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Clinical trial for people who can't sleep with CPAP in progress


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Clinical trial for people who can't sleep with CPAP in progress

Photo: Quin Stevenson/Unsplash
BPT - If you are one of the more than 35 million Americans who are estimated to have obstructive sleep apnea (OSA), you already know how disruptive it can be to your life. While OSA is one of the most common and serious sleep disorders, the condition is widely under-diagnosed, so the number of affected Americans may be far greater.

What is obstructive sleep apnea?

OSA occurs when the muscles in the throat relax during sleep, blocking normal breathing. This can lead to low levels of oxygen in your blood while you sleep and result in poor sleep, fatigue and sleepiness that can negatively impact quality of life for many. In the long term, OSA has also been shown to contribute to high blood pressure, diabetes, cardiovascular disease and stroke.

Most people diagnosed with OSA are prescribed positive air pressure therapy devices such as continuous positive airway pressure, or CPAP, which can work very well in helping people receive the oxygen they need while they are sleeping. However, because many have difficulty using or tolerating these devices, a significant percentage of the population with OSA remains untreated, undertreated and at risk.

A new option for treating obstructive sleep apnea

Apnimed is a pharmaceutical company working to change the way OSA is treated. The company recently completed a large Phase 2b clinical trial, called MARIPOSA, to study AD109 (an investigational medication which is a single pill taken at bedtime) as a possible treatment for obstructive sleep apnea.

AD109 has the potential to be the first oral medication that treats both the underlying cause of OSA - airway obstruction at night - and improve the daytime symptoms of OSA, such as fatigue. It is designed to treat people with OSA from mild to severe.

Many patients with OSA are unable to adequately treat their condition with existing options, and the team at Apnimed is driven to find new solutions for patients and their doctors to overcome these barriers to treatment. The success of this effort is largely dependent on the dedicated work done by patients and doctors in the community who take part in clinical research.

"MARIPOSA results showed that AD109 improved daytime fatigue, which is an often debilitating effect of poor sleep due to OSA," said Paula Schweitzer, Ph.D., an investigator in the MARIPOSA trial and director of research at St. Luke's Sleep Medicine and Research Center, Chesterfield, Missouri. "For those who cannot tolerate current treatments, AD109 has the potential to be a convenient oral pill that could improve people's quality of life at night and during the daytime as well."

Learn about enrolling in the clinical trial

With the promising results from the MARIPOSA study, a new study is now available for people with OSA.

If you or a loved one has obstructive sleep apnea and you are unable to successfully use or tolerate treatment with a CPAP machine, you could be eligible to enroll in a six-month clinical trial called SynAIRgy.

To learn more about the clinical trial and to enroll, visit: www.SynAIRgyStudy.com.

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Have you been boosted? Here's why the CDC recommends it

by Arthur Allen
Kaiser Health News
The virus sometimes causes severe illness even in those without underlying conditions, causing more deaths in children than other vaccine-preventable diseases...

Everyone over the age of 6 months should get the latest covid-19 booster, a federal expert panel recommended Tuesday after hearing an estimate that universal vaccination could prevent 100,000 more hospitalizations each year than if only the elderly were vaccinated.

The Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices voted 13-1 for the motion after months of debate about whether to limit its recommendation to high-risk groups. A day earlier, the FDA approved the new booster, stating it was safe and effective at protecting against the covid variants currently circulating in the U.S.

After the last booster was released, in 2022, only 17% of the U.S. population got it — compared with the roughly half of the nation who got the first booster after it became available in fall 2021. Broader uptake was hurt by pandemic weariness and evidence the shots don’t always prevent covid infections. But those who did get the shot were far less likely to get very sick or die, according to data presented at Tuesday’s meeting.

The virus sometimes causes severe illness even in those without underlying conditions, causing more deaths in children than other vaccine-preventable diseases, as chickenpox did before vaccines against those pathogens were universally recommended.

The number of hospitalized patients with covid has ticked up modestly in recent weeks, CDC data shows, and infectious disease experts anticipate a surge in the late fall and winter.

The shots are made by Moderna and by Pfizer and its German partner, BioNTech, which have decided to charge up to $130 a shot. They have launched national marketing campaigns to encourage vaccination. The advisory committee deferred a decision on a third booster, produced by Novavax, because the FDA hasn’t yet approved it. Here’s what to know:

Who should get the covid booster?

