‘Digital Pill’ Tells Doctor When Patient Takes It

TUESDAY, Nov. 14, 2017 (HealthDay News) — The first drug designed to alert a doctor when a patient takes the medication has been approved by the U.S. Food and Drug Administration.

Abilify MyCite (aripiprazole with sensor) has an embedded sensor that sends a message to a wearable patch that the medication’s been taken. This allows the patient and doctor to track the medication’s use via smartphone.

Abilify, first approved in 2012, is now OK’d to treat schizophrenia, manic depression and bipolar disorder, the FDA said in a news release.

“Being able to track ingestion of medications prescribed for mental illness may be useful for some patients,” said Dr. Mitchell Mathis, director of the agency’s Division of Psychiatry Products.

Abilify MyCite hasn’t been proven to improve patient compliance with taking medication on a prescribed schedule, the FDA stressed. And the drug shouldn’t be used in an attempt to track “real-time” ingestion, since detection could be delayed, the agency added.

As with similar antipsychotic drugs, Abilify MyCite’s label will include a boxed warning that elderly people with dementia-related psychosis are at increased risk of death if they take this medication, the FDA said. The label also warns of increased risk of suicidal thinking and behavior among children, teens and young adults.

Abilify MyCite’s approval was granted to Japan’s Otsuka Pharmaceuticals. The sensor technology and patch are made by Proteus Digital Health, in Redwood City, Calif.

Heart donor appeal for six-week-old Charlie Douthwaite

Charlie Douthwaite is believed to be the youngest person in Britain waiting for a transplant, and is being cared for at Newcastle’s Freeman Hospital.

A Europe-wide appeal has been launched in the hope another family grieving at the loss of their child, might be able to help.

Paramedic Rob Moore with a thumbs upImage copyrightRob Moore

When a paramedic found himself reading too many stories about the abuse encountered by his colleagues, he decided it was “time for a morale boost” and started a campaign to get people sharing happier experiences.

“Sometimes, it’s hard to remember that most people are really appreciative of what we do every day,” Rob Moore explained.

The paramedic has been working for the West Midlands Ambulance Service in Birmingham for more than four years.

Last week, one of his colleagues found a note left on an ambulance telling them not to block a driveway.

And over the weekend, footage emerged online appearing to show a driver hurling abuse at a paramedic.

So Rob started #BlueLightHappy with a plea on Twitter for “stories of people doing nice things” – to “show people do care” about the emergency services’ work.

His efforts sparked a flurry of responses – some from grateful members of the public and others from first responders themselves, recalling heartfelt letters, emails and gestures aimed their way.

Skip Twitter post by @georgette_eaton

@WMASTStarkey@wmasrobmoore Not all notes left on our vehicles are insulting, this was left on mine in Reading in 2012

— Georgette Eaton (@georgette_eaton) November 13, 2017

End of Twitter post by @georgette_eaton

Skip Twitter post by @MajesticSeahawk

To whoever sent in a Thank You email for the good job I did taking you emergency call. You made this little calltaker happy on a paticuarly stressfull day. Also thank you for being my first official thank you I’ve had #team999#BlueLightHappy

— ⛵ Sammii ⛵ (@MajesticSeahawk) November 13, 2017

End of Twitter post by @MajesticSeahawk

One of those to respond was Liv Pontin from West Sussex. Six years ago, her mum died suddenly of pancreatic cancer.

“We had the paramedics out that evening. Rapid response turned up and they were really good with her,” the 28-year-old told the BBC News website.

Liv’s mum died in A&E later that night, but shortly after, she wrote to the paramedic to say thank you for his efforts.

“We were all so scared and he just reassured her.”

This September, an ambulance was called for Liv herself – and she came face to face with the same reassuring paramedic.

“I didn’t recognise him, but I saw his name and that he was a practitioner,” she said. “I just remembered that the paramedic (who treated mum) had said he was training to be a practitioner.

“I told him where we lived and he said that he remembered.”

