Bacteria Are Hard to Avoid in Public Bathrooms

Study Shows Public Restrooms Are Often Hot Spots for Infection-Causing Bacteria

 

An article on WebMD states: Frequent hand washing will keep those nasty bugs at bay, right? Not if you’re using a public bathroom. Paper dispensers, hand dryers, door handles -- all the things you touch after scrubbing -- are contaminated with all sorts of menacing microbes, sometimes too many to count.

"We documented extensive bacterial contamination of high‐touch environmental sites in 22 public restrooms and aircraft," says researcher Lennox Archibald, MD, PhD, of the College of Medicine, University of Florida, in Gainesville.

Translation: Bathrooms in restaurants, resorts, hospitals, and even libraries are crawling with bugs that can cause everything from diarrhea to wound infections.

"You can go paranoid thinking about it," Archibald said.

Variety of Bacteria in Public Restrooms

 

There's been virtually no research into how many bacteria, and how many different types of bacteria, lie in wait in public restrooms, he says.

So from December 2010 through February 2011, his team descended on restrooms inside four commercial aircraft and 18 public places, including a mall, a hospital, offices, a lecture hall, a conference center, department stores, restaurants, an airport, and a resort.

They swabbed and cultured what Archibald calls "high-touch" areas -- faucets, paper dispenser levers, and doorknobs and handles.

The researchers hit the microorganism jackpot. They recovered staph, which can cause everything from boils to antibiotic-resistant infections. They found E. coli. They cultured Enterococcus, a fecal bug that can cause urinary tract infections and wound infections. And more.

Cultures of high‐touch sites in three hospital restrooms yielded seven bugs that are responsible for two‐thirds of hospital‐associated infections.

The findings were presented at the annual meeting of the Infectious Diseases Society of America (IDSA) in Boston.

Keeping Away From Bacteria

 

For Archibald, one solution is to hold it in. "I only use bathrooms on very long-distance flights," he says.

For those times when you have to go, carry paper towels or tissues to protect your hands after washing, he says.

William Schaffner, MD, chair of IDSA's immunization work group and head of preventive medicine at Vanderbilt University Medical Center in Nashville, has a more bug-friendly viewpoint.
Some bacteria boost our immune system, he states.

"We don't live in a sterile world," Schaffner says. "You don't want to obsess. On the other hand, you want to be hygienic," he says.

His tip: Carry a little vial of hand sanitizer where ever you go.



For more information on staying healthy, getting the necessary vaccines, managing heart disease, controlling high blood pressure, or general health issues, please contact Dr. Gregory Cohen, Medical Director at Westside Preventive Medicine. 

Dr. Cohen is a board certified Internist and Cardiologist in Los Angeles. 

Our patients come not only from Los Angeles, but frequently from Santa Monica, Malibu, Brentwood, Hollywood, the Valley and even as far as Glendale and Pasadena. They all come for our compassionate, "whole-person" approach to medicine. 

To book an appointment, call us at 310-231-9500, or go online to our website at www.westsidepreventivemedicine.com

 

Skipping Doses Can Be Dangerous for Heart Patients

The American Heart Association recently announced the biggest threat to heart patients—and it's not cheese fries or stress. It is "patients' failure to take prescription medicines correctly."

Statistics suggest that if a doctor prescribes a drug to 100 patients, 12% of them won't fill the prescription, another 12% will fill it but not take a single pill, and 22% will stop taking the drug before the prescription runs out.

Skipped meds, needless heart attacks
When it comes to medications for the heart, skipping doses can be costly. It's estimated that thousands of Americans have avoidable heart attacks each year because they neglect to consistently take the cholesterol-lowering statins prescribed by their doctors. A 2007 study of heart patients suggested that skimping on prescribed medications can double the risk of heart attack, stroke, or other cardiovascular events.

Why heart patients skip doses
People have many reasons for skipping doses: forgetfulness, wariness of side effects, and the high cost of some medications, to name a few.

People who are depressed - and that includes up to 20% of heart disease patients—may take a "so what" attitude that makes it hard to stick to a treatment plan.

Heart medications can be especially easy to ignore or forget because most do their work silently. Since you can't feel your cholesterol dropping, you may not notice any obvious benefits of your medication.

Here are some strategies for remembering to take your drugs.

