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Lowering Body Temperature May Help Cardiac Arrest Patients

Lowering the body temperature after someone’s heart has stopped beating may improve the odds of surviving with good brain function, a new study suggests

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In fact, patients whose body temperatures were lowered (therapeutic hypothermia) were nearly three times more likely to survive cardiac arrest, the study found. Those treated with the cold therapy were also 3.5 times more likely to have better mental function than those who didn’t receive the therapy, the researchers said.

“Our findings provide support for the idea that all unconscious post-arrest patients should receive aggressive care with therapeutic hypothermia,” said lead researcher Dr. David Gaieski, an associate professor of emergency medicine at the School of Medicine at Thomas Jefferson University in Philadelphia.

“Withholding [this treatment] does not make sense given these data and other data from other studies at many institutions around the world,” he said.

The report was published Nov. 16 online in the journal Circulation.

The body gets too little blood when the heart stops beating, or when blood flow is blocked by a blood clot or stroke, Gaieski said. In these situations, lowering the body’s temperature can help protect it, he explained.

Earlier studies have shown that the cold treatment can improve survival and brain function in people with “shockable” rhythms, such as ventricular fibrillation, the study said. Ventricular fibrillation is a condition where the lower chambers quiver, preventing the heart from pumping blood and causing cardiac arrest, the American Heart Association notes. In many of these cases the heart can be “shocked” into a normal rhythm, Gaieski said.

But there are cases of patients in cardiac arrest with “nonshockable” rhythms. This is when there is no electrical activity in the heart, or when there is electrical activity, the heart isn’t contracting and blood isn’t flowing, he explained. Currently, there aren’t a lot of hospitals using temperature-lowering therapy for patients who have a nonshockable rhythm, the researchers said.

For the study, Gaieski’s team looked at data from more than 500 patients whose hearts stopped beating between 2000 and 2013. All had nonshockable rhythms. Lowering the body’s temperature increased survival rates and brain function in these patients, the study said.

Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City and a spokesman for the American College of Emergency Physicians, said, “This important trial demonstrates that cooling should be tried in all patients with cardiac arrest, regardless of the initial heart rhythm.”

Glatter noted that the actual number of patients who survive mentally intact remains low. But, he added, reducing the body temperature has been shown to have a positive effect on improving outcomes.

“There has been a slow adoption of this treatment from lack of understanding the benefits of this easily implemented therapy,” he said.

Glatter added that lowering body temperature doesn’t require special equipment. It can be accomplished using equipment already in every hospital, he said.

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Rectal Thermometer Remains Gold Standard for Spotting Fever

Although it’s no one’s favorite method, a rectal thermometer is the best way to determine someone’s body temperature, experts say.

Accurate body temperature readings are important because they are used to make diagnoses, check for infectious diseases, evaluate whether or not a treatment is working, and guide patient management, the study authors explained.

Rectal thermometers are considered the gold standard, the researchers said. But the accuracy of thermometers used in the mouth or under the arm (peripheral thermometers) has been unclear.

So, the researchers reviewed 75 published studies. They found that peripheral thermometers are less accurate than rectal thermometers, particularly for low-grade fevers.

The findings were published online Nov. 16 in the journal Annals of Internal Medicine.

Health care workers should use rectal thermometers when a patient’s temperature will influence diagnosis and treatment, the researchers said in a news release from the American College of Physicians.

Rectal thermometers can be used for most children and adults. When that isn’t possible, a calibrated ear thermometer (or a bladder thermometer for patients with bladder catheters) are good alternatives, according to Dr. Daniel Niven from Alberta Health Services in Canada, and colleagues.

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FDA Finalizes New Food Safety Rules

In the wake of wide-ranging outbreaks of foodborne illness, the U.S. Food and Drug Administration on Friday finalized new rules to help keep contaminated food out of American kitchens.

These food safety regulations for fruit and vegetable farms and food importers were developed as a result of the Food Safety Modernization Act of 2011

Taylor said that outbreaks caused by leafy greens, cantaloupes, cilantro and other produce underscore the need for the new requirements

“A recent outbreak of salmonella in imported cucumbers killed four Americans and sent more than 157 to the hospital,“ he said. “These outbreaks are just the kind of food safety problems today’s rules are meant to prevent.”

The establishment of regulations changes the FDA’s mission from reacting to outbreaks of foodborne illness to making the food industry responsible for preventing them, Taylor said.