Not only did he remember Liv and her mother, but the paramedic told her he still had the thank you letter she sent in his locker.

“It meant a lot to me because no-one really knows what happened that night except my family and the ambulance workers,” she said.

On getting involved in the #BlueLightHappy effort, she added: “It was nice to say thank you.”

Skip Twitter post by @hannaathompson

Had 2 amazing paramedics attend to my autistic daughter who had a head injury aged 4, they were amazing with her! So much patience & even ate the fake dinner she made them after lol #BlueLightHappy

— Hannaa (@hannaathompson) November 13, 2017

End of Twitter post by @hannaathompson

Skip Twitter post by @JadeAdelexox

The support from the paramedics when my dad had a cardiac arrest was amazing, unfortunately he passed away but the paramedics were so supportive and did everything they could. Forever grateful #BlueLightHappy 🙌🏻

— Jade🍂 (@JadeAdelexox) November 14, 2017

End of Twitter post by @JadeAdelexox

Other ambulance workers recalled offers of tea and biscuits and even free ice creams.

Oscar Miller said someone offered to buy him lunch on the day after the Westminster Bridge terror attack in London, “I’d already paid, but a nice gesture,” he added.

Another Twitter user said she “cried a little bit” on receiving her first thank you letter.

“And when random strangers let you skip the queue in Tesco when you pop in. So sweet,” she added.

Most people tweeting with the hashtag have just been saying thank you, Rob said.

“To receive an unsolicited thank you is just magical… It’s one of the absolute best feelings in this job.”

On a recent shift, Rob and some of his colleagues had a meal bought for them in the middle of the night.

“It really took me back. It’s heart-warming,” he said.

“One small gesture can make someone’s whole week.”

FDA Warns of Herb Kratom’s Opioid-Like Harms
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TUESDAY, Nov. 14, 2017 (HealthDay News) — The U.S. Food and Drug Administration on Tuesday issued an advisory about harms tied to kratom — an imported herbal supplement with opioid-like effects that is increasing in popularity.

People are taking the unapproved supplement to treat conditions like pain, anxiety and depression — without medical supervision, FDA Commissioner Dr. Scott Gottlieb said in a statement. Others use kratom for its euphoric effects, or to wean addicts off opioids such as prescription painkillers or heroin, also without medical say-so.

“Importantly, evidence shows that kratom has similar effects to narcotics like opioids, and carries similar risks of abuse, addiction and, in some cases, death,” Gottlieb said. “At a time when we have hit a critical point in the opioid epidemic, the increasing use of kratom as an alternative or adjunct to opioid use is extremely concerning.”

The United States is in the grip of an opioid epidemic. Since 2000, more than 500,000 Americans have died from a narcotic overdose, according to the U.S. Centers for Disease Control and Prevention. President Donald Trump recently declared the crisis a public health emergency.

Meanwhile, a similarly troubling trend has been seen with kratom. Between 2010 and 2015, kratom-related calls to U.S. poison control centers jumped 10-fold. And 36 deaths have been linked to kratom-containing products. Kratom use can also cause seizures, liver damage and withdrawal symptoms, the FDA said.

In the United States, there are no FDA-approved uses for kratom, which grows naturally in Southeast Asia.

In some cases reported to the FDA, kratom is laced with opioids like hydrocodone (Vicodin), Gottlieb noted.

The commissioner stressed the need to evaluate the drug’s potential benefits and harms. He said kratom products must go through the FDA’s drug review process before they can be legally marketed for therapeutic uses in the United States.

“This is especially relevant given the public’s perception that it can be a safe alternative to prescription opioids,” he added.

So far, no marketer has tried “to properly develop a drug that includes kratom,” Gottlieb said.

“While we remain open to the potential medicinal uses of kratom, those uses must be backed by sound science and weighed appropriately against the potential for abuse,” Gottlieb added.

