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Popularity of vaping grows as more studies reveal health risks

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E-cigarette use is rising, putting more Americans at risk of blood vessel damage and heart disease, according to three new studies.

In the first study, researchers found that nearly 1 in 20 adults use e-cigarettes.

“Our study may have important public health implications and ramifications for educational strategies aimed at targeting various population segments to inform them of the health effects and risks associated with the use of e-cigarettes,” said lead author Dr. Mahmoud Al Rifai, a cardiology fellow at Baylor College of Medicine in Houston.

His findings are based on a government survey of more than 930,000 adults. Of those, nearly 29,000 said they were current e-cigarette users, which translates to nearly 11 million American adults overall.

Overall, vaping rose from 4.3 percent in 2016 to 4.8 percent in 2018.

The increase was striking among women, with their current e-cigarette use rising from 3.3 percent to 4.3 percent. It also rose from 3.9 percent to 5.2 percent among 45- to 54-year-olds, and from 5.2 percent to 7.9 percent among former smokers.

Vaping is also growing in popularity among users of smokeless tobacco. Their use of e-cigarettes rose from 9.2 percent in 2016 to 16.2 percent in 2018, the study found.
Al Rifai suspects the trends reflect manufacturers’ efforts to market e-cigarettes as products for smoking cessation.

Meanwhile, two studies from the University of California, Los Angeles, found that vaping might not be as harmless as some people think.
In fact, it may increase heart disease risk by causing oxidative stress, a process that can trigger cell damage, researchers said.

“Elevated oxidative stress in otherwise healthy young people who vape may predict increased risk for premature cardiovascular disease,” said Dr. Holly Middlekauff, a UCLA cardiologist who led both studies.

“Although the levels were lower than in smokers, it is unknown if there is a safe level of oxidative stress,” she said. “If you do not smoke tobacco cigarettes, you should not start using electronic cigarettes.”

In the UCLA studies, researchers compared blood samples from nonsmokers, tobacco smokers and e-cigarette users. The aim was to look for differences in immune cells and markers of oxidative stress linked to buildup of plaque in arteries.

They found that vaping caused the same cell changes and increases in oxidative stress as cigarette smoke.
The findings from these studies are scheduled to be presented Wednesday during an online meeting of the American College of Cardiology. Research presented at meetings is typically considered preliminary until published in a peer-reviewed journal.

Dr. Eugenia Gianos is director of Women’s Heart Health at Lenox Hill Hospital in New York City.
“We never thought that vaping was safe, but we have a lot of suggestion that there could be more harm than we anticipated,” said Gianos, who wasn’t involved with the studies.

Specifically, she suspects vaping can cause heart disease, because oxidative stress causes inflammation, which can damage heart cells.

Although e-cigarettes haven’t been around long enough for us to know their long-term consequences, Gianos said there’s no need to wait 20 years to recognize the potential dangers.

“We have evidence of concern that there are major hazards with e-cigarettes,” she said. “And there could be far more negative effects that we don’t even know about.”

Vaping has caused lung damage that has hospitalized and killed people in recent months. Gianos added that ingredients in e-cigarettes may cause cancer and possibly lead to worse outcomes from the current coronavirus pandemic.

More information

For more on smoking and heart disease, head to the U.S. National Heart, Lung, and Blood Institute.

Copyright 2020 HealthDay. All rights reserved.



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‘Green prescriptions’ could cancel mental health benefits for some

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So-called “green prescriptions” may end up being counterproductive for people with mental health conditions, researchers say.

Spending time in nature is believed to benefit mental health, so some doctors are beginning to “prescribe” outdoor time for their patients.

That led researchers to investigate whether being in nature helps actually does help people with issues such as anxiety and depression. They collected data from more than 18,000 people in 18 countries.

The takeaway: Time in nature does provide several benefits for people with mental health conditions, but only if they choose on their own to visit green spaces.

While being advised to spend time outdoors can encourage such activity, it can also undermine the potential emotional benefits, according to the authors of the study published this month in the journal Scientific Reports.

The researchers said they were surprised to find that people with depression were spending time in nature as often as folks with no mental health issues, and that people with anxiety were doing so much more often.

While in nature, those with depression and anxiety tended to feel happy and reported low anxiety. But those benefits appeared to be undermined when the visits were done at others’ urging, the investigators found.

The more external pressure people with depression and anxiety felt to visit nature, the less motivated they were to do so and the more anxious they felt.

“These findings are consistent with wider research that suggests that urban natural environments provide spaces for people to relax and recover from stress,” said study leader Michelle Tester-Jones, a postdoctoral research associate at the University of Exeter in the United Kingdom.

But the findings also show that health care practitioners and loved ones should be sensitive about recommending time in nature for people who have mental health issues.

“It could be helpful to encourage them to spend more time in places that people already enjoy visiting, so they feel comfortable and can make the most of the experience,” Tester-Jones said in a university news release.

More information

For more on the benefits of green spaces, go to the National Recreation and Park Association.

Copyright 2020 HealthDay. All rights reserved.



