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‘Redlined’ neighborhoods have higher rates of asthma than others

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Jan. 27 (UPI) — The discriminatory practice of “redlining” neighborhoods may be history, but its legacy includes health effects that linger today, a new study suggests.

In an analysis published Monday in the The Lancet Planetary Health, researchers report that current rates of asthma-related emergency room visits are more than twice as high in areas that were once redlined — or categorized as high risk for investment as part of government-sponsored programs.

The analysis was based on findings in eight California cities.

“Redlining may have shaped neighborhood development in ways that compound risk factors for asthma,” study co-author Neeta Thakur, assistant professor of medicine at the University of California San Francisco, said in a press release.

Overall, approximately 8 percent of all Americans have asthma, a disease of airway inflammation often linked with pollution or poor air quality that causes difficulty breathing.

However, past research has suggested that the disease disproportionately affects communities of color. According to the Centers for Disease Control and Prevention, more than 10 percent of black Americans and nearly 13 percent of Puerto Ricans have asthma.

Thakur and her colleagues sought to determine whether this discrepancy might be traced to where these people live. The researchers specifically considered if study participants lived in areas that had been redlined by the Home Owners’ Loan Corporation, or HOLC, a New Deal-era federal government-sponsored corporation created to provide mortgages to homebuyers and spur real estate sales during the Great Depression.

In evaluating loan applicants, the HOLC essentially graded their neighborhoods based on investment risk, with “A” areas — typically affluent ones — considered lowest risk and “D” areas — those marked in red on maps — considered highest risk.

The redlined areas were typically low-income neighborhoods with high minority and immigrant populations. Many were located in industrial areas and subsequently earmarked for development projects not wanted in more affluent neighborhoods, like highways and railroad lines, further worsening the air quality.

“Redlined neighborhoods had high rates of low socioeconomic status, which are associated with decreased access in health service and increased psychosocial stress, both contributors to asthma incidence, prevalence and severity,” Thakur said.

The researchers reviewed HOLC maps for Fresno, Los Angeles, Oakland, Sacramento, San Diego, San Jose, San Francisco and Stockton against rates of ER visits due to asthma between 2011 and 2013. They also looked at levels of diesel exhaust particle emissions, or PM2.5 levels, in these areas, and the proportion of the current residents living with incomes below twice the federal poverty level.

In all, they found the risk for ER visits due to asthma was 2.4 times higher in neighborhoods that were redlined than those in A-graded neighborhoods — 63.5 versus 26.5 visits annually per 10,000 residents. In “D” neighborhoods, they authors also noted that there were more people who were non-Hispanic black and Hispanic, more people living in poverty and higher amounts of diesel exhaust particle emissions.

“Eighty years or more after the development of the security maps, we observed persistently higher asthma-related emergency department visits in redlined neighborhoods compared with higher-graded neighborhoods,” said co-author John Balmes, a professor of pulmonary and critical care medicine at UCSF.

“These areas also see higher diesel particle emission levels and rates of poverty. Together these might partly reflect a discriminatory legacy of redlining,” Balmes added. “Similar research is needed to assess whether our findings apply beyond the eight Californian cities we studied.”



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Study: Seizures after vaccination don’t affect child development

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Kids who have a fever-related seizure after getting a vaccine won’t have developmental and behavioral problems as a result, according to a new study.

These so-called febrile seizures do not affect children’s development whether they occur after a vaccination or not, the researchers said.

“A febrile seizure can occur following vaccination and understandably can be quite distressing to parents. It can also cause parents to lose confidence in future vaccinations,” said study author Dr. Lucy Deng. She is a pediatrician at the National Center for Immunization Research and Surveillance in Sydney, Australia.

“Now, parents will be relieved to hear that having a febrile seizure following vaccination does not affect the child’s development,” Deng added.

For the study, Deng’s team compared 62 kids who had a fever-related seizure within two weeks of a shot with 70 who had a seizure from another cause and 90 who never had a seizure. All were about 2 years old.

The investigators found no differences in development, thinking skills or behavior among the three groups.

“At a time when there is a global resurgence of measles and new diseases are emerging, our findings are particularly important in reassuring parents and providers on the safety of vaccines,” Deng said in a news release from the American Academy of Neurology.

The report was published online July 1 in the journal Neurology.

More information

To learn more about fever-related seizures, visit the U.S. National Institute of Neurological Disorders and Stroke.

Copyright 2020 HealthDay. All rights reserved.



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Most MS patients use alternative treatments like marijuana, vitamins or massage

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Despite the existence of conventional medications to manage multiple sclerosis (MS) symptoms, a majority of patients also rely on alternative therapies, including vitamins, exercise and marijuana, a new survey suggests.

For the study, researchers at Oregon Health and Science University in Portland asked MS patients if they used “complementary and alternative therapies” — medicines and practices outside of standard medical care.

A majority of just over 1,000 respondents said they used some type of alternative therapy, including marijuana, vitamins, herbs and minerals, plus mind-body therapies like exercise, mindfulness, massage and various diets.

An earlier survey, conducted in 2001, found some people regularly used these therapies — and many found them helpful — but only 7 percent were talking to their doctors about them.

“It was a little bit of a wake-up call to physicians that they need to be more educated about complementary or alternative therapies, and then consider these therapies as part of the overall treatment plan for their patients,” said lead author Dr. Elizabeth Silbermann, a neurology fellow.

MS is a potentially disabling disease that results from the immune system attacking the nervous system and damaging nerves. Symptoms vary, and while some patients eventually lose their ability to walk, others may experience only mild symptoms. MS has no known cure, but treatments can slow the disease’s progression and help patients manage symptoms.

