MRSA CHALLENGES PHYSICIANS, ENDANGERS COMMUNITIES

USA Today (12/17, Eisler) reports in a nearly 2,700-word article on the dangers of MRSA bacteria and their ability to resist antibiotics, reporting that “MRSA infections, particularly outside of health care facilities, are much more common than government statistics suggest,” affecting hundreds of thousands of Americans annually with minor skin boils, deadly pneumonia, and other symptoms, and causing over 20,000 fatalities. Public health officials remain unable to detect or track cases, with Center for Disease Dynamics, Economics & Policy head Ramanan Laxminarayan stating, “It’s not about winning or losing the battle (against MRSA), it’s that the battle is shifting. You’re seeing people who are young and healthy getting this (in the community), and it’s very serious.”

        Another USA Today (12/17, Fecto, Eisler) article reports that MRSA can be particularly dangerous where individuals remain close together or have frequent skin-to-skin contact, such as in schools, athletic facilities and prisons. The paper mentions open skin, such as scrapes, as avenues for the disease to enter the body, and the Center for Disease Control and Prevention encourages educating athletic coaches and players about prudent hygiene and laundry practices as well as antibacterial soap and improved laundry methods in prisons.

        A USA Today (12/17) video depicts individual Eric Allen’s experience with the disease, noting that he was hospitalized for 45 total days.

        On the front of its Personal Journal section, the Wall Street Journal (12/16, D1, Wang, Subscription Publication) reports an over 1,100-word article that new strategies to combat antibiotic-resistant bacteria include combining substances like silver with antibiotics, genetically sequencing bacteria to develop drugs more quickly, or simply rendering bacteria incapable of infecting humans. Some pharmaceutical companies are experimenting with additives to short-circuit bacteria’s defenses.

GENE THERAPY AND "KILLER T CELLS"

Researchers reprogram T cells to fight leukemia.

In a 1,000-word article, the AP (12/8, Marchione) reported, “In one of the biggest advances against leukemia and other blood cancers in many years, doctors are reporting unprecedented success by using gene therapy to transform patients’ blood cells into soldiers that seek and destroy cancer.”

        In an 1,100-word article on its website, CNN (12/8, Cohen) reported that first, a patient’s T cells are removed. Physicians “then reprogram the cells by transferring in new genes.” After they are “infused back into the body, each modified cell multiplies to 10,000 cells. These “hunter” cells then track down and kill the cancer in a patient’s body.”

        In an 1,100-word article, Bloomberg News (12/8, Lopatto) reported, that in one study, presented at the American Society of Hematology meeting, researchers found “that 15 of 32 patients with chronic lymphocytic leukemia experienced a reduction of their cancers and 7 achieved remission.” Meanwhile, researchers found that among those “with acute lymphoblastic leukemia, 19 of 22 children experienced complete remission, as did all five adults tested.”

        The Philadelphia Inquirer (12/8, McCullough) pointed out, however, that as is the case “with conventional chemotherapy and radiation, remissions achieved with the T cells are not necessarily cures.” The data indicated that “five pediatric patients whose cancer seemed to be eradicated – sensitive technology could not detect a single malignant cell – relapsed after months of robust health.”

BREAST CANCER AND CHOLESTEROL

Byproduct of cholesterol may fuel tumors in some common forms of breast cancer.

McClatchy (11/30, Price) reported that previous research has “shown a link between obesity and breast cancer, and now scientists at Duke Cancer Institute may have found one important explanation: a byproduct of cholesterol that fuels tumors in some of the most common forms of the disease.” The findings are published in Science. The research, partially funded by the National Institutes of Health, may lead to “simple methods to reduce breast cancer risk, including using cholesterol-lowering drugs such as statins and eating a healthier diet.”