The CDC advises that everyone over 6 months old should, for the broader benefit of all. Those at highest risk of serious disease include babies and toddlers, the elderly, pregnant women, and people with chronic health conditions including obesity. The risks are lower — though not zero — for everyone else. The vaccines, we’ve learned, tend to prevent infection in most people for only a few months. But they do a good job of preventing hospitalization and death, and by at least diminishing infections they may slow spread of the disease to the vulnerable, whose immune systems may be too weak to generate a good response to the vaccine.

Pablo Sánchez, a pediatrics professor at The Ohio State University who was the lone dissenter on the CDC panel, said he was worried the boosters hadn’t been tested enough, especially in kids. The vaccine strain in the new boosters was approved only in June, so nearly all the tests were done in mice or monkeys. However, nearly identical vaccines have been given safely to billions of people worldwide.

When should you get it?

The vaccine makers say they’ll begin rolling out the vaccine this week. If you’re in a high-risk group and haven’t been vaccinated or been sick with covid in the past two months, you could get it right away, says John Moore, an immunology expert at Weill Cornell Medical College. If you plan to travel this holiday season, as he does, Moore said, it would make sense to push your shot to late October or early November, to maximize the period in which protection induced by the vaccine is still high.

Who will pay for it?

When the ACIP recommends a vaccine for children, the government is legally obligated to guarantee kids free coverage, and the same holds for commercial insurance coverage of adult vaccines. For the 25 to 30 million uninsured adults, the federal government created the Bridge Access Program. It will pay for rural and community health centers, as well as Walgreens, CVS, and some independent pharmacies, to provide covid shots for free. Manufacturers have agreed to donate some of the doses, CDC officials said.

Will this new booster work against the current variants of covid?

It should. More than 90% of currently circulating strains are closely related to the variant selected for the booster earlier this year, and studies showed the vaccines produced ample antibodies against most of them. The shots also appeared to produce a good immune response against a divergent strain that initially worried people, called BA.2.86. That strain represents fewer than 1% of cases currently. Moore calls it a “nothingburger.”

Why are some doctors not gung-ho about the booster?

Experience with the covid vaccines has shown that their protection against hospitalization and death lasts longer than their protection against illness, which wanes relatively quickly, and this has created widespread skepticism. Most people in the U.S. have been ill with covid and most have been vaccinated at least once, which together are generally enough to prevent grave illness, if not infection — in most people. Many doctors think the focus should be on vaccinating those truly at risk.

With new covid boosters, plus flu and RSV vaccines, how many shots should I expect to get this fall?

People tend to get sick in the late fall because they’re inside more and may be traveling and gathering in large family groups. This fall, for the first time, there’s a vaccine — for older adults — against respiratory syncytial virus. Kathryn Edwards, a 75-year-old Vanderbilt University pediatrician, plans to get all three shots but “probably won’t get them all together,” she said. Covid “can have a punch” and some of the RSV vaccines and the flu shot that’s recommended for people 65 and older also can cause sore arms and, sometimes, fever or other symptoms. A hint emerged from data earlier this year that people who got flu and covid shots together might be at slightly higher risk of stroke. That linkage seems to have faded after further study, but it still might be safer not to get them together.

Pfizer and Moderna are both testing combination vaccines, with the first flu-covid shot to be available as early as next year.

Has this booster version been used elsewhere in the world?

Nope, although Pfizer’s shot has been approved in the European Union, Japan, and South Korea, and Moderna has won approval in Japan and Canada. Rollouts will start in the U.S. and other countries this week.

Unlike in earlier periods of the pandemic, mandates for the booster are unlikely. But “it’s important for people to have access to the vaccine if they want it,” said panel member Beth Bell, a professor of public health at the University of Washington.

“Having said that, it’s clear the risk is not equal, and the messaging needs to clarify that a lot of older people and people with underlying conditions are dying, and they really need to get a booster,” she said.

ACIP member Sarah Long, a pediatrician at Children’s Hospital of Philadelphia, voted for a universal recommendation but said she worried it was not enough. “I think we’ll recommend it and nobody will get it,” she said. “The people who need it most won’t get it.”

KFF Health News is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF—an independent source of health policy research, polling, and journalism.
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Infective endocarditis death rates declined overall in the U.S. over past 21 years.

