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Oxygen therapy brings ‘remarkable’ turnaround for toddler who fell in pool

(CNN)Eden Carlson’s story might be one in a million.

The toddler, who suffered brain damage after falling into a swimming pool at 23 months old, has begun to rebuild her brain function after treatment with hyperbaric oxygen therapy, according to a case study published last month in the journal Medical Gas Research.
“We’re stimulating growth of tissue and inhibiting inflammation and stopping cell death,” said Dr. Paul G. Harch, clinical professor and director of hyperbaric medicine at LSU Health New Orleans School of Medicine.
    Hyperbaric oxygen therapy introduces a greater-than-usual amount of oxygen to patients within a special chamber. The special chamber allows a doctor to control both the pressure and the level of vital gas, explained Harch, who treated the child and is lead author of the case study.
    After months of oxygen treatments, Eden is a “typical 3-year old,” said her mother, Kristal Carlson of Fayetteville, Arkansas.
    “Her cognitive abilities and speech are completely recovered. Most of her fine motor skills have returned,” Carlson wrote in an email. “Today she walks with assistance really well. She can walk independently, also, but not long distances.”

    A mother’s nightmare

    While Carlson was in the shower on February 29, 2016, Eden, who had just learned to walk, slipped through a baby gate and fell into the backyard swimming pool.
    “Her older siblings lost track of her and thought she was with me,” explained Carlson, who is still unsure how long Eden may have been in the water.
    It could have been “as long as 15 minutes,” she said, but was “at least five minutes.”
    Also unclear is how long her heart stopped beating, Harch said.
    “She stopped breathing, obviously, once she was face-down and probably inhaled some water, but we don’t know how long after that her heart stopped and her blood pressure went to zero,” Harch said. “We just know that when Mom got her out of the pool, there was nothing.”
    Carlson said her first instinct was to get her daughter to breathe.
    “So I gave her a couple of breaths and patted her, saying her name,” Eden’s mother said. “Then chest compressions.” Paramedics took over CPR, which was delivered for 100 minutes before Eden’s heart began beating on its own.
    Stabilized, the child was flown to Arkansas Children’s Hospital, where she spent five weeks, her mother recalled. “When we brought her home, she was a vegetable, unable to do anything,” she said. “She had a feeding tube, could not speak, could not sit up, etc.”
    “She was profoundly injured,” Harch said. The hospital sent the child home with a monitor because when she’d fall asleep, she’d stop breathing at times and needed her parents to resuscitate her. “The predictions given to the family by the doctors were a list of never-evers: She will never ever talk, walk or eat on her own.”
    It soon became clear that the doctors and neurologists at Arkansas Children’s Hospital could do nothing more for Eden, so her parents “started googling alternative ways to treat brain injuries,” Carson explained. They found Harch’s website about three weeks after returning home from the hospital and “went from there.”

    ‘Bridging treatment’

    Eden could not be moved, and no hyperbaric oxygen chambers could be found in the Fayetteville area, so Harch treated the girl remotely with a “bridging therapy.”
    Using a normal oxygen tank with tubes to the nose, Harch put the child on “just 2 liters per minute for 45 minutes a day,” with the first treatment exactly 55 days after Eden fell into the pool.
    “We noticed an immediate difference in her,” her mother said. She videotaped Eden’s response to send to Harch.
    He said he saw a positive change in the child’s affect and decided to continue the treatments for three weeks.
    “She was more relaxed, her neuro-storming stopped, she started smiling, laughing, swallowing, tracking with her eyes, and saying words,” Carlson said.
    When Eden’s condition stabilized, her parents took her to New Orleans for treatments in a hyperbaric chamber, using the same amount of oxygen but with added pressure.
    The treatments are spaced out over time in order to allow the brain to improve on its own, said Harch, who is also a co-owner of Harch Hyperbarics Inc., a consulting company.
    “She began saying more words and speaking in sentences,” her mother said. “She started sitting up, crawling, pulling to stand, and trying to walk!”
    The ultimate proof: An MRI scan taken 162 days post-drowning — 27 days after Eden’s 40th oxygen session — compared with one taken in the hospital shows only mild residual injury to the brain, plus a near-complete reversal of brain shrinkage that sometimes occurs in similar cases.

    How does hyperbaric medicine work?

