Early Respiratory Infection May Double Type 1 Diabetes Risk: Study

Researchers looked at children who had first-degree relatives with the autoimmune disease

By Serena Gordon

HealthDay Reporter

MONDAY, July 1 (HealthDay News) -- What may seem like a harmless cold during the first six months of life may more than double a child's chances of developing antibodies that often lead to type 1 diabetes, new German research suggests.

Infections that occur later don't seem to pose as high as risk. When infants between 6 and 12 months had a respiratory illness, their risk only increased by 32 percent, the study found.

The researchers noted that these findings probably don't apply to all youngsters, because this study was done with children who have a high risk of developing the disease because they have a first-degree relative who has type 1 diabetes.

"In general, the early immune system is still in a phase of development, and may therefore be particularly susceptible for challenges by infectious agents. However, we cannot explain yet why specifically respiratory infections might be relevant in this phase," said study author Andreas Beyerlein, head of the working group on epidemiology at the Institute of Diabetes Research in Munich.

Results of the study were published online July 1 in JAMA Pediatrics.

Infections have long been suspected as potential triggers of type 1 diabetes. Type 1 diabetes is an autoimmune condition that causes the body's immune system to mistakenly attack and destroy insulin-producing beta cells in the pancreas, according to background information in the study. Insulin is a hormone needed to metabolize the carbohydrates in foods so that they can be used as fuel for the body and brain.

Substances called islet autoantibodies appear in the blood before the development of type 1 diabetes, sometimes years before diabetes is evident. These autoantibodies help researchers predict whether or not someone will develop type 1 diabetes.

In the current study, the researchers followed 148 children who were under 3 months old when they started the study. All of the babies had a first-degree relative with type 1 diabetes.

When the children were 3 months old, the parents were asked to complete a detailed questionnaire that included information about their baby's history of infections, fever and medication use. They were asked to detail the types of symptoms their child had. They were also asked about family history of diabetes, and questions about lifestyle factors, such as whether the mother smoked during pregnancy.

Parents were then asked to record information about any illnesses or diseases that occurred until the child was 3 years old. The children also had their blood tested every three months to look for evidence that they had developed islet autoantibodies.

Over the three-year study, there were 1,245 infectious "events." Most -- 669 -- were respiratory infections that affected the upper respiratory tract, including the ear, nose, throat or eye. Infections that affected the digestive system totaled 257, and another 319 cases were classified as "other" infections, such as skin infections.

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Some Antidepressants May Raise Risk for Gastro Infection

Researchers aren't sure why these meds are linked to chances of contracting C. difficile

By Robert Preidt

HealthDay Reporter

TUESDAY, May 7 (HealthDay News) -- People who take certain types of antidepressants may be at higher risk for potentially deadly Clostridium difficile infection, a new study suggests.

This type of infection is one of the most common caught by hospital patients and causes more than 7,000 deaths each year in the United States. Several medications are thought to increase the risk for this infection, including antidepressants.

In this study, University of Michigan researchers examined C. difficile infection in people with and without depression, and found that those with major depression had a 36 percent higher risk than those without depression. Older, widowed people were 54 percent more likely to catch C. difficile than older married people. People who lived alone had a 25 percent higher risk than those who lived with others.

The researchers then investigated if there was a link between antidepressants and C. difficile infection. They found that only two -- Remeron (mirtazapine) and Prozac (fluoxetine) -- increased the risk, and that each drug doubled the risk.

The findings, published May 6 in the journal BMC Medicine, should improve identification and early treatment of C. difficile infection in people taking these antidepressants, the researchers said.

The reason for the increased risk of infection in people taking the antidepressants is unknown, and people who have been prescribed the drugs need to keep taking them unless their doctor tells them otherwise, the researchers said. The research showed an association between antidepressant use and increased risk of contracting the infection, but it did not prove a cause-and-effect link.

"Depression is common worldwide," study leader Dr. Mary Rogers said in a university news release. "We have long known that depression is associated with changes in the gastrointestinal system."

