10 Crohn’s Friendly Recipes

Crohn’s and Colitis Awareness Week

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While what you eat isn’t a surefire way to cause, or cure, Crohn’s disease, certain foods may trigger a flare or make your symptoms worse. Eating a healthy diet can help you manage your nutrition intake, which is especially important during a flare-up. However, knowing which foods to eat or avoid isn’t always easy. Crohn’s disease affects everyone differently, and you’ll need to figure out what works — or doesn’t work — for you. Some common food triggers include spicy, fatty, and gas-producing foods, and many people with Crohn’s need to limit dairy products and high-fiber foods such as whole grains and beans. But that doesn’t mean your diet needs to be bland. Try the following recipes to spice up your meals. If any of the ingredients are known problem foods for you, you can get creative with substitutions.

Click the link below to be transfered to the Everyday Health recipes!

https://www.everydayhealth.com/crohns-disease/diet/crohns-friendly-recipes/#01

What is Crohn’s and Ulcerative Colitis?

December 1-7: Crohn’s and Colitis Awareness Week

ulcerative-colitis-crohns-different-tunes

Crohn’s disease and Ulcerative colitis (UC) are both under the umbrella of Inflammatory bowel disease (IBD) and affect at least 1.6 million Americans and 112 million worldwide. While treatments for these diseases are available, there is not yet a known cure. These diseases are also very tricky because every person’s body reacts differently which means that there is not one treatment, but many different methods and approaches to managing the symptoms of each case. Many people affected by Crohn’s or UC may not even be aware that they have it, as symptoms vary in frequency and severity, and may take several doctor visits to diagnose.

Crohn’s disease was first discovered in 1932 by Burrill Crohn, Leon Ginzberg, and Gordon D. Oppenheimer. At the time, it was only identified as being a “new disease entity”, but was later named by those who discovered it. (CCFA) Reports of this disease date back to the early 1900s. Ulcerative Colitis was first described in 1875 by Wilks and Moxon, two English physicians. Reports of UC date all the way back to before the Civil War, though there are reports of similar symptoms before that when the practice of medicine was less specific.

Crohn’s disease and Ulcerative colitis (UC) are only two of the inflammatory diseases (there are many others) that affect the gastrointestinal (GI) tract. Crohn’s disease can affect any of the GI tract, but UC affects only the large intestine and the rectum. When these areas are irritated and inflamed, it inhibits the body’s ability to properly absorb nutrients and water, as well as affecting the elimination of waste, which can then lead to additional health problems. Early symptoms of the disease include abdominal cramps, diarrhea, fatigue, loss of appetite, fever, and blood in your stool.

crohns diagram

One of the reasons why there is yet a cure for these types of IBD is because the diseases themselves are not completely understood. It is known, however, that the genes, immune system, and environmental factors all interact to cause the diseases to present. For people with IBD, the body mistakes the healthy and harmless bacteria in the digestive tract as “harmful invaders” and this causes the body to have an immune response. The immune response is what then causes the inflammation to occur in the gut. The main issue for IBD is that this inflammation then becomes chronic, because the immune response does not stop happening, which can result in ulcers and “thickening of the intestinal wall”. (CCFA)

Types of medical treatment for IBD include medication and surgical. Medications largely stem around anti-inflammatory agents which can help to control the irritation and inflammation. There are also antibiotics which can be used to target infections that occur because of the overgrowth of bacteria and other digestive flora. For people who cannot get control of these diseases with medication, sometimes surgery is needed. Those with Crohn’s are at a greater chance of needing surgery with statistics around 70% of those with Crohn’s. This surgery, however, is only a treatment for the disease and not a cure. As Crohn’s can affect the entirety of the digestive tract, these patients can have a recurrence within 3 years. For UC, around 30% will need surgery which involves the removal of the colon and rectum (the areas affected by the disease). As this is the only area affected by the UC, those patients who have this surgery are cured of their UC.

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Interestingly, even though it is the digestive system that is affected dietary treatments for Crohn’s and UC vary widely. Since for Crohn’s, the disease can affect different areas, it is not possible to assign a specific diet to help in the treatment of the whole population of disease. However, there are many recommendations for diet that can be tested per individual as different foods can cause differing bacteria reactions for individuals. For people affected by the disease it can be helpful to start a food diary to track your nutrition and also be aware of what you ingested if something is causing a flair up in your symptoms.

