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Giant Ball of Fungus Removed from Farmer’s Lung

A man who suffered from a bloody cough that persisted for more than a year was surprised to find that the cause was a giant ball of fungus growing in his lung, according to a recent report of his case

The man, a farmworker in Italy, may have contracted a fungal infection, called aspergilloma, while working in the fields. For a year, he struggled with not only the cough but also fever and weight loss. His symptoms hadn’t improved despite several courses of antibiotics, according to the report published Oct. 24 in the journal BMJ Case Reports.

Aspergilloma, a fungal infection that mainly infects the lungs, is relatively uncommon, and this particular clump of fungus was extremely large, at nearly 3 inches (7.6 centimeters) wide.

“My experience is very large, and it’s the biggest I’ve ever seen,” said study co-author Dr. Marcello Migliore, a thoracic surgeon at the University of Catania in Italy.

Aspergilloma enters the lungs through the respiratory tract. It creates a cavity inside the lungs, and then a ball of fungus grows inside that space. The fungus typically infects people with suppressed immune systems or lung problems such as tuberculosis. If left untreated, aspergillomas can cause pneumonia and death, Migliore said. (7 Devastating Infectious Diseases)

When the 42-year-old farmworker, a chronic smoker, initially came to see doctors, he had lost 77 pounds (35 kilograms) over the previous a year. Despite taking antibiotics for several months, the man’s symptoms worsened.

A computed tomography (CT) scan revealed a 2.75-inch by 2.5-inch (7 cm by 6.5 cm) “vegetative” mass in the left upper lobe of his lung. Depending on whether the man was lying down or sitting up, the position of the lesion moved.

Still, the doctors didn’t know at that point what was causing the cavity, though the CT scans did reveal a suggestive halo around the lesion that is a signature of the fungus.

“When there is a large cavity like that, medical therapy does not do anything, so we must remove it,” Migliore told LiveScience.

When Migliore performed the surgery, he realized it was a large ball of fungus — the biggest he had ever seen. (Image of the fungus)

When the doctors followed up with the man 16 months after the surgery, they found he had improved greatly, and no longer had any troublesome symptoms.

“Now that half of the lung is away, things are going well, he is now happy,” Migliore said.

Source: Discovery news

US moves to ban trans fats in foods

US food safety officials have taken steps to ban the use of trans fats, saying they are a threat to health.

Trans fats, also known as partially hydrogenated oils, are no longer “generally recognised as safe”, said the Food and Drug Administration (FDA).

The regulator said a ban could prevent 7,000 deaths and 20,000 heart attacks in the US each year.

The FDA is opening a 60-day consultation period on the plan, which would gradually phase out trans fats.

“While consumption of potentially harmful artificial trans fat has declined over the last two decades in the United States, current intake remains a significant public health concern,” FDA Commissioner Margaret Hamburg said in a statement.

“The FDA’s action today is an important step toward protecting more Americans from the potential dangers of trans fat.”

‘Industrially produced ingredient’

If the agency’s plan is successful, the heart-clogging oils would be considered food additives and could not be used in food unless officially approved.

The ruling does not affect foods with naturally occurring trans fats, which are present in small amounts in certain meat and dairy products.

  • Some processed baked goods such as cakes, cookies, pies
  • Microwave popcorn, frozen pizza, some fast food
  • Margarine and other spreads, coffee creamer
  • Refrigerator dough products such as cinnamon rolls

Artificial trans fats are used both in processed food and in restaurants as a way to improve the shelf life or flavour of foods. The fats are created when hydrogen is added to vegetable oil, making it a solid.

Nutritionists have long criticised their use, saying they contribute to heart disease more than saturated fat.

Some companies have already phased out trans fats, prompted by new nutritional labels introduced in 2006 requiring it to be listed on food packaging.

New York City and some other local governments have also banned it.

But trans fats persist primarily in processed foods – including some microwave popcorns and frozen pizzas – and in restaurants that use the oils for frying.

According to the FDA, trans fat intake among Americans declined from 4.6g per day in 2003 to around 1g per day in 2012.

The American Heart Association said the FDA’s proposal was a step forward in the battle against heart disease.

“We commend the FDA for responding to the numerous concerns and evidence submitted over the years about the dangers of this industrially produced ingredient,” said its chief executive, Nancy Brown.