"The interaction between the brain and the gut, called the 'brain-gut axis,' is fascinating and deserves more study," Rogers said. "Our finding of a link between depression and Clostridium difficile should help us better identify those at risk of infection and perhaps encourage exploration of the underlying brain-gut mechanisms involved."

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HPV Vaccine Lowering Infection Rates Among Girls: CDC

Extent of protection from sexually transmitted virus higher than expected, suggesting 'herd immunity' is at work, experts say

By Dennis Thompson

HealthDay Reporter

WEDNESDAY, June 19 (HealthDay News) -- Vaccination against the cancer-causing human papillomavirus (HPV) is proving highly effective in reducing the spread of the sexually transmitted virus among young women, new research shows.

The rate of new infections with strains of HPV targeted by the vaccine have dropped by 56 percent among females aged 14 to 19 since the first vaccine was approved in 2006, report researchers at the U.S. Centers for Disease Control and Prevention.

According to the CDC, HPV infection is known to be the major cause of cervical cancer, and has also been strongly linked to vulvar, vaginal, penile, anal, and certain throat/oral cancers.

The new findings "are striking results, and I think they should be a wake-up call that we should increase vaccination rates, because we can protect the next generation of adolescents and young girls against cancer," CDC director Dr. Tom Frieden said in a press conference held Wednesday.

The findings are published in the June issue of The Journal of Infectious Diseases.

Each year in the United States about 19,000 cancers caused by HPV occur in women, with cervical cancer being the most common. Virtually all cases of cervical cancer are caused by HPV, and just two HPV subtypes, 16 and 18, are responsible for seven out of every 10 cervical cancers.

About 8,000 cancers caused by HPV occur each year in men in the United States, most commonly being throat cancer.

The decline in HPV infections among girls is actually higher than had been expected, indicating that "herd immunity" may have taken effect as more girls receive the vaccine, study lead author Dr. Lauri Markowitz said at the press conference.

Herd immunity occurs when widespread vaccination shrinks the pool of infected people to the point that it becomes less likely that a person can catch the disease from someone else. In this type of scenario, "even people who aren't vaccinated will have some protection due to the vaccination program," Markowitz said.

Another possible reason for the better-than-expected results could be that the vaccine is so effective that a girl receives protection from HPV even if she receives only one or two shots out of the full recommended three-dose series of vaccination.

Whatever the reason, the new statistics are "great news," according to Dr. Jay Brooks, chairman of hematology/oncology at Ochsner Health System in Baton Rouge, La. "I think every young woman should have the opportunity to have this vaccine. That's what I've been telling people for however long the vaccine has been available."

HPV is highly infectious. In fact, about 79 million Americans, most in their late teens and early 20s, are thought to be currently infected with HPV, and each year about 14 million people become newly infected.

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Closed Windows in Hospital Rooms May Raise Infection Risk

FRIDAY, April 19 (HealthDay News) -- Closed windows in large hospital wards may increase patients' risk of getting an infection, a new study suggests.

British researchers used carbon dioxide as a tracer gas to simulate how airborne infections spread in a traditional hospital ward, which typically includes two rows of up to 30 beds.

The carbon dioxide represented potentially infectious exhaled breath, and was released by popping carbon dioxide-filled balloons. Carbon dioxide detectors were placed where beds might be located in a functioning ward.

"By measuring the concentration of the gas over time, we were able to quantify the exposure at each bed and therefore the potential risk to a patient in that bed," study team member Laura Pickin said in a University of Leeds news release. "We were also able to use the same data to measure the overall ventilation rate in the ward."

When the windows were open, ventilation in the ward was generally good and the risk of airborne infection low. But the danger of infection increased fourfold when the windows were closed, according to the study in the current online issue of the Building and Environment Journal.

