William Browning William Browning – Thu Jun 9, 2:16 pm ET
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The Greene County (Mo.) Health Department has issued a memo to health care workers who are treating injured victims of May's deadly Joplin tornado, warning them that a powerful fungus has infected patients' wounds.
The Springfield News-Leader reports as many as nine cases have been reported in tornado victims across the area in various hospitals. Once the aggressive fungus -- called zygomycosis -- enters the body, it causes the death of infected cells. Three or four patients, who otherwise would have survived their wounds, have died from it.
If the fungus stays in a limb, like an arm or leg, some treatments have necessitated amputation to save the patient. Others with wounds near the head weren't so lucky -- as soon as brain tissue started dying, it was too late to save the patient.
The National Institutes of Health says this rapid form of infection most often occurs in patients with suppressed immune systems. One study in 2009 noted a diabetes patient who died of the fungal infection at age 48. Despite being treated early, the man's health rapidly declined as the fungus spread through his lungs.
Infections spread through the blood and affects blood circulation. It is unknown how many people may be suffering from infections, but the problem doesn't stop with those injured by the tornado.
KYTV in Springfield reports those helping with cleanup efforts may become scratched by nails or splinters and any fungus residue on those objects may infect someone.
Anyone with diabetes should be extremely careful. The National Institutes of Health lists severe symptoms of the infection: fever, headache, sinus pain, and swelling. Complications that can arise from these fungal infections include nerve damage, blindness, blood clots to the brain and lungs, or even death in extreme cases.
Cases of the deadly fungal infection have shown up in massive disasters before such as the 2004 tsunami off the coast of Indonesia. Health officials in Greene County stated in their memo that this particular infection is "invasive" and that aggressive treatment may be needed "within 24 hours" of reoccurring symptoms.
Any patients suspected of having this infection have been told to seek the guidance of a trauma surgeon or the infectious disease doctor on call.
William Browning, a lifelong Missouri resident, writes about local and state issues for the Yahoo! Contributor Network. Born in St. Louis, Browning earned his bachelor's degree in English from the University of Missouri. He currently resides in Branson.
Showing posts with label diabetes and death. Show all posts
Showing posts with label diabetes and death. Show all posts
Wednesday, June 15, 2011
Wednesday, April 27, 2011
Cause of Blood Vessel Damage in People with Diabetes Discovered
Researchers have identified a key mechanism that appears to contribute to blood vessel damage in people with diabetes....
The researchers said studies in mice show that the damage appears to involve two enzymes, fatty acid synthase (FAS) and nitric oxide synthase (NOS) that interact in the cells that line blood vessel walls. First author Xiaochao Wei said, "We already knew that in diabetes there's a defect in the endothelial cells that line the blood vessels."
"People with diabetes also have depressed levels of fatty acid synthase. But this is the first time we've been able to link those observations together."
Wei studied mice that had been genetically engineered to make FAS in all of their tissues except the endothelial cells that line blood vessels. These so-called FASTie mice experienced problems in the vessels that were similar to those seen in animals with diabetes. "It turns out that there are strong parallels between the complete absence of FAS and the deficiencies in FAS induced by lack of insulin and by insulin resistance," said Clay F. Semenkovich, the Herbert S. Gasser Professor of Medicine, professor of cell biology and physiology and chief of the Division of Endocrinology, Metabolism and Lipid Research, Washington University in St. Louis, Missouri.
Comparing FASTie mice to normal animals, as well as to mice with diabetes, Wei and Semenkovich determined that mice without FAS, and with low levels of FAS, could not make the substance that anchors nitric oxide synthase to the endothelial cells in blood vessels. "We've known for many years that to have an effect, NOS has to be anchored to the wall of the vessel," Semenkovich said.
"Xiaochao discovered that fatty acid synthase preferentially makes a lipid that attaches to NOS, allowing it to hook to the cell membrane and to produce normal, healthy blood vessels." In the FASTie mice, blood vessels were leaky, and in cases when the vessel was injured, the mice were unable to generate new blood vessel growth.
