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Antibiotic-resistant bacteria may lurk in U.S. water, soil

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A potentially deadly antibiotic-resistant bacteria could be hiding in the dirt and water of the southernmost U.S. states, warns a new report from the U.S. Centers for Disease Control and Prevention.

The bacterial infection, called melioidosis, caused the lungs of a 63-year-old Texan to shut down in late 2018, forcing doctors to put him on a ventilator to save his life, the researchers said.

U.S. citizens who’ve caught melioidosis in the past typically picked it up in a foreign country, but this man had not recently traveled abroad, said Johanna Salzer, a veterinary medical officer with the CDC’s Bacterial Special Pathogens Branch.

What’s more, the bacteria that caused the man’s melioidosis was genetically similar to two prior U.S. cases, one in Texas in 2004 and one in Arizona in 1999.

“We feel like this is evidence that it could be in the environment” in the United States, Salzer said. “We just need to find it.”

Melioidosis is caused by the bacteria Burkholderia pseudomallei. Humans pick up the bacteria by inhaling dust or tiny droplets of water, or by dirt or water getting into an open wound, Salzer said.

There are an estimated 160,000 cases of melioidosis every year around the world, and 89,000 deaths, “which is really high for a disease a lot of people don’t know about,” Salzer said. It most commonly kills through blood poisoning or respiratory failure.

The fatality rate is estimated to exceed 70 percent if a person sick with melioidosis is left untreated, Salzer said.

There’s no vaccine for the bacteria, and it is naturally resistant to many commonly used antibiotics. These include penicillin, ampicillin, cephalosporins, gentamicin, tobramycin and streptomycin, the researchers said.

Patients often require at least two weeks of IV drugs followed by several months of oral antibiotics to wipe out the infection.

The man, from Atascosa County, Texas, went to the hospital in November 2018. He’d had fever, chest pain and shortness of breath for three days, according to the report in the June issue of the CDC journal Emerging Infectious Diseases.

Doctors diagnosed him with pneumonia, and a blood test revealed a B. pseudomallei infection. He subsequently developed a large ulcer on his chest.

Four days after admission to the hospital, the man stopped breathing and was put on a ventilator. He was transferred to another hospital, which switched him to an antibiotic that was more effective against the bacteria.

The patient left the hospital after three weeks, but remained on daily antibiotics for another three months, according to the report. The disease also injured his kidney, which required dialysis three times a week.

These bacteria are most commonly found in the tropical climates of Southeast Asia, South and Central America, and northern Australia. It also has been detected in two U.S. territories, Puerto Rico and the U.S. Virgin Islands, Salzer said.

Previously, B. pseudomallei “has never been found in the environment in the continental United States,” Salzer said.

Unfortunately, the handful of cases cited by the researchers seem to indicate that the bacteria might have made a home for itself in the southern United States.

“There is global modeling that the bacteria could survive, and survive well, in Texas and areas of Florida,” Salzer said.

The CDC plans to partner with academic institutions to search for the bacteria in the continental United States, in much the same way that it was uncovered in Puerto Rico and the Virgin Islands, Salzer said.

Melioidosis can be tough to diagnose, Salzer said.

“It’s been called the Great Mimicker or the Imitator Disease,” Salzer said. “If you’re not looking for it, it doesn’t have really clear and reliable symptoms in all people.”

Symptoms also can take months or years to develop, making it even more difficult for doctors to puzzle out their patient’s illness, the report added.

The CDC experts urge doctors to test for the presence of the bacteria in patients in the southwestern United States who:

  • Have symptoms that seem to indicate pneumonia, blood infection, skin lesions or internal organ abscesses.
  • Have chronic diseases that put them at increased risk for dangerous infections, especially diabetes or kidney disease.
  • Don’t improve after treatment with commonly used antibiotics.

More than 60 percent of melioidosis patients have diabetes, including the man in Texas, Salzer said.

