TIME medicine

World’s First Malaria Vaccine Could Be a Year Away

A Thai public-health official places a thermometer into a child's mouth at a malaria clinic in Sai Yoke district, Kanchanaburi province, Thailand, on Oct. 26, 2012 Sukree Sukplang—Reuters

Researchers published promising findings, while a pharmaceutical company applied for the first-ever regulatory approval of malaria vaccine

The world’s first malaria vaccine may just be a year away, after a thorough trial of a new drug showed promising results.

PLOS Medicine on Tuesday published a study, in which researchers found that for every 1,000 children who received the vaccine, 800 cases of illness could be prevented. The children also retained protection 18 months after being injected.

Now, pharmaceutical manufacturer GlaxoSmithKline (GSK) has applied the drug for regulatory approval — the first time a malaria vaccine has reached this stage.

“This is a milestone,” Sanjeev Krishna, professor of molecular parasitology and medicine at St. George’s, University of London, who reviewed the paper for the journal, told the BBC. “The landscape of malaria-vaccine development is littered with carcasses, with vaccines dying left, right and center. We need to keep a watchful eye for adverse events, but everything appears on track for the vaccine to be approved as early as next year.”

Around 800,000 people die from malaria every year, most of them children under 5 in sub-Saharan Africa. Several African countries were involved in the trial of the new vaccine, which is developed by GSK in cooperation with the nonprofit Path Malaria Vaccine Initiative, for which they have received funding from the Bill & Melinda Gates Foundation.

TIME Research

The Link Between 9/11 and Cancer Still Isn’t Entirely Clear

National 9/11 Memorial Museum
People visit the National 9/11 Memorial Museum in New York City on May 25, 2014. Cem Ozdel—Anadolu Agency/Getty Images

A number of complicating factors and delayed data make conclusions difficult to draw

The New York Post reported Sunday that the number of cancer cases among 9/11 first respondents had more than doubled in the past year, from 1,140 to over 2,500. However, to scientists who specialize in analyzing such data, the number of cases cannot ever tell the full story.

Dr. Roberto Lucchini is an epidemiologist and director of the World Trade Center Health Program Data Center at Mount Sinai Hospital, which treats and researches the police officers, construction workers, sanitation workers and iron workers who were among the first respondents on 9/11. To Lucchini, the number of observed cancer cases among these patients cannot be significant until compared to the number of expected cancer cases.

“I don’t think there’s a double of cases one year to the other,” Lucchini told TIME. “When you compare one year to the other, you have to be careful and try to understand what you are comparing. If you don’t compare correctly, you can come up with information that is not exactly true.”

“I don’t think they compared like-with-like which is what you normally do in epidemiology,” adds Dr. Billy Holden, a deputy director of the data center. “I don’t know how they came to the conclusion that there was a doubling.”

Mount Sinai has a record of 1,646 confirmed cancers from 2002 to present-day among the over 30,000 first respondents that they oversee. The hospital’s cases are reviewed and certified by the National Institute of Occupational Safety and Health (NIOSH). Meanwhile, the public registry—which also collects data on these cases—has confirmed 1,172 cancers among Mount Sinai patients, but the registry’s number only represents data through the year 2010, which may account for the difference.

“That’s the latest that we have in reliable data that we can use,” Holden says. “The delay is coming from the registries themselves. It takes them a long time to get the data.”

According to a press release from Mount Sinai, “analysis of available data through 2010 shows that there is an approximately 20% increase in cancer incidence in 9/11 rescue and recovery workers compared to the general population, with a particular increase in thyroid cancer, prostate cancer, myeloma, and leukemia.”

This elevated incidence rate could result from the high exposure to carcinogens that many first respondents endured. However, even this number is subject to question due to a number of complicating factors, including over-diagnosis of certain cancers—such as thyroid and prostate—and questionably reliable data for the general population.

“Over-diagnosis means you’re just screening for cancers, and you pick up cancers that in the normal course of things would never cause symptoms and would never cause death,” Holden says. “The screening for thyroid and prostate cancer is picking up these really non-malignant cancers that don’t do anything.”

