A common skin bacterium put children with severe eczema at higher risk of food allergy

In a new study published today in the Journal of Allergy and Clinical Immunology, scientists from King’s College London have found that young children with severe eczema infected with Staphylococcus aureus (SA) bacterium, are at a higher risk of developing a food allergy.

Staphylococcus aureus (SA) is a bacterium that can be found in the nose and the skin of healthy individuals.

However, SA is more common in sufferers of eczema, especially severe eczema.

When someone has an allergy, their immune system mistakes a harmless substance (such as eggs or peanuts) as an intruder and overreacts in response. Their body produces a molecule or else antibody known as Immunoglobin E (IgE).

When IgE encounters the intruder on the skin or within the body it releases chemicals, such as histamine that cause the allergic reaction.

The team of scientists found that young children with severe eczema who are infected with SA produce more IgE against peanut, egg and milk indicating they have a food allergy to each of these.

These children were also more likely to have their egg allergy persist at the age of 5 or 6 years in comparison to children that did not have SA present.

Lead author Dr Olympia Tsilochristou from King’s College London said: “This is significant as most children with egg allergy usually outgrow this at an earlier age.

“We do not know yet the exact mechanisms that lead from eczema to food allergy however our results suggest that the bacteria Staphylococcus aureus could be an important factor contributing to this outcome.”

These results build on the earlier ones from the Learning Early About Peanut Allergy (LEAP) study which demonstrated that infants who were at a high-risk of developing peanut allergy but consumed a peanut?containing snack throughout the study were prevented from later developing a peanut allergy.

In this current study, scientists found that children with SA on their skin and/or nose were more likely to develop peanut allergy despite them being fed with peanut from early ages as part of the LEAP study protocol.

Co-author Professor du Toit said: “These findings indicate that SA may have reduced the chance of young infants gaining tolerance to peanut, even if peanut was eaten in early childhood.”

Professor Lack, who conceived and led the LEAP study, said that “SA could be considered as an additional risk factor for the development of food allergy.”

7 Best Natural Ingredients for Your Skin

By Liesa Goins

The beauty world is brimming with high-tech devices and cutting-edge ingredients, but when it comes to handling some of the most common skin care problems, newer isn’t always better. In some cases, simple natural options might be as effective as scientifically engineered solutions.

“Many of my patients practice ‘clean’ eating and want to extend that philosophy to their skin care routine,” says Papri Sarkar, MD, a dermatologist in Brookline, MA. “Finding effective clean beauty products isn’t as simple as finding organic produce at the grocery store, but it’s easier than ever before to find something that will fit your needs.”

We asked experts to share the ingredients that are the best of both worlds — naturally based and science-backed.
Coconut Oil
Benefits: Hydration, anti-inflammatory. There’s growing science supporting the use of this plant fat as a topical skin soother. Recent research shows that extra virgin coconut oil suppresses some of the body’s natural inflammatory agents while making the skin a better barrier. “Many people love coconut oil products to help fight dry, itchy skin and skin diseases such as eczema and psoriasis,” says Laurel Naversen Geraghty, MD, a dermatologist in Medford, OR. “Some of my psoriasis patients swear by overnight coconut oil scalp treatments worn under a plastic shower cap.” But Geraghty warns against putting coconut oil on blemish-prone areas because it may worsen acne.

Find it in: Jars in the cooking aisle.

Gotu Kola (Also Known as Centella asiatica)
Benefits: Wound healing. This ancient herb often used in Asian cuisine is now a part of modern skin care due to its wound-healing benefits, says Michelle Wong, PhD, a cosmetics chemist and creator of the Lab Muffin Beauty Science blog. Chemicals in the plant boost blood supply to injury sites and strengthen the skin. Researchers have found that when skin injuries in rats are treated with Centella asiatica, the sites showed higher healing. The combination of amino acids, beta carotene, fatty acids, and phytochemicals help speed healing time, making it a helpful way to treat injuries.

Find it in: Wong likes La Roche-Posay Cicaplast Baume B5 Soothing Repairing Balm ($15) and Dr. Jart+ Cicapair Tiger Grass Cream ($48).
Green Tea
Benefits: Sun protection, anti-aging. The connection between drinking green tea and improved health has been suggested for years, but it may also help to use the plant on the skin. “Green tea has good results in terms of photoprotection and anti-aging benefits,” says Jeanine Downie, a dermatologist in Montclair, NJ. The polyphenols in green tea have antioxidant properties as well as soothing abilities that help treat sun-damaged skin and offer a way to address the signs of sun damage, she says.