Our study findings raise a public health concern, especially since the deaths in younger age groups are on the rise ...

by American Heart Association

DALLAS - Death rates related to infective endocarditis declined in most adults across the U.S. within the last two decades, yet accelerated among young adults ages 25 to 44 years old, according to new research published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association.

Infective endocarditis, also called bacterial endocarditis, is an infection caused by bacteria that enter the bloodstream and settle in the heart lining, a heart valve or a blood vessel. The disease is rare, however, people with previous valve surgeries, heart valve abnormalities, artificial valves, congenital heart defects or previous infective endocarditis have a greater risk of developing it. It can also be a complication of injecting illicit drugs.

“Our study findings raise a public health concern, especially since the deaths in younger age groups are on the rise,” said study lead author Sudarshan Balla, M.D., an associate professor of medicine at the West Virginia University Heart and Vascular Institute at J.W. Ruby Memorial Hospital in Morgantown, West Virginia. “We speculate that this acceleration was likely, in the most part, due to the opioid crisis that has engulfed several states and involved principally younger adults.”

Researchers examined death certificate data from the Centers for Disease Control and Prevention’s (CDC) Multiple Cause of Death dataset, which contains death rates and population counts for all U.S. counties. They looked for national trends in deaths caused by infective endocarditis, plus differences in deaths related to age, sex, race and geography among states from 1999-2020. Researchers also analyzed the association with substance use disorder, considering the emergence of the opioid epidemic during the study’s time frame.

The analysis found:

  • In the 21-year period analyzed, infective endocarditis death rates declined overall in the U.S.
  • Death rates increased significantly for young adults, at an average annual change of more than 5% for the 25-34 age group and more than 2% for the 35-44 age group.
  • In the 45-54 age category, death rates remained stagnant at 0.5%, and there was a significant decline among those aged 55 and older.
  • Substance use disorder associated with multiple causes of death increased drastically – between 2-fold and 7-fold among the 25-44 age group.
  • Kentucky, Tennessee and West Virginia showed an acceleration in deaths caused by infective endocarditis in contrast to other states with either a predominant decline or no change.

“We found that substance use was listed as a contributing cause that could explain the higher death rates in the younger age groups and also in the states in those who died due to endocarditis,” Balla said.

The study researchers call the rise of infective endocarditis as the underlying cause of death in adults 25-44 years old “alarming” and recommend more investigation to identify the reasons for these trends among young adults and in the three states noted. Researchers speculate the increase is connected to the opioid crisis that has engulfed several states and involves primarily younger adults.

“Comprehensive care plans for those treated for infective endocarditis should also include screening and treatment for substance use disorder,” Balla said.

To address intravenous drug use, some states have started harm reduction programs, which are public health efforts to reduce the harm from substance use and drug abuse, such as increased risk of infectious diseases like HIV, viral hepatitis, and bacterial and fungal infections. “Whether these programs make an impact is yet to be determined,” Balla said.

Researchers were limited in the medical details they could collect because of the use of death certificate data, which may contain inaccuracies, such as errors in diagnosis, data entry and cause of death. For similar reasons, researchers could not determine a direct cause-and-effect relationship between the rise in deaths caused by infective endocarditis in younger adults and substance use disorder.   

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Innovation is the key to improving health in rural areas

by The American Heart Association

Dallas, TX - Cardiovascular mortality is on the rise in rural areas of the United States, where more than 60 million Americans live, according to an American Heart Association presidential advisory. Understanding and addressing the unique health needs of people in rural America is critical to the Association’s pursuit of a world of longer, healthier lives.

Today — on National Rural Health Day — the Association, the world’s leading nonprofit organization focused on heart and brain health for all, announces two new collaborative efforts to help close the gap between rural and urban hospital care and bring equitable care to all, regardless of where you live.

“Addressing the unique health needs of people in rural America is critical to achieving the American Heart Association’s 2024 impact goal for equitably increasing healthy life expectancy nationwide,” said Karen Joynt-Maddox, M.D., MPH, American Heart Association volunteer, associate professor at the Washington University School of Medicine and co-director of the Washington University in St. Louis Center for

Advancing Health Services, Policy & Economics Research. “Innovative collaborations like these are key to improving rural health across the nation.”

