Monthly Archives: April 2017

A Bodybuilder Died Because Most Drink Protein Shakes

A 25-year-old woman in Australia died after consuming too much protein, in the form of shakes, supplements and protein-packed foods, the New York Post reported yesterday.

The woman, a bodybuilder named Meegan Hefford, was found unconscious in her apartment and was taken to the hospital. Hefford was declared brain-dead by doctors and died two days later.

After Hefford’s death, the doctors discovered that she had a rare condition called a urea cycle disorder, which affects how the body breaks down protein, according to the New York Post. [7 Foods You Can Overdose On]

What is a urea cycle disorder, and how can too much protein lead to death?

When a person eats protein, the body breaks the macronutrient down into its building blocks, called amino acids. After using what it needs, the body converts the leftover amino acids into nitrogen, which is removed from the body, according to Cincinnati Children’s Hospital Medical Center. To remove the nitrogen, enzymes convert the chemical into a compound called urea, in a process called the urea cycle. This substance is then excreted from the body in a person’s urine.

But when a person has a urea cycle disorder, the body can’t convert nitrogen into urea, Cincinnati Children’s says. This causes nitrogen to build up in a person’s blood in the form of ammonia, a highly toxic substance, according to the Genetic and Rare Diseases Information Center (GARD). Too much ammonia in the blood can lead to irreversible brain damage, coma or death, GARD says.

Urea cycle disorders stem from deficiencies in one of the six enzymes in the body responsible for converting nitrogen to urea, GARD says. The disorders are genetic, meaning that they are passed down from parent to child, according to Cincinnati Children’s.

The symptoms of urea cycle disorders depend on how severe the condition is. A severe urea cycle disorder, for example, means that a person has little to no activity in one of the necessary enzymes. In people with less severe disorders, enzyme activity levels may be lower than those of a healthy person.

For instance, if a baby is born with a severe urea cycle disorder, symptoms will appear about 24 hours after birth, according to theNational Urea Cycle Disorders Foundation (NUCDF). These babies can develop seizures and breathing problems, and may fall into comas, the NUCDF says.

Urea cycle disorders are rare; about 1 in 30,000 newborns is affected, Cincinnati Children’s says.

Symptoms of mild to moderate urea cycle disorder can show up in childhood, according to the NUCDF, and can initially include refusal to eat high-protein foods, failure to thrive and inconsolable crying. As the disease progresses, children can develop vomiting, lethargy and delirium. If untreated, the condition can lead to coma and death.

People with mild urea cycle disorders may go until adulthood before they are diagnosed, the NUCDF says. High-protein diets and excessive exercise can trigger symptoms, as can childbirth and certain viruses. In some adults and children, stress can also trigger symptoms, according to Cincinnati Children’s.

Although there is no cure for urea cycle disorders, the condition can be managed with a low-protein diet and certain medications that help remove ammonia from the body, Cincinnati Children’s says. Sometimes, a person may also need to take amino acid supplements to ensure that the body gets what it needs to function.

In severe cases of these disorders, a doctor may recommend a livertransplant, Cincinnati Children’s says. The liver produces the enzymes involved in the urea cycle.

Flu Shot Facts & Side Effects

The flu can be a very serious illness, especially in young children, adults ages 65 and over, those with underlying health conditions, and pregnant women.

The flu shot is the best way to protect yourself and family from the flu, the CDC says.

Strains of the flu virus are constantly changing, so a new flu vaccine is made each year. Scientists make the vaccine before the flu season starts by predicting which flu strains are likely to be the most common during the upcoming season.

“Since the flu virus frequently drifts in its genetic composition, you have to reformulate the vaccine, and this is one of the reasons that people have to [get a flu shot] on an annual basis,” said Dr. William Schaffner, a preventive medicine and infectious disease expert at Vanderbilt University School of Medicine.

Flu shots protect against three or four strains of flu virus. Trivalent flu vaccines protect against two influenza A strains — H1N1 and H3N2 — and one influenza B strain. Quadrivalent flu vaccines — offered for the first time in the 2013-2014 flu season — protect against the same strains as the trivalent vaccine, as well as an extra influenza B strain.

