A Deadly Form of Diabetes That Doctors Sometimes Miss

Common signs of type 1 diabetes often resemble symptoms of other illnesses

By Serena Gordon

HealthDay Reporter

WEDNESDAY, June 19 (HealthDay News) -- Addie Parker was a happy 4-year-old who appeared to have the flu. But within hours she was in a coma.

Tragically, her parents weren't familiar with the signs of type 1 diabetes -- extreme fatigue, thirst and sweet-smelling breath, among others -- in time to save their little girl. Soon after she was diagnosed, Addie's brain hemorrhaged. She died six days later, about a month shy of her fifth birthday.

Experts say a lack of awareness of the signs of type 1 diabetes is all too common. Just this month, a Wisconsin toddler died apparently because of undiagnosed type 1 diabetes.

"Addie had flu symptoms," recalled her mother, Micki Parker, who works in the operating room at a nearby hospital but was unfamiliar with type 1 diabetes.

"By the next morning, she was throwing up every hour," Parker said. Addie didn't have a fever, but later that day, she couldn't get up from the bathroom floor because she was so dizzy.

Eventually, the Parkers learned that Addie's blood sugar level was 543 milligrams per deciliter (mg/dL) -- more than four times higher than normal, according to the American Diabetes Association.

Most people have heard of type 2 diabetes, but type 1 diabetes is far less common. It can strike at any age -- even though it used to be known as juvenile diabetes -- and it always requires treatment with injected insulin or insulin delivered through a pump. People with type 1 diabetes don't produce insulin, a hormone needed to convert the food you eat into fuel for the body. Without insulin, glucose (blood sugar) rises to unhealthy levels.

Untreated, type 1 diabetes causes serious complications and even death. But it's often mistaken for other illnesses -- even by doctors.

"There's an underawareness of type 1 diabetes in the public, and in the healthcare system," said Dr. Richard Insel, chief scientific officer for JDRF (formerly the Juvenile Diabetes Research Foundation). "Missed diagnoses even occur in emergency rooms; people don't always think of it."

Every day, about 80 Americans are diagnosed with type 1 diabetes, and the total number rose 23 percent between 2000 and 2009 in children under 20. Currently, about 3 million Americans -- most of them adults -- are living with type 1 diabetes, according to the JDRF.

One of them is 20-year-old Amanda Di Lella, who was 13 when she knew something was seriously wrong.

"I was losing weight, but I was always hungry. I was always tired. My symptoms weren't extreme at first, but they quickly got worse," she said. "I went from being tired to not being able to get out of bed, from being thirsty to drinking 10 bottles of water in the middle of the night. I had lost 15 pounds, and only weighed 75 pounds when I begged my mother to take me to the doctor."

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Deadly Meningitis Cases Worry Gay Community

By Randy Dotinga
HealthDay Reporter

TUESDAY, April 23 (HealthDay News) -- A series of bacterial meningitis cases in Southern California and New York City, resulting in the deaths of several gay men, have set the gay community on edge. However, preliminary tests suggest the cases on each coast aren't connected.

Health activists became concerned in Los Angeles after a 33-year-old gay attorney from West Hollywood suddenly became ill from meningitis and died on April 13. The AIDS Healthcare Foundation, which advocates for health for gay men, initially criticized local health officials for not pushing for vaccinations. However, "we don't think it's part of an outbreak or due to him being a gay man," said Dr. Wayne Chen, the organization's acting chief of medicine.

Still, the Los Angeles County's public health department is offering meningitis vaccinations for free for those who are poor or uninsured.

In New York City, health officials are recommending that certain groups of gay and bisexual men, along with certain visitors to the city, get vaccinated against meningitis.

According to Los Angeles County health officials, four cases of meningitis in gay or bisexual men have been confirmed in the region since December, including one 30-year-old who died of meningitis in Los Angeles, and another man of the same age who died in the San Diego area, both in December, according to news reports.

The officials say the four Los Angeles cases in gay and bisexual men don't appear to be "highly related" to those elsewhere in Southern California or in New York City.