    “It’s not completely understood,” Harch said, explaining that in the late 1950s, doctors in the Netherlands began experimenting with trying to give maximum amounts of oxygen to patients with conditions in which lack of oxygen was a problem, such as gangrene.
    The US Navy also uses hyperbaric oxygen therapy to treat decompression sickness or diver’s disease.
    It wasn’t until 2008 that the medical profession really began to understand “what this therapy is about,” Harch said. “Some doctors took human cells, put them in a Petri dish and put them in a hyperbaric chamber and gave them a typical treatment.” They used mass gene array analysis to measure and analyze gene activity.
    “What they found at the end of 24 hours, 8,101 human genes had either been turned on or turned off, and the largest clusters were those that code for growth and repair hormones — in other words, stimulate tissue growth and heal wounds — and the anti-inflammatory genes,” Harch said. “And the largest clusters of the turned-off ones — and these are temporary, the turning on and turning off of genes — were the pro-inflammatory genes and the ones that code for cell death.”
    Dr. Justin Sempsrott, executive director of Lifeguards Without Borders and medical director of International Surf Lifesaving Association, said Eden’s case is “remarkable” and “shows future direction for rehabilitation after non-fatal drowning.”
    Sempsrott, who was not involved in Eden’s treatment or the case study, noted that it was “done in an academically rigorous way.”
    “The most important determining factor of whether or not a person — adults or children — is going to survive drowning is how long they were under water,” Sempsrott explained. For those known to be underwater for fewer than five minutes, 86% survive with good neurological outcome, and when it’s less than 10 minutes, 77% survive with good neurological outcome.
    People underwater for 15 to 25 minutes are “kind of all over the place,” Sempsrott said. “More than 25 minutes is universally bad outcomes; they are typically neurologically devastated.”
    This is one reason giving breath along with good-quality chest compression is recommended for drowning resuscitation, he said.

    Cold vs. warm water

    “It’s possible to maintain that oxygenation even for a long period of time when someone comes out of the water,” Sempsrott said. “The time she was given CPR and survived is really not unheard of.”
    Generally, though, CPR cannot distribute oxygen throughout the body as effectively as natural breathing.
    Though Harch believes that the cold water in the pool was protective, Sempsrott said that “overwhelmingly,” most people who fall into cold water are simultaneously dying of hypothermia and drowning. “Hibernation state” does not help preserve the organs from harm, he said, though this is a common misperception.
    “They actually have either worse or the same outcomes,” he said.
    In most cases, Semsprott said, “after the news story dies down,” the person with little to no brain function requires round-the-clock care for the rest of their lives.
    “Non-fatal drowning is far more common than fatal drowning,” he said. A conservative estimate is that for every drowning, there are four non-fatal events, while the Centers for Disease Control and Prevention tallies seven non-fatal events for every drowning among children.
    Dr. Paul S. Auerbach, Redlich Family Professor in the Department of Emergency Medicine at the Stanford University School of Medicine, said “prevention is the name of the game.”
    “Parents need to understand all the best methods for trying to prevent drowning in children,” said Auerbach, whose complete list of tips in his classic book, “Wilderness Medicine,” begins with the single most important rule:
    Watch your children.
    “Toddlers are at greatest risk for drowning,” he said, though all children under 14 are at a high risk.
    “Teach children to swim, but be advised that such teaching does not absolutely ‘drownproof’ a child,” Auerbach said. “In other words, never let a small child out of your sight when he is near the water, even if he knows how to swim.”

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    Ultimately, Sempsrott said, Eden’s story is “remarkable” and one he hopes can be reproduced, “because this was an otherwise very common, hopeless, severe brain damage drowning story.” Still, he said, even if this is a one in a million story, for the Carlsons, hyperbaric oxygen treatments have “made all the difference in the world.”
    “We have no doubt that as she grows, the walking will become easier for her,” Carlson wrote of her daughter’s progress. “Eden is doing really well today.”

    Read more: http://www.cnn.com/2017/07/21/health/oxygen-therapy-drowning-brain-damage/index.html

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    Sen. John McCain has brain cancer, aggressive tumor surgically removed

    (CNN)Sen. John McCain, 80, has been diagnosed with a primary glioblastoma, a type of brain tumor, Mayo Clinic doctors directly involved in the senator’s care told CNN exclusively. The doctors spoke directly to CNN Chief Medical Correspondent, Dr. Sanjay Gupta.

    The senator underwent surgery to remove a blood clot on Friday at Mayo Clinic Hospital in Phoenix. Lab results from that surgery confirmed the presence of brain cancer associated with the blood clot.
    Glioblastoma is a particularly aggressive tumor that forms in the tissue of the brain and spinal cord, according to the American Brain Tumor Association.
      A pathologist was in the operating room during the procedure, a minimally invasive craniotomy with an eyebrow incision, said his doctor, who added that the surgery lasted about three to four hours. Post-surgical brain scans show the tissue causing concern has been completely removed.
      McCain is recovering “amazingly well,” according to a statement from his office.
      The senator showed no neurological problems before or after the operation, said his doctors. Though not identified by name, at McCain’s request, his doctors were given permission to speak with Gupta, who is also a practicing neurosurgeon.
      McCain is now recovering at his Arizona home. He and his family are considering treatment options, which will likely include radiation and chemotherapy, his doctors said.
      “The news of my father’s illness has affected every one of us in the McCain Family,” tweeted Meghan McCain on Wednesday. “It won’t surprise you to learn that in all this, the one of us who is most confident and calm is my father.”

