Today in history

October 12, 1928–An iron lung respirator is used for the first time at Children’s Hospital, Boston. This negative pressure ventilator has been replaced by positive pressure ventilation, and the disease most associated with it, polio, has been mostly eradicated by vaccines.

I remember seeing some old iron lung respirators in a basement in the LSU hospital when I was a medical student.

A smart bandage that could lead to faster healing?

Researchers from the University of Nebraska-Lincoln, Harvard Medical School and MIT have designed a smart bandage that could eventually heal chronic wounds or battlefield injuries with every fiber of its being.

The bandage consists of electrically conductive fibers coated in a gel that can be individually loaded with infection-fighting antibiotics, tissue-regenerating growth factors, painkillers or other medications.

A microcontroller no larger than a postage stamp, which could be triggered by a smartphone or other wireless device, sends small amounts of voltage through a chosen fiber. That voltage heats the fiber and its hydrogel, releasing whatever cargo it contains.

A single bandage could accommodate multiple medications tailored to a specific type of wound, the researchers said, while offering the ability to precisely control the dose and delivery schedule of those medications. That combination of customization and control could substantially improve or accelerate the healing process, said Ali Tamayol, assistant professor of mechanical and materials engineering at Nebraska.

Measles kills first patient in 12 years

The USA has suffered its first measles death in 12 years, according to Washington state health officials.

The woman’s measles was undetected and confirmed only through an autopsy, according to the Washington State Department of Health. The woman’s name was not released, but officials said she lived in Clallam County. . . .

Pneumonia is one of several serious common complications of measles and the most common cause of death from the virus, said William Schaffner, a professor at Vanderbilt University School of Medicine in Nashville. Measles kills one or two children out of every 1,000 infected, according to the CDC.

It’s not surprising that the woman had no obvious measles symptoms; people with compromised immune systems often don’t develop a rash when infected with the virus, said Paul Offit, chief of infectious disease at Children’s Hospital of Philadelphia.

The woman’s death was a preventable, but predictable, consequence of falling vaccination rates, said Peter Hotez, president of the Sabin Vaccine Institute and Texas Children’s Hospital Center for Vaccine Development in Houston.

Measles has surged back in recent years as groups of like-minded parents have opted against fully vaccinating their children. Last year, 644 people contracted the virus.

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Cialis and other ED meds linked with reduced heart attack risk and improved heart attack survival

Men with type 2 diabetes taking treatments for erectile dysfunction could be reducing their risk of a heart attack and improving their chances of surviving a heart attack, according to a study funded by the British Heart Foundation (BHF) and the National Institute of Health Research (NIHR).

The findings, published in the BMJ journal Heart, provide strong evidence that erectile dysfunction treatments that block an enzyme called PDE5 act to reduce risk of death in type 2 diabetes, according to the researchers. Viagra is one example of an erectile dysfunction treatment that works by blocking the PDE5 enzyme.

Compared with non-users, the 1,359 men who were prescribed PDE5 inhibiting drugs experienced lower percentage of deaths during follow-up (19.1 per cent vs. 23.8 per cent) and lower risk of death (31 per cent) by any cause. Risk of death was still reduced after adjusting for age and other factors that affect heart disease risk. They also found that there were significantly fewer heart attacks in people taking erectile dysfunction treatment over the study period. And in a subgroup of patients who had a history of heart attack or had one during the study period, the drugs were associated with significantly lower risk of death.

This is good news, but note that it is a retrospective rather than a prospective study. More investigation is forthcoming, I am sure.

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Whole-fat milk consumption associated with leaner children, research finds

Children who drink whole milk are leaner and have higher vitamin D levels than those who drink low-fat or skim milk, new research suggests.

Children who drank whole (3.25 per cent fat content) milk had a Body Mass Index score that was 0.72 units lower than those who drank 1 or 2 per cent milk in the study published today in the American Journal of Clinical Nutrition.

That’s comparable to the difference between having a healthy weight and being overweight, said lead author Dr. Jonathon Maguire, a pediatrician at St. Michael’s Hospital.
The study did not assess why consuming higher fat content milk was associated with lower BMI scores. But Dr. Maguire hypothesized that children who drank whole milk felt fuller than those who drank the same amount of low-fat or skim milk. If children don’t feel full from drinking milk, they are more likely to eat other foods that are less healthy or higher in calories, said Dr. Maguire. Therefore children who drink lower fat milk may actually consume more calories overall than those who drink whole milk.

The study also found that children who drank one cup of whole milk each day had comparable vitamin D levels to those who drank nearly 3 cups of one per cent milk. This could be because vitamin D is fat soluble, meaning it dissolves in fat rather than water. Milk with higher fat content therefore contains more vitamin D. There may also be an inverse relationship in children between body fat and vitamin D stores, according to the study; as children’s body fat increases, their vitamin D stores decrease.

“Children who drink lower fat milk don’t have less body fat, and they also don’t benefit from the higher vitamin D levels in whole milk,” said Dr. Maguire. “It’s a double negative with low fat milk.”

The study’s findings differ from Health Canada, National Institutes of Health and American Academy of Pediatrics guidelines recommending two servings of low fat (one per cent or two per cent) milk for children over the age of two to reduce the risk of childhood obesity.

Update–link fixed.

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Long-eradicated diphtheria reappears in Venezuela

Diphtheria, an extremely contagious disease that has been mostly eradicated worldwide through vaccination, has reappeared in Venezuela.

So far it has killed four children.

More than 20 cases have been reported in just one month, including those four fatalities in the southern state of Bolivar.

In the crisis-stricken South American nation, many of the children don’t have access to the DPT vaccine that prevents the centuries-old disease. Caused by the Corynebacterium diphtheriae bacterium, the disease becomes serious if the bacterial toxin enters the bloodstream and spreads through the respiratory tract. It leads to heart failure and neurological illnesses.

Even with treatment, death occurs in between 5 and 10 percent of those affected.

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In the mail

DHHEOC@la.gov

Message Urgency: HIGH

This is a message from the Louisiana Department of Health Emergency Operations Center (LDH EOC). Please share and distribute with relevant stakeholders and partners through your own distribution channels.

Mumps
The Arkansas Department of Health (ADH) is investigating a large outbreak of mumps in northwest Arkansas. So far there have been 476 confirmed cases of mumps, mostly in school-aged children and college students in the northwest area of the state. We are sending this health alert to clinicians across Louisiana to be alert for the signs and symptoms of mumps given our proximity to this outbreak.

Immunize your kids, folks.

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Do you follow the 5 second rule?

If not, read this: I’m a Doctor. If I Drop Food on the Kitchen Floor, I Still Eat It.

You may have read or heard about the study debunking the five-second rule. It said that no matter how fast you pick up food that falls on the floor, you will pick up bacteria with it.

Our continued focus on this threat has long baffled me. Why are we so worried about the floor? So many other things are more dangerous than that.

There’s no magic period of time that prevents transmission. But even though I know bacteria can accumulate in less than five seconds, I will still eat food that has fallen on my kitchen floor. Why? Because my kitchen floor isn’t really that dirty.

…the kitchen floor was likely to harbor, on average, about three colonies per square inch of coliform bacteria (2.75 to be exact). So there are some. But here’s the thing — that’s cleaner than both the refrigerator handle (5.37 colonies per square inch) and the kitchen counter (5.75 colonies per square inch).

Read the whole thing, of course.

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