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Immunoglobulin A (IgA) antibodies protect against this disease. And preterm infants get IgA from their mother's breast milk during the first weeks of life, researchers from the University of Pittsburgh and UPMC Children's Hospital of Pittsburgh explained.

IgA antibodies bind to bacteria in the gut. The more bacteria that's bound with IgA, the less likely babies are to develop NEC, this study found.
"It's been well-known for a decade that babies who get NEC have particular bacteria -- Enterobacteriaceae -- in their guts, but what we found is that it's not how much Enterobacteriaceae there is, but whether it's bound to IgA that matters. And that's potentially actionable," said study senior author Timothy Hand. He's an assistant professor of pediatric infectious diseases at Pitt's School of Medicine.
The researchers analyzed fecal samples from 30 preterm infants with NEC and 39 without NEC. Breast-fed babies had more IgA-bound gut bacteria -- a good thing -- than formula-fed babies. Infants who developed NEC were more likely to have been formula-fed.
Among babies without NEC, Enterobacteriaceae was largely tied up by IgA, allowing diverse types of bacteria to flourish. But among infants with NEC, IgA-unbound Enterobacteriaceae dominated in the days before the disease was diagnosed, according to the researchers.
The study was published June 17 in the journal Nature Medicine.
As part of their research, the team bred mice that couldn't produce IgA in their breast milk. Pups that received IgA-free milk from their mothers were just as susceptible to NEC as those that were fed formula.
However, preventing NEC may not be as simple as adding IgA to infant formula, Hand said.
He noted that breast milk provides other benefits beyond IgA, so donor milk is the best choice if breastfeeding or pumped breast milk isn't an option.
"What we showed is that IgA is necessary but may not be sufficient to prevent NEC," Hand said in a university news release. "What we're arguing is that you might want to test the antibody content of donor milk and then target the most protective milk to the most at-risk infants."

Ailing Heart Can Speed the Brain's Decline, Study Finds

 The strong link between brain health and heart health is reinforced in a new study. The research showed that as cardiovascular health falters, so too does thinking and memory.
In one of the largest and longest studies of its kind to date, researchers studied a group of nearly 8,000 people in the United Kingdom. The participants were over 49 years of age and their health was tracked from 2002 to 2017.
Everyone in the study had relatively healthy hearts and brains at the beginning of the research. People with a history of stroke, heart attack, angina, dementia or Alzheimer's disease were excluded.
But over 15 years of follow-up, nearly 6% of the participants did go on to suffer a heart attack or angina (chest pain), according to a team led by Wuxiang Xie, a research fellow at the Imperial College School of Public Health in London.
The researchers found that all of these participants also displayed a faster decline in their mental function, concurrent with the heart trouble.
Patients who suffered from angina had a significant decline in tests of "temporal orientation" -- being able to accurately state the current date, day of week and time. Patients who had a heart attack showed a substantial decline in tests of verbal memory (assessed by a word-memory test) and language fluency. They also had the worse cognitive decline overall, the researchers found.
All of that is important, because "even small differences in cognitive function can result in an increased risk of dementia in the long-term," Xie said in a news release from the American College of Cardiology.
"Because there is no current cure for dementia, early detection and intervention are essential to delay the progression to dementia," Xie said. "Heart attack and angina patients need careful monitoring in the years following a diagnosis."
The connection between declines in memory and thinking and heart disease may be as simple as the brain not getting the amount of oxygen that it used to, the researchers theorized. Tiny "microinfarcts" -- heart-linked damage to small vessels in the brain -- might hamper blood flow and oxygen supply.
Two U.S. experts who reviewed the findings agreed that the heart-brain connection is crucial to health.
"This study further emphasizes that approaching the body holistically is crucial for brain health and to prevent dementia," said Dr. Gayatri Devi. She is a neurologist specializing in memory disorders at Lenox Hill Hospital in New York City.
"Brain health is dependent on heart health and health of the entire individual," Devi added.
Dr. Guy Mintz directs cardiovascular health at North Shore University Hospital in Manhasset, N.Y. He called the new study "a wake-up call for physicians to improve the risk factors associated with atherosclerosis [hardening of the arteries] early in life."
Mintz pointed out that "patients can live with heart disease, but patients and their families suffer from decline in brain function. Watching someone become mentally lost in life is tragic and, in some cases associated with atherosclerosis, may be preventable."
Devi stressed that keeping the brain sharp involves fitness of both mind and body.
"It is not enough to do Sudoku or crossword puzzles. It is just as important to take care of the body," she said. "Proven ways to prevent brain disease, including Alzheimer's dementia and stroke, are to take better care of one's heart and body, by exercising, eating and sleeping well, and refraining from smoking."
The new report was published June 17 in the Journal of the American College of Cardiology.

Ozanimod

 Celgene Corporation (NASDAQ:CELG) today announced that the U.S. Food and Drug

Administration (FDA) has accepted for review the New Drug Application for ozanimod for the treatment of people with relapsing forms of multiple sclerosis (RMS) in the United States. The European Medicines Agency (EMA) also accepted for review the Marketing Authorization Application for ozanimod for the treatment of adults with relapsing-remitting multiple sclerosis (RRMS) in the European Union. Ozanimod is an oral, sphingosine 1-phosphate (S1P) receptor modulator that binds with high affinity selectively to S1P subtypes 1 (S1P1) and 5 (S1P5). Under the Prescription Drug User Fee Act, the FDA has set its action date as March 25, 2020. A regulatory decision from the EMA is expected in the first half of 2020.
Both applications are based primarily on ozanimod data from the SUNBEAM™ and RADIANCE™ Part B phase 3, multicenter, randomized, double-blind, double-dummy, active-controlled trials.
“The U.S. Food and Drug Administration and European Medicines Agency acceptances of our applications represent a crucial step forward in our efforts to bring ozanimod to people with multiple sclerosis,” said Jay Backstrom, M.D., Chief Medical Officer for Celgene. “We believe that ozanimod has the potential to be an important option early in the treatment of relapsing forms of MS and a best-in-class S1P receptor modulator.”
Ozanimod is an investigational compound that is not approved for any use in any country.
About SUNBEAM™

SUNBEAM is a pivotal, phase 3, multicenter, randomized, double-blind, double-dummy, active-controlled trial evaluating the efficacy, safety and tolerability of two doses of oral ozanimod (0.92 mg and 0.46 mg, equivalent to 1 mg and 0.5 mg ozanimod HCI respectively) against weekly intramuscular interferon beta-1a (Avonex®) for at least a 12-month treatment period. The study included 1,346 people living with RMS across 152 sites in 20 countries.
The primary endpoint of the trial was annualized relapse rates (ARR) during the treatment period. The secondary MRI endpoints included the number of new or enlarging hyperintense T2-weighted brain MRI lesions over 12 months, number of gadolinium-enhanced brain MRI lesions at month 12 and percent change from baseline in whole brain volume at month 12. Cortical grey and thalamic volume changes were also prospectively assessed versus active comparator.
An analysis of the time to onset of 3-month confirmed disability progression was pre-specified using pooled data from both the SUNBEAM and RADIANCE Part B phase 3 trials.
About RADIANCE™

RADIANCE Part B is a pivotal, phase 3, multicenter, randomized, double-blind, double-dummy, active-controlled trial evaluating the efficacy, safety and tolerability of two doses of oral ozanimod (0.92 mg and 0.46 mg, equivalent to 1 mg and 0.5 mg ozanimod HCI respectively) against weekly intramuscular interferon beta-1a (Avonex®) over a 24-month treatment period. The study included 1,320 people living with RMS across 150 sites in 21 countries.
The primary endpoint of the trial was ARR over 24 months. The secondary MRI endpoints included the number of new or enlarging hyperintense T2-weighted brain MRI lesions over 24 months, number of gadolinium-enhanced brain MRI lesions at month 24 and percent change from baseline in whole brain volume at month 24. Cortical grey and thalamic volume changes were also prospectively assessed versus active comparator.
An analysis of the time to onset of 3-month confirmed disability progression was pre-specified using pooled data from both the SUNBEAM and RADIANCE Part B phase 3 trials.
About Ozanimod

Ozanimod is an oral, sphingosine 1-phosphate (S1P) receptor modulator that binds with high affinity selectively to S1P subtypes 1 (S1P1) and 5 (S1P5). Ozanimod causes lymphocyte retention in lymphoid tissues. The mechanism by which ozanimod exerts therapeutic effects in multiple sclerosis is unknown, but may involve the reduction of lymphocyte migration into the central nervous system.
Ozanimod is in development for immune-inflammatory indications including RMS, ulcerative colitis and Crohn's disease.
About Multiple Sclerosis

Multiple sclerosis (MS) is a disease in which the immune system attacks the protective myelin sheath that covers the nerves. The myelin damage disrupts communication between the brain and the rest of the body. Ultimately, the nerves themselves may deteriorate — a process that's currently irreversible. Signs and symptoms vary widely, depending on the amount of damage and the nerves affected. Some people living with MS may lose the ability to walk independently, while others experience long periods of remission during which they develop no new symptoms. MS affects approximately 400,000 people in the U.S. and approximately 2.5 million people worldwide.
RMS is characterized by clearly defined attacks of worsening neurologic function. These attacks — often called relapses, flare-ups or exacerbations — are followed by partial or complete recovery periods (remissions), during which symptoms improve partially or completely with no apparent progression of disease. RMS is the most common disease course at the time of diagnosis. Approximately 85 percent of patients are initially diagnosed with RMS, compared with 10-15 percent with progressive forms of the disease.
About Celgene