Sharing clinical educational resources

The American Heart Association is collaborating with the National Rural Health Association (NRHA) to highlight and share cardiovascular and stroke clinical educational resources such as model practices, collaborative learnings and rural quality research findings with NRHA membership.

Through this collaboration, the American Heart Association will submit content for NRHA’s magazine Rural Horizons, weekly e-newsletter NRHA Today and Journal of Rural Health, as well as participate in NRHA’s 2024 Annual Rural Health Conference and 2024 Rural Health Clinic and Critical Access Hospital Conference.

“NRHA is excited to partner with the American Heart Association to share resources and education to help reduce rural cardiovascular health disparities,” said NRHA CEO Alan Morgan.

Harmonizing quality data for analysis and validation

The American Heart Association and the American College of Emergency Physicians (ACEP) are collaborating on efforts to resolve outcomes gaps and identify model practices for hospitals and health systems in the rural setting. This effort will identify sites participating in both organizations’ respective quality programs and cross-promote their data registries, as well as explore data harmonization and opportunities for shared data analysis and validation.

The Association and ACEP share common priorities in addressing outcomes gaps in rural areas and building the knowledge base needed for evidence-based clinical practice. Reaching clinicians and providers and other key constituents with important messages is foundational to these efforts.

ACEP’s E-QUAL stroke initiative strives to make stroke quality improvement strategies accessible for emergency departments of all shapes and sizes. The E-QUAL data submission activities have been designed to allow hospitals who are already participating in the American Heart Association’s Get With The Guidelines® programs to seamlessly meet all E-QUAL reporting requirements.

“Through ACEP’s E-QUAL stroke initiative, we strive to make stroke quality improvement strategies accessible for emergency departments of all shapes and sizes,” said Kori Zachrison, M.D., MSc, E-QUAL Stroke Initiative co-lead. “While many rural EDs may be working with fewer resources at their disposal, they remain the anchor of the community’s stroke chain of survival. We’re thrilled to work side-by-side with the AHA in investing in these communities.”

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Diabetes is a silent killer because people tend to ignore symptoms

Diabetes Test Kit
Photo: Sweet Life/Unsplash
by Shelli Dankoff
OSF Healthcare
Evergreen Park - During the winter months there is typically a spike in seasonal illnesses such as common colds, flu, and pneumonia. While there are tips and tricks forkeeping seasonal illnesses at bay, they are sometimes unavoidable. And for those with other health conditions a simple cold can be so much more than that.

According to the American Diabetes Association (ADA), when someone who has diabetes gets sick with things like colds or the flu, the illness and stress cause their body to release hormones that raise blood sugar (blood glucose) levels, making it harder to keep their blood sugar in their target range. The ADA adds that while having diabetes in and of itself does not necessarily make someone more likely to get a cold or the flu, it does raise the chances of getting seriously sick. Some people may not even know they have diabetes until a severe illness occurs.

“If you have poorly controlled or undiagnosed diabetes and develop symptoms of something like the flu, you will have increased risk factors of severe illness. I would encourage those people to get quickly examined at an urgent care or their primary physician,” says Mohammed Khan, M.D., an OSF HealthCare family medicine physician.

The National Institutes of Health (NIH) says that nearly a third of people with diabetes do not know they have it, and someone can go years before getting a diagnosis. The reason diabetes can fly under the radar is because the symptoms can be minor, especially early on.

“When patients have certain symptoms like more frequent urine and going to the restroom more often, losing weight, having lack of energy, having dry mouth, feeling thirsty and drinking more often, having recurrent infections like skin and urine infections – those are the things that indicate a screening for diabetes,” explains Dr. Khan.

He adds, “People who have diabetes sometimes ignore the symptoms and think they are not affected which is why it is a silent killer. The body is getting destroyed from the inside and many do not notice it unless you go to regular health exams or are screened for it. Diabetes is also one of the most common causes for chronic kidney disease. For a lot of people who develop problems like kidney failure or needing dialysis, the root cause for that most of the time is diabetes.”

Dr. Khan advises people who do have diabetes to keep it under control as best as possible, as well-controlled diabetes helps manage seasonal illnesses when they do occur. However, serious illness can still occur.

“With diabetes, your immune system goes down which is a risk factor. If you have diabetes, you want to make sure you are fully vaccinated and get the flu shot and are up to date on COVID vaccinations. If they are at a higher risk factor due to age and are in the age group to receive the pneumonia vaccination, we encourage get that as well, Dr. Khan advises.

