Asthma May Be Misdiagnosed In Many Adults

As many as one in three adults diagnosed with asthma may not actually have the chronic lung disorder, a Canadian study suggests.

Researchers did lung function tests on 613 adults who had been diagnosed with asthma within the past five years. If participants took asthma medicines, researchers gradually weaned them off the drugs over four clinic visits to see how well their lungs worked without treatment.

The evaluations ruled out asthma in 203 of the participants, or 33 percent. After one year of follow-up, 181 of these people still did too well on lung tests to be diagnosed with asthma, researchers report in JAMA.

“We were able to get these patients completely off asthma medications, and they did well in follow up over the next year despite remaining off medications,” said lead study author Dr. Shawn Aaron of the University of Ottawa and the Ottawa Hospital Research Institute.

“Some of these patients were clearly misdiagnosed to begin with, and they had other conditions other than asthma, and some did have asthma but it was in remission,” Aaron added by email.

Asthma can be difficult to diagnose because not all patients have the same triggers or symptoms, which can include difficulty breathing, chest pain, cough and wheezing. Some chronic asthma patients experience periods of remission and relapse.

For the current study, researchers had all of the patients monitor symptoms and do breathing tests at home to see how fast air comes out of their lungs, a measurement known as peak expiratory flow.

All of the participants also did bronchial challenge tests. For these assessments, patients inhaled a medication that causes the bronchial tubes to constrict, simulating conditions that can cause asthma to see how well airways react.

Each patient also did spirometry tests that measure lung function by seeing how much air people inhale, how much they exhale and how fast they exhale.

Participants in whom a diagnosis of current asthma was ultimately ruled out were followed up clinically with repeated bronchial challenge tests over one year.

Among those misdiagnosed with asthma, 12 people, or 2 percent of the participants, had serious conditions other than asthma, like heart disease and pulmonary hypertension, the study found. Still others were found to have conditions like chronic obstructive pulmonary disease (COPD), gastroesophageal reflux (GERD) or anxiety-related hyperventilation rather than asthma.

Those who were misdiagnosed were less likely to have had airflow limitation tests when they were originally diagnosed, compared with participants who had their original asthma diagnosis confirmed in the current study.

For patients who had asthma ruled out, 90 percent had asthma medications safely stopped for one year after being weaned off drugs for the study.

One limitation of the study is that researchers only followed patients for a total of 15 months, which isn’t long enough to rule out the possibility that some patients in remission might have asthma symptoms in the future, the authors note. The study also excluded patients using long-term oral corticosteroids, leaving only people with milder forms of asthma to participated.

Still, the study reaffirms the need for patients who have been diagnosed with asthma to have their diagnosis confirmed with objective lung function testing, particularly spirometry, before being started on lifelong therapy, Dr. Alan Kaplan, a researcher at the University of Toronto who wasn’t involved in the study, said by email.

“The most important potential harm of misdiagnosis of asthma is not treating the patient’s actual disease,” said Dr. Helen Hollingsworth of Boston University, co-author of an accompanying editorial.

“For other patients, not recognizing that asthma is in remission, can lead to taking unnecessary medication,” Hollingsworth added by email. “While the adverse effects of asthma medication are minimal, no one wants to take unnecessary medication.”

Dealing with a Difficult Colleague in the Medical Field

Working in the medical field is full of stress-causing factors, including having an obnoxious colleague who’s difficult to work with. Dealing with someone like this on a regular basis can really add to the stress in your workplace. However, that doesn’t mean you can’t do anything about it. Consider the following tips on dealing with difficult colleagues in the medical field.

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  1. You can’t expect instant change.

An individual can take months or even years to develop an attitude, which means it will also take a long time to change for the better. Simply telling your colleague to change is like telling them to change their personality then and there. Not only is that impossible, but it can also have the opposite effect and cause them to be more obnoxious or even openly hostile towards you.