"These wards are still in operation and, although they have often been subdivided into smaller areas with six to eight beds, their ventilation and structure is still fundamentally the same," lead investigator Cath Noakes, from the University of Leeds' School of Civil Engineering, said in the news release.

With natural ventilation from windows, the wards are safe. But that changes when the windows are closed during the winter or permanently sealed to lower energy costs.

"Some of these wards were designed by the Victorians, and our results show that they knew what they were doing. But there is a danger that we could be adapting our buildings to improve efficiency without thinking how it might affect patients," Noakes said.

-- Robert Preidt
Copyright © 2013 HealthDay. All rights reserved. SOURCE: University of Leeds, news release, April 16, 2013

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Infection, autoimmune disease linked to depression

Posted June 17, 2013, 5:47 am

Depression, bipolar disorder, and other mental health problems arise when something goes wrong with brain function. What causes that malfunction is an open question. In some people, a serious infection or autoimmune disease could be the trigger.

A report published online in JAMA Psychiatry explores this hypothesis. Researchers turned to comprehensive Danish databases that include all Danes born in the country, each identified by a unique registration number. One of the databases stores health-related information, including records of hospitalizations. Among Danes born between 1945 and 1995, almost 92,000 had a mood disorder. Of these, 36,000 had suffered a severe infection or developed an autoimmune disease (such as type 1 diabetes, celiac disease, lupus, and the like) at some point before being diagnosed with the mood disorder.

People who had been treated for a severe infection were 62% more likely to have developed a mood disorder than those who never had one. An autoimmune disease increased the risk by 45%. Multiple infections or the combination of severe infection and an autoimmune disease boosted the odds of developing depression, bipolar disorder, or another mood disorder even further.

The researchers estimated that in the Danish population, severe infection and autoimmune disease account for 12% of mood disorders.

“A link between infection and depression and mood disorders is intriguing,” says Dr. Michael C. Miller, assistant professor of psychiatry at Harvard Medical School and a member of JAMA Psychiatry’s editorial board. “But it’s important to keep in mind that both infections and mood disorders are very common, making it difficult to tease out what causes what.”

He ticks off three possible explanations for the results:

Severe infection and autoimmune disease may cause mood disorders.Mood disorders may create a susceptibility to infection or autoimmune disease.Mood disorders, severe infection, and autoimmune disorders may share common triggers.

The Danish study isn’t the first to explore links between infection or autoimmune diseases and depression. Much of the evidence supports a connection.

Depression isn’t the only mental health issue that may be related to infections and autoimmune condition. Writing last year in the Harvard Health blog, Dr. Jeff Szymanski described how some children with strep throat suddenly develop obsessive-compulsive disorder. It’s one manifestation of pediatric acute-onset neuropsychiatric syndrome. Quick treatment with antibiotics can reverse the problem.

How might an infection or autoimmune disorder lead to a mood or other mental health disorder? Infection causes localized and body-wide inflammation. Inflammation generates substances called cytokines that have been shown to change how brain cells communicate. In autoimmune diseases, the body’s defense system attacks healthy tissues rather than threatening invaders. It’s possible that in some cases the wayward immune reaction could target brain cells and other nerve cells throughout the body.

The connection between infection, autoimmune disease, inflammation, and mood disorders has prompted some researchers to wonder “Can we vaccinate against depression?” The short answer, at least for now, is “no.”

But there are things you can do. “Healthy living has all sorts of benefits,” says Dr. Miller. It can help you fight infection, reduce inflammation, ease stress, and make you feel better day to day, all of which work against the development of a mood disorder.”

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Valley Fever Fungal Infection on Rise in Southwest

Title: Valley Fever Fungal Infection on Rise in Southwest
Category: Health News
Created: 3/28/2013 4:36:00 PM
Last Editorial Review: 3/29/2013 12:00:00 AM

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Valley Fever Fungal Infection on Rise in Southwest

Flu-like symptoms can last weeks or months, CDC researchers say

By Robert Preidt

HealthDay Reporter

THURSDAY, March 28 (HealthDay News) -- Cases of a fungal lung infection called Valley Fever increased sharply in several southwestern states since the late 1990s, according to a report released Thursday.

