The FDA has announced that samples of ranitidine, an H2 Blocker used for upset stomach, reflux and ulcers sold generically and under the brand name of Zantac, were found to have the contaminant N-nitroso dimethylamine (NDMA).  This is one of the chemicals that prompted the generic ARB blood pressure medication recalls last year.

There have been no reports of users becoming ill and no recall has been suggested at this time. In animals, NDMA is known to cause liver and lung cancer.  In humans its carcinogenic risk is unknown, however the CDC states it may cause liver function impairment and cirrhosis.

The FDA writes:

THE FDA IS NOT CALLING FOR INDIVIDUALS TO STOP TAKING RANITIDINE AT THIS TIME; HOWEVER, PATIENTS TAKING PRESCRIPTION RANITIDINE WHO WISH TO DISCONTINUE USE SHOULD TALK TO THEIR HEALTH CARE PROFESSIONAL ABOUT OTHER TREATMENT OPTIONS. PEOPLE TAKING OTC RANITIDINE COULD CONSIDER USING OTHER OTC MEDICINES APPROVED FOR THEIR CONDITION. THERE ARE MULTIPLE DRUGS ON THE MARKET THAT ARE APPROVED FOR THE SAME OR SIMILAR USES AS RANITIDINE.
CONSUMERS AND HEALTH CARE PROFESSIONALS SHOULD REPORT ANY ADVERSE REACTIONS WITH RANITIDINE TO THE FDA’S MEDWATCH PROGRAM TO HELP THE AGENCY BETTER UNDERSTAND THE SCOPE OF THE PROBLEM:

The investigation is ongoing and more needs to be looked at when it comes to this manufacturing process suspected to result in these “impurities” being made.

Last year NDEA was also found in the generic  blood pressure medications that were the subject of recall, however has not yet been suggested as being present in ranitidine.

N-Nitroso-N-methyl-4-aminobutyric acid (NMBA) was the third chemical detected resulting in the latest two recalls of losartan, an angiotensin receptor blocker commonly used to treat hypertension (high blood pressure).  It is believed to have been created during the manufacturing process of the generic drug.

NMBA, according to Toronto Research Chemicals, is a known carcinogen in a wide range of animal species.

Last Fall, ScieGen Pharmaceuticals, Inc. recalled certain lots of Irbesartan, a similar angiotensin receptor blocker used in blood pressure management.

The recalls initially began last summer when FDA recalled a number of lots of valsartan due to an “impurity,” N-nitroso dimethylamine (NDMA) that is known to cause cancer in animals.  Weeks later they additionally found traces of N-nitrosodiethylamine (NDEA).

According to Reuters, earlier last summer, the MHRA, Medicines and Healthcare Products Regulatory Agency, located in the UK, said the appearance of the impurity, N-nitroso dimethylamine (NDMA), came after a change in the process for making valsartan at one facility owned by Zhejiang Huahai Pharmaceuticals, a company in Linhai, China.

With NDEA, data is limited, but due to its classification as a nitrosamine and its prevalence in tobacco smoke it is classified as a probable human carcinogen.

According to New Jersey Department of Health’s website, NDEA has been linked to liver, lung and gastrointestinal tract cancer in animals.

Losartan, valsartan and Irbesartan are medications in the class of angiotensin receptor blockers (ARBs) used for high blood pressure and congestive heart failure.

Those taking either tablet for their blood pressure are urged to not abruptly stop their medication but rather check with their medical provider and pharmacy to see if their particular prescription is involved in the recall.

I suspect more recalls will follow as processes may be similar across multiple pharmaceutical facilities and NMBA, NDMA and NDEA are byproducts that may not be individually unique to just one “brand” of medication manufacturing.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

Published in Health

The CDC is currently investigating close to 450 cases of vaping related illness and 5 reported deaths.  A recent study in the New England Journal of Medicine has found evidence of lipoid pneumonia in a case where a 21 year old became sick after vaping nicotine and tetrahydrocannabinol (THC) daily.

