Tuesday, 30 September 2014

Fish Oil Supplements Have Little Effect on Irregular Heartbeat: Study


Atrial fibrillation increases the risk for stroke, researchers note

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

TUESDAY, Sept. 30, 2014 (HealthDay News) -- High doses of fish oil supplements won't prevent the return of a common type of irregular heartbeat known as atrial fibrillation, Canadian researchers report.

In fact, 64.1 percent of those taking fish oil for its omega-3 fatty acids experienced new bouts of atrial fibrillation over the course of 16 months, compared to 63.2 percent of those taking a placebo. Fish oil supplements also did not reduce the twin ills of inflammation or oxidative stress, which may explain why they didn't guard against atrial fibrillation, the study authors noted.

"Fish oil has no role to play in the treatment of atrial fibrillation," said lead researcher Dr. Anil Nigam, an associate professor in the department of medicine at the University of Montreal.

Atrial fibrillation is a common malady in which the heartbeat is irregular and can race as fast as 150 beats a minute. A normal heart rate is around 70 beats a minute.

For the study, Nigam and his colleagues randomly assigned 337 patients with atrial fibrillation who were not being treated with medications to prevent the abnormal heart rhythm to 4 grams of fish oil a day or to a placebo. The patients were followed for up to 16 months.

The study, funded by the Canadian Institutes for Health Research and the Heart and Stroke Foundation of Quebec, was published online Sept. 29 in the Journal of the American College of Cardiology.

According to the Heart Rhythm Society, 2.7 million Americans suffer from atrial fibrillation, and that number is likely to increase as the population ages. The condition increases the risk of stroke fivefold and is responsible for 88,000 deaths each year.

Certain risk factors are associated with the development of atrial fibrillation, including obesity, high blood pressure, diabetes and sleep apnea, Nigam said. Some heart conditions, such as heart failure and heart valve problems, can also increase the risk of atrial fibrillation.

"For most people without heart problems, we believe a healthy weight and healthy lifestyle, and a good control of risk factors, can probably help reduce the risk of developing this condition, although this has not been studied per se," Nigam said.

He added that recent studies have found no benefit from fish oil supplements in people with heart disease who are being optimally treated and whose heart is working normally.

"However, people with poor heart function might still benefit from taking fish oil supplements," Nigam said. "What is better and should be recommended is a Mediterranean-type diet rich in natural omega-3 fats and other nutrients, including fresh fruits and veggies, legumes, olive oil, while lowering intake of red meat, trans fats and saturated fats," he said.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said, "While some studies of omega-3 fatty acid supplementation have shown a modest benefit in treating patients with heart failure, there appears to be no benefit with omega-3 fatty acids in treating atrial fibrillation."

For patients with atrial fibrillation, prescribing traditional medications to prevent this abnormal heartbeat is the most common treatment. Patients may also need to take a blood thinner to help reduce the risk of stroke, he said.

In addition, some patients can benefit from a procedure called catheter ablation, which in essence, burns tiny sections of the heart to prevent the recurrence of atrial fibrillation, Fonarow added.

Preventing atrial fibrillation in the first place is a challenge, and much more research is needed, he noted.

source : Fish Oil Supplements Have Little Effect on Irregular Heartbeat: Study
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California To Launch Medicaid-Funded Teledentistry

By Daniela Hernandez

Mon, Sep 29 2014

California Governor Jerry Brown has signed into law a bill that would require Medi-Cal, the state’s insurance program for the poor, to pay for dental services delivered by teams of hygienists and dentists connected through the Internet.

California is among the first states to launch such teledentistry services, which are intended to increase the options for patients in remote and underserved areas. Other states, like Oregon, Colorado, Hawaii and West Virginia, are interested in creating their own teledentistry programs but are farther behind, advocates for the projects said.

The bill, signed by the governor over the weekend, also expands the types of procedures hygienists and certain assistants can perform without onsite supervision by a dentist — deciding what X-rays to take, for instance, or installing temporary fillings that help prevent decay. The hygienists and other workers will consult with a dentist remotely, sharing records online but will refer a person directly to a dentist if more sophisticated  procedures are needed.

