Ehlers-Danlos Syndrome Ranges from Mild to Deadly

Ehlers-Danlos syndrome (EDS) is the name given to a group of hereditary disorders that all involve the weakening of connective tissues in the body. Among the most common symptoms seen in patients with EDS are skin that bruises and stretches easily, small and fragile blood vessels, loose joints, and weakness of body tissues.

Since connective tissue is found throughout the body and serves many important roles, such as supporting skin and bones and making up blood vessels, malfunctioning in this tissue can be a very serious problem. Joints can move beyond their normal range of motion, and this can lead to dislocation of the shoulder and other major joints.

There is no cure for Ehlers-Danlos syndrome. Treatment for these disorders focuses on managing symptoms.

For more information on Ehlers-Danlos syndrome, see these articles from the Mayo Clinic, Medicine.net, and the U.S. government's National Library of Medicine. These articles explain the six different types of Ehlers-Danlos syndrome, their characteristics, and more

Crib Recall, November 2009 - CPSC Recalls 2.1 Million Cribs

More than two million cribs made by Stork Craft are being recalled, the U.S. Consumer Products Safety Commission (CPSC) announced on its Web site Monday, November 23rd.

About 1.2 million of the drop-side cribs were sold in the U.S.; the remainder were sold in Canada, where Stork Craft is based. Some of the cribs were sold with the Fisher-Price label.

A baby can become trapped between the side and the mattress, creating a suffocation hazard. In addition, broken or missing parts can cause a problem, and in some cases the side of the crib can be installed upside down, also causing a hazard.

The CPSC announcement says in part:

"CPSC urges parents and caregivers to immediately stop using the recalled cribs, wait for the free repair kit, and do not attempt to fix the cribs without the kit. They should find an alternative, safe sleeping environment for their baby. Consumers should contact Stork Craft to receive a free repair kit that converts the drop-side on these cribs to a fixed side."

This is the biggest crib recall in history. There have been other crib recalls this year, including those made by Delta Enterprises and Simplicity, as well as Stork Craft. The earlier Stork Craft recall this year involved more than half a million cribs.

Check the CPSC crib recall announcement for descriptions of how the cribs can malfunction, manufacture dates, and retailers that sold the cribs.

Google Helps You Find Flu Shots & Tracks Flu Trends

With the word out today that the swine flu has claimed nearly 4,000 lives in the U.S., the good news is that search giant Google is using its algorithms and technology to assist in the effort to combat the illness.

The company once again has put up its Google Flu Trends Web page to indicate where outbreaks of the flu may be occurring (this link is to the U.S. map, but you can choose other countries). To see how Google Flu Trends works, click on the FAQ or "How does this work?" links.

With shortages of both seasonal and swine flu vaccines around, Google is this year also trying to simplify finding a flu shot with its new Flu Shot Finder at www.google.com/flushot. A page on Google's blog explains how the Flu Shot Finder works.

You can also find the Flu Shot Finder at the U.S. government's flu information Web site, www.flu.gov.

Maclaren Recalls Child Strollers for Injury Risk

Although this isn't strictly a medical issue, I thought it important to post news of the Maclaren child stroller recall because of the possible safety risks. A Wall Street Journal article today notes that a side hinge had amputated the fingertips of 12 children.

Maclaren announced the recall in conjunction with the Consumer Products Safety Commission. The company is offering a free repair kit that includes pieces to cover the hinges that have been causing the problem.

Maclaren USA has posted a recall notice on its Web site, which reads in part:

"Consistent with our unwavering commitment to child safety we are providing U.S. consumers notice of a voluntary recall of all Maclaren umbrella strollers sold in the U.S. In cooperation with the U.S. Consumer Product Safety Commission, we are providing free of charge to all affected consumers and retailers a kit to cover the stroller's hinge mechanism, which poses a fingertip amputation and laceration hazard to the child when the consumer is unfolding/opening the stroller. The affected models include Volo, Triumph, Quest Sport, Quest Mod, Techno XT, Techno XLR, Twin Triumph, Twin Techno and Easy Traveller."

You can find out more information at the CPSC Maclaren recall page.

Alli and Xenical: Risk for Liver Damage?

The FDA is investigating whether the weight-loss drug orlical may be causing liver damage. The only medication approved by the FDA for weight loss, orlical is sold as the over-the-counter drug Alli and as the prescription drug Xenical. An article from the Associated Press says that the agency announced yesterday that it had received 30 reports of patients with liver damage from taking Alli and Xenical.