Dr. Robert Glatter is an emergency medicine physician with Lenox Hill Hospital in New York City. “Lack of an international travel history should not rule out a diagnosis of melioidosis. People who also travel to the southwest U.S. are consequently at increased risk,” he said.

“Increased health care provider awareness and education regarding the geographical distribution of this disease along with risk factors and pitfalls for managing melioidosis can help reduce mortality,” Glatter added.

More information

The U.S. Centers for Disease Control and Prevention has more about melioidosis.

Copyright 2020 HealthDay. All rights reserved.



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Almost 14 million U.S. adults vape, with use rising fastest in young

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The number of Americans using electronic cigarettes is soaring, especially among youth, a new study finds.

Nearly 14 million U.S. adults vaped in 2018, up from just over 11 million adults in 2016. The increase was seen in all socioeconomic groups, the researchers found.

“An increasing number of individuals are using e-cigarettes, especially in the younger age groups, which suggests that more individuals are becoming addicted to e-cigarettes rather than just experimenting with them, making the increased uptake among tobacco-naive individuals even more concerning,” said lead researcher Dr. Olufunmilayo Obisesan. She’s a postdoctoral fellow at Johns Hopkins Ciccarone Center for the Prevention of Cardiovascular Disease, in Baltimore.

“The increase in e-cigarette use among individuals with other health-risk behaviors is also concerning, particularly in light of the outbreak of e-cigarette or vaping use-associated lung injuries that has been linked to the vaping of tetrahydrocannabinoids [THC],” she said. THC is the main mind-altering ingredient found in marijuana.

Between 2016 and 2018, young adults aged 18 to 24 years old were the fastest-growing population to start using e-cigarettes. E-cigarette use in that age group increased from 9% in 2016 to 15% in 2018, and use among students increased from 6% in 2016 to 12% in 2018.

E-cigarette use even increased among people who had never smoked traditional cigarettes — from more than 1.4% in 2016 to 2.3% in 2018, the findings showed.

Also, people who were into other risky behaviors — such as drinking alcohol and smoking marijuana — were more likely to use e-cigarettes, the study authors said.

For the study, the researchers collected data on more than one million Americans who took part in the Behavioral Risk Factor Surveillance System for 2016 to 2018.

“Increase in e-cigarette use among adults in the U.S., particularly daily use, is reflective of the addictive potential of e-cigarettes,” Obisesan said. “This is very important to note, particularly for the youth and for individuals who currently use or are considering using them as a means of experimentation.”

The report was published online Sept. 8 in JAMA Internal Medicine.

Stanton Glantz, a professor of medicine at the Center for Tobacco Control, Research and Education at the University of California, San Francisco, said the increase in e-cigarette use is troubling because the health risks of e-cigarettes are similar to the risks linked to traditional cigarettes.

“I think there’s some things that are pretty clear now — one is in terms of lung disease. E-cigarettes are about as bad as cigarettes — you’re still breathing in ultrafine particles, heavy metals and flavors that have high pulmonary toxicity,” he said.

Glantz also pointed out that the damage e-cigarettes can cause in the lungs may also make COVID-19 infections more severe.

E-cigarette use has also been tied to an increased risk of heart disease, and in animal experiments, to cancer and DNA damage, he added.

The bottom line for Glantz is that e-cigarettes aren’t safe alternatives to regular cigarettes and often lead to dual use.

The U.S. Food and Drug Administration has the power to regulate e-cigarettes, and they could actually ban them, Glantz said.

“The FDA can simply say, we’re not going to allow these products to be sold,” he said. “In order to sell e-cigarettes in the United States, you need to have what’s called a marketing order. If the FDA doesn’t grant a marketing order, then the product can’t be sold. If the product can’t be legally sold, that will solve the problem.”

More information

For more on e-cigarettes, head to the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.



