TIME medicine

The Best Way to Quit Smoking Isn’t E-Cigs

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In the latest in-depth review of studies investigating which smoking cessation methods work best, experts say there isn’t enough evidence to support using e-cigarettes to kick the habit

The U.S. Preventive Services Task Force, a government-convened group of experts, says that if you want to quit smoking, you’re better off with drug-based methods, behavior modification programs or a combination of both—not puffing on e-cigarettes. There isn’t enough evidence to support claims that e-cigs, which have been touted as the latest way to wean people off tobacco, can actually help people quit.

The task force focused on studies that investigated how effective various smoking cessation methods are, for both adults and pregnant women. Drugs that address nicotine’s effects on the body, as well as nicotine replacement options, are better ways to quit, and the data suggest that they are even more effective if used together. In addition, behavioral interventions, including support groups and counseling sessions, can boost quit rates from 7-13% compared to rates of 5-11% among those who don’t use them.

MORE: E-Cigs Are Smokers’ Favorite Quitting Tool

“We have an embarrassment of riches in terms of a menu of things to offer patients who want to quit smoking,” says Dr. Francisco Garcia, director and chief medical officer of the Pima County Health Department in Arizona and member of the task force. “But every individual is different; some might respond better to behavioral therapy, some might respond better to varenicline, some might feel nicotine replacement is important to bridge them away from tobacco use.” For most people, it’s a matter of discussing with the smoker which method has the most appeal, and which one they are more likely to stick with long enough to go smoke-free.

But for certain populations, there isn’t enough data to support one strategy over another. Among pregnant women, for example, there haven’t been many studies to show how drug-based methods might affect the developing fetus, so it’s hard to determine if the benefits of quitting outweigh he risks represented by the medications. So for now, the task force advises that pregnant women rely on behavioral, non-drug strategies to help them stop smoking.

MORE: This Is The New Best Way to Quit Smoking, Study Finds

And for e-cigarettes, the data is sparse. The panel concluded that there was “insufficient” evidence to determine whether e-cigarettes improve or hinder quit rates.

TIME medicine

Puerto Rico Governor Signs Executive Order to Legalize Medical Marijuana

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The order goes into immediate effect

The governor of Puerto Rico signed an executive order Sunday to permit the use of medical marijuana in the U.S. territory.

“We’re taking a significant step in the area of health that is fundamental to our development and quality of life,” Gov. Alejandro Garcia Padilla said in a statement. “I am sure that many patients will receive appropriate treatment that will offer them new hope.”

Padilla noted that research supports the use of marijuana to relieve pain and symptoms from disorders that range from multiple sclerosis to glaucoma.

Puerto Rico’s health secretary has three months to release a report on how the executive order will be implemented in the territory and what its impact will be, the Associated Press reports. Medical marijuana is legal in 23 U.S. states.

[AP]

TIME Research

This New Drug Might One Day Cure Even the Most Painful UTIs

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More and more women are getting antibiotic-resistant UTIs

Antibiotic resistance is becoming a growing global problem, and for many women that’s having an unexpected effect. One very common infection among women, the urinary tract infection, is becoming increasingly resistant to the drugs used to treat it. New research published in the journal PLOS Pathogens sheds light on the rise of the antibiotic-resistant UTI and hints at a potentially new treatment that may one day offer women some relief.

More than half of women will experience at least one UTI in their lifetime, and between 30 and 40% of those infections will come back within six months. UTIs account for around eight million visits to the doctor’s office every year, totaling about $450 million in medical costs. Most UTIs are caused by the bacteria Escherichia coli (E. coli), and recent surveillance data shows a significant rise in cases of UTIs caused by E. coli that are resistant to the antibiotics most commonly used to that treat them. One study that looked at cases of UTIs from 2000 to 2010 found that the number of UTIs caused by E. coli that were resistant to the antibiotic ciprofloxacin increased five fold, and the number of UTIs resistant to the commonly used antibiotic trimethoprim-sulfame-thoxazole rose from about 18% to 24% during the same time period.

