One boy’s spirit shines despite Ebola

The Ebola virus is spreading exponentially. Some scientists, like Alessandro Vespignani at Northeastern University in Boston, project that there will be between 10,000 and 25,000 cases by mid-October. He told NPR that cases of Ebola are doubling every two to three weeks.

But there are small glimmers of hope like one 11-year-old boy in Liberia who wouldn’t let his Ebola diagnosis keep him down.

NPR reports Mamadee was in an isolation unit where roughly a third of patients don’t survive the Ebola virus. He was there for two weeks, and his sister died from the disease during that time.

Doctors Without Borders captured his spirit in a short video. Mamadee recovered and has been discharged.

The link between gut microbes and diet soda

 A man opens a bottle of Diet Coke. Justin Sullivan/Getty Images

A man opens a bottle of Diet Coke. Justin Sullivan/Getty Images

The journal Nature published a study this week finding that popular artificial sweeteners used in many food and drinks might trigger high blood-sugar levels in some people.

The Washington Post reports that although the exact reason is unknown, the findings have to do with the ecosystem of bacteria in our gut called the microbiota.

Researchers found that saccharine, sucralose and aspartame (commonly known as Sweet n’ Low, Splenda and Equal) caused glucose intolerance in mice — a condition that can lead to diabetes. They also monitored seven human participants by giving them regular doses of saccharine over the course of a week. Four of them developed glucose intolerance.

The Washington Post said these findings add to the long, contentious debate about the risks of artificial sweeteners found in things like diet soda. Some past studies have found no health risks associated with the sweeteners, while others have found they contribute to obesity and cancer.

Lisa Lefferts, a senior scientist at the nonprofit Center for Science in the Public Interest, told the Washington Post the biggest benefit of the study is the link it shows between artificial sweeteners and the microbiota.

The scientists who authored the study said the issue is far from being resolved and that people shouldn’t take this study as a recommendation for cutting out diet soda.

“We do not view that as our role,” Eran Segal, a computational biologist at the Weizmann Institute of Science in Israel told the Washington Post. “Rather, as scientists, we simply point to the immense body of experiments that we carried out in both humans and in mice. . . . This study and these results should prompt additional debates and study into what is currently a massive use of artificial sweeteners.”

Physician Martin Blaser, who directs the Human Microbiome Program at New York University told NPR he found the study exciting because linking artificial sweeteners and gut microbes is a new idea to explore.

James Hill, director of the Center for Human Nutrition at the University of Colorado is also calling for more research into the link.

“It’s much too early, on the basis of this one study, [to conclude that] artificial sweeteners have negative impacts on humans’ [risk for diabetes],” Hill told NPR.

Study: American waistlines are growing

Television personality and medical doctor Dr. Mehmet Oz measures the waistline of Sony Corp. Chairman and CEO Sir Howard Stringer.   David McNew/Getty Images

Television personality and medical doctor Dr. Mehmet Oz measures the waistline of Sony Corp. Chairman and CEO Sir Howard Stringer. David McNew/Getty Images

A new study in The Journal of the American Medical Association says Americans are gaining more weight in their abdomens even though they’re not getting fatter overall.

This is problematic because other studies have linked abdominal fat with an increased risk of diabetes, strokes and heart disease.

NPR reports this waistline growth comes at a time when obesity rates overall have stabilized. “We’re a little bit puzzled for explanations,” Dr. Earl Ford, a medical epidemiologist at the Centers for Disease Control and Prevention and lead author of the study, told NPR.

The study polled 32,816 adult men and women and found the mean waist circumference of Americans increased from 37.6 inches in 1999-2000 to 38.8 inches in 2011-2012.

The Boston Globe reports that women’s waste sizes have grown at a faster rate than men’s. The study shows that abdominal obesity affects 44 percent of men and 65 percent of women. The Globe’s reporter Deborah Kotz theorizes that women may be unaware of their waist size because women’s clothing manufacturers no longer label clothing by waist measurement.

Study: Antibiotics prescribed for children twice as often as needed

A pharmacist counts antibiotic pills to fill a prescription.  Joe Raedle/Getty Images

A pharmacist counts antibiotic pills to fill a prescription. Joe Raedle/Getty Images

A new study in the journal Pediatrics found that over half of the antibiotics being prescribed to children are unnecessary.

NPR reports that 57 percent of infections for which children are prescribed antibiotics are viral, rather than bacterial. The study — done by researchers at Seattle Children’s Hospital — found that only 27 percent of acute respiratory tract infections are caused by bacteria. Not only can overuse of antibiotics lead to antibiotic resistance, NPR reports the practice can lead to up to 11 million unnecessary prescriptions a year.

The study also found that some infections were more likely to be caused by bacteria than others. For example, ear infections were caused by bacteria more often than strep throat. The only quick test available is for strep, so NPR says this study can offer more insight for doctors — who often have to guess if an infection is caused by bacteria or a virus.

The American Academy of Pediatricians advised last year that doctors practice what it calls “judicious use” of antibiotics when treating children’s cold and flu symptoms.

