1. Art and Diseño

ARAB TIMES, SATURDAY, JANUARY 31, 2015
HEALTH
36
Health
Young adults vape
E-cigs safe &
fun technology
SAN FRANCISCO, Jan 30,
(RTRS): Many young adults are
enthusiastically “vaping” e-cigarettes, drawn by the nifty technology, tasty flavors and their own
physical sense that the devices are
doing them no harm, according to
new research.
The authors
of the small
study, which
focused
on
young adults
in New York
City, say this
segment of the
vaping population needs
more educaLing
tion on the
possible health effects of e-cigarettes, including the potential for
becoming addicted to nicotine.
A ban on flavors and on marketing tactics that are already prohibited for tobacco could help slow the
uptake of e-cigarettes as well, the
researchers conclude in the journal
Tobacco Control.
“I think my main concern is not
so much that this product is going
to end up being more toxic than
cigarettes — because cigarettes are
so toxic you almost can’t come up
with a product that is worse — but
young adults are still in a stage
where they are initiating nicotine
use,” Dr Pamela Ling, one of the
study’s two authors, told Reuters
Health.
E-cigarettes have grown into a
$5 billion global business in recent
years, but research into their safety
and how and why people use the
devices has lagged.
Most researchers agree that the
nicotine-laced vapor delivered by
e-cigarettes contains far fewer toxic
chemicals and none of the tar in traditional cigarettes.
Smokers
It’s still unclear whether e-cigarettes help smokers to cut down or
quit traditional cigarettes, but a
growing number are using them to
try.
Some research suggests that
using nicotine in any form could
open a gateway to addiction that
leads young people to take up
tobacco. California’s chief public
health officer issued a report
Wednesday calling e-cigarettes a
threat to public health and the
state’s anti-tobacco efforts.
Many e-cigarette studies have
focused on smokers, generally
older, some with a declared intent
to quit using tobacco. Ling and her
coauthor wanted to look at how
younger people, who may or may
not be smokers, are using e-cigarettes and why.
The researchers point out in
their report that e-cigarette use in
the US is highest among young
people, with about 14 percent of
18-24 year olds having tried “vaping” in 2013.
In 2012 and 2013, Ling and her
colleague recruited 87 men and
women between the ages of 18
and 27 years old for a series of
focus groups followed by indepth interviews with a smaller
group. About a third of participants had used an e-cigarette in
the past 30 days. Just over half of
those were daily smokers of
tobacco and 41 percent smoked
less than daily.
Of the current e-cigarette users,
50 percent said they had no intention to quit smoking in the next six
months, 48 percent said they had
made a quit attempt in the past 12
months and 31 percent said they
were currently trying to quit smoking.
Pediatrician Charles Goodman poses for photo with the MMR vaccine, an immunization vaccine against measles, mumps, and rubella at his practice in Northridge, Calif, on Jan 29. With California gripped
by a measles outbreak, Dr Goodman posted a clear notice on his door and on Facebook: His practice will no longer see children whose parents won’t get them vaccinated. At left, is his wife, Judith. (AP)
Some doctors won’t see patients with anti-vaccine views
With California gripped by a measles
outbreak, Dr Charles Goodman posted
a clear notice in his waiting room and
on Facebook: His practice will no longer
see children whose parents won’t get
them vaccinated.
It’s a sentiment echoed by a small
number of doctors who in recent years
have “fired” patients who continue to
believe debunked research linking vaccines to autism. They hope the strategy
will lead parents to change their minds;
if that fails, they hope it will at least
reduce the risk to other children in the
office.
“Parents who choose not to give
measles shots, they’re not just putting
their kids at risk, but they’re also putting
other kids at risk — especially kids in
my waiting room,” the Los Angeles
pediatrician said.
The tough-love approach — which
comes amid the nation’s secondbiggest measles outbreak in at least 15
years, with 95 cases or more since last
month, most of them traced directly or
indirectly to Disneyland in Southern
California — raises questions about
doctors’ ethical responsibilities.
The American Academy of Pediatrics
says doctors should bring up the importance of vaccinations during visits but
should respect a parent’s wishes unless
there’s a significant risk to the child.
“In general, pediatricians should
avoid discharging patients from their
practices solely because a parent
refuses to immunize his or her child,”
according to guidelines issued by the
group.
However, if the relationship between
patient and doctor becomes unworkable, the pediatrics academy says, the
doctor may want to encourage the vaccine refuser to go to another physician.
Some mothers who have been
dropped by their doctors feel “betrayed
and upset,” said Dotty Hagmier,
founder of the support group Moms in
Charge. She said these parents made
up their minds about vaccines after
“careful research and diligence to
understand the risks versus the benefits for their own children’s circumstances.”
Dropping patients who refuse vaccines has become a hot topic of discus-
sion on SERMO, an online doctor hangout. Some doctors are adamant about
not accepting patients who don’t
believe in vaccinations, with some saying they don’t want to be responsible for
someone’s death from an illness that
was preventable.
