Astonishingly excellent.

August 24, 2016. 

Four hours.

In Huntington, West Virginia last week, there were 27 heroin overdoses within four hours, including one death. Officials believe that many victims were injected from a batch of the drug that was laced with Fentanyl, a synthetic opioid up to 100 times more potent than morphine. Huntington has a population of about 50,000 people and usually sees around 18 to 20 overdoses in a week. “We have never seen anything like this before to this magnitude.”

The opioid epidemic. More Americans are dying from opioids than at any time in recent history, with overdose deaths hitting 28,000 in 2014. That amounts to 78 Americans dying from an opioid overdose every day. Note: The CDC uses opioid as an umbrella term for painkillers and drugs derived naturally from opium (AKA opiates), such as heroin.

Where’s the beef?

For most of the past decade, meat consumption in the U.S. was falling. Great news for environmental, health, and animal advocates. It’s not falling anymore. According to a recent analysis, consumption of meat in the U.S. rose by 5% in 2015, the largest increase in 40 years.

 Zika update.

The Zika outbreak in Florida is growing in two neighborhoods of Miami, including Miami Beach. The CDC advises pregnant women to avoid these neighborhoods and to consider postponing travel to all parts of Miami-Dade County. So far, 37 people are reported to have caught the virus in these neighborhoods. However, scientists are concerned that the outbreak in Florida may be more widespread. “Zika is one of those diseases that is always like an iceberg — you just see the tip,” says Alessandro Vespignani, a computer scientist at Northeastern University in Boston.

The effect on the brain. A new study demonstrates the damage to 45 Brazilian babies whose mothers were infected with Zika during pregnancy.

 Marijuana research.

While 25 states have approved the medical use of marijuana for certain conditions, including Parkinson’s, Crohn’s disease, Alzheimer’s, and lupus, the research to back up the effectiveness of its use is sparse. The Obama administration is planning to remove a barrier to marijuana research in an effort to increase the supply of marijuana available to researchers.

Physician burnout.

According to a new study, nearly two-thirds of physicians feel more overworked now than when they first started their careers. Physicians report they are spending more time at work, leading to overexertion and a poor work-life balance. Many doctors feel they have less free time and are unsatisfied with the amount of time they get to spend with patients, with paperwork cutting into that time. The problem has become so intense that more than half of the physicians surveyed have considered leaving the medical field altogether.

The health of our next president.

Donald Trump, 70, and Hillary Clinton, 68, have been more secretive than many recent presidential nominees in sharing details about their health, despite the fact that they are senior citizens. Each released a brief medical statement in 2015 but have not added to it since.

Mr. Trump. He has provided only a four-paragraph statement from his gastroenterologist last December. While it lacked many important details, it described Mr. Trump’s blood pressure (110/65) and laboratory test results as “astonishingly excellent.” His doctor concluded that Mr. Trump “will be the healthiest individual ever elected to the presidency.” Now, that’s astonishing.

Mrs. Clinton. Mr. Trump is questioning Mrs. Clinton’s “physical and mental strength and stamina” and sharing unfounded rumors that she is ill. You may recall that in 2012, she fainted at her home and suffered a concussion. Doctors found a blood clot, she was treated, and soon returned to her regular routine. In July 2015, Mrs. Clinton issued a two-page letter from her physician, attesting to her good health and fitness to serve as president.

It turns out.

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Morning Anxiety.

August 9, 2016

What’s with the cupping?

A number of Olympians, including Michael Phelps, have been photographed with large red circles on their skin. They are the result of a practice known as “cupping,” an ancient therapy where heated cups are placed on the skin. The technique, a form of acupuncture, is done by lighting flammable liquid in a glass cup. Once the flame goes out, the drop in temperature creates suction, which promotes blood flow and leaves the red spots. Athletes use it to ease aches and pains, and to help with recovery due to constant training and competing. So far, the repeated effect of cupping therapy over time is not known, but it’s generally believed to be safe.

We’re growing.

A CDC report found that that U.S. men and women weigh about 15 lbs more than they did 20 years ago. The average man is 5 ft 9 in and weighs 196 lb, and the average woman is almost 5 ft 4 in and weighs 169 lb. For men, that’s 15 lb and for women, 16 lb heavier, than we were 20 years ago. Heights were about the same at that time.

And we’re anxious.

 Over the past eight years, Google search rates for anxiety have more than doubled. “So far, 2016 has been tops for searches for driving anxiety, travel anxiety, separation anxiety, anxiety at work, anxiety at school and anxiety at home.” Additionally, searches for “anxiety in the morning” and “anxiety at night” have increased significantly. Two factors that were found to cause anxiety: major recession and one less expected factor – opiate withdrawal.

 Do you floss?

 The American Dental Association recommends regular flossing to reduce the likelihood of gum disease and tooth decay. They estimate that about 40 percent of Americans floss daily, 20 percent don’t floss at all, and 27 percent lie about it. I’m guessing a good amount of people floss once a year, on the day of their annual teeth cleaning. It turns out that few studies on the effectiveness of flossing have been completed. “Overall there is weak, very unreliable evidence which suggests that flossing plus toothbrushing may be associated with a small reduction in plaque at 1 or 3 months.” Despite the lack of evidence, I immediately felt the need to floss after reading this article.