  1. Remember that it’s not your fault.

Nobody decides to be obnoxious towards people on a whim. Remember that whatever’s causing your colleague’s attitude could be anything from issues with their household, personal health, or even finances. Never take their attitude personally since it also encourages you to harbor negative feelings towards them (and yourself).

  1. Hear them out

It may seem like avoiding a colleague with a bad attitude altogether is a good idea, but it only reinforces a bad relationship between you two. There are some times when it’s easier to tolerate people with a bad attitude if you understand why they act that way. Hear them out; ask them why they act that way. They don’t have to open up to you, but letting them know you want to understand them can help ease the situation.

  1. Set your limits

While forcing them to change is out of the question, you still have the final say on what offends you and what doesn’t. Be honest with your colleague about what you will not tolerate, but say it in a respectful manner. For example, telling your colleague “I’d appreciate it if you don’t make fun of my hobbies,” sounds a lot better than “Shut up about my hobbies!”

  1. Don’t retaliate

It might be tempting to get back at an obnoxious colleague, but retaliation is easily one of the worst things you can do. Instead of “teaching them a lesson”, you’ll more likely end up with a more hostile attitude towards you and it can be even more difficult to get back on good terms with them.

  1. Stay safe

While most displays of negative attitude don’t really mean much, do stay vigilant in case it takes a turn for the worse. If your colleague issued threats – especially those involving physical violence or sexual harassment – don’t hesitate to let the higher ups know what’s up.

The medical field is all about bringing good health to other people, but it can still take a toll on your own mind and body. Keeping healthy relationships with the people you’re working with and resolving conflicts before they get out of hand encourages everyone to have each other’s backs even during stressful times.

Stem Cells Could Restore Vision After Eye Disease

A new technique using stem cells can restore vision in mice that have end-stage eye disease, a condition that is thought to bring irreversible vision loss.

Researchers used stem cells to grow new retina tissue in a lab, and then transplanted that tissue into mice that had end-stage retinal degeneration. More than 40 percent of the mice gained the ability to see light as the result of the procedure, the researchers said.

This is the first time researchers have successfully transplanted the cells that sense light, the retina’s light receptors, so that these cells connect to the host’s nervous system and send signals to the host’s brain, the researchers said.

“We were at first very excited to see that the transplants do robustly respond to light,” Dr. Michiko Mandai, the first author of the paper and a deputy project leader at the RIKEN Center for Developmental Biology in Japan, told Live Science.

The researchers hope to eventually increase the number of connections between the cells in the host’s degenerated retina and the stem cell transplants, Mandai said. This could allow the mice to see not only light, but also a large figure or movement, Mandai said.

The retina is the layer of tissue at the back of the eye that actually senses light and passes signals on to the brain, where the information is processed and an image is perceived . In individuals with retinal degeneration, the light-sensing cells are gradually lost, eventually leading to total blindness, Mandai said. Age-related macular degeneration , the most prevalent type of retinal degeneration, affects approximately 15 million people in the U.S. and 170 million people worldwide.

In the study, researchers converted skin cells from an adult mouse into mouse induced pluripotent stem cells (iPSCs). The scientists then converted these stem cells into retinal tissue and transplanted the tissue into mice that had end-stage retinal degeneration.

The researchers used what is called a shuttle avoidance test to determine whether the mice could see light. The test involves a sound- and light-insulated box with two chambers, separated by a wall with a small opening that allows mice to move between the two compartments.

A mouse is placed in the box and trained to recognize that a simultaneous beep and light signal is a warning of an electric shock. The mouse can avoid the shock by moving to the other chamber. In the study, once the mice were trained to avoid the shock, only the light (and not the beep) was used as a warning, to test whether the mouse could see the light.

In the experiment, after retinal transplantation , four of 10 mice with transplants in both eyes, and five of 11 mice with a transplant in only one eye, could respond to the light signal, according to the findings, published Jan. 10 in the journal Stem Cell Reports.