• Make your medicine schedule as simple as possible. Plan times to take your medicines when you are doing other things, like eating or getting ready for bed.
• Talk with your doctor if you are having problems with your medicine schedule. Your doctor may be able to change your medicines or the times you are taking them.
• Talk with your doctor if you have any changes in your health that might affect your heart condition, such as side effects of medicines or a medical condition.
• Use any tools, like daily or weekly pill containers, that make taking your medicines simpler.

For more information on managing heart disease, high blood pressure, or general health issues, please contact Dr. Gregory Cohen, Medical Director at Westside Preventive Medicine. 


Dr. Cohen is a board certified Internist and Cardiologist in Los Angeles. 


Our patients come not only from Los Angeles, but frequently from Santa Monica, Malibu, Brentwood, Hollywood, the Valley and even as far as Glendale and Pasadena. They all come for our compassionate, "whole-person" approach to medicine. 


To book an appointment, call us at 310-231-9500, or go online to our website at www.westsidepreventivemedicine.com

Aging Well Through Exercise

A recent NY Times article asked if physical frailty is inevitable as we grow older. That question preoccupies scientists and the middle-aged, particularly when they become the same people. Until recently, the evidence was disheartening. A large number of studies in the past few years showed that after age 40, people typically lose 8 percent or more of their muscle mass each decade, a process that accelerates significantly after age 70. Less muscle mass generally means less strength, mobility and among the elderly, independence. It also has been linked with premature mortality.

But a growing body of newer science suggests that such decline may not be inexorable. Exercise, the thinking goes, and you might be able to rewrite the future for your muscles.

Consider the results of a stirring study published last month in the journal The Physician and Sportsmedicine. For it, researchers at the University of Pittsburgh recruited 40 competitive runners, cyclists and swimmers. They ranged in age from 40 to 81, with five men and five women representing each of four age groups: 40 to 49, 50 to 59, 60 to 69, and 70-plus. All were enviably fit, training four or five times a week and competing frequently. Several had won their age groups in recent races.

They completed questionnaires detailing their health and weekly physical activities. Then the researchers measured their muscle mass, leg strength and body composition, determining how much of their body and, more specifically, their muscle tissue was composed of fat. Other studies have found that as people age, they not only lose muscle, but the tissue that remains can become infiltrated with fat, degrading its quality and reducing its strength.

There was little evidence of deterioration in the older athletes’ musculature, however. The athletes in their 70s and 80s had almost as much thigh muscle mass as the athletes in their 40s, with minor if any fat infiltration. The athletes also remained strong. There was, as scientists noted, a drop-off in leg muscle strength around age 60 in both men and women. They weren’t as strong as the 50-year-olds, but the differential was not huge, and little additional decline followed. The 70- and 80-year-old athletes were about as strong as those in their 60s.


“We think these are very encouraging results,” said Dr. Vonda Wright, an orthopedic surgeon and founder of the Performance and Research Initiative for Masters Athletes at the University of Pittsburgh Medical Center, who oversaw the study. “They suggest strongly that people don’t have to lose muscle mass and function as they grow older. The changes that we’ve assumed were due to aging and therefore were unstoppable seem actually to be caused by inactivity. And that can be changed.”

Other recent studies have produced similar findings. Last year, researchers at the Canadian Centre for Activity and Aging, for instance, examined muscle tissue from older competitive runners, checking for the density of their motor units, a measure of muscle health. A motor unit is, essentially, the control mechanism of a functioning muscle, composed of a neuron and the particular muscle fibers that that neuron activates. The more motor units in a muscle, the stronger it generally is.

In multiple earlier studies, people over 50 have been found to possess far fewer muscle motor units than young adults. But that wasn’t true for the sexagenarian runners, whose leg muscles teemed with almost as many motor units as a separate group of active 25-year-olds. Running, the scientists wrote, seemed able to “mitigate the loss of motor units with aging well into the seventh decade of life.”
Of course, the volunteers in both Dr. Wright’s and the Canadian study were, for the most part, lifelong athletes. Whether similar benefits are attainable by people who take up exercise when they are middle-aged or older “isn’t yet clear,” Dr. Wright says, “although there’s no reason to think that you wouldn’t get similar results no matter when you start.”