According to an FDA statement (link below), "Between 1999 and October 2008, 32 reports of serious liver injury, including 6 cases of liver failure, in patients using orlistat were submitted to FDA’s Adverse Event Reporting System. Thirty of the 32 reports occurred outside the United States. The most commonly reported adverse events described in the 32 reports of serious liver injury were jaundice (yellowing of the skin or whites of the eyes), weakness, and abdominal pain. Hospitalization was reported in 27 of the 32 cases." It says that it is continuing to analyze the data.

The FDA has said that it hasn't found a definitive association between orlistat and liver injury, and recommends that users of the drug keep using it. The agency advises patients to consult their doctor if they experience any of the possible signs of liver injury or damage, such as:

• weakness or fatigue
  
• fever
  
• jaundice
  
• brown urine
  
• nausea or vomiting
  
• abdominal pain

You can read the FDA's statement about Xenical, Alli, and orlistat here. The FDA approved Xenical in 1999; Alli gained approval in 2007. Xenical contains 120mg of orlistat, while Alli has 60mg.

You can find out more about Xenical at the Drugs.com profile page or at the manufacturer's Web site, www.xenical.com.

Klinefelter Syndrome: Men with an Extra X Chromosome

In normal male development, there is one X chromosome and one Y chromosome. But in the rare disorder called Klinefelter syndrome, patients have an extra X chromosome or part of one in most cells of the body (which is why the disorder is also called XXY condition).

Persons with Klinefelter syndrome produce less testosterone and may have more feminized physical features such as smaller testicles and less facial and body hair than other males, as well as breast enlargement. Persons may also suffer from infertility. (Ironically, though, some children and adults with the disorder may be taller than their counterparts of the same age, according to a Klinefelter syndrome article from the Genetics Home Reference.)

Unfortunately for Klinefelter sufferers, the disorder has more than just these physical symptoms. Boys with Klinefelter syndrome may also have problems with speech and language development, and may have learning disabilities.

You can find more information on Klinefelter syndrome at the government's Medline online medical encyclopedia, which gives a good lay overview.

For details on clinical research being done on Klinefelter syndrome, the National Human Genome Research Institute has an overview with links to research studies and additional resources.

Michael Jackson Asked for Deprival, a Powerful Sedative, Nurse Says

A nurse who treated Michael Jackson several months ago has said that the late singer's people contacted her less than a week before he died, and that Jackson had asked her to get him the powerful sedative Deprival.

Interviewed on CNN's Anderson Cooper 360 Tuesday night, nutritionist and registered nurse Cherilyn Lee said that in April Jackson had said he was unable to sleep well and had asked her to get him Diprivan (generic name propofol), a drug usually used as an anesthetic during surgery. Lee said that she strongly recommended Jackson against Diprivan, explaining that "If you take this you might not wake up."

Jackson said he had taken Diprivan before, which is apparently why he asked for it again.

Lee said that one of Jackson's staff contacted her four days before he died on a different matter, saying that he was feeling hot on one side and cold on the other. She said that she told the staffer to take him to a hospital, thinking the problem might be some kind of cardiovascular or nervous system problem.

Diprivan is given intravenously and is usually administered to start or maintain anesthesia during surgery. The drug is also used on patients in intensive care units (ICUs). CNN medical correspondent Sanjay Gupta, a neurosurgeon, confirmed Lee's warning about the seriousness of taking Diprivan, and noted that he had never heard of it being administered outside of a hospital.

A fact sheet from Astra-Zeneca, the maker of Diprivan, describes the drug as "an intravenous sedative-hypnotic agent for use in the induction and maintenance of anesthesia or sedation." It is a fast-acting drug: the fact sheet notes that it takes effect in about 40 seconds.

The product information from Astra-Zeneca also notes that for general anesthesia or sedation, Diprivan "should be administered only by persons trained in the administration of general anesthesia" and facilities for maintaining the patient's airway, as well as artificial ventilation, oxygen, and resuscitation, "must be immediately available."

The Web site RxList gives a detailed review of Diprivan effects, side effects, indication, warnings, and more.

CDC Provides Updates on Swine Flu Cases, Precautions, and More

Swine flu cases in the United States are limited in severity, but the Center for Disease Control and Prevention (CDC) is still making sure that the public is informed with the latest information.

The CDC's Swine Flu Web site is updated frequently throughout the day, including information on:
* Key facts on swine flu
* Symptoms of swine flu
* Antiviral drugs and swine flu
* Number of swine flu cases in the U.S. currently known
* What you can do to stay healthy
* Travel notices related to swine flu
* Guidelines for health professional, reports and publications on swine flu, and press briefings

The CDC notes that the swine virus, influenza A (H1N1), is susceptible to the prescription antiviral drugs oseltamivir (brand name: Tamiflu) and zanamivir (brand name: Relenza).