Celgene Corporation, headquartered in Summit, New Jersey, is an integrated global pharmaceutical company engaged primarily in the discovery, development and commercialization of innovative therapies for the treatment of cancer and inflammatory diseases through next‐generation solutions in protein homeostasis, immuno‐oncology, epigenetics, immunology and neuro‐inflammation. For  

HTX-011

Heron Therapeutics Receives Complete Response Letter For HTX-011 For The Management Of Postoperative Pain

SAN DIEGO, May 1, 2019 /PRNewswire/ -- Heron Therapeutics, Inc. (Nasdaq: HRTX), a
commercial-stage biotechnology company focused on improving the lives of patients by developing best-in-class treatments to address some of the most important unmet patient needs, today announced that it received a Complete Response Letter (CRL) from the U.S. Food and Drug Administration (FDA) on April 30, 2019 regarding its New Drug Application (NDA) for HTX-011 for the management of postoperative pain.
The CRL stated that the FDA is unable to approve the NDA in its present form based on the need for additional CMC and non-clinical information. Based on the complete review of the NDA, the FDA did not identify any clinical safety or efficacy issues, and there is no requirement for further clinical studies or data analyses.
"We plan to request a meeting with the FDA to obtain its agreement on our approach to resolve the issues outlined in the CRL and resubmit the NDA as soon as possible," said Barry Quart, Pharm.D., President and Chief Executive Officer of Heron Therapeutics.
About HTX-011 for Postoperative Pain

HTX-011, which utilizes Heron's proprietary Biochronomer® drug delivery technology, is an investigational, long-acting, extended-release formulation of the local anesthetic bupivacaine in a fixed-dose combination with the anti-inflammatory meloxicam for the management of postoperative pain. By delivering sustained levels of both a potent anesthetic and a local anti-inflammatory agent directly to the site of tissue injury, HTX-011 was designed to deliver superior pain relief while reducing the need for systemically administered pain medications such as opioids, which carry the risk of harmful side effects, abuse and addiction. HTX-011 has been shown to reduce pain significantly better than placebo or bupivacaine solution in five diverse surgical models: hernia repair, abdominoplasty, bunionectomy, total knee arthroplasty and breast augmentation. HTX-011 was granted Fast Track designation from the FDA in the fourth quarter of 2017 and Breakthrough Therapy designation in the second quarter of 2018. Heron submitted an NDA to the FDA for HTX-011 in October of 2018 and received Priority Review designation in December of 2018. A CRL was received from the FDA regarding the NDA for HTX-011 on April 30, 2019. An MAA for HTX-011 was validated by the EMA in March 2019 for review under the Centralised Procedure.
About Heron Therapeutics, Inc.

Heron Therapeutics, Inc. is a commercial-stage biotechnology company focused on improving the lives of patients by developing best-in-class treatments to address some of the most important unmet patient needs. Heron is developing novel, patient-focused solutions that apply its innovative science and technologies to already-approved pharmacological agents for patients suffering from pain or cancer. For  

Avapritinib

Blueprint Medicines Submits New Drug Application to U.S. Food and Drug Administration for Avapritinib for the Treatment of PDGFRA Exon 18 Mutant GIST and Fourth-Line GIST

CAMBRIDGE, Mass., June 14, 2019 /PRNewswire/ -- Blueprint Medicines Corporation (NASDAQ: BPMC), a precision therapy company focused on genomically defined cancers, rare diseases and cancer immunotherapy, today announced it has submitted a New Drug Application (NDA) to the U.S. Food and Drug Administration (FDA) for avapritinib for the treatment of adult patients with PDGFRA Exon 18 mutant gastrointestinal stromal tumors (GIST), regardless of prior therapy, and fourth-line GIST. Currently, no effective therapy exists for either population. Avapritinib is an investigational, potent and highly selective KIT and PDGFRA inhibitor for patients with advanced GIST.
Avapritinib has received Breakthrough Therapy Designation from the FDA for the treatment of patients with unresectable or metastatic GIST harboring the PDGFRα D842V mutation, as well as Fast Track Designations for the treatment of patients with GIST harboring a PDGFRα D842V mutation regardless of prior therapy, and patients with GIST who have progressed following treatment with imatinib and a second tyrosine kinase inhibitor.
Blueprint Medicines has requested priority review for the application, which, if granted, could result in a six-month review process. The FDA has a 60-day filing review period to determine whether the NDA is complete and acceptable for filing.
"There is an important need for new treatment options that offer durable responses for PDGFRA Exon 18 mutant and fourth-line GIST patients," said Andy Boral, M.D., Ph.D., Chief Medical Officer at Blueprint Medicines. "By targeting the underlying molecular drivers of GIST, avapritinib has the potential to help these patients realize the benefits of precision therapy. We plan to work closely with the FDA to bring avapritinib to appropriate GIST patients as quickly as possible."
About GIST

GIST is a sarcoma, or tumor of bone or connective tissue, of the gastrointestinal (GI) tract. Tumors arise from cells in the wall of the GI tract and occur most often in the stomach or small intestine. Most patients are diagnosed between the ages of 50 to 80, and diagnosis is typically triggered by GI bleeding, incidental findings during surgery or imaging and, in rare cases, tumor rupture or GI obstruction.
Most GIST cases are caused by a spectrum of clinically relevant mutations that force the KIT or PDGFRA protein kinases into an increasingly active state. Because currently available therapies primarily bind to the inactive protein conformations, certain primary and secondary mutations typically lead to treatment resistance and disease progression.
In unresectable or metastatic GIST, clinical benefits from existing treatments can vary by mutation type. Mutational testing is critical to tailor therapy to the underlying disease driver and is recommended in expert guidelines. Currently, there are no approved therapies for patients with KIT-driven GIST whose disease progresses beyond imatinib, sunitinib and regorafenib. In patients with metastatic PDGFRα D842V-driven GIST, progression occurs in a median of approximately three to four months with available therapy.
About Avapritinib

Avapritinib is an investigational, oral precision therapy that selectively and potently inhibits KIT and PDGFRA mutant kinases. It is a type 1 inhibitor designed to target the active kinase conformation; all oncogenic kinases signal via this conformation. Avapritinib has demonstrated broad inhibition of KIT and PDGFRA mutations associated with GIST, including potent activity against activation loop mutations that are associated with resistance to currently approved therapies.
Blueprint Medicines is initially developing avapritinib for the treatment of advanced GIST, advanced systemic mastocytosis (SM), and indolent and smoldering SM. The FDA has granted Breakthrough Therapy Designation to avapritinib for two indications: one for the treatment of unresectable or metastatic GIST harboring the PDGFRα D842V mutation and one for the treatment of advanced SM, including the subtypes of aggressive SM, SM with an associated hematologic neoplasm and mast cell leukemia.
Blueprint Medicines has an exclusive collaboration and license agreement with CStone Pharmaceuticals for the development and commercialization of avapritinib and certain other drug candidates in Mainland China, Hong Kong, Macau and Taiwan. Blueprint Medicines retains development and commercial rights for avapritinib in the rest of the world.
About Blueprint Medicines

Blueprint Medicines is a precision therapy company striving to improve human health. With a focus on genomically defined cancers, rare diseases and cancer immunotherapy, we are developing transformational medicines rooted in our leading expertise in protein kinases, which are proven drivers of disease. Our uniquely targeted, scalable approach empowers the rapid design and development of new treatments and increases the likelihood of clinical success. We are currently advancing four investigational medicines in clinical development, along with multiple research programs. For  