In Arizona, California, Nevada, New Mexico and Utah, the number of cases climbed from less than 2,300 in 1998 to more than 22,000 in 2011, the U.S. Centers for Disease Control and Prevention found.

During that time, Arizona and California had the largest average increases in Valley Fever incidence, at 66 percent and 31 percent per year, respectively.

Valley Fever (Coccidioidomycosis) is caused by inhaling a fungus called Coccidioides, which lives in the soil in southwestern states. Not everyone who is exposed to the fungus gets sick, but those who do become ill typically have flu-like symptoms that can last for weeks or months.

More than 40 percent of patients who get sick may require hospitalization, with an average cost of nearly $50,000 per visit. And research has shown that 75 percent of those who get sick miss work or school for about two weeks, the CDC said.

Between 1998 and 2011, nearly 112,000 cases of Valley Fever were reported in 28 states and Washington, D.C., but 66 percent of the cases were in Arizona, 31 percent were in California, 1 percent were in Nevada, New Mexico and Utah, and about 1 percent were in all other states combined.

More research is needed to determine what is causing the increase in Valley Fever and how to reduce its effects, the CDC said. Possible reasons could be population growth, weather changes that could affect where the fungus grows and how much of it is circulating, or changes in the way the disease is detected and reported to the CDC.

"Valley Fever is causing real health problems for many people living in the southwestern United States," Dr. Tom Frieden, director of the CDC, said in an agency news release. "Because fungus particles spread through the air, it's nearly impossible to completely avoid exposure to this fungus in these hardest-hit states. It's important that people be aware of Valley Fever if they live in or have traveled to the southwest United States."

Doctors and patients need to be aware that the symptoms of Valley Fever are very similar to flu or pneumonia symptoms, the CDC said. A lab test is the only way to diagnosis Valley Fever.

Not everyone who gets Valley Fever requires treatment, but early diagnosis and treatment are important for those at risk for the more severe forms of the disease. Those at higher risk for severe disease include people of Asian descent (particularly Filipino), blacks, pregnant women and people with weakened immune systems, according to the CDC website.

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Can You Skip Antibiotics for Urinary Tract Infection?

In small study, UTI symptoms cleared on their own for most women, but an expert urges caution

By Kathleen Doheny

HealthDay Reporter

TUESDAY, June 4 (HealthDay News) -- Some women with symptoms of a urinary tract infection may be able to skip the antibiotics typically prescribed and have their symptoms improve or clear, according to a new Dutch study.

"In healthy people, many mild infections can be cured spontaneously," said study leader Dr. Bart Knottnerus, a researcher at the Academic Medical Center of the University of Amsterdam.

A U.S. expert, however, had a number of cautions about the findings, including the small number of women studied.

For the research, published May 31 in the journal BMC Family Practice, Knottnerus recruited women from 20 general medical practices in and around the Netherlands from 2006 to 2008. Women who had contacted their doctor complaining of frequent urination, painful urination or both were asked if they would be willing to delay antibiotics -- but only if their symptoms had been present for no longer than seven days.

Certain women were excluded, including those pregnant or breast-feeding or those whose immune systems were compromised.

In all, 176 women participated. Of those, 137 were asked to delay antibiotics and 51 agreed. All the women gave a urine sample to be analyzed and cultured. The women reported on their symptoms over the next week.

After a week, 28 of the 51 women willing to delay antibiotic use still had not used an antibiotic. Twenty of these women (71 percent) reported disappearance or improvement of their symptoms. Of these 20, more than a third had a positive culture result, indicating an infection. The researchers did not know the culture results at the start of the study.

Most of the women not willing to delay antibiotics had a positive culture.