In 16 countries, kratom is a controlled substance. And in the United States, Alabama, Arkansas, Indiana, Tennessee and Wisconsin have banned kratom. Several other states are reviewing proposals to outlaw it, Gottlieb noted.

For now, the FDA said it is working to prevent shipments of kratom from entering the country.

“We’ve learned a tragic lesson from the opioid crisis: that we must pay early attention to the potential for new products to cause addiction, and we must take strong, decisive measures to intervene,” Gottlieb said.

Weighing Too Much or Too Little When Pregnant Can Be Risky
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TUESDAY, Nov. 14, 2017 (HealthDay News) — For women contemplating having a baby, new research adds to the evidence suggesting that starting a pregnancy at a normal weight is best.

The study found that too much or even too little weight increases an expectant mom’s risk for severe illnesses and death.

“Not only for baby’s sake, but also for your own sake, have a healthy diet and get regular exercise before pregnancy,” said study lead author Dr. Sarka Lisonkova. She’s an assistant professor in the department of obstetrics and gynecology at the University of British Columbia and the Children’s and Women’s Health Centre in Vancouver.

“It’s never too late, even if you’re already pregnant,” Lisonkova said, adding that weight gain during pregnancy can also increase the risk for severe illnesses and even death in expectant mothers.

The study, published Nov. 14 in Journal of the American Medical Association, included information on nearly three-quarters of a million women from Washington state. They averaged 28 years old.

Before pregnancy, about 3 percent were underweight, 48 percent were of normal weight and 26 percent were overweight. In addition, about 13 percent were categorized as class 1 obese, 6 percent class 2 and 4 percent class 3, with a higher class indicating greater weight and health risk.

The researchers used body mass index (BMI) to determine if someone was overweight, obese or underweight. Body mass index is a rough estimate of how much body fat a person has, calculated from their weight and height. For a 5-foot-6-inch woman, a normal BMI would correlate to 118 to 150 pounds. That same woman would be overweight if she weighed 155 to 180 pounds, and obesity would begin at about 186 pounds, according to the U.S. National Heart, Lung, and Blood Institute.

The researchers found that the more a woman weighed, the more likely she was to have a severe illness or to die during pregnancy. Underweight women also had an increased risk for these outcomes. Severe illness included such conditions as eclampsia (convulsions or coma brought on by high blood pressure), sudden kidney failure, sepsis, hemorrhage and respiratory problems.

The risk to any one woman, though, is quite low. For instance, the study found that, compared with normal-weight pregnant women, there were about 25 more cases of either severe illness or death for every 10,000 pregnant women if the woman was obese.

“The chance that any one woman dies in pregnancy is about 1 in 6,000 in the United States,” said Dr. Aaron Caughey, who chairs the department of obstetrics and gynecology at Oregon Health and Science University in Portland. He also wrote an editorial that accompanied the study.

However, what’s especially concerning about this study’s findings, he said, is that more and more women are entering pregnancy obese or super-obese. With higher levels of obesity, “there’s an incredibly high inflammatory state that increases the risk of rare outcomes, like thromboembolism,” a blood clot, Caughey said.

He said that underweight women likely had a chronic illness that increased their risk.

Both Caughey and Lisonkova said that ideally, women should be at a normal weight before getting pregnant. If a woman isn’t at her ideal weight, pregnancy is a good time to start focusing on things such as eating a healthy diet and getting regular exercise, they said.

Pregnancy can be a “focusing event for affecting behavior change in women,” Caughey said, because once pregnant, a woman often focuses on doing what she can to have a healthy baby.

“Pregnancy is a great time to think about diet and exercise, especially because women often drive health behaviors in the family, so there’s no time like the present to make healthy changes,” he said.

Lisonkova also emphasized the importance of good prenatal care. “Clinicians can catch signs of potential complications earlier with regular checkups,” she said.

Mom’s overall health isn’t the only concern linked to excess maternal weight.

A second study that followed about 2,800 women from their first trimester through delivery found that the babies of obese women were born heavier than babies born to slimmer moms.