Meds for Blood Pressure, Cholesterol Help the Heart -- But Maybe Not the Mind

 While effective at cutting heart risks, blood pressure and cholesterol drugs may not help preserve seniors' brain health, new research finds.
That conclusion came from the tracking of more than 1,600 men and women in 21 countries.
Over an average span of nearly six years, all of the seniors took different combinations of drugs to lower blood pressure and/or statins to control high cholesterol. All took memory and thinking tests at the start and end of the study, the Canadian researchers said.
The result: None of the drugs appeared to have any impact on long-term mental declines.
Study author Jackie Bosch said her team was not really surprised by the findings. She is an investigator at the Population Health Research Institute and an associate professor in the School of Rehabilitation Science at McMaster University in Hamilton, Ontario.
Why no surprise? On the one hand, Bosch noted that "there have been few studies to demonstrate an effect of blood pressure-lowering on cognitive decline."
At the same time, "there have not been [any] studies to show a protective effect" linked to statins, with some prior research having raised "concerns, based on observational data, that statins [may even] cause memory loss," she added.
On the bright side, "results actually confirm that there is no greater cognitive decline in those taking statin compared to placebo," Bosch said. "So, no effect is actually reassuring in this case."
Worldwide, roughly 1 in 10 individuals over the age of 60 suffer from some degree of thinking impairment, the investigators noted.
Prior research has suggested that living with uncontrolled high blood pressure and/or high cholesterol during middle age may raise the long-term risk for developing thinking declines.
Still, research has been mixed as to whether that risk can be limited by taking drugs to control heart disease risk factors.
In the latest study, published online Feb. 27 in the journal Neurology, the participants were an average age of 74, while 6 in 10 were women. Just under half (45 percent) had high blood pressure, and all were believed to face a moderate risk for developing heart disease.
Over the course of the study, all participants took one of four daily regimens: a high blood pressure drug combination including 16 milligrams (mg) of the ARB (angiotensin II receptor blocker) medication candesartan (Atacand) along with 12.5 mg of the diuretic hydrochlorothiazide (Microzide); or a daily 10 mg pill of the cholesterol-lowering drug rosuvastatin (Crestor); a combination of the two; or a placebo pill.
All participants underwent a battery of thinking and memory tests, both when the study began and ended, along with biannual physical checkups.
In the end, the drugs were found to have no effect on mental health outcomes.
Still, Bosch acknowledged that more research would be needed to explore the possibility that such drugs might prove protective if started earlier in life and taken over a longer period of time.
That point was seconded by Keith Fargo, director of scientific programs and outreach with the Alzheimer's Association in Chicago. He agreed that "certainly, more research is needed in this area."
For one, Fargo underscored the fact that other investigations had come to different conclusions. In particular, he highlighted the findings of the recent SPRINT MIND study, which weighed similar questions among a larger pool of patients.
The SPRINT study, said Fargo, permitted doctors to prescribe any blood pressure control med they wanted, in contrast to the Bosch effort, which only explored the potential impact of a few specific medications.
And the SPRINT investigation did find that "lowering blood pressure in people with existing hypertension significantly decreases risk for developing mild cognitive impairment [MCI]," Fargo said.
So the latest investigation, suggested Fargo, is not the final word, and "should not be interpreted to mean that controlling heart health risk factors is ineffective in decreasing risk for cognitive impairment or dementia."

Seniors With UTIs Need Antibiotics ASAP, Study Says

 For older adults with a urinary tract infection (UTI), antibiotic treatment should begin immediately to prevent serious complications, a new British study finds.
Delaying or withholding antibiotics in this age group can increase the risk of bloodstream infection (sepsis) and death, researchers reported Feb. 27 in the BMJ.
The findings suggest that doctors should "consider early prescription of antibiotics for this vulnerable group of older adults, in view of their increased susceptibility to sepsis following UTI and despite a growing pressure to reduce inappropriate antibiotic use," Paul Aylin and colleagues said in a journal news release. Aylin is a professor of epidemiology and public health at Imperial College London.
UTI is the most common bacterial infection in older patients. But concerns about antibiotic resistance have led to reductions in antibiotic use in England, the study authors noted.
For the study, the researchers analyzed data on more than 300,000 urinary tract infections among more than 150,000 patients aged 65 and older, between 2007 and 2015.
Of those patients, 87 percent were prescribed antibiotics on the day of diagnosis, 6 percent received a prescription within seven days, and 7 percent did not take antibiotics, according to the report.
The patients were tracked for 60 days after their diagnosis. After accounting for other factors, the investigators found that sepsis and death rates were much higher among patients with no antibiotics or delayed prescriptions, compared with those who received immediate prescriptions.
On average, for every 37 patients not given antibiotics and for every 51 patients with delayed antibiotic treatment, one case of sepsis would occur that would not have occurred with immediate antibiotic treatment, the study authors said.
However, because this was an observational study, it cannot prove cause and effect.
The researchers also found that hospital admission rates were 27 percent among patients with no and delayed prescriptions, compared with 15 percent among those with immediate prescriptions.
Older men, especially those over 85, and those living in poorer areas had the highest risk of problems from no prescriptions or treatment delays, the findings showed.
Writing in an accompanying journal editorial, Alastair Hay, of the University of Bristol in England, suggested that further research is needed "to establish whether treatment should be initiated with a broad- or a narrow-spectrum antibiotic, and to identify those in whom delaying treatment [while awaiting test results] is safe."

He's a professor of experimental and applied clinical psychology at the University of Exeter in England.

"Diet and nutrition held promise as one means to reach large numbers of people. However, this trial convincingly demonstrates that nutritional supplements do not help to prevent depression," he said in a university news release.

That suggests counseling works only if people get an adequate "dose" of therapy and make significant changes in their diet, according to the study published March 5 in the Journal of the American Medical Association.

"Because depression is such a common problem, finding effective and widely available ways to prevent depression at a population level is an important goal," said study co-author Ed Watkins.
He's a professor of experimental and applied clinical psychology at the University of Exeter in England.
"Diet and nutrition held promise as one means to reach large numbers of people. However, this trial convincingly demonstrates that nutritional supplements do not help to prevent depression," he said in a university news release.

Excess weight is often linked with depression, the researchers noted.

Half of the study participants took daily supplements containing folic acid, vitamin D, omega-3 fish oils, zinc and selenium. Half took a placebo pill.
Half were also counseled about their eating habits and urged to limit snacking and follow a healthy Mediterranean-style diet.
In a one-year follow-up, the researchers discovered that the supplements worked no better than the placebo in helping ward off depression.
Similarly, the counseling was not effective overall, though it seemed to help prevent depression in participants who attended a recommended number of sessions.
That suggests counseling works only if people get an adequate "dose" of therapy and make significant changes in their diet, according to the study published March 5 in the Journal of the American Medical Association.
"Because depression is such a common problem, finding effective and widely available ways to prevent depression at a population level is an important goal," said study co-author Ed Watkins.
He's a professor of experimental and applied clinical psychology at the University of Exeter in England.
"Diet and nutrition held promise as one means to reach large numbers of people. However, this trial convincingly demonstrates that nutritional supplements do not help to prevent depression," he said in a university news release.

Much like a canary in a coal mine, Florida chickens have warned researchers of a rare but deadly mosquito-borne virus in their midst.

These sentinels have revealed that eastern equine encephalitis virus (EEEV) originates in the state's panhandle and then spreads as far north as Nova Scotia, Canada, the new study found.
"In the region of the panhandle, this is year-round. You can get exposed to this virus by infected mosquitoes year-round," said lead researcher Suman Das, an associate professor of infectious diseases at Vanderbilt University Medical Center in Nashville, Tenn.
Now that scientists know where the virus comes from, they can focus prevention efforts in mosquito-ridden areas of the panhandle, Das said.
"This is, I would say, the deadliest virus we are potentially exposed to in the United States," Das said. "It's been lurking around in the country about 20 to 30 years, and the mortality rate is about 40 percent."
EEEV, which sickens humans and horses, is rare in people, with only about 70 cases reported since 2008. But experts fear the infection rate could rise as global warming extends the reach of mosquito populations farther north.
The virus causes brain swelling in its human victims, and even survivors can pay a long-lasting price, Das said.
"Even when people don't die, in those cases, there is a lot of neurological disease and ultimately, they die earlier," Das said.
EEEV infection can result in severe intellectual impairment, personality disorders, seizures and paralysis, according to the U.S. Centers for Disease Control and Prevention.
Previous research had shown that EEEV spreads outward from Florida, but up to now no one had been able to say what part of the state served as the virus' wellspring, Das said.
Northern states track mosquito-borne viruses by using insect traps and then directly testing the pests for the presence of pathogens, but that method doesn't work in mosquito-beclouded Florida, Das said.
"There are much fewer mosquitoes in the northeastern states compared to Florida. You'd be looking for a needle in a haystack," he explained.
So, Florida turned to chickens to help track the progress and source of EEEV and other viruses.
Between 2005 and 2016, 38 of Florida's 67 counties participated in the state's sentinel chicken surveillance program. Flocks of chickens are strategically placed in coops around the counties, and their blood is regularly tested for viral infection, Das said.
"If a chicken is exposed to EEEV, it doesn't kill the bird but they will make antibodies" against the virus, he explained.
Over 12 years, the chickens demonstrated that the virus is a year-round phenomenon in the panhandle but occurs only seasonally in northern and north-central regions of Florida, Das said.
That probably means EEEV spreads from the Florida panhandle.
"We think that the panhandle, the source of the activity, seeds to the rest of the state, and Florida is the source for the Northeastern United States," Das said.
Thus, mosquito control efforts focused on the Florida panhandle might stand a chance of killing EEEV in its crib, he said.
"That the Florida panhandle appears to be a year-round nexus of transmission is important for epidemiological understanding of this virus and its mosquito vector," said Dr. Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security in Baltimore.
Adalja, who wasn't involved with the research, said the findings underscore the importance of aggressive mosquito control in at-risk areas and the need for eastern equine encephalitis to be considered in patients who live in or travel to areas where it has been shown to flourish.
The new study was published March 11 in the American Journal of Tropical Medicine and Hygiene.