      Routine exam

      Doctors discovered the clot during a routine physical exam last week. They said he is very diligent about coming in for scheduled exams and is seen every four months for skin checks due to his history of skin cancer.
      He arrived at his early morning appointment, Friday before 8 a.m. and as per usual, looked good, according to a doctor who has been involved in his care for nearly a decade. McCain, described as not being a complainer, did report feeling fatigued, which he attributed to a rigorous travel schedule.
      He also told his doctor he had, at times, felt foggy and not as sharp as he typically is. In addition, he reported having intermittent double vision. These symptoms and doctor intuition prompted a CT scan.
      When the results came back, McCain, who had already left the clinic, was asked to return for an MRI. Before the operation, his neurological exam was normal, according to his doctor.
      The operation began in the late afternoon and the senator was recovering in the ICU by evening. His doctors told Gupta they were amazed at how sharp McCain was when he awoke. He knew what year it was and started cracking jokes. He also made it clear that he wanted to leave the hospital and get back to work, his doctors said.
      Showing no signs of cognitive delays, McCain was discharged Saturday and has been recovering at his home since then.
      His doctors would not reveal details but said his post operative care is standard.

      ‘Aggressive tumor’

      His doctor said McCain was oriented, with good balance and no headaches or seizures.
      The clot was over the senator’s left eye, not far from the left temple where he was diagnosed with melanoma in 2000. Previously, McCain had three other malignant melanomas removed in 1993, 2000 and 2002. None of these melanomas were invasive. All were declared Stage 0.
      However, McCain has been regularly screened by his doctors since 2000.
      Gupta was one of a select group of reporters who reviewed McCain’s medical records in 2008 when he was campaigning for president.
      The surgical procedure McCain underwent is “a significant operation,” said Gupta, explaining that a bone underneath the eyebrow had to be removed to do the procedure and then later put back.
      “It’s a very aggressive tumor,” said Gupta. He explained that average survival for malignant glioblastoma tends to be around 14 months with treatment. In McCain’s case, additional therapy, including radiation, could not begin until the incision heals, which would be in the next three or four weeks.
      Still, one 2009 study reported that almost 10% of patients with glioblastoma may live five years or longer, according to the American Brain Tumor Association.

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      “This is the same tumor that Ted Kennedy had,” said Gupta.
      McCain’s diagnosis is the latest chapter in a storied life. Tortured as a Vietnam prisoner-of-war, the maverick politician fell short of the pinnacle of politics with two failed presidential runs. His absence from Washington in recent days has come at a politically inopportune time for a bill repealing and replacing Obamacare. This week, McCain broke ranks and called for discussions with Democrats and a full committee process to finally provide “Americans with access to quality and affordable health care.”

      Read more: http://www.cnn.com/2017/07/19/health/gupta-mccain-glioblastoma/index.html

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      When a woman took sick days for mental health, her email sparked a larger discussion

      (CNN)Madalyn Parker sent an email to her team at work saying she’d be out of office for a few days to focus on her mental health.

      “I was absolutely touched. It brought tears to my eyes,” Parker told CNN. “It was surprising to be applauded for my vulnerability.”

      The email

        Parker, 26, lives in Ann Arbor, Michigan. She’s a software developer or “empathy engineer” — a title she chose for herself — for Olark, a Michigan-based live-chat platform that helps businesses talk to customers. It has a staff of about 40.
        She told CNN she suffers from chronic anxiety, depression and post-traumatic stress disorder. And every now and then, she needs to take some time to focus on her well-being.
        “I had experienced several nights of insomnia and was poorly rested and also having lots of suicidal thoughts, which make it difficult to accomplish much at work,” she said.
        A few weeks ago, she sent an email to her team that said:
        “Hey team,
        I’m taking today and tomorrow to focus on my mental health. Hopefully, I’ll be back next week refreshed and back to 100%.
        Thanks
        Madalyn.”

        The response

        The next day, she opened her inbox to find a flood of response. But one that caught her eye was from company CEO Ben Congleton.
        “I can’t believe this is not a standard practice at all organizations,” read part of his email. “You are an example to us all, and help cut through the stigma so we can all bring our whole selves to work.”
        So, Parker posted the exchange online.
        “I thought the internet should see what a good example he’s setting,” she said.
        Ever since, she’s been flooded with messages telling her just how great her boss must be.
        “Wow, I wish! I needed a medical mental health stay once. Upon my return, my boss told me not to let it happen again or my job would be gone,” one woman wrote.
        Another said, “I had to take a mental health day recently and lie about my reasoning for not coming in, because it’s not seen as a viable excuse for missing work.”