The new farm rule sets requirements for water quality; employee health and hygiene; wild and domesticated animals; compost and manure; and equipment, tools and buildings, the FDA said.

Also, food importers must verify that foreign suppliers are producing foods that meet U.S. safety standards. And the suppliers’ facilities must achieve the same level of food safety as domestic farms and food facilities.

The FDA will also empower accredited independent auditors to conduct food safety inspections of foreign food facilities. In some cases, the FDA can require certification that imported food is safe.

Each year some 48 million Americans — one in six — are sickened by foodborne diseases. About 128,000 people are hospitalized and 3,000 die from contaminated food, according to the U.S. Centers for Disease Control and Prevention.

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Study suggests vitamin D deficiency may cause erectile dysfunction

Low levels of vitamin D may be associated with erectile dysfunction, a new study suggests.

Researchers analyzed data from more than 3,400 American men, age 20 and older, who did not have heart disease. Thirty percent were vitamin D deficient, which means their levels of the “sunshine vitamin” were below 20 nanograms per milliliter of blood. And 16 percent had erectile dysfunction.

Vitamin D deficiency was present in 35 percent of men with erectile dysfunction, compared with 29 percent of those without erectile dysfunction, the study found.

“Vitamin D deficiency is easy to screen for and simple to correct with lifestyle changes that include exercise, dietary changes, vitamin supplementation and modest sunlight exposure,” study lead investigator Dr. Erin Michos, an associate professor of medicine at Johns Hopkins University School of Medicine, said in a university news release.

The researchers concluded that men with vitamin D deficiency were 32 percent more likely to be impotent than those with sufficient vitamin D levels. This association held even after the study authors accounted for other factors associated with erectile dysfunction, such as drinking, smoking, diabetes, higher blood pressure, inflammation and certain medications.

The researchers emphasized that their findings are observational and don’t prove cause and effect. They said more research is needed to determine if there’s a direct link between low vitamin D levels and erectile dysfunction. If that’s the case, they said it could lead to new treatment approaches.

“Checking vitamin D levels may turn out to be a useful tool to gauge ED risk,” Michos said. “The most relevant clinical question then becomes whether correcting the deficiency could reduce risk and help restore erectile function.”

About 40 percent of men older than 40 and 70 percent of those older than 70 are unable to attain and maintain an erection, the researchers said. Vitamin D deficiency affects up to 40 percent of adult Americans, according to the U.S. Centers for Disease Control and Prevention.

The study was presented Tuesday at the American Heart Association’s annual meeting in Orlando, Fla. Research presented at meetings should be considered preliminary until it’s published in a peer-reviewed medical journal.

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Study says Medicines Last as Long in Space as Here on Earth

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Medicines don’t degrade faster in space than they do on Earth, a new study finds.

Researchers analyzed nine medications that were stocked on the International Space Station for 550 days and returned unused to Earth, where they were kept under controlled conditions for three to five months.

The medications included pain relievers, sleeping aids, antihistamines/decongestants, an anti-diarrheal and an alertness drug.

The researchers assessed whether the active ingredients and the amount of degradation in the medications met United States Pharmacopeia (USP) guidelines for viability.

One medication met the USP standards five months after its expiration date, four met the standards up to eight months after their expiration dates, and three met the standards when tested three months before their expiration dates. A dietary supplement/sleeping aid did not meet the standards when tested 11 months after its expiration date.

No unusual degradation was found in any of the medications, according to the study published online Nov. 6 in the AAPS Journal.

Until now, there has been little information about how long periods of time in space affect medications.

While the International Space Station is regularly resupplied with medications, this may not be possible on long missions to more distant locations in space, said study leader Virginia Wotring. She’s with the Center for Space Medicine and Department of Pharmacology at Baylor College of Medicine in Houston.

Researchers said further studies in this area are necessary before planning long-term space flights, such as missions to Mars.

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FDA Approves Adynovate for Hemophilia A

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The U.S. Food and Drug Administration today approved Adynovate, Antihemophilic Factor (Recombinant), PEGylated for use in adults and adolescents, aged 12 years and older, who have Hemophilia A. Adynovate is modified to last longer in the blood and potentially require less frequent injections than unmodified Antihemophilic Factor when used to reduce the frequency of bleeding.