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View blog New post  Using Blogger as Theo Posts All (28) Published (28) Stats Comments Earnings Pages Layout Theme Settings Reading List Help Terms of Service Privacy Content Policy 1-25 of 28 Health Tip: Managing Insomnia Theo 0 0 6/15/19 One-Third of U.S. Kids Have Back Pain, Study Says Theo 0 0 6/15/19 Water Polo Study Highlights Head Injury Risk Theo 0 0 6/14/19 Does Your
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Gene Test Might Someday Gauge Your Heart Attack Risk
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U.S. Expert Panel Supports HIV-Prevention Pill Truvada, for People at High Risk
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Health Tip: Managing Insomnia
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One-Third of U.S. Kids Have Back Pain, Study Says
Theo
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Water Polo Study Highlights Head Injury Risk
Theo
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Does Your Sunscreen Work for You?
Theo
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6/14/19

'Secret Shopper' Study Finds Many Who Need Addiction Treatment Can't Get It
Theo
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Is MRI Screening Worth It for Breast Cancer Survivors?
Theo
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Common Supplement Ingredient Vinpocetine Could Harm Fetus, FDA Warns
Theo
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AHA News: For LGBTQ Patients, Discrimination Can Become Barrier to Medical Care
Theo
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Chicken No Better Than Beef for Your Cholesterol?
Theo
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Health Highlights: June 5, 2019
Theo
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5 Easy Ways to Cut Back Your Salt Intake
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Average American Ingests 70,000 Bits of Microplastic Each Year
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Few Prostate Cancer Patients Are Getting Checkups They Need
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Tight Diabetes Control Alone May Not Benefit the Heart Long-Term
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Whooping Cough Vaccine Effectiveness Fades With Time: Study
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Investigational Drug Teplizumab May Help Delay Onset of Type 1 Diabetes
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AHA News: 3 Simple Steps Could Save 94 Million Lives Worldwide
Theo
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Legalizing Medical Pot Won't Ease Opioid Crisis: Study
Theo
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Gene Test Might Someday Gauge Your Heart Attack Risk
Theo
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Study Refutes Notion That People on Warfarin Shouldn't Eat Leafy Greens
Theo
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U.S. Expert Panel Supports HIV-Prevention Pill Truvada, for People at High Risk
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Namibia's success in the fight against HIV
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A group of nurses won the lottery but gave their winnings to two colleagues who needed it more
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6/15/19

Water Polo Study Highlights Head Injury Risk
Theo
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6/14/19

Does Your Sunscreen Work for You?
Theo
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6/14/19

'Secret Shopper' Study Finds Many Who Need Addiction Treatment Can't Get It
Theo
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6/14/19

Is MRI Screening Worth It for Breast Cancer Survivors?
Theo
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6/14/19

Common Supplement Ingredient Vinpocetine Could Harm Fetus, FDA Warns
Theo
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6/14/19

AHA News: For LGBTQ Patients, Discrimination Can Become Barrier to Medical Care
Theo
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6/14/19

Chicken No Better Than Beef for Your Cholesterol?
Theo
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6/14/19

Health Highlights: June 5, 2019
Theo
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5 Easy Ways to Cut Back Your Salt Intake
Theo
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Average American Ingests 70,000 Bits of Microplastic Each Year
Theo
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Tight Diabetes Control Alone May Not Benefit the Heart Long-Term
Theo
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Whooping Cough Vaccine Effectiveness Fades With Time: Study
Theo
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Investigational Drug Teplizumab May Help Delay Onset of Type 1 Diabetes
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AHA News: 3 Simple Steps Could Save 94 Million Lives Worldwide
Theo
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Legalizing Medical Pot Won't Ease Opioid Crisis: Study
Theo
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6/13/19

Gene Test Might Someday Gauge Your Heart Attack Risk
Theo
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Study Refutes Notion That People on Warfarin Shouldn't Eat Leafy Greens
Theo
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6/13/19

U.S. Expert Panel Supports HIV-Prevention Pill Truvada, for People at High Risk
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Health Tip: Managing Insomnia

-- A good night's sleep is important for physical and mental health.
Long-lasting sleep problems can increase your risk of anxiety or depression, the U.S. National Institutes of Health says.
The NIH suggests these ways to manage insomnia:
Talk to your doctor.
Seek cognitive behavioral therapy or relaxation therapy.
Set good bedtime habits.
Consider sleep medicine.

One-Third of U.S. Kids Have Back Pain, Study Says

 As American kids pack on the pounds, the number of those with back pain is on the rise.
One in three between the ages of 10 and 18 said they had backaches in the past year, according to a survey of about 3,700 youngsters. The incidence rose along with kids' age and weight and was higher among those who play competitive sports.
Though many people probably associate back pain with older people, the orthopedic surgeon who led the study was not surprised by his findings.
"We see a lot of kids who have pain from overuse injuries or joint pain from playing sports," said Dr. Peter Fabricant, who treats pediatric patients at the Hospital for Special Surgery in New York City. "Of these kids who had back pain, very few actually required any sort of medical intervention. Most didn't need treatment at all."
About 80 percent of adults suffer from lower back pain at some time, according to the U.S. National Institutes of Health.
But this is the first time the extent of back pain among children has been estimated on nationwide scale, the authors said. The youngsters surveyed were equally split by age and gender.
On average, those who reported back pain weighed more and had higher body mass indexes, or BMIs. (BMI is a measure of body fat based on height and weight.)
Back pain was more common among girls than boys (38 percent to 29 percent). And the percentage reporting back pain rose about 4 percent with each year of increasing age, according to the authors. Most often, pain affected the lower back.
Nearly half said they hurt in the evenings and more than 15 percent said back pain interrupted their sleep. Only 41 percent sought treatment, and most who did had physical therapy.
Participation in competitive sports was strongly linked to back pain, with junior varsity and varsity athletes experiencing it more often than younger or recreational players. Most survey participants were active, with basketball the most commonly played sport, followed by dance, baseball, football and soccer.
Another contributor to kids' back pain is the backpacks they use to tote their stuff, researchers said. Those who used one strap to carry their packs reported significantly more back pain than did those who used both straps.
Those who used rolling backpacks reported back pain the most often. Fabricant said it wasn't clear whether pain prompted their use of the rolling packs or whether the rolling packs contributed to their pain.
While long-term pain prospects are unclear, Fabricant said "it would certainly stand to reason" that kids who experience backaches would be more likely to do so as adults.
Dr. Henock Wolde-Semait is a pediatric orthopedist at NYU Winthrop Hospital in Mineola, N.Y., who reviewed the findings. He said the results mirror what he sees in his own practice.
"Lots of kids have back pain for various reasons. It seems like it's on the rise," he said.
"The majority of them do well [without surgical treatment], which is why in the past this may have been overlooked or taken for granted," Wolde-Semait added.
Fabricant suggested parents urge their kids to avoid any sport or activity related to their back pain. Physical therapy may help by stretching and strengthening key muscles, he said, and it's wise to avoid carrying backpacks on only one shoulder.
Wolde-Semait said excessive screen time may also play a role in kids' back pain. He said youngsters should seek "moderation in every aspect."
The study is to be presented March 12 at the American Academy of Orthopaedic Surgeons' annual meeting, in Las Vegas. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

Water Polo Study Highlights Head Injury Risk

 Water polo players appear to face similar head injury risks as athletes in better-known sports, a new study FINDS.
"For years, water polo's head trauma risks have been downplayed or overshadowed by football-related brain injuries," said study co-author James Hicks.
"Our data quantifies the extent of the problem and sets the stage for additional research and possible rule changes or protective gear to improve water polo safety," Hicks added. He is chairman of the department of ecology and evolutionary biology at the University of California, Irvine.
"People who've never seen a game may not realize how physical it is," Hicks said in a university news release. "Head-butts and elbows. Balls flying up to 50 miles per hour."
And while no concussions were diagnosed among players in the study, the force of the head blows was "similar to those observed in collegiate soccer, another sport that is commonly studied for the risks associated with repeated head impact exposure," he added.
For the study, Hicks and his colleagues tracked several dozen players in Division 1 NCAA Men's Water Polo over three seasons. The players wore caps embedded with electronic sensors.
Overall, the researchers counted an average of 18 head hits per game.
Offensive players were far more likely to get hit in the head than players in defensive and transition positions (60%, 23% and 17%, respectively), the findings showed.
Players attacking from the left side of the goal suffered more head hits than players on the right, possibly because right-handed athletes commonly throw shots from the left zone, the researchers noted.
Offensive center was the most dangerous position in terms of hits to the head. On average, those players took nearly seven blows to the head per game, which amounted to 37% of all head impacts recorded in the study.
The second-most vulnerable position, defensive center, averaged two head hits per game, according to the report.
The study authors concluded that "intercollegiate water polo athletes may represent a valuable cohort for studying the acute and chronic effects of repeated head impacts in sport to extend our knowledge of athlete physiology and neurology and to inform evidence-based policies to promote the safety of athletes and the benefits of sport."
The study was published online May 2 in the journal PLOS ONE.
In a previous study, Hicks and a colleague found that 36% of 1,500 USA Water Polo players recalled at least one concussion during their playing career.

Does Your Sunscreen Work for You?