The Centers for Disease Control and Prevention (CDC) recommends a pneumonia shot for anyone age two or older who, because of chronic health problems (such as diabetes) or age, has a greater chance of getting pneumonia, and urges all eligible individuals who are six months and older to get their annual flu shot.

If you have diabetes, have a kit on hand with the following items in it: A glucose meter, extra batteries, supplies for your insulin pump or continuous glucose monitor, ketone test strips, a week’s worth of glucose-lowering medication (but don’t store these longer than 30 days before use), glucose tabs or gels, and flu or cold medications that won’t disrupt your diabetes management.

If you do end up with a seasonal illness, keep track of your symptoms and let your primary doctor know if they get worse. If your symptoms become severe or unmanageable, go to the nearest urgent care or emergency department.

If you have not been diagnosed with diabetes but are exhibiting any possible signs and symptoms, make an appointment with your doctor.

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With heart attacks, timing is everything and it can save your life

To say time was of the essence for Tammi Fanson on July 18, 2022, would be an understatement.

The Gibson City, Illinois, woman had been dealing with high blood ...

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SAD: Do you get the seasonal blues, here's a tip on what might help

Woman lying on a bed
Shorter days throughout them are thought to be linked to a chemical change in the brain and may be part of the cause of seasonal affective disorder or more commonly known as SAD. Exposure to artificial UV light have shown effectiveness in limiting the changes brought less sunlight.
Photo: Yuris Alhumaydy/Unsplash
by Shelli Dankoff
OSF Healthcare
BLOOMINGTON - Now that Labor Day has come and gone, so have the days of summer sun into the evening hours. While this is a typical sign of changing seasons, it can also come with a change in mood for those who suffer from seasonal affective disorder, or SAD.

It’s estimated that SAD affects 5-million to 8-million people a year in the United States, particularly in late fall and colder, winter months when days are shorter and nights are longer.

It is thought to be related to the lack of available sunlight, leading to a deficiency of Vitamin D. This can disrupt a person’s natural sleep cycle, and the effect on the brain can cause a person to function differently.

“People in the winter time, particularly in northern, far northern latitudes or far southern latitudes, farther away from the equator will tend to get kind of sluggish and maybe depressed, they start to have carbohydrate cravings, and it may be enough that it’s really a significant problem for them,” explains Dr. Scott Hamilton, a psychiatrist with OSF HealthCare Behavioral Health in Bloomington.

As a behavioral health psychiatrist, Dr. Hamilton works with people suffering from Seasonal Affective Disorder. He says there’s a difference between SAD and a case of the occasional winter blahs. If you find your mind and mood are impacting your relationships, ability to work, or social activities, it’s something that needs to be addressed.

There are a number of treatment opportunities for Seasonal Affective Disorder. Dr. Hamilton says one of the most effective is bright light therapy.

“These have a UV shield, full spectrum light, 30 minutes in the morning is how most studies were done with pretty good results. Pretty uniformly positive results in people that have wintertime depression, and people that don’t have winter depression, they do sometimes still help, but they’re not as likely to be helpful.”

Dr. Hamilton says these light boxes are available online, often for less than $50. He also says that simple behavior modification can help with SAD symptoms. He says eating well and exercise can have a tremendous effect on depression symptoms, but if a person is having a tough time functioning on a day-to-day basis, he or she might want to see a therapist for professional help.

“I think trying that and getting more exercise and doing some healthy things first does make sense,” said Dr. Hamilton. “If they get to the point where they can’t function or they get suicidal thoughts, things like that, then they ought to talk to somebody. Those would be the real red flags.”

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Staying sun-smart: Remembering Jimmy Buffett

When enjoying the warm rays of the sun, use sun block. It is recommended you read the instructions for how often to apply it because it does wear off exposing your skin to harmful rays from the sun.
Photo: Igor Shalyminov/Unsplash

Matt Sheehan
OSF Healthcare

Evergreen Park - The month of September started on a somber note when country music superstar Jimmy Buffett passed away. The Margaritaville creator died from an aggressive form of skin cancer called Merkel cell carcinoma (MCC), a disease he battled the past four years.