Another complicating factor is the continued aging of the first respondents. Epidemiologists would expect the number of observed cancer cases among this population to increase over the coming years regardless because everyone’s risk of cancer rises with time. “Numbers are interesting, but they’re not revealing because we have to look at the rates,” Holden says. “Looking at numbers themselves doesn’t mean anything. You have to put them in a certain context.”

The search for a similar context alone can result in frustration for researchers. As so many residents of New York need not be reminded, 9/11 is an event that stands alone in our history.

“There’s nothing like this in the whole history of the world,” Lucchini says. “We can think about Chernobyl or Fukushima, but this is a totally different situation here… So for us to compare this to other studies and other experiences is quite difficult.”

Lucchini adds, “We are doing as much as we can.”

When it comes to the men and women who first responded on that fateful day, the question remains of how much can ever be enough.

TIME Research

Google Seeks Human Guinea Pigs for Health Project

Google's "Baseline Study" aims to get clear picture of human health

Updated: July 29, 10:05 am

Google’s newest project aims to create a crowd-sourced picture of human health by collecting anonymous genetic and molecular information from participants.

The project, called Baseline Study, will start off by collecting data from 175 people, but Google hopes to expand that sample size to thousands more, the Wall Street Journal reports.

The researchers hope the project can help move medicine towards prevention over treatment by giving scientists a more accurate picture of what a healthy body looks like, which can help them detect ailments like heart disease and cancer much quicker.

The lead researcher, Dr. Andrew Conrad, said that part of detecting disease is getting a clear picture of how a healthy body works. “We are just asking the question: If we really wanted to be proactive, what would we need to know?” he told the WSJ, which originally reported on this project. “You need to know what the fixed, well-running thing should look like.”

The project will collect hundreds of samples, and then find “biomarkers,” or patterns, within the data. Scientists hope these biomarkers will help them detect disease much sooner, or tell them which kinds of biological conditions make someone a likely candidate for high cholesterol.

Google said that the information from Baseline would be both private and anonymous, would be used only for medical purposes, and wouldn’t be shared with insurance companies. Institutional review boards from Duke University and Stanford University will monitor the study to make sure the data isn’t being misused, Google said, and will only have access to the samples once they’ve already been stripped of identifying data, like names and social security numbers. The samples will be collected by independent testing companies.

But Google wants to collect a staggering amount of information about each of its anonymous human guinea pigs. They’re mapping each person’s entire genome, and their parents’, not to mention looking at how they metabolize food, and how their hearts beat, and their oxygen levels. Participants will even wear special smart contact lenses so Google can monitor their glucose levels.

The Baseline project is the latest endeavor of GoogleX, the arm of the company devoted to long-term, high-risk projects with potential for high reward.

[WSJ]

TIME Research

Survey: Teen Use of Human Growth Hormones Surges

Rate of high schoolers admitting use of synthetic hGH, or performance enhancing drugs, jumps from 5% to 11% in one year

The number of teens using synthetic human growth hormones (hGH) without a prescription have doubled, according to a new survey of high school students.

A survey from the Partnership for Drug-Free Kids found that 11% of the 3,705 high schoolers surveyed reported “ever having used” synthetic hGH without a prescription. That’s a jump from the last four years: in 2012 and 2011 the number of teens using hGH was 5%. The survey also found that steroid use among teens went up from 5 to 7%.

African-American and Hispanic teens were the most likely to say they’ve used synthetic hGH, and the researchers found that both boys and girls had claimed to use hGH and steroids without a prescription. The awareness of online steroid and hGH marketing among teens also rose from 17% in 2012 to 22% in 2013, and kids are less likely to think there is a high or moderate risk associated with them compared to earlier years.

The data shows that about one in five teens says they have at least one friend who uses steroids, and another one in five teens say it’s easy to get them.

Prescription and over-the-counter hGH are considered safe for uses that include treatment for muscle deterioration due to HIV/AIDS and longterm treatment for kids of short stature. But as the report points out, some supplement products that are not regulated by the FDA and not safe for teen consumption can make it onto store shelves, and many are sold online.

“The proliferation of commercially available products that are marketed saying they contain synthetic hGH, or promote the natural production of hGH within the body, is staggering,” said Steve Pasierb, president and CEO of the Partnership for Drug-Free Kids in a statement.