The toll of Type 2 diabetes, in poems

In this video screen grab, Erica Sheppard McMath recites her poem "Death Recipe" for Youth Speaks. Courtesy Youth Speaks

In this video screen grab, Erica Sheppard McMath recites her poem “Death Recipe” for Youth Speaks. Courtesy Youth Speaks

Public health educators in California are using poetry to engage young people about diabetes.

Dr. Dean Schillinger, a professor at the University of California San Francisco School of Medicine, started the partnership between UCSF and Youth Speaks as a way to spark conversations about the disease.

The partnership, called The Bigger Picture, holds workshops to educate teens and young adults about diabetes. After the workshops, the teens take the information and express their reactions through poetry.

Schillinger told NPR Type 2 diabetes needs to be talked about as a social disease, rather than focusing on people’s personal decisions.

Type 2 diabetes is worse in poor, urban neighborhoods and communities of color. NPR reports that half of African-American youths and a third of Latino youths born in 2000 are expected to develop Type 2 diabetes at some point in their lives.

Here is an excerpt of a poem written by 22-year-old Erica Sheppard McMath, followed by its full video rendition. In the poem, she expresses trying to stay healthy while watching her family struggle with obesity and disease:

It’s like knowing most of your family has diabetes
but your still smacking on sour patches
as you’re walking your aunt to her dialysis appointment
It’s like Auntie Marlow being blind at 32
It’s like Grandma Susie dying from a heart attack at 51
It’s like cousin Kieara shooting insulin in her nine year old arm

Geneticist: All women should get tested for mutations that cause breast cancer

Balloons fly over the Yemeni capital Sanaa to increase awareness and promote treatment of breast cancer.  MOHAMMED HUWAIS/AFP/Getty Images

Balloons fly over the Yemeni capital Sanaa to increase awareness and promote treatment of breast cancer. MOHAMMED HUWAIS/AFP/Getty Images

A prominent geneticist is urging all women to get tested for genetic mutations that cause breast cancer.

Mary-Claire King, a professor of genome science at the University of Washington, identified the first breast cancer gene. The genes are called BRCA1 and BRCA2. NPR reports that women who have mutations in these genes are much more likely to get breast cancer and ovarian cancer.

Doctors usually only recommend women get tested for the BRCA gene if breast cancer or ovarian cancer runs in their family.

recent article by King published in The Journal of the American Medical Association asserts that the current approach misses identifying genetic mutations in some women. About half the women who carry BRCA1 and BRCA2 don’t have a family history of breast or ovarian cancer, according to the JAMA article.

But King’s recommendation concerns breast cancer advocates.

Fran Visco, president of the National Breast Cancer Coalition, told NPR the tests are unnecessary and can lead to serious and expensive surgeries. Screening tests can cost hundreds to thousands of dollars depending on insurance coverage.

“We are far, far from being ready to recommend that all women be screened for genetic predisposition to breast cancer,” Visco said.

Testing for the mutations has spiked since the activist and actress Angelina Jolie announced that she had been tested and decided to undergo prophylactic mastectomies after discovering she carried the gene mutation. A recent study by The Journal of the American Medical Association found no survival benefit to getting a double mastectomy, a procedure many women who test positive for BRCA1 and 2 often choose.

The science of diet and headlines: Does low-carb really win?

Several fruits and vegetables: grapefruit, strawberry, red cabbage, kiwi and pepper.  Jose R. Aguirre/Cover/Getty Images

Several fruits and vegetables: grapefruit, strawberry, red cabbage, kiwi and pepper. Jose R. Aguirre/Cover/Getty Images

A new study in the Annals of Internal Medicine shows diets low in carbohydrates like bagels and pasta lead to more weight loss than diets low in fat. The study is one of many contradictory studies about diet that can lead to misleading headlines about what to eat or not to eat.

Cardiologist Harlan Krumholz directs the Yale-New Haven Hospital Center for Outcomes Research and Evaluation and is a director of the Robert Wood Johnson Clinical Scholars Program at Yale. Krumholz says more comprehensive studies are needed to make results like these meaningful. In an op-ed for NPR he details his concerns about the state of diet studies:

The JAMA survey of studies went back as far as 1966 and found fewer than 50 blinded trials. All told, they included fewer than 8,000 people. The studies were generally small (most had fewer than 100 people), and they typically lasted for only 24 weeks. Finally, these trials weren’t able to determine whether a particular diet actually lowered the risk of disease.

Doctors have built recommendations based off observational studies that Krumholz says are limited. That’s because people who eat different diets often live different lifestyles that aren’t taken into account in observational studies. The most recent study that’s creating buzz in the low-carb debate enrolled 148 people, a very small sample. “The diet industry generates billions of dollars annually, but it is built on razor-thin evidence about what is best for any individual,” he said.

Krumholz called for personalized diet recommendations for people based on more than weight loss findings. But in order for that to happen we need larger studies with longer follow-up, he says.