Find it in: Downie likes sunscreen containing green tea, such as Paula’s Choice Skin Balancing Ultra-Sheer Daily Defense Broad Spectrum SPF 30 ($23).

Benefits: Anti-inflammatory, eczema relief. “Oatmeal contains anti-inflammatory and anti-irritant chemicals called avenanthramides,” Wong says. “It also has moisturizing beta glucans and starches. It’s the reason why oatmeal baths are so effective for conditions like eczema and rashes.” But not all oatmeal is created equal, Geraghty says. “Colloidal oatmeal is powder that’s derived from grinding and preparing oats into very tiny, specific sizes,” she says. This size and quality of oats is what makes the ingredient so therapeutic and able to blend with water to form the soothing paste when mixed with water.
“I like colloidal oatmeal products because they’re gentle and safe, and studies show they don’t tend to cause allergies or irritation,” Geraghty says. “I’ve found that if my eczema patients develop gentle skin care habits and regularly slather on a thick moisturizer containing colloidal oatmeal, they don’t need topical steroids as much or as often.”

Find it in: Wong likes Aveeno colloidal oatmeal products like their Soothing Bath Treatment, ($10).

Shea Butter
Benefits: Anti-inflammatory, itch relief. Derived from the nut of a shea tree, shea butter is an ingredient in many moisturizers. “It seems to hydrate skin effectively because it’s loaded with fatty acids,” Geraghty says. These nutrients have a calming and anti-inflammatory effect on the skin. She says shea butter might be most useful for treating and soothing eczema. Clinical studies using shea butter as a treatment for eczema in children showed less itching within 4 weeks, and another study with adults showed improvement in 2 weeks. Geraghty points out another plus of the natural moisturizer: Shea butter doesn’t seem to cause skin allergies often, which makes it right even for the most sensitive skin types.

Find it in: Geraghty likes Dove Cream Oil Shea Butter Body Lotion ($6) and L’Occitane Pure Shea Butter ($38).
Benefits: Inhibits pigmentation, improves collagen production. Soybeans contain a variety of plant-based chemicals that impact the skin. Among them are antioxidants, fatty acids, and isoflavones. The legume also produces estrogens or phytoestrogens that address skin conditions related to menopause.

“One of the reasons we believe that a woman’s skin turgor and brightness decreases after menopause is because of decreased estrogen,” Sarkar says. “Topical estrogens have been shown to help decrease UV-induced pigmentation and can improve collagen synthesis.” She says soy won’t offer as robust results as retinoids, but it’s another option for patients looking to address these conditions. The isoflavones in soy also offer sun protection that can help address pigmentation to keep skin even, according to research.

Find it in: Sarkar likes Aveeno Positively Radiant Daily Moisturizer ($13).

Tea Tree Oil
Benefits: Anti-microbial, blemish-fighting. The herbal remedy derived from tea tree leaves has antimicrobial and anti-inflammatory effects that help combat a range of germs, fungus, and bacteria, Geraghty says. “The fact that tea tree oil helps combat bacteria-driven acne means it may help reduce the inflammatory type of blemishes — the tender pustules or inflamed pink papules,” she says. But the topical treatment doesn’t have much effect against deep cystic acne or comedones. Geraghty also warns about the potential for irritation when using tea tree oil on the skin. She suggests monitoring areas for signs of redness and a rash.
Find it in: Geraghty likes Biossance Squalane + Tea Tree Detox Mask ($39).

A Final Note
As is the case when trying any new treatment, it’s a good idea to run something by your dermatologist to make sure you’re using a natural therapy the right way, Geraghty says. “Coconut oil can worsen breakouts, for example, and some treatments are completely unproven — they wouldn’t be worth it.”

The Scoop: Split Up With Split Ends
Fight your hair’s No. 1 enemy with these pro tips from Shaun Surething, lead stylist and co-owner of Seagull Salon in New York City.