In addition to the standard-dose flu vaccine given through a needle, flu shots are available in several different forms, including a high-dose version for those ages 65 and older, a small-needle version (intradermal flu vaccine) for people ages 18 to 64, an egg-free version that’s grown in animal cells rather than hen’s eggs and is approved for people ages 4 and older, and a nasal spray, which is approved for healthy people ages 2 to 49.

There is also a needle-free flu shot, delivered by a so-called jet injector, which uses a high-pressure stream of fluid to inject the vaccine, the CDC says. It is approved for adults ages 18 to 64.

The composition of the 2017-2018 flu shot will be slightly different from last season’s flu shot. Specifically, there will be a different strain of the H1N1 virus in this season’s flu shot, compared with last season’s shot. According to the CDC, the 2017-2018 trivalent flu shot will contain the following strains of the flu virus:

  • A/Michigan/45/2015 (H1N1)pdm09-like virus – This is the H1N1 component that is different from last year’s flu shot.
  • A/Hong Kong/4801/2014 (H3N2)-like virus – This is the H3N2 component that is the same as last year’s flu shot.
  • B/Brisbane/60/2008-like (B/Victoria lineage) virus – This is the influenza B strain component that is the same as last year’s shot.

The 2017-2018 quadrivalent vaccine will also contain a second influenza B strain called “B/Phuket/3073/2013-like (B/Yamagata lineage) virus,” which was also included in last season’s quadrivalent vaccine.

Just like the last flu season, the flu nasal spray is not recommended for anyone during the 2017-2018 flu season. This is the second year in a row that the CDC has omitted the nasal spray from the list of recommended flu shot types. This decision was based on data showing that the nasal spray was not very effective at preventing flu from 2013 to 2016, the CDC says. In addition, omitting the nasal spray during the 2016-2017 flu season did not affect the overall percentage of Americans who recieved a flu shot that season, according to American Academy of Family Physicians. It’s not clear whether this recommendation will change in future seasons.
In addition, the CDC clarified that pregnant women may recieve any of the flu vaccines recommended for their age group, except the nasal spray (also called the live attenuated influenza vaccine, or LAIV.) This means pregnant women can receive either “inactivated” (killed) flu vaccine, or the “recombinant” flu vaccine, which is produced without the use of chicken eggs and can be given to people with egg allergies. Previously, the CDC had said pregnant women should recieve the “inactivated,” but did not mention use of recombinat vaccines.

Exactly when the flu season starts and ends is unpredictable, so health officials recommend that people get their flu shot in early fall, preferably by the end of October, the CDC says. Flu activity typically peaks in January or February.

“We’d like to get as many people protected against influenza before influenza becomes active in communities across the country,” Schaffner said.

Most flu vaccines are given before Thanksgiving, Schaffner said, but people can still get their shot throughout the winter months. Each season’s flu shot expires in June of that year, but Schaffner said that he would consider it “too late” to get a flu vaccine after March, unless a person is traveling to the Southern Hemisphere (where the flu season will be starting).

After vaccination, it takes a person about two weeks to build up immunity against the flu.

People can visit the CDC’s HealthMap Vaccine Finder to find flu shot locations, although they should call the location ahead of time to see if they have the vaccine in stock.

The effectiveness of the seasonal flu vaccine depends upon several factors, including how well the flu strains in the vaccine match the strains in circulation. Some studies show that when strains in the vaccine are a good match with the ones that are circulating, vaccinated individuals are 60 percent less likely to catch the flu than people who aren’t vaccinated,according to the CDC.

Flu vaccine effectiveness can also vary depending on the person being vaccinated — the vaccine tends to work best in healthy adults and older children, and less well in older adults.

For instance, a 2013 study from the CDC found that the year’s flu vaccine was not very effective in adults ages 65 and over: Older people who got the vaccine were just as likely to visit the doctor for flu symptoms as those who did not get the vaccine.