MCC is a much rarer form of skin cancer, the Skin Cancer Foundation says, with one case per 130,000 people in the United States. Roughly 3,000 new cases are diagnosed a year, and the foundation says this is expected to increase to 3,250 cases a year by 2025.

OSF HealthCare advanced practice registered nurse Banesa Chavez warns people not to underestimate the signs of skin cancer.

“People think ‘oh this lesion is nothing,’ but you don’t know what’s underneath that lesion you see,” Chavez says. “You can have it there for years and it could have already spread elsewhere.”

If you notice any changes to your skin -- a lesion that’s growing, or something that’s new -- make sure you address it.

Chavez says the aggressiveness of Buffett’s MCC should be cause for concern for people, and a reminder to take good care of your skin.

“They found it (the cancer) in the last couple of years, so it progressed quickly. Or it was already metastasized by the time they found it.”

Chavez says skin cancer doesn’t discriminate based off age or overall health. But she notes it is harder to battle skin cancer at an older age.

“You’re healthier when you’re younger. When you’re older, your organs aren’t functioning as they would for a 20 or 30-year-old person,” Chavez says. “So your treatment options may vary based on your health.”

Tips to protect skin:

“If you notice any changes to your skin -- a lesion that’s growing, or something that’s new -- make sure you address it. Don’t ignore it. Also, apply sun block. When you apply sun block, look at the recommendations for how often you’re supposed to apply it. Because it does wear off.”

Chavez adds to wear a hat when you’re outside to avoid sun damage as well. She says if you do notice any changes in your skin, see your doctor as soon as possible so they can refer you to a dermatologist.

Skin cancer is by far the most common cancer. About one in five Americans will be diagnosed with skin cancer in their lifetime. When diagnosed early, the five-year survival rate for people with skin cancer is 99%.

To check on your skin’s health, you can get a baseline exam with a dermatologist. You can visit the OSF HealthCare website here to find a location near you to get seen.


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More men than women die from melanoma; tips for men to stay alive longer


by Paul Arco
OSF Healthcare

Let’s face it, fellas. We’re not always the best when it comes to taking care of ourselves.

That includes protecting one of our most vital and largest organs – our skin.

It’s that time of the year when people are outdoors for several reasons – sporting activities, vacations, and working outside jobs.

But under the brilliant sun rays lurks a potential danger especially to men – skin cancer, more specifically melanoma.

According to the American Cancer Society, more than 97,000 new melanomas will be diagnosed this year (58,120 in men and 39,490 in women). Nearly 8,000 people will die from melanoma, the majority – nearly 5,500 of them – will be men.

“Men are more likely to develop skin cancer, in fact twice as likely, to develop melanoma over time because of several different reasons, whether that's related to the type of job that they do because men tend to work outdoors more often," says Ben Guth, a nurse practitioner for OSF HealthCare. "It can be education related where they aren't taught what to look for when it comes to signs and symptoms of skin cancer. And finally, they just don't use sunscreen when they go outside, which is very protective when it comes to sunburns and developing skin cancer in the future.”

There are other factors. Some research suggests that women’s sun-damaged skin seems to heal better than men. And men tend to have thicker skin, which makes it more susceptible to UV damage which can lead to melanoma.

The good news is that if caught early, melanoma and most skin cancers are highly curable. The problem, however, is most skin cancers don’t have symptoms until it reaches the later stages. So that makes it even more important to take care of our skin and know what to look for.

It starts with education.

“I think you need to have a well-rounded approach when it comes to protecting yourself from the sun and that education comes, one, from primary care providers and dermatologists," says Guth. "We educate on the importance of sunscreen, applying it every two hours, especially when outside. The American Academy of Dermatologists recommend using at least an SPF of 30 and that being a broad spectrum and even water-resistant, depending on the type of work or activity you’re doing outside.”

When applying sunscreen, don’t forget to lotion up around the ears, behind the neck and on top of the scalp, especially men who are balding. Ask your partner for a hand to get to those hard-to-reach spots.

While not everyone is a fan of using sunscreen lotion, don’t despair. There are other ways to help keep your skin protected this summer.

“There several other options if you don't like sunscreen or the greasy feel on your skin – wearing long sleeve shirts and pants, especially those that block sun, wearing a big hat, whether that's a baseball cap or a wide-brimmed hat with sunglasses," says Guth. "And you can also find areas of shade or protection from the sun especially during those high times where the sun is most strong, especially between 10 a.m. and 2 p.m.”