Adynovate is approved for on-demand (as needed) treatment and control of bleeding episodes and to reduce the frequency of bleeding episodes (prophylaxis) in patients with Hemophilia A. Adynovate consists of the full-length Coagulation Factor VIII molecule (historically known as Antihemophilic Factor) linked to other molecules, known as polyethylene glycol (PEGylated). This link makes the product last longer in the patient’s blood.

“The approval of Adynovate provides an important therapeutic option for use in the care of patients with Hemophilia A and reduces the frequency of Factor VIII infusions needed to avoid bleeding,” said Karen Midthun, M.D., director of the FDA’s Center for Biologics Evaluation and Research. Hemophilia A is an inherited, sex-linked, blood-clotting disorder that primarily affects males, which is caused by defects found in the Factor VIII gene. According to the Centers for Disease Control and Prevention, Hemophilia A affects one in every 5,000 male births in the United States. Patients with hemophilia A may experience repeated episodes of serious bleeding, primarily into the joints, which can be severely damaged as a result. The safety and efficacy of Adynovate were evaluated in a clinical trial of 137 adults and adolescents aged 12 years and older, which compared the recommended routine prophylactic (preventative) treatment regimen to on-demand therapy. The trial demonstrated that Adynovate was effective in reducing the number of bleeding episodes during routine care. Additionally, Adynovate was effective in treating and controlling bleeding episodes. No safety concerns were identified during the trial. Adynovate is manufactured by Baxalta US Inc., based in Westlake Village, California.

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Kidney transplant may increase the risk for certain types of cancer, a new study suggests.

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Kidney failure and having a kidney transplant may increase the risk for certain types of cancer, a new study suggests.

Poor kidney function and immune system-suppressing drugs may be behind this increased risk, according to Elizabeth Yanik, of the U.S. National Cancer Institute, and colleagues.

For the study, published in the Nov. 12 online edition of the Journal of the American Society of Nephrology, the researchers looked at data from more than 200,000 U.S. kidney transplant candidates and recipients.

Along with finding that these patients are at increased risk for certain types of cancer, the investigators also identified clear patterns of risk associated with different types of treatment. However, the associations seen in the study do not prove cause-and-effect.

The risk of kidney and thyroid cancers was especially high when kidney failure patients were on dialysis. The risk of non-Hodgkin lymphoma, lung cancer, melanoma and certain other types of skin cancers was highest after kidney transplantation. The increased risk after a transplant is probably a result of the drugs that suppress the immune system that patients have to take to prevent rejection of the new kidney, the study authors suggested.

“Our study indicates that the needs of individuals with end-stage renal disease, in terms of cancer prevention and cancer screening, will likely differ over time,” Yanik said in a news release from the American Society of Nephrology.

“Vigilance for kidney cancer and thyroid cancer may be of particular importance while these individuals are on dialysis. Extra consideration for screening for melanoma or lung cancer may be called for while taking immunosuppressant medications following a kidney transplant,” she concluded.

The findings show the need to closely monitor these patients for cancer, Yanik’s team said.

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Kitchen Utensils Can Spread Bacteria, Study Finds

– Kitchen utensils such as knives and graters can spread bacteria between different types of produce, a new study finds.

University of Georgia researchers contaminated different types of fruits and vegetables with bacteria such as salmonella and E. coli. They cut the produce with a knife or shredded it with a grater, then used the unwashed utensils on other produce.

Both utensils spread the bacteria to other types of produce, the study found.

The researchers also found that certain types of produce contaminated knives to different degrees.

“For items like tomatoes, we tended to have a higher contamination of the knives than when we cut strawberries,” said lead author Marilyn Erickson, an associate professor in the department of food science and technology.

“We don’t have a specific answer as to why there are differences between the different produce groups. But we do know that once a pathogen gets on the food, it’s difficult to remove,” she said in a university news release.

Further testing revealed that brushes and peelers also transfer bacteria between produce.

Many people don’t know that kitchen utensils can spread bacteria, Erickson said.

“Just knowing that utensils may lead to cross-contamination is important,” she said. “With that knowledge, consumers are then more likely to make sure they wash them in between uses.”

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Physical Fitness Linked to Mental Fitness in Seniors

Connections between different parts of the brain weaken with age, but new research suggests that being physically fit can boost long-term brain function.

A study from the University of Illinois at Urbana-Champaign found that age-related differences in the brains of older adults varied, depending on their level of aerobic endurance.

“Our study provides the strongest evidence to date that fitness in an older adult population can have substantial benefits to brain health in terms of the functional connections of different regions of the brain,” Arthur Kramer, director of the Beckman Institute, said in a university news release.