In food news.

 Almost antibiotic-free McNuggets. After making a pledge last year, McDonald’s is no longer serving chicken raised on antibiotics that are important in human medicine. This is a response to the concern that the more antibiotics are given to animals, the more quickly bacteria could become resistant to it. About “70 percent of medically important antibiotics (classes of drugs also used in human medicine) in the U.S. are sold for use on animals, not people.” The FDA is encouraging farmers who raise livestock to reduce antibiotic use. Chicken served at McDonald’s may still contain ionophores, a type of medicine that is not used to treat people.

Super. Foods like salmon and kale have been called “superfoods.” It turns out that the label doesn’t have an established definition. “Despite thousands of websites and lifestyle articles devoted to superfoods, there is hardly any published research in peer-reviewed scientific journals.” The European Union forbade food companies from using the term on food labels unless they could use an approved piece of research to back up a health claim. The U.S. does not have similar regulations.

The challenge of de-prescribing.

Nearly 60 percent of Americans take at least one prescription drug. An estimated 15 percent take five or more medications, which is known as polypharmacy. As medication lists grow, so can the many side effects. It’s hard for doctors to “de-prescribe” medicines, citing that when “patients expect treatment, we are more likely to prescribe a drug—whether medication is needed or not.” Often patients want to stay on a drug that has helped them, even if it was prescribed for a condition that was temporary. Additionally, discontinuing a drug prescribed by another physician, gives doctors pause, because “physicians hesitate to step on another doctor’s toes.”

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Comeback kids.

August 2, 2016.

 Oh, Mi-ami.

Zika is now in the US. Fourteen people in Florida have been infected with the virus by local mosquitoes.

Travel warning. The CDC issued an unprecedented travel warning, advising pregnant women and their partners not to travel to a community near downtown Miami, where Zika is circulating. This is the “first time the CDC warned people not to travel to an American neighborhood” for fear of catching a disease.

 In the U.S. There are now more than 1,600 confirmed Zika cases in the continental U.S. Up until last week, all of them had been a result of travel abroad. The virus was contracted either by a mosquito bite elsewhere or by intercourse with someone who had been to a Zika-affected area.

In Puerto Rico. There are about 5,500 confirmed infections on the island, including 672 pregnant women. But experts believe this is an undercount, estimating that thousands of residents, including up to 50 pregnant women, are infected each day.

What is Zika? An infectious disease mainly spread through mosquito bites and can also be sexually transmitted. Symptoms, if any, are mild and can include fever, rash and headache. Infections during pregnancy can cause microcephaly (small head) and other brain malformations in some babies.

Making a comeback.

Now, some good news in the world of children’s health. Time magazine reports that “after years of falling vaccination rates and alarming outbreaks of measles, whooping cough and other vaccine-preventable illnesses, the trend lines at last appear to be changing.” Parents have become more accepting of vaccines for two main reasons: increased fear of infectious diseases in general and concern that their child could contract a vaccine-preventable disease. The evidence wins.

The buckets helped.

I’m certain you recall the ice bucket challenge of 2014. More than 2.4 million tagged videos circulated on Facebook, many of them dominating your feed. Supporters raised over $115 million for the Amyotrophic Lateral Sclerosis (ALS) Association. Those donations helped fund research to help people living with the disease. This week, the association announced the discovery of the NEK1 gene, which is among the most common genes that contribute to the disease and is associated with three percent of ALS cases. It provides scientists with a new potential target for therapy development.

Room service. To your hospital bed.

“At the Henry Ford West Bloomfield Hospital outside Detroit, patients arrive to uniformed valets and professional greeters. Wi-Fi is free and patient meals are served on demand 24 hours a day. Members of the spa staff give in-room massages and other treatments.” As hospitals compete with one another to provide patient care, marketing and word-of-mouth recommendations are important, especially because there is so little reliable comparative data on hospitals’ medical outcomes. One concern cited in this New York Times article: who is paying for this?

 Did you know?

At home pregnancy tests did not become available in the U.S. until 1977. This is years after the technology first became available. Until then, it was thought that women needed a doctor to administer the test and “managers [at the company that made them] seemed terrified by scenarios in which hysterical women killed themselves” upon finding out they have an unwanted pregnancy. It was pioneer Margaret Crane who pushed back, arguing that women can remove the doctor middleman and complete the test themselves. Today, eight out of ten women learn they are pregnant from a drugstore device.

Worth a watch.

The Frontline documentary, Chasing Heroin, is a powerful two-hour investigation that tells the stories of individual addicts and their families and reveals a major public health issue, noting how the opioid pill market is “priming the heroin market.”

In the news. This week, NPR reported that health care claims for people with opioid dependence diagnoses “rose more than 3,000 percent between 2007 and 2014.” That’s a big jump. But on the bright side: at least it’s being recognized more.

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