It is unclear whether the new technique could be applied in humans, and testing it is likely a long way off, the researchers said. One aspect of human health to consider is that, whereas the mice in this experiment were able to respond to light one month after the retina transplantation, the human retina takes a longer time to mature, the researchers said in a statement . Thus, it may take up to five or six months for a transplanted retina in humans to start responding to light, they said.

Furthermore, researchers still need to test whether the same procedure would work in humans, the scientists said.

“From a clinical point of view, although we think that these results are very promising, human eyes may have a different environment from mice, and [the questions of] whether they accept retinal transplants and make connections with transplants are yet to be tested,” Mandai told Live Science. “We would get the answers only in [a] human study.”

Cancer Spread Cut By 75% In Tests

The deadly spread of cancer around the body has been cut by three-quarters in animal experiments, say scientists.

Tumours can “seed” themselves elsewhere in the body and this process is behind 90% of cancer deaths.

The mouse study, published in Nature, showed altering the immune system slowed the spread of skin cancers to the lungs.

Cancer Research UK said the early work gave new insight into how tumours spread and may lead to new treatments.

The spread of cancer – known as metastasis – is a fight between a rapidly mutating cancer and the rest of the body.

The team at the Sanger Institute in Cambridge was trying to figure out what affected tumour spread in the body.

Researchers created 810 sets of genetically modified lab mice to discover which sections of the DNA were involved in the body resisting a cancer’s spread.

The animals were injected with melanomas (skin cancer) and the team counted the number of tumours that formed in the lung.

Their hunt led them to discover 23 sections of DNA, or genes, that made it either easier or harder for a cancer to spread.

Many of them were involved in controlling the immune system.

Targeting one gene – called Spns2 – led to a three-quarters reduction in tumours spreading to the lungs.

‘Interesting biology’

“It regulated the balance of immune cells within the lung,” Dr David Adams, one of the team, told the BBC News website.

“It changes the balance of cells that play a role in killing tumour cells and those that switch off the immune system.”

The field of immunotherapy – harnessing the power of the immune system to fight cancer – has delivered dramatic results for some patients.

A rare few with a terminal diagnosis have seen all signs of cancer disappear from their body, although the drugs still fail to work in many patients.

Dr Adams said: “We’ve learnt some interesting new biology that we might be able to use – it’s told us this gene is involved in tumour growth.”

Drugs that target Spns2 could produce the same cancer-slowing effect but that remains a distant prospect.

Dr Justine Alford, from Cancer Research UK, said: “This study in mice gives a new insight into the genes that play a role in cancer spreading and may highlight a potential way to treat cancer in the future.

“Cancer that has spread is tough to treat, so research such as this is vital in the search for ways to tackle this process.”

What Wellness Strategies Should I Implement To Become Healthier?

2017 is almost here. If you’re one of those people who wants each year to be progressively better than the last, it’s important for you to implement wellness strategies that will facilitate great health. Taking this step is important because poor health compromises mood, decreases self-confidence, and complicates your ability to perform well in the work setting. With these realities in mind, make sure that you use the following techniques to ensure that 2017 becomes your healthiest year yet:

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1. Obtain Excellent Medical Services.

Individuals who are serious about optimizing wellness should know that attaining great medical care is a must. Doing so will help you detect and correct medical problems that might be complicating your life or causing you pain. If you’re in need of digital x-ray imaging services, the professionals of Middletown Medical Imaging can assist you. When you start your search for the ideal medical services, make sure that you choose a professional firm whose employees have extensive industry experience and a proven track record of facilitating holistic wellness.

2. Do Yoga.

In addition to obtaining excellent medical services, make sure that you give yoga a try. Yoga is one of the most powerful forms of exercise on the planet, and this is the case for several reasons. One of them includes yoga’s ability to significantly decrease stress levels. Additionally, yoga is known to improve circulation, enhance metabolism, and promote the maintenance of a leaner, more shapely physique. If you’re not familiar with the world of yoga, you can purchase beginner DVDs and practice from the privacy of your home.