Macrophages, which are scavengers that rid the body of pathogens and other harmful substances in the body, were found to be “lipid-laden,” or full of a fatty substance. They suspect this fatty substance to be caused by inhalation of Vitamin E acetate that was only present in marijuana vaping products and not the average nicotine e-cig.  Vitamin E is commonly used in hand creams, moisturizers and as a supplement due to its oily nature, but is not to be inhaled.

Since the lungs are designed to oxygenate the lungs and exchange out carbon dioxide, oily substances can clog the works.

Experts say the Vitamin E acetate is not believed to be apart of regular e-cigarettes that do not vape THC, the psychoactive component to marijuana.

This is a developing story….

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Vaping linked to seizures

The FDA is investigating 127 reports of seizures in e-cigarette users (up from 35 this Spring).

Many were teenagers and young adults.

Since 2010 the agency has received multiple reports but is unclear if e-cigarettes actually caused the seizures or if there were underlying medical conditions predisposing the neurological disorder.

The 92 additional cases since this April is concerning and the FDA is working to determine if vaping contributes contributes directly to serious neurological conditions.

In April FDA Commissioner Dr. Scott Gottlieb tweeted:

While we’re still learning about the long-term potential benefits and health risks of e-cigs, existing scientific research offers some clear evidence that several of the dangerous chemicals in tobacco smoke are also present in the aerosol of some e-cig products.

Dr. Ned Sharpless, current acting FDA Commissioner, is encouraging people to report adverse events as, “Additional reports or more detailed information about these incidents are vital to help inform our analysis and may help us identify common risk factors and determine whether any specific e-cigarette product attributes, such as nicotine content or formulation, may be more likely to contribute to seizures,” (Reported by CNBC).

What is a seizure?

A seizure occurs when there is abnormal electrical activity in the brain.  If the electricity doesn’t conduct properly, brain function gets disrupted. This could lead to convulsions  (involuntary jerking movements), loss of muscle tone, changes in senses such as vision, hearing and smell, loss of bladder control, loss of consciousness and sometimes stroke, brain damage and death.

HGT0066_neurons-seizure-brain_FS.jpg

 

Nicotine toxicity has been linked to seizures.  E-cigs sometimes contain more nicotine than cigarettes alone. 

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A study published by the American Heart Association found nine different E-cig flavors  to impair blood vessel function, which can impair heart health.

Endothelial cells, which delicately line blood and lymph vessels, were found to become inflamed at low concentrations of some vapor flavors.  And at high concentrations of others, exhibited cell death.  Nitric oxide production, necessary for vessel dilation to improve blood flow, was impaired as well. These are often the same changes seen in early heart disease.

sample_01001118_110141.jpg

 

The 9 flavors (and the chemicals within) cited in the report to cause the endothelial inflammation and/or damage were:

  • Mint (menthol)
  • Vanilla (vanillin)
  • Clove (eugenol)
  • Cinnamon (cinnamaldehyde)
  • Strawberry (dimethylpyrazine)
  • Banana (isoamyl acetate)
  • Butter (diacetyl)
  • Eucalyptus/spicy cooling (eucalyptol)
  • Burnt flavor (acetylpyridine)

Strawberry flavoring appeared to have the most adverse effect on the cells.

Many other flavors were not included in this study, so it's unknown how safe they may be.

For more on the study, read here.

An alternate study published last November looked at vaping flavors and their effects on heart muscle cells.

For more on this study, read here.

The moral?  Just because we love the taste of something, doesn’t mean its safe to inhale.

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Vaping Linked to Heart Disease and Cancer

 

A study from New York University found the nicotine in electronic cigarettes to cause DNA damage similar to cigarette smoking.

Dr. Moon-shong Tang and his colleagues exposed mice to e-cig smoke during a three-month period, 5 days a week for three hours a day.  They found these mice, compared to those breathing filtered air, to have DNA damage to cells in their bladders, lungs and hearts. The amount of nicotine inhaled was approximately 10mg/ml.   That dose would be commonly consumed by many humans who vape.

nicotine.jpg

 

They then looked at human bladder and lung cells and found tumor cells were able to grow more easily once exposed to nicotine and vaping chemicals.