For more on this topic:

  • Listen to The Daily Circuit’s interview with Dr. Lawrence Cheskin,  director of Johns Hopkins Weight Management Center and Dr. Marion Nestle, professor of nutrition, food studies and public health at New York University, Steinhardt.
  • Read about it in The New York Times
  • Watch Duke University’s Dr. Eric Westman answer questions about low-carb diets

Apple event and health

Apple CEO Tim Cook announces the new Apple Watch.  Justin Sullivan/Getty Images

Apple CEO Tim Cook announces the new Apple Watch. Justin Sullivan/Getty Images

Apple unveiled its new iPhone and Apple Watch Tuesday, and some industry observers say the event fell short of big expectations about the role of health technology in the announcement. A new “Health” app and “HealthKit” software developed with Mayo Clinic were announced earlier this summer, and fueled feverish anticipation of a breakthrough in technology and personal health data. Bloomberg calls all this new technology “Dr. Apple’s” first steps into “a giant market that affects everyone personally and is at the core of America’s fiscal problems.”

But Forbes’ Dan Diamond reports that the tech company’s health plans got cut from yesterday’s program. He suggests among the reasons was Apple’s recent implication in the iCloud data breech that led to the hacking of celebrity nude photographs may have caused the company to hold back on promoting the idea of an app that holds consumers’ health data.

And other reports ask whether the Apple event was a game changer for health technology or a bitter disappointment. Industry watchers report that the vision of wearable technology to manage personal medical care remains the major promise of technology like the Apple Watch.

High school athletes and concussions

People take a concussion screening at the Science Museum of Minnesota Friday, Feb. 24, 2012. Health Fair 11, in association with North Memorial Medical Center, is offering the free screenings during the state high school sports tournaments to encourage awareness of brain injuries in Minnesota. The tests are used as a baseline for possible future brain injuries. Alex Kolyer for MPR News

People take a concussion screening at the Science Museum of Minnesota Friday, Feb. 24, 2012.  Alex Kolyer for MPR News

Will you let your teen-ager play contact sports?  Last week, state health officials in Minnesota released data showing that nearly 3,000 high school athletes in the state suffered concussions.

That number — which amounts to 22 concussions per high school — is dramatically higher than previous estimates, according to MPR News.

Most states have passed concussion laws that require a health provider’s clearance before a student athlete can return to play following a concussion injury and that has helped track the occurrences.

A study from the Institute of Medicine showed that football players in high school are nearly twice as likely to suffer a concussion than college players, but it’s still unclear whether repetitive injuries lead to long-term brain disease.

Researchers at Cleveland Clinic developed an app that works with the gyroscope and accelerator within the iPad 2 to measure motion and acceleration. The app can also assess cognitive skills through a series of tests taken on the iPad. It’s been used to test high school athletes for concussions for more than two years, but is being expanded for use in emergency settings.

Lori Glover with the Institute for Athletic Medicine at Fairview Health Services, which collaborated on the report in Minnesota, told MPR News that concussions are easily hidden or overlooked.

“What I would say to parents, coaches, kids, the important thing is be attentive to this. Don’t take it lightly,” she added. “Most resolve typically, so don’t be afraid, but you need to get it managed appropriately.”

List of resources below video

Resources

Study: Double mastectomies don’t save lives

Dr. Edward Sickles MD (R) and Larisa Gurilnik RT look at films of breast x-rays at the UCSF Comprehensive Cancer Center August 18, 2005 in San Francisco, California.  Justin Sullivan/Getty Images

Dr. Edward Sickles MD (R) and Larisa Gurilnik RT look at films of breast x-rays at the UCSF Comprehensive Cancer Center August 18, 2005 in San Francisco, California. Justin Sullivan/Getty Images

Double mastectomies following diagnosis of cancer in one breast have become more common in the United States in the last 10 years. NPR reported recently that most women with cancer in one breast are not at risk for developing cancer in the other breast and that doctors consider the trend worrisome.

Now, a study by the Journal of the American Medical Association finds no survival benefit with bilateral mastectomy compared with less drastic surgery accompanied by radiation.

The results confirm what many doctors have suspected, said Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society.

The study looked at records of 189,734 women in California who were diagnosed with early-stage breast cancer from 1998 to 2011. It found that the survival rate was higher for women who chose to get a lumpectomy rather than women who chose a double mastectomy. Those women also avoided risks of major surgery and loss of a healthy breast.

By 2011, the last year of the study, 33 percent of the women under 40 were choosing bilateral mastectomy, even though most of them had stage zero or 1 cancer, a very early, very treatable form, NPR reports.

The senior author of the study hopes the numbers will help educate women and doctors.

Another recent JAMA study showed the biggest reason women were making the choice to get a double mastectomy was worry about their cancer coming back. More than two-thirds of the women who had the double mastectomy — 69 percent — had no genetic or family risk factors that would make it more likely that they would get breast cancer again, according to NPR.

You can find more context and information about mastectomies — why they’re done, the risks and results — on the Mayo Clinic site.