The actual mechanism involved in binding NOS to the endothelial cells is called palmitoylation. Without FAS, the genetically engineered mice lose NOS palmitoylation and are unable to modify NOS so that it will interact with the endothelial cell membrane. That results in blood vessel problems.
It's a long way, however, from a mouse to a person, so the researchers next looked at human endothelial cells, and they found that a similar mechanism was at work.
"Our findings strongly suggest that if we can use a drug or another enzyme to promote fatty acid synthase activity, specifically in blood vessels, it might be helpful to patients with diabetes," Wei said.
Journal of Biological Chemistry. Jan. 2011
The researchers said studies in mice show that the damage appears to involve two enzymes, fatty acid synthase (FAS) and nitric oxide synthase (NOS) that interact in the cells that line blood vessel walls. First author Xiaochao Wei said, "We already knew that in diabetes there's a defect in the endothelial cells that line the blood vessels."
"People with diabetes also have depressed levels of fatty acid synthase. But this is the first time we've been able to link those observations together."
Wei studied mice that had been genetically engineered to make FAS in all of their tissues except the endothelial cells that line blood vessels. These so-called FASTie mice experienced problems in the vessels that were similar to those seen in animals with diabetes. "It turns out that there are strong parallels between the complete absence of FAS and the deficiencies in FAS induced by lack of insulin and by insulin resistance," said Clay F. Semenkovich, the Herbert S. Gasser Professor of Medicine, professor of cell biology and physiology and chief of the Division of Endocrinology, Metabolism and Lipid Research, Washington University in St. Louis, Missouri.
Comparing FASTie mice to normal animals, as well as to mice with diabetes, Wei and Semenkovich determined that mice without FAS, and with low levels of FAS, could not make the substance that anchors nitric oxide synthase to the endothelial cells in blood vessels. "We've known for many years that to have an effect, NOS has to be anchored to the wall of the vessel," Semenkovich said.
"Xiaochao discovered that fatty acid synthase preferentially makes a lipid that attaches to NOS, allowing it to hook to the cell membrane and to produce normal, healthy blood vessels." In the FASTie mice, blood vessels were leaky, and in cases when the vessel was injured, the mice were unable to generate new blood vessel growth.
The actual mechanism involved in binding NOS to the endothelial cells is called palmitoylation. Without FAS, the genetically engineered mice lose NOS palmitoylation and are unable to modify NOS so that it will interact with the endothelial cell membrane. That results in blood vessel problems.
It's a long way, however, from a mouse to a person, so the researchers next looked at human endothelial cells, and they found that a similar mechanism was at work.
"Our findings strongly suggest that if we can use a drug or another enzyme to promote fatty acid synthase activity, specifically in blood vessels, it might be helpful to patients with diabetes," Wei said.
Journal of Biological Chemistry. Jan. 2011
Tuesday, March 22, 2011
Diabetes to double or triple in U.S. by 2050: government
WASHINGTON (Reuters Life!) – Up to a third of U.S. adults could have diabetes by 2050 if Americans continue to gain weight and avoid exercise, the Centers for Disease Control and Prevention projected on Friday.
The numbers are certain to go up as the population gets older, but they will accelerate even more unless Americans change their behavior, the CDC said.
"We project that, over the next 40 years, the prevalence of total diabetes (diagnosed and undiagnosed) in the United States will increase from its current level of about one in 10 adults to between one in five and one in three adults in 2050," the CDC's James Boyle and colleagues wrote in their report.
"These are alarming numbers that show how critical it is to change the course of type-2 diabetes," CDC diabetes expert Ann Albright said in a statement.
"Successful programs to improve lifestyle choices on healthy eating and physical activity must be made more widely available because the stakes are too high and the personal toll too devastating to fail."
The CDC says about 24 million U.S. adults have diabetes now, most of them type-2 diabetes linked strongly with poor diet and lack of exercise.