Teens tend to use synthetic hGH and steroids–which can be injected or taken orally–to improve their athletic performance or physical appearance. The Partnership for Drug-Free Kids encourages parents and coaches to talk to young people about the risks. The group has also collaborated with the Major League Baseball Charities to create a program that teaches young athletes about the dangers of performance-enhancing drugs.

TIME Infectious Disease

MERS Could Be Airborne, Research Indicates

The disease has already claimed 288 lives

Findings from a scientific paper published Tuesday indicated that Middle East Respiratory Syndrome (MERS) may be able to spread through the air.

A research team in Saudi Arabia collected air samples from a camel barn that the virus had previously plagued. Their analysis of the air sample tested positive for a strain of MERS RNA, CNN reports.

The possibility of MERS as an airborne illness has been previously floated after reports said that some of those infected previously had close contact to fellow MERS patients. The disease has claimed at least 288 live, according to the World Health Organization.

However, scientists are hesitant to jump to conclusions from these findings. “What they say is that virus particles can be airborne, but it’s premature to conclude that MERS is transmitted through aerosols,” said Dr. Mark Denison, a Vanderbilt University School of Medicine professor.

“Do we still need to consider the possibility of airborne transmission?” Denison added. “Yes, of course.”

[CNN]

TIME Stress

Burnout in the Hospital: Why Doctors Are Set Up for Stress

Every job can lead to burnout, but what happens when it strikes doctors, who make decisions that can affect their patients' lives?

Some experts call physician burn out “inevitable,” given the high-pressure environment in which they must make potentially life-saving, and almost always life-altering, choices on a constant basis. Research shows that up to 40% of U.S. doctors experience emotional, physical, and psychological burnout from their jobs, and the consequences are no different for them than they are for people in other occupations — substance abuse and cutting corners.

In the premiere issue of the journal Burnout Research, which is dedicated to research on the topic, Anthony Montgomery, an associate professor in the Psychology of Work and Organizations in the University of Macedonia in Greece, focused on physician burnout, and argues that the way doctors are trained may set them up for a career of frustrations and high-stress situations. And the consequences may be hurting the care they provide patients.

He says that while doctors interact with people on a daily basis, their training and their worth as physicians are focused almost entirely on their technical capabilities, leaving them with few tools for understanding and navigating social interactions and for collaborating as part of a larger team or organization.

Montgomery argues that most medical students are chosen because of their high test scores, so medical school becomes like an extension of school. They then become residents, thrown into a more social environment in which they are expected to interact with patients, hospital staff and colleagues in ways they may not have expected to or been prepared to do. It’s assumed they have the leadership skills and the proper emotional capacity to guide patients through extremely stressful and often traumatic experiences, but not having the tools to manage these situations can be stressful on the doctors themselves. While burnout among physicians is widespread, some studies have shown surgeons and OBGYNs can be at a particularly high risk.

“The irony is that doctors are the one group of people we don’t want to be stressed, yet we are increasing the possibility for them to make mistakes,” says Montgomery. “Doctors understand that their job is to be the best doctor they can, but [they do] not necessarily [understand] their part in helping the hospital as a whole better serve the community.” In his practice, for example, Montgomery says that his colleagues admitted to learning skills like communication and teamwork on the job, after they left medical school.

And that’s not just a problem for the medical community. The more doctors feel stressed about their jobs, the more they feel burned out and defeated by the health care system, leading to less motivation to improve conditions, both for themselves and for patients. A 2012 study published in Archives of Internal Medicine reported that nearly 1 in 2 U.S. physicians report at least one symptom of burnout, like losing enthusiasm for their work, or growing cynical. Forty percent of doctors reported being unsatisfied with their work-life balance and that they did not have time to devote to their families or their personal lives. And in a 2013 study published in JAMA, the consequences of that burnout started to emerge — only 36% of 2,556 surveyed physicians believed doctors had a major responsibility in reducing health care costs, despite the fact that they prescribe the drugs, tests and procedures that can escalate costs. Other studies also link burnout to poorer quality care and increased rates of medical errors.