The CDC is using social media to get the word out, and has an account on Twitter (@CDCemergency) that you can follow to get the latest information, including links to the latest bulletins.

The American public radio show The Takeaway has a handy swine flu Q&A, which also answers questions such as the difference between a pandemic vs. an epidemic, etc.

As of Monday, April 27th the U.S. Government is suggesting that Americans avoid travel to Mexico, where the swine flu has infected more people and has caused a number of deaths.

Cholera Still Killing People in the 21st Century

In the developed world the deadly disease cholera is all but extinct, but it's still killing thousands of people in less developed areas. Cholera is an acute infectious disease of the intestine that at its worst can cause watery diarrhea and vomiting, and can result in death within hours of onset. Fortunately, only one in 20 people who contract cholera will have symptoms this severe, according to the CDC.

Cholera is caused by the bacterium Vibrio cholerae, and is usually contracted by consuming contaminated drinking water (or food), which unfortunately is widespread in the developing world where clean drinking water is in short supply.

More than 4,000 people have died of cholera in Zimbabwe since August 2008, but newly drilled wells are helping to reduce the death toll there. Health officials are also trying to stop cholera outbreaks in war-torn Somalia, where civilians fleeing the turmoil has led to a humanitarian emergency, and in Kenya, where cholera has killed 47 people, believed to be caused by a drought has led people to drink contaminated water.

Cholera can be treated effectively with oral hydration therapy, which gives the sufferer fluids and electrolytes to replace that lots through diarrhea. In severe cases, intravenous fluid replacement may be needed.

Learn about about the causes, symptoms, and treatment of cholera in these articles from the MedLine Plus Encyclopedia, the Mayo Clinic, and MedicineNet.

Actress Natasha Richardson Has Died at Age 45

A sad end to this story: Actress Natasha Richardson died today, her family announced in a statement. Richardson suffered head trauma Monday while skiing in Canada.

It sounds as if it was known when she was hospitalized in Canada that her situation was grave, and her family decided to bring her to New York to give her family a chance to say goodbye to her. The decision was made today to take her off life support. The New York Times has a brief obituary of Natasha Richardson tonight; they'll probably have a more complete one up by tomorrow.

Natasha Richardson's Head Injury: An FAQ from WebMD

With questions swirling about the brain injury suffered by actress Natasha Richardson, WebMD has put up an informative article about Richardson's injury.

Among the questions addressed are how such a seemingly minor accident could have such a life-threatening impact; why she seemed fine at first, only to become gravely ill later; what are the symptoms of a brain injury; and what doctors can do about bleeding in the brain.

CNN Health published an article today that also sheds light on brain trauma, explaining why head injuries that seem minor may not be.

There has still been no word on Richardson's condition from her doctors or family, but gossip columnist Liz Smith has been reported as saying that the actress is brain dead and the family decided Wednesday afternoon to take her off life support.

Natasha Richardson's Ski Accident: Just How Bad is Her Head Injury?

Tony-winning actress Natasha Richardson suffered a head injury the other day while skiing in Canada, but it's unclear just how severe her condition is. Reports are that the 45-year-old actress fell down during a beginner's lesson and originally felt fine, but then started feeling ill an hour or so later and was taken to a nearby hospital.

It's suspected that she may have had internal bleeding in the head or neck, which can cause such symptoms. Some stories speculated that Richardson is brain dead or suffering what's been called "talk and die" syndrome (seeming fine at first, but then having a delayed reaction as blood builds up and puts pressure on the brain). One doctor at NYU Medical Center (who has not treated Richardson) says that Richardson's symptoms seem consistent with epidural hemorrhage, a buildup of blood between the skull and the brain. Other news sources have used terms such as epidural hematoma or subdural hematoma to describe Richardson's condition.

What is known is that Natasha Richardson is now at New York's Lenox Hill Hospital; her sister Joely Richardson and mother Vanessa Redgrave have been seen entering the Upper East Side hospital. Richardson's husband, fellow actor Liam Neeson, left a film shoot in Toronto to be with her and is now presumably in New York.

It seems strange that a person with a serious head injury would be moved such a distance... of course her family wants to be near her, but is it a good idea to transport someone in what may be critical condition? I'd guess Richardson is hooked up to all kinds of tubes and breathing equipment. And if she was able to be transported, does that mean that her condition is better or worse than has been reported?

