BOSTON) -- Peripheral artery disease (PAD) is a condition caused by plaque formation in the arteries of the legs, and this narrowing of the blood vessels increases the risk of heart attack and stroke.  

A study conducted by Brigham and Women’s Hospital, involving a national survey of almost 7,500 adults, found that an estimated 7.1 million Americans have peripheral artery disease based on a simple screening test.

According to the findings of the study published in Circulation, authors found that only a third of the respondents said they took medicine to lower cholesterol, while only a quarter reported taking blood pressure-lowering medications.

Taking two or more of these medications was associated with a 65-percent lower rate of death, and based on the study’s findings, researchers say that millions of individuals with PAD don’t appear to be receiving medications that may reduce their risk of death.

Copyright 2011 ABC News Radio


Paying Attention to Your Prescriptions Saves Big Bucks

Comstock/Thinkstock(WASHINGTON) -- If you are one of the many Americans who do not have prescription drug coverage, there are several secrets to savings that could really help you out. Even if your insurance does cover medications, often the ones your doctor prescribes are not included in the plan or the co-pay is exorbitant. Here are several tweaks and tricks you can try in order to afford the prescriptions you need:

Get Two Prescriptions for the Same Medication. Just in case a new medicine doesn't agree with you, you don't want to waste money on several months' worth. So instead, ask your doctor to write you two prescriptions: one that will last a couple of days or weeks and another, longer one that you can fill later if the medication agrees with you and helps you.

Beware of Prescription Drugs that End in "ER," "CD," "XR" and so on. These initials stand for "extended release" and "continuous delivery." They are often trumped up variations of medications that were big money makers for the manufacturer but lost their patent. Manufacturers sometimes invent slightly new versions of their biggest blockbusters and patent them in an attempt to keep the dollars flowing. That's their right. And it's your right to ask whether older, cheaper, generic drugs will work just as well for you.

Just Say No to Drugs; Brand New Ones, That Is. If your doctor offers you free samples of a medication for a chronic condition, you might want to pass. Pharmaceutical reps usually distribute freebies of the newest, most expensive medicines in their collection.

If there is a less expensive, older drug, you don't want to get started on a pricey new one that you will have to pay for once the samples run out. On the other hand, if your doc can provide free samples for a brief, acute illness such as a sinus infection, go for it.

Save Not Just by What's Written but How It's Written. Ask your doctor to write "use as directed" instead of detailed dosing instructions if you want to split pills. Some insurance companies don't allow you to get more than a month's supply of medicine at a time.

So, if your strategy is to get 30 higher dose pills and split them so they last two months, that could be a problem. Exactly how you take those pills can be a private matter between you and your doctor. Ask your doctor to explain the pill-splitting protocol during your office visit instead of on the prescription pad.

Look Into Drug Discount Cards. Drug discount cards allow you to purchase approved drugs for 15 to 40 percent off. The Together RX Access card is the broadest, offering close to 300 brand name meds plus a pile of generics from several different manufacturers.

To qualify, you must not be eligible for Medicare. For more information, visit: Medical manufacturers, who do not participate in this discount card, might have others of their own.

Pharmaceutical Company Websites Can Be Sources of Freebies and Discounts. The more commercialized prescription drugs have gotten, the more drug companies have borrowed pages from more common products' playbooks. So figure out who makes medicines you take routinely and check out their sites. You might see coupons for discounts or even free samples. You then work through your doctor and pharmacy to take advantage of these offers.

Copyright 2011 ABC News Radio


When Taking Heart Medication, Time of Day Matters

Medioimages/Photodisc/Thinkstock(NEW YORK) -- Regularly taking prescribed medication for heart disease is essential to reducing the risk of a heart attack, but the time of day this medication is taken makes a big difference, according to new research from the University of Guelph in Spain.

Many doctors prefer to give heart drugs to patients in the morning, but this study found that ACE inhibitors, a common drug given to patients following a heart attack, are more effective when they can work overnight while the patient is sleeping. Timing has such a large effect on these drugs that researchers found that ACE inhibitors given in the morning were no more effective than placebos at improving heart structure and function.

This bedtime timing holds true for those who take baby aspirin to thin their blood. In another study from Spain -- the University of Vigo this time -- researchers found that those with prehypertension who took an aspirin at 11 p.m. had lower blood pressure readings after three months than those who took their aspirin at 8 A.M.

Copyright 2011 ABC News Radio


Study: Meditation Prescribed More Often as Alternative to Medicine

Medioimages/Photodisc(BOSTON) -- More than 6 million Americans are advised meditation and other mind-body therapies by conventional health care providers, according to a report released Monday by Harvard Medical School. And for sicker patients, these alternative therapies seem to provide both emotional and physical relief for many types of medical ailments, according to the findings, which were published in the Archives of Internal Medicine.

Nearly 40 percent of Americans use some form of complementary and alternative medicine, according to the 2007 National Health Interview Survey. These practices include meditation, yoga, acupuncture and other types of mind-body-practices. And now, many are receiving the support of conventional doctors who have seen apparent benefits in some of their patients.

Meditation has more recently been tried to treat eating disorders, alcoholism, eating disorders, psoriasis, and even impotence. More than two dozen medical centers across the country, including specialized cancer centers, have attached complementary medicine centers, or provide meditation or other mind-body classes.

However, many of these uses of meditation are experimental, and the results vary by each patient. Many experts say meditation is more likely to treat medical conditions successfully when it is used in conjunction with conventional therapies.

Copyright 2011 ABC News Radio

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