 Sunscreen is a real key to protecting your skin from the sun and preventing skin cancer, but are you using it correctly?
Santa Monica-based dermatologist Dr. Tanya Kormeili thinks not.
A recent American Academy of Dermatology (AAD) found "only about a third of Americans are reapplying their sunscreen every two hours while outside. Since sunscreen wears off, incorrect usage leaves you unprotected and susceptible to skin cancer," Kormeili said in an AAD news release.
She outlined other common sunscreen mistakes and how to avoid them.
First, read the sunscreen labels. You should choose sunscreens that are broad-spectrum, water-resistant and have an SPF of 30 or higher.
Second, most people apply only one-quarter to one-half of the recommended amount of sunscreen. To fully cover their body, most adults need about 1 ounce of sunscreen, or enough to fill a shot glass. Apply enough sunscreen to cover all skin that isn't covered by clothing. Apply it 15 minutes before going outdoors, and reapply every two hours while outdoors or after swimming or sweating.
Third, only 20% of Americans apply sunscreen on cloudy days, but the sun's harmful ultraviolet (UV) rays go through clouds. Apply sunscreen every time you go outside, even under clouds.
Another mistake is using old sunscreen. Sunscreens are required to retain their original strength for at least three years. Throw out your sunscreen if it's expired or you're unsure how long you've had it. If you buy sunscreen that doesn't have an expiration date, write the purchase date on the bottle so that you know when to stop using it.
"Sunscreen is the most important skin care product you can use, as it helps prevent sunburn, skin cancer and premature skin aging, including wrinkles and age spots," Kormeili said. "However, to ensure the best protection for you and your family, it's important to follow the manufacturer's directions before using."
She added, however, that no sunscreen can block 100% of the sun's UV rays. So even when you use sunscreen, it's also important to seek shade and wear protective clothing, including a lightweight, long-sleeved shirt, pants, a wide-brimmed hat and sunglasses with UV protection.
Skin cancer is the most common cancer in the United States, affecting 1 in 5 Americans in their lifetime, according to the AAD.

'Secret Shopper' Study Finds Many Who Need Addiction Treatment Can't Get It

 When people who are addicted to opioids make the difficult decision to quit, the last thing they need to face are barriers to treatment.
Yet, a new "secret shopper" study suggests most addicts seeking a prescription for buprenorphine -- which helps people stop using opioids -- would have trouble even getting an appointment with a doctor qualified to dispense the drug.
When researchers called doctors' offices posing as addicts who wanted to get a prescription for buprenorphine so they could stop using heroin, 46% of those who said they had Medicaid were denied an appointment, while 38% of those who said they would pay in cash were turned away.
"When people are seeking treatment, you want to make it as easy as possible. But our study showed you have to be quite persistent. That can be tough and might lead to them giving up," said study senior author Dr. Michael Barnett. He's an assistant professor of health policy and management at the Harvard T.H. Chan School of Public Health in Boston.
Barnett said buprenorphine is "a long-acting medication that stimulates the same receptors in the brain as opioids. It helps quash cravings without the euphoria or high of opioids. It lets people get back to their life."
The challenge in prescribing it, however, is that people have to be in mild to moderate withdrawal before they can be given the drug. Paradoxically, if you are high on opioids and you take buprenorphine, it sends you into an immediate and difficult withdrawal. So, it must be carefully administered by someone who's had the right training, Barnett explained.
Providers have to obtain a federal waiver to be able to prescribe buprenorphine. Doctors have to have eight hours of training, and nurse practitioners and physician assistants need 24 hours of training. Fewer than 6% of doctors in the United States have these waivers. And even those who do aren't always actively prescribing the drug.
The U.S. Substance Abuse and Mental Health Services Administration maintains a public list of doctors who agreed to be listed when they obtained their waivers to prescribe buprenorphine.
For the study, two female researchers called the doctors on this list. They posed as heroin addicts seeking an appointment for a buprenorphine prescription. They posed as either a patient with Medicaid or someone who would pay with cash. Each doctor's office was called twice, several weeks apart.
The researchers planned to call nearly 1,100 providers in six states. However, 530 of the providers were culled from the list because they had invalid contact information (such as a non-working phone number) or they were no longer prescribing buprenorphine.
Some of the remaining doctors couldn't be reached. For example, their phone may have gone to voicemail instead of a live person. The researchers completed just over 430 calls as a Medicaid patient, and nearly 420 as a cash payer.
Only between half and two-thirds of doctors scheduling an appointment planned to give a prescription on the first visit.
One bright spot the study found was when researchers did find a doctor willing to book an appointment, the wait time was often less than two weeks.
"We do have a prescriber workforce that is open for business and ready to help, but it may be hard for patients to find these providers in those directories," Barnett said.
As to why people, particularly the Medicaid group, had trouble getting an appointment, Barnett said there are a number of reasons why. One is that Medicaid may put up barriers to prescribing buprenorphine, such as requiring a prior authorization before prescribing the medication. Also, he said, some doctors didn't want to accept cash payments.
And, he said, there may still be a stigma against these patients. "They're just people. It's like treating any other chronic illness, and buprenorphine can literally turn people's lives around," Barnett explained.
The findings were published June 3 in the Annals of Internal Medicine.
Dr. Pooja Lagisetty, an assistant professor at the University of Michigan and a primary care physician herself, co-wrote an editorial that accompanied the study. "There was a big difference between those willing to take Medicaid versus the self-pay patients. It makes you question whether insurance may not be reimbursing enough," she said.
"Addiction is a disease, and people do better on this medication when they're on it long term. We need to make sure providers are being appropriately reimbursed for the care they're providing," Lagisetty said.
Dr. Paul Earley, president of the American Society of Addiction Medicine, said, "What's most disconcerting is that some of the states with the worst opioid overdoses are where people had a harder time getting an appointment."
Earley said in this age of data, it shouldn't be too hard to ask a doctor to be sure to update their information on the list every year, so that people trying to get help aren't frustrated by calling numbers that are out-of-date and aren't working.
He also said that doctors seeking the federal waivers that allow them to prescribe should set up a system for caring for these patients. Earley said they need urine testing to be sure they're taking the medication as they should, and that they need to be called more often with appointment reminders.
"All of those things require a certain amount of work to set up," he said. But it can be done successfully, Earley noted, pointing to the doctors who were able to see patients quickly in this study.

Is MRI Screening Worth It for Breast Cancer Survivors?

 Breast MRI screening is a good way to detect small tumors, but it's unclear how much it benefits women with a history of breast cancer, a new study finds.
Right now, experts recommend that breast cancer survivors have yearly mammograms to help catch any recurrences early. An unresolved question is whether adding breast MRI to that screening is beneficial.
In the new study, researchers found that when survivors underwent MRI screening, it did tend to detect more tumors, compared to yearly mammography alone. But it also more than doubled the number of biopsies women needed -- many of which turned out to be benign.
Experts said it leaves women with a choice to make.
"Rather than deciding for women that the risks of any exam outweigh the benefits, we need to be clear and open about exactly what those risks and benefits are, and let them decide what's most important to them," said Dr. Mary Newell, a radiologist at Emory University's Winship Cancer Institute in Atlanta.
Newell wrote an editorial accompanying the study published online June 4 in the journal Radiology.
Breast MRIs can catch some tumors not seen on standard mammograms, but they are also more likely to spot something that turns out to be benign, according to the American Cancer Society (ACS).
Because of that, MRI is reserved for women at high risk of breast cancer. (The average U.S. woman has about a 12% risk.) Right now, the ACS recommends MRI, along with yearly mammograms, when women have a roughly 20% or higher lifetime risk of breast cancer.
That group includes women who carry certain inherited gene mutations, or who have a particularly strong family history of breast cancer.
But it does not include women with a personal history of breast cancer.
That's because at the time the recommendations were made -- in 2007 -- "there simply weren't any good studies from which we could draw conclusions," said Robert Smith, vice-president of cancer screening for the ACS.
Even now, he said, there remains little research evidence.
The new study is the largest and most comprehensive to look at the issue so far, according to lead researcher Karen Wernli of Kaiser Permanente Washington Health Research Institute in Seattle.
Wernli and her colleagues combed through information on more than 13,000 breast cancer survivors who were screened for breast cancer at several sites across the United States. All together, they had received nearly 34,000 mammograms and about 2,500 MRI screenings between 2005 and 2012.
Overall, MRI caught more tumors -- at a rate of 11 per 1,000 exams, compared to eight per 1,000 for mammography alone. To achieve that rate, though, the MRI group had to undergo more biopsies: 10% of those screenings led to a biopsy, compared to 4% of mammograms.
And while MRI detected more early tumors, it's not clear what the ultimate benefit is: The rate of "interval" cancers -- cancers diagnosed in the year between screenings -- was the same in the mammography-only and MRI groups.
That suggests, according to Wernli, that mammography did about as well as MRI in detecting tumors that were "clinically important" -- small tumors that would progress enough to produce symptoms (like a lump) in the next year.
Wernli pointed to the potential broader impact of using MRI screening for all women with a history of breast cancer. If every U.S. woman diagnosed with non-advanced breast cancer in 2018 underwent one MRI, there would be more than 14,000 additional biopsies.
For individual patients, however, those types of figures may not mean much, Newell pointed out. If, she said, a woman has a lot of anxiety about a cancer recurrence, for example, she might feel the higher odds of needing a biopsy are worth it.
The decision comes down to women discussing the pros and cons of MRI screening with their doctors, the experts said.
They also agreed that more research is needed to figure out whether MRI screening benefits certain breast cancer survivors more than others.
Smith pointed to some examples. It might be that women with dense breast tissue -- which can make mammography interpretation harder -- benefit more from adding MRI. The same could be true of women with a family history of breast cancer.
But studies are needed to find out, Smith said.
There are also practical issues. Breast MRI costs substantially more than mammography, and the ACS advises women to first check that their insurance plan covers it.