We'll have to wait until her family decides to make a statement about her condition and prognosis. It may be that they are waiting to see what course the injury takes before saying anything. In some cases a person with a head injury can have dire symptoms, but those can decrease as swelling in the brain (if that's what Richardson has) decreases, either on its own or due to drainage and other medical interventions.

(On a related note, the New York Times notes today that Richardson's accident has put new life in the debate over whether skiiers should wear helmets (the actress was not wearing one at the time of her accident).

For those not familiar with Natasha Richardson, she has been in movies ranging from "Nell" (with Jodie Foster and Liam Neeson) to "The Parent Trap" (with Dennis Quaid and the young Lindsay Lohan), and has also acted on Broadway (winning a Tony award for "Cabaret.") Her mother is the actress Vanessa Redgrave, and her father is the late British director Tony Richardson, known for films including "The Loneliness of the Long-Distance Runner."

Health News: Finding Good Health Care in Bad Times

Many Americans were having problems affording good health care even before the recent recession and wave of layoffs began. The economic downturn has only made things worse. The Wall Street Journal has two articles on finding good health care in hard times.

One story looks at how a family's health care support system unraveled in the recession. The family's children have a rare bone-marrow disorder and relied on donations to meet the costs insurance didn't cover. But the economic downturn has greatly reduced the donations; contributions to their former church's medical care fund are down, and a fundraiser held to gain contributions has yielded less money this year than last.

On a more positive note, there's an article explaining how some new online services have arisen to provide basic medical consults in an easy, low-cost manner. Patients can interact with doctors in a variety of ways (online video, text chat, or phone), and the fees can be as low as $10 for a 10-minute consult. Other services charge a monthly fee and then a per-consult fee. This article looks at some of the companies now offering these services, and notes their pluses and minuses.

Merck to Buy Schering-Plough

Drug makers Merck and Schering-Plough have announced that they will merge in a $41 billion deal made up of cash and stock. The merger of the two New Jersey-based pharmaceutical giants comes just a month and a half after news of another blockbuster merger between Pfizer and Wyeth. The merged company will keep the Merck name.

Merck and Schering-Plough are co-marketers of the cholesterol drugs Zetia and Vytorin.

These mergers are spurred by economic pressures created by drug pipelines lacking new drugs to replace the bestsellers due to come off patent in the coming years, and by what's perceived as coming pressure by the U.S. government to reduce prices. The Wall Street Journal discusses the Merck Schering-Plough deal, and offers a live blog of the companies' analyst conference call.

Shares of Merck stock (MRK) were down more than 6% in early trading Monday, while Schering-Plough stock (SGP) was up sharply, seeing a 15% rise.

Health News: Health Care Reform Problems and Prognosis

Health care in the U.S. seems destined to change somehow during the Obama administration, though nobody knows how. A cople of recent articles look at some of the issues and problems involved, and what solutions might be needed.

The L.A. Times offers a story called "A National Health Care Primer," which examines some of the big issues that will have to be tackled as the debate gets underway. Among them: Will people be able to keep their current health insurance? If I don't have insurance now, would I have to buy it? And, of course, How can the country pay for all this re-jiggering of the health care system?

One person who knows the pluses and minuses of the U.S. health care system is Dan Cortese, the outgoing CEO of the Mayo Clinic. The Wall Street Journal's health blog sat down with him and asked him a few questions about a subject that he's become more and more involved in over the last few years: national health policy and how to design a health care system.

The point person for health care reform in the Obama administration will be Kansas governor Kathleen Sebelius, the newly named secretary of health and human services. Another article in the Journal's health blog looks at the successes, and setbacks, she's had in trying to push through health reform in her state.

Health News: Questions on Heart Therapies; Where NOT to Have a Heart Attack

Today's Wall Street Journal offers some less-than-encouraging news on one of the nation's leading killers and most-studied health problems: heart disease.

One article notes that for all the research that goes into heart disease, "just 11% of more than 2,700 recommendations approved by cardiologists for treating heart patients are supported by high-quality scientific testing," according to a new study published in this week's Journal of the American Medical Association. The research says that much of the recommended advice for cardiac patients is based on subjective expert opinion.

Another article says that a hotel may be the worst place for your heart to stop beating, because of the lack of automated external defibrillators (AEDs). The story explains that while AEDs have become standard equipment on airplanes, health clubs, and even some shopping malls, hotel chains are hesitant to adopt them because of concerns over liability. Some of the chains the Journal talked to either cited low percentages of defibrillators in their hotels, or didn't want to say how many they had.