Others warn that refusing treatment
to such people will just send them into
the arms of quacks.
The measles-mumps-rubella vaccine, or MMR, is 97 percent effective at
preventing measles, according to the
Centers for Disease Control and
Prevention.
Measles spreads easily through the
air and in enclosed spaces. Symptoms
include fever, runny nose, cough and a
rash all over the body. In rare cases,
particularly among babies, measles can
be deadly. Infection can also cause
pregnant women to miscarry or give
birth prematurely.
All US states require children to get
certain vaccinations to enroll in school.
California is among 20 states that let
parents opt out by obtaining personal
belief waivers. Some people worry that
vaccines cause developmental problems, despite scientific evidence disproving any link. Others object for religious or philosophical reasons.
Nationally, childhood measles vaccination rates have held steady for years
at above 90 percent. But there seem to
be growing pockets of unvaccinated
people in scattered communities, said
Dr Gregory Wallace of the CDC. (AP)
‘High intensity therapy proven to be better’
After heart attacks, most don’t get enough statins
NEW YORK, Jan 30, (RTRS): In the
US, less than a third of older heart
“event” patients being discharged from
the hospital get the recommended
high-intensity statins, according to a
new study that looked at prescriptions
filled.
National guidelines from the
American College of Cardiology and
American Heart Association say the
majority of patients should be on a
high-dose statin following a serious
heart disease-related event like heart
attack or bypass surgery.
“It appears that there’s tremendous
reticence in prescription of statin therapy,” said lead author Dr Robert S.
Rosenson of the Icahn School of
Medicine at Mount Sinai in New York.
“Whatever the dose of statin people
were taking when they came to the hospital was the dose they went out on, the
acute event didn’t change it,” he told
Reuters Health. “This is very disappointing.”
The authors studied a random sample of Medicare beneficiaries ages 65
to 74 who filled a statin prescription
after having a heart attack or bypass
surgery between 2007 and 2009.
Of more than 8,000 people who
filled a statin prescription after one of
these events, only 27 percent of the
first post-discharge prescriptions were
for “high-intensity” statins, such as 40
to 80 milligrams of atorvastatin
(Lipitor) or 80 milligrams of simvastatin (Zocor).
Less than 25 percent of people who
were not taking a statin before their
hospitalization filled a high-intensity
statin prescription on their release, and
less than 10 percent of those who had
been taking a low-intensity statin
switched to a high-intensity one.
Prescription
About 80 percent of people who had
already been taking high-intensity
statins filled another such prescription
immediately upon leaving the hospital,
according to the results in the Journal
of the American College of Cardiology.
Of the patients whose first post-discharge prescription fill was for a low-
intensity statin, less than 12 percent
switched to a high-intensity dosage
within the following year.
“There’s a tremendous amount of
confusion,” Rosenson said. Though the
clinical guidelines, which are supported by rigorous studies and high quality
results, indicate that high dose statins
are better than low dose statins after an
acute cardiac event, many doctors
appear not to be following them.
High intensity statins have been
linked to better health outcomes in the
short and long term for these patients,
he said.
“It could be that either the doctors
are not aware of the guidelines that
high intensity therapy is proven to be
better, or more likely they are focusing
on the (low-density lipoprotein) cholesterol level,” he said.
There has been confusion on
whether or not to dose statins based on
LDL cholesterol readings for some
patients, but for those who have suffered an acute cardiac event, a high
dose is better, he said.
“If statins are fairly safe and highly
effective agents particularly for these
types of patients, yet only about 50 to
60 percent of these patients are on what
has been recommended and proved,
why is that?” asked Dr Prakash
Deedwania of the University of
California San Francisco School of
Medicine in Fresno who wrote an editorial accompanying the new results.
Side effects from statins are rare, he
noted, and cost of the drugs — which
are mostly generic, inexpensive, and
covered by insurance including
Medicare — should not be an issue.
There is some risk of developing what
is know as “chemical diabetes,” but the
benefits of the drugs far outweigh this
risk, Deedwania told Reuters Health.
Harm
“The benefit is 10-fold greater than
any sort of harm,” he said.
When doctors know that an oversight body is going to be looking at
their prescribing data, they are more
likely to follow guidelines, he said.
“We should be doing this without
anyone looking, but unfortunately it
doesn’t work like that,” Deedwania
said.
Though the authors focus on doctors
likely not prescribing the recommended statin dose, there could be confusion
or reluctance on the patient side as
well, he said.
Much like blood pressure medication, statins don’t provide immediate
symptom relief while they are acting in
the body. Since patients don’t feel a
difference when they take the medication, they may not be motivated to continue taking it, he said.
“The burden is on us to educate our
patients, tell them precisely in simple
terms what are the benefits of statins,”
Deedwania said.
In addition to reducing the risk of
another heart attack and making a
bypass graft more durable over time,
statins reduce the risk of stroke, he
said.
“That resonates really well,”
Deedwania said. “Everybody wants to
get extra benefits,”