Last May, researchers from Vanderbilt-Ingram Cancer Center in Nashville found e-cig smoke to increase one’s risk of bladder cancer.

In 2015, the University of Minnesota identified chemicals commonly found in e-cig vapor to include:

  • Formaldehyde (human carcinogen)
  • Acetaldehyde (carcinogen related to alcohol drinking)
  • Acrolein (highly irritating and toxic)
  • Toluene (toxic) NNN, NNK (tobacco carcinogens related to nicotine)
  • Metals (possible carcinogens and toxins)

Although electronic cigarette “juice” may appear safe, it could produce harmful chemicals once heated to become a vapor.

A lethal dose of nicotine for an adult ranges from 30-60 mg and varied for children (0.5-1.0 mg/kg can be a lethal dosage for adults, and 0.1 mg/kg for children).  E-cigs, depending on their strengths (0 – 5.4%) could contain up to 54 mg of nicotine per cartridge (a 1.8% e -cig would contain 18mg/ml).

The topic of nicotine increasing one’s vulnerability to cancer is nothing new as decades ago researchers found nicotine to affect the cilia (brush border) along the respiratory tree, preventing mucus production and a sweeping out of carcinogens trying to make their way down to the lungs.

More research needs to be performed but this recent report reminds us that exposing our delicate lung tissue and immune system to vaping chemicals may not be as safe as we think.

For more on the study read here.

Toxic metals found in vaping liquid

Last week, experts warned that many chemicals in vaping liquid may change to toxic substances (once heated) that can irritate the lungs.

Last year one study reported that toxic levels of lead and other metals may leak from the heating coil element into the vapor inhaled during e-cig use.

Researchers at Johns Hopkins Bloomberg School of Public Health found these metals to include:

  • lead
  • nickel
  • manganese
  • chromium
  • arsenic

We’ve known for some time that vaping fluid could contain chemicals that turn toxic once heated, but this study shed light on e-cig metal components causing metal leakage to the vapor making contact with delicate respiratory epithelium (lining).

Reported by Forbes, Rich Able, a medical device marketing consultant, stated the following, “the FDA does not currently test any of the most popular vaping and e-cigarette instruments being manufactured at unregulated factories in Asia that source  low-grade parts, batteries, and materials for the production of these devices,” suggesting that “the metal and parts composition of these devices must be stringently tested for toxic analytes and corrosive compounds.”

These chemicals may act as neurotoxins, affecting our nervous system, cause tissue necrosis (cell death) and even multi-organ failure.  Moreover, they can affect how our immune system reacts to other chemicals as well as foreign pathogens, affecting our ability to fight other diseases.

Although studies have suggested e-cig vapor to be safer than tobacco smoke, not enough research has been done, in the relatively few years vaping has been around, looking at how heat-transformed chemicals and leaked metals affect our breathing, lungs and other organs once absorbed into the body.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

 

Published in Health

Reports of former Vice President Joe Biden’s eye turning “bloody” surfaced this week.  He was speaking at a CNN hosted town hall on climate change when reporters noticed his left eye turned blood red.

 

Biden-Eye-640x335.jpg

The condition however is called a “subconjunctival hemorrhage” and is harmless, but needs some explanation.

What is a subconjunctival hemorrhage?

The conjunctival is a vascular membrane that lines the eye and lids.  When a blood vessel breaks, hemorrhages, it appears dark beefy red over a portion of the white part of the eye.

conjunc.jpg

 

Sometimes these hemorrhages occur when one incurs trauma to the eye or rubs it aggressively, but most often it occurs spontaneously within a week or two as the blood gets cleared by body mechanisms.

However, of note, a subconjunctival hemorrhage could happen when blood pressure rises, such as during a sneeze, laugh, strain when stooling, or cough.  It could also happen if one has a bleeding disorder, or inability to clot.