The legislation will take effect on Jan. 1.

Expanding teledentistry statewide will increase Medi-Cal costs minimally in the short-term — by upward of $500,000 a year, according to a State Assembly’s Appropriations Committee fiscal analysis. If teledentistry takes off, the costs could be higher.

Already, the Medi-Cal budget for dental services is slated to grow from $682 million to roughly $940 million by June 2015, thanks to legislation signed in June 2013 that brought back certain dental benefits for adults.

Dr. James Stephens, a Palo Alto dentist and president of the California Dental Association, said that teledentistry could save money down the line, however.

“That’s the real key. It’s a way of getting people who are outside the system into the system,” he said. “Preventive care costs so much less.”

The newly signed law is the culmination of years of work and research by hygienists,� dentists and patient advocacy organizations across the state. About five years ago, Dr. Paul Glassman, a dentist at the University of the Pacific in San Francisco, started the pilot Virtual Dental Home Demonstration Project to show that teledentistry could provide a means to improve access at low costs.

“We’re very very excited. It’s a great ending to a long, long adventure here,” Glassman said. “The next challenge is to be able to spread this system.”

According to Glassman, as many as 50 percent of consumers eligible for dental services through Medi-Cal don’t get care. The idea is to deploy hygienists and dental assistants to schools, nursing homes and other community organizations where underserved populations gather. Glassman and other advocates say that will ease transportation, financial, language and cultural barriers that typically keep people from accessing treatment.

Telemedicine in general has been gaining traction, thanks in part to an increasing number of small Internet-enabled medical devices and consumer health trackers as well as growing interest among venture capitalists.  The federal Affordable Care Act has emphasized the use of digital technologies to improve care and cut costs. Recently, a bill was introduced in the U.S. House of Representatives that would allow accountable care organizations to get reimbursed for and use telemedicine more widely.

source : California To Launch Medicaid-Funded Teledentistry
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Doctors' Group Issues Painkiller Guidelines


Narcotics too risky in many cases, American Academy of Neurology says

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

MONDAY, Sept. 29, 2014 (HealthDay News) -- The risks of powerful narcotic painkillers outweigh their benefits for treating chronic headaches, low back pain and fibromyalgia, a new statement from the American Academy of Neurology says.

Narcotic, or opioid, painkillers include medications such as morphine, codeine, oxycodone (Oxycontin), methadone, fentanyl, hydrocodone or a combination of the drugs with acetaminophen.

The drugs can cause serious side effects, overdose, addiction and death. Research shows that 50 percent of patients who took opioids for at least three months are still on them five years later, according to the academy.

Studies find that while opioids may provide short-term pain relief, there is no proof that they maintain pain relief or improve patients' ability to function over long periods of time without a serious risk of overdose, dependence or addiction, the statement says.

"More than 100,000 people have died from prescription opioid use since policies changed in the late 1990s to allow much more liberal long-term use," Dr. Gary Franklin, of the University of Washington in Seattle, said in an academy news release.

"There have been more deaths from prescription opioids in the most vulnerable young to middle-aged groups than from firearms and car accidents," he added. "Doctors, states, institutions and patients need to work together to stop this epidemic."

Doctors should consult with a pain management specialist if a patient's daily opioid dosage reaches 80 milligrams to 120 milligrams, especially if the patient isn't showing substantial improvement in pain levels and physical function, the statement advises.

The statement, published in the Sept. 30 issue of the journal Neurology, also outlines ways for doctors to prescribe opioids more safely and effectively. These suggestions include: screening for depression and current and past drug abuse; creating an opioid treatment agreement with the patient; and using random urine drug screenings.

"More research and information regarding opioid effectiveness and management is needed, along with changes in state and federal laws and policy to ensure that patients are safer when prescribed these drugs," Franklin said.

source : Doctors' Group Issues Painkiller Guidelines
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Too Many Heart Scans May Pose Radiation Risks, Cardiologists Say


American Heart Association urges doctors to make sure patient understands dangers, test is appropriate

WebMD News from HealthDay

By Robert Preidt

HealthDay Reporter

MONDAY, Sept. 29, 2014 (HealthDay News) -- Doctors need to make sure patients understand the radiation-related risks of heart imaging tests before sending them for such procedures, a new American Heart Association scientific statement says.