The study, led by Dr. Cuilin Zhang from the U.S. National Institutes of Health, found the median weight difference was 7 ounces (20 grams). The results were published Nov. 13 in JAMA Pediatrics.

Having a bigger baby can lead to labor and delivery complications and may make a cesarean section more likely, according to the March of Dimes.

Should healthcare be rationed for patients who smoke or are obese?

Is it right for patients to be prevented from having certain types of treatment, unless they quit smoking or lose weight?

Some health trusts argue this is a way to improve results of non-emergency operations, but critics claim it is also a way to deal with the pressure on NHS budgets by rationing care.

Daily Politics reporter Emma Vardy visited Hertfordshire, where some new rules have caused controversy, and spoke to Ruth Robertson of the King’s Fund and Prof Helen Stokes-Lampard of the Royal College of GPs.

America’s Love Affair with Sugary Sodas Is Fading
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TUESDAY, Nov. 14, 2017 (HealthDay News) — Consumption of sodas and other sweet drinks — a big source of sugar in Americans’ diets — has dropped in the past decade among both kids and adults, researchers find.

Overall, the number of adults who said they drank a sugary beverage on a daily basis dropped by 12 percentage points between 2003 and 2014, Harvard researchers said, and by 19 percentage points among kids.

“People’s preferences are shifting,” Bleich said. “Beverage consumption overall is going down, in addition to sugary beverage consumption. It may be that messages about beverages are starting to get through to people.”

However, despite this drop in sugary drink consumption, the obesity epidemic continues apace, with more obese middle-aged people, young adults and children than ever before, Bleich noted.

Americans are still consuming too many calories. “Even if beverages overall are going down, we are eating too much. And it’s because we are eating too much that obesity continues to rise,” she said.

The report was published online Nov. 14 in the journal Obesity.

Samantha Heller is a senior clinical nutritionist at New York University Medical Center. She said, “The good news is the consumption of sugar-sweetened beverages has declined in the U.S. The bad news is we still have more work to do because sugar-sweetened beverages are the largest contributor to added sugars in the U.S. and are highly associated with obesity.”

Reducing the amount of these drinks that people consume could have a significant effect on obesity, Heller noted, as long as they are replaced with healthier options — such as water, seltzer, tea or milk.

Using data from the U.S. National Health and Nutrition Examination Surveys from 2003 to 2014, Bleich and her colleagues collected information on 18,600 children aged 2 to 19, and more than 27,600 adults 20 or older.

The participants were asked about what drinks they had consumed in the past day — including sugar-sweetened drinks, 100-percent juice, diet drinks, milk (including flavored milk), unsweetened coffee or tea, alcohol and water.

In 2003-2004, nearly 80 percent of children and 62 percent of adults said they had a sugar-sweetened drink on a given day.

That had dropped to about 61 percent of children and 50 percent of adults by 2013-2014, the findings showed.

Despite this drop, teens and young adults still consumed more than the recommended amount of added sugar set by the 2015-2020 Dietary Guidelines for Americans, Bleich said.

According to the American Heart Association, adults should not have more than six to nine teaspoons of sugar a day — including sugar in everything you eat and drink. Most Americans consume about 20 teaspoons of sugar a day.

And children should not have more than four teaspoons of sugar a day.

The biggest drop in the consumption of sugary drinks was among white adults of almost all ages, Bleich said. Consumption of sugary drinks remained high among blacks, Mexican Americans and Hispanic teens — groups at high risk for obesity and type 2 diabetes.

Bleich said these groups tend to live in poorer areas where access to cheap sugary drinks is abundant.

“There is an effect over time where you get conditioned to drinking sugary beverages, and it becomes a regular part of life, as opposed to drinking water and other things that don’t have calories in them,” she said.

The overall reduction in consumption of sugary drinks was offset by an increase in kids drinking more milk, and kids and adults drinking more water — both positive trends, Bleich noted.