If this is a disease that affects you, do not despair. There are many options for treating and dealing with the symptoms and style of life that comes with having a digestive disorder. The first step to dealing with Crohn’s or UC is to fully accept the diagnosis and move forward with living your definition of a full and healthy life. The biggest deterrent for those diagnosed with these digestive diseases from remission and relief is the attitude and approach to recovery. Those diagnosed who have the greatest success with treating their diseases are those who stay disciplined and focused on their goal of remission.

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For more information and resources, take a look at the website for the Crohn’s & Colitis Foundation included in our sources. Connect with your community, explore the current research, and learn how to help others and yourself!

 

Sources:

http://www.crohnscolitisfoundation.org
http://www.crohnscolitisfoundation.org/resources/facts-about-inflammatory.html
https://www.healthline.com/health/crohns-disease#diet

5 new life-saving cancer developments New studies are paving the way for faster diagnosis, better treatment — and more lives saved.

Article Source: https://www.mnn.com/health/fitness-well-being/blogs/new-life-saving-cancer-developments
Cancer researcer

Cancer is complex, but researchers are breaking new ground in understanding the many types of the disease. (Photo: science photo/Shutterstock)

Cancer. We’re all touched by it in one way or another, whether we are survivors ourselves, or our friends or loved ones have been affected by the disease. But while the statistics are sometimes grim — the number of new cancer cases is projected to rise to 22 million within the next 20 years, according to the World Health Organization— there are also rays of light in cancer research that offers hope for better options when it comes to diagnosis, treatment and a cure.

Here’s a snapshot of four breakthroughs happening right now in cancer research that are certain to save lives in the near future.

1. New tools to fight childhood cancer

Childhood cancerBy creating maps of childhood cancer tumors and sharing them with the world, researchers have opened the door for new breakthroughs in diagnosis and treatment. (Photo: frantab/Shutterstock)

Cancer is complex, as each type causes a unique reaction within the body and reacts differently to treatment. Now, thanks to a team of U.S. scientists at the Howard Hughes Medical Institute (HHMI), researchers around the world will have models of 12 common types of childhood cancer that they can use to better understand these complex reactions and test how various treatments will affect different cancer cells.

The team grew cells from patient tumors in mice and created nearly 100 models of 12 types of pediatric cancer, HHMI said in a statement. They’re making the samples available for free to the scientific community by publishing their data in the journal Nature. This new wealth of information is predicted to break open many areas of childhood cancer research.

The 12 cancers they modeled are:

  • Neuroblastoma
  • Osteosarcoma
  • Rhabdomyosarcoma
  • Retinoblastoma
  • Wilms tumours
  • Ewing sarcomas
  • High-grade sarcoma
  • Malignant rhabdoid tumour
  • Synovial sarcoma
  • Renal medullary carcinoma
  • Desmoplastic small round cell tumor
  • Epithelioid sarcoma

2. Breakthroughs in immunotherapy treatment

T cells attacking cancer cellIn this illustration, T-cells (gray) can be seen attacking a cancer cell (hot pink). (Photo: royaltystockphoto.com/Shutterstock)

Current treatment options for cancer include chemotherapy, radiation and immunotherapy, which means using the body’s own immune system to fend off the disease. Of the three, immunotherapy is the least devastating to the body as a whole because it relies on targeted cancer destruction rather than attacking all of the cells in the general area of the cancer. So a breakthrough in cancer immunotherapy treatment is a big deal. Recently, there have been two.

The Food and Drug Administration recently approved the use of a new cell-based gene therapy to treat acute lymphoblastic leukemia (ALL), which is a cancer of blood and bone marrow and the most common childhood cancer in the U.S. The treatment involved removing cells from a patient’s own immune system, genetically modifying them to kill cancer cells, and then sending them back into the patient to wipe out the disease.

The drug is called Kymriah, or CAR-T-cell therapy, and it is changing the outcome for patients with this type of cancer. In a clinical study, 63 ALL patients were given the treatment after their cancer failed to respond to other treatment methods. After three months, 83 percent of those patients were in remission.

In another immunotherapy research breakthrough, a team of scientists lead by researchers at the National Cancer Institute have identified the specific genes that can help improve success with the treatment. In the past, doctors have been baffled when certain tumors don’t respond to immunotherapy treatment. This study identified 100 genes that play a role in the immunotherapy process. With this information, doctors can more easily identify issues that could hinder treatment, such as a malfunction in one of the identified genes.

Researchers are hoping this study will serve as a blueprint to help cancer scientists better understand immunotherapy and develop new treatments to circumvent resistant tumors.