Although the subconjunctival hemorrhage is benign, those who incur one might consider having their blood pressure checked and labs to ensure they have strong clotting abilities.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

 

Published in Health

Editor’s note: Technically, National Blood Donation Day is September 5th, as Doc D. notes. BUT National Blood Donation week continues through the week ending on the 9th, so here you go.

This year September 5th is National Blood Donation Day.  Blood banks all across America are holding drives to increase our nation’s blood supply.

Governors from nearly all states have proclaimed State Blood Donation Days to show their support.

Every two seconds, someone needs blood.

The American Red Cross provides these startling statistics:

  • Approximately 36,000 units of red blood cells are needed every day in the U.S.
  • Nearly 7,000 units of platelets and 10,000 units of plasma are needed daily in the U.S.
  • Nearly 21 million blood components are transfused each year in the U.S.
  • The average red blood cell transfusion is approximately 3 pints.
  • The blood type most often requested by hospitals is type O.
  • Sickle cell disease affects 90,000 to 100,000 people in the U.S. About 1,000 babies are born with the disease each year. Sickle Cell patients can require blood transfusions throughout their lives.
  • According to the American Cancer Society, about 1.7 million people are expected to be diagnosed with cancer in 2017. Many of them will need blood, sometimes daily, during their chemotherapy treatment.
  • A single car accident victim can require as many as 100 pints of blood.

We wear red today to show our support.

To donate blood visit the following sites:

United Blood Services/BloodHero.com

American Red Cross Blood Drive Locator

Donating blood is a simple process that takes less than 45 minutes.  For those who cannot donate blood, hosting a drive can be just as life saving and easy to do.  Blood banks can host a drive at work on site or through a bloodmobile in the parking lot, with no cost to the host.

UBS-Mobile-Unit.jpg

 

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National Blood Donation Week

Almost all of the United States have declared State Blood Donation Days to help combat our nation’s blood shortage as part of National Blood Donation Week (NBDW).

This year National Blood Donation Week is September 2nd-0th with September 5th being National Blood Donation Day.

The movement began in 2015 when Nationally Syndicated Radio Host Dr. Daliah Wachs, asked Governor Brian Sandoval to proclaim Nevada Blood Donation Day to help fight the state’s blood shortage. The next year she took this movement national asking all governors to proclaim state blood donation days.

From our September 4th post:

Governors in just about every state have already proclaimed September 5th to be their state Blood Donation Day for 2018.

Oklahoma has proclaimed the month of September - Blood Donation Month.

Alaska proclaimed the month of July - Blood Donation Month.

“Blood and platelet donations are currently being distributed to hospitals as fast as donations are coming in, and more donations are needed, especially type O, to replenish the blood supply,” said Laurie Nehring, communications director for the American Red Cross. “We appreciate Dr. Daliah’s efforts to educate the public about the importance of regular blood donations.”

Emergency rooms treating trauma victims, hospitals treating anemic patients, and medical clinics replenishing low blood levels in cancer patients require a steady supply of blood products.

38% of the U.S. population is eligible to donate blood but less than 10% actually do.

“The unified effort across America to proclaim state blood donation days around the Labor Day holiday comes at an important time for patients,” said Mitzy Edgecomb, Blood Systems Vice President, Donor Marketing & Communication. “Blood donations often drop dramatically during the summer months and over holiday weeks when regular donors take time away to enjoy family vacations.  We appreciate and applaud the governors from the multiple states who have called attention to the ongoing need for blood donations and thank those who step forward to make a life-transforming impact on others by giving blood.”

Donating blood is easy and takes less than one hour.  Many places of work can hold blood drives so employees don’t have to take off work (plus you get yummy cookies).

Inconsistent donation patterns during the year result in unpredictable and reliable blood supply numbers, hence donation is requested year round.

United Blood Services suggests donating three times a year.The summer and holiday season appear to be the “driest” in terms of donations.  States and regions frequently need to ship blood to areas who are in need. Blood supplies have been critical in many parts of the country due to natural disasters such as storms and wildfires.