Common Supplement Ingredient Vinpocetine Could Harm Fetus, FDA Warns

 Vinpocetine, a compound found in many dietary supplements, may pose a risk to women of childbearing age, U.S. health officials warn.
A review by the U.S. Food and Drug Administration found that vinpocetine may cause a miscarriage or harm a developing fetus.
"We're advising pregnant women and women who could become pregnant not to take vinpocetine," FDA Deputy Commissioner Dr. Amy Abernethy said in an agency news release. "We are also advising firms marketing dietary supplements containing vinpocetine to evaluate their product labeling to ensure that it provides safety warnings against use by pregnant women and women who could become pregnant."
Vinpocetine is a man-made compound used in some products sold as dietary supplements, either alone or combined with other ingredients. It may appear on labels as Vinca minor extract, lesser periwinkle extract or common periwinkle extract, the FDA said.
Supplements that contain vinpocetine claim to enhance memory, focus or mental acuity. They are also touted to increase energy and aid weight loss, the FDA noted.
The agency is asking companies that make supplements containing vinpocetine to ensure they warn against use by pregnant women and women who could become pregnant.
In some countries, vinpocetine is treated as a prescription drug. In the United States, however, supplements containing the compound have not been reviewed by the FDA. Thus, neither the safety and effectiveness nor the label claims for these supplements are approved, the agency said.

AHA News: For LGBTQ Patients, Discrimination Can Become Barrier to Medical Care

TUESDAY, June 4, 2019 (American Heart Association News) -- In recent years, medical experts have been awakening to the specialized needs of LGBTQ people. But one of the most significant barriers to their care can sometimes be right in their doctor's office.
Jamison Green knows this firsthand.
"One of the worst things is actually just anticipating having to explain yourself," said Green, 70, who began his medical transition from female to male in 1988. "It causes tremendous stress and anxiety to think about being thrown out of a doctor's office or being laughed at or being treated insensitively to the point of feeling abused."
Green, who lives in Vancouver, Washington, and is a former president of the World Professional Association for Transgender Health, has dealt with a doctor so hostile he refused to look Green in the eye.
And although he's been able to find good doctors, too, he knows the affronts other transgender people have endured.
Discrimination is not limited to transgender patients. Gay, lesbian, bisexual and other sexual or gender minority people encounter doctors who are ill-informed, ask inappropriate questions or refuse to treat them.
"We hear stories very frequently from people going into a provider's office and having an inappropriate encounter," said Dr. Mitchell Lunn, co-director of The PRIDE Study, the first long-term national health study of people of all LGBTQ identities, for which Green is a volunteer ambassador.
Green gives the example of health care workers who refuse to call people by their preferred name. Lunn has heard of a transgender person with a respiratory complaint being subjected to an unnecessary genital exam while trainees observed.
Surveys show how widespread such discrimination can be.
Lunn, an assistant professor of medicine in nephrology at Stanford University in California, cited the 2015 U.S. Transgender Survey, which found a third of transgender people who saw a health care provider in the prior year had at least one negative experience, such as being verbally harassed or refused treatment.
A 2014 report by the advocacy group Lambda Legal found more than half of lesbian, gay or bisexual survey respondents and 70% of transgender people had experienced discrimination while seeking health care.
The consequences can be life-threatening. "If you're never showing up to a provider's office because you're discriminated against every time you go there, then that hypertension that you have might never be diagnosed, even though you got it when you were 35," Lunn said. "And then you have a heart attack or stroke at 65 or 55." Or someone might skip a screening that would have detected cancer.
The Williams Institute at the UCLA School of Law says about 4.5% of U.S. adults -- 11 million people -- identify as LGBT; about 1.4 million people identify as transgender.
That's a lot of people, said Dr. M. Brett Cooper, an assistant professor of pediatrics at UT Southwestern Medical Center in Dallas, but the problems they encounter are not widely discussed by the general public.
People who haven't been discriminated against say, "'I can't believe this would happen!'" said Cooper, who is co-chair for the Society for Adolescent Health and Medicine's special interest group on LGBTQ health. "Well, it does. And it's not just in the small towns. It happens in Dallas. It happens in New York City. It happens all over."
Cooper, who led a 2018 study that showed the benefits of exposing medical students to a lecture on LGBTQ topics, said better education could help.
"It's really just trying to educate people that, when you ask questions, for example, about husbands or wives or partners, or if you need to ask about certain private body areas, that you don't make assumptions about what that person has, and you either leave it open-ended or give that person multiple options."
Cooper said there has been a dearth of research on LGBTQ topics -- something The PRIDE Study seeks to address. It's a long-term effort that so far has collected data from 13,800 people.
"We have something like 10 to 12 papers that are somewhere in the pipeline right now, from being written to under review," Lunn said.
Some are asking basic questions about the ways people identify their sexuality. Others are looking at possible links between migraine headaches and the trauma of being stigmatized; or the differences in substance abuse based on identity; or a skin cancer study focused on gay men, who are six times more likely than straight men to use tanning beds.
Thanks to policies that require inclusion of sexual and gender minority people in research, and money being provided for such research, "we're totally at a time when people are talking about sexual and gender minority health in a new way," Lunn said.
In the end, Cooper hopes everyone can get the informed, sensitive care they are entitled to, from any doctor, anywhere. "LGBT folks want to be treated in the office just like any other patient that would walk through the doors."

Chicken No Better Than Beef for Your Cholesterol?

        Flying in the face of popular belief, new research suggests both red meat and white meat can drive up your cholesterol levels.
The study was conducted by researchers from the Children's Hospital Oakland Research Institute (CHORI), part of the University of California, San Francisco. The analysis is reportedly the first to
comprehensively compare the impact that red and white meat have on cholesterol.
Red meat, such as beef and lamb, has become unpopular in recent years because of its association with heart disease, and government nutrition guidelines have encouraged consumers to eat poultry as a healthier alternative, the researchers noted.

"When we planned this study, we expected red meat to have a more adverse effect on blood cholesterol levels than white meat, but we were surprised that this was not the case," said study senior author Dr. Ronald Krauss. "Their effects on cholesterol are identical when saturated fat levels are equivalent."
Krauss is senior scientist and director of atherosclerosis research at CHORI.
After tracking how red meat, white meat and plant protein all impacted cholesterol levels, Krauss and his team determined that both red and white meat prompted higher blood cholesterol levels than diets containing an equivalent amount of plant protein. (Grass-fed beef, fish and processed meat products such as bacon were not included in the analysis.)
The finding held up even after accounting for a high intake of saturated fats, investigators noted, and it suggests that the best way to keep cholesterol under control is to turn to non-meat proteins, such as vegetables, legumes and dairy products.
"Our results indicate that current advice to restrict red meat and not white meat should not be based only on their effects on blood cholesterol," Krauss noted in a university news release. "Indeed, other effects of red meat consumption could contribute to heart disease, and these effects should be explored in more detail in an effort to improve health."
The findings were published June 4 in the American Journal of Clinical Nutrition.

Health Highlights: June 5, 2019

Here are some of the latest health and medical news developments, compiled by the editors of HealthDay:
Former CDC Director Pleads Guilty to Sex Abuse
Tom Frieden, who ran the U.S. Centers for Disease Control and Prevention in the Obama administration avoided jail by pleading guilty to groping a family friend, ABC News reported.
The incident occurred in October 2017. In 2018, the women involved reported that Frieden had grabbed her butt in a Brooklyn apartment. Frieden turned himself into police.
Frieden, 58, wasn't required to explain to Brooklyn Criminal Court Judge Edwin Novillo what happened. Frieden plea avoided up to a year in jail for misdemeanor forcible touching, third-degree sexual abuse and second-degree harassment.
Frieden pleaded guilty to disorderly conduct in exchange for having all of the criminal charges dropped. He was sentenced to a conditional discharge, which will be dismissed and sealed in a year as long as he doesn't get arrested during that time.
The judge also ordered Frieden not to have contact with the woman for a year.
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Congo Ebola Cases Exceed 2,000
An outbreak of Ebola in the Democratic Republic of Congo has reach more than 2,000 cases in 10 months, BBC News, reported.
The outbreak, which has killed two thirds of its victims, is now the second largest in history. The number of cases has risen rapidly in recent weeks.
The fight against the epidemic has been hindered by mistrust of violence towards health care workers, the BBC said.
Although more than 1,300 deaths from the disease have been reported since August, the NGO Oxfam told the BBC, that their teams meet people everyday who don't believe Ebola even exists.
Still others say they don't trust health care workers, so they avoid treatment. That makes it more difficult to curb the outbreak, Oxfam said.
In addition, from January to May more than 40 attacks on health stations have occurred. Recently, however, the attacks have lessened.
Although the outbreak is confined to two provinces, there is a fear that it will spread because violence in the region is making it harder to contain.
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Beverly Hills Is First U.S. City to Stop Most Tobacco Sales
Beverly Hills city council voted Tuesday to ban sales of cigarettes, cigars, e-cigarettes and other tobacco products starting in 2021.
It's the first city to take such a step, according to a report from the Associated Press.
The ban covers gas stations, drugstores and convenience stores, but exempts hotels and three cigar lounges in the posh LA suburb.
Exempting hotels was done to accommodate tourists.
Owners of gas stations said the new ban targeted their businesses, which could cause layoffs. But public health advocates believe the benefits to health are worth the costs.
"I'll never understand why a product that causes diseases and harm to nearly every organ of the body can be sold at every gas station and drug store," Laurent Huber, executive director of Action on Smoking and Health, said in a news release.
"No other hazardous, proven-deadly product receives the same free pass to be sold for mass consumption," Huber said. "Beverly Hills is the first domino falling for tobacco sales, and other jurisdictions with no doubt soon follow their lead."
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Apple Watch Adding Menstrual Cycle Tracker
Among the new Apple Watch apps announced on Monday is one to track a women's menstrual cycle, CNN reported.
The app will predict the timing of a woman's menstrual cycle, which can help tell when she is likely to be fertile.
"Knowing more about your menstrual cycle gives you a window into your health, from simply insuring you are prepared to understanding your personal patterns and regularities," Sumbul Desai, Apple's vice president of health, said during the Worldwide Developers Conference, CNN said.
According to Apple, women can add information related to their menstrual cycle, including current period, flow, symptoms, results from ovulation prediction kits and other elements of fertility tracking.
The app will be available with the release of iOS 13.

