African Americans suffer asthma more often and more severely than Caucasian patients. However, clinical trials that have shaped treatment guidelines have included few African Americans. A new report demonstrates a shortcoming of that history. Researchers at National Jewish Health and their colleagues around the nation in the National Heart, Lung & Blood Institute’s AsthmaNet report that African American children respond differently than African American adults and Caucasian adults and children to step-up therapies for inadequately controlled asthma.

Rebecca Patterson was in surgery for 11-and-a-half hours while the operation took place.

A Kentucky teacher went to extreme lengths recently to ensure that one of his students didn’t miss out on a class field trip because of her physical disability.

When Shelly King learned that her daughter Ryan was having a class field trip on Sept. 20 to the Falls of the Ohio State Park near the border of Indiana and Kentucky, she instantly began to think about creating a plan B.

“I was preparing for an ‘alternate field trip day,'” King wrote on the “Team Ryan” Facebook page, created for her 10-year-old daughter, who was diagnosed with Spina bifida as a baby.

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The birth defect, which happens when the spine and spinal cord don’t form properly, has caused Ryan to rely on a wheelchair to get around — so a hiking trip was less than ideal for the Tully Elementary School student.

“Obviously, NOT accessible,” King pointed out.

That is, until, Jim Freeman, a teacher at the school, offered to carry Ryan around on his back all day so she could explore the fossil beds with the rest of her classmates.

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In several sweet photos, Freeman was captured carrying Ryan on his back in a carrier — her holding onto his shoulders — as they explored the river banks, state park, and 390-million-year-old fossil beds beside the other students and teachers.

King said on Facebook that the gesture meant a lot to her and the family, especially because it prevented Ryan from feeling left out and missing the class trip.

The Kentucky mother also explained that she was sharing the photos in a bid to raise awareness about the state’s excellent teachers, who often go out of their way to help children in need and inspire people around their community.

“She is sooooo excited to do this independent from me ️” King wrote in her post. “Omg MELT MY HEART … We are sooooo blessed to have an ENTIRE school that is so compassionate and empathetic and NEVER make her feel left out ️”

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Speaking to USA Today, King called Freeman’s offer to carry the 55-pound fourth-grader “out of the blue,” noting how he wasn’t Ryan’s teacher and that they had rarely ever interacted at school.

“That’s how wonderful this man is,” King told the outlet. “We’ve never really talked. I didn’t know his first name before he offered to do this.”

“It melted my heart,” she shared, adding that she hopes this story will inspire other physically-disabled people that they don’t need to miss out on things because of their wheelchair.

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“To anybody else who is in a wheelchair, nothing should stop you … and you shouldn’t be afraid to ask for help,” King said. “There are good people out there who want to help you.”

As for Freeman, he said the gesture was nothing more than a way to help a student in need but pointed out that it happens often in Kentucky’s Jefferson County Public School District.

“This is just one physical act that you can see, but we do this countless times throughout the school day and throughout the year,” Freeman told WLKY News. “All the teachers here at Tully and JCPS, they work harder than most people realize.”

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The number of confirmed or suspected severe lung illnesses linked to vaping has now climbed to 805 cases across 46 states and the Virgin Islands, US health officials have reported.

There have also been 12 confirmed deaths in 10 states – California (2 cases), Florida, Georgia, Illinois, Indiana, Kansas (2 cases), Minnesota, Missouri, Mississippi and Oregon, officials added. That’s nearly a doubling of fatalities compared to the seven deaths reported a week ago.

Looking for potential clues

Unfortunately, officials still don’t know exactly what is triggering these lung injuries.

“Although the investigation continues, no consistent e-cigarette or vaping product, substance, additive or brand has been identified in all cases, nor has any one product or substance been conclusively linked to lung injury in patients,” Dr Anne Schuchat, principal deputy director of the US Centers for Disease Control and Prevention, said during a media briefing held last week.

The US Food and Drug Administration now has more than 150 vaping product samples tied to these cases, and is analysing them for any potential clues, Mitch Zeller, director of the FDA’s Center for Tobacco Products, said at the same meeting.

“FDA is analysing these samples for the presence of a broad range of chemicals,” Zeller said.

The investigation has been hampered by the fact that there are so many different vaping products on the market being used in many different ways, Schuchat and Zeller explained.

There’s also the possibility that some people have been sickened by exposure to more than one type of product, Schuchat said.

A mix of results

One potential culprit is an oily chemical called vitamin E acetate. Vitamin E acetate is typically available as a dietary supplement and skin treatment, and it continues to be found in some of the samples, Zeller said.

But Zeller added that “our laboratory analysis continues to show a mix of results. There’s no one compound, ingredient, constituent – including vitamin E acetate – that’s showing up in all of the samples tested.”