“We have a lot more treatment options for our patients, and we’re treating our patients earlier than we ever did before,” Silbermann said.

But now that there are so many more medications, the researchers wanted to know if people are still using complementary or alternative medicines.

To find out, Silbermann’s team surveyed MS patients in Oregon and Washington between August 2018 and March 2019.

The investigators found that 80 percent of respondents used dietary supplements (such as vitamins, minerals, and herbs) compared to 65 percent in 2001.

Around 70 percent reported using conventional medications to manage their MS symptoms.

The percentage using mind-body therapies (such as mindfulness and massage) nearly tripled — 39 percent of current patients, up from 14 percent in the earlier survey. More than eight in 10 were exercising, an increase from 67 percent in 2001.

Good evidence for exercise

Exercise is one of the only alternative therapies in the survey that has strong evidence of success in curbing MS symptoms.

“This is a disease that does cause physical disability and weakness, so it’s very natural to refer patients to physical therapy and to encourage them to be physically active,” Silbermann explained. “There’s pretty good evidence that things like stretching can be helpful for MS-related muscle tightness, and that staying physically active and doing some aerobic exercise can be very helpful for our patients.”

In the current survey, about 30 percent of participants reported using marijuana in a variety of forms. Pot is legal in Oregon and Washington, where the study was conducted, potentially limiting generalization of the results.

There is some evidence that marijuana can help patients with muscle “spasticity” or tightness.

“When you ask patients to report how tight their muscles feel, they will report consistently that their muscles feel less tight when they are using cannabis, which is great,” said Silbermann.

Pot’s pros and cons

Sean Hennessy, an epidemiologist at the University of Pennsylvania Perelman School of Medicine in Philadelphia, said, “One of the few uses for cannabis-based products for which there’s reasonable evidence of effectiveness is muscle spasticity associated with multiple sclerosis.”

Hennessy was involved in a 2017 report from the National Academies of Sciences, Engineering, and Medicine that synthesized available information on cannabis products and their use in medicine.

But pot can potentially exacerbate existing MS symptoms, including muddled thinking and memory problems. Silbermann said that “it goes to show us that everything does have a side effect that we have to consider as part of an overall treatment strategy and plan.”

One of the most significant findings of the new survey was that over half of respondents said they spoke to their doctors about their use of alternative medicines, compared to the dismal 7 percent in 2001.

Silbermann said she hopes this is because patients feel that physicians are more accepting and knowledgeable about other treatment options. However, not enough is known about alternative therapies for physicians to decide which are safe and effective, she added.

Physicians need to know what supplements or drugs you might be taking for many reasons, but especially to ensure that the medications they prescribe don’t have any potentially negative interactions. But alternative medicines like supplements and cannabis are not well-regulated or well-studied, limiting the ability to assess their safety and efficacy.

“It’s hard to know exactly what you’re getting. So there’s always a concern about the purity of whatever you’re taking, and that’s especially true in cannabis,” Silbermann explained.

According to Hennessy, there are not enough referenced resources that physicians can rely on to know what medications interact poorly with cannabis.

“So, yes, it’s a good idea to tell your physician if you’re using cannabis, but they don’t really have anywhere to look to see whether cannabis interacts with whatever other drugs you’re taking,” Hennessy said.

Silbermann stressed that more research is needed to back up any recommendations about alternative therapies. “It’s an entire other field of medicine, and I think that we’re just learning how important it is to our patients,” she said.

The results were recently published online in the journal Multiple Sclerosis and Related Disorders.

More information

There’s more about multiple sclerosis at the National Multiple Sclerosis Society.

Copyright 2020 HealthDay. All rights reserved.



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90% of COVID-19 patients recover sense of smell, taste within 4 weeks, study finds

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July 2 (UPI) — Nearly 90 percent of COVID-19 patients who lose their sense of smell or taste or both after becoming infected will see these symptoms begin to resolve within a few weeks, according to a study published Thursday by JAMA Otolaryngology-Head & Neck Surgery.

Even in patients for whom the symptoms remain, or worsen, the lingering effects are not a sign that the new coronavirus, SARS-CoV-2, remains in their system, the researchers said.

“The loss of smell or taste is among the most common and persistent symptoms of COVID-19 in patients with mildly symptomatic disease,” the authors wrote.

“However, at four weeks from the onset, most patients reported a complete resolution or improvement of these symptoms,” they said.

An earlier analysis by the same team of researchers — from Treviso Regional Hospital in Italy and St. Thomas Hospital in London — found that roughly two-thirds of patients with mild COVID-19 lose their sense of smell and/or taste. That finding was based on an assessment of 202 patients treated at Treviso.

For this study, the researchers surveyed the same group of 202 patients in mid-April — roughly four weeks after they were first diagnosed with COVID-19 — and asked them about their symptoms and retested them for the virus.

Fifty-five patients — or nearly 49 percent — reported complete resolution of their smell and/or taste impairment, while 46 — or just under 41 percent — indicated that they had experienced an improvement in symptom severity, the researchers said.

Only 12 — or less than 11 percent — reported that their smell/taste deficiencies remained or had worsened, they said.

The duration of smell or taste impairment in recovered patients was approximately 11 days, the researchers said.

However, persistent loss of smell and taste was not necessarily an indicator of the continued presence of SARS-CoV-2, they said.

Of the 58 patients who still were experiencing smell and/or taste deficiencies four weeks after symptom onset, 31 — or roughly 54 percent — still tested positive for the virus, compared to 26 — or just over 46 percent — of fully recovered patients, the researchers said.

“A higher severity of smell and taste impairment at [onset of infection], reasonably due to a more severe injury … was associated with a lower likelihood of recovery at four weeks,” the authors wrote.



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