In New York City, officials have noted more than 20 meningitis cases since 2010 in gay or bisexual men; seven of the men died. The city recommends vaccinations for any HIV-infected gay or bisexual men and those who have had close or intimate contact with men they met via websites, apps or at bars or parties. Visitors who have been to the city since Sept. 1 and engaged in these types of activities should get vaccinated too, city officials added.

Meningitis is transmitted through close contact with an infected person and kills, often quickly, by causing the lining around the brain to swell. It commonly spreads through places where people live closely together, such as dorms and military housing.

Meningitis hasn't previously been connected to gay men in particular, Chen said.

Many people have the bacteria that cause meningitis in their nasal passages, but the germs often don't cause problems, said infectious disease specialist Dr. William Schaffner, chair of the department of preventive medicine at Vanderbilt University Medical Center. "They can carry these bacteria for long periods of time and transmit them to other people without being aware of the process."

The germs can create a mild illness at first that can quickly turn deadly, especially if the bacteria gets into the bloodstream, he said.

"You feel kind of punky, and you maybe have a sore throat," Schaffner said. "You lose your appetite, you get drowsy. Then you can slip into a coma."

Antibiotics effectively treat bacterial meningitis, he said, but they must be given quickly. That's why people should seek medical care if they suffer from symptoms like stiff neck, high fever (beyond 100.1 degrees Fahrenheit) or severe headache, he said.

Meningitis vaccines cost about $100, Chen said, and can cause side effects that are similar to those possible in people who get flu vaccines. The vaccines work against most strains of meningitis, Schaffner said, and take 10 to 14 days to become effective.

Copyright © 2013 HealthDay. All rights reserved. SOURCES: William Schaffner, M.D., professor and chair, department of preventive medicine, Vanderbilt University Medical Center, Nashville, Tenn.; Wayne Chen, M.D., acting chief, medicine, AIDS Healthcare Foundation, Los Angeles

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Treatment for New, Deadly Coronavirus Shows Promise

THURSDAY, April 18 (HealthDay News) -- A treatment for a new coronavirus that has caused 11 deaths, mostly in the Middle East, shows promise in early tests, U.S. government researchers report.

The investigators discovered that a combination of two antiviral drugs -- ribavirin and interferon-alpha 2b -- can stop the so-called nCoV coronavirus from multiplying in laboratory-grown cells. While the results suggest that this drug combination could be used to treat patients infected with nCoV, more research is needed to confirm these early findings.

Both drugs are approved in the United States for treating people with hepatitis C.

The nCoV coronavirus was first identified in Saudi Arabia in September 2012. As of April 16, 2013, there had been 17 reported cases, including 11 deaths. Most cases have occurred in the Middle East.

While the number of cases is small, there has been person-to-person transmission of the nCoV coronavirus in situations where people -- mainly family members -- have had close contact with infected people, the researchers noted in a news release from the U.S. National Institute of Allergy and Infectious Diseases (NIAID).

That, along with the high death rate, led the NIAID researchers to look for treatments. In laboratory tests using cells from two monkey species, the research team found that either ribavirin or interferon-alpha 2b alone could stop nCoV from replicating in the cells.

However, the drug concentrations needed to do this were higher than what is recommended for people. The researchers then combined the two drugs, and found that they were effective at a dose that can be used in people, according to the study in the April 18 issue of the journal Scientific Reports.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: U.S. National Institute of Allergy and Infectious Diseases, news release, April 18, 2013

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Study Probes Use of Filter Device to Stop Deadly Blood Clots

Title: Study Probes Use of Filter Device to Stop Deadly Blood Clots
Category: Health News
Created: 3/18/2013 4:35:00 PM
Last Editorial Review: 3/19/2013 12:00:00 AM

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Daily Aspirin Linked to Lower Risk for Deadly Skin Cancer in Women

Title: Daily Aspirin Linked to Lower Risk for Deadly Skin Cancer in Women
Category: Health News
Created: 3/11/2013 10:35:00 AM
Last Editorial Review: 3/11/2013 12:00:00 AM

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Daily Aspirin Linked to Lower Risk for Deadly Skin Cancer in Women

Large study found up to 30 percent reduced odds of developing melanoma

By Steven Reinberg

HealthDay Reporter

MONDAY, March 11 (HealthDay News) -- Older women who take an aspirin regularly may be lowering their risk of developing the deadly skin cancer melanoma, a new study suggests.