Boyle's team took census numbers and data on current diabetes cases to make models projecting a trend. No matter what, diabetes will become more common, they said.
"These projected increases are largely attributable to the aging of the U.S. population, increasing numbers of members of higher-risk minority groups in the population, and people with diabetes living longer," they wrote.
Diabetes was the seventh-leading cause of death in the United States in 2007, and is the leading cause of new cases of blindness among adults under age 75, as well as kidney failure, and leg and foot amputations not caused by injury.
"Diabetes, costing the United States more than $174 billion per year in 2007, is expected to take an increasingly large financial toll in subsequent years," Boyle's team wrote.
The numbers are certain to go up as the population gets older, but they will accelerate even more unless Americans change their behavior, the CDC said.
"We project that, over the next 40 years, the prevalence of total diabetes (diagnosed and undiagnosed) in the United States will increase from its current level of about one in 10 adults to between one in five and one in three adults in 2050," the CDC's James Boyle and colleagues wrote in their report.
"These are alarming numbers that show how critical it is to change the course of type-2 diabetes," CDC diabetes expert Ann Albright said in a statement.
"Successful programs to improve lifestyle choices on healthy eating and physical activity must be made more widely available because the stakes are too high and the personal toll too devastating to fail."
The CDC says about 24 million U.S. adults have diabetes now, most of them type-2 diabetes linked strongly with poor diet and lack of exercise.
Boyle's team took census numbers and data on current diabetes cases to make models projecting a trend. No matter what, diabetes will become more common, they said.
"These projected increases are largely attributable to the aging of the U.S. population, increasing numbers of members of higher-risk minority groups in the population, and people with diabetes living longer," they wrote.
Diabetes was the seventh-leading cause of death in the United States in 2007, and is the leading cause of new cases of blindness among adults under age 75, as well as kidney failure, and leg and foot amputations not caused by injury.
"Diabetes, costing the United States more than $174 billion per year in 2007, is expected to take an increasingly large financial toll in subsequent years," Boyle's team wrote.
Saturday, February 5, 2011
Motivating a Teen With Type 1 Diabetes
Q: My 16-year-old son is having difficulty staying motivated to consistently take care of his diabetic needs like checking his blood sugar often and keeping a log book. His doctor hospitalized him at the start of school to establish better control — his first hospitalization since diagnosis with type 1 10 years ago. He is active in sports, likes to stay up late, eats only 15 to 30 carbs for breakfast, and is on a regimen of Lantus twice daily and Humalog for meals and highs (injections, no pump.) His last A1c was 10.3. Do you have suggestions for helping him be motivated to care for himself?
— Janelle
A:
That's a tough situation indeed. Many of my colleagues who care for teenaged patients have similar moments of exasperation. As you know so well, the teen years are filled with layers of complexities for kids themselves and their families. There are many issues that become priorities in any teenager's life, among them the challenges presented by their own growth and development. These issues become even more complicated for a teenager with diabetes.
Adolescence is a time of great change, and with physical growth come greater insulin requirements. And with rebellion, experimentation and the need for peer acceptance comes greater non-adherence. In addition, while trying to find and assert their own identity, teens become less reliant on mom and dad. The challenge for parents is equally great and the solutions, unfortunately, are usually time-consuming and labor-intensive.
Your son is doing certain things for which he should be congratulated, including getting involved in sports, carbohydrate counting and injecting his insulin several times a day. These are feats that many of my adult patients do not accomplish. Motivating your son further might require one or more of the following:
1.Understanding his attitude towards frequent glucose checks and his coping and problem-solving skills will help you in identifying specific ways to help him change his behavior.
2.Assessing his knowledge-base about the need to check his sugar levels and his knowledge of glucose and insulin balance during athletic engagements can identify gaps, which can be easily addressed.
3.Understanding his priorities and academic responsibilities and showing empathy to these daily challenges can help you provide a structure that is conducive to checking blood glucose levels and diabetes self-management.