The women who did agree to delay, Knottnerus said, might be aware of the bacterial resistance that can result from antibiotic use. "Furthermore," he said, "in the Netherlands, other mild infections -- like eye, ear, throat and respiratory infections -- are usually not treated with antibiotics. Therefore, people might be more receptive to delayed antibiotic prescriptions."

Antibiotics for urinary tract infections usually work within two or three days. How would an infection clear on its own? "Our defense mechanisms are strong and often do not need any help from antibiotics," Knottnerus said. He studied only uncomplicated infections of the bladder -- defined as those in healthy, non-pregnant women.

Dr. Jennifer Leighdon Wu, a gynecologist at Lenox Hill Hospital in New York City, was cautious about the findings. "The number of women who agreed to delay was 51," she said. "Before changing my practice, I would like to see much larger numbers."

Checking in with your doctor might uncover some other problem, she said. "I can't tell you how many people have come in thinking it's a urinary tract infection and it's a yeast infection," she said.

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Transfusions With Heart Surgery Might Raise Infection Risk

Delicate balance exists between treating anemia, avoiding side effects from infusion of red blood cells, study says

By Mary Elizabeth Dallas

HealthDay Reporter

THURSDAY, May 30 (HealthDay News) -- Patients who receive a red blood cell transfusion during or after heart surgery may be at greater risk for infection, according to a new study.

However, the use of platelets during transfusions does not appear to carry a similar risk. Limiting red blood cell use could result in fewer major postoperative infections, the researchers suggested.

The study is published in the June issue of the Annals of Thoracic Surgery.

"A common problem for many surgeons, and thereby the patient, is how to balance the risk of surgery-induced anemia with the increased risk of infection when using red blood cell transfusion to correct the anemia," study author Dr. Keith Horvath, at the U.S. National Heart, Lung, and Blood Institute, said in a journal news release.

"Through this study, we hoped to shed light on the problem and to encourage hospitals and surgeons to examine cell-salvage techniques and other alternatives to [red blood cell] transfusion during and after cardiac surgery," he explained.

The observational study, conducted by the Cardiothoracic Surgical Trials Network, involved nearly 5,200 adults who underwent heart surgery between February and September 2010.

"Our study enrolled a large population of patients from a number of different institutions who were undergoing any type of cardiac surgery," Horvath noted. "This large patient set enabled us to better examine the relationship between transfusion and infection in a very diverse population."

Of the study's participants, 48 percent received a red blood cell transfusion and 31 percent received platelets.

With red blood cell transfusions, 84 percent took place during a transplant or left ventricular assist device implantation. Meanwhile, 63 percent occurred during thoracic aortic procedures, 45 percent took place during isolated coronary artery bypass grafting surgery and 40 percent occurred during isolated valve surgery.

The study found that 65 days after surgery, 5 percent of the patients developed at least one major infection, such as pneumonia, C. difficile colitis (a bacterial infection in the colon) and bloodstream infections.

With each red blood cell unit transfused, there was a 29 percent increase in infection risk. In contrast, platelets transfused along with more than four unit of red blood cells was associated with a lower infection risk.

"Few in regulatory agencies have grasped the complex but real relationships between red cell transfusions, infection and ... readmissions," Dr. Bruce Spiess, from Virginia Commonwealth University Medical Center, wrote in a related journal commentary.

Spiess concluded that improvements in blood management among cardiac teams would enhance patient safety, reduce hospital-acquired infections and reduce critical blood shortages.

However, the researchers pointed out that since this was an observational study, the reported associations cannot be considered as a cause-and-effect relationship.

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Petroleum Jelly Tied to Vaginal Infection Risk in Study

Title: Petroleum Jelly Tied to Vaginal Infection Risk in Study
Category: Health News
Created: 3/8/2013 10:35:00 AM
Last Editorial Review: 3/8/2013 12:00:00 AM

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Petroleum Jelly Tied to Vaginal Infection Risk in Study

Use of such products doubled odds of bacterial vaginosis, researchers find

By Amy Norton

HealthDay Reporter

FRIDAY, March 8 (HealthDay News) -- Women who use petroleum jelly vaginally may put themselves at risk of a common infection called bacterial vaginosis, a small study suggests.