5 Easy Ways to Cut Back Your Salt Intake

 About two-thirds of Americans have taken steps to cut back on salt, according to the International Food Information Council Foundation.
This often starts with comparing labels and choosing foods -- from soups to canned veggies -- with less sodium. Here are four more steps that you can take to reduce your salt intake.
You know that processed red meats and lunch meat of all kinds are loaded with salt, but also be aware of less obvious sources, like packaged breads. If you have toast at breakfast, a sandwich at lunch and a roll at dinner, all that salt will add up. Prepared and packaged dinners can be high in salt, especially pizza, chicken nuggets and many ethnic foods, the American Heart Association warns. The same goes for poultry that's been "pre-basted" or injected with a sodium solution.
Make more food from scratch. Restaurants, and fast-food establishments in particular, add a lot of salt and sodium-based flavor enhancers to foods. When you do the cooking, you control the salt. Besides herbs, use spices to add flavor. Try various pepper-based ones like ancho and chipotle chilies and paprika. Using garlic and onions adds sweetness and depth. Just beware of spice blends with hidden salt, like taco seasoning -- look for no- and low-salt varieties.
Track your salt intake on the same app or website that you use to track calories. Watching the numbers add up should motivate you to cut back.
Even though the salt added from a salt shaker is only a small part of the average person's added salt, get into the habit of tasting the food on your plate before you reach for it, whether you're at home or eating out. Add flavor with black pepper, fresh lemon juice or a sprinkling of a no-salt blend.

Average American Ingests 70,000 Bits of Microplastic Each Year

 Extremely tiny bits of plastic: They're in your food and drink, and even in the air around you.
Now, new research calculates that the average American consumes more than 70,000 particles of these "microplastics" every year -- and even that's likely an underestimation, the scientists noted.
Your microplastic intake might be even higher if you choose products that have more plastics involved in their processing or packaging -- including bottled water, the research team said.
Just how harmful is all this plastic in your body? That's still unclear, said one expert unconnected to the new study.
"It's certainly concerning," said Dr. Kenneth Spaeth, chief of occupational and environmental medicine at Northwell Health in Great Neck, N.Y. "I think the best we can say is perhaps there's minimal harm here, but I think there is a possibility the harm could be extensive."
Other recent studies have shed light on the ubiquity of microplastics in people's bodies.
For example, one report out of Austria found that the average human stool sample contained at least 20 bits of microplastic. In another study, microplastic was found in 90% of samples of common table salt.
However, it's tough to accurately calculate the amount of plastic people consume, noted the lead author of the new study, Kieran Cox. That's because the 26 studies used in the evidence review involved food sources that only reflect about 15% of people's daily diet, he noted. Cox is a Ph.D. candidate with the University of Victoria in British Columbia, Canada.
The researchers added that a person's microplastics consumption rises based on personal food choices they make. For example, a person who only drinks bottled water could be ingesting an additional 90,000 microplastics annually, compared with just 4,000 microplastics for someone who only drinks tap water.
That shows how "simple choices may drastically alter your exposure to plastics," Cox said.
Microplastic particles are incredibly tiny, less than 130 microns in diameter. For comparison, a human hair has a diameter of about 50 microns.
In the new study, Cox and his colleagues analyzed more than two dozen studies that estimated the average microplastic content of different types of foods.
They then estimated what an average person's microplastic intake would be if they ate the recommended daily amount of these foods.
The studies included in the review focused on such commonly consumed items as seafood, sugar, salt, honey, alcohol and bottled water, Cox said. A whole host of other common foods, including chicken, deli meats, vegetables and dairy products, have not been analyzed for their microplastic content.
"We don't have a huge part of the puzzle," Cox said. "We have a small portion of it. We know these are underestimates."
Based on these studies, the researchers estimated that annual microplastic consumption ranges between 39,000 to 52,000 particles, depending on age and sex.
If microplastic particles inhaled via breathing contaminated air are included in the estimate, the annual load increases to between 74,000 and 121,000, the team said.
The numbers would likely be higher for people who eat foods and drink liquids that are processed using plastics or packaged in plastics, Cox added.
For example, studies show that tap water exposes people to between 3,000 and 6,000 microplastic particles each year, but bottled water exposes them to between 64,000 and 127,000 particles annually if that's their only water source.
That's because bottled water is exposed to plastic in a number of different ways, both during processing and as it sits in its plastic bottle waiting for someone to take a swig, Cox said.
There's no clear handle yet on how these plastic particles could affect human health, Cox and Spaeth said.
"The extent to which it is posing a health risk is uncertain at this point," Spaeth said. "There's very little data in the way of human studies that look at health effects in any way."
There's a chance that harmful chemicals in the plastic might leach out of the particles as they pass through the body, Spaeth said.
Some particles also might lodge in the body following inhalation or ingestion, causing immune system responses and cellular damage, the researchers added.
"Once in the lung, depending on the size of the particle, it could conceivably pass into the circulation and go anywhere in the body," Spaeth said. "This study points out there's an accumulation of these particles at pretty high numbers."
The findings were published June 5 in the journal Environmental Science and Technology.

Few Prostate Cancer Patients Are Getting Checkups They Need

 While men with early-stage prostate cancer can delay treatment, few follow guidelines for monitoring their condition, researchers report.
In fact, their study of nearly 350 men from North Carolina found that only 15% who chose what's known as active surveillance followed the recommended guidelines.
"Active surveillance has rigorous guidelines -- people need regular PSA tests, they need prostate exams, they need prostate biopsies so you can watch the cancer very closely, and you don't lose the opportunity to treat the cancer when it starts to grow," said study co-author Dr. Ronald Chen. He's an associate professor from the University of North Carolina Lineberger Comprehensive Cancer Center in Chapel Hill.
Guidelines recommend prostate-specific antigen (PSA) tests at least every six months; a yearly digital rectal exam, and a biopsy within 18 months of diagnosis.
"We're finding very few patients who elected to undergo active surveillance actually received the recommended monitoring," said first author Sabrina Peterson, a UNC medical school student.
Among 346 men with low- or intermediate-risk prostate cancer, the study found that within six months of their diagnosis, 67% had undergone a PSA test and 70% had a digital rectal exam.
But only 35% had the recommended biopsy during the first 18 months. Over two years, only 15% had undergone all the recommended tests.
It wasn't clear why so few men followed the guidelines, the researchers said. No connection was seen with income, race or age.
"This raises the question of whether we need to investigate whether active surveillance is a safe option when patients do not receive routine monitoring," Chen said in a university news release. "Our goal is not to reduce the number of patients choosing active surveillance; rather, the results of this study should increase awareness and efforts to ensure that active surveillance patients are monitored rigorously."
Chen and his colleagues also investigated why men would or wouldn't choose active surveillance. They found that men opted for treatment when their cancer began to progress.
Patients who were anxious about their cancer were also more likely to stop active surveillance and switch to treatment, the researchers found.
The preliminary findings were presented Sunday at a meeting of the American Society of Clinical Oncology, in Chicago. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