3. Get A Facial.

One final wellness technique that can work wonders for your health in 2017 is getting a facial each month. In addition to removing impurities from your face before they can enter your bloodstream, facials can help decrease or eliminate skin issues such as hyperpigmentation and acne. Be sure to research a beauty clinic’s background before you allow any aesthetician to work on your skin!

Implement These Wellness Strategies Now!

If you know that you want to look and feel great in 2017, you need to think and act in a strategic manner. Three health techniques that can help you optimize your wellness in the new year include obtaining excellent medical services, doing yoga, and obtaining a facial each month. Start implementing these strategies now so you can look great and feel good in 2017!

What Type of Braces Should you Choose?

Braces have improved quite a bit with more choices than the conventional metal braces that are sometimes uncomfortable to wear. Metal braces are still chosen by some but typically they are worn by children. This is why many adults are opting for clear braces to correct their dental problems.

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What are Clear Braces?

There are a few types from which to choose if you have decided on clear braces clayton mo. One is a clear type such as Ivisalign that are available from providers such as Brentwood Dental Group. The braces are almost invisible and they can be removed. This makes it easier to take care of your teeth when it comes to brushing and flossing. They are custom made by a laboratory from impressions your dentist takes from your teeth. The impressions are three-dimensional and new ones are made as your teeth begin to realign themselves.

Another type is ceramic braces. This type is either clear or white and use rubber bands or clips to hold them to an arch wire. The clips are called ligatures and they are changed on a regular basis as your teeth become straighter. As with metal braces, the ceramic braces stay in until the teeth are completely realigned. Because of their color, they are not as visible as metal braces. Sometimes this type is used with metal braces. The ceramic braces are put on the front teeth and metal ones are used on the back teeth where they are not as visible.

Inside braces are another type. They are fitted to the inside of the upper teeth as well as the lower teeth. Images are taken of the insides of your teeth and a computer designs the best fit for your teeth. They are preferred by many people who may not want anyone to know they are wearing braces. Some people have complained of this type being somewhat uncomfortable on their tongue in the beginning but generally they do not notice this discomfort after the first week.

Choosing which type is best for your needs is made simpler by talking to a dentist. They can make a recommendation based on your dental problems. Often adults who work with the public want an invisible type. This allows them to correct their teeth without wearing the conventional metal braces. Clear or invisible braces may be a bit higher in cost than metal braces. It will really depend on the length of time they must be worn or changed and the type that is chosen.

Doctor’s Anti-Vaccine Claims Ignite Pr Firestorm For Cleveland Clinic

A doctor at the prestigious Cleveland Clinic sparked an online uproar when he published an article Friday filled with anti-vaccine rhetoric, including the widely debunked claim that vaccines are linked to autism. Physicians took to Twitter to call the article “vile” and “Post-truth medicine” and demand whether the clinic endorsed its doctor’s views.

Dr. Daniel Neides, a family doctor and the director and chief operating officer of the Cleveland Clinic Wellness Institute, wrote on a blog on the news site cleveland.com that preservatives and other ingredients in vaccines are dangerous and are likely behind the increase in diagnosed cases of neurological diseases such as autism — a claim that has long been discredited by researchers.

“Does the vaccine burden — as has been debated for years — cause autism? I don’t know and will not debate that here. What I will stand up and scream is that newborns without intact immune systems and detoxification systems are being over-burdened with PRESERVATIVES AND ADJUVANTS IN THE VACCINES,” he wrote. Adjuvants are added to vaccines to prompt a stronger immune response.

“Some of the vaccines have helped reduce the incidence of childhood communicable diseases, like meningitis and pneumonia,” he continued. “That is great news. But not at the expense of neurologic diseases like autism and ADHD increasing at alarming rates.”

Neides’s wellness institute provides “world-class medical care and quality wellness programs to change unhealthy behaviors and to make healthy life choices,” according to its website. But to the wider medical community, the claims that Neides espoused did not promote “healthy life choices.” Instead, they said these statements were downright dangerous.

