Category Archives: Health

Bubonic Plague Knowladge

Widely known as the disease that caused the “Black Death” of the European Middle Ages, bubonic plague is still around today — although cases are relatively rare.

Between 1900 and 2012, there were about 1,000 confirmed cases of plague in the United States.

More than 80 percent of these U.S. cases were bubonic plague, according to a 2015 report in the journal Emerging Infectious Diseases.

Plague can affect people of any age, but 50 percent of reported cases occur in people between ages 12 and 45, according to the Centers for Disease Control and Prevention (CDC).

 

Types of Plague

There are three forms of plague:

  • Bubonic
  • Septicemic
  • Pneumonic

Bubonic plague, the most common type, cannot be transmitted directly between people. It is instead spread through the bite of a flea that carries Y. pestis bacteria from an infected rodent.

The bacteria travels from the bite wound to the nearest lymph node, where it spreads to the lymphatic system and causes inflammation in the tonsils, adenoids, spleen, and thymus.

Septicemic plague, an infection of the bloodstream, accounts for about 10 percent of plague cases and is usually also transmitted through the bite of an infected flea.

But you can also get septicemic plague from direct contact with the bodily fluids of someone infected with the plague, or if you have another form of plague that spreads to your bloodstream.

Pneumonic plague, as its name suggests, causes pneumonia. You can get it if you have bubonic or septicemic plague that spreads to your lungs.

You can also catch pneumonic plague if someone with pneumonic plague coughs or sneezes, and you breathe in the infected droplets.

Pneumonic plague accounts for about 8 percent of plague cases and is the least common form of the disease.

It is, however, the most contagious type of plague and has a very high fatality rate.

Cats and — to a much lesser degree — dogs are susceptible to plague, and can transmit it to their owners or veterinarians.

In fact, cats are common sources of plague in people, notes the CDC.

Most cases of plague in cats are of the bubonic variety, which causes enlarged lymph nodes beneath the cat’s lower jaw.

But abscesses on feline lymph nodes due to plague are sometimes identical to abscesses from bite wounds and other causes, making the disease difficult to diagnose on sight.

Cats may pass bubonic plague to people through scratches and bites, as well as indirectly through fleas. They can also pass pneumonic plague to people through coughs and sneezes.

More often than not, dogs exhibit only a very minor plague illness, if they show any signs of the disease at all. But they can still pass it on to people.

In 2014, the CDC recorded the first U.S. case of human pneumonic plague that came from a dog.

Both cats and dogs get plague from infected fleas, or from biting or getting bitten by an infected rodent (prairie dogs and squirrels are common carriers in the United States).

 

Plague Outbreaks

In recorded human history, there have been three major plague pandemics.

Centered in the Byzantine Empire, which rimmed the Mediterranean Sea, the Justinian Plague began in 541 A.D. and caused outbreaks for the next 200 years, killing more than 25 million people, according to the CDC.

The Black Death or Great Plague began in China in 1334, and eventually spread to Europe through trade routes. It killed up to 60 percent of the European population.

In 1860, the Modern Plague began in China and spread throughout the world as steamships brought infected rats to various port cities.

Today, an average of seven new cases of plague are reported each year in the United States, mostly in the rural West.

Worldwide, 1,000 to 2,000 new cases are reported each year to the World Health Organization (WHO), but the actual incidence is probably much higher, the CDC notes.

The disease most often affects people in Madagascar, the Democratic Republic of Congo, and Peru, according to the WHO.

Ambulance is not an easy decision

On the other hand, almost 50 percent thought a woman in labor deserved such a ride to the hospital — just one of many scenarios found to be illustrative of inappropriate use of ambulances, Helen Kirkby, BS, and Dr. Lesley Roberts, of the University of Birmingham in England, reported online in the Emergency Medicine Journal.

“Most people would call for an ambulance appropriately when a real emergency occurred, but there are high levels of inappropriate calls when emergencies are not present,” they wrote.

Those also include a toddler bumping its head, a child with Lego blocks stuffed up the nose, or a drunk friend who is conscious but ill.

 

Abuse of ambulance services is high, the researchers said, with previous work suggesting that between 16 percent and 52 percent of calls to request one are inappropriate.

So Roberts and Kirkby conducted an online survey listing 12 common scenarios that may require medical attention, and asked participants to identify when they would request an ambulance.

Seven of those situations did not require an ambulance, while five did. Among the 150 respondents who completed the questionnaire, 66 percent were women and 96 percent were white.

Because the researchers sent it to family, friends, and colleagues, 25 percent of the survey population had some medical training, and 45 percent had some first aid training.

Almost all of the respondents correctly identified the need for an ambulance in three of the five scenarios — a patient having a heart attack, a drug overdose, and a motorcyclist thrown more than two meters from his bike.