And the longer postmenopausal women take aspirin, the more melanoma risk appears to diminish.

The effect is only seen with aspirin, not with other pain relievers such as acetaminophen (Tylenol), the researchers noted.

For the study, the research team collected data on nearly 60,000 white women who were part of the Women's Health Initiative, a long-term national study. The women, aged between 50 and 79, were asked about what medications they took and other lifestyle preferences.

Over 12 years of follow-up, the investigators found that women who took aspirin had a 21 percent lower risk of developing melanoma compared to women who didn't take aspirin.

But it's too soon to make firm conclusions, a researcher cautioned.

"Aspirin could be potentially used to prevent melanoma, but a clinical trial is needed," said lead author Dr. Jean Tang, an assistant professor of dermatology at Stanford University School of Medicine in Palo Alto, Calif.

This type of population-based study can only show an association between aspirin and the reduced risk for melanoma, not that aspirin actually helps prevent it.

Tang doesn't believe women should start taking aspirin solely to try to prevent melanoma. "It's too early to say this," she said.

It is possible that aspirin's anti-inflammatory properties might be responsible for lowering the risk of melanoma, Tang suggested. "Aspirin may also promote cell death of melanoma cells," she added.

Whether a protective effect also occurs in men is not known, said Tang, who plans to look at that in her next study.

The new report was published in the March 11 online edition of Cancer.

The study found that women who took aspirin for at least five years had their melanoma risk drop by 30 percent, compared to women who didn't take aspirin.

To try to isolate the effect of aspirin on melanoma, Tang's group accounted for other factors such as skin tone, tanning and use of sunscreen.

Each year in the United States there are nearly 77,000 new cases of melanoma and more than 9,000 deaths from it, according to the U.S. National Cancer Institute.

One expert doesn't see any problem taking aspirin to prevent melanoma, especially for people with a family history of the disease.

Prolonged use of aspirin is not without risks, including stomach bleeding, but the benefits of preventing melanoma outweigh the risk for vulnerable people, said Dr. Michele Green, a dermatologist at Lenox Hill Hospital in New York City. She praised the new research.

"I think it's fantastic. It's really a remarkable study," Green said.

"If you have a family history of melanoma, I don't see any downside of taking aspirin for this," she said. "I would urge my patients who have a family history of melanoma to take aspirin based on this study."

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Dog Sniffs Out Deadly C. diff Infection

Dec. 13, 2012 -- A 2-year-old beagle named Cliff may hold the key to preventing an infection that kills thousands of Americans each year.

Researchers in the Netherlands taught Cliff to sniff out the intestinal bacteria Clostridium difficile(C. difficile or C. diff) in stool samples from infected patients and even from the patients themselves.

C diff is commonly spread in hospitals and long-term care centers, causing diarrhea that can be mild to life-threatening. It is responsible for as many as 14,000 deaths in the U.S. each year, the CDC says.

The hope is that other dogs can be trained to identify the infection far faster than it is found through current tests, preventing potentially deadly outbreaks in these settings.

“This study proves the concept, but we have to confirm that this approach will be useful in the real-world setting,” says researcher Marije K. Bomers, MD, of the VU University Medical Centre in Amsterdam, Netherlands.

Hospitalized older adults who have recently had a course of antibiotics are most at risk for C. diff infections.

Early detection can prevent the spread in hospitals and other care facilities, but current tests can take anywhere from two days to up to a week to confirm infection, Bomers says.

She says the idea for the study came from the observation that the diarrhea of patients with C. diff infections has a particular smell that she and her colleagues could sometimes detect.

It occurred to them that if humans could smell the infection some of the time, then dogs, with their superior sense of smell, should be able to smell it all the time.

To test the theory, they enlisted psychologist and dog trainer Hotsche Luik, who was also Cliff’s owner.

Over two months, the beagle was taught to identify the C. diff toxin in smaller and smaller quantities and in different samples, including human stool.

During one test, he correctly identified 50 of 50 C. diff positive stool samples and 47 of 50 negative samples.