UTIs typically cause women to have a severe urge to urinate, and to do so frequently. It’s also often very painful when they do, and many experience a burning sensation in their bladder or urethra. Uncomplicated UTIs usually go away with drugs within two to three weeks, but in some cases women may take antibiotics for 6 months or longer if their UTIs keep coming back.

“It’s definitely a growing problem,” says Dr. Victor Nizet, a professor of pediatrics and pharmacy at the University of California, San Diego School of Medicine. “Some women get them over and over again, year in and year out.”

In the new study, Nizet and his colleagues looked at an alternative way to treat UTIs. The researchers tested an experimental drug—not an antibiotic but an immune-boosting agent. The drug stabilizes a protein called HIF-1alpha, which was shown to protect mice and human bladder cells from infection with a common UTI pathogen, a kind of E. coli. The researchers found that using the experimental drugs in healthy human urinary tract cells made the cells more resistant to infection by the pathogen. The researchers also discovered that using the stabilizers directly in the bladders of mice protected against infection and that mice who were treated saw a 10-fold reduction in bacteria colonization in their bladders compared to untreated mice.

“A classic antibiotic is something that targets the bacteria directly,” says Nizet. “This [new drug] would be a treatment that would stimulate the body to produce its natural antimicrobials, which are many.” Nizet says the next step is to explore testing in humans and learn more about the effectiveness of oral versions of the drugs.

Dr. Mamta M. Mamik, an assistant professor of obstetrics, gynecology and reproductive science at the Icahn School of Medicine at Mount Sinai (who was not involved in the study) says she’s seen more and more women with UTIs that are resistant to drugs. In those situations, physicians will sample and isolate the bacteria to see what it’s sensitive to and then recommend a drug based on those results, she says. In a worst-case scenario, they may need to give women intravenous antibiotic therapy.

“I think use of antibiotics should be monitored strictly,” says Mamik. “Very judicious use of antibiotics is really necessary or we will end up in a situation that’s really terrifying. If everyone starts attracting these bacterial-resistant infections, we don’t have the resources. We can’t give intravenous antibiotics to everybody—that’s not a solution.”

Mamik says that women who think they have a UTI should schedule an appointment to see their doctor in person, and not to ask their physician to call them in a prescription for antibiotics. Doctors should insist on seeing their patients too, if they want to cut down on the risk, she says. “It’s uncomfortable but not life-threatening, so [women] don’t go in,” says Mamik. “That’s a practice that has to stop. It perpetuates the problem. You don’t know what you’re treating.”

TIME Longevity

Scientists Discover the Secret to Keeping Cells Young

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Researchers say it may be possible to slow and even reverse aging by keeping DNA more stably packed together in our cells

In a breakthrough discovery, scientists report that they have found the key to keeping cells young. In a study published Thursday in Science, an international team, led by Juan Carlos Izpisua Belmonte at the Salk Institute, studied the gene responsible for an accelerated aging disease known as Werner syndrome, or adult progeria, in which patients show signs of osteoporosis, grey hair and heart disease in very early adulthood.

These patients are deficient in a gene responsible for copying DNA, repairing any mistakes in that replication process, and for keeping track of telomeres, the fragments of DNA at the ends of chromosomes that are like a genetic clock dictating the cell’s life span. Belmonte—together with scientists at the University Catolica San Antonio Murcia and the Institute of Biophysics at the Chinese Academy of Sciences—wanted to understand how the mutated gene triggered aging in cells. So they took embryonic stem cells, which can develop into all of the cells of the human body, and removed this gene. They then watched as the cells aged prematurely, and found that the reason they became older so quickly had to do with how their DNA was packaged.

