Your Health

Delayed Drowning: Man Dies Hours After Pulling Himself from Water

iStockphoto/Thinkstock(NEW YORK) -- A 60-year-old man fell into New York’s Long Island Sound, pulled himself out, and then died several hours later, apparently of drowning. Emergency doctors Tuesday called it a case of secondary drowning, something very unusual.

The man, Tommy Mollo of Yonkers, N.Y., fell off the back of a friend’s boat Saturday morning while helping to move it between slips at a marina in nearby New Rochelle, WABC-TV reported. Mollo returned to his apartment and told his wife he felt ill. She called 911 and emergency workers took Mollo to a hospital, where he was pronounced dead at 12:05 p.m., the station reported.

An ER doctor told the station that water got into Mollo’s lungs when he fell overboard, which led to subsequent breathing difficulties that could have been exacerbated by medical issues he already had.

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Mollo’s case represents a rare occurrence of a relatively rare phenomenon, beginning with his self-rescue, emergency room doctors said.

Secondary drowning typically occurs “when one is immersed in water, they almost drown, water successfully enters the lungs, and then they are rescued,” said Dr. Gabe Wilson, associate director of emergency medicine at St. Luke’s-Roosevelt Hospital in New York City. “Conceivably water could be inhaled while one still had the means to pull themselves out, but it would certainly be a rare occurrence as usually panic sets in by then.”

Wilson cited one study that showed secondary drownings make up five percent of overall drownings in children and teens. "There is no great data for adults,” he told ABC News.

The lag between the time water enters the lungs and begins to cause problems can range from one to 48 hours, he said: “Because onset can be rapid, it is not known whether there are predictable warning signs.” As a result, anyone who experiences an episode of near-drowning should be evaluated in an emergency department and “possibly observed for 24 hours,” Wilson said.

Lung damage from secondary drowning occurs when water comes into direct contact with the cells lining the lungs, interfering with their ability to supply needed oxygen to the body and to take away carbon dioxide, a gaseous waste product.

This damage can be particularly severe when delicate lung tissues are flooded with salty ocean water, like that of Long Island Sound. The water “tends to pull fluid from the body into the lungs,” said Dr. Larry Baraff, associate director of the emergency department at the Ronald Reagan UCLA Medical Center. When fluid moves into the lungs, it “takes up space where the air would be.”

In Mollo’s case, he said, "It’s conceivable that the drowning episode and lack of oxygen led to a heart problem, like a cardiac arrhythmia or a myocardial infarct (heart attack).”

However, he said secondary drownings are survivable with fast-enough medical attention.

“If you make it to the hospital alive, it’s very unusual to die from drowning,” Baraff said. Survivors of near-drownings who arrive at the ER in what seems to be good shape will undergo monitoring “just to make sure they don’t get worse.”

Those who are in distress can be put on a ventilator. Doctors then use pressure to “force fluid out of the lungs so oxygen can get back in.”

Copyright 2012 ABC News Radio

Critics Call Government's Alzheimer's Plan Unrealistic

Tom Williams/Roll Call(WASHINGTON) -- The Obama administration and the National Institutes of Health have homed in on Alzheimer's disease, setting an ambitious goal to have an effective treatment for the brain-wasting disease by 2025.

The plan is intended to give a "clear, national focus and attention on Alzheimer's that we've given to other diseases," said Health and Human Services Secretary Kathleen Sebelius in a meeting at the NIH Tuesday.

But Alzheimer's disease experts' reactions to the pledge are less optimistic: Some say giving more attention to the disease can only help, while others call the goal unrealistic.

Most say it is helpful to focus the nation's lens on Alzheimer's, which currently ravages the brains of about 5.4 million Americans and strains 15 million caregivers, numbers that will surely climb as the population ages.

But for some experts, the scope of the government's effort is only a fraction of what is needed to make a difference.

"It's great to have the attention drawn to the disease and have a temporary blip in funding," Dr. Samuel Gandy, a professor of Alzheimer's disease research at Mount Sinai School of Medicine, told ABC News. "But this is at least an order of magnitude off the figure that is likely to have meaningful impact."

The NIH devoted $448 million in fiscal year 2011 for Alzheimer's disease research, compared with the nearly $5.5 billion for cancer research and $3.1 billion for HIV/AIDS. So far, progress against Alzheimer's has been disappointing. There is no cure for the disease, and the treatments that are available only temporarily relieve its symptoms.

Much of the research so far has focused on amyloids in the brain, and whether targeting these protein tangles can prevent or reverse the disease. But answers have been tantalizingly out of reach, despite much research.

"We have had good reason to focus therapies on amyloid, yet they have failed to date. That is discouraging," Dr. Richard Caselli, a professor of neurology at the Mayo Clinic, told ABC News. "So challenge No. 1 is finding good alternative targets."