Fine hair: For all hair types, but especially fine hair, sleeping with a humidifier is an absolute must. Hair splits because it is dry, and fine hair splits the easiest. “If you can take the financial leap, a good humidifier with a digital display is great,” says Surething. “Keeping the humidity level higher will help keep moisture in the hair and prevent it from splitting.”
Wavy hair: Swap your cotton pillowcase for satin, which allows waves to glide freely over the pillow rather than snag on cotton fibers. If you prefer cotton pillowcases, consider wrapping your hair in a satin scarf before you drift to sleep, Surething suggests.

Curly hair: As fun as it is to change the look of your hair, remember that using hot tools and styling tools too much can cause ends to split. Surething says to always start gently, from the bottom, when combing or brushing. Never yank at tangles, because it can cause tearing and splitting of the strand. Shield ends from heat with a thermal-protecting spray.
Coarse hair: On coarse, kinky hair, it’s more difficult to keep in moisture, so weekly masks and hydrating conditioners are paramount. “These products lock in moisture and keep a barrier between your hair’s cuticle and the elements, including rain, snow, and sun,” says Surething.

Diabetes drug cuts cardiovascular and kidney problems

By Jo Carlowe

A large international trial has linked the use of the drug dulaglutide with a reduction in cardiovascular events in middle-aged and older people with type 2 diabetes.

The clinical trial* followed more than 9,900 people in 24 countries. During more than five years of follow-up, cardiovascular events like heart attacks and strokes were reduced by 12% in people taking dulaglutide compared to people taking a placebo.

This effect was seen in both men and women with or without previous cardiovascular disease. In addition, during the same period, the drug reduced the development of kidney disease by 15%.

The trial was led by the Population Health Research Institute (PHRI) of McMaster University and Hamilton Health Sciences, Canada. Two papers describing the cardiovascular and kidney results of the trial were published in the journal The Lancet from the study called the Researching Cardiovascular Events with a Weekly Incretin in Diabetes (REWIND) trial.

“Compared to others, people with diabetes have twice the rate of cardiovascular events like heart attacks and strokes, and up to 40% of people with diabetes develop kidney disease,” said Hertzel Gerstein, principal investigator for the study, professor of medicine at McMaster and deputy director of the PHRI.

“The REWIND trial shows that dulaglutide can safely reduce these events while improving diabetes control and modestly lowering weight and blood pressure in middle-aged people with type 2 diabetes.”

Dulaglutide is a glucagon-like peptide-1 receptor agonist that is injected once per week.

The drug was well tolerated, modestly reduced weight, low-density lipoprotein (LDL) cholesterol and blood pressure, and modestly increased heart rate.

Oral Novo Nordisk diabetes drug poses no more heart risk than placebo: study

(Reuters) – An experimental oral form of a Novo Nordisk drug for type 2 diabetes posed no greater risk of serious heart problems or death than a placebo in patients at high risk for such complications, according to data from a large study presented on Tuesday.
Patients with type 2 diabetics and either heart disease or at high risk for heart problems who received the drug semaglutide in pill form had a combined rate of heart attack, stroke or heart-related death of 3.8% compared with 4.8% for placebo, successfully demonstrating non-inferiority.

Death from any cause occurred in 1.4% of semaglutide patients and 2.8% for placebo, according to data from the 3,183-patient trial presented at the American Diabetes Association meeting in San Francisco and published online by the New England Journal of Medicine.

While the drug led to a lower rate of death and other heart problems, the trial was not designed to show statistically significant superiority, only that semaglutide was as safe as, or non-inferior to, placebo. Similar drugs have also shown an ability to cut the risk of cardiovascular problems.

“The drug is safe,” Dr. Mansoor Husain, director of the Toronto General Hospital Research Institute who led the study, told Reuters Health in a phone interview.

“This is the first orally-available GLP-1 (glucagon-like peptide-1) receptor agonist and that’s a pretty big deal,” Husain said, noting the fear many patients have for injections. “Just being able to take a pill every day makes it much more accessible.”

Semaglutide, which stimulates insulin production, is seen as an important growth driver for Novo Nordisk, which funded the study known as Pioneer 6.
The Danish drugmaker already sells an injectable once-weekly version of the drug under the brand name Ozempic at a cost of about $800 per month, according to the website goodrx.com. The oral version is a once-a-day tablet.

Novo filed for U.S. approval for oral semaglutide in March. It is seeking priority review in hopes of getting approval within six months.