MORE: The Cure for Aging

In order to function properly, DNA is tightly twisted and wound into chromosomes that resemble a rope in the nucleus of cells. Only when the cell is ready to divide does the DNA unwrap itself, and even then, only in small segments at a time. In patients with Werner syndrome, the chromosomes are slightly messier, more loosely stuffed into the nuclei, and that leads to instability that pushes the cell to age more quickly. Belmonte discovered that the Werner gene regulates this chromosome stability. When he allowed the embryonic stem cells that were missing this gene to grow into cells that go on to become bone, muscle and more, he saw that these cells aged more quickly.

“It’s clear that when you have alterations in [chromosome stability], the process of aging goes so quickly and so fast that it’s tempting to say, yes, this is the key process for driving aging,” says Belmonte.

Even more exciting, when he analyzed a population of stem cells taken from the dental pulp of both younger and older people, he found that the older individuals, aged 58 to 72 years, had fewer genetic markers for the chromosome instability while the younger people aged seven to 26 years showed higher levels of these indicators.

MORE: What Diet Helps People Live the Longest?

“What this study means is that this protein does not only work in a particular genetic disease, it works in all humans,” says Belmonte. “This mechanism is general for aging process.”

Before it can be considered as the Fountain of Youth, however, Belmonte says new and better techniques need to be developed that can more specifically and safely alter the Werner gene in people, not just a culture dish of human cells. He also stresses that there may be other processes contributing to aging, and it’s not clear yet how important chromosome stability is compared to those factors. But, he says. “having technologies like this will allow us to determine how important each of these parameters are for aging.” And if the findings hold up, they could be first step toward finding a way to help cells, and eventually people, live longer.

TIME medicine

The FDA Just Approved a Drug to Get Rid of Your Double-Chin

Kybella was approved after two clinical trials with 1,022 adults with moderate or sever submental fat

The U.S. Food and Drug Administration (FDA) approved an injection to get rid of double-chin fat.

An FDA news release says Kybella has been approved as a treatment for “adults with moderate-to-severe fat below the chin, known as submental fat.” When injected below the chin, Kybella will destroy fat cells. But the release cautions that injecting Kybella elsewhere could be harmful.

Kybella was approved after two clinical trials with 1,022 adults with moderate or sever submental fat. After patients were randomly assigned to receive Kybella or a placebo, reductions in the fat below the chin were observed more frequently in those patients who had received Kybella.

Kybella could be an attractive alternative for patients seeking a reduction in chin fat who don’t want surgery.

“Options at the moment for submental fat are [to] cut it out or suck it out,” Dr. Susan Weinkle, a dermatologist in Florida who has been working with the drug in trials since 2007, told ABC News. “However, this is going to be a noninvasive in-the-office procedure that can be performed by your dermatologist and [gets] excellent results.”

According to the FDA, the most common side effects of Kybella are swelling, bruising, pain, numbness, redness and hardness in the treatment area.

TIME medicine

Doctors Used Lab-Printed Splint to Save 3 Babies From Suffocation

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The fairly inexpensive procedure could save countless young lives, medical officials say

Three small children with weak airways that were constantly collapsing are alive and well thanks to a “4-D” printed splint that saved them from almost certain suffocation.

Three years after the splints were custom made and attached to their tracheas, the children are able to breathe on their own, a team of doctors reported on Wednesday. The splints are not only precisely fitted to the children, but they’re made to grow as the children grow. (That’s the fourth dimension, the researchers say.)

Now they want to try their method in kids who are not so close to death, to see…

Read the rest of the story from our partners at NBC News

TIME celebrities

David Lynch Tweets Support for Dr. Oz

Says he supports embattled doctor 100%

Director David Lynch tweeted Tuesday that he supports Dr. Oz, who is defending himself against a group of doctors who want to see him ousted from Columbia University.

Dr. Mehmet Oz, a physician and TV personality, has been embroiled in conflict since a group of doctors asked Columbia University to fire him earlier this month, saying he has an “egregious lack of integrity” and accusing him of promoting “quack treatments and cures in the interest of personal financial gain.” He was also scolded by senators last year for promoting bogus diet products on his show.