Nearly three-quarters of the people who’ve developed lung injury from vaping are male, Schuchat said, and more than half the cases are in people younger than 25.

Symptoms include cough, shortness of breath and chest pains. Some patients have had so much trouble breathing that they wind up on oxygen, and in extreme cases placed on a mechanical ventilator.

“Until we know more, if you are concerned about these specific health risks, CDC recommends you not use an e-cigarette or vaping product,” Schuchat said.

The fallout from the ongoing outbreak of illnesses has hit the vaping industry hard.

Eroding public confidence

Vape device maker Juul Labs said it is stopping all print, digital and television advertising, and its CEO, Kevin Burns, is stepping down.

Juul, by far the largest vaping products maker in the United States, also said it will not fight a proposed nationwide ban on flavoured e-cigarettes put forward earlier this month by the Trump administration, the Associated Press reported.

K.C. Crosthwaite, an executive from Altria, will replace Burns. Tobacco giant Altria owns a 35% share of San Francisco-based Juul.

In a statement, Crosthwaite alluded to “unacceptable levels of youth usage and eroding public confidence in our industry”, the AP said.

“We must strive to work with regulators, policymakers and other stakeholders, and earn the trust of the societies in which we operate,” Crosthwaite added. “That includes inviting an open dialogue, listening to others and being responsive to their concerns.”

The news from Juul came a day after testimony on Capitol Hill regarding the expanding number of cases of a sometimes fatal vaping-linked lung illness.

Nicotine patch or gum

In her testimony before a congressional subcommittee, the CDC’s Schuchat told lawmakers that “we are seeing more and more cases each day.”

The situation has also spurred the Trump administration to call for a ban on flavoured e-cigarettes. New York and Michigan have already put restrictions on the sale of vaping products and retail giant Walmart announced last week that it is pulling all e-cigarette products from its shelves.

And Massachusetts stopped the sales of all vaping products for four months. Rhode Island is also planning to ban flavoured e-cigarettes.

Giving the new health risks, Schuchat advised that former smokers who now vape should ask their doctor about using a nicotine patch or gum instead and not contemplate a return to smoking.

Health officials particularly warn against buying any vaping products off the street, especially if they’ve been laced with THC, the compound in marijuana that gets you high, Zeller said.

But again, THC products have not been involved in all the cases, Schuchat said. Some patients have used products containing THC and others containing nicotine, while some have only used nicotine products.

^{Image credit: iStock}

HealthDay

It’s bad enough to have an aching head, but about one in 10 people who suffer from headaches also experience facial pain, researchers have found.

The study included more than 2 900 people with primary headaches. These are ones not caused by another condition and they include migraine and cluster headaches. Participants completed questionnaires about their headaches and any facial pain.

Highest rate of facial pain

People with dental problems that could explain facial pain were not included in the study.

Ten percent of patients reported having facial pain. Those with paroxysmal hemicrania – a type of headache with severe, often short attacks on one side of the head – had the highest rate of facial pain (45%).

Facial pain also affected 21% of patients with hemicrania continua, a headache with continuous pain that varies in severity; 20% of those with short-lasting unilateral neuralgiform, a headache characterised by frequent attacks on one side of the head; 15% of those with cluster headache; and 2% of migraine sufferers, the investigators found.

Among those with migraine who did experience facial pain, 41% experienced pain mostly in the face. And among cluster headache patients who experienced facial pain, 31% felt the pain mostly in their face, according to the study.

Six patients in the study had constant facial pain on one side of the head only, in addition to facial pain attacks lasting 10 to 30 minutes several times a day. This type of pain syndrome has not been described before, and researchers suggested calling it “constant unilateral facial pain with added attacks,” the study authors said in a news release from the American Academy of Neurology.

Proper diagnosis and treatment

“Facial pain has not been well recognised as a symptom of headache, and some people end up waiting a long time for a proper diagnosis and treatment,” study author Dr Arne May said in the news release. “This study shows that facial pain is not uncommon, and for many people their pain occurs mainly in the face, not the head.”

May is a professor of neurology at the University of Hamburg, in Germany.

“For a better understanding of these types of facial pain and ultimately for the development of treatments, it’s crucial that we understand more about facial pain and whether it is the same disease as the headache, but showing up in a different place, or whether they are two different syndromes,” he concluded.

The report was published in the online issue of the journal Neurology.

^{Image credit: iStock}

HealthDay

The current Ebola disease outbreak in the Democratic Republic of the Congo (DRC) is the second largest in history.

It has been raging for over a year with no indication that it is nearing an end. Many of the issues that prevent effective containment of Ebola disease outbreaks have been discussed.

These include porous borders, community mistrust of health workers, and the spread of misinformation.

Read more: Why it’s hard to stop Ebola spreading – between people and across borders

But one area that requires further study is Ebola virus’ persistence in the reproductive systems of otherwise healthy survivors.