What can be done to alleviate some of the pressure on physicians? Montgomery cites revisiting the way doctors are educated in order to arm them with stronger social and leadership skills, as well as some untraditional strategies, including teaching mindfulness. Improving the doctor-patient relationship may also help, so physicians and patients collaborate in their care rather than perpetuate a hierarchical system which neither doctor nor patient finds satisfying. He writes: “The uncomfortable truth is that we may need to reimagine healthcare in a way that views some errors as unavoidable, demystifies the physicians as superheroes, engages real patient participation and steers healthcare professionals away from cultures of self-preservation.” In other words, making health care more satisfying for physicians and patients may be a group effort, and that’s something that doctors aren’t quite used to yet.

 

TIME

3 Skin Products You Need to Stop Using

Girl with skincare product
Marili Forastieri—Getty Images

You may think that as long as an item is on store shelves, it’s got a proven health and safety record. But the truth is, the long-term impact of personal-care creations aren’t always fully understood until years after they go to market.

That’s the case with several high-profile health and beauty products on the market today: Doctors and scientists are discovering that despite their popularity and “healthy” image, they may not be so good for us, or for the planet. So we asked Lisa Donofrio, M.D., associate clinical professor of dermatology at Yale University, for her take on the recent headlines. Here’s her advice on which ingredients to avoid, plus her recommended alternatives.

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Antibacterial soaps and body washes
Liquid hand and body soaps that boast “antibacterial” claims often contain an ingredient called triclosan, which has been linked to antibiotic resistance and hormone disruption. (Triclosan is also present in some toothpastes and cosmetics.) “It gets into the water supply and kills off beneficial bacteria,” says Dr. Donofrio. Plus, she adds, research hasn’t shown a true health benefit to antibacterial products. “We need to be a little dirty; it’s good to give our immune systems something to do so they don’t turn on us.”

The FDA has warned manufacturers that in the coming years, they’ll need to prove that products containing triclosan are more effective in preventing illness and reducing the spread of infection than regular soap and water, or they’ll have to reformulate their products. And Minnesota recently issued a ban on triclosan, which will go into effect in 2017.

Antibacterial bar soaps can contain a similar chemical, called triclocarban, that should be avoided as well. Instead, says Dr. Donofrio, choose bars, liquid soaps, and body washes with natural antimicrobials (she likes formulas that contain benzoyl peroxide or sulphur, which are gentler on the environment and don’t foster drug resistance), or use an alcohol-based sanitizer to clean your hands when you’re not near soap and water.

Health.com: 16 Hair Myths You Should Stop Believing

Face and body scrubs with microbeads
These tiny plastic beads are added to face and body washes as an exfoliant, and they help scrub away dead skin. The problem is, recent studies have shown that they also slip through water filtration systems and are making their way into our streams and oceans, potentially hurting fish and wildlife. The synthetic ingredient was recently banned by Illinois, and several other states are following suit.

In light of this news, a “natural” exofoliant may seem like the way to go—but Dr. Donofrio cautions against face and body washes that contain ground up pieces of nuts, seeds, and pits, which can have jagged edges and scratch or irritate skin. Her best alternative? “A coarse washcloth is a great exfoliator, as are scrubs that contain fine sea salt or sugar.”

Health.com: 13 Everyday Habits That Age You

Anything with parabens
These preservatives are found in everything from shampoos to soaps to lotions, and are used to prevent bacteria growth and extend shelf life. But they are also absorbed into our bodies, and research suggests that they may be tied to hormone disruption and certain cancers. “They bind to estrogen receptors and pose a potential health risk since they are stored in body fat,” says Dr. Donofrio. “Since we are uncertain if they pose a real or theoretical health problem, why tempt fate?”

Parabens are listed on ingredient labels—as methylparaben, propylparaben, or other words ending in -paraben—so it’s easy to choose products that don’t contain them, says Dr. Donofrio, or to limit your exposure by keeping their use to a small amount of skin area. Preservative-free products, or those with natural preservatives (such as grapefruit-seed extract, rosemary extract, or citric acid), likely won’t last as long, but if you use them regularly you should still finish them before their expiration date.

This article originally appeared on Health.com.

TIME neuroscience

A ‘High’ From Marijuana Is Really the Opposite in Your Brain

Daily Life In South Africa
A youth smokes marijuana in Soweto township, near Johannesburg, on July 2, 2013 Christopher Furlong—Getty Images

Marijuana dulls your response to dopamine

A new study suggests marijuana blunts the brain’s reaction to dopamine, making users less responsive to the chemical responsible for feelings of reward and pleasure.