Dr. Oz wrote an op-ed for TIME.com defending himself against the allegations. “My exploration of alternative medicine has never been intended to take the place of conventional medicine, but rather as additive,” he wrote. “Critics often imply that any exploration of alternative methods means abandoning conventional approaches. It does not.”

Lynch is himself an advocate of alternative medicine, and his organization, the David Lynch Foundation for Consciousness-Based Education and World Peace, encourages transcendental meditation as treatment for stress-related disorders.

TIME Nepal

International Aid to Nepal Ramps Up

Supplies, medics, rescue teams and millions of dollars are pouring in

As the death toll from Saturday’s 7.8-magnitude earthquake surpasses 4,350, international aid agencies and foreign governments are scrambling to deliver much-needed financial assistance and supplies to Nepal.

Since Saturday, supplies, search-and-rescue and medical teams have been sent from around the world to Nepal’s only international airport, located in the capital, Kathmandu.

Here are some of those efforts:

The U.S. announced Monday it would donate an additional $9 million in assistance for Nepal, bringing the total to $10 million through the U.S. Agency for International Development (USAID). In addition, search-and-rescue teams have been dispatched to Nepal as part of USAID’s disaster-assistance response team and 45 tons of supplies have been dispatched.

“This emergency assistance builds on our years of support for risk-reduction partnerships in Nepal,” said Jeremy Konyndyk, director of USAID’s Office of U.S. Foreign Disaster Assistance.

India has been heavily involved in the aid operation to Nepal since Saturday, sending 1,000 National Disaster Response Force personnel to help with search-and-rescue efforts. In addition, India has deployed 13 aircraft, six Mi-17 helicopters and two Advanced Light Helicopters. On Sunday, 10 tons of blankets, 50 tons of water, 22 tons of food items and 2 tons of medicine were dispatched to Kathmandu. As well as aid, India has sent three army field hospitals, an engineering task force and medical units of civilian doctors, according to the Indian Express.

The U.K. is giving $7.6 million in aid, of which slightly more than half will address immediate needs in Nepal, with the rest to be donated to the Red Cross, which is helping with rescue and recovery efforts in Nepal. An eight-member team of disaster-response specialists has been working in Nepal since Sunday. Experts from a number of U.K.-based charities including the British Red Cross and Oxfam are operational in Nepal. A Royal Air Force plane carrying 1,100 shelter kits and more than 1,700 solar lanterns departed for Nepal on Monday.

“I have now activated the Rapid Response Facility. This means we can fast-track funding to aid workers on the ground so they can provide desperately needed supplies including clean water, shelter, household items and blankets,” International Development Secretary Justine Greening said in a statement on Sunday.

China sent a 62-member search-and-rescue team on Sunday and has promised $3.3 million in aid, including emergency shelters, clothing, blankets and power generators.

Israel has sent a 260-member team to Nepal to assist with rescue and relief operations along with 95 tons of aid and medical supplies. On Monday, a plane carrying a medical team of 200 doctors, nurses, paramedics, rescue teams and other personnel landed in Kathmandu and began to set up field hospitals.

Australia’s Foreign Minister Julie Bishop pledged Sunday $3.9 million in assistance that will be split between Australian NGOs, supporting U.N. partners and the Australian Red Cross.

Malaysia said Sunday it will deploy 30 members from the Special Malaysia Disaster Assistance and Rescue Team (SMART) and is sending 20 doctors to help with operations on the ground in Nepal.

Pakistan deployed four Pakistan Air Force aircraft carrying rescue and relief assistance, including a 30-bed hospital and a medical team of doctors and paramedics, to Nepal on Sunday.

The E.U. is making available $3 million in its response to the Nepal earthquake. This is in addition to assistance from member states and the deployment of the European Commission’s humanitarian aid and civil-protection experts to the worst-affected areas. Emergency aid includes clean water, medicine, emergency shelter and telecommunications.