What makes NBDW so unique is that both Republican and Democratic governors are uniting and coming together for a common cause. One pint of blood has the potential to save three lives.  Imagine what the whole country can do!

blood bags

For a list of Governor Proclamations visit here.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in Health

A case report in Annals of Internal Medicine describes a teen who went “blind” from a junk food diet.

A 14 year-old boy described as a “fussy eater” presented to his doctor with fatigue after years of eating meals rich in fries, white bread, chips and processed meat.  He was told to take supplements when they found him to be iron and B12 deficient but progressively over the next 3 years he began to suffer from vision loss.  Upon lab testing he was found to be deficient in iron, copper, selenium, Vitamin D and Vitamin B 12. And upon further testing was found to suffer from optic neuropathy.

He was further treated with supplements and now is under the care of specialists including nutritionists and eating disorder specialists.

His condition stabilized but reportedly he still has deficits such as blind spots  in the middle of his vision (central scotoma), rendering him “legally blind.”

This wasn’t the first case of nutritional optic neuropathy.

optic neuropathy.jpg

 

Above is a picture of the fundi of a 28 year-old male who suffered from central vision loss as a result of his diet which consisted of heavy alcohol use.  The progression of his disease has stabilized with intervention but he too has had to learn to adapt to his central scotoma.

Our eyes need vitamins such as A, a variety of B’s, C, E, and omega-3 fatty acids to name a few. Vitamin D is crucial for bone health and for protection against diabetes and cancer.

Most fast food is rich in carbohydrates, fats, salt and preservatives, and lacking in rich nutrients and amino acids.

So comes the question, are the majority of our youth “malnourished?”

Unless our children are eating diets rich is fruit, vegetables, whole grains, protein, dairy and health fats, they could be at risk of not receiving vital nutrition.

vitamins.png

 

Vitamin supplementation helps but may not satisfy all the nutritional needs of a growing child. Hence in addition to the millions of children who suffer from malnourishment due to poverty, millions more are expected to suffer similarly as a result of poor diet choices.

This is a developing story.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in Health

70 year-old music legend, Edward Mahoney “Eddie Money,” revealed in a video released by his realty TV series “Real Money” that he has stage 4 esophageal cancer.

The episode airs on AXS TV on September 12 and discusses how he went in for a routine screen when he was diagnosed.

He recently underwent heart valve surgery and reports say he also battled pneumonia.

Despite the cancer having spread to his liver, lymph nodes and stomach, he appears optimistic saying cancer has come a long way since the 1950’s and 60’s and “everyday above ground is a good day.”

What is esophageal cancer?

Esophageal cancer can occur anywhere along the gullet/food pipe.  There are different types such as adenocarcinoma (lower portion near the stomach), more commonly seen in Caucasians, and squamous cell carcinoma (middle to upper esophagus) more commonly seen in African Americans.  It’s the 6th common cause of cancer death worldwide and comprises 1% of all cancers diagnosed in the US.

According to the American Cancer Society, estimates for 2019 include:

  • ABOUT 17,650 NEW ESOPHAGEAL CANCER CASES DIAGNOSED (13,750 IN MEN AND 3,900 IN WOMEN)
  • ABOUT 16,080 DEATHS FROM ESOPHAGEAL CANCER (13,020 IN MEN AND 3,060 IN WOMEN)

a-medical-illustration-of-esophageal-cancer-original.jpg

 

What are the symptoms of esophageal cancer?

Early esophageal cancer may not exhibit any signs. However if it progresses, symptoms may include any of the following:

  • abdominal pain
  • heartburn
  • feeling full despite not eating
  • nausea
  • vomiting blood
  • weight loss
  • loss of appetite
  • chest pain
  • cough 

What are the risk factors for esophageal cancer?