        The Cleveland Plain Dealer (12/1, Townsend) reported that the researchers “found that a byproduct of cholesterol – a molecule called 27-hydroxycholesterol, or 27HC – functions like estrogen, fueling the growth and spread of breast cancer.” Although “the findings are drawn from studies in mice and tumor cells, the” scientists “say they are significant enough to set the stage for what the researchers call ‘near-term’ clinical trials in humans that can begin exploring how statins and other anti-cholesterol drugs might be used to help lower, or even prevent, a woman’s chances of developing breast cancer.”

        BBC News (11/29, Gallagher) pointed out, however, that “cancer charities cautioned that it was too soon to advise women to take statins.”

"NIP TUCK" COACH

 Michele is a "coach" that helps patients get through the sometimes confusing large volume of information on cosmetic surgery issues. She does background work for patients to help them make wise decisions.  It is important that patients do their own research, but in some cases, patients may need assistance.  Web Sites like the one by the American Society of Plastic Surgeons offer detailed information about dozens of surgeries and procedures.  Researching the doctors being considered is another important aspect of preparing for cosmetic surgery. "What are the qualifications of the physician they're going to see, how many types of procedures have they performed, of course board certification, and also talk to previous patients of that practice," recommends board certified plastic surgeon, James Newman, M.D., FACS. Some patients turn to Michele to do much of that background work for them.  There is a fee for her service. Michele Garber has written an e-book called "Safety First: 10 Golden Rules for Safe Cosmetic Surgery."

TREATMENT OF HYPERTROPHIC SCARS WITH LASERS

Current laser therapy approaches are effective for treating excessive scars resulting from abnormal wound healing, concludes a special topic paper in the December issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
The review by Dr. Qingfeng Li and colleagues of Shanghai Ninth People's Hospital in Shanghai, China, provides strong support for laser treatment of hypertrophic scars-but less so for another type of abnormal scars called keloids. The authors highlight the need for further research in this and other key areas, including the benefits of different types of lasers and the results of laser treatment for scarring in patients with darker skin.
Seventy Percent Success Rates with Laser Treatment for Excessive Scars...
Dr. Li and coauthors identified and analyzed previous studies of laser treatment for abnormal scarring. They found 28 well-designed clinical trials using various medical lasers for two types of excessive scarring: hypertrophic scarring and keloids. Both are abnormal tissue responses that lead to raised and thickened areas of scarring, resulting in cosmetic and sometimes functional problems.
Hypertrophic scars are limited to the initially injured area. Keloids-which are more common in dark-skinned individuals-can spread beyond the area of the initial wound. Most of the studies evaluated the effects of laser therapy for hypertrophic scarring; just three reports focused exclusively on keloids.
Data from more than 900 patients showed high success rates with laser treatment: about 70 percent for both hypertrophic scarring and keloids. Based on studies targeting scars that were less than one month old, laser therapy had a similar success rate in prevention of excessive scarring.
The responses appeared best with two specific lasers: the 585/595 nm pulsed-dye laser (PDL) and the 532 nm laser. (The figures in nanometers [nm] indicate the wavelength of the laser light used.) About two-thirds of the studies reviewed examined the 585/595 nm PDL; just three studies evaluated the 532 nm laser.

Some studies provided data on objective responses to laser treatment, reporting improvements on standard rating scales and measures of scar height and redness. Data from the PDL studies suggested that the best interval for repeated laser treatments was five to six weeks; PDL treatment appeared most effective in patients with fairer skin types.
More Research Needed on Darker Skin, Different Laser Types

INFECTIONS AFTER COSMETIC SURGERY

Boston health officials are investigating several reports of severe infections in patients who traveled to the Dominican Republic for cosmetic surgery.

At least two patients in Boston, and another in Worcester, are believed to have been infected with Mycobacterium abscessus, bacteria that are not easily battled with antibiotics and can take months of treatment to vanquish.

The patients were part of a group that went to the Dominican Republic during the summer for surgeries and started having health problems earlier this fall, including abscesses and drainage from their surgery sites, said Dr. Anita Barry, director of the infectious disease bureau at the Boston Public Health Commission.