        The reason

        Congleton, the boss, said that as he read through the comments on the email chain, he started to get emotional. He realized it was time to make a change.
        “I think there’s a lot of people out there that don’t really understand what mental health is. I feel sorry for them,” he told CNN. “Mental health (is) just as important as physical health in these situations.”
        The National Institute of Mental Health, in a study in 2015, found that an estimated 16.1 million adults in the US experienced a major depressive episode in the previous year.
        And an American Psychological Association survey in 2016 found less than half of working Americans say the climate in their workplace support employee well-being.
        “It’s 2017,” Congleton wrote on Medium. “When an athlete is injured they sit on the bench and recover. Let’s get rid of the idea that somehow the brain is different.”
        His advice to employers? Create a workplace where your employees feel safe talking about what’s bothering them.
        “There’s this misconception that you can leave part of yourself home when you go to work,” Congleton told CNN. “(But) some personal stuff is gonna hang in there and hold on.”

        Read more: http://www.cnn.com/2017/07/12/health/mental-health-response-from-company-ceo-trnd/index.html

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        Meningitis vaccine may also cut risk of ‘untreatable’ gonorrhoea, study says

        Bacteria causing two different illnesses belong to the same family and share much of the same genetic code providing unexpected cross protection

        Hopes to fight untreatable strains of gonorrhoea have risen after it emerged that a new vaccine against meningitis unexpectedly reduced the risk of people getting the sexually transmitted infection.

        Some strains of gonorrhoea are resistant to all available drugs, making vaccine development an urgent global health priority. But according to a study in The Lancet, a vaccine has offered protection against the sexually transmitted disease for the first time.

        Gonorrhoea spreads through unprotected vaginal, oral or anal sex and many of those who contract the disease experience no symptoms. If left untreated, the disease can cause infertility and can increase the transmission of HIV infection.

        A New Zealand meningitis epidemic in the early 2000s prompted the mass vaccination of a million people and fortuitously set the scene for the current study. The vaccine used, known as MeNZB, was designed to protect against meningococcal group B infection the cause of the most deadly form of meningitis.

        But intriguingly, over the next few years, scientists noticed fewer gonorrhoea cases than expected in those who had been vaccinated against meningitis.

        Dr Helen Petousis-Harris, a vaccine specialist from the University of Auckland who led the study, was optimistic: Some types of gonorrhoea are now resistant to every antibiotic we have, and there appeared [to be] little we could do to prevent the steady march of gonorrhoea to superbug status. But now theres hope, she added.

        The research team studied over 14,000 people aged 15-30 whod been diagnosed with gonorrhoea at sexual health clinics across New Zealand and who had been eligible for the MeNZB vaccine during the emergency vaccination programme. They found vaccinated individuals were over 30% less likely to develop gonorrhoea.

        Despite meningitis and gonorrhoea being very different illnesses, both are caused by bacteria from the same family and share much of the same genetic code, providing a possible explanation for the cross-protection that the team observed.

        More than 78 million people worldwide get gonorrhoea each year with most infections in men and women under the age of 25. It is the second most common bacterial sexually transmitted infection in the UK after chlamydia. In England alone, almost 35,000 people were affected in 2014.

        British Association for Sexual Health and HIVs President, Dr Elizabeth Carlin, who was not involved in the study, was more sceptical: These early findings are to be welcomed but its important to keep in perspective that the vaccine offered only moderate protection …. an individual receiving this vaccine remains susceptible to gonorrhoea but just less so than if unvaccinated.

        The MeNZB vaccine used in the current study is no longer manufactured, but Petousis-Harris has high hopes for a similar meningitis vaccine called 4CMenB, available in many countries.

        Petousis-Harris was clear about what needed to happen next. We need an urgent assessment of current meningitis vaccines to see if they protect against gonorrhoea. It may be possible to eliminate many gonorrhoea infections using a vaccine with only moderate protection. It does not need to be perfect, she added.

        Read more: https://www.theguardian.com/science/2017/jul/10/meningitis-vaccine-may-also-cut-risk-of-untreatable-gonorrhoea-study-says

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        ‘Pierced’ baby picture sparks outrage among parents

        (CNN)Enedina Vance was fed up. She felt like other parents didn’t understand her message. She felt like they weren’t listening to her.