However, far fewer identified the need for an ambulance for a child with symptoms of meningitis (53 percent said they wouldn’t call) or in a suspected stroke (25 percent said they wouldn’t call if an elderly patient started slurring their words without having consumed alcohol).

“This [stroke] statistic is concerning, given the current government FAST [face, arm, speech, time to call 999 (the U.K. ambulance hotline)] campaign to raise awareness of the signs of stroke,” they wrote.

When it came to conditions that didn’t require an ambulance:

  • 48 percent incorrectly thought that a woman in labor should ride to the hospital in the emergency vehicle
  • 16 percent wanted to call an ambulance for a toddler who bumped his or her head hard
  • 8 percent would call for a 3-year-old with a Lego block up the nose
  • 7 percent would call for a man with chronic back pain who has run out of painkillers

In subgroup analyses, the researchers found that those with first aid training were less likely to make an inappropriate decision, but in further regression analyses, no characteristics were predictive of calling an ambulance inappropriately, they said.

However, when they analyzed the data by individual scenarios, they found that the ambulance was more likely to be called inappropriately if the caller was female or single).

Affect Brain Activity

Holding a cell phone to your ear for a long period of time increases activity in parts of the brain close to the antenna, researchers have found.

Glucose metabolism — that’s a measurement of how the brain uses energy — in these areas increased significantly when the phone was turned on and muted, compared with when it was off, Dr. Nora Volkow, director of the National Institute on Drug Abuse, and colleagues reported in the Journal of the American Medical Association.

“Although we cannot determine the clinical significance, our results give evidence that the human brain is sensitive to the effects of radiofrequency-electromagnetic fields from acute cell phone exposures,” co-author Dr. Gene-Jack Wang of Brookhaven National Laboratory in Long Island, where the study was conducted, told MedPage Today.


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Although the study can’t draw conclusions about long-term implications, other researchers are calling the findings significant.

“Clearly there is an acute effect, and the important question is whether this acute effect is associated with events that may be damaging to the brain or predispose to the development of future problems such as cancer as suggested by recent epidemiological studies,” Dr. Santosh Kesari, director of neuro-oncology at the University of California San Diego, said in an e-mail to MedPage Today and ABC News.

There have been many population-based studies evaluating the potential links between brain cancer and cellphone use, and the results have often been inconsistent or inconclusive.

Most recently, the anticipated Interphone study was interpreted as “implausible” because some of its statistics revealed a significant protective effect for cell phone use. On the other hand, the most intense users had an increased risk of glioma — but the researchers called their level of use “unrealistic.”

But few researchers have looked at the actual physiological effects that radiofrequency and electromagnetic fields from the devices can have on brain tissue. Some have shown that blood flow can be increased in specific brain regions during cell phone use, but there’s been little work on effects at the level of the brain’s neurons.

So Dr. Volkow and colleagues conducted a crossover study at Brookhaven National Laboratory, enrolling 47 patients who had one cell phone placed on each ear while they lay in a PET scanner for 50 minutes.

The researchers scanned patients’ brain glucose metabolism twice — once with the right cell phone turned on but muted, and once with both phones turned off.

There was no difference in whole-brain metabolism whether the phone was on or off.


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But glucose metabolism in the regions closest to the antenna — the orbitofrontal cortex and the temporal pole — was significantly higher when the phone was turned on.

Further analyses confirmed that the regions expected to have the greatest absorption of radiofrequency and electromagnetic fields from cell phone use were indeed the ones that showed the larger increases in glucose metabolism.

“Even though the radio frequencies that are emitted from current cell phone technologies are very weak, they are able to activate the human brain to have an effect,” Dr. Volkow said in a JAMA video report.

The effects on neuronal activity could be due to changes in neurotransmitter release, cell membrane permeability, cell excitability, or calcium efflux.

How to make stressed out

Stressed-out mice may have serendipitiously cued researchers in to a treatment for hair loss.

The mutant mice bred to overproduce a stress hormone called “corticotrophin-releasing factor” became bald on their backs as they aged. But after a week of daily injections with a compound to block CRF — called astressin-B — developed by the group to treat gastrointestinal disease, the mice unexpectedly regrew their missing hair and were indistinguishable from controls.

The effect remained for up to four months, which the researchers pointed out in a press release is a long time in a mouse’s less than two-year life span. It far exceeded the mild regrowth produced by minoxidil (Rogaine) in the same mouse model, the group reported in the journal PLoS One.

Since CRF is also expressed in human skin, the researchers expressed optimism that a similar approach could be a “breakthrough therapy for alopecia.”

– C.P.

Bone Hormone Has Effects on Testosterone

The interaction between the skeletal system and reproduction was thought to be a one-way street running from the gonads to the bones.