"With technological improvements, medical imaging has become an increasingly vital tool in diagnosing and treating patients with heart disease, but the rising use of the tests has led to increasing radiation exposure over the past two decades," Dr. Reza Fazel, chair of the statement writing committee and a cardiologist at Beth Israel Deaconess Medical Center in Boston, said in an association news release.

"Heart imaging procedures account for almost 40 percent of the radiation exposure from medical imaging," Fazel said.

Before referring a patient for a heart imaging test, the cardiologists say, doctors need to address questions such as:

  • How will the test help diagnose or treat the heart problem?
  • Are there alternatives that don't use radiation?
  • What are the levels of radiation exposure, how will it affect the risk of cancer later in life and how does that compare to the risk from other common activities?

"In general, the radiation-related risk of any imaging test to an individual patient is very small and, when the test is clinically appropriate, the benefits of the test typically far outweigh any potential risks," Fazel said.

Doctors who order heart imaging tests need to understand when each type of test is appropriate, the typical average radiation dose and the potential risks, according to the statement published Sept. 29 in the journal Circulation.

"Radiation-related risk is one of the factors that should be considered in the decision to use cardiovascular imaging with ionizing radiation, particularly in younger patients in whom the potential risk of radiation exposure is thought to be higher," Fazel added.

When deciding on a heart imaging test, doctors also need to consider the test's diagnostic accuracy, availability, cost, convenience and other potential risks.

Widely used types of heart imaging tests that use radiation include nuclear stress tests, cardiac CT scans, and fluoroscopy. Fluoroscopy is a technique that uses X-rays to create "real-time" or moving images of the body. Ultrasound and MRI tests do not expose patients to radiation.

source : Too Many Heart Scans May Pose Radiation Risks, Cardiologists Say
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Health Officials Investigating Paralysis in Kids With Enterovirus D68

WebMD Health News

Sept. 29, 2014 -- Some children hospitalized with breathing problems caused by enterovirus D68 in Colorado and Kansas City have also developed unexplained paralysis in their arms and legs, officials say.

Doctors have been watching for paralysis in enterovirus patients affected by the current outbreak, which the CDC says has spread to at least 40 states.

That’s because D68 is related to the virus that causes polio, which crippled thousands of children across the United States before a successful vaccine was created in the 1950s. And in 2012, researchers at Stanford University reported 25 childhood cases of paralysis of an unknown cause that shared features of polio, and in some cases also started as a respiratory illness.

When enteroviruses move beyond the gut or airways, they can attack nerve cells in the spine that control movement.

“The polio virus is a professional at doing this. All the other enteroviruses are amateurs. They do it very, very, very rarely,” says William Schaffner, MD. He's an infectious disease expert at Vanderbilt University in Nashville, TN. “But D68 is a new one. It’s a bit of a different enterovirus. The question is: Could it be doing this?”

He cautions that other germs, including West Nile virus, can also cause paralysis, and it could simply be a case of double infection in this cluster of children.

“This could be just coincidental, so we can’t leap to the conclusion that enterovirus D68 is the cause of this paralysis,” he says. “It’s right at the top of our list of suspects, but we haven’t nailed it yet.”

Investigation Details

Early in the outbreak, pediatricians said they hadn’t seen any signs that infected children were having trouble moving their limbs.

But that changed last week when Children’s Hospital Colorado reported they had a cluster of nine patients with paralysis and signs of nerve damage on MRIs.

Four of the nine affected children have had enterovirus D68 isolated from their airways. Tests are pending for two others. And now the CDC is also checking samples of the children’s spinal fluid for the virus.

The CDC sent out an alert to doctors across the country on Friday telling them to report similar cases. On Monday, a spokesperson for the agency declined to say how many patients with paralysis officials are aware of across the country or when the CDC might have test results.

Mary Anne Jackson, MD, is chief of the pediatric infectious diseases section at Children’s Mercy Hospital in Kansas City, one of the first hospitals to flag the surge in enterovirus D68 infections. She says they also had cases under investigation with symptoms similar to those seen in the Colorado patients.