All trial participants were at high risk of cardiovascular problems because they were at least 50 years old with established heart disease or chronic kidney disease, or at least age 60 with cardiovascular risk factors. They were followed for a median of 15.9 months. The trial was designed to end after a combination of at least 122 heart attacks, strokes and deaths had accrued.

Individual cardiovascular events in the composite also showed no significant differences.

The rate of non-fatal heart attack was 2.3% with semaglutide versus 1.9% with placebo, while the rate of non-fatal stroke was 0.8% with the drug and 1.0% for placebo. The odds of death from any cardiovascular cause were 0.9% in the semaglutide group and 1.9% in the placebo group.

“We did see a 50% reduction in cardiovascular death and all-cause mortality, but these were secondary endpoints,” Husain said. The main goal of the study “was just to demonstrate safety,” he said.

He cautioned people should not to read too much into the apparent reduction in the death risk. “We urge caution because they’re small numbers and it’s a relatively short-duration study.”

The rate of patients dropping out of the trial was higher for those who received semaglutide – 11.6% compared with 6.5% for placebo – with gastrointestinal problems such as nausea and vomiting being the driving force. Those are common side effects for the GLP-1 class of diabetes medicines.

Gene mutation evolved to cope with modern high-sugar diets

The gene variant became more common in humans after cooking and farming became widespread, and might now help people avoid diabetes, according to the findings published in eLife.

“We found that people differ in how efficiently their bodies can manage blood sugar levels, resulting from an evolutionary process that seems to have been brought about by changing diets,” said the study’s lead author, Professor Frances Brodsky, Director of UCL Biosciences.

The researchers were investigating the CLTCL1 gene, which directs production of the CHC22 protein that plays a key role in regulating a glucose transporter in our fat and muscle cells.

After people eat, the hormone insulin reacts to higher levels of blood glucose by releasing the transporter to remove glucose from the blood, taking it into muscle and fat tissue. Between meals, with the help of the CHC22 protein, the glucose transporter remains inside muscle and fat so that some blood sugar will continue to circulate.

The research team, consisting of specialists in population genetics, evolutionary biology, ancient DNA and cell biology, analysed human genomes as well as those of 61 other species, to understand how the gene producing CHC22 has varied throughout evolutionary history.

In humans, by looking at the genomes of 2,504 people from the global 1000 Genomes Project, they found that almost half of the people in many ethnic groups have a variant of CHC22 that is produced by a mutated gene, which became more common as people developed cooking and farming.

The researchers also looked at genomes of ancient humans, and found that the newer variant is more common in ancient and modern farming populations than in hunter-gatherers, suggesting that increased consumption of carbohydrates could have been the selective force driving the genetic adaptation.

By studying cells, the researchers found that the newer CHC22 variant is less effective at keeping the glucose transporter inside muscle and fat between meals, meaning the transporter can more readily clear glucose out of the blood. People with the newer variant will therefore have lower blood sugar.

“The older version of this genetic variant likely would have been helpful to our ancestors as it would have helped maintain higher levels of blood sugar during periods of fasting, in times when we didn’t have such easy access to carbohydrates, and this would have helped us evolve our large brains,” said first author Dr Matteo Fumagalli, who began the study at UCL before moving to Imperial College London.

“In more recent years, with our high-carb diets that often provide us too much sugar, the newer variant may be advantageous,” Dr Fumagalli added.

The researchers say that while this genetic variant does not play a direct role in the development of diabetes, having the older variant may make people more likely to develop diabetes, and it may also exacerbate insulin resistance involved in diabetes.

“People with the older variant may need to be more careful of their carb intake, but more research is needed to understand how the genetic variant we found can impact our physiology,” added Professor Brodsky.

Co-author Professor Mark Thomas (UCL Genetics, Evolution & Environment) added: “Our analyses strongly suggest that we have found yet another example of how prehistoric changes in dietary habits have shaped human evolution. Understanding how we have adapted to these changes doesn’t only inform us about why people lived or died in the past, but also helps us to better understand the relationship between diet, health and disease today.”

The study was funded by the National Institutes of Health (USA), Wellcome and the Medical Research Council (UK).

Bedroom Light at Night Might Boost Women’s Weight

By Steven Reinberg

HealthDay Reporter

MONDAY, June 10, 2019 (HealthDay News) — Women, beware: Sleeping with a light on or the TV going in your bedroom could make you put on weight.