But now, studies by Dr. Gerard Karsenty of Columbia University and colleagues show that bones may have a say in male fertility, at least in mice.

The team had previously observed that mice whose skeletons did not secret the hormone osteocalcin had problems reproducing.

So, as reported in Cell, the researchers conducted some in vitro and in vivo studies showing that osteocalcin enhances the production of testosterone. When osteocalcin was not present, testosterone levels dropped, as did sperm count.

“This study expands the physiological repertoire of osteocalcin and provides the first evidence that the skeleton is an endocrine regulator of reproduction,” Karsenty and his colleagues wrote.

If confirmed in humans, the findings may explain why some men have low levels of testosterone, and could open the possibility of drugs that mimic osteocalcin to treat infertility.

The researchers noted that there is evidence that a similar phenomenon occurs in men — osteocalcin is found in human testes and the hormone is an indicator of glucose intolerance in both mice and men, suggesting similar behavior.

– T.N.

New Vessels to Heal Old Bone

Disrupted blood vessels are a common reason why broken bones fail to rejoin on their own. That has prompted efforts to stimulate vessel growth artificially near the fracture sites.

Attempts to use angiogenic growth factors such as VEGF for this purpose have failed to yield consistently good results. But in a study reported this week at the American Academy of Orthopaedic Surgeons’ meeting in San Diego, researchers from St. Michael’s Hospital in Toronto suggested that a stem-cell therapy might do the trick.

A gel foam impregnated with endothelial progenitor cells greatly accelerated healing of severed femur bones in rats, according to the researchers’ report. Moreover, the healed femurs showed biomechanical properties approaching those of intact bone.

– J.G.

Opioids Work If You Believe They Do

Although many would relegate the subject of the ‘power of positive thinking’ to self-help books or women’s magazines, a new study gives it some cred in terms of pain relief — and upholds its converse as well.

When patients in a study were told that their pain would be eased by a powerful opioid, a biting heat stimulus became far less so. But when subjects were made to believe that the narcotic wouldn’t help in the least, they felt no relief.

Dr. Ulrike Bingel of the University Medical Center Hamburg-Eppendorf and her colleagues took 22 healthy volunteers and put them through two procedures that subjected their legs to brief heat stimuli as they lay in an MRI machine.

Patients were told that the drug, Ultiva, would alleviate pain, have no effect, or exacerbate their pain.

The self-reported pain ratings were corroborated by MRI brain scans that showed heightened or diminished activity in pain processing regions.

Those who expected pain relief had activity in the endogenous pain modulatory system; those who expected no help from the drug had activity in the hippocampus.

Bingel and colleagues, writing in Science Translational Medicine, said the findings suggest that it may be necessary to take patients’ expectations into account in order to optimize their therapeutic regimens.

How to Make Good on Promises

The Republican-controlled House of Representatives has passed a bill to continue funding government programs in 2011, but cut federal funding for Planned Parenthood and the Affordable Care Act (ACA).

The debate over HR 1, a bill that would continue appropriating 2011 funds, lasted five grueling days, ending with final passage early Saturday morning by a vote of 235 to 189. No Democrats voted in favor of the appropriations bill, but three Republicans crossed the aisle to vote against it.

Health Insurance Resource Center

Last week was filled with emotional debate on the House floor over what the government should fund, and what programs should have funding cut or eliminated.

One of the most contentious items wrapped up in the budget bill was an amendment by Mike Pence (R-Ind.) to cut off all federal funding for Planned Parenthood, which passed by a vote of 240-185.

During debate over that measure, Rep. Jackie Speier (D-Calf.) took to the floor and delivered an angry and impassioned speech that revealed she’d had an abortion, and to denounce amendment that would take away funding for family planning, sexual health services, and abortions.

Other amendments offered ranged from space exploration to NASCAR, to studying Asian carp, and served to highlight the wide differences in spending priorities held by the two political parties.

One GOP amendment would bar the use of funds in the bill to pay the salary of any employee of the Department of Health and Humans Services (HHS) who works to comply with the ACA. That amendment passed by a vote of 241-184.

Republicans passed another measure to cut off funding for the IRS to enforce the individual mandate in the ACA, and another that would cut off funds for federal work on health exchanges.

An amendment by Rep. Tom Price (R-Ga.), a physician, would cut off funds for to implement the medical loss ratio provision of the ACA, which stipulates that insurers must spend most of the money premiums on patient care.

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But this appropriations bill won’t cut all funding for those ACA provisions because the most of the spending for healthcare reform is budgeted for future years.

The spending bill — with all its healthcare amendments — now goes to the Senate where it faces more contentious debate on Feb. 28 when Congress returns from its Presidents’ Day holiday recess.