3. Advances in melanoma diagnoses

Dermatologist inspecting a new moleNew mole? It’s more likely to be melanoma than a mole you’ve had for a long time. (Photo: Pop Paul-Catalin/Shutterstock)

Check those moles and stay on top of what your skin looks like. A team of Italian and Greek researchers published a study in the Journal of the American Academy of Dermatology that says new moles are more likely to pop up as the result of melanoma. The team also found that when melanoma does develop from an existing mole, it’s likely to be thinner than those that come from new moles, suggesting a better possible outcome for the patient. Armed with this new knowledge, doctors can make better and more immediate recommendations for their skin cancer patients.

4. A link between breast cancer and heart health

Woman with breast cancer ribbonCould cholesterol medications be a new option for breast cancer prevention? (Photo: Dolores Giraldez Alonso/Shutterstock)

What’s the link between breast cancer and heart health? Researchers recently presented a study at the European Society of Cardiology Congress in Barcelona that found women with a history of high cholesterol tend to have lower rates of breast cancer, suggesting that statin drugs — often prescribed to treat high cholesterol — may also offer protective benefits when it comes to breast cancer.

In a review that included more than 32,000 women — half with high cholesterol and half without — researchers found that women who were taking statin medications to control their high cholesterol were 33 percent less likely to develop breast cancer than those whose cholesterol levels were normal. And the women with high cholesterol who did develop breast cancer were 40 percent less likely to die over the 14-year study period than women who had developed breast cancer but did not have high cholesterol.

The study’s authors don’t know for sure why women with high cholesterol would have a lower incidence and a higher survival rate for breast cancer, but they think it might have something to do with the statin drugs, which not only reduce cholesterol but also have been shown to reduce overall inflammation in the body. This finding could help improve treatment options for women battling the disease.

5. A pen that detects cancer during surgery

This last development in cancer research isn’t as far along as some of the others on this list, but a handheld device called the MasSpec Pen is so revolutionary that it warranted an honorable mention, so to speak.

The pen-shaped device is designed to help surgeons determine if tissue is cancerous, which means they’re able to remove more of a cancerous tumor during a surgery with less risk of leaving any cancerous tissue behind. It takes a small sample of molecules from the tissue through a drop of water at the tip of the pen, then passes them through a mass spectrometer. About 10 seconds later, it tells doctors whether the tissue is cancerous or not, and what kind of cancer it is.

“If you talk to cancer patients after surgery, one of the first things many will say is ‘I hope the surgeon got all the cancer out,’” Livia Schiavinato Eberlin, an assistant professor of chemistry at the University of Texas at Austin, who designed the study and led the team, said in a press release. “It’s just heartbreaking when that’s not the case. But our technology could vastly improve the odds that surgeons really do remove every last trace of cancer during surgery.”

This new invention is much faster than the current process, which UT Austin explains:

The current state-of-the-art method for diagnosing cancers and determining the boundary between cancer and normal tissue during surgery, called Frozen Section Analysis, is slow and sometimes inaccurate. Each sample can take 30 minutes or more to prepare and interpret by a pathologist, which increases the risk to the patient of infection and negative effects of anesthesia. And for some types of cancers, frozen section interpretation can be difficult, yielding unreliable results in as many as 10 to 20 percent of cases.

Though the pen has not yet gone through clinical trials, early tests suggest the pen is accurate about 96 percent of the time.

SLMA September – Cholesterol Awareness

Article Source: https://www.houmatimes.com/health_and_wellness/slma-september—cholesterol-awareness/article_93f7e882-9242-11e7-9f9b-b337abd6dd90.html

 

Back to school is just around the corner, but September is about more than just new books and school clothes, it’s also Cholesterol Awareness Month. Celebrate the start of fall by learning more about cholesterol and how you can help keep your body healthy.

What is Cholesterol?

We often hear and talk about cholesterol but may not know exactly what it means. Cholesterol actually isn’t a bad thing; it’s a waxy, soft, fat-like substance that our bodies need to produce cell membranes and other important substances. The liver produces the cholesterol needed by the body to function properly. But cholesterol also comes from the food we eat, specifically food from animals, like meat and full-fat dairy. These foods also contain saturated and trans fats which signal your liver to produce more cholesterol. This can result in levels that are too high. Nearly one-third of adults in the United States have high cholesterol levels.