Brain Research: New Alzheimer's Theory, and those "Brain Exercises"

Research on the brain and how it works has yielded some interesting findings related to cognitive function, namely how it may decline and whether popular techniques can really stave off this decline.

Scientists at the biotech company Genentech have offered a new theory of how Alzheimer's disease kills brain cells, a finding that could yield new ideas for developing effective treatments. The researchers "believe a chemical mechanism that naturally prunes away unwanted brain cells during early brain development somehow gets hijacked in Alzheimer's disease." A chemical called amyloid precursor protein (APP), which is a key part of the plaques found in the brain in Alzheimer's patients, is thought to be the "driving force" behind the process.

In another dementia-related finding, the author of a study on "brain exercises" that have been pitched to older adults says that these programs are not effective at warding off cognitive decline, at least not in healthy adults.

The programs, which range from Web sites to PC-based games, have seen sales skyrocket as older adults try to find ways to prevent Alzheimer's and other forms of dementia. Reuters Health quoted Dr. Peter J. Snyder of Lifespan Affiliated Hospitals in Providence, Rhode Island as saying, "These marketed products don't confer any additional benefit over and above being socially and intellectually active in one's normal daily life."

The study found that some types of "brain training" may be of use to patients who already have memory problems, but they haven't clearly shown a benefit to patients who don't have cognitive impairment.

The "Dream Diet": How to Lose Weight through Sleep

Yes, it sounds too good to be true, but sleep can really help you lose weight. But what scientists have found is not really a "diet" per se, but rather new insight into the relationship between sleep and weight. In a nutshell, it has been found that the amount of sleep you get and the quality of that sleep can affect hormones in your body that have been found to impact appetite.

A number of studies have shown that lack of sleep can affect the levels of two appetite-related hormones, leptin and ghrelin. The studies have revealed that people who sleep less weigh more. The article noted above also examines another sleep-weight interaction, the relationship between weight and sleep apnea.

Of course, today's horrible economic times don't exactly encourage restfulness and a good night's sleep, but with the many real benefits of getting enough sleep, it's definitely a worthwhile thing to put at the top of even the longest to-do list.

Intermittent Explosive Disorder - More Common Than Commonly Thought?

We've all seen scary cases when a person flies into a violent rage for no reason, whether it's road rage or a couple's overheated argument. What you may not know is that, for some people at least, a real disorder may be behind the problem: intermittent explosive disorder (IED). This is not your everyday type of angry outburst, but rather a violent reaction that is way out of proportion to the event that brought it on. Often the outburst involves throwing or breaking things or other injury to property or people.

An article on WebMD says that IED may be more common than we think, affecting as many as 16 million adults in the U.S. It note the results of a study that defined IED as "involving at least three incidents over a lifetime of anger attacks in which physical harm was done to other people or to property." And the incidents had to not be linked to factors such as drug or alcohol use or depression.

Before an incident of IED, sufferers may report feeling an increased energy level and irritability or rage. Episodes may be accompanied by physical sensations such as tingling, tremors, palpitations, or chest tightness. After an episode of intermittent explosive disorder the person may feel embarrassment, guilt or shame, various sources say.

An article on the Mayo Clinic's Web site talks about the causes, symptoms, diagnosis, risk factors, and treatments for intermittent explosive disorder, and tells what medications can be effective in treating IED. Psychology Today also discusses what intermittent explosive disorder is and covers some of the same aspects of the disorder as the Mayo article.

If you feel you or someone you know may be affected by IED, consult a medical professional to learn more about the specific symptoms, causes, and characteristics of intermittent explosive disorder.

Peanut Butter Recall: Troubles Continue as Number of Products Grows

The peanut butter recall is growing, and it's unclear how far it will go. U.S. News and World Report notes that more companies are pulling products off the shelves, from cookies to candies. This comes after the FDA warned on Saturday that consumers should avoid products that contain peanut butter or peanut butter paste while the investigation into salmonella contamination continues. (It should be noted that no jars of peanut butter are involved in the warning or recalls; the products concerned are things like crackers, cookies, and other prepared foods.)

General Mills and Kellogg are two of the most recent food makers to issue recalls; the Kroger grocery chain has also issued a recall for some of its private label products containing peanut butter. It seems most if not all of the contamination cases are linked to products from one supplier, Peanut Corporation of America (PCA).

Check out the FDA salmonella outbreak fact sheet for details on what products have been recalled, information on salmonella, and an update on the agency's investigation into the peanut butter salmonella outbreak.

The salmonella outbreak linked to peanut butter products has now affected people in 43 of America's 50 states as well as parts of Canada. Nearly 500 people have become sick, and six deaths have resulted.