Schaffner says that in many children, symptoms of paralysis will ease over time as inflammation and swelling of the tissues improves.

source : Health Officials Investigating Paralysis in Kids With Enterovirus D68
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Medical Implant Devices Skate Through Review Process, Studies Claim


Researchers criticize FDA for lax oversight; agency defends its approach

WebMD News from HealthDay

By Dennis Thompson

HealthDay Reporter

MONDAY, Sept. 29, 2014 (HealthDay News) -- Every day, people receive medical implants -- artificial valves, hip replacements, surgical mesh and the like -- that may not have been rigorously tested before or after their approval by the U.S. Food and Drug Administration, two new studies contend.

The studies -- conducted by prominent nonprofit groups and published online Sept. 29 in JAMA Internal Medicine -- lay the blame for inadequate medical device testing on lax oversight by the FDA.

Manufacturers didn't submit any scientific evidence on the safety or effectiveness of 42 out of a sample of 50 new implants in their applications to the FDA, according to a review conducted by the nonprofit National Center for Health Research. The FDA cleared the implants for use in humans.

"If you are a doctor who wants to know what the scientific evidence is that this device is safe and effective, there is no publicly available evidence," said Diana Zuckerman, president of the National Center for Health Research.

The FDA also doesn't appear to rigorously pursue companies regarding required postmarket studies intended to verify the safety of medical implants following their approval, a study by the Pew Charitable Trusts reported.

The Pew researchers found that months pass before regulators and manufacturers can even agree on the parameters for these studies, and that the studies rarely result in any action beyond a change in a device's labeling.

"We know that for a lot of the studies, there are delays of six months or more in finalizing the protocol," said co-author Dr. Joshua Rising, director of medical devices for the Pew Charitable Trusts. "We need more information to understand why it's taking so long to finalize some protocols, and why progress is inadequate for so many studies."

The FDA defended its practices in a statement, saying its "approach has served the American public well by balancing the need for robust evidence to assure safety while expeditiously bringing new technologies to the patients who need them."

The National Center for Health Research study focused on new medical devices submitted to the FDA as a modified, or "substantially equivalent," version of a device already on the market.

Under federal law, these modified devices aren't required to undergo new clinical testing. But manufacturers must provide data in their applications that prove the device is substantially equivalent to the prior version, including tests regarding safety and effectiveness, Zuckerman said.

Most new implants are cleared using this process, the study authors said. Fewer than 20 devices a year are approved under the more rigorous procedure for wholly unique implants, they said.

The researchers selected a representative sample of 50 new devices cleared by the FDA between 2008 and 2012, and checked the applications to see if companies included this information.

source : Medical Implant Devices Skate Through Review Process, Studies Claim
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Antibiotic Use Before Age 2 Might Raise Obesity Risk, Study Says


Researchers suspect broad-spectrum versions change makeup of microbes in gut

WebMD News from HealthDay

By Kathleen Doheny

HealthDay Reporter

MONDAY, Sept. 29, 2014 (HealthDay News) -- Children who are given broad-spectrum antibiotics before the age of 2 may face a slightly higher risk of becoming obese during childhood, new research suggests.

Broad-spectrum antibiotics target a larger number of organisms than narrow-spectrum ones, according to the study.

"It is a reason to think about whether you need antibiotics, and which antibiotic you are picking," said lead researcher Dr. Charles Bailey, attending physician at Children's Hospital of Philadelphia and an assistant professor of clinical pediatrics at the University of Pennsylvania.

Bailey and his colleagues looked at the health records of nearly 65,000 children who were seen at clinics from 2001 through 2013. The researchers followed the children from birth to age 5. They tracked the height and weight of the children, and classified them as normal weight, overweight or obese.

The study authors found that 69 percent of the children were given antibiotics before age 2. On average, the children had 2.3 episodes of antibiotic use.

Children who had four or more exposures to antibiotics were 11 percent more likely to be obese than those who did not. The researchers also looked at whether the antibiotics prescribed were narrow-spectrum, which are recommended as first-line treatment of common childhood infections, or broad-spectrum. "Kids who got broad-spectrum antibiotics had a 16 percent higher risk [of obesity than those who did not]," Bailey said.