4.Exploring the barriers of checking his sugar level at school, as well as the challenges he might face from his peers about having diabetes, doing frequent glucose checks and injecting insulin, might uncover issues that he finds difficult to discuss. Since you live in a small town, there might not be many other kids living with diabetes. Perhaps your son can connect with other kids with diabetes via the Internet for peer support. A good place to start is the American Diabetes Association.
5.More importantly, understanding your communication pattern with your son and assessing its effectiveness will help you find a happy medium between too much involvement and too little engagement. Empathy is important, but so is leaving him room to make his own decisions. In other words, asking him how he can meet the challenge of good glucose control might also be more effective than telling him to make a specific change in his behavior.
6.When exploring these areas, you should enlist the help of your son's doctor as well as a psychologist or diabetes educator in your area. In addition, if you find that there are barriers at school that prevent your son from checking glucose, you should involve the school and teachers. Some teens like taking leadership roles in teaching others about diabetes, advocating for students with diabetes and organizing groups. This gives them the motivation for also managing their diabetes better. Teachers can be recruited to stage such a forum for your son and perhaps other teens. Other possible venues you might explore include religious organizations, social clubs, and community fitness centers.
Finally, this might be time to consider the insulin pump, which many teens like because it allows them better control. I wish you much luck and hope you will write back with further questions or to tell us how you and your son are doing.
— Janelle
A:
That's a tough situation indeed. Many of my colleagues who care for teenaged patients have similar moments of exasperation. As you know so well, the teen years are filled with layers of complexities for kids themselves and their families. There are many issues that become priorities in any teenager's life, among them the challenges presented by their own growth and development. These issues become even more complicated for a teenager with diabetes.
Adolescence is a time of great change, and with physical growth come greater insulin requirements. And with rebellion, experimentation and the need for peer acceptance comes greater non-adherence. In addition, while trying to find and assert their own identity, teens become less reliant on mom and dad. The challenge for parents is equally great and the solutions, unfortunately, are usually time-consuming and labor-intensive.
Your son is doing certain things for which he should be congratulated, including getting involved in sports, carbohydrate counting and injecting his insulin several times a day. These are feats that many of my adult patients do not accomplish. Motivating your son further might require one or more of the following:
1.Understanding his attitude towards frequent glucose checks and his coping and problem-solving skills will help you in identifying specific ways to help him change his behavior.
2.Assessing his knowledge-base about the need to check his sugar levels and his knowledge of glucose and insulin balance during athletic engagements can identify gaps, which can be easily addressed.
3.Understanding his priorities and academic responsibilities and showing empathy to these daily challenges can help you provide a structure that is conducive to checking blood glucose levels and diabetes self-management.
4.Exploring the barriers of checking his sugar level at school, as well as the challenges he might face from his peers about having diabetes, doing frequent glucose checks and injecting insulin, might uncover issues that he finds difficult to discuss. Since you live in a small town, there might not be many other kids living with diabetes. Perhaps your son can connect with other kids with diabetes via the Internet for peer support. A good place to start is the American Diabetes Association.
5.More importantly, understanding your communication pattern with your son and assessing its effectiveness will help you find a happy medium between too much involvement and too little engagement. Empathy is important, but so is leaving him room to make his own decisions. In other words, asking him how he can meet the challenge of good glucose control might also be more effective than telling him to make a specific change in his behavior.
6.When exploring these areas, you should enlist the help of your son's doctor as well as a psychologist or diabetes educator in your area. In addition, if you find that there are barriers at school that prevent your son from checking glucose, you should involve the school and teachers. Some teens like taking leadership roles in teaching others about diabetes, advocating for students with diabetes and organizing groups. This gives them the motivation for also managing their diabetes better. Teachers can be recruited to stage such a forum for your son and perhaps other teens. Other possible venues you might explore include religious organizations, social clubs, and community fitness centers.
Finally, this might be time to consider the insulin pump, which many teens like because it allows them better control. I wish you much luck and hope you will write back with further questions or to tell us how you and your son are doing.
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