“What is needed most are medical teams and relief supplies. I call on all E.U. member states to join the coordinated European response,” E.U. Commissioner for Humanitarian Aid and Crisis Management Christos Stylianides said in a statement on Sunday.

The U.N. has released $15 million from its central emergency-response fund for earthquake victims in Nepal. Valerie Amos, the under secretary general for humanitarian affairs, said U.N. agencies were coordinating international efforts and were working with partners in Nepal, including the government, to get aid to those affected.

The World Food Programme is also providing food and supplies as well as logistical support on the ground, and UNICEF has mobilized two cargo flights carrying 120 tons of humanitarian aid, including medical supplies, tents and blankets.

Other countries involved in donating financial aid or sending in personnel to help with rescue and relief operations include Canada, Bhutan, France, Italy, Japan, New Zealand, Norway, Singapore, South Korea, Sri Lanka, Switzerland and the United Arab Emirates.

But with so many cargo and civilian planes flying in to help, Kathmandu’s tiny airport is struggling to cope under the strain. Agencies warn that if you want to help, donate money not stuff and avoid hopping on a plane to Nepal to help with relief efforts in person.

“More than your plane ticket or your collection of old T-shirts, what is most needed in Nepal right now is money,” writes Claire Bennett in the Guardian.

Read this next: 6 Ways You Can Give to Nepal Earthquake Relief

TIME medicine

How the Polio Vaccine Trials Relieved a Worried Nation

Between 1954 and 1955, the polio vaccine transitioned from a trial of 1.8 million to a regular feature of life for households across America

JONAS SALK
Alfred Eisenstaedt—The LIFE Picture Collection/Getty ImagesDr. Jonas Salk examining test tube sample of polio virus used in making his polio vaccine, at Univ. of Pittsburgh.

On April 26, 1954, children at the Franklin Sherman Elementary School in McLean, Virginia, held their breaths as needles penetrated the skin of their upper arms. They were the first of nearly two million volunteers in a three-month trial of epidemiologist Jonas Salk’s inactivated polio vaccine, which would be deemed safe for general use just shy of one year later.

The day before the trials were deemed a success, in April 1955, LIFE published a series of photos of a nation preparing for wide distribution of the vaccine it desperately hoped would be approved. The National Polio Foundation had 27 million vaccine shots ready for release, to be administered to all first- and second-grade students and children who had received a placebo during the 1954 trial. Pharmaceutical companies, too, had chosen not to wait for the announcement to begin their own frantic manufacturing process.

During the early 1950s, polio cases in the U.S. had surged to nearly 60,000, with around one third rendering victims paralyzed. Given parents’ heightened fear for their children’s health in recent years, it didn’t take long for Salk to be hailed a hero:

Tributes ranged down from a citation from the President and a proposal that he be given a special Congressional Medal of Honor to offers of farm equipment. Newspapers in several cities were raising Salk funds and a U.S. senator introduced a bill to give him an annual stipend of $10,000. Salk, 40, who lives on a University of Pittsburgh research professor’s salary and hopes to increase the effectiveness of his vaccine from 80% to 100%, said he would take no money for himself but indicated it would be used for further research.

In the years since the vaccine’s development, polio has been all but eradicated throughout most of the world, save for a few countries where vaccination is not universally available and prevention continues to be a struggle.

Liz Ronk, who edited this gallery, is the Photo Editor for LIFE.com. Follow her on Twitter at @LizabethRonk.

TIME medicine

Hormone Treatments Raise Cancer Risk Even After They’re Stopped

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Estrogen and progestin therapy to treat menopause has led to controversial and confusing recommendations. But in the latest and longest term look at the data, experts say the risks of the hormones may last long after women stop taking them

Researchers admit that when it comes to hormone therapy — estrogen and progestin — to treat the symptoms of menopause for women, they don’t have a lot of consistent or convincing answers. They thought the medications could not only help menopause symptoms but also protect against heart disease, although some studies showed the added hormones could also raise risk of breast cancer. The resulting advice to women seeking answers about whether hormone therapy is for them has been anything but satisfying.