Heller believes that parents can influence the choice of drinks their children prefer simply by choosing unsweetened drinks themselves. For instance, “studies have found that children’s frequency of water intake is strongly influenced by parenting practices and parental role modeling,” she said.

“There is no reason for children to be drinking sodas (diet or regular), chocolate milk or fruity drinks,” Heller said, adding that, when raised drinking water, milk or unsweetened, plant-based milks, children are generally perfectly happy with these choices.

“Eventually, they will be exposed to sugar-sweetened beverages,” she said, “but hopefully the healthier habits they learned when little will prevail.”

Is Too Much Time Online Raising Suicide Risk in Teen Girls?
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TUESDAY, Nov. 14, 2017 (HealthDay News) — A spike in the amount of time teenage girls in the United States spend online is a likely culprit behind the surge in rates of depression, suicide and contemplation of suicide, new research suggests.

The finding stems from an analysis of fatal injury data collected between 1999 and 2015 by the U.S. Centers for Disease Control and Prevention, as well as two large ongoing surveys that have been tracking the thoughts of roughly a half-million American teens since 1991.

“Around 2012, rates of depression, suicide attempts and suicide itself suddenly increased among teens, especially among girls,” said Jean Twenge. She is a psychology professor at San Diego State University and the study’s lead author.

“The increase occurred right around the same time smartphones became popular,” Twenge said.

“We found that teens who spent more time online were more likely to have at least one suicide-related outcome, such as depression, thinking about suicide, making a suicide plan, or having attempted suicide in the past,” she added.

The researchers first reviewed CDC data concerning teen suicide, finding that the suicide rate for girls aged 13 to 18 had shot up by 65 percent between 2010 and 2015. The investigators then reviewed teen responses to the Monitoring the Future survey and the Youth Risk Behavior Surveillance System survey.

The polls revealed that the percentage of girls who said they’d experienced symptoms of severe depression had increased by 58 percent in that time frame. Hopelessness and suicidal contemplation had gone up by 12 percent.

At the same time, nearly half of teens who indicated they spend five or more hours a day on a smartphone, laptop or tablet said they had contemplated, planned or attempted suicide at least once — compared with 28 percent of those who said they spend less than an hour a day on a device.

Depression risk was also notably up among teens who spent excessive time on a device, the findings showed.

Results of the analysis were published Nov. 14 in the journal Clinical Psychological Science.

Boys are likely to be affected in the same way as girls, Twenge said, although she noted that boys tend to “spend less time on social media and more time on games, which might not affect mental health as much.”

Twenge also acknowledged the possibility “that instead of time online causing depression, depression causes more time online,” but she said that prior research suggests that’s not the case.

“In addition, depression causing online time doesn’t explain why depression increased so suddenly after 2012,” Twenge noted. “Under that scenario, more teens became depressed for an unknown reason and then started buying smartphones — an idea that defies logic.”

That said, teens who spend less than two hours a day online do not appear to face any elevated mental health risks, suggesting there might be a practical sweet spot for device use short of total abstinence.

“So parents can try to limit their teens’ use to two hours a day [and] insist that phones be left outside of the bedroom at night to encourage better sleep,” Twenge suggested.

Scott Campbell, an associate professor of communication studies at the University of Michigan, took a wary stance on the findings. He said more research is needed to focus not just on how much time kids spend online, but on what they’re actually doing while online.

“Like food, alcohol, sex, shopping and just about everything else, too much screen time is bad for you. In that sense, I am not terribly surprised that the heaviest of media users in this study reported the lowest well-being,” he said.

“However, I am very cautious about the findings because we need to be open to the possibility that depression might drive young people toward heavy screen time, as noted in the study,” Campbell added.

Dr. Anne Glowinski, a child psychiatrist, expressed little surprise with the study findings, while also suggesting that increased device use could be driving teenage mental issues on many fronts.

“For instance, increased virtual time could be related to nighttime virtual time — which is related to poor sleep, which is related to depression and thus suicide,” she said.