Outgoing New York Mayor Michael Bloomberg, who led the charge to ban trans fats in that city, said the FDA plan “deserves great credit”.

“The groundbreaking public health policies we have adopted here in New York City have become a model for the nation for one reason: they’ve worked,” he said.

Source: BBC News

 

Doctor Suspended after feeling up patient

A Blenheim doctor who unnecessarily intimately examined a South Korean vineyard worker and then altered his notes has been banned for 18 months and must always have a chaperone present with females on his return to practice.

Ravi Kiran Reddy Tamma, who has returned to India, worked for the Marlborough After Hours GP Services in Blenheim in August 2011, when he examined a South Korean woman who was working in the vineyards.

She believed she had a recurrence of a urinary tract infection.

Dr Tamma did not explain she could have a chaperone present and examined her completely naked, during which he touched her vagina and massaged her abdomen and legs, all while not wearing gloves.

He made no record of her breathing, pulse, blood pressure or heart rate and diagnosed her with a kidney infection.

The Health Practitioners Disciplinary Tribunal said Dr Tamma also changed his notes to justify what he knew to be an inappropriate examination.

Dr Tamma admitted he had breached professional standards.

The tribunal ruled he be suspended for 18 months and for three years after that he must have a chaperone present whenever he sees a female patient.

In addition:

  • his notes will be randomly audited;
  • he will be assessed by a sexual misconduct team;
  • he must take a course on maintaining appropriate professional boundaries;
  • he must pay nearly $19,000 towards the case against him.

Dr Tamma, in a letter from India, apologised to the patient for his behaviour. He said he wanted to return to practice in New Zealand but wanted to make sure he was mentally stable first.

Source: 3news

A boy born without a brain dies after three-year

A three-year-old Colorado boy born without a brain has died after living what doctors called a miracle life.

 Nickolas Coke suffered from a rare condition known as anencephaly, meaning he was born with only a brain stem.

While most children with this condition die shortly after their birth, Nickolas far exceeded that sentence.

“Nickolas Coke suffered from a rare condition known as anencephaly which meant he was only born with a brain stem

Children with the very rare condition are considered unable to think or have emotions

His family believed he was growing both physically and mentally”

Surviving on little else than pain medication, Nickolas lived what his family called an incredible life.

‘He was never hooked up to any machines, no tubes, no nothing,’ Sherri Kohut, Nickolas’s grandmother, told KOAA in Colorado.

‘He taught us everything, he taught the love, how to be family. He taught us everything.’

Kohut, who was with Nickolas when he died, said the boy stopped breathing after having difficulties doing so all morning.

Medical officials attempted to revive him using CPR, but after three failed attempt, he was pronounced dead.
‘They told us “no more, let him go”,’ Kohut said. ‘So he died at 12:40 Peacefully.’

Nickolas was apparently in good spirits just days before his death. Recent photographs posted on Facebook show the boy smiling and laying in a pumpkin patch.

‘He was laughing because he thought it was funny that we couldn’t get him to stay still enough to roll off the pumpkins,’ Kohut said.

The family made an effort to get Nickolas out as much as possible, taking him on trips to the zoo and going camping.

 Anencephaly occurs in about 1 in every 10,000 births, according to the National Center of Biotechnology Information. 

Children with anencephaly are considered unable to think or have emotions.

Without a brain, Nickolas couldn’t speak, eat or walk and frequently suffered from debilitating seizures.

Still his family believed the boy was growing both physically and mentally.

‘He was our hero because he showed the strength if I can do this anything can be done,’ Kohut said.

‘He will always be remembered.’
Source: Daily Mail

New algorithm ‘boosts accuracy’ of physical activity apps

There are many cell phone apps that track your physical activity. These are useful, not only for your own sense of achievement, but also for doctors who look to these apps to track a patient’s movement and develop tailored treatments. Now, researchers have created a way to make these apps even more accurate.

 A team from Northwestern University in Chicago and Evanston say that previous research surrounding physical activity apps has shown that the majority of people who use them carry their cell phones in a bag, purse or pocket, or they attach it to a belt.

But the researchers note that the location of the phone can have a significant impact on how well the app can pick up a person’s movement.

Therefore, they have created a computer algorithm that can be used in conjunction with a physical activity app that is able to “predict” the location of a mobile phone throughout the day with “near perfect accuracy.”