Understanding how Ebola disease outbreaks are exacerbated by sexual transmission is important to stop new chains of transmission and to prevent the disease from spreading to new geographic regions.

Multiple reports strongly suggest that re-emergence of Ebola disease is linked to persistent infections and sexual transmission from survivors.

What this means is that people who have survived infection by Ebola virus – and who no longer show any symptoms of the disease – can continue to carry the virus and pass on the infection months after they have recovered.

Our research group recently reviewed the current understanding of rates and mechanisms of Ebola virus persistence in male disease survivors.

We are using this information to fill in gaps about how persistence relates to sexual transmission of the virus.

In addition, we are combining molecular investigations with insights from survivors to better equip future outbreak response efforts.

We also hope the work will help address long-term health issues faced by Ebola disease survivors.

The role of the reproductive system

Nearly everything known about Ebola virus persistence in the reproductive system has resulted from testing semen of West African Ebola disease survivors.

It has been established that the Ebola virus can be detected in semen long after it is cleared from other organs and tissues. For example, a recent study showed that the virus could be detected in 50% of male survivors 115 days after recovery and may linger for up to three years.

The virus has also been detected in semen at concentrations greatly exceeding that found in the blood at peak infection. The data suggests that this occurs in the absence of any symptoms of disease.

In addition, sexual transmission of Ebola virus from male survivors has been reported up to 18 months following their recovery.

These observations are important to public health. Firstly, long-term persistence of Ebola virus could lead to the initiation of new chains of disease transmission long after outbreaks have ended.

Secondly, the presence of high concentrations of virus in the semen in the absence of disease symptoms means that male survivors could carry and transmit the virus without knowing they’re still infected.

But the fact that only semen is being used in these studies presents a problem. This means that the perseverance of the virus is only being traced in males. This means that little is known about persistence of the virus in women.

This urgently needs attention because Ebola virus has been detected in female survivors up to 15 months following recovery, and there are recorded cases of female to male transmission.

Unanswered questions

There is a strong need for greater understanding of Ebola virus infections, including:

• When Ebola virus is transmitted to reproductive tissues during illness.

• How Ebola virus persists over extended periods in reproductive tissues.

• How long persistent virus remains infectious.

• How often sexual transmission occurs.

In a bid to answer some of these questions – particularly the molecular intricacies of Ebola virus persistence within the reproductive system – we used laboratory models of male and female reproductive systems. This allowed us to:

• Study the dynamics of Ebola virus transmission to the reproductive system.

• Identify the particular types of cells that are infected by Ebola virus in the reproductive system.

• Determine how local immune responses in the infected cells help facilitate Ebola virus persistence.

• Characterise damage to the reproductive system, including altered sperm health.

We have also performed Ebola virus infections in mice to better understand how our molecular data reflects the complex pathophysiology of Ebola virus disease and persistence in humans. Mouse models have been used in numerous investigations of Ebola virus infection.

By infecting mice with Ebola virus, we can determine whether the male reproductive system is damaged by persistent infection. We can also determine if there is an effect on fertility, and how often persistent infections result in sexual transmission.

In addition, infections of female mice help us determine the severity of disease caused by sexually transmitted Ebola virus, the effects on female fertility, and consequences for gestational development.

In addition to our laboratory research, we are surveying Ebola disease survivors in Sierra Leone in an effort to identify and understand the long-term health consequences, with a focus on reproductive health.

Our goal is to determine if survivors have encountered post-recovery reproductive complications such as reduced fertility or problems during pregnancy.

We are also investigating whether Ebola disease survivors face greater burdens of subsequent infections by other pathogens.

Future outbreaks

The recent success of vaccination and therapeutic treatments in the current DRC Ebola disease outbreak provides hope. But a great deal about the virus remains unknown.

A greater understanding of the mechanisms of how persistent infections occur will help us guide future outbreak response efforts, with the goal of reducing additional Ebola virus transmission events and providing increased care, support and safety for survivors and their communities.

^{Andrew L. Webb, PhD Candidate, University of Manitoba; Brayden G. Schindell, PhD Candidate, University of Manitoba; Jason Kindrachuk, Assistant Professor/Canada Research Chair in emerging viruses, University of Manitoba, and Jia B. Kangbai, PhD candidate, Ludwig Maximilian University of Munich}

^{This article is republished from The Conversation under a Creative Commons license. Read the original article.}

^{Image credit: iStock}

Andrew L. Webb, Brayden G. Schindell, Jason Kindrachuk, Jia B. Kangbai

A quasi-particle that travels along the interface of a metal and dielectric material may be the solution to problems caused by shrinking electronic components, according to an international team of engineers.

Transport routes, support for care homes and medicine stockpiles are raised as concerns in a new report.