Guth strongly recommends men make a standing appointment for a skin checkup.

“If you have a dermatologist, it's good to have annual skin checks especially if you've had lesions in the past or had skin cancer in the past and had them removed," says Guth. "Outside of that men should just be talking with their provider about their concerns.”

Guth adds that if something doesn’t look or feel right, talk to your primary care provider or dermatologist. Don’t wait. And remember to always pack your sunscreen, even on those cloudy days.

Like smoking, it’s never too late to stop ignoring the dangers to our skin.

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Fatal heart attack risks may be higher during days with extreme heat & air pollution

The combination of soaring heat and smothering fine particulate pollution may double the risk of heart attack death, according to a new study of more than 202,000 heart attack deaths in China. The study published today ...
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Fatal heart attack risks may be higher during days with extreme heat & air pollution

by The American Heart Association

Our findings provide evidence that reducing exposure to both extreme temperatures and fine particulate pollution may be useful to prevent premature deaths from heart attack, especially for women and older adults
DALLAS — The combination of soaring heat and smothering fine particulate pollution may double the risk of heart attack death, according to a new study of more than 202,000 heart attack deaths in China. The study published today in the American Heart Association’s flagship journal Circulation.

"Extreme temperature events are becoming more frequent, longer and more intense, and their adverse health effects have drawn growing concern. Another environmental issue worldwide is the presence of fine particulate matter in the air, which may interact synergistically with extreme temperatures to adversely affect cardiovascular health," said senior author Yuewei Liu, M.D., Ph.D., an associate professor of epidemiology in the School of Public Health at Sun Yat-sen University in Guangzhou, China. "However, it remains unknown if and how co-exposure to extreme temperatures and fine particulate pollution might interact to trigger a greater risk of death from heart attack, which is an acute response potentially brought on by an acute scenario and a great public health challenge due to its substantial disease burden worldwide."

AHA Logo To examine the impact of extreme temperatures with and without high levels of fine particulate pollution, the researchers analyzed 202,678 heart attack deaths between 2015-2020 that occurred in Jiangsu province, a region with four distinct seasons and a wide range of temperatures and fine particulate pollution levels. The deaths were among older adults with an average age of 77.6 years; 52% were older than age 80; and 52% were male. Particulate exposure on the day of each death and one day before death were included in the analysis.

Extreme temperatures were gauged according to the daily heat index (also referred to as apparent temperature) for an area, which captures the combined effect of both heat and humidity. Both the length and extremeness of heat waves and cold snaps were evaluated. Heart attack deaths, or case days, during these periods were compared with control days on the same day of the week in the same month — meaning that if a death occurred on a Wednesday, all other Wednesdays in the same month would be considered control days. Particulate levels were considered high on any day with an average level of fine particulate matter above 37.5 micrograms per cubic meter.

"Our findings provide evidence that reducing exposure to both extreme temperatures and fine particulate pollution may be useful to prevent premature deaths from heart attack, especially for women and older adults," Liu said.

Compared with control days, the risk of a fatal heart attack was observed at the following levels:

  • 18% higher during 2-day heat waves with heat indexes at or above the 90th percentile (ranging from 82.6 to 97.9 degrees Fahrenheit), increasing with temperature and duration, and was 74% higher during 4-day heat waves with heat indexes at or above the 97.5th percentile (ranging from 94.8 to 109.4 degrees Fahrenheit). For context, 6,417 (3.2%) of the 202,678 observed deaths from heart attack happened during heat waves with heat indexes at or above the 95th percentile (ranging from 91.2 to 104.7 degrees Fahrenheit) for three or more days.
  • 4% higher during 2-day cold snaps with temperatures at or below the 10th percentile (ranging from 33.3 to 40.5 degrees Fahrenheit), increasing with lower temperatures and duration, and was 12% higher during 3-day cold snaps with temperatures at or below the 2.5th percentile (ranging from 27.0 to 37.2 degrees Fahrenheit). For context, 6,331 (3.1%) of the 202,678 observed deaths from heart attack happened during cold spells with temperatures at or below the 5th percentile (ranging from 30.0 to 38.5 degrees Fahrenheit) for 3 or more days.
  • Twice as high during 4-day heat waves that had fine particulate pollution above 37.5 micrograms per cubic meter. Days with high levels of fine particulate pollution during cold snaps did not have an equivalent increase in the risk of heart attack death.
  • Generally higher among women than men during heat waves.
  • Higher among people ages 80 and older than in younger adults during heat waves, cold snaps or days with high levels of fine particulate pollution.
  • The mean age of all individuals who died from a heart attack in Jiangsu from 2015-2020, including during non-extreme temperature events, was 77.6 years old; 52.1% of these individuals were over 80 years old.