The study involved both younger and older adults. Using functional MRI brain scans, the researchers assessed the strength of the connections in different parts of the participants’ brains while they were awake but not performing any particular task.

Unsurprisingly, the younger adults had stronger brain connections than the older participants. But among the older people, the investigators found a relationship between their level of fitness and the strength of the connections between certain areas of their brains.

“The idea that fitness could be related to brain health regardless of one’s physical activity levels is intriguing because it suggests there could be clues in how the body adapts for some people more than others from regular activity,”study leader Michelle Voss, who was a postdoctoral researcher at the University of Illinois at the time of the study,

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Gonorrhea Becoming More Resistant to One Antibiotic: CDC

One of several antibiotic treatment options for the sexually transmitted disease gonorrhea seems to be losing its effectiveness, U.S. health officials warn in a new report.

The U.S. Centers for Disease Control and Prevention’s latest tracking suggests that although resistance to the antibiotic treatment cefixime went down between 2011 and 2013, it started to creep back up in 2014.

The good news is that cefixime isn’t usually the first drug of choice for treating gonorrhea infections. The CDC’s most recent guidelines for gonorrhea treatment (issued in 2012) recommend only using cefixime when the preferred option — ceftriaxone-based combination therapy — isn’t available. And the CDC’s new report doesn’t indicate any recent waning in the effectiveness of that combination therapy.

Still, indications of antibiotic resistance among any gonorrhea treatment is considered troubling, the study authors said.

“It is essential to continue monitoring antimicrobial susceptibility and track patterns of resistance among the antibiotics currently used to treat gonorrhea,” said study lead author Dr. Robert Kirkcaldy, an epidemiologist in the CDC’s division of STD prevention in Atlanta.

“Recent increases in cefixime resistance show our work is far from over,” he said.

The study findings are published as a research letter in the Nov. 3 issue of the Journal of the American Medical Association.

The CDC noted that gonorrhea is spread during unprotected vaginal, anal or oral sex. The sexually transmitted infection is particularly common among youth and young adults between the ages of 15 and 24.

Many people have no symptoms when infected. When symptoms do occur, they may include a painful or burning sensation when urinating; painful, swollen testicles and discolored discharge from the penis among men. In women, symptoms may include increased vaginal discharge and vaginal bleeding between periods. Rectal infections may spark soreness, itching, bleeding, discharge, and painful bowel movements, the CDC said.

If gonorrhea goes untreated, “serious health complications” can result, Kirkcaldy said. Those can include chronic pelvic pain, infertility and life-threatening ectopic pregnancy — an abnormal pregnancy that occurs outside of the uterus. In rare cases, gonorrhea can spread to your blood or joints, causing a potentially life-threatening infection, the CDC warned.

But when identified, antibiotics can provide an effective cure for those with gonorrhea.

The new CDC study looked at treatment outcomes among male gonorrhea patients who had been treated at public clinics across the United States between 2006 and 2014.

More than 51,000 samples were gathered across 34 cities. About one-third were collected in the western United States and one-third collected in the South. A little more than a quarter of the samples were drawn from men who either identified as gay or bisexual, the study said.

The investigators found that the CDC’s 2012 shift away from recommending cefixime and toward ceftriaxone-based combination therapy had a profound impact: while the combination therapy had been given to less than 9 percent of the patients in 2006, that figure shot up to nearly 97 percent by 2014.

Alongside that shift, the team found that cefixime-resistance went up from 0.1 percent in 2006 to 1.4 percent in 2011, and then back down to 0.4 percent in 2013. But by 2014 resistance trended upward to 0.8 percent, the research revealed.

What does this mean? “Trends of cefixime susceptibility have historically been a precursor to trends in ceftriaxone,” said Kirkcaldy. “So it’s important to continue monitoring cefixime to be able to anticipate what might happen with other drugs in the future.”

Dr. Kirsten Bibbins-Domingo, co-vice chair of the U.S. Preventive Services Task Force in Rockville, Md., emphasized the importance of routine screening.

“The task force recommends screening for gonorrhea in sexually active women age 24 years or younger, and in older women who are at increased risk for infection,” she said.

The task force doesn’t advocate for or against screening for men, saying more research is needed to prove effectiveness. However, Kirkcaldy said that the “CDC recommends an annual gonorrhea screening for high-risk sexually active women and for sexually active gay, bisexual, and other men who have sex with men.”