        So she got on her phone, found a picture of her 6-month-old daughter and pasted a diamond stud over the infant’s dimple to make it look like she had a piercing.
        Vance, a strong advocate against piercing or circumcising children, posted the edited picture to Facebook, where it had more than 13,000 shares as of Thursday afternoon.
          “I make all of her decisions until she’s 18, I made her, I own her!!” she wrote.
          What Vance didn’t expect was the reaction she’d get from parents around the world. Outrage. Hate mail. Threats to call Child Protective Services.
          But the image also proved her point, and it got parents talking.
          “The reaction that parents have when they see this beautiful perfect baby being … mutilated, that initial shock, that reaction of anger, I want them to hold on to that,” the 35-year-old said.

          Many thought photo was real

          The stay-at-home mom from Fostoria, Ohio, knew that seeing a picture of a baby with a dimple piercing would get her family and friends talking, so she shared it in parenting Facebook groups.
          The post quickly incited outrage among the parenting community, and she was called “a bad mother” and worse.
          Many people assumed the piercing was real and lambasted Vance for her apparent decision.
          “I seriously can not believe how many people missed that this was purely satirical, I actually used the hashtag #sarcasm,” Vance wrote on Facebook. “Yet people were still threatening to beat me to death, call child protective services, & take away my children.”
          Other parents simply disagreed with her stance on piercing.
          One woman wrote, “I got my ears pierced as a baby. I grew up just fine. … I’m having a girl and I will get her ears pierced.”
          Ohio law allows children under age 18 to get piercings and tattoos with a parent or guardian present. Most states allow minors to be pierced with parental consent.
          Amid the death threats and hate mail, Vance said she also got countless positive messages from parents. Some said they felt they didn’t have a choice in whether their sons were circumcised. Another was told it was a “cleanliness thing.”
          “A lot of this responsibility lies on our medical community. They encourage parents,” Vance said. “It shouldn’t be an option. It shouldn’t be a question.”

          ‘Not a good enough reason’

          Vance didn’t always feel so strongly about circumcision.
          Coming from a family of all women, she said she didn’t know a lot about circumcision until she became pregnant for the first time in the late ’90s. Vance had twin girls, but the research she did stuck in her mind.
          “It felt so outdated, so primitive,” she said. “We as a civilized society should have grown past this and (I) was shocked that cutting my infant’s genitals was even an option.”
          Many parents choose to circumcise their children because of hygienic, health or religious reasons.
          In 2012, the American Academy of Pediatrics found that the health benefits of circumcision outweigh the risks. However, the academy said the benefits weren’t great enough to recommend that all newborn boys be circumcised.
          “There is no compelling reason to deny boys their legitimate right to make their own informed decision when they are old enough to do so,” the report said.
          Vance sees this as a call to action and will tell anyone she meets how she feels if it comes up in conversation. She protested last fall in Cleveland with the Bloodstained Men & Their Friends, an organization that advocates against circumcision.
          But her beliefs extend beyond circumcision.
          “No one has the right to alter, modify, or mutilate another human being’s body for aesthetic purposes, not even parents,” she said.
          Vance has argued that ultimately, children should be able to decide for themselves.
          “What 1-week-old is asking to have earrings?” she said. “Just because it looks cute, just because it looks better — that’s not a good enough reason.”

          Read more: http://www.cnn.com/2017/07/06/health/photoshopped-baby-picture-with-piercing-trnd/index.html

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          Untreatable gonorrhoea ‘superbug’ spreading around world, WHO warns

          World Health Organization tells of very serious situation after confirming three known cases where all antibiotics were ineffective


          The World Health Organization has warned of the spread of totally untreatable strains of gonorrhoea after discovering at least three people with the superbug.

          Giving details of studies showing a very serious situation with regard to highly drug-resistant forms of the sexually transmitted disease (STD), WHO experts said on Friday it was only a matter of time before last-resort gonorrhoea antibiotics would be of no use.

          Gonorrhoea is a very smart bug, said Teodora Wi, a human reproduction specialist at the Geneva-based UN health agency. Every time you introduce a new type of antibiotic to treat it, this bug develops resistance to it.

          The WHO estimates 78 million people a year get gonorrhoea, an STD that can infect the genitals, rectum and throat.

          The infection, which in many cases has no symptoms on its own, can lead to pelvic inflammatory disease, ectopic pregnancy and infertility, as well as increasing the risk of getting HIV.

          Wi, who gave details in a telephone briefing of two studies on gonorrhoea published in the journal PLOS Medicine, said one had documented three specific cases one each in Japan, France and Spain of patients with strains of gonorrhoea against which no known antibiotic is effective.

          These are cases that can infect others. It can be transmitted, she told reporters. And these cases may just be the tip of the iceberg, since systems to diagnose and report untreatable infections are lacking in lower-income countries where gonorrhoea is actually more common.