Although esophageal cancer appears to afflict men more than women, risk factors  include:

  • Smoking
  • Alcohol use
  • Frequent imbibing of hot liquids
  • Obesity
  • Chronic GERD or heartburn that may have led to esophagus lining changes such as Barrett’s Esophagus disease
  • Vitamin deficiency
  • Drinking liquids that contain lye, an alkaline  chemical present in many soaps
  • Prior radiation to the chest 

What is the prognosis of esophageal cancer?

If caught early and localized, the 5-year survival rate is over 45%. However, if it has spread, the 5 year survival rate can range any where from 5-20%.

How is esophageal cancer treated?

There are a variety of treatments for esophageal cancer including surgery, chemotherapy and radiation.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in Health

Super Bowl Champion Quarterback and Bronco’s General Manager John Elway revealed  to TODAY that he was diagnosed with a debilitating hand condition 15 years ago.  After he retired in 1999 he developed contractures, or permanent bending of his fingers.  It affected both his ring fingers such he couldn’t straighten them out and subsequently couldn’t hold a football.

In the interview he states,

“IT IS HEREDITARY AND IT ALSO CALLED THE ‘VIKING’S DISEASE.’
“IF YOU HAVE A NORWEGIAN BACKGROUND, YOU HAVE A HIGHER CHANCE OF DEVELOPING IT. THAT’S A POSSIBILITY FOR ME, BUT NOBODY ELSE IN MY FAMILY HAS HAD IT. I’M NOT SURE IF ME PLAYING FOOTBALL HAS PLAYED A PART TOO.”

“Viking’s Disease”, or Dupuytren’s Disease, is thought to have originated in the Viking population and spread throughout Northern Europe during the 9th and 10th Century.  It wasn’t until French physician, Baron Guillaume Dupuytren, described the flexion of the fingers and hand contortion that it received its modern name of “Dupuytren’s Contracture.”

In Dupuytren’s disease, the fascia, or fibrous layer that surrounds the muscles and tendons underneath the skin in the hand becomes thickened and tents, or tightens around the local area.  This can cause a contracture, or pulling of the finger to a position in which they can’t extend or straighten back out.

 

 

Risk factors for Dupuytren’s disease with resulting contractures include:

  • Diabetes
  • Genetics
  • Northern European ancestry
  • Older age
  • Male
  • Alcohol use

Treatments include conservative measures such as steroid injections, enzyme injections and therapy and in more severe cases surgical options are available.

John Elway states he chose to go the conservative route and forewent surgery.  It was successful and he now has normal movement of his fingers but the condition can return.  The football legend is currently a spokesperson for the Facts On Hand Campaign, raising awareness of this common condition.

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

 

Published in Health

Jeffrey Epstein's cause of death has been ruled a suicide by hanging; however, there a series of conspiracy theories that suggest he was strangled. There are some distinct physical findings that would differentiate the two. 

66 year-old Jeffrey Epstein, who recently pleaded not guilty of sex trafficking charges, was found dead in his jail cell on August 10.  He had recently been on suicide watch and reports initially suggested he had hung himself by his bed sheet.

However,  the results of the financier’s autopsy suggest he sustained trauma consistent with hanging (after preliminary reports suggested strangulation).  How do forensic experts tell the difference?

Hanging

With hanging, one drops from a height and suspends, incurring a fracture of a neck bone which in turn may sever the spinal cord.

 

hangman's fracture.jpg

 

A severe blood pressure drop can ensue and the victim may die within minutes

As seen above, a “hangman’s fracture” is seen with hyperextension injuries where the pars interarticularis on the pedicle of the C2 vertebrae becomes fractured. The distance of the drop is crucial in determining the success of the execution. A drop to long could cause beheading, a drop too short could cause strangulation.

If they do strangulate ...they asphyxiate (lose air flow), or lose blood flow from their carotid arteries being compromised.

From a capital punishment standpoint, hanging is one of the most common and barbaric ways to execute. Three states still have this form of execution as an option if lethal injection is not available (DE, NH, WA).

Strangulation

Strangulation occurs when one compresses the structures of the neck causing decrease air and blood flow.  It could be executed using a ligature (scarf, sheet, cord) or by one’s hands.  Moreover, it can occur if a hanging drop is improperly calculated.  Many times the hyoid bone is fractured (1/3 of all homicides) as its think U-shape is vulnerable to the forces of strangulation.