Dr. Peter Whitehouse, a professor of neurology at Case Western Reserve University in Cleveland, said if the government plan is to succeed, the NIH should broaden its focus on research against Alzheimer's to include more that will help patients cope with the disease or prevent it altogether, such as community design, diet and exercise.

"The field of Alzheimer's research is getting a little distorted. There's a constant need to focus on magic bullets and single molecules," Whitehouse told ABC News. "It really requires a public health focus. The most effective interventions are not going to be drugs."

Other experts defend the government's efforts, saying the plan can only improve current efforts to fight the disease.

"No doubt it's an ambitious goal. What's different now is that we have a goal," said Harry Johns, president and chief executive officer of the Alzheimer's Association.

Sebelius announced new steps in the government's strategy to develop treatments for the disease and provide better support to patients, families and caregivers in the next 13 years.

The first steps include millions in NIH funding devoted to research on Alzheimer's. Two trials will begin immediately -- $8 million for a clinical trial of a potential treatment for early Alzheimer's (an insulin nose spray), and $16 million to study the potential for a treatment to target amyloid, the brain hallmark of Alzheimer's disease, in Colombian people who are healthy but have a genetic mutation that puts them at high risk for developing the disease.

The initiative is part of the National Alzheimer's Plan Act, signed into law by President Obama in January, which marks $50 million for Alzheimer's research in fiscal year 2012 and another $100 million in fiscal year 2013.

According to the Alzheimer's Association, caring for people with dementia cost $200 billion this year alone, and could reach $1 trillion by 2050. The disease is physically and mentally devastating, not just for patients but for families and caregivers who struggle to care for them.

To help embattled caregivers, the government launched www.alzheimers.gov, an online resource for patients, families and caregivers looking for information on dementia and where they can get help, and is assigning $26 million to provide resources for patients and caregivers, including support in local communities and a public awareness campaign with TV, radio, online and outdoor ads.

Sebelius said she hoped the government's effort would lead to a strikingly different picture of Alzheimer's disease in the U.S. by 2025.

Copyright 2012 ABC News Radio

How Cheap Meat Practices Beef Up Superbugs Like MRSA

Simon Sparrow, 1, died from a MRSA infection in 2004. His mother has since been on a mission to raise awareness of superbugs. (Everly Macario)(WASHINGTON) -- As 1½-year-old Simon Sparrow lay dying in a hospital in April 2004, doctors were perplexed as to what was causing his illness.

"None of the health care professionals at the University of Chicago had any clue as to why he died," Simon's mother, Everly Macario, recalls. "From the moment he got strange symptoms to when he died was 24 hours."

Tests following Simon's death revealed that he'd succumbed to an overwhelming infection caused by a highly antibiotic-resistant strain of bacteria known as methicilliin-resistant Staph aureus, or MRSA. Despite having a doctorate in public health from Harvard, Macario had never heard of MRSA or its potentially deadly consequences.

Since her son's death, Macario has made it her mission to raise awareness of these deadly infections. On Tuesday in Washington, D.C., Macario joined a group of concerned mothers, health care providers, farmers and chefs in a roundtable meeting to raise awareness of the growing problem of antibiotic-resistant bacteria.

The "Supermoms Against Superbugs" event, co-sponsored by the American Academy of Pediatrics and the Pew Campaign on Human Health and Industrial Farming, is meant to raise awareness of the link between antibiotic overuse in farm animals and an increase in antibiotic-resistant "superbug" infections in humans.

MRSA is among a growing number of bacterial strains that are highly resistant to antibiotics and are very difficult to treat when they cause serious infections. According to infectious disease experts, the increase in the number of superbugs over the past three decades comes from the overuse of antibiotics -- not only in humans but also in farm animals. All told, livestock consume nearly 25 million pounds of antibiotics versus the three million pounds used in humans each year, according to the Union of Concerned Scientists.

And an estimated 70 percent of antibiotics sold in the United States are given to healthy farm animals -- not to treat disease but to promote animal growth, allow animals to live closer together and decrease the amount of time it takes to raise an animal and send it to market.

Superbugs can be the unfortunate side effect of this process. When farm animals eat the antibiotics placed in their food, it exposes the bacteria that live in their gut and skin to low levels of the drug. Some of these bugs survive this low-level assault and go on to develop resistance to the antibiotics. The resistant superbugs can then spread to humans either by direct contact with farm animals or by eating contaminated meat from the animals.

Once superbugs such as MRSA, E. coli and salmonella escape the farm, they can spread their antibiotic resistance to other bacteria that also cause infections in humans.

Dr. James Johnson, an infectious disease specialist and professor of medicine at the University of Minnesota, says this is a big problem.

"Antibiotics are losing their effectiveness against bacteria," Johnson says. "New antibiotics are not being developed at a fast enough rate, and we have fewer treatment options for infected patients."