In an encouraging animal study from last year, elderly rats that had been sedentary throughout their adult lives were put on a running program. After 13 weeks, their leg muscle tissues had filled with new satellite cells, a specialized type of stem cell that is known to build and repair muscle. Comparable experiments in older people have yet to be done, though.

Other questions about the impacts of exercise on aging muscle also remain unanswered. “We don’t know what kinds of exercise are best,” Dr. Wright says and, in particular, whether endurance exercise is necessary for muscle sparing or whether weight training might be as good or better. Scientists also haven’t determined just how much activity is required to maintain muscle mass, or how intense it needs to be.

“What we can say with certainty is that any activity is better than none,” Dr. Wright says, “and more is probably better than less. But the bigger message is that it looks as if how we age can be under our control. Through exercise, you can preserve muscle mass and strength and avoid the decline from vitality to frailty.”



For more information on aging well, managing heart disease, high blood pressure, or general health issues, please contact Dr. Gregory Cohen, Medical Director at Westside Preventive Medicine. 


Dr. Cohen is a board certified Internist and Cardiologist in Los Angeles. 


Our patients come not only from Los Angeles, but frequently from Santa Monica, Malibu, Brentwood, Hollywood, the Valley and even as far as Glendale and Pasadena. They all come for our compassionate, "whole-person" approach to medicine. 


To book an appointment, call us at 310-231-9500, or go online to our website at www.westsidepreventivemedicine.com

 

Cholesterol levels in middle age affect dementia risk

A large study has found that even moderately elevated cholesterol levels in middle age increase the risk of developing dementia in old age.

Researchers analyzed the health outcomes of 9,844 members of the Kaiser Permanente Northern California Medical Group, who had undergone detailed health evaluations, including cholesterol testing, at ages 40 to 45. The researchers then examined participants' medical records 30 to 35 years later.

When compared with participants with desirable cholesterol levels (defined as less than 200 mg/dL), those with moderately elevated levels (200 to 239 mg/dL) were 50% more likely to develop vascular dementia later on. They were also more likely to develop Alzheimer's disease, although the results did not reach statistical significance.

Those with high cholesterol (240 mg/dL or higher) were 57% more likely to develop Alzheimer's. They were also more likely to develop vascular dementia, but the results did not reach statistical significance.

Previous studies have shown that high cholesterol and other factors that contribute to heart disease can increase risk of dementia. But this study is notable for its size and inclusion of participants from multiple ethnic backgrounds. As such, it adds further evidence that finding ways to keep cholesterol levels in the healthy range is good for the mind as well as for the heart.

Solomon A, et al. "Midlife Serum Cholesterol and Increased Risk of Alzheimer's and Vascular Dementia Three Decades Later," Dementia and Geriatric Cognitive Disorders (Aug. 2009): Vol. 28, No. 1, pp. 75–80.

For more information on managing cholesterol, heart disease, high blood pressure, or general health issues, please contact Dr. Gregory Cohen, Medical Director at Westside Preventive Medicine. 


Dr. Cohen is a board certified Internist and Cardiologist in Los Angeles. 


Our patients come not only from Los Angeles, but frequently from Santa Monica, Malibu, Brentwood, Pacific Palisades, Hollywood, the Valley and even as far as Glendale and Pasadena. They all come for our compassionate, "whole-person" approach to medicine. 


To book an appointment, call us at 310-231-9500, or go online to our website at www.westsidepreventivemedicine.com

Studies: New drug combinations slow down metastatic breast cancers

A new combination of treatments can help battle some forms of metastatic breast cancer and slow down the spread of the disease, according to two separate studies.


The new studies show that the combinations of treatments significantly overcome or reduce drug resistance in the metastatic phase. That phase is when the cancer has spread beyond the breasts and lymph nodes, doctors said.

Results from the two clinical trials also revealed combining two targeted therapies can slow the progression of the cancer. Scientists presented the research at the San Antonio Breast Cancer Symposium on Wednesday in Texas.

About 200,000 women are diagnosed with breast cancer a year, according to Dr. Ben Ho Park, an associate professor of oncology at Johns Hopkins University School of Medicine.
"These two studies address about 80% of breast cancers in the metastatic setting," said Park, who is not involved in the trials.

In one trial -- BOLERO-2 -- researchers found postmenopausal women with advanced "hormone receptor-positive breast cancer" did better when they took combination therapies rather than a single hormonal treatment.
Women in the trial took a combination of a hormone blocking drug called Aromasin along with a kidney cancer drug called Afinitor, which blocks another signal path inside the cancer cell that tells it to proliferate.