But other studies suggest that individuals who do get sick develop less serve symptoms if they are vaccinated. A 2013 study published in the journal Clinical Infectious Diseases found that people who got the flu shot were less likely to be hospitalized with the flu.

There are some studies that suggest the high-dose flu vaccine provides better protection for older adults. The high-dose flu vaccine contains four times the dose of the standard vaccine, Schaffner said. A 2014 study in the New England Journal of Medicine found that the high-dose vaccine provides 24 percent more protection against the flu than the standard dose, Schaffner said.

Yes. Studies show flu vaccines are safe for women in any stage of pregnancy, the CDC says.

There are several reasons why it’s important for pregnant women to get a flu shot, Schaffner said.

“Pregnant women, when they get influenza, have a tendency to get a more severe disease,” and are at increased risk for complications and hospitalization from the disease, Schaffner said.

In addition, flu vaccination in pregnancy helps to protect the baby against flu during the first six months of life, when the baby is too young to receive a flu shot, Schaffner said. The mother “passes that protection on to her newborn baby,” Schaffner said.

According to the CDC, mild side effects from the flu shot include soreness, redness or swelling at the injection site, low-grade fever and aches. Only about 1 percent to 2 percent of people who get a flu shot will have fever as a side effect, Schaffner said.

Rare but serious side effects can occur, including allergic reactions. Symptoms of serious side effects include difficulty breathing, swelling around the eyes or lips, hives, racing heart, dizziness and high fever. If you experience serious side effects, you should seek medical care immediately, the CDC says.

For children, side effects from the flu nasal spray can include runny nose, wheezing, headache, vomiting, muscle aches and fever. For adults, side effects include runny nose, headache, sore throat and cough. These side effects last a short time compared to the actual flu illness, the CDC says.

“It’s a myth that you can get flu from the flu vaccine,” Schaffner said.

The viruses in the flu shot are killed, so people cannot get the flu from a flu vaccine. However, because it takes about two weeks for people to build up immunity after they get the flu vaccine, some people may catch the flu shortly after their vaccinated, if they are exposed to the flu during this time period.

Some people may also mistakenly attribute symptoms of a cold to the vaccine, Schaffner said.

The nasal spray vaccine contains a “live attenuated” flu virus, but the virus is weakened so that it cannot cause the flu. The viruses in the nasal spray can’t replicate in the warm temperatures of the lungs and other parts in the body. However, because temperatures in the nose are colder, the virus causes a small infection in the nose. This infection does not cause symptoms in most people, but in some people, it causes symptoms such as runny nose and sore throat, Schaffner said.

This local infection will prompt the body to make antibodies against the flu virus, Schaffner said. “That provides better protection against the real flu, which is of course, is a virus that can make you seriously ill,” Schaffner said.

Children younger than 6 months cannot get a flu shot. Those who’ve had a severe allergic reaction to a flu vaccine in the past should generally not be vaccinated, the CDC says.

You should not get the flu vaccine if you have a high fever. (You should wait until the fever is gone.)

However, if you have minor illness, like a mild cold or a headache, you can still get a flu shot, Schaffner said. “The vaccine does perfectly well in those folks.”

How to CT Scan from Olive Led to Man’s Crohn’s Disease Diagnosis

When a 24-year-old man in Belgium went to the hospital because he had belly pain, doctors found an olive stuck in his small intestine — and soon after, diagnosed him with Crohn’s disease.

The man had sudden and severe abdominal pain for two days before he went to the doctor, according to a report of the man’s case, published Aug. 9 in the journal BMJ Case Reports. The incident took place about six months ago.

The doctors performed a CT scan of the man’s abdomen to see if they could spot the reason for his pain. They found that a portion of the wall of the small intestine was thickened, and within that thickened tissue, they discovered an odd-looking spot that turned out to be a black olive. [Here’s a Giant List of the Strangest Medical Cases We’ve Covered]

Olives were one of the man’s favorite foods, and he had accidentally swallowed the olive whole, pit included, said lead author Dr. Halil Yildiz, an internal-medicine physician at University Hospital Saint-Luc in Belgium who treated the man.