“Online time could [also] be taking time away from time that is mental health-promoting, such as community activities in person, time with family, exercise or meditation,” Glowinski suggested. She is director of child and adolescent psychiatry education and training at Washington University School of Medicine in St. Louis.

As for parental advice, Glowinski suggested that “it’s a good idea to have clear discussions before placing a smartphone in your child’s hands.” She also urged parents to set clear rules so that children know their usage is limited, both in terms of when they can hop online and what they are allowed to do once there.

Swings in Blood Pressure Can Pose Long-Term Dangers
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TUESDAY, Nov. 14, 2017 (HealthDay News) — Everyone knows that sustained high blood pressure does no favors for your heart or life span.

But new research suggests that up-and-down shifts in blood pressure may be equally hazardous to your health.

“The takeaway from the study is, if you allow your blood pressure to be uncontrolled for any period of time, or notice big changes in your blood pressure between doctor visits, you increase your risk of stroke, heart attack, kidney or heart failure or even death,” said study author Dr. Brian Clements. He’s an internal medicine specialist at Intermountain Medical Center Heart Institute in Salt Lake City.

One cardiologist who reviewed the findings wasn’t surprised.

“Swings in blood pressure cause more stress to the arteries of the heart and brain than a consistent blood pressure,” said Dr. Satjit Bhusri, of Lenox Hill Hospital in New York City.

He said the study supports the notion that high blood pressure medications should be taken continuously, not just when pressure seems to spike.

“All too often patients take their blood pressure medications ‘as needed,’ ” Bhusri said. “It is up to their doctor to reinforce that blood pressure medications are not ‘as needed’ meds, and that in fact the ‘as needed’ use of such meds can cause more harm than not taking them at all.”

The findings were to be presented Monday in Anaheim, Calif., at the annual meeting of the American Heart Association.

In the study, Clements’ team tracked the medical records of nearly 11,000 patients. The researchers found that those whose systolic blood pressure (the upper number in a reading) varied by as much as 30 or 40 points between doctor visits were much more likely to die over five years of follow-up than those with less extreme changes in their blood pressure.

Normal systolic blood pressure is 120 mm Hg, while a high reading is 130 or higher, according to new American Heart Association guidelines issued Monday.

“Blood pressure is one of those numbers we encourage people to keep track of, as it’s one indicator of your health heart,” Clements said. He urges patients “to do everything they can to control their blood pressure on a regular basis.”

Clements advised, “Eat healthy foods, exercise regularly, and if your doctor has prescribed you medications for your blood pressure, be sure and take them consistently. Because any time your blood pressure is out of control, you’re at higher risk of injury or death.”

Another cardiologist who reviewed the findings said more study may still be needed, however.

“The result of this study is intriguing, but not firmly conclusive,” said Dr. Joseph Diamond, who directs nuclear cardiology at Long Island Jewish Medical Center in New Hyde Park, N.Y. He noted that people’s blood pressure often fluctuates throughout the day.

Also, experts note that studies presented at medical meetings are typically considered preliminary until published in a peer-reviewed journal.

New lymphoma treatment developed at Cardiff University
A T-cellImage copyrightGetty Images
Image caption T-cell lymphoma is rare and can often be aggressive

A new method for treating a rare and often aggressive type of blood cancer has been developed by researchers at Cardiff University.

Researchers at its School of Medicine have discovered a way to kill cancerous T-cells in lymphoma patients without destroying healthy T-cells which are essential to the immune system.

Further research is needed before clinical trials on patients.

Lymphomas arise when immune cells called lymphocytes become cancerous.

There are two types of lymphocytes – B-cells and T-cells. Recent developments have transformed the once fatal diagnosis of B-cell lymphoma into a curable condition.

T-cell lymphoma is much rarer but often more aggressive.

The research, conducted with biopharmaceutical company Autolus Ltd, has been funded by charities including Wellcome and Cancer Research UK.