In the study published Monday in the journal Proceedings of the National Academy of Sciences, the researchers studied the brains of 24 marijuana abusers — that is, people who smoked multiple times a day — and how they reacted to methylphenidate, a stimulant often used to treat ADHD and narcolepsy. Using personality tests and brain imaging, the researchers found the pot users had blunted behavioral, cardiovascular and brain responses to methylphenidate compared with control participants. Marijuana abusers scored lower on tests of positive emotional activity and higher on negative emotional reactions.

The researchers believe that pot not only dampens the brains’ dopamine reaction to stimulants but also influences the area of the brain involved in reward processing. The participants had lower reward sensitivity, higher levels of irritability, and likely more depression and anxiety.

The researchers conclude that the way pot interferes with the brain may contribute to drug cravings. And that a “high” is really the opposite in the brain.

TIME Exercise/Fitness

Athletes Should Not Play With Head Injuries, Say Doctors

Christoph Kramer of Germany receives a medical treatment during the 2014 FIFA World Cup Brazil Final match between Germany and Argentina on July 13, 2014 in Rio de Janeiro.
Christoph Kramer of Germany receives a medical treatment during the 2014 FIFA World Cup Brazil Final match between Germany and Argentina on July 13, 2014 in Rio de Janeiro. Shaun Botterill—FIFA/Getty Images

Germany’s decision to let midfield Christof Kramer keep playing in the World Cup final yesterday after being slammed in the head was understandable—if this were 1962, anyway. Back then, a little concussion wasn’t seen as much of a big deal.

That’s not true anymore, and given the fact that everyone from kids’ coaches to the NFL (if grudgingly) recognize that even mild head injuries can have serious consequences, that decision looks close to insane—especially given that Kramer “looked as if he was on another planet and had to be helped off the field,” as TIME’s Bill Saporito observed.

Of course, it’s possible that the German team didn’t realize that this sort of thing can cause permanent brain damage. Or maybe they think that what applies to American football is irrelevant to real football. Except that studies have shown that soccer players are equally at risk.

Clearly, they didn’t read the editorial in The Lancet Neurology published the day before the game reminding coaches and team officials that “cerebral concussion is the most common form of sports-related traumatic brain injury (TBI), and the long-term effects of repeated concussions may include dementia, amyotrophic lateral sclerosis, and other neurological disorders.” The decision to let players continue in a game, wrote these learned medical experts, should be made solely by doctors.

It turns out that FIFA doesn’t have any clear rules about what to do in case a player suffers an apparent concussion. But the fact that Kramer stayed in the game, no matter how important a World Cup final match might be, was at best highly questionable. “I can’t remember very much but it doesn’t matter now,” the dazed player reportedly said after the game was over.

If the medical professionals are right about how serious concussions can be, Kramer and his teammates might well have a different take on things a few years down the road.

TIME medicine

Study: Phones, Tablets May Irritate People With Nickel Allergies

Ken Miyauchi, vice president and chief operating officer of Softbank Corp., left, holds an Apple Inc. iPad Mini during a ceremony as the device goes on sale at the Softbank store in the Ginza district of Tokyo on November 30, 2012.
Ken Miyauchi, vice president and chief operating officer of Softbank Corp., left, holds an Apple Inc. iPad Mini during a ceremony as the device goes on sale at the Softbank store in the Ginza district of Tokyo on November 30, 2012. Bloomberg/Getty Images

One boy had skin rashes from his iPad

A nickel allergy is one of the most common types of skin allergies, causing many people to experience irritation from jewelry, for example. New research shows that nickel allergies are becoming more common among kids, with one case being triggered by exposure to an iPad tablet.

In a recent case study published in the journal Pediatrics, an 11-year-old boy with a history of skin rashes had a particularly persistent breakout that lasted over six months. The doctors ultimately determined the trigger was nickel in his family’s iPad. An iPad cover was added, the boy changed his diet, and the rashes improved.

Apple did not respond to requests for comment.

The report’s authors say dermatologists should be mindful that some electronic devices may cause irritation for people with nickel allergies. As the Associated Press reports, only about 25% of children tested for skin allergies are allergic to nickel. Individuals who have no problems when it comes to the metal — the majority of people — shouldn’t worry about the nickel in their gadgets.

 

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