No link was found between the narrow-spectrum drugs and obesity risk.

The researchers took into account other factors affecting obesity, such as insurance status, use of steroids and having an asthma diagnosis, and the association held.

The study was published in the Sept. 29 online edition of the journal JAMA Pediatrics.

Bailey and his team decided to look at the possible link between early antibiotic use and obesity risk because previous research has suggested that a person's intestinal microbe environment may be linked with obesity; antibiotic use may affect that environment.

"What we see here is an association," Bailey said. "We haven't proven cause and effect," he explained.

"For most kids, obesity is not the result of one thing they do or don't do," he said. And the 16 percent higher risk is not great, he acknowledged, but the many factors that may drive obesity risk add up.

Parents can ask a doctor who is recommending their young child take an antibiotic if the treatment is really needed. If it is, parents can ask if a narrow-spectrum antibiotic would do the job.

The study was funded by an unrestricted donation from the American Beverage Foundation for a Healthy America to the Children's Hospital of Philadelphia to support the hospital's Healthy Weight Program. The Healthy Weight Program directly funded the study, Bailey said.

The risk found is relatively small, but the finding is "certainly one more reason to be concerned that we should use [antibiotics] more carefully and more prudently," said Dr. Andrew Pavia, chief of pediatric infectious diseases at the University of Utah School of Medicine, in Salt Lake City.

If children really need an antibiotic, he said, "the good outweighs the harm."

He suggested asking these questions if your child's doctor is suggesting an antibiotic: "Do I really need [to give my child] an antibiotic or could we wait another day and see?" or "Is this the most narrow-spectrum to do the job?"

source : Antibiotic Use Before Age 2 Might Raise Obesity Risk, Study Says
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Drug Gives Big Survival Boost Against Type of Advanced Breast Cancer


Women with HER2-positive tumors gained an average 16 more months of life with Perjeta, study finds

WebMD News from HealthDay

By E.J. Mundell

HealthDay Reporter

MONDAY, Sept. 29, 2014 (HealthDay News) -- Adding the drug Perjeta to a standard medication, Herceptin, may give women with a form of advanced breast cancer a significant boost in survival, a new study finds.

The finding is limited to patients with tumors called HER2-positive that have spread (metastasized). And experts say that this type of treatment-linked boost in survival -- an average of nearly 16 extra months of life -- is very rare in cancer research.

Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City, described the new findings as "extremely exciting."

"Great strides have been made in treating breast cancer, and it is particularly encouraging that we now have additional treatment to offer patients with HER2-positive metastatic disease that extends survival," she said.

"Treatment regimens continue to become more tailored to a patient's individual cancer, lessening unwanted side effects from drugs that may not be beneficial, and focusing on treatments that have been shown to improve outcomes for a specific tumor," added Bernik, who was not involved with the study.

Some breast tumor cells carry a "receptor" protein on their surface called HER2, which is thought to fuel the cancer.

However, certain HER2-targeted medications such as Herceptin and Perjeta (pertuzumab) aim to interrupt this process, curbing the tumor's spread.

According to the U.S. National Cancer Institute, about 20 percent of breast cancers are HER2-positive.

The study -- funded by drugmaker Genentech and presented Sunday at the European Society for Medical Oncology meeting in Madrid, Spain -- follows a positive report for Perjeta released in 2012. That trial suggested that patients with HER2-positive cancers might benefit, but more time was needed to discover just how big the benefit might be.

The study involved more than 800 women with advanced HER2-positive breast cancers whose illness had either never been treated, or who had returned for treatment after undergoing a different regimen. Patients either received a combination of three drugs -- Perjeta, Herceptin and docetaxel -- or Herceptin, docetaxel and a "dummy" drug (placebo). Patient outcomes were then tracked for a median of more than 4 years.

The researchers reported that people who took Perjeta along with the other two standard medications gained an average 15.7 months in survival (56.5 months versus 40.8 months). This was equivalent to a 32 percent reduction in the odds that the patient would die over the length of the trial, the authors noted.