          The WHOs programme for monitoring trends in drug-resistant gonorrhoea found in a study that from 2009 to 2014 there was widespread resistance to the first-line medicine ciprofloxacin, increasing resistance to another antibiotic drugs called azithromycin, and the emergence of resistance to last-resort treatments known as extended-spectrum cephalosporins (ESCs).

          In most countries, it said, ESCs are now the only single antibiotics that remain effective for treating gonorrhoea. Yet resistance to them has already been reported in 50 countries.

          Manica Balasegaram, director of the Global Antibiotic Research and Development Partnership, said the situation was grim and there was a pressing need for new medicines.

          The pipeline, however, is very thin, with only three potential new gonorrhoea drugs in development and no guarantee any will prove effective in final-stage trials, he said.

          We urgently need to seize the opportunities we have with existing drugs and candidates in the pipeline, he said. Any new treatment developed should be accessible to everyone who needs it, while ensuring it is used appropriately, so that drug resistance is slowed as much as possible.

          Read more: https://www.theguardian.com/society/2017/jul/07/untreatable-gonorrhoea-superbug-spreading-around-world-who-warns

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          Opioid Opana ER to be pulled by pharmaceutical company

          (CNN)One month after the FDA asked it to remove an opioid from the market, pharmaceutical maker Endo has announced it will pull the drug.

          The company said in a statement posted on its website it still believes in the efficacy and safety of Opana ER, or oxymorphone hydrochloride.
          The FDA said the request was the first time it had asked that an opioid pain medication be pulled because of “the public health consequences of abuse.”
            Opana ER is a powerful painkiller, about twice as powerful as OxyContin, another often abused opioid.
            Endo said it had worked for years to “combat misuse and abuse.” The drug was approved in 2006 and was intended to be used to manage moderate to severe pain over a long period with just one pill.
            But addicts crushed it to get a massive high all at once
            So, the company made the tablets with a coating that made them hard to crush. It also changed the formula in 2012.
            The FDA said post-market data suggested that after the company reformulated the medication, people were injecting it more than they were snorting it.
            If Opana ER sounds familiar, it’s because it was the drug of choice for many addicts at the center of an HIV outbreak in Indiana in 2015.
            The company will work with the FDA on a timeline to remove the drug from the market while giving patients and doctors the chance to find new treatments.

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            Endo sold $35.7 million worth of Opana ER in the first three months of 2017 and $158.9 million last year.
            The United States is in the midst of an opioid overdose epidemic, according to the US Centers for Disease Control and Prevention. Opioid overdose killed more than 33,000 people in 2015, more than any year on record. Nearly half of all overdose deaths involve some kind of prescription drug.

            Read more: http://www.cnn.com/2017/07/06/health/opioid-opana-er-pulled-endo/index.html

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            Mom’s sweet tooth may be linked to child’s allergies, study says

            (CNN)Women who consume too many sugary foods and drinks during pregnancy may be increasing their children’s risk of developing an allergy or allergic asthma, according to a study published Thursday in the European Respiratory Journal.