Types of Cholesterol

There are two types of cholesterol: low-density lipoprotein (LDL) and high-density lipoprotein (HDL). LDL is known as bad cholesterol because it carries particles of cholesterol around your body in the bloodstream and leaves them on the walls of your arteries. This results in build up along the artery walls so they become hard and narrow. On the other hand, HDL is known as good cholesterol because it works to remove cholesterol from your bloodstream, taking it to the liver so it can be broken down. Having high levels of HDL and low levels of LDL is ideal.

Causes of High Cholesterol

A number of factors can influence your cholesterol levels, including the following:

● Obesity – Extra weight increases LDL levels

● Inactivity – Regular physical activity helps lower LDL and increase HDL

● Poor diet – Diets high in saturated fat and cholesterol increase the level of LDL in the bloodstream

● Family genetics – Your genes can impact how much cholesterol your body produces

● Age – Cholesterol levels rise with age

● Gender – Men often have higher cholesterol levels than women before menopause; after menopause, the levels tend to even out

Managing Cholesterol

Whether you have high cholesterol and want to lower your levels or you just want to prevent high cholesterol from developing, it’s important to focus on lifestyle changes. What you eat is an important part of fighting cholesterol, so work toward consuming a heart-healthy diet. Well-balanced diets focused on fiber-rich foods, fruits, vegetables and whole grains are key. You should also minimize the amount saturated and trans fats you consume, which are found in foods like meat, full-fat dairy, fried food and store-bought baked goods. Here are some examples of heart-healthy foods to include in your diet:

● Barley

● Oatmeal

● Leafy greens

● Avocado

● Nuts

● Salmon

● Beans

● Eggplant

● Soybeans

● Black tea

● Garlic

Regular physical activity is also important. Aim for at least 30 minutes of aerobic exercise five days week. Other lifestyle changes can also help lower cholesterol, including reducing stress, losing weight and quitting smoking.

Cholesterol Medication

Managing cholesterol should focus on making lifestyle changes. However, if you are working on changing your lifestyle and are struggling to bring down your cholesterol levels, then talk to your doctor. They may prescribe certain medications, including fibrates, statins and niacin, to help lower cholesterol. These medications may be taken individually or in combination; your doctor will determine what is appropriate for you.

Test Your Cholesterol

Having your cholesterol tested is the only way to know what your levels are like. A simple blood test determines your current levels. The most common cholesterol screening is a lipid profile; it measures the level of fats in your blood, including cholesterol. It’s recommended that people over age 20 get a cholesterol screening at least once every five years, but certain factors make it better for some people to get tested more often. Optimal cholesterol levels are as follows:

● Total cholesterol below 200 mg/dL

● HDL at 60 mg/dL or above

● LDL below 100 mg/dL

Dangers of High Cholesterol

Although it’s usually impossible to determine if you have high cholesterol without a blood test, that doesn’t mean it isn’t impacting your body and health. If left unchecked, high cholesterol can contribute to a number of health problems. The biggest problem is a buildup of cholesterol in your arteries that combines with other substances and leads to the formation of plaque. This buildup of plaque in your arteries is known as atherosclerosis. As the plaque deposits continue to grow, they narrow the space inside your arteries. This restricts the flow of blood. A clot that develops in your bloodstream can easily become stuck in an area where the arteries are narrowed, completely blocking the flow of blood. If your blood can’t carry oxygen to your heart or brain, then a heart attack or stroke will occur.

When to See Your Doctor

It’s important to talk to your doctor about testing your cholesterol levels. Many times you won’t notice high cholesterol until it’s too late. Regular screenings can determine your cholesterol levels so you can take appropriate action if necessary. In addition, if you notice chest pain it’s important to see your doctor right away. This can be a sign that the blood flow to your heart is restricted.

Managing your cholesterol levels is an important part of overall health, particularly heart health. Celebrate Cholesterol Awareness Month by talking to your doctor about getting a cholesterol screening. Then choose a lifestyle change to work on for better heart health.

Everything You Need to Know About the Yellow Fever Vaccine

Article source: http://www.travelandleisure.com/trip-ideas/yoga-wellness/yellow-fever-vaccine

The Yellow Fever Virus

Yellow fever, a viral hemorrhagic disease caused by the yellow fever virus, affects roughly 200,000 people a year. Though the disease got its start in Africa, outbreaks have occurred as far away as the Yucatan Peninsula and even Philadelphia, where 5,000 people were wiped out during a single epidemic in the 18th century.