Superbugs can cause a variety of diseases in humans, including urinary tract infections, blood stream infections, meningitis and pneumonia. The most vulnerable patients tend to be the very young, chronically ill, hospitalized patients and the elderly.

Johnson says that despite the increase in the number of superbugs, infection tends to be a "somewhat uncommon occurrence." When it does occur, however, the infection is "more difficult to treat, more costly and more likely to lead to death in severe cases."

As the superbug threat grows, lawmakers and experts alike say the solution to the problem is clear -- but not necessarily easy to get going.

One approach, doctors say, is to reduce antibiotic use in both humans and animals -- essentially using them only to treat disease, rather than for disease prevention. Rep. Louise Slaughter, D-N.Y., who is also the only microbiologist in Congress, has in recent years introduced legislation that would regulate antibiotic use in animal feed. So far, this bill has not passed into law.

Proponents of feeding antibiotics to healthy livestock argue, however, that the process is necessary to ensure animal health and to maintain efficiency. Eliminating antibiotics from feed would decrease the number of animals meat producers can raise, and so increase meat prices.

Data from the National Research Council estimates that a ban on antibiotic use in animal feed would cost a family of four an additional 34 to 75 cents per week for meat. Critics, on the other hand, cite the total cost to U.S. households from superbug infections. According to a news release from the advocacy group Alliance for the Prudent Use of Antibiotics, these costs amount to $35 billion when factoring in lost wages, hospital stays and premature deaths nationwide.

Macario says there is a solution to the problem of increased antibiotic resistance. "I want to make sure that people don't shut down or feel like the world is going to end. Not all issues are solvable, but this one is."

Copyright 2012 ABC News Radio

Beijing Olympics Show Air Pollution-Heart Attack Link

Top Photo Group/Thinkstock(NEW YORK) -- Eat healthy. Exercise. Don’t smoke. These are all tips we’ve heard on ways to reduce the risk of heart attacks and blood clots. But most people would never think air pollution can increase their risk.

A study, published Tuesday in the Journal of the American Medical Association, found that a drop in air pollution levels during the 2008 Beijing Olympics was linked to decreased risk factors for heart problems, stroke and blood clots there.

Authors of the research attributed the improved air in China’s capital to a decreased amount of traffic in normally congested areas during this time. Two weeks after the Olympics, the air pollution returned to its normally high levels -- and so did the risk factors in Beijing’s inhabitants.

While previous research has suggested such a link, “this study is different because it is the first study to show how air pollution affects young and healthy hearts,” said Junfeng Zhang, professor of environmental and global health at the University of Southern California and one of the authors. “It also shows how our body responds rapidly to changes in pollution.”

In separate research, Dr. Tim Nawrot, associate professor at Hasselt University in Belgium, led a 50-year review of the literature on the relationship between heart attacks and air pollution. His findings also supported the link between air pollution and heart disease -- and he believes the impact can even be quantified.

“On a population level, our study found that air pollution is comparable to other triggers for heart attacks such as using cocaine, stress, physical exertion, and excess coffee or alcohol,” Nawrot said. “Actually, we can say that at a population level, five percent of heart attacks are triggered by air pollution.”

In light of the growing body of research, major organizations such as the American Heart Association are taking notice.

“Previously we thought that air pollution affects only the lungs but there is a huge body of evidence that suggests air pollution synergizes with other risk factors such as diabetes, high cholesterol, smoking, obesity, and hypertension to increase the risk of having a heart attack,” said Dr. Sanjay Rajagopalan, professor of cardiovascular medicine at Ohio State University and a member of the heart association’s Scientific Statement Committee. “In and of itself, air pollution is a weak factor, but in conjunction with other risk factors, it can amplify the risk for heart attacks.”

So what can be done in light of Tuesday’s study? Zhang suggests greater use of public transportation and not going outdoors when levels of air pollution are high.

Rajagopalan said people should focus on the things they can control, such as blood pressure, cholesterol, diabetes, and smoking. He also suggests avoiding nonessential travel to areas that are heavy in air pollution.

Internationally, this would include India, which was found to have the worst air pollution in the entire world, followed by Bangladesh, Pakistan and China. The figures come from the 2012 Yale and Columbia Universities Environmental Performance Index.

According to the American Lung Association, the top 10 polluted U.S. cities in 2012 include:

Bakersfield-Delano, Calif.
Hanford-Corcoran, Calif.
Los Angeles-Long Beach-Riverside, Calif.
Visalia-Porterville, Calif.
Fresno-Madera, Calif.
Pittsburgh-New Castle, Pa.
Phoenix-Mesa-Glendale, Ariz.
Cincinnati-Middletown-Wilmington, Ohio/Ky./Ind.
Louisville-Jefferson County-Elizabethtown-Scottsburg, Ky./Ind.
Philadelphia-Camden-Vineland, Pa./N.J./Del./Md.