“Most women carry their phones in a purse. Some people carry theirs on their belt or in their hand. We may change where we carry our phone throughout the day as well,” says first author Stephen Antos, of the McCormick School of Engineering and Applied Science at Northwestern University.

“We wanted to solve this problem and find a way to make these trackers as accurate as possible, no matter where you carry your phone.”

Algorithm ‘accurately detects second-by-second activity’

To create the algorithm, researchers recruited 12 healthy participants who were required to carry out a series of physical activities, including walking, sitting and standing.

During these activities, the participants carried smart phones in different locations – in their purse, backpack, belt, hand or pocket. This same method was also used on two people who had Parkinson’s disease.

The data from this experiment was then used to “train” a computer algorithm to predict where a person is carrying their cell phone, and from this, it was able to successfully detect “second-by-second” physical activity.

Commenting on the findings, published in the Journal of Neuroscience Methods, principal investigator Konrad Kording, of the Northwestern University Feinburg School of Medicine, says:

“While it remains true that smart phone activity trackers are the most accurate when the phone is placed in the pocket or on a belt, with this algorithm we can provide an estimate of error associated with other locations where the phone is carried.”

The researchers note that this algorithm can be applied to patient populations without hesitation, and Kording believes that in the future, smart phone apps will play a major part in helping us to manage our health.

“I believe we will have apps running on smart phones that will know exactly what we’re doing activity-wise and will warn us of diseases before we even know that we have those diseases,” he says.

“In the future, phones will have a major role in motivating people toward behavior that is good for their health.”

Source: Medical news today

Open-heart surgery gives new lease of life to 5-day-old baby

A five-day-old baby with G6PD deficiency – a disorder caused by an abnormal X-chromosome gene, successfully underwent a complex open-heart surgery recently.

According to medical literature, till date, only two paediatric cardiac cases were associated with the disorders have been successfully treated.

Dr Vijay Agarwal, chief paediatric cardiac surgeon, at Fortis Hospital, said, “The child had turned blue due to lack of oxygen supply in his body. His tests showed that he had transposition of great arteries that required immediate surgery if we want to save him.”

Luckily, Dr Agarwal said the hospital where the child was born had done a battery of tests as a part of their routine which revealed that he was suffering from G6PD.

“It was a crucial piece of information that helped us in taking the right measures. In G6PD patients, you have to avoid certain medications that may lead to heavy bleeding and death.
Therefore, it was the biggest challenge in front us,” said Dr Agarwal.

Dr Agarwal added that apart from the G6PD disorder the child also had a single coronary artery instead of two. “Usually in open-heart surgery we need to cool the child below 30 degree Celsius to protect his organs. In his case, it was not possible as that would have led to severe bleeding because of his disorder,” said Dr Agarwal.

Taking help of medical literature, the team of doctors took measures for all possible risk associated with the surgery. The surgery lasted for seven hours. “We avoided the general drugs used in anaesthesia. We maintained the cooling temperature at 33 degree Celsius. Luckily, everything fell in place and the operation was successful. The child had an unusual combination of problems. Moreover, the child weighed only 2.4kg and had jaundice at birth. He has still managed to survive and we are happy that he is now fit to be discharged,” said Dr Agarwal. The team of doctors will be presenting the case in international conferences because of its uniqueness.

Source: http://bit.ly/1doePCr

Johnson & Johnson to pay $2 billion for false marketing

Johnson & Johnson will pay $2.2 billion to settle charges that the company marketed drugs for unapproved uses and paid “kickbacks” to doctors and nursing homes.

The penalties announced Monday involve fines and forfeiture to the federal government and several states. The settlement involves the schizophrenia drugs Risperdal and Invega, and the heart failure drug Natrecor, the company and Attorney General Eric Holder said.

Johnson & Johnson and two subsidiaries “lined their pockets at the expense of American taxpayers, patients and the private insurance industry,” Holder said.

The penalty amounts to one of the country’s largest health care-related settlements, the Justice Department said.

It also results in what one plaintiff’s attorney called the largest whistleblower payout in U.S. history. Whistleblowers in three states will collect $167.7 million under the False Claims Act.

In 2011, Johnson & Johnson $1.2 billion in fines for deceptive marketing and making false claims about Risperdal. The Arkansas case involved 239,000 violations of the state’s False Claims Act and 4,600 violations of the Deceptive Trade Practices Act.