Related: What You Need to Know About Vaccines

Typically, yellow fever causes, chills, nausea, vomiting, muscle pain, and — of course — a fever. It’s certainly not a pleasant way to spend any part of your trip. While most people recover after 3 or 4 days, some experience a second wave of afflictions, which can bring jaundice (hence the name), abdominal pain and vomiting, and bleeding from the mouth, nose, and eyes. In cases where yellow fever has developed past this point, the risk of death is about 50 percent.

Back in the day, yellow fever was no joke. A single outbreak had the power to annihilate huge groups of people in small areas, though the cause of the illness eluded doctors. It wasn’t until the 1900s that they determined yellow fever was transmitted by mosquitoes.

The Yellow Fever Vaccine

Per the Centers for Disease Control and Prevention, there is no cure for yellow fever. Instead, patients are treated based on their symptoms (described above), and on their recent travel history.

While a vaccine is recommended for any travel to Africa or South America, other important prevention methods include mosquito nets, wearing clothes that cover the entire body, and using a strong insect repellent with DEET.

The yellow fever vaccine was developed by Max Theiler in the United States, and he won the Nobel Prize for this life-saving contribution. Unlike other vaccines, the yellow fever vaccine is a one-time deal: a single dose provides lifetime immunity. (Travelers who frequently visit at-risk areas should get a booster shot ever 10 years.)

The vaccine can be given to infants as young as 9 months, and is recommended for anyone traveling to certain areas in Africa and South America.

As with most vaccines, an amount of time is needed for the vaccine to work its way through your body, and it’s recommended that you schedule the vaccine appointment 10 days prior to traveling.

The yellow fever vaccine is only offered at designated vaccination centers, and can cost between $150 and $350, depending on availability. Certain countries, including Ghana, Liberia, and Sierra Leone, even require a proof of vaccination from all travelers when they arrive — and that certificate is obtained from your doctor after being given the shot.

Visiting physician sheds new light on Lyme disease

Article Source: http://www.mvtimes.com/2016/07/13/visiting-physician-sheds-new-light-lyme-disease/

 

This past Friday, Dr. Nevena Zubcevik, attending physician at Harvard Medical School and co-director of Dean Center for Tick Borne Illness at Spaulding Rehabilitation Hospital in Charlestown (SRH) traveled to one of the nation’s front lines in the public health battle against Lyme disease to speak to a group of Martha’s Vineyard Hospital physicians. “I wanted to do this presentation by Skype because of all the ticks you have here,” she joked.

Dr. Zubcevik was at Martha’s Vineyard Hospital (MVH) to speak at grand rounds, a weekly meeting of clinicians, which on this day was open to the public, resulting in an overflow crowd at the Community Room just off the hospital lobby.

Over the course of the hour, she shared the most recent findings that she and her colleagues have made on the diagnosis and treatment of Lyme disease, in particular on the 10 to 15 percent of patients who suffer long-term symptoms, defined by Centers for Disease Control (CDC) as post-treatment Lyme disease syndrome (PTLDS). She discussed the protean nature of tick-borne diseases, the importance of public awareness, and the urgent need for the medical community to step up its game.

“Graduating medical students and doctors really aren’t educated about the gravity of this epidemic,” she said. “There’s a gap there that needs to be filled. We’re all responsible to educate our young doctors about what this entails.”

Dr. Zubcevic said the recent revelation that actor, singer, and songwriter Kris Kristofferson was cured of dementia once he was properly diagnosed with Lyme disease should be a lesson for medical professionals on how pervasive the disease is, and how often it is overlooked.

“Sudden-onset dementia should really be a red flag for Lyme [disease], especially in people with compromised immune systems,” she said.

“Everyone over 50 has a compromised immune system.”

Dr. Zubcevik said that doctors and parents should know that Lyme presents differently in children than it does in adults. “71 percent of the time, headache is the most common symptom in children,” she said. “Mood disturbance, fatigue, and irritability are also frequent symptoms in children. If they are acting out in school all of a sudden, get them tested.”

Dr. Zubcevik cited a particularly compelling example of undiagnosed Lyme disease where a 29-year-old male had been institutionalized four times for schizophrenia. After a series of tests, and in concert with a psychiatrist, Dr. Zubcevik began a course of daily antibiotics on him. “The first month he could remember what he had for breakfast,” she said. “The second month he could read a chapter of a book, and after six months he was back to normal. He could tolerate light and sound again, which he couldn’t before.”