 

 

hyoid.jpg

 

 

Injuries incurred

 

So injuries incurred can be similar in both strangulation and hanging, especially if the latter is done improperly and ineffectively severs the spinal cord.

However, since hanging causes a blood pressure drop and strangulation causes a backup of pressure into the head due to vessel constrictions, on autopsy one may find more signs of hemorrhage (retinal hemorrhages) and swelling (brain edema) during strangulation than accurate hanging.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

 

 

 

 

Published in News & Information

The start of the school year may be the most exciting time of the year (well maybe just for parents…) However going back to school can bring on a slew of health issues, so let’s look at how we can prevent them.

Good hand-washing

The most basic and easiest thing we can teach our children is to wash their hands whenever they touch something dirty, use the restroom or before they eat. True we need to be exposed to germs to increase our immunity, but some of these germs aren’t friendly and bring on colds, flu, rashes and intestinal bugs when we’re not expecting it.

 

Good nutrition

If a child skips breakfast or eats primarily sugar and carbohydrates, they not only face immune system weaknesses but also poor attention, concentration and ability to do well in school. Make sure your kids eat a good breakfast with protein and Vitamin C-packed fruits before heading for the school bus.

Good sleep

If the kids were accustomed to staying up late and now have to wake up at 5:30 in the morning, they might spend much of their school day nodding off.  Insufficient sleep has been linked to obesity as well as poor immunity so get them on a regular schedule of a bedtime that will allow 8-10 hours of sleep a night.

 

 

Proper clothing

Chances are your child grew an inch this summer, so shoes and clothing may be a little tight.  Use the finger tip rule for pants and shoes to make sure there is room to grow. And avoid accessories that your kids can chew on, swallow or can lose as they will concentrate more on the lost earring than what the teacher is saying.

Talk to them, often

Back to school can bring on anxiety in many children and make sure you have open conversations to allow them to share their fears.  Bullies make themselves apparent the first few days of school, and your child may be getting wet willies, wedgies or their lunch stolen right under the teacher’s nose.

Be aware of what’s going around the school

If joining the PTA doesn’t appeal to you, at least make buddies with parents of children in your kid’s class as they will be the first to notify you if lice, pink eye or sore throat is making the rounds before a school may.

Discuss stranger safety with your children

If you child walks to or from school or a bus stop, educate them on how to avoid strangers and what to do if approached by one.  Consider driving your child if you think they are at risk.

Teachers face health risks

In 2006, a study published in BMC Public Health, found teachers to suffer more from ENT (ear, nose and throat) ailments, dermatitis, bladder infections, bronchitis, conjunctivitis and varicose veins than those who work in other professions.  Teachers are on the front lines when it comes to cough and cold season as they come into contact with hundreds of children a day, many of whom are contagious prior to knowing they are symptomatic. Once the fever shows itself, parents may keep the child home but the student already exposed others earlier in the day.

Standing on one’s feet for extended hours does a number on the peripheral vascular system, manifesting in leg swelling and at times, varicose veins.  And when breaks are infrequent, bladder infections brew since one can’t visit the bathroom when they need.

Long work hours during the week prevent many educators from seeing a health care provider and many health plans don’t have providers who work on the weekends.  Teachers can very easily put their own health care needs on the back burner during a long school year.

Taking care of school business is paramount during the school year but parents, teachers and kids need to still put health and safety.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

Published in Health

A 6th case of West Nile virus has been confirmed in Clark County, Nevada. The Southern Nevada Health District has declared an “outbreak of mosquito-borne diseases” following new cases of the virus being reported.

This summer has been a wetter season in the Southwest, most likely causing an uptick in mosquito activity.

States throughout the country have been reporting cases of West Nile virus as well, with the highest occurring in Arizona (42 cases as of 7/23/19 per CDC).