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Study: Nearly half of ‘essential workers’ in U.S. at risk for severe COVID-19

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Nov. 9 (UPI) — Nearly half of those classified as “essential workers” in the United States are at increased risk for severe COVID-19, according to an analysis published Monday by JAMA Internal Medicine.

This means that more than 74 million workers and those with whom they live could be at risk for serious illness, based on disease risk guidelines developed by the U.S. Centers for Disease Control and Prevention, the researchers said.

“Many parts of the country face high and rising infection rates, [and] we should not think about work exposure and health risks in isolation, given that workers and persons at increased risk often live in the same households,” study co-author Thomas M. Selden told UPI.

“Insofar as we can reduce the prevalence of COVID-19 in our communities, we can reduce the extent to which policymakers have to choose between the economy and keeping the population safe,” said Selden, an economist with the U.S. Department of Health and Human Services’ Agency for Healthcare Research and Quality.

Since the COVID-19 pandemic spread to the United States in March, states and cities across the country have instituted lockdown measures designed to limit the spread of the disease.

Many of these measures entailed closing schools and non-essential businesses, with only banks, grocery stores, pharmacies and other businesses deemed to provide vital services allowed to stay open.

For this study, Selden and his colleagues analyzed data on the U.S. workforce to examine how many people were in essential jobs, how often they were able to work at home, their risk for severe COVID-19 and the potential health risks for their household members.

Of the more than 157 million workers across the country, 72% are in jobs deemed essential — based on U.S. Department of Homeland Security criteria — and more than three-fourths of all essential workers are unable to work at home, Selden said.

Essential workers include those in the medical and healthcare, telecommunications, information technology systems, defense, food and agriculture, transportation and logistics and energy, water and wastewater industries, as well as those in law enforcement and public works, the DHS criteria stipulates.

The study notes that up to 60% of these workers have underlying health issues, placing them at increased risk for severe COVID-19 if they get infected, as defined by U.S. Centers for Disease Control and Prevention guidelines.

Those with diabetes, heart disease, high blood pressure and chronic respiratory conditions like asthma are considered to be at high risk for serious illness, the CDC says.

Based on these findings, between roughly 57 million and 74 million adults working in on-site essential jobs — and their families — are at increased risk for serious illness, Selden and his colleagues estimated.

“Policymakers face important decisions about how to balance the economic benefits of keeping workers employed and the public health benefits of protecting those with increased risk of severe COVID-19,” Selden said.

“These issues arise in the context of decisions to close segments of the economy and decisions about how to distribute vaccines, which will initially be available only with limited supply, [and] become all the more difficult when the prevalence of infection rises in parts of the country,” he said.



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Study: Hydroxychloroquine no better than placebo for hospitalized COVID-19 patients

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Nov. 9 (UPI) — COVID-19 patients treated with hydroxychloroquine showed no signs of significant improvement in “clinical status” compared with those given a placebo, a study published Monday by JAMA found.

Patients given a five-day course of the drug were scored as “category six” based on the World Health Organization’s seven-category COVID Ordinal Outcomes Scale, the same as those given a placebo, the researchers said.

Also, 28 days after they started treatment, 10.4% of those treated with hydroxychloroquine died, just slightly lower than the 10.6% fatality rate in the placebo group.

“The results show that hydroxychloroquine did not help patients recover from COVID-19,” study co-author Dr. Wesley H. Self told UPI.

“In the study, patients treated with hydroxychloroquine and those treated with a placebo had nearly identical outcomes, [so] I do not foresee any role for hydroxychloroquine in acutely ill patients hospitalized with COVID-19,” said Self, an infectious disease specialist at Vanderbilt University Medical Center.

Hydroxychloroquine is an immunosuppressive and anti-parasitic drug that is used to treat malaria.

Early in the COVID-19 pandemic, it was touted by President Donald Trump and others as a potential treatment for the virus, despite the lack of any scientific data supporting its use.

Given its effectiveness helping those sickened with malaria — a mosquito-borne infection — to recover, “there was a strong rationale for why hydroxychloroquine may have been beneficial for patients with COVID-19,” according to Self.

However, in July, the U.S. Food and Drug Administration warned against the drug’s use in the treatment of those infected with the new coronavirus, due to potentially serious heart-related side effects.

For this study, Self and his colleagues treated 433 COVID-19 patients at 34 hospitals across the United States with either the drug or a placebo for a period of five days.

Patients assigned to the hydroxychloroquine group received 400 milligrams of the drug in pill form twice a day for the first two doses and then 200 mg. in pill form twice a day for the next eight doses, for a total of 10 doses over the five days.

All of the patients were then assessed based on the WHO’s COVID Ordinal Outcomes Scale, which categorizes those infected according to disease severity.

Most of the patients in both the hydroxycholorquine group and the placebo group were in “category six,” meaning they were hospitalized and receiving extracorporeal membrane oxygenation or invasive mechanical ventilation to maintain their breathing, the researchers said.

“Our results, especially when combined from other studies conducted in the United Kingdom and Brazil, are good evidence that hydroxychloroquine does not provide benefit for patients hospitalized with COVID-19,” Self said.



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