Prior studies have linked douching to ill effects, including bacterial vaginosis, and an increased risk of sexually transmitted diseases and pelvic inflammatory disease. But little research has been conducted on the possible effects of other products some women use vaginally, said Joelle Brown, a researcher at the University of California, San Francisco, who led the new study.

She and her colleagues found that of 141 Los Angeles women they studied, half said they'd used some type of over-the-counter product vaginally in the past month, including sexual lubricants, petroleum jelly and baby oil. Almost as many, 45 percent, reported douching.

When the researchers tested the women for infections, they found that those who'd used petroleum jelly in the past month were more than twice as likely as non-users to have bacterial vaginosis.

Bacterial vaginosis occurs when the normal balance between "good" and "bad" bacteria in the vagina is disrupted. The symptoms include discharge, pain, itching or burning -- but most women have no symptoms, and the infection usually causes no long-term problems.

Still, bacterial vaginosis can make women more vulnerable to sexually transmitted diseases, including HIV. It also sometimes leads to pelvic inflammatory disease, which can cause infertility.

The new findings, reported in the April issue of Obstetrics & Gynecology, do not prove that petroleum jelly directly increased women's risk of bacterial vaginosis.

But it's possible, said Dr. Sten Vermund, director of the Institute for Global Health at Vanderbilt University School of Medicine in Nashville, Tenn.

Petroleum jelly might promote the growth of bad bacteria because of its "alkaline properties," explained Vermund, who was not involved in the study.

"An acidic vaginal environment is what protects women from colonization from abnormal organisms," Vermund said.

He noted that many studies have now linked douching to an increased risk of vaginal infections. And that may be because the practice "disrupts the natural vaginal ecology," Vermund said.

Normally, the vagina predominantly contains "good" bacteria that produce hydrogen peroxide. And experts say that this natural environment "cleans" the vagina; women do not need special products to do it.

Yet many women continue to douche, using products that may contain irritating antiseptics and fragrances. Up to 40 percent of U.S. women aged 18 to 44 douche regularly, according to the U.S. Department of Health and Human Services.

"The frequency with which American women use unnecessary and harmful intravaginal products is unfortunate," Vermund said.

It's not certain that douching, itself, causes infections, but the American College of Obstetricians and Gynecologists advises women against the practice.

The current findings are based on a group of racially diverse women who agreed to screening for sexually transmitted diseases. Slightly more than one-quarter were HIV-positive.

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Pediatrics Group Issues New Ear Infection Guidelines

By Serena Gordon

HealthDay Reporter

MONDAY, Feb. 25 (HealthDay News) -- The American Academy of Pediatrics has issued new guidelines for identifying and treating a common childhood ailment that can cause a lot of misery -- the ear infection.

In the guidelines released Monday, the pediatrics group more clearly defines the signs and symptoms that indicate an infection that might need treatment. They also encourage observation with close follow-up instead of antibiotic treatment for many children, including some under the age of 2 years. And, for parents of children with recurrent infections, the new guidelines advise physicians and parents when it's time to see a specialist.

"Between a more accurate diagnosis and the use of observation, we think we can greatly decrease the use of antibiotics," said the lead author of the new guidelines, Dr. Allan Lieberthal, a pediatrician at Kaiser Permanente Panorama City, in Los Angeles, and a clinical professor of pediatrics at the Keck School of Medicine at the University of Southern California.

The last set of guidelines was issued in 2004. Lieberthal said those stimulated a lot of new research, which provided additional evidence for the current American Academy of Pediatrics (AAP) guidelines appearing in the March issue of Pediatrics.

Lieberthal said the biggest change in the new document is the definition of the diagnosis itself.