            The researchers looked at allergies that produce respiratory and skin symptoms, including dust mites, cats and grass. “Allergic asthma” causes breathing problems, like wheezing and coughing, in the presence of common allergens such as dust.
            Researchers from Queen Mary University of London used data gathered from nearly 9,000 mother-child pairs in the Avon Longitudinal Study of Parents and Children, an ongoing research project that tracks the health of families with children born between April 1, 1991, and December 31, 1992.
              According to the World Health Organization, 235 million people have asthma, and it’s a common disease among children. That number is expected to increase to 400 million by 2025. The American Academy of Allergy, Asthma & Immunology reports that worldwide, sensitivity to one or more allergens among children is approaching 40% or 50%, and 10.6% of children reported respiratory allergies in the previous 12 months in 2012.
              “The dramatic ‘epidemic’ of asthma and allergies in the West in the last 50 years is still largely unexplained — one potential culprit is a change in diet,” said Annabelle Bedard, lead author and a postdoctoral fellow at Queen Mary’s Centre for Primary Care and Public Health Blizard Institute. “Intake of free sugar and high fructose corn syrup has increased substantially over this period.”
              Free sugars” include those that are naturally present in honey, syrups and unsweetened fruit juices — though not those in whole vegetables and fruits — and those that are added to food and beverages by the manufacturer, the cook or the consumer.
              “We know that the prenatal period may be crucial for determining risk of asthma and allergies in childhood and recent trials have confirmed that maternal diet in pregnancy is important,” Bedard wrote in an email.
              To investigate a potential connection between a mom’s diet and a child’s allergies, Bedard and her colleagues calculated the amount of free sugars consumed by the women during pregnancy based on self-reported estimates in questionnaires.
              Next, the team looked at how the moms’ sugar consumption compared with allergies and asthma diagnosed in the children beginning age 7.
              Nearly 62% of the children did not have any allergic conditions, but the remaining children had one or more maladies or symptoms. About 22% of the kids had a common allergy, 16% had eczema, 12% had asthma, 11% had wheezing with whistling, and 9% had hay fever, the researchers found.
              Then, the researchers compared the children of moms who ate the least sugar during pregnancy — less than 34 grams, or 7 teaspoons, per day — with the children of moms who ate the most — between 82 and 345 grams, or 16 and 69 teaspoons, per day.
              The children of women with highest sugar intake during pregnancy had a 38% higher risk of allergy diagnosis, the researchers calculated. Kids of the moms in this group had a 73% increased risk of being diagnosed with an allergy to two or more allergens. And the allergic asthma risk increased by 101% for children of moms in the high-sugar consumption group, meaning the risk of developing allergic asthma was double that of kids born to women in the low-sugar group.
              Only weak evidence linked sugar consumption during pregnancy to chronic asthma, the researchers say. And there were no ties between a mother eating sweets during pregnancy and either eczema or hay fever.
              Bedard and Seif Shaheen, senior researcher of the study and a professor at Queen Mary, emphasized that the research is simply observational and so does not conclude that moms who eat sugar during pregnancy cause allergies in their children.
              “Similarly, we cannot rule out the possibility that the main findings arose by chance,” Bedard said.
              With such strong results, though, the team is continuing to examine the issue and trying to replicate the findings among two other groups of children, Bedard explained.
              Sheena Cruickshank, senior lecturer in immunology at the University of Manchester and a representative for the British Society for Immunology, said it is unclear from the study findings how strong the effect is.
              “More studies will be needed to work out if there is any causation in this relationship,” said Cruickshank, who was not involved in the new research. “Atopic diseases, such as allergy and asthma, are complex and associated with many genetic and environmental effects, including the microbes and pollutants we are exposed to.”
              Bacteria are commonly found within the digestive tracts of all humans. When it comes to babies, Cruickshank noted that it is well-known that this bacterial content “is influenced by how a baby is delivered, the type of milk the baby is fed as well as their diet as they grow older.”
              “Future studies should look to take these variables into account so we can understand the full relationship between maternal diet during pregnancy and allergic disease in the offspring,” Cruickshank said.
              Dr. Shannon M. Clark, a spokeswoman for the American College of Obstetricians and Gynecologists and an associate professor at University of Texas Medical Branch-Galveston, said the large number of participants was a strength of the study. However, the researchers did not examine each mother’s sugar intake until after 32 weeks of pregnancy.
              “As a result, the impact of exposure early in pregnancy cannot be assessed,” said Clark, who was not involved in the research. “As with any study of this design, additional research would be ideal.”

              See the latest news and share your comments with CNN Health on Facebook and Twitter.

              Nutrition guidelines from the World Health Organization and the US Department of Agriculture recommend everyone limit sugar in their diets.
              Clark noted that pregnant women need to eat healthy diets to reduce risk of developing gestational diabetes, a form of diabetes that occurs in pregnancy and that is more common among overweight and obese mothers.
              “Eating excessive amounts of sugar in pregnancy can put the mother at risk for developing gestational diabetes,” she said. “Gestational diabetes increases the risk of having a large baby, cesarean delivery and preeclampsia.” And babies born to women with gestational diabetes may have problems with breathing, low glucose levels and jaundice.
              For pregnant women, Bedard said, it would be “prudent” to follow general nutritional guidelines cautioning against eating an abundance of sugary products — “whether or not we subsequently show that a high sugar intake in pregnancy causes allergy in the offspring.”

              Read more: http://www.cnn.com/2017/07/05/health/sugar-pregnancy-child-allergy-asthma-study/index.html

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              People taking heartburn drugs could have higher risk of death, study claims

              Research suggests people on proton pump inhibitors are more likely to die than those taking different antacid or none at all

              Millions of people taking common heartburn and indigestion medications could be at an increased risk of death, research suggests.

              The drugs, known as proton pump inhibitors (PPIs), neutralise the acid in the stomach and are widely prescribed, with low doses also available without prescription from pharmacies. In the UK, doctors issue more than 50m prescriptions for PPIs every year.

              Now researchers say the drugs can increase risk of death, both compared with taking a different type of acid suppressant and not taking any at all.

              We saw a small excess risk of dying that could be attributed to the PPI drug, and the risk increased the longer they took them, said Ziyad Al-Aly, an epidemiologist from the University of Washington and co-author of the study.

              The team say the study suggests those who take the drugs without needing to could be most at risk. They urged people taking PPIs to check whether this was necessary.