Tick truths challenged

Dr. Zubcevik said recent research debunks several commonly held beliefs about the transmission and treatment of tick-borne diseases.

“The conception that the tick has to be attached for 48 hours to inject the bacteria is completely outdated,” she said. “There are studies that show that an attachment of 15 minutes can give you anaplasmosis,10 minutes for the Powassan virus, and for the different strains of Borrelia burgdorferi, we have no idea.”

Dr. Zubcevic said the notion that children, infants, or pregnant women should not be given doxycycline is also outdated. “Dermatologists have prescribed doxycycline to kids for years to treat acne; why not for such a debilitating disease?”

She also said the two-day course of doxycycline, often prescribed for people who find a tick embedded on their body, has little or no prophylactic value. “It should be 100 to 200 milligrams of doxycycline twice a day for 20 days, regardless of the time of engorgement,” she said. “It is not a two-day thing.”

The blood tests currently used to detect the presence of the Borrelia burgdorferi bacterium are the enzyme-linked immunosorbent assay (ELISA) and the Western blot test.

Dr. Zubcevik said research has shown there are 10 different strains of Lyme disease in the United States, and many of them do not test positive on the traditional Western blot or ELISA tests. In a previous email to The Times, she wrote that with current testing, 69 out of 100 patients who have Lyme disease may go untreated.

“The bull’s-eye rash only happens 20 percent of the time,” she said. “It can often look like a spider bite or a bruise. If you get a bull’s-eye it’s like winning the lottery. Borrelia miyamotoi, which we have a lot in Massachusetts, will not test positive on either test. That’s a huge problem, so the CDC is moving toward a different kind of test.”

Borrelia miyamotoi also has the potential to spread rapidly, since it’s transmitted directly from mother to offspring. Nymphal deer ticks need to feed on a mammal, most likely the white-footed mouse, to contract the virulent Borrelia burgdorferi bacterium.

In addition to Lyme disease, Islanders are also vulnerable to coinfections such as babesiosis, anaplasmosis, ehrlichiosis, and tularemia, which can also go undetected. “Babesiosis is a malaria-like disease that can persist for months or even years,” she said. “Patients who can’t catch their breath are a red flag for babesiosis.”

Double whammy

Dr. Zubcevik described deer tick nymphs as “the perfect vector” because of their diminutive size — the size of the “D” on a dime — and because of the analgesic in their saliva that often makes their bite almost undetectable.

The bacteria they inject are equally crafty.

“Borrelia burgdorferi is an amazing organism; I have a lot of respect for it,” she said. “It is a spirochete, meaning it can corkscrew into tissue as well as travel in the bloodstream. It can do whatever it wants. It’s twice the speed of a [white blood cell], which is our fastest cell. It’s so strong it can swim against the flow of the bloodstream.”

Dr. Zubcevik said there are videos that show a white blood cell pursuing a spirochete, which evades capture by drilling into tissue.

“It’s really easy to see why this adaptive bug can avoid the immune system,” she said.

Dr. Zubcevik said doxycycline stops the bacteria from replicating, but it doesn’t kill them. The rest is up to the body’s immune system, which is the reason some people suffer for so long.

“There’s a lot of neurotoxicity, which is why people feel so bad all over. It’s like a toxic warfare going on inside the patient’s body.”

Controversy continues

Last week, Governor Charlie Baker rejected the legislature’s controversial budget amendment that would have required insurance companies to cover the cost of long-term antibiotic treatment which chronic Lyme Disease (CLD) advocates maintain is the most effective treatment for their symptoms. The Massachusetts Infectious Disease Society, representing more than 500 infectious disease specialists, does not recognize CLD, and urged the governor to reject the amendment, asserting that long-term intravenous antibiotic therapy can be dangerous and possibly lead to “superbugs” that are immune to current treatments.

The CDC also does not recognize CLD or the use of long-term antibiotics for PTLDS. “Regardless of the cause of PTLDS, studies have not shown that patients who received prolonged courses of antibiotics do better in the long run than patients treated with placebo,” the CDC website states. “Furthermore, long-term antibiotic treatment for Lyme disease has been associated with serious complications.”

However, the website also says, “Recent animal studies have given rise to questions that require further research.”

Dr. Zubcevik diagnoses the condition with a different name — “persistent symptoms related to Lyme disease.”