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Study: NSAID pain relievers don’t increase risk for severe COVID-19

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Sept. 8 (UPI) — People who use non-steroidal anti-inflammatory drugs, or NSAIDs, to treat pain are not at risk for more severe illness from COVID-19, according to a study published Tuesday by the journal PLOS Medicine.

Among users of NSAID pain relievers like ibuprofen and diclofenac infected with the new coronavirus, nearly 25% needed to be hospitalized, 5% required admission to the intensive care unit and 6.3% died, the data showed.

To compare, for those who did not use these drugs but tested positive for COVID-19, 21% were hospitalized, 5% needed ICU care and 6.1% died.

In the early phases of the pandemic, there were concerns that the use of the painkiller ibuprofen may lead to a more severe course of coronavirus disease, the researchers, from the University of Southern Denmark and Aarhus University Hospital in Denmark, said.

“Considering the available evidence, there is no reason to withdraw well-indicated use of NSAIDs during the pandemic,” they wrote.

“However, the well-established adverse effects of NSAIDs, particularly their renal, gastrointestinal and cardiovascular effects, should always be considered, and NSAIDs should be used in the lowest possible dose for the shortest possible duration for all patients,” they said.

Ibuprofen and other NSAIDs are some of the most commonly used medications in the United States, with an estimated 30 million doses consumed and 70 million prescriptions administered annually, according to the American College of Rheumatology.

For this study, the researchers obtained data on all 9,326 Danish residents who tested positive for COVID-19 between Feb. 27 and April 29, including NSAID use, hospitalization, ICU admission and need for mechanical ventilation and acute renal replacement therapy.

Overall, 248 people — or just under 3% — of the patients included in the analysis had filled a prescription for NSAIDs within 30 days of their positive virus test, according to the researchers.

There was no association between disease severity and NSAID use, the researchers said.

Another study published Aug. 12 had similar findings.



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Low-dose electrical stimulation helps adults with dyslexia read, study finds

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Sept. 8 (UPI) — Electrical stimulation of the brain improves reading accuracy in adults with dyslexia, according to a study published Tuesday by PLOS Biology.

Transcranial alternating current stimulation, a non-invasive procedure that delivers low-dose electricity to the brain over a period of 20 minutes, was found to improve phonological processing — or ability to discern how words sound or are pronounced — and reading accuracy in 15 adults with dyslexia, the researchers said.

The beneficial effect on phonological processing was most pronounced in those individuals who had poor reading skills, while a slightly disruptive effect was observed in very good readers, they said.

Dyslexia, known commonly as a reading disorder, affects up to 10% of the population, and is characterized by lifelong difficulties with written material,” according to the researchers, who are from the University of Geneva in Switzerland.

Although several possible causes have been proposed for dyslexia, the predominant one is a phonological deficit, or a difficulty in processing word sounds, the researchers said.

The phonological deficit in dyslexia is associated with changes in rhythmic or repetitive patterns of electrical activity in the brain, specifically “low-gamma” oscillations, measuring at 30 hertz or volts, in the left auditory cortex, they said.

However, studies have yet to prove that these these oscillations affect a person’s ability to process word sounds and cause dyslexia, the researchers said.

For this study, the researchers applied transcranial alternating current stimulation over the left auditory cortex in 15 adults with dyslexia and 15 fluent readers for 20 minutes.

At a dose of 30 hertz or volts, the approach resulted in significant improvement in reading accuracy in those with dyslexia, the researchers said.

However, the same improvements were not seen following application of a higher, 60-hertz dose, they said.

The results demonstrate for the first time that low-gamma oscillatory activity causes deficits in phonemic processing and may pave the way to non-invasive treatments aimed at normalizing oscillatory function in auditory cortex in people with dyslexia, the researchers said.

They plan “to investigate whether normalizing oscillatory function in very young children could have a long-lasting effect on the organization of the reading system [and] explore even less invasive means of correcting oscillatory activity,” study co-author Silvia Marchesotti, a post-doctural researcher at the University of Geneva, said in a press release.



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