On Monday, Johnson & Johnson defended Risperdal “as safe and effective for its approved indications” and said two decades of research shows it is “an important treatment option for people with serious mental illness.”

Risperdal was approved by the Federal Drug Administration to treat schizophrenia but was marketed to doctors and nursing homes as a treatment for elderly patients with dementia.

Johnson & Johnson subsidiary will plead guilty to a misdemeanor misbranding charge stemming from the marketing charges.

The company knew patients on the drug were at increased risk for developing diabetes, but did not publicly acknowledge the risk, according to the settlement. The company also promoted the drug in nursing homes in part by sending paid pharmacists to review patient records.

“Although consultant pharmacists purported to provide ‘independent’ recommendations based on their clinical judgment, J&J viewed the pharmacists as an ‘extension of [J&J’s] sales force,'” the Justice Department said. Holder said kickbacks and other incentives could have put the “health of some patients at risk.”

Johnson & Johnson and another subsidiary also marketed Risperdal and Invega as safe for elderly patients, a claim the FDA considered “misleading.” This was done in part through an “ElderCare sales force,” federal officials said.

The heart failure drug Natrecor was marketed as a treatment for patients with less severe heart failure than mentioned in its FDA approval, according to the DOJ statement.

The settlement includes payments to the federal government and several states by Johnson & Johnson, as well as subsidiaries Janssen Pharmaceuticals and Scios.

Source: http://cnnmon.ie/173Tgb7

Demand for doctors will grow as population in US

Driven by an aging population and increased access to health insurance, the U.S. will need more doctors by 2025, says a new study.

The expected rise in demand varies by state and medical specialty, according to the study’s lead author.

“What’s happening at the state level can be very different than what’s happening at the national level,” Timothy Dall told Reuters. He is a managing director at the research and information service firm IHS in Washington, D.C.

The new study, published in Health Affairs, looks at future demands for primary and specialized health care providers. Those specialists include cardiologists, neurologists and urologists.

The researchers used a computer model to estimate future health care demand by taking into account a growing and aging population and increased access to health insurance due to the Affordable Care Act – commonly known as Obamacare.

The U.S. Census Bureau projects the country’s population will increase by 9.5 percent between 2013 and 2025. The Congressional Budget Office also estimates that an additional 28 million people will have health insurance by 2023.

The researchers found the expected increase in doctor demand was largely attributed to a growing number of diseases among an older population. Obamacare, on the other hand, was linked only to an increase of a few percentage points.

Overall, the researchers found the demand for primary care or family doctors will grow by 14 percent by 2025. That’s less than the expected growth among some medical specialties.

Dall and his colleagues estimate that demand for vascular surgeons – who perform bypass surgeries and insert stents, for instance – will increase by about 31 percent and demand for cardiologists will increase by 20 percent.

But those estimates vary by state.

For example, though the demand for cardiologists is estimated to grow by 51 percent in Nevada, demand in West Virginia is only estimated to grow by 5 percent.

Dall cautioned that the estimates are subject to change based on health care delivery systems and behaviors.

For example, Dr. Reid Blackwelder, president of the American Academy of Family Physicians, said conditions that would drive people to see specialists are largely preventable with adequate primary care. Focusing on prevention and primary care would be expected to shift demand toward family doctors.

“As we start to recognize the foundational nature of true primary care and prevention, we’re going to need more primary care providers to be that foundation,” Blackwelder told Reuters.

Blackwelder, who was not involved with the new study, is also affiliated with East Tennessee State University’s James H. Quillen College of Medicine in Johnson City.

“The bottom line is that care delivery patterns will change,” Dall said.

He told Reuters the new study can’t say whether the U.S. will experience a shortage of doctors by 2025.

Previously, the Association of American Medical Colleges estimated that the U.S. doctor shortage will grow to more than 130,000 by 2025.

“It’s important that we continue to update projections and not wait a decade before we update them because things are continually changing,” Dall said.

Read More: http://bit.ly/175VG8U

Woman who never aged dies at 20

A woman who never aged has died.

Brooke Greenberg, of Reisterstown, Maryland, looked and behaved like a toddler until her last breath.

Brooke was eventually diagnosed by her physician with “Syndrome X”, an unidentifiable and unexplained rare disease – which is known to affect only about six people in the world – where they do not age physically or mentally since early childhood.