Tight Diabetes Control Alone May Not Benefit the Heart Long-Term

 Type 2 diabetes is a known risk factor for heart disease, and researchers thought that five years of really tight blood sugar control might reduce the risk of heart disease for years to come.
But a new 15-year follow-up study found that was not the case. The findings suggest it might be more important to control other risk factors for heart disease, such as high blood pressure, cholesterol and unhealthy weight.
"Glucose-lowering has a modest benefit, but it's not enough by itself. We need to address all the other cardiovascular risk factors," said the study's lead author, Dr. Peter Reaven. He's a staff physician at Phoenix Veterans Affairs Health Care System, in Arizona.
Reaven emphasized that these findings apply to this particular population -- people who had type 2 diabetes for more than 10 years on average before the study began. Their average age was around 60, and the study group was nearly all men.
So it's not yet clear what the results might be if a blood sugar-lowering intervention was started soon after diagnosis with type 2 diabetes. It's also not known if these findings apply to people with type 1 diabetes.
The initial phase of the study included almost 1,800 people. They were randomly selected to receive either standard diabetes treatment or intensive blood sugar-lowering treatment.
Both groups received the same medications. The difference was in the dosing. People in the intensive group were given enough medication to lower their hemoglobin A1C levels below 7%. Hemoglobin A1C is a blood test that provides an estimate of average blood sugar levels.
An A1C of under 5.9% is considered normal. Researchers aimed to get the intensive treatment group to below 7%. Reaven said the initial average A1C of the whole group was about 9%.
During the intervention part of the study, the group getting usual care lowered their A1C to 8.4%. The intensive group had an average A1C of 6.9%. The intervention lasted nearly six years.
Approximately 10 years after the study began, the researchers found a 17% drop in the risk of heart disease and stroke.
"We wanted to learn if there was a continued benefit, a 'legacy' effect," Reaven explained. And, at least in the short-term, it appeared there might be.
But the 15-year follow-up found no statistically significant difference in the rate of heart attacks and strokes, or deaths.
"This was a fairly definitive assessment, and in this group of older type 2 diabetes patients, there's no evidence of a legacy effect," Reaven said. "Our data suggests that for glucose-lowering to have continued benefit, it must be sustained."
Since the intervention portion of the study was done, newer medications -- some that have specifically been shown to reduce the risk of heart disease -- have been introduced for type 2 diabetes. It's not clear what the long-term effect of these medications might be, or if these newer drugs have a legacy effect.
Results of the study were published June 6 in the New England Journal of Medicine.
Dr. Kasia Lipska from Yale School of Medicine is co-author of an editorial in the same issue of the journal.
"We've learned over time that how you lower blood glucose matters when it comes to cardiovascular risk. With newer medicines that have different mechanisms of action, the benefits for cardiovascular disease are pretty quick," she said.
But she said that controlling other risk factors for heart disease and stroke is crucial. "Very tight control of glucose for cardiovascular disease is not the best way to reduce risk. Avoiding smoking, blood pressure control, statin therapy [to lower cholesterol] are known to reduce cardiovascular disease risk," Lipska said.
That doesn't mean that controlling blood sugar isn't important, it is. But there needs to be a balance. People shouldn't be trying to lower their blood sugar so much that they end up having a dangerous low blood sugar episode.
"Patients need to have a conversation with their doctor about what is right for them," she advised.
Dr. Gerald Bernstein is program coordinator at Lenox Hill Hospital's Diabetes Institute, in New York City. He pointed out -- as did the study authors -- that widespread use of blood pressure and cholesterol medications may have affected the potential benefits from lowering blood sugar. He said this study's findings shouldn't change current blood sugar management.
"The upshot is, control of blood glucose is better than not," Bernstein said.

Whooping Cough Vaccine Effectiveness Fades With Time: Study

 The waning effectiveness of a flawed whooping cough vaccine is the main culprit in recent outbreaks of the highly contagious bacterial infection, a new study reports.
More than four out of five confirmed whooping cough (pertussis) cases strike children who are fully vaccinated, the study authors said.
That's because the vaccine for whooping cough loses effectiveness over time, the researchers discovered.
Up to age 7, kids have a five times higher whooping cough risk when they're three years out from their last shot, compared to the year immediately after vaccination, according to the report published online June 10 in Pediatrics.
And kids between 7 and 11 have double the risk if they are more than six years away from their last shot, compared with less than three years after, the findings showed.
"We found children who received their vaccines and who are far away from their last vaccine were at increased risk of pertussis [whooping cough]," said lead researcher Ousseny Zerbo. He is a staff scientist in the Vaccine Study Center at Kaiser Permanente Northern California in Oakland. "As time goes by, the effectiveness starts to wane."
Researchers hastened to point out that the vaccine remains a vital means of preventing the disease.
Risk of catching whooping cough is 13 times higher among unvaccinated children and twice as likely among kids who are behind on their shots, compared with fully vaccinated kids, the study authors said.
Senior researcher Dr. Nicola Klein, director of the Kaiser Permanente Vaccine Study Center, stressed that "it's still very risky not to vaccinate. Vaccination does prevent pertussis."
The researchers said that the findings underscore the importance of keeping up to date on a child's shots, and the critical need to develop new and better vaccines against whooping cough.
Despite high vaccination rates, the United States and other countries have seen large whooping cough outbreaks since the 1990s, when a new acellular pertussis vaccine replaced the prior whole-cell pertussis vaccine, the researchers said in background notes.
According to Dr. Kathryn Edwards, director of the Vaccine Research Program at Vanderbilt University in Nashville, Tenn., "The old vaccine worked very well, but it was associated with a lot of local reactions and a lot of fever."
Whooping cough cases fell as low as 1,010 in 1976, but began rising in the 1990s, the U.S. Centers for Disease Control and Prevention reports. In 2012, nearly 48,300 cases were reported nationwide, the most since 1955.
But researchers didn't know whether these cases and outbreaks were caused by kids going unvaccinated or by a flaw in the new vaccine. So the Kaiser scientists followed nearly 470,000 kids born in California between 1999 and 2016 to see how vaccination related to whooping cough cases.
Vaccination rates among these children were strong. Only 1% went unvaccinated; 3% were undervaccinated.
And 82% of whooping cough infections occurred in kids who were fully vaccinated, the researchers found.
Klein said, "That really tells us the major contributor towards these outbreaks is the waning of the vaccination."
The statistics revealed that risk of whooping cough steadily increases the longer it's been since a child's last shot.
For example, kids younger than 7 have a 36% higher risk of contracting whooping cough two years out from their last shot, but more than double the risk three or more years out.
Children 7 to 11 have a 90% increased risk between three and four years after their last shot, but 4.7 times the risk if they are six or more years out, the study found.
Klein said parents shouldn't be alarmed by this, because the vaccine still is preventing countless cases of the disease.
But it does underscore the need for a better pertussis vaccine, Klein and Edwards said.
New vaccines based on live weakened or genetically modified pertussis bacteria are in various stages of development and testing, Edwards said.
"We need a new vaccine we could give that would be more durable," said Edwards, who wrote an editorial accompanying the new study.

Investigational Drug Teplizumab May Help Delay Onset of Type 1 Diabetes

 A two-year delay in the onset of type 1 diabetes could make a big difference for people with the disease. And researchers say a new drug may make that postponement possible.
Researchers gave the drug teplizumab or a placebo to a small group of people who were nearly certain to develop type 1 diabetes, based on genetics and certain symptoms. Those given a placebo, or dummy drug, progressed to type 1 diabetes in an average of just over 24 months. Those given the drug developed the autoimmune disease in an average of 48 months.
It's at least a few years until this drug could possibly be approved for use outside of a clinical trial, said Jessica Dunne, senior director of research at JDRF (formerly the Juvenile Diabetes Research Foundation).
Still, "keeping kids off insulin as long as possible is really exciting," Dunne said. "This study shows with just a short course of therapy, it's feasible to give people two years less of insulin shots, finger pricks and daily monitoring."
Dunne also noted that a delay means a child might be more mature and able to help manage the condition. "The difference between a 12-year-old and a 14-year-old being diagnosed is huge," she said.
A delay in diagnosis also means two fewer years with the disease. That might translate into fewer complications later in life, according to the JDRF.
"This is the first study to show any drug can delay type 1 diabetes diagnosis a median of two years in people at high risk," said study lead author Dr. Kevan Herold, a Yale University professor, in a news release from the school.
Type 1 diabetes occurs when the body's immune system mistakenly attacks insulin-producing cells called beta cells in the pancreas. Insulin is a hormone that helps usher the sugar from foods into the body's cells to be used as fuel.
These people must replace that lost insulin through daily injections or an insulin pump. Up to 1.5 million Americans have type 1 diabetes, according to the study authors.
Teplizumab targets specific types of immune system cells, interfering with the destruction of beta cells.
The study included 76 people older than 8 years. Most were under 18 years old. They were at very high risk of developing type 1 diabetes. They had a relative with type 1 diabetes and evidence that their own immune systems might already be attacking beta cells (auto-antibodies). The study volunteers also showed signs that their bodies weren't processing blood sugar normally.
Slightly more than half of this group received teplizumab for two weeks intravenously. The others were given a placebo by IV. Study participants were followed until they developed type 1 diabetes. The average study follow-up for most was three years, though some of the study participants haven't yet developed diabetes and are still being followed.
In addition to delaying the average onset of type 1 diabetes by two years, the researchers found that only 43% in the treatment group developed type 1 diabetes compared to 72% in the placebo group.
The findings were presented Sunday at the American Diabetes Association meeting, in San Francisco. They were published simultaneously in the New England Journal of Medicine.
Dr. Clifford Rosen, from the Maine Medical Research Institute, and Dr. Julie Ingelfinger, from Massachusetts General Hospital, wrote an editorial in the same issue of the journal.
"The results of this trial are striking, with several caveats," they wrote.
An important caveat, they said, is that these findings shouldn't be interpreted as a cure. But the findings do provide clues to potential causes of type 1 diabetes, and suggest ways to possibly try to modify the course of the disease.
The editorialists also noted that the study was small, and involved just a two-week course of treatment.
JDRF's Dunne agreed that the study raises new questions to be explored, such as what would happen if people were given more than one treatment? Or what if this drug was used with another?
But she said, "This study is particularly compelling because it was just a single course of the drug."
Funding for this study was provided by the U.S. National Institutes of Health, JDRF and the American Diabetes Association.