    The researchers estimated that up to 2.8% of heart attack deaths may be attributed to the combination of extreme temperatures and high levels of fine particulate pollution (> 37.5 micrograms per cubic meter), according to WHO targets.

    Reducing exposure to air pollution and reversing the negative impact of poor air quality on cardiovascular health, including heart disease and stroke, is essential to reducing health inequities in Black and Hispanic communities.

    "Strategies for individuals to avoid negative health effects from extreme temperatures include following weather forecasts, staying inside when temperatures are extreme, using fans and air conditioners during hot weather, dressing appropriately for the weather, proper hydration and installing window blinds to reduce indoor temperatures," said Liu. "Using an air purifier in the house, wearing a mask outdoors, staying clear of busy highways when walking and choosing less-strenuous outdoor activities may also help to reduce exposure to air pollution on days with high levels of fine particulate pollution. To improve public health, it is important to take fine particulate pollution into consideration when providing extreme temperature warnings to the public."

    In a 2020 scientific statement and a 2020 policy statement, the American Heart Association details the latest science about air pollution exposure and the individual, industrial and policy measures to reduce the negative impact of poor air quality on cardiovascular health. Reducing exposure to air pollution and reversing the negative impact of poor air quality on cardiovascular health, including heart disease and stroke, is essential to reducing health inequities in Black and Hispanic communities, those that have been historically marginalized and under-resourced, and communities that have the highest levels of exposure to air pollution.

    The investigators recommended additional research about the possible interactive effects of extreme weather events and fine particulate pollution on heart attack deaths in areas with different temperature and pollution ranges to confirm their findings. The study did not include adjustments for any adaptive behaviors taken by individuals, such as using air conditioning and staying indoors, when temperatures are extreme or pollution levels are high, which could cause misclassification of individuals’ exposure to weather and alter their risk patterns. These results also may not be generalizable to other regions in China or other countries due to potential variations of adaption capacity and temperature distribution.


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    Illinois adults aren't getting enough sleep

    During the pandemic sleep quality decreased and bedtime routines became less structured.
    by Mark Richardson
    Illinois News Connection
    Illinois - More than three in 10 Illinois adults reported getting too few hours of sleep a night, which can contribute to poor job performance and health problems, according to America's Health Rankings.

    Sleep experts say people ages 18 to 60 need between seven and nine hours of sleep per night to be healthy. Losing sleep has been linked to increasing rates of Type 2 diabetes, high blood pressure and obesity.

    Dr. Ravi Johar, chief medical officer for United Healthcare, explained developing a consistent bedtime routine is critical for a good night's rest.

    "That's something that's really important, just having a routine," Johar outlined. "Whether it's brushing your teeth, changing into pajamas. Doing some kind of activity before you go to sleep; yoga, listening to music, reading. Setting your alarm for the same time every day."

    Statistics show 31% of Illinois adults get less than seven hours of sleep a night, just under the national average of 32%. There are also differences in race and gender. Among Black Illinois residents, 47% get too little sleep, compared to about 27% of white and Hispanic residents. Women get about 5% more sleep than men.

    Johar emphasized it is also important to turn off laptops and phones a few hours before bed, because the blue light from screens suppresses the release of melatonin, which induces restful sleep. He also pointed out eating right before bed can trigger a cascade of events to throw off circadian rhythm and metabolism.

    "Avoid eating large meals before bedtime," Johar advised. "Those can cause a lot of restless sleep and problems."

    Johar added people experiencing prolonged issues with sleep need to see their doctor.

    "Sometimes, there may be underlying medical problems that are making it difficult for you to sleep," Johar noted. "And the other thing that's really important that people don't realize is how much stress and behavioral health issues can factor into their sleep."

    During the pandemic, while more people reported sleeping longer, sleep quality decreased and bedtime routines became less structured.

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