"Adding Perjeta to treatment with Herceptin and chemotherapy resulted in the longest survival observed to date in a clinical study of people with HER2-positive metastatic breast cancer," study lead author Dr. Sandra Horning, chief medical officer at Genentech, said in a company news release. She called the survival boost "a magnitude of improvement we rarely see in clinical trials in advanced cancer."

source : Drug Gives Big Survival Boost Against Type of Advanced Breast Cancer
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Obese in Adolescence, Colon Cancer in Later Life?


Study doesn't prove cause-and-effect, but suggests the need for healthy habits in childhood

WebMD News from HealthDay

By Steven Reinberg

HealthDay Reporter

MONDAY, Sept. 29, 2014 (HealthDay News) -- Obesity and inflammation in late adolescence are associated with increased risk for colon and rectal cancer in adulthood, a new study of Swedish males suggests.

The 35-year study found that 16- to 20-year-olds who were obese had more than twice the risk of developing colon or rectal cancer compared to normal-weight teens.

And teens with high levels of inflammation had a 63 percent increased risk of developing colorectal cancer, compared with those with low levels of inflammation, researchers found.

"These results are important because we know relatively little about the role of early life exposures in the development of colon cancer," said lead researcher Elizabeth Kantor, a postdoctoral research fellow in the department of epidemiology at the Harvard School of Public Health in Boston.

However, Kantor said this study doesn't prove that obesity and inflammation in adolescence caused the increased risk for colorectal cancer.

"We are talking about associations and cannot say whether or not they are causal," she said. "For this reason, I think it's important to be cautious with the conclusions of the study," she added.

For one thing, nothing was known about the diets of the boys studied, the researchers noted.

Obesity is thought to be a cause of inflammation, which has been associated with an increased risk for a variety of cancers, according to the American Cancer Society.

The study findings were scheduled for presentation Monday at a meeting of the American Association for Cancer Research in New Orleans.

Dr. Andrew Chan, an associate professor in the department of medicine at Harvard Medical School, said there is "pervasive evidence" that obesity is a risk factor for colon cancer.

It isn't clear, however, when obesity matters the most, he said. "We know that the development of colon cancer takes many years. So it is important to understand whether it's obesity earlier or later in life that is more influential," Chan said.

Kantor agreed that more work is needed to determine how obesity and inflammation might influence colorectal cancer risk at different stages in life.

For the study, Kantor's team analyzed data on nearly 240,000 Swedish males drafted into the military from 1969 to 1976 when they were between 16 and 20 years of age.

When they were inducted into the military, the men underwent a blood test to measure inflammation in their body and had their height and weight recorded.

To identify men with colorectal cancer from this group, the researchers linked draft records with a national cancer registry. By the start of 2010, the investigators found that 501 men had developed colon cancer and 384 had developed rectal cancer.

Obesity was associated with 2.37 times greater risk of developing colorectal cancer, the researchers said.

Dr. David Katz, director of the Yale University Prevention Research Center, wasn't surprised by the findings. "We have long known that obesity is associated with an increased risk of almost all cancers, and obesity is associated with inflammation," he said.

Establishing healthful eating and physical activity patterns in childhood is crucial, he said. "A healthy lifestyle is the best defense we have against obesity, inflammation, and the dangers these portend over a lifetime," he said.

Data and conclusions presented at meetings are typically considered preliminary until published in a peer-reviewed medical journal.

source : Obese in Adolescence, Colon Cancer in Later Life?
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American Doctor Exposed to Ebola Admitted to NIH Hospital


The patient was working in West Africa; not clear if infection occurred

HealthDay – Not on Site

By Dennis Thompson

HealthDay Reporter

MONDAY, Sept. 29, 2014 (HealthDay News) -- Another American doctor exposed to the Ebola virus while working in West Africa was admitted Sunday to a hospital at the National Institutes of Health in suburban Washington, D.C.

The unidentified patient was working at an Ebola treatment unit in Sierra Leone when exposed to the highly lethal virus that has been ravaging four West African nations for months.

The patient was admitted to the NIH Clinical Center's special clinical studies unit "out of an abundance of caution," the agency said in a news release. The unit's staff is "trained in strict infection control practices optimized to prevent spread of potentially transmissible agents such as Ebola," the release said.