“I’m new to this field,” she said. “For me there’s no controversy. We have to innovate, we have to find solutions. [SRH] has connected with top scientists from all around the country. Studies show that after treatment in mice, dogs, and monkeys, Borrelia burgdorferi bacteria are still there. This has also been shown in human tests.”

Citing the work of Dr. Ying Zhang at Johns Hopkins Lyme Center, she said the most likely effective remedy will be a combination of several antibiotics. In a previous interview with The Times, Dr. Zhang said he has worked on an effective PTLDS treatment for six years, and that current Lyme disease treatments may not clear bacterial debris, or “persisters,” which may be one of the possible causes of PTLDS. Dr. Zhang said that his work on tuberculosis (TB) is his primary focus; however, advances in fighting TB, e.g. using new combinations of drugs already approved by the Food and Drug Administration (FDA), have yielded promising results in the fight against “persisters.”

“There’s also a need to develop a more sensitive test,” he said.

Patient advocate

Although she started out at Spaulding Rehabilitation Hospital focusing on the neuropathy of concussions, Dr. Zubcevik branched out into treating people with Lyme disease in part because both maladies can cause similar cognitive impairment. “I heard Lyme disease patients say they can’t remember what they had for breakfast, or they get lost driving home,” she said. “It sounded the same as concussion symptoms, so we started doing PET scans.”

Positron emission tomography, or PET scan, is an imaging test that uses a radioactive substance that shows brain functioning. Dr. Zubcevik said PET scan of a patient with persistent Lyme disease symptoms showed a brain colored in blue and purple hues, where a healthy brain presented with shades of yellow and green. She showed an image of the patient’s brain after six months of intravenous antibiotics, which was dominated by shades of yellow and green.

Dr. Zubcevik told the hospital gathering that many patients she sees have been suffering the physical, mental, and emotional effects of the disease for so long, they have lost the will to live. “I literally have patients who were just done,” she said. “They couldn’t go on. The first thing I do is validate their experience, and tell them, ‘I believe you.’ Sometimes they start crying because somebody finally listened. Some patients show symptoms of post-traumatic stress disorder because they’ve been ignored for so long. Marriages dissolve all the time because one spouse thinks the other is being lazy. Many chronically ill patients end up alone.”

Treatment at SRH borrows from many different disciplines. In addition to medication, it can include nutrition counseling, physical therapy, occupational therapy, speech language therapy, mental health counseling, and referrals to infectious disease and other specialists as necessary.

Dr. Zubcevik said that the program was initially funded by a donation from a patient who was treated shortly after the clinic opened. “We’re always looking for more funding,” she said.

The current wait list at Spaulding is about four months.

Prevention, prevention, prevention

“Once patients are doing better, I will call harass them on the weekend to check if they are taking the proper precautions,” Dr. Zubcevik said. “Are they using repellant? Are they doing daily checks? Are they treating their dogs? I don’t want to do another PICC line [intravenous drug access] or PET scan.”

Dr. Zubcevik also said many people need to know proper tick removal — using tweezers to grab the head of the tick, not at the body.

“Don’t don’t squeeze the belly of the tick, it will inject the bacteria into your bloodstream. Do not use oils; it can make the tick vomit the bacteria into the bloodstream. If the tick is deeply embedded, go to the doctor.”

More information on SRH can be found at www.spauldingrehab.org/deancenter

More information on tick-borne disease prevention can be found on the Martha’s Vineyard Boards of Health Tick-Borne Disease webpage.

Numerous videos on Lyme disease prevention, including Dr. Zubcevik’s presentation, are available on the MVTV website.

If you have been diagnosed with Lyme disease you might be eligible to donate plasma or a blood specimen and earn up to $600 or more. Visit www.plasmamedpatients.com for more info or call/text 561-962-5093.

Why ‘tropical disease’ is a global problem

Article Source:  https://blog.oup.com/2017/07/tropical-disease-global-problem/

In 2015, the United Nations agreed upon Sustainable Development Goals which set seventeen ambitious targets for the next two decades focusing on tackling poverty, reducing disease, protecting the environment, and driving forward an international community based on sustained commitments to – and improvements in – education, health, human rights, and equity. At first glance, infectious diseases in the tropics do not make headlines among the seventeen goals. On closer scrutiny, however, tropical medicine epitomizes issues that are woven into the heart of this sustained global initiative, and that are relevant to all of us with an interest in 21st century health, wherever we live and work.

Among the seventeen goals, ‘good health and well being’ (goal 3) is the most obviously relevant to tropical medicine, with a bold statement that sets out an agenda to be achieved by 2030, to ‘end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases’. Within this goal are additional targets, including provision of sexual health services and access to essential vaccinations.