Dr. Vinay Prasad, a hematologist-oncologist at the Oregon Health and Sciences University, expressed disbelief on Twitter:

In an email to STAT, Prasad added, “That article … contains many of the tired, unsupported, irrational concerns about pediatric vaccines, as well as generally unsupported thoughts on ‘toxin’ exposure. Frankly, it is a little surprising it is written by a doctor, and not someone on the fringe, who lacks basic science and medical training.”

Dr. Jeffrey Matthews, chair of the University of Chicago’s Department of Surgery, tweeted:

Scientists and doctors were horrified about the misinformation contained in the article, especially given that the source is affiliated with a such a prestigious medical institution. A spokesperson for Cleveland Clinic told STAT on Saturday that Neides “will not be doing an interview.”

“He wrote this opinion piece on his own and it does not reflect the position of the Cleveland Clinic whatsoever, and we strongly support vaccinations and the protection of patients and employees,” said Eileen Sheil, executive director of corporate communications for the medical center.

Many doctors saw the post as an embarrassment for the Cleveland Clinic.

Dr. Benjamin Mazer, a resident physician in pathology at Yale New Haven Hospital who tweeted that the article was “one of the most vile, false things I have ever read by a doctor,” said in an interview that it wasn’t an isolated event.

“This is really part of a larger movement that distrusts mainstream medicine, distrusts mainstream public health, and really trades in conspiracy theories,” he told STAT. “This article is a really prime example of that. It’s just a shame that it’s a physician spreading these conspiracy theories because people naturally trust physicians.”

He was especially appalled at the misinformation that Neides was spreading about hepatitis B vaccines, which, Mazer said, “have prevented thousands of deaths.”

Non-clinicians were just as worried.

“When I see opinion pieces that stoke fears about the truly minuscule amounts of formaldehyde (a naturally occurring metabolite in every one of us) in vaccines or suggest that there is still some ‘debate’ as to whether or not vaccines and autism are linked, it sets off alarm bells and huge red flags in my head,” Michael Wosnick, the former scientific director of the Canadian Cancer Society Research Institute, told STAT by email.

French Baby Death Linked To Vitamin Dose

France has acted to suspend the sale of a vitamin D supplement after the death of a newborn baby who suffocated hours after being given it.

The 10-day-old baby had been given a dose of Uvesterol D, widely given to French children under the age of five to prevent vitamin D deficiency.

France’s medical safety agency said there was a “probable link” to that particular supplement.

But officials said there were many other products that could be used.

Health Minister Marisol Touraine said children were not in danger by taking vitamin D supplements in general as “it’s the specific way the product is administered that poses risks”. She promised parents “transparent, objective and reliable information.”

In a statement (in French), the national medical safety agency (ANSM) said “only Uvesterol D administered with a pipette is involved”. The product is not sold in the UK.

The baby died at home on 21 December, apparently after being given a dose of the substance orally through a plastic pipette. It showed immediate signs of suffocation before dying two hours later of cardio-respiratory arrest.

News of the baby’s death was not disclosed by France’s health authorities immediately but emerged in French media on Monday.

ANSM said that in 2006 it had imposed measures to reduce risks from taking Uvesterol D after adverse effects became known. However, until December there had been no deaths since it went on the market in 1990, it added.

French daily Le Monde has revealed that Uvesterol D has for years been at the centre of fears over how it has been ingested, with several cases documented of serious illness. The paper cited the oily nature of the substance as being different from other types of liquid vitamin D.

The supplement’s producer Crinex changed the pipette in 2006 to prevent the liquid being administered too quickly.

Then, in 2013, the medical safety agency urged parents to give the supplement drip-by-drip before feeding and ensure the baby was in a semi-sitting position. It also reduced the recommended dosage.

In 2014, health journal Prescire called for an end to the use of Uvesterol vitamin supplements for newborn babies, complaining of half-measures and procrastination from both the company and the medical safety agency.