"More patients die of hormone receptor-positive breast cancer than other types of breast cancer," said Dr. Gabriel Hortobagyi, one of the study's authors and chairman of the department of breast medical oncology at the University of Texas in Houston.

Women with hormone receptor-positive breast cancer are given hormone blocking drugs like Tamoxifen (for pre-and postmenopausal patients), blocking estrogen activity in the breast or other aromatase inhibitors (in postmenopausal women), which stop the production of estrogen.

But cancer cells have the ability to get around these hormone-blocking drugs and find ways to make tumors grow again like activating a protein called mTOR, which promotes cell growth and division.
In this trial, 724 women, whose cancer had become resistant to aromatase inhibitors Femara and Arimidex, were given the aromatase inhibitor Aromasin plus placebo or Aromasin plus Afinitor, an approved kidney cancer drug that blocks the mTOR protein.

While it is too early to determine whether this drug combination helps women live longer, Hortobagyi says it determined that for women taking Afinitor, the cancer stopped growing in a higher proportion of patients and for a longer period of time than in women getting the placebo.

After one year, researchers found women getting Aromasin plus Afinitor had on average 7.4 months of progression-free survival -- more than doubling progression free survival - compared to women in who only took Aromasin and a placebo.

The other trial, known as CLEOPATRA, looked at preventing drug resistance in a type of breast cancer where tumor growth is driven by a protein called Her-2/neu, which is found in about 25% of breast cancers.

A drug called herceptin directly attacks the protein and shuts down cancer growth, which makes pairing it with chemotherapy more effective, doctors said.

But cancer cells can figure out a way around treatments too.

In the CLEOPATRA trial, 808 women were given standard therapy plus placebo or standard therapy plus an experimental drug pertuzumab, which binds to a different part of the Her2 protein.
The median progression-free survival for women getting standard therapy was 12.4 months; in women also taking pertuzumab, the cancer didn't start to grow again until six months later on average.

"This is huge. It is very uncommon to have a clinical trial show this level of improvement in progression-free survival," lead researcher Dr. Jose Baselga said in a news release.

Both studies only measured progression-free survival, but Park cautions the gold standard for determining the benefit of a cancer drug is overall survival.

Is the patient living longer because of the treatment? He says early studies for another Genentech cancer drug called Avastin showed a benefit in progression-free survival and the FDA approved its use for breast cancer patients.

But after more studies didn't show women were living longer after taking Avastin, the FDA withdrew its approval for breast cancer last month (it's still approved for other cancers).

CLEOPATRA results were presented at the conference Wednesday and published in the New England Journal of Medicine. Genentech applied for FDA drug approval and its parent company Roche submitted an application to the Europe's counterpart to the FDA, the European Medicines Agency, according to the company.

Both drugs used in the BOLERO trial are FDA approved, so doctors could prescribe the kidney cancer Afinitor to treat breast cancer, which is called "off-label" use.

But it's unclear whether doctors will be prescribing this right away.

"Oncologists are familiar with this drug and know it's available, said Dr. Vered Stearns, co-director of the breast cancer program at Johns Hopkins University School of Medicine.

Results of the BOLERO trial are promising, Stearns said, adding that she's not sure whether this treatment will be readily available in the near future because "many insurance companies ask for the diagnosis as well." Afinitor is only approved for kidney cancer and kidney transplants, according to Stearns, so the question becomes whether the insurance companies will pay for prescriptions for breast cancer treatment.

"l don't how easy it is to write a prescription and get it paid for," she said.

For more information on catching cancers early while they are more easily treated, or for questions about heart disease, high blood pressure, or general health issues, please contact Dr. Gregory Cohen, Medical Director at Westside Preventive Medicine. 


Dr. Cohen is a board certified Internist and Cardiologist in Los Angeles. 


Our patients come not only from Los Angeles, but frequently from Santa Monica, Malibu, Brentwood, Pacific Palisades, Hollywood, the Valley and even as far as Glendale and Pasadena. They all come for our compassionate, "whole-person" approach to medicine. 


To book an appointment, call us at 310-231-9500, or go online to our website at www.westsidepreventivemedicine.com