That’s the finding of new research published in JAMA Internal Medicine. While the study doesn’t prove that sleeping with a light on causes weight gain, it suggests the two may be linked, the researchers said.

“Turning off the light while sleeping may be a useful tool for reducing a possibility of weight gain and becoming overweight or obese,” said lead author Dr. Yong-Moon Mark Park. He is a postdoctoral fellow at the U.S. National Institute of Environmental Health Sciences in Research Triangle Park, N.C.

Park said that exposure to artificial light at night may suppress the sleep hormone melatonin and disrupt the natural sleep-wake cycle.

“It also may disturb day-to-day variations of stress hormones and affect other metabolic processes in ways that contribute to weight gain,” Park added.

Keeping a light on might also result in poorer sleep. Shorter sleep could prompt you to exercise less and eat more, he noted.

For the study, Park’s team relied on self-reported data from nearly 44,000 women, aged 35 to 74. They weren’t shift workers, daytime sleepers or pregnant when the study began.

Women who slept with a light on were 17% more likely to gain 11 pounds or more over five years, the study found. And the level of artificial light seemed to matter, Park said.

“For example, using a small nightlight was not associated with weight gain, whereas women who slept with a light or television on were,” he explained.

The findings didn’t change when researchers accounted for women’s diet and physical activity, which suggests that light during sleep may be important in weight gain and obesity.

Dr. David Katz, director of the Yale-Griffin Prevention Research Center in New Haven, Conn., reviewed the findings. He said the link between exposure to artificial light at night and obesity may not indicate that one causes the other.

“As with any study of association, two findings are true — true, but not directly related,” he said.

The key takeaway relates to poor sleep, Katz suggested.

“Sleep deficiency and impairment is a known obesity risk factor, for reasons ranging from mood and reduced restraint, to changes in hormonal balance,” he said.

It’s also possible that reliance on artificial light at night and obesity are both linked to other factors, such as “loneliness, anxiety or some form of social insecurity,” Katz said.

The report was published online June 10.

Diet Sodas May Not Help Kids Cut Calories

By Amy Norton
HealthDay Reporter

THURSDAY, May 2, 2019 (HealthDay News) — Kids who favor diet sodas over sugary ones don’t consume fewer calories over the course of a day, a new study finds.

And they average 200 more calories daily than their peers who choose water, according to the results of a survey of over 7,000 U.S. children and teens.

Experts said the findings support what’s already recommended by groups like the American Heart Association: Ideally, kids should be drinking water instead of sugar-laden beverages — or artificially sweetened ones.

“Water is best, and we should be promoting it over low-calorie sweetened beverages,” said lead researcher Allison Sylvetsky, an assistant professor at George Washington University’s School of Public Health, in Washington, D.C.

Unfortunately, a survey published just last week suggests this could be an uphill battle. On any given day, one in five American youngsters don’t drink any water at all, the Penn State researchers found.

That said, the latest results — published May 2 in the journal Pediatric Obesity — do not prove that reduced-calorie drinks are bad.

The findings come from a one-time survey, Sylvetsky said, so there are unanswered questions. For example, kids drinking low-cal beverages might have switched from sugary varieties, and were actually consuming fewer calories than they used to. In that case, the beverages would be a positive influence.

Julie Stefanski, a registered dietitian who was not involved in the study, made another point.

“It’s possible that the children who are drinking low-calorie beverages are already individuals who prefer a larger quantity of food, and parents were trying to make changes to reduce their overall calorie intake,” said Stefanski, who is a spokesperson for the Academy of Nutrition and Dietetics.

However, she noted, there is evidence that beverages can sway food choices.

“In some studies in adults, it’s been found that artificial sweeteners caused a craving for more sweet foods,” Stefanski said. “This isn’t an automatic association, but if your taste buds are wired to always expect a sweet sensation, plain water might help to decrease that craving for sweets.”

In the survey, the teens were asked to recall what they’d eaten and had to drink the previous day.

Kids who’d had at least 4 ounces of water, and little to no sugary or artificially sweetened drinks, were considered water consumers.

On average, those kids had the lowest calorie intake for the day, and consumed the least amount of sugar and added sugar. In comparison, their peers who had low-calorie sweet drinks — at least 4 ounces for the day — consumed 200 more calories, on average.