              Previous research has raised a range of concerns about PPIs, including links to kidney disease, pneumonia, more hip fractures and higher rates of infection with C difficile, a superbug that can cause life-threatening sepsis, particularly in elderly people in hospitals.

              But the latest study is the first to show that PPIs can increase the chance of death. Published in the journal BMJ Open, it examined the medical records of 3.5 million middle-aged Americans covered by the US veterans healthcare system.

              The researchers followed 350,000 participants for more than five years and compared those prescribed PPIs to a group receiving a different type of acid suppressant known as an H2 blocker. They also took into account factors such as the participants age, sex and conditions ranging from high blood pressure to HIV.

              The results show that those who took PPIs could face a 25% higher risk of death than those who took the H2 blocker.

              In patients on [H2 blocker] tablets, there were 3.3 deaths per 100 people over one year. In the PPI group, this figure was higher at 4.7 per 100 people per year, said Al-Aly.

              The team also reported that the risk of death for those taking PPIs was 15% higher than those taking no PPIs, and 23% higher than for those taking no acid suppressants at all.

              Similar levels of increased risk were seen among people who used PPIs but had no gastrointestinal conditions, a result which the authors speculated might be driving the higher risk seen overall.

              Gareth Corbett, a gastroenterologist from Addenbrookes hospital in Cambridge who was not involved with the study, cautioned against panic, pointing out that in most cases the benefits of PPI far outweighed any risk. What was more, he said, while the increased risk sounded high, it was still very low for each person.

              PPIs are very effective medicines, proven to save lives and reduce the need for surgery in patients with bleeding gastric and duodenal ulcers and several other conditions, he said.

              The studys authors said it was important that PPIs were used only when necessary and stopped when no longer needed.

              Corbett agreed that many people take PPIs unnecessarily. They could get rid of their heartburn by making lifestyle changes, such as losing weight and cutting back on alcohol, caffeine and spicy foods, he said.

              The authors said the study was observational, meaning it did not show that PPIs were the cause of the increased risk of death, and that it was unclear how the drugs would act to affect mortality. They said the drugs could affect components within cells, known as lysosomes, that help break down waste material, or shortening protective regions at the end of chromosomes, known as telomeres.

              Aly said people on PPIs should check with their GP whether the drugs were still needed, adding: In some cases we expect that PPIs can be safely stopped, particularly in patients who have been taking them for a long time.

              Read more: https://www.theguardian.com/science/2017/jul/04/people-taking-heartburn-drugs-could-have-higher-risk-of-death-study-claims

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              Mendel.ai nabs $2 million to match cancer patients with the latest clinical trials

              Dr. Karim Galil was tired. He was tired of losing patients to cancer. He was tired of messy medical records. And he was tired of trying to stay on top of the avalanche of clinical trials touting one solution or another. Losing both patience and too many patients, Galil decided to create an organized and artificially intelligent system to match those under his care with thebest diagnostic and treatment methods available.

              He called his new system Mendel.ai after Gregor Mendel, the father of modern genetics science, and has just raised $2 million in seed funding from DCM Ventures, Bootstrap Labs and Launch Capitalto get the project off the ground.

              Mendel.ai is similar in many ways to the U.K.-based BenevolentBio, which is focused on skimming through scientific papers to find the latest in cutting-edge medical research. But rather than using keyword data, Mendal.ai uses analgorithm that understands the unstructured, natural language content within medical documents pulled from clinicaltrials.gov,and then compares it to a patients medical record. The search process returns a fully personalized match and evaluates the patients eligibility for each suggested treatment within minutes, according to Galil.

              The startup could prove useful for doctors whoincreasingly find it difficult to keep up on the exhaustive amount of clinical data.

              Patients are also overwhelmed at the prospect of combing through mountains of clinical trial research. A lung cancer patient, for example, might find 500 potential trials on clinicaltrials.gov, each of which has a unique, exhaustive list of eligibility criteria that must be read and assessed, says Galil. As this pool of trials changes each week, it is humanly impossible to keep track of all good matches.

              Mendel.ai seeks to reduce the time it takes and thus save more lives. The company is now integrating with the Comprehensive Blood & Cancer Center (CBCC) in Bakersfield, Calif, which will allow the centers doctors to quickly match their patients with available clinical trials in a matter of minutes, according to Galil.

              The plan going forward is to workwith hospitals and cancer genomics companies like the CBCC to improve Mendel.ai and introduce the system. A more immediate goal, Galil says, would be challenging IBMs Watson against his system to see which one can match up the patients better.

              This is the difference between someone dying and someone living. Its not a joke, Galil told TechCrunch.

              Read more: https://techcrunch.com/2017/07/01/mendel-ai-nabs-2-million-to-match-cancer-patients-with-the-latest-clinical-trials/