 

wnv-activity-07092019.jpg

 

West Nile Virus Disease Cases* and Presumptive Viremic Blood Donors by State – United States, 2019 (as of July 23, 2019)

State

Neuroinvasive

Disease Cases†

Non–neuroinvasive

Disease Cases

Total

cases

Deaths

Presumptive viremic

blood donors‡

Arizona

42

15

57

1

16

Arkansas

1

0

1

1

0

California

2

0

2

1

1

Colorado

0

1

1

0

0

Iowa

0

2

2

0

0

Kentucky

1

0

1

0

0

Maryland

0

1

1

0

0

Missouri

1

0

1

0

0

Nebraska

1

0

1

1

0

Nevada

1

0

1

0

0

New Jersey

1

0

1

0

0

North Dakota

1

0

1

0

0

Oklahoma

1

2

3

0

0

South Dakota

0

1

1

0

0

Virginia

0

1

1

0

0

Wyoming

1

0

1

0

0

Totals

53

23

76

4

17

*INCLUDES CONFIRMED AND PROBABLE CASES.
†INCLUDES CASES REPORTED AS MENINGITIS, ENCEPHALITIS, OR ACUTE FLACCID PARALYSIS.
‡PRESUMPTIVE VIREMIC BLOOD DONORS (PVDS) ARE PEOPLE WHO HAD NO SYMPTOMS AT THE TIME OF DONATING BLOOD THROUGH A BLOOD COLLECTION AGENCY, BUT WHOSE BLOOD TESTED POSITIVE WHEN SCREENED FOR THE PRESENCE OF WEST NILE VIRUS. SOME PVDS DEVELOP SYMPTOMS AFTER DONATION.
PLEASE REFER TO STATE HEALTH DEPARTMENT WEB SITES FOR FURTHER DETAILS REGARDING STATE CASE TOTALS.

What is West Nile virus?

West Nile virus was originally discovered in the 1930’s in the West Nile district of Uganda.  It is believed to have reached the United States in the late 1990’s.

It’s in the family of Flaviviridae in which the disease is vector transmitted, such as by ticks, or mosquitoes, and can infect mammals as hosts. West Nile is in the same family as Zika, Yellow Fever, Dengue Fever, and Japanese Encephalitis.

Culex genus/species of mosquitoes are the usual culprit.  They feed from evening to morning, hence are more active during those times.

How is West Nile transmitted?

A mosquito contracts the disease while feeding on an infected bird and then can transmit it to humans.

 

WNV-transmission-cycle.jpg

 

What are the symptoms of West Nile virus infections?

80% of those infected do not exhibit symptoms.  Some however, may elicit the following if they have mild illness:

  • Fever
  • Body aches
  • Fatigue
  • Nausea
  • Vomiting
  • Joint  pains
  • Weakness
  • Rash

Rarely (1 in 150 people) may become seriously ill with neuroinvasive symptoms.  These include:

  • Headache
  • Neck pain/Stiff neck
  • High fever
  • Sensitivity to light (photophobia)
  • Tremors
  • Weakness
  • Paralysis
  • Confusion
  • Disorientation
  • Seizures
  • Coma
  • Death

Since mosquitoes are the primary vector, avoiding them is paramount to limiting infection.  We recommend the following:

Clean up areas of standing water around the house such as kiddie pools, puddles, buckets as they provide a breeding ground for mosquitoes.

Wear light long sleeve clothing, pants tucked into socks/shoes when outside.

Use DEET or insect repellant that can also be sprayed onto clothes when planning to be outdoors.

Be aware that many mosquitoes are active from dusk till dawn.

If bitten by a mosquito, contact your local medical provider if you have any of the aforementioned symptoms.

 

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Daliah Wachs is a guest contributor to GCN news, her views and opinions, medical or otherwise, are her own. Doctor Wachs is an MD,  FAAFP and a Board Certified Family Physician.  The Dr. Daliah Show , is nationally syndicated M-F from 11:00 am - 2:00 pm and Saturday from Noon-1:00 pm (all central times) at GCN.

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