“While the outside world may have noticed Brooke’s physical stature and been puzzled by her unique development state, she brought joy and love to her family,” Rabbi Andrew Busch, who delivered the eulogy at the funeral yesterday, told the New York Daily News. “Her parents, three sisters and extended family showered her with love and respected her dignity throughout her entire life.”

Brooke and her family appeared on Katie Couric’s talk show in the US in January.

They said Brooke could not talk, had baby teeth and still had to be pushed about in a chair.

“From age one to four, Brooke changed. She got a little bit bigger. But age four, four to five, she stopped,” her father told Couric.

Source: fox news

 

Man lives without breathing for a month

A year ago, 42-year-old runner Victor Carlos never thought he’d be excited just to see the starting line. But that was before he almost died.

In fact, the father of two girls didn’t breathe for a month; a machine pushed oxygen through his body.

Now he’s training for another marathon.

It all began in December with a bad bout of the flu that led to an acute bacterial infection. By the time he checked into the hospital, Carlos was barely hanging on.

“We walked into the triage, and his oxygen level was only 57%, and everybody turned a corner,” Carlos’ wife, Brenda Voglewede, told CNN. Healthy blood oxygen levels are higher than 95%.

Carlos was in deep trouble. He had developed acute respiratory distress syndrome, also known as ARDS. It was slowly killing Carlos by attacking his lungs.

“Not only that, but he had multiple organ failure related to the infection. So his kidneys were not working. His liver was not working. And his bone marrow was failing as well,” said Dr. Ashok Babu, a cardiothoracic surgeon at the University of Colorado Hospital.

“The lungs basically collapse down to nothing. … They are just resting.”

Dr. Ashok Babu

Babu had no time to spare. He knew trying to force air into Carlos’ lungs would do more harm than good. But without oxygen, Carlos’ organs would soon shut down. Babu had one shot: a procedure called extracorporeal membrane oxygenation, or ECMO.

With this treatment, doctors turn down the patient’s respirator, then insert a special tube through the heart. A pump draws blood from the body, flushes it through an oxygenation machine that removes the carbon dioxide and delivers oxygen back to the heart. It functions as an external lung, without the patient taking a single breath.

“So (oxygenated blood) could pass through the lungs, and the lungs didn’t have to do anything to it because it was already processed,” Babu said. “And what we see on the X-ray is the lungs basically collapse down to nothing. … They are just resting. We support the patient until the lungs can heal on their own.”

Carlos’ family was told he had a 40% to 50% chance of survival.

“Dr. Babu initially said he thought he’d be on ECMO for a week,” Voglewede recalled. “Then the week turned into two weeks. And then he’s just like, ‘Well, sometimes you just have to wait these things out.’ ”

Babu said, “Two weeks into it we were all pretty worried that we had this young guy whose lungs just didn’t seem to be coming back. At the time, he was the patient we had had on ECMO the longest in the history of our program.”

Two weeks became four. Carlos didn’t take a single breath for a month.

Then a breakthrough came.

“Somewhat miraculously, his lungs just started to open up on their own,” Babu said.

By that time, Carlos was a shadow of his former self. He had lost more than 30 pounds.

“You can imagine, before going into the hospital you are this active person. Then you go in, they put you under, and when you wake … you can’t sit up, you can’t move your arms up and you look at your legs, and they’re just not there anymore,” Carlos said. “Then you realize it’s far worse than you ever expected it to be.”

Still, he was determined to make a full recovery. Seven weeks after entering the hospital, Carlos got to go home.

Carlos recently completed a 20-mile run while training for his next marathon.

“I started out just walking a block and then pushing that out the following day to a block and a half, or two. Then it was like walking to school with the girls,” he said.

Remarkably, just six months later, Carlos is running.

“My goal at the time was to be able to jog nonstop for three miles. And I didn’t think that was going to happen until November. That happened in May,” he said.

Once he was able to cover three miles, the distance he usually started out at to train for a marathon, “that’s when I knew it was just a matter of time.”

Carlos has set his sights on completing the Denver Rock ‘N Roll Marathon on October 20. He’s already covered the 26.2 miles in a training run.

Carlos isn’t running for time. He’s running just because he can.

“Every long run gets a little emotional for me this time around. I think of all the people who were there when I couldn’t do it for myself. I think of the nurses, people at work, my boss who sent cards … neighbors, friends, family, all praying for me,” he said.

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