Now the scientists involved in the first large trial of hormone therapy, the Women’s Health Initiative (WHI), have continued to study those women who participated in the 1990s and found some surprising results. Reporting in the journal JAMA Oncology, they say that the risk of breast cancer for women taking the combination of estrogen and progestin remains the same seven to eight years after they stop the drugs than while they were taking them.

MORE: Hormone Replacement Therapy After Menopause: What Women Need to Know

The estrogen helps to maintain levels of that hormone as natural amounts start to drop during menopause, and the progestin protects the uterus from potential tumors arising from excess amounts of estrogen. They also found that for the quarter or so post-menopausal women who have had a hysterectomy, and can take estrogen alone, the hormone can lower their risk of breast cancer.

The WHI was created to study the health effects of hormone therapy on the millions of women taking them. Some small studies had suggested that the hormones could protect women from heart disease; women tend to have heart attacks about a decade or so later than men on average, and researchers believed some of that protection came from estrogen. But doctors were concerned about the known connection between estrogen and breast cancer, since during puberty estrogen contributes to breast tissue growth, and wanted to understand how the benefits for the heart matched up against the risks to the breast, so they enrolled more than 26,600 women aged 50 to 79 years in the WHI.

MORE: Estrogen After Menopause Lowers Breast Cancer Risk for Some Women

They intended to study them until 2005, but in 2002, they stopped the trial when it became clear that there was a group of women experiencing higher heart disease rates. It turned out that these were the women taking hormones, either the combination or estrogen alone.

MORE: The Truth About Hormones

The results completely changed menopause treatment, and led to a precipitous drop in the use of the medications; in the U.S., where about 40% of women turned to the hormones, only 15% did after most experts agreed that they should only be used in the short term, for about a year or so during and just after menopause. The assumption was that the benefits in lowering breast cancer risk would be similar — if women stopped taking the hormones, then their risk would decline.

That seemed to be true, at least for the first year or so after discontinuing the therapy. But in 2013, Dr. Rowan Chlebowski, an oncologist at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, and one of the initial investigators on WHI, reported that the benefit didn’t hold for long. He found that if women who had previously been on estrogen and progestin therapy were studied for more than eight years, their risk of breast cancer started climbing back up, to levels that were on par with when they were taking the medications.

That finding, however, contradicted other results from studies. And to make matters more confusing, the women who had had a hysterectomy, and no longer had a uterus so could take estrogen alone, did not seem to experience the same increased risk of breast cancer. All of this data prompted Chlebowski to do a more detailed analysis of the WHI data on women who agreed to continue to participate years after they stopped taking the hormone therapy.

MORE: Making Sense of Hormone Therapy After Menopause

In the current study, it’s clear that the combination of estrogen and progestin increases breast cancer risk, he says. The drop in risk that occurs immediately after the therapy is stopped is likely due to the changing hormone environment. Any small or emerging tumors that were already present before hormone treatment started may eventually start growing again years later.

For women who have had a hysterectomy, taking estrogen alone does not increase breast cancer risk and may, according to the latest results, even provide some protection against the disease.

“It looks like hormones have longer term lingering effects,” says Chlebowski. “For estrogen and progestin together, we see an increase in risk even years after you stop. But for estrogen alone, it looks like the hormone may be more favorable in reducing breast cancer risk than we thought before. The estrogen alone findings are now quite compelling that we may had to call lit risk reduction.”

The results should stress the importance of defining what menopausal symptoms are, and how much they interfere with women’s daily lives. Most health groups now recommend short term hormone therapy, but it’s clear that the risks of breast cancer remain even after exposure. So doctors and patients need to weigh the relief of symptoms against the unhealthy legacy of taking these medications. “There is a little more risk than we thought with estrogen and progestin,” says Chlebowski. “But it’s always difficult to figure out how to categorize that risk. It’s different for each woman.”

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