Research to Prevent Alzheimer’s Will Target Group With Rare Form

File photo. iStockphoto/Thinkstock(NEW YORK) -- A team of researchers will soon try out an experimental drug that could prevent Alzheimer’s disease in a group of people with a genetic mutation that makes it likely they will develop the debilitating condition.

Scientists will begin a clinical trial of crenezumab in about 300 Colombians whose genes predispose them to a rare form of Alzheimer’s that hits very early — usually in the 40s or 50s — and can affect multiple members of the same family. Funding for the study is provided by the National Institutes of Health, Genentech and Banner Health System. Genentech is the developer of the experimental drug.

There will also be a subjects with the same mutation recruited in the U.S., but those people still need to be identified.

“Clinical trials will be done at a time when a patient has no symptoms. We’re trying to stop or slow the onset of the disease in this group of patients,” said Richard Scheller, executive vice president of research and development at Genentech. “We know when they will contract the disease because of the numerous studies that have been done on the mutation.

The drug acts on a substance known as ABeta. Scheller explained that ABeta is a major component of the brain plaque that is a characteristic of Alzheimer’s disease.

“The mutation causes a more rapid accumulation of ABeta in the brains of people who have it. It activates the enzyme that produces the ABeta,” he said. The clinical trial, he added, will help answer the question of whether ABeta is definitely responsible for this rare form of the disease.

There are also separate clinical trials underway looking at the effects of crenezumab on mild to moderate Alzheimer’s disease.

Experts not involved with the crenezumab research thus far say preventing Alzheimer’s from ever happening is more promising than treating it once symptoms start appearing. Drugs that are available now only target symptoms, not the mechanisms that cause the disease.

The clinical trial is expected to begin in 2013 and continue until 2018.

Copyright 2012 ABC News Radio

Boy, 9, Rejects Further Cancer Treatment

File photo. (Jose Luis Pelaez/Stone)(LOS ANGELES) -- After five years of fighting a rare form of brain cancer, with seven surgeries, four rounds of chemotherapy and two bouts of radiation, 9-year-old Ryan Kennedy told his mother “I’m done with this.”

In February, Ryan’s mother told him about another surgery that doctors said would buy the Clarkston, Mich. native about three more months, but potentially could leave him on a breathing and feeding tube, according to the Oakland Press.

“When I told him about it, he said, ‘No. I told you, Mom, I don’t want to do anything anymore,’” Kimberly Morris-Karp told the Oakland Press. “He literally screamed and cried in hysterics, saying ‘I’m done. I’m done with this.’

“The selfish part of me wanted to say, ‘No, I want you to do this,’ but I said, ‘OK, this is what you want,’” Morris-Karp said. “And we keep asking him over and over again. Once a week, I would ask him the same question: ‘Are you sure you’re OK with this? You don’t want anymore treatment?’ ‘Yup, I’m sure,’” she said Ryan replied.

The decisions to end treatment for children fighting cancers are especially difficult ones to make, said Dr. Lisa Humphrey, director of the pediatric palliative care program at University Hospitals Rainbow Babies & Children’s Hospital in Cleveland, because decisions tend to be based in the instinctual place where parents are never supposed to bury their children, she said.

“For Ryan to have the courage to make such a decision and be able to talk to his family about it speaks volumes about the journey that they went on together,” she said. “We know for a fact that children who have life-threatening illnesses mature very quickly in some ways. They’re able to understand what is at stake, and they often have an exquisite sense of what’s going on in their bodies.”

Often times, children with life-threatening illnesses will ask if they’re dying, Humphrey said. But, in many cases, they won’t ask their parents. Instead, they’ll ask an aunt, a family friend or a nurse.

“They know what’s going on with their bodies and they’re curious and want to check in, but in a way, the child wants to protect the parent a much as a parent wants to protect their child,” Humphrey said.

It’s best for parents to be open and act as a sounding board for their child and gauge how much they understand about their illness and potential prognosis, she said.

Each year, about 50,000 children in the United States die from life-threatening illnesses. A 2004 Swedish study found that, out of 300 families who had children who died from terminal illness, about 35 percent of them discussed the pending deaths with their children. The survey showed that not one family regretted discussing death. Of those who did not discuss death with their children, 27 percent of the families reportedly regretted their decision.

Ryan recently became a trending topic on Twitter when it was thought to be his dying wish. Celebrities, including Britney Spears, offered their support for the child.

“Ryan really wasn’t the one who wanted to trend on Twitter — he’s 9 — he doesn’t have a Twitter account,” Morris-Karp told CNN. “He really didn’t even know what Twitter was.”

Doctors say Ryan will not likely make it to his tenth birthday on May 24.

“[I will] rub his feet, help him with whatever he needs,” his mom told CNN. “I just plan on being there and just loving him through this.”