To confirm that the spot on the scan was an olive, however, the doctors did something that had never been done: They performed another CT scan — a scan of a single fresh olive. “This is the first time that CT acquisition of a fresh olive has been compared with patient images,” the doctors wrote in the report.

The olive scan did its part: It confirmed that the small fruit really was lodged in the man’s bowels, Yildiz told Live Science.

No surgery was required to remove the olive; instead, the man was given steroids to reduce the inflammation in his gut, and eventually, the olive passed out of his body in his feces, Yildiz said.

In most cases when a person swallows a “foreign body” — in other words, something they shouldn’t have swallowed — it passes safely through the gastrointestinal tract and out the other end, according to the report. Occasionally, something may get stuck, but “this complication is very rare with olives,” the authors wrote.

Indeed, it turns out that there was another factor at play that made it much more likely for the olive to get stuck in the man’s gut, Yildiz said: He had a type of inflammatory bowel disease called Crohn’s disease.

But neither the man nor the doctors knew that the patient had Crohn’s disease until after the olive had passed out of his body and the patient returned for a follow-up colonoscopy, according to the report. It was during that exam that the doctors diagnosed the man with Crohn’s disease.

“If there was no bowel disease,” the olive wouldn’t have caused a problem, Yildiz said. “Crohn’s disease [made] the obstruction more likely.”

Why You Need Eclipse Glass, to Stare at it?

With the Aug. 21 solar eclipse just days away, you’ve likely heard the warnings to never look directly at the sun without proper eye protection. And for good reason: A recent case illustrates the real danger of doing so — A 12-year-old girl in Florida damaged her eyes by looking at the sun for 1 minute, according to a new report of the girl’s case.

One day after staring at the sun, the girl went to an ophthalmology emergency room because her vision had become blurry, according to the report, published today (Aug. 18) in the journal JAMA Ophthalmology.

The girl had a condition called “solar retinopathy,” which means her eyes were damaged from looking at the intense light of the sun, said Dr. Kara Cavuoto, an ophthalmologist at the Bascom Palmer Eye Institute at the University of Miami Health System. Cavuoto and co-author Dr. Ta Chen Chang, also an ophthalmologist at the same institute, treated the patient. [2017 Total Solar Eclipse: Everything You Need to Know]

Solar retinopathy is thought to occur when extremely bright light creates molecules known as free radicals in a person’s eyes. These highly reactive molecules can kill cells in the retina, leading to blurry vision, according to the American Academy of Ophthalmology (AAO).

The girl’s case didn’t take place during a solar eclipse, but “there’s no difference in risk between looking at the sun during a [solar] eclipse versus any other time,” Cavuoto told Live Science. “People often stare at the sun for prolonged periods of time during an eclipse and may underestimate the harm the sun is causing to their eyes.”

In solar retinopathy, the central part of the retina, called the macula, is damaged, Cavuoto said. In particular, the damage occurs in a central pit in the macula called the fovea, which is responsible for sharp vision. “This results in blurred vision or a blind spot in one or both eyes,” she said.

The condition isn’t painful, and the symptoms don’t start immediately after a person looks at the sun. Generally, a person starts to notice the effects a few hours after looking at the sun, Cavuoto said. In the girl’s case, she noticed that her vision was blurry several hours later, and by the following day, her vision had gotten worse.

The doctors noted in the report that the girl had glaucoma, a condition that causes increased pressure in the eye and can also damage vision. (The girl already had glaucoma before staring at the sun; the condition did not result from that incident.) It’s possible that because the girl’s vision was already decreased, she might have stared at the sun longer to see all of the details, Cavuoto said.

In some cases of solar retinopathy, people’s vision may improve within six months, but they rarely return to “normal” vision, Cavuoto said. The girl’s vision, however, did not improve, according to the report.

Despite the name solar retinopathy, staring at the sun isn’t the only cause of the condition. Activities such as welding, which emits a very bright light, and misusing a laser pointer can also cause solar retinopathy, Cavuoto said.