That put them on par with kids who’d had sugar-sweetened drinks. (Any beverage dubbed sugar-free, diet, light, low-calorie or no-calorie was categorized as a low-calorie sweetened drink.)

On the other hand, kids who drank diet beverages were doing better in some ways, the study found. They consumed less daily sugar for the day — including added sugars — than those who drank sugar-sweetened beverages.

So the fact that their calorie intake was the same is not necessarily a bad thing, according to Sylvetsky — if those calories came from nutritious foods.

“We weren’t able to look at overall diet quality,” she said. “We’d like to do that in a future study.”

The Calorie Control Council, which represents the low-calorie food industry, said the study has too many unknowns to draw conclusions.

“These results do not challenge the existing evidence that [low-calorie sweetened beverages] are one of many helpful tools in weight management and overall calorie reduction,” the group said in a statement.

The study did not prove a cause-and-effect link, other diet and lifestyle factors weren’t measured, and self-reported results can be biased, the council explained.

Stefanski said it’s always important to consider a child’s overall diet when deciding whether beverage “swaps” are needed.

But, she stressed, “parents should definitely steer clear of foods or drinks with a lot of added sugar.”

If your child turns her nose up at water, Stefanski said, there are ways to “jazz it up” — like adding lemon, or slices of strawberry or cucumber.

“Younger kids can help to cut up the fruit or vegetables and create their own fancy color combos,” she suggested.

As Melanoma Rises, Doctors Challenge Some Early Testing

May 6, 2019 — As melanoma cases continue to rise sharply, Americans are being urged to get screened early for this deadliest of skin cancers. But some dermatologists question whether screening people without symptoms has resulted in overdiagnosing melanoma, bringing unnecessary anxiety and treatments.

They note that while the number of invasive melanoma cases diagnosed in the U.S. doubled from 1982 to 2011 and continue to rise, death rates have only dropped slightly. From 2007 to 2016, deaths from melanoma decreased by 2% in adults 50 and older and by 4% in people younger than 50.

“A huge increase in diagnosed melanomas should be associated with a steep decline in mortality,” says Ade Adamson, MD, a dermatologist and assistant professor at Dell Medical School at the University of Texas at Austin. “This is a very delicate discussion in my field because we want to believe so badly that screening healthy people and early detection is going to save lives, regardless of the cancer.”

Adamson says advances in technology contribute to overdiagnoses, including skin scanning tools that pick up tiny changes the eye can’t see. He says it is difficult, sometimes impossible, for a doctor or pathologist to tell a malignant melanoma lesion from a benign mole in the earliest stages of skin cancer.

He says the United States Preventive Services Task Force — a group of independent experts that use evidence to guide decision making — cites overdiagnosis as one of the reasons it doesn’t endorse routine skin cancer screening. The task force said it didn’t have enough data to determine if screening helps save lives. This recommendation is for people without a history or skin cancer who do not have any suspicious moles or other spots.

“The potential for harm clearly exists,” according to a statement the task force released in 2016, although “current evidence is insufficient to assess the balance of benefits and harms of visual skin examination by a clinician to screen for skin cancer in adults.”

It says potential harms include misdiagnosis, overdiagnosis, cosmetic effects from biopsy (where a doctor removes a small amount of tissue to examine it for cancer cells), and overtreatment. For instance, surgical removal of moles can leave scars, and medications can have side effects.

A Controversial Topic

Overdiagnosis is controversial in the field of dermatology, where the prevailing wisdom is that greater exposure to ultraviolet (UV) radiation from the sun and tanning salons has led to higher melanoma rates over the years. Dermatology organizations urge Americans to use sunscreen, avoid tanning salons, and regularly get screened for skin cancer, especially if they sunburn easily or have a family history of the disease.

Since 1985, the American Academy of Dermatology has offered free skin cancer screening clinics around the country in May, which is melanoma awareness month.

A spokesman for the academy, Joel Cohen, MD, says the rise in melanoma cases may be related to better technology in the field that helps detect cancer early, screening programs that find melanoma early, and public education campaigns about how to recognize the early signs of skin cancer. When caught early, melanoma doesn’t have to be a death sentence, he says.