‘Clean water and sanitation’ (goal 6) is crucial for health and wellbeing in ways that are obviously fundamental and is pertinent to curbing the spread of waterborne diseases including hepatitis A, cholera, and typhoid. Less well recognized diseases are also tackled within this aspiration, including schistosomiasis (blood flukes) and dracunculiasis (‘guinea worm’).

Tropical and subtropical regions are particularly vulnerable to the spread of infectious diseases – the perfect storm arising from the intersection of poor sanitation, lack of education, inadequate resources and infrastructure for healthcare, and specific climates and environments. At the root of this all is poverty. ‘No poverty’ (goal 1) includes an aspiration that individuals, families, and society have sufficient reserves and resource to cope with a crisis – to access drugs and healthcare, and to continue to provide for their children throughout periods of instability arising from illness. Implicit in the aim for economic growth (goal 8) is the need to have a population of adults who are well enough to be economically active in contributing to productivity, development, and prosperity.

‘Quality education’ (goal 4) highlights a particular need to focus on girls and women, whose education is often neglected but whose literacy is known to impact significantly on the health of their children. Education is empowering per se, but also provides a specific foundation for women to become active participants in vaccinating their families, taking measures to prevent mother-to-child transmission of infection, compliance with therapy, promoting and developing better sanitation, and improving sexual health. Tackling inequality is such a key issue that it is also independently represented within goals 5 and 10.

“Malaria still kills over 290,000 children a year – that is a child every two minutes”
So how, and why, are these challenges aimed mostly at low and middle-income settings relevant to affluent, developed countries?

One answer is that we are part of a delicate global community, in which the health and wellbeing of all human populations is interdependent. In other cases, numbers provide a powerful answer to the question: in Africa, malaria still kills over 290,000 children every year – that is a child every two minutes. None of us should absolve ourselves of responsibility for continued investment in tackling this humanitarian tragedy.

But there are other answers: we are all vulnerable to threats which wreak their worst effects in the tropics – organisms like Streptococcus pneumoniae (a cause of pneumonia) and E. coli (a cause of diarrhoea and urinary tract infections) are common the world over.

The Ebola virus, arising out of a tropical situation, was in no way confined by the bounds of Cancer and Capricorn; it had the potential to take hold in situations of poverty and limited infrastructure and then to spread fast, facilitated by its huge infectivity, and fuelled by human behaviour and environments including crowding, migration, and international travel. Other organisms, like cholera, measles, meningitis, and polio rear their heads in disaster situations; in a world so uncertain, none of us knows when this is around the next corner.

Food by PublicDomainPictures. CC0 public domain via Pixabay.
Changes in climate and the environment allow creatures that are the reservoirs and vectors of infection to spread to new locations; the concern for the Zika epidemic in South America has been its rapid dissemination by a mosquito that has the potential to become ubiquitous. The spread of organisms that are resistant to multiple drugs is another major threat to global health. One example is Mycobacterium tuberculosis, the organism that causes TB, where multi-drug resistant (MDR) and extensively-drug resistant (XDR) strains are now well-established. Associated with a high burden of disease, high death rates, and difficult, expensive treatment, these organisms are by no means confined to the tropics.

And what about financial security? We value crops like tea, coffee, chocolate, and bananas which are the exclusive preserve of tropical and subtropical farmers; our supplies depend on their health and productivity. Rich natural resources – from coal to gold – are mined from these regions of the world, and the manufacturing, clothing, and electronics industries are built on tropical and subtropical manpower.

Infections that flourish in the tropics continue to cause a catastrophic burden at the level of individual patients, their families, and wider society at national and international level. They impose an enormous economic cost upon healthcare systems and society, related both to providing care and to the lost output of young adults who are unable to contribute to society through work or raising their families. Labelling them as ‘tropical’ identifies a strong association with some of the world’s most vulnerable settings – but perhaps we need to move on from the term ‘tropical medicine’ to considering ‘global health’

Despite being open to criticism for being too broad, too ambitious, too expensive, the Sustainable Development Goals do put emphasis on tackling the cause of problems rather than just trying to fix the end result. In order for our planet and its populations to thrive and flourish, the aims represented are crucial. The health, well-being, and future of our children and grandchildren are tightly bound to these bold aspirations, and the strides we make against ‘tropical diseases’ represent steps forward for us all.