Dr. Anthony Fauci, director of the NIH's National Institute of Allergy and Infectious Diseases, wouldn't discuss details about the patient. But he told the Associated Press that exposure to the Ebola virus doesn't automatically mean someone will become sick.

"When someone is exposed, you want to put them into the best possible situation so if something happens you can take care of them," Fauci said.

The patient poses minimal risk to the NIH staffers and the public, the news release said.

The patient is the fifth U.S. health care professional exposed to the Ebola virus while working in West Africa.

Three others who became infected with the virus have recovered, while a fourth continues to undergo treatment at Emory University Hospital in Atlanta.

The third American Ebola patient to become infected -- a medical missionary -- left a Nebraska hospital on Thursday, free of the virus.

Treatments given to Dr. Rick Sacra, 51, included doses of an experimental drug and blood transfusions from a fellow U.S. medical missionary who also survived infection with the virus.

"The CDC [U.S. Centers for Disease Control and Prevention] has declared me safe and free of virus," Sacra said during a Thursday morning news conference at Nebraska Medical Center in Omaha. "Thank God. I love you all."

Sacra said his friend and fellow medical missionary and Ebola survivor, Dr. Kent Brantly, "communicated with me about a week ago and let me know in no uncertain terms that this was not going to be a quick recovery. So I have to take things one day at a time." Brantly gave blood to Sacra in the hope that antibodies to the Ebola virus would aid Sacra in his recovery.

Sacra received two transfusions of blood serum from Brantly, the first American to be infected with the virus during the West African outbreak. The men are good friends and both work for missionary groups active in the fight against Ebola in West Africa.

Nebraska hospital officials said Thursday that they don't know what helped Sacra survive his ordeal -- the experimental drug, the transfusions, the supportive care provided by doctors and nurses, or the combination of all three.

Both Brantly, 33, and another American aid worker, Nancy Writebol, 59, made a full recovery from Ebola following treatment with another experimental drug called ZMapp at Emory University Hospital in Atlanta.

The Ebola epidemic in West Africa is the worst outbreak ever of the disease. So far, an estimated 6,500 people have become infected and nearly 3,100 have died in the countries of Guinea, Liberia, Nigeria and Sierra Leone, according to the World Health Organization.

The epidemic could strike as many as 1.4 million people by mid-January unless the global community mounts a rapid response to the crisis, according to estimates by the CDC.

source : American Doctor Exposed to Ebola Admitted to NIH Hospital
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Small Heart, Stroke Risks From Asthma Drug: FDA

Medscape Medical News

Sept. 29, 2014 -- A safety study done by the maker of the asthma drug omalizumab (Xolair) suggests it poses slightly increased but serious risks for heart attacks and mini-strokes known as TIAs (transient ischemic attacks), the FDA says.

Because of certain "weaknesses" in the 5-year study, the FDA says it is "unable to definitively confirm or determine the exact increased level of these risks with Xolair."

Omalizumab, also approved to treat a type of chronic hives, already carries a boxed warning on its label about the risk for a rare but potentially life-threatening allergic reaction called anaphylaxis. The FDA says it will add label information about the new potential risks, which include chest pain and blood clots.

The safety study did not find that people taking omalizumab had a higher rate of death from ischemic stroke or heart disease compared to people not taking it, though.

Also, the FDA will revise the drug's label to say it cannot rule out a potential risk for cancer. It noted that some earlier clinical trials spotted a slightly higher cancer rate among people taking omalizumab compared to people who did not receive the drug. The new  study did not uncover any difference in cancer rates among these two groups, but "limitations" in the study mean we can’t be sure there’s no difference.

More information about the announcement is available on the FDA web site.

To report problems with omalizumab, contact MedWatch, the FDA's safety information and adverse-event reporting program, by telephone at 1-800-FDA-1088, by fax at 1-800-FDA-0178, online here, with postage-paid FDA form 3500, available here, or by mail to MedWatch, 5600 Fishers Lane, Rockville, Maryland 20852-9787.

source : Small Heart, Stroke Risks From Asthma Drug: FDA
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