In a separate test, he was taken to two hospital wards to examine his ability to sniff out the infection in patients.

He correctly identified C. diff in 25 of 30 infected patients. He also identified no infection in 265 of 270 non-infected patients.

He completed this task in one of the wards in less than 10 minutes.

The researchers write that highly trained dogs like Cliff may one day patrol hospital wards to seek out C. diff infection.

“I love dogs. I think they are amazing,” says infection disease specialist Bruce Hirsch, MD, of North Shore University Hospital in Manhasset, N.Y. “But I’m not sure I see this being deployed in an efficient way in a large hospital setting where there are many distractions.”

Despite his skepticism, Hirsch says the research is definitely worth pursuing even though confirmation of the infection has already been shortened from a few days to a few hours in many hospitals, including his.

“One big question for me is, ‘What else can a dog’s amazing sensory apparatus be utilized to detect?'" he says. “There are already studies suggesting that they can smell some cancers. There is no telling what else they may be trained to sniff out.”

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Dog Sniffs Out Deadly C. Diff Infection

BySalynn Boyles
WebMD Health News Reviewed byLaura J. Martin, MD

Dec. 13, 2012 -- A 2-year-old beagle named Cliff may hold the key to preventing an infection that kills thousands of Americans each year.

Researchers in the Netherlands taught Cliff to sniff out the intestinal bacteria Clostridium difficile(C. difficile or C. diff) in stool samples from infected patients and even from the patients themselves.

C diff is commonly spread in hospitals and long-term care centers, causing diarrhea that can be mild to life-threatening. It is responsible for as many as 14,000 deaths in the U.S. each year, the CDC says.

The hope is that other dogs can be trained to identify the infection far faster than it is found through current tests, preventing potentially deadly outbreaks in these settings.

“This study proves the concept, but we have to confirm that this approach will be useful in the real-world setting,” says researcher Marije K. Bomers, MD, of the VU University Medical Centre in Amsterdam, Netherlands.

Dogs Can Smell Better

Hospitalized older adults who have recently had a course of antibiotics are most at risk for C. diff infections.

Early detection can prevent the spread in hospitals and other care facilities, but current tests can take anywhere from two days to up to a week to confirm infection, Bomers says.

She says the idea for the study came from the observation that the diarrhea of patients with C. diff infections has a particular smell that she and her colleagues could sometimes detect.

It occurred to them that if humans could smell the infection some of the time, then dogs, with their superior sense of smell, should be able to smell it all the time.

To test the theory, they enlisted psychologist and dog trainer Hotsche Luik, who was also Cliff’s owner.

Over two months, the beagle was taught to identify the C. diff toxin in smaller and smaller quantities and in different samples, including human stool.

During one test, he correctly identified 50 of 50 C. diff positive stool samples and 47 of 50 negative samples.

In a separate test, he was taken to two hospital wards to examine his ability to sniff out the infection in patients.

He correctly identified C. diff in 25 of 30 infected patients. He also identified no infection in 265 of 270 non-infected patients.

He completed this task in one of the wards in less than 10 minutes.

New Type of ‘Pet Scan’

The researchers write that highly trained dogs like Cliff may one day patrol hospital wards to seek out C. diff infection.

“I love dogs. I think they are amazing,” says infection disease specialist Bruce Hirsch, MD, of North Shore University Hospital in Manhasset, N.Y. “But I’m not sure I see this being deployed in an efficient way in a large hospital setting where there are many distractions.”

Despite his skepticism, Hirsch says the research is definitely worth pursuing even though confirmation of the infection has already been shortened from a few days to a few hours in many hospitals, including his.

“One big question for me is, ‘What else can a dog’s amazing sensory apparatus be utilized to detect?'" he says. “There are already studies suggesting that they can smell some cancers. There is no telling what else they may be trained to sniff out.”

View Article Sources

SOURCES:

Bomers, M.K. BMJ, 2012.

Marije K. Bomers, MD, department of internal medicine, VU University Medical Center, Amsterdam, Netherlands.

Bruce Hirsch, MD, North Shore University Hospital, Manhasset, N.Y.

News release, BMJ, Dec. 13, 2013.

CDC: "Clostridium difficile Infection."

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