Pediatrician Dr. Roya Samuels, who has reviewed the new guidelines, agreed. "The definition is more clear-cut, more precise," she said. But, she added, "There's still no gold standard for diagnosis. There are different stages of [ear infections], and making the diagnosis can be tricky."

Because the diagnosis isn't always easy to make, the AAP offers detailed treatment suggestions, encouraging observation with close follow-up, but also leaves it up to the discretion of the doctor whether or not to prescribe antibiotics. If children who are being observed don't improve within 48 to 72 hours from when symptoms first began, the guidelines recommend beginning antibiotic therapy.

Previous guidelines recommended giving antibiotics for ear infections in children age 2 and under. The new guidelines suggest that children aged between 6 months and 23 months can be observed with close follow-up as long as they don't have severe symptoms.

Another key component of the new guidelines is pain management. "Antibiotics take 24 to 48 hours before they start to improve signs and symptoms, so if a child has fever or pain, it's important to place them on [pain-relieving or fever-reducing medications]," Samuels said.

The guidelines also confirm that amoxicillin should be the antibiotic of choice unless the child is allergic to penicillin, or if the child has been treated with amoxicillin during the past month.

The new guidance from the AAP also states that children, even those with recurrent infections, shouldn't be on long-term daily antibiotics to try to prevent infections from occurring.

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Dialysis Catheters Tied to Higher Risk for Infection, Death, Study Finds

By Mary Elizabeth Dallas

HealthDay Reporter

THURSDAY, Feb. 21 (HealthDay News) -- Dialysis patients using catheters have a higher risk for death, infection and heart problems than patients using other procedures to access the blood, according to a new analysis.

Researchers examined 67 studies involving nearly 600,000 dialysis patients to compare the risks associated with three procedures used to access the blood: arteriovenous fistula, arteriovenous graft and central venous catheter.

An arteriovenous fistula is formed when a patient's vein and artery are connected to form a site through which blood can be removed and returned. An arteriovenous graft is a plastic channel between an artery and a vein. A third option for dialysis patients is a catheter, which patients often use to avoid surgery or needles or because of declining health.

Because of kidney failure, more than 1.5 million people around the world are treated with hemodialysis. The procedure involves filtering the blood to remove wastes, extra salt and water.

In conducting the study, the researchers assessed the link between these three types of vascular access and death, infection and major heart problems, such as heart attack and stroke.

The study, published Feb. 21 in the Journal of the American Society of Nephrology , revealed that patients using catheters had a 38 percent greater risk for a major heart problem, a 53 percent higher risk of dying and more than double the risk of developing a fatal infection than patients with fistulas.

Grafts also had an 18 percent higher risk of death and a 36 percent greater risk of serious infections than fistulas. But the researchers noted that patients with grafts did not have a greater risk for a major heart problem than those with fistulas.

Assuming patients on dialysis were of similar health, the researchers concluded that catheters used for hemodialysis have the highest risks for death, infections and heart trouble, while fistulas are the least risky.

"Our findings are reflected in current clinical practice guidelines, which promote fistulas as the preferred form of bloodstream access in hemodialysis patients," Dr. Pietro Ravani, of the University of Calgary, in Canada, said in a journal news release.

The study's authors noted that patients involved in the study who were using catheters were probably sicker than those using fistulas. They concluded that more research is needed to determine individual patient risk and assess the safety of the various types of blood access used for hemodialysis.

More information

The U.S. National Kidney and Urologic Diseases Information Clearninghouse provides more information on hemodialysis.

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Little-Known Respiratory Infection Sends Many Kids to Hospital

Title: Little-Known Respiratory Infection Sends Many Kids to Hospital
Category: Health News
Created: 2/13/2013 6:36:00 PM
Last Editorial Review: 2/14/2013 12:00:00 AM

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Scientists Explore How Zinc Fights Off Infection

Title: Scientists Explore How Zinc Fights Off Infection
Category: Health News
Created: 2/7/2013 12:35:00 PM
Last Editorial Review: 2/8/2013 12:00:00 AM

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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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