“Early diagnosis is absolutely essential when it comes to melanoma,” says Cohen, director of AboutSkin Dermatology in Greenwood Village, CO. “When we catch something tiny, believe me, it’s something to celebrate about. You’ve actually given this person a chance at life.”

Five-year survival rates for people whose melanoma is detected early is 92%, according to data provided by the American Society of Clinical Oncology. If the cancer has spread to other part of the body, that rate drops to 23%.

A recent study examined the American Academy of Dermatology’s SPOTme skin cancer screening program from 1986 to 2014. It said the data suggest that the program “detected thousands of skin cancers that may have gone undetected or experienced a delay in detection.”

It also said that people who went on to be diagnosed with skin cancer were more likely to be uninsured.

‘We’re Ramping Up Health Anxiety’

David J. Elpern, MD, a dermatologist in Williamstown, MA., says that overdiagnosis — not exposure to the sun — has contributed to rising melanoma rates. He believes dermatologists are finding more cases of melanoma early because of “diagnostic drift,” a growing tendency to diagnose and treat benign lesions as malignant cancers.

“You’re picking up tumors that probably never would have amounted to anything,” says Elpern, who has spoken out about changes in the field of dermatology that promote care that’s wasteful and not needed.

Overdiagnosis is not without consequences, he says. Once a patient is labeled with cancer, they’re launched into the health care system, where they’re subjected to excessive and expensive treatments, including biopsies, that are profitable for dermatologists.

“We’re ramping up health anxiety,” he says. Some dermatologists argue that these lowest-risk conditions shouldn’t be labeled as cancers at all. Instead, they should be watched.

But Stephanie Gardner, MD, a dermatologist in suburban Atlanta, says they are vigilant for a reason.

“Patient education and self-exams, appropriate timing of skin exams by dermatologists, and removal and surveillance of suspicious lesions all help to prevent advanced disease,” she says. “I would much rather be overdiagnosed than have a cancer missed, along with all of those ramifications.”

Prevention Tips

Prevention is the first step to avoid skin cancer. The American Academy of Dermatology urges everyone to take these steps:

  • Seek shade when needed. The sun’s strongest rays are between 10 a.m. and 2 p.m.
  • Wear protective clothing when possible: a wide-brimmed hat, sunglasses, long pants, and long-sleeved shirts.
  • Generously apply a broad-spectrum, water-resistant sunscreen with SPF 30 or higher. Use it whenever you are outside, even on cloudy days.
  • Reapply sunscreen every 2 hours.
  • Avoid tanning beds.
  • Do regular skin self-exams to look for new or suspicious spots on your skin.

People at higher risk of skin cancer include those who have:

  • Light skin
  • Skin that burns or freckles easily
  • Blue or green eyes
  • Blond or red hair
  • Certain types and a large number of moles
  • A family history of skin cancer
  • A personal history of skin cancer

Do Adults Need a Measles Booster Shot?

By Dennis Thompson
HealthDay Reporter

WEDNESDAY, May 8, 2019 (HealthDay News) — New York’s ongoing measles epidemic alarmed midtown Manhattan resident Deb Ivanhoe, who couldn’t remember whether she’d ever been vaccinated as a child.

So Ivanhoe, 60, sought out her long-time primary care doctor, who performed an antibody test to see whether she had any protection against measles.

To her surprise, the test revealed that Ivanhoe had no immunity to measles. Her doctor quickly gave her a measles booster shot.

“I’m a New Yorker. I’m out and about. I take the subway every day,” Ivanhoe said of her concerns. “One of the outbreak areas is in Williamsburg, Brooklyn. I have friends in Williamsburg. I go to there to visit, for dinner. It all becomes local.”

Ivanhoe is one of a growing number of adults who are worried that their immunity against measles might have lapsed, if they even received a vaccination.

The U.S. Centers for Disease Control and Prevention has downplayed these concerns, saying that only adults in high-risk groups should talk with their doctor about a measles vaccination.

But experts are divided on whether the CDC is underestimating the threat posed by possibly waning immunity in adults.

New outbreaks, new dangers

There’s good reason adults are worried. At least 764 cases of measles across 23 states have been reported so far this year, the CDC says. Most cases have occurred in unvaccinated groups living in communities located on either side of the nation, in the areas surrounding New York City and Portland, Ore.

The high-risk groups of adults who should discuss measles vaccination with their doctor include international travelers, health care workers, and folks living in communities that are in the throes of an outbreak, Dr. Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, said in a media briefing last week.

“Most adults are protected against measles. That’s what the science says,” Messonnier said. “That includes people who were born before measles vaccine was recommended, and even folks who only got a single dose.”

Ivanhoe’s physician, Dr. Len Horovitz, said her antibody test “clearly proves that is not the case.”

Horovitz recommends his adult patients get a blood test that shows the level of antibodies they have against measles and other infectious diseases.

“By the time you reach your [childhood] pediatrician it’ll be weeks, if he’s still even alive and hasn’t retired or moved,” said Horovitz, an internist with Lenox Hill Hospital in New York City. “It’s impossible to get vaccination records for my patients. They’re tearing their hair out.”

But, Horovitz noted, “In a 24-hour turn-around time, I can offer them a blood test and have an answer.”

Waning effectiveness of early vaccine

Besides people at high risk due to their circumstances, there’s only one group of adults that really should talk with their doctor about getting the measles shot, the CDC says.

One of the first measles vaccines used a killed version of virus, and was administered between 1963 and 1967. That vaccine did not provide lasting immunity, and for decades the CDC has urged that generation of folks to undergo vaccination with the better live version of the measles vaccine.

“If you happen to be someone 50 years ago that got this killed measles vaccine, then you’d have to get re-vaccinated with the live virus vaccine,” said Dr. Sandra Fryhofer, an internal medicine specialist in Atlanta.

People born in the United States earlier than 1957 are presumed to be immune to measles because the virus is so contagious everyone caught measles in those days.

Pediatric infectious disease specialist Dr. Matthew Zahn says the CDC is right that most adults are protected against measles.

“Our experience overwhelmingly has been that it becomes a numbers game,” said Zahn, who is on staff at the Children’s Hospital Orange County in Orange, Calif. “The vaccine seems to be about 99% effective in keeping you from getting sick, but if you have hundreds and hundreds of people who are exposed, then you will see occasional cases of persons who’ve been vaccinated previously who are getting sick anyway.”

Best use of resources

Zahn figures people who are worried about the status of their measles immunity should just go ahead and get the vaccine, rather than go through an antibody test.

“If you’re not sure you’ve had your two doses before and you want to be up to date, there’s nothing wrong with getting that additional dose,” Zahn said, noting that a person who undergoes the antibody test pays extra and faces getting stuck with a needle twice.

There’s plenty of measles vaccine on hand so there’s no concern about shortages, Zahn said. Doctors are simply trying to focus their attention on the most critical weaknesses in America’s immune protection, and waning adult immunity doesn’t seem to be contributing to the ongoing outbreaks.

“It’s more of an issue where you want to best use everybody’s time and resources,” Zahn said. “We certainly are seeing outbreaks, but those outbreaks are so weighted towards unvaccinated persons, that’s where the community is by far at risk.”

Genetic therapy heals damage caused by heart attack

Researchers from King’s College London have found that therapy that can induce heart cells to regenerate after a heart attack.

Myocardial infarction, more commonly known as a heart attack, caused by the sudden blocking of one of the cardiac coronary arteries, is the main cause of heart failure, a condition that now affects over 23 million population in the world, according to the World Health Organisation.

At present, when a patient survives a heart attack, they are left with permanent structural damage to their heart through the formation of a scar, which can lead to heart failure in the future. In contrast to fish and salamander, which can regenerate the heart throughout life.

In this study, published today in Nature, the team of investigators delivered a small piece of genetic material, called microRNA-199, to the heart of pigs, after a myocardial infarction which resulted in the almost complete recovery of cardiac function at one month later.

Lead author Professor Mauro Giacca, from King’s College London said: “It is a very exciting moment for the field. After so many unsuccessful attempts at regenerating the heart using stem cells, which all have failed so far, for the first time we see real cardiac repair in a large animal.”

This is the first demonstration that cardiac regeneration can be achieved by administering an effective genetic drug that stimulates cardiac regeneration in a large animal, with heart anatomy and physiology like that of humans.

“It will take some time before we can proceed to clinical trials” explained Professor Giacca.

“We still need to learn how to administer the RNA as a synthetic molecule in large animals and then in patients, but we already know this works well in mice.”