One sip of a vodka tonic

he woman had a rare condition called “quinine-induced thrombotic microangiopathy,” which caused a body-wide reaction to quinine, a chemical found in tonic water, the doctors who treated her wrote in the case report, published today (Jan. 4) in The New England Journal of Medicine.

The illness “hit like lightning,” said Dr. James George, a hematologist at the University of Oklahoma and the lead author of the report.

At the time of the incident in 2009, the woman told doctors that she had suddenly become ill when driving home from an office party. She developed chills, muscle aches, nausea and abdominal cramps, the doctors wrote.

That night, she ran a fever of 102 degrees Fahrenheit (38.9 degrees Celcius), and her stomach problems persisted. But by the time she went to the emergency room the next morning, her symptoms had improved. At the time, the ER doctors suspected that the woman had viral gastroenteritis — the stomach flu.

But the woman returned to the ER two days later; she still had back pain and had not urinated since she got sick, according to the case report. This time, she was admitted to the hospital, where tests showed that she had experienced kidney damage, according to the report.

The doctors suspected that the woman had thrombotic microangiopathy (TMA), which occurs when blood clots form in the tiny vessels in the body and can be caused by a range of factors, George said.

In her case, however, the cause of TMA wasn’t one that doctors often see, such as problems with blood-clotting mechanisms or a particular type of E. coli infection, George said.

Quinine, the chemical found in tonic water, can also cause TMA, but George said the woman told him that she didn’t take quinine pills or drink gin and tonics. (The Food and Drug Administration banned quinine pills in 2007 because of severe reactions linked to them.)

It was only then that the woman recalled having a sip of a vodka tonic at her office holiday party the night she got sick, George said.

In addition, she also realized that she had a similar reaction 16 months earlier, when she drank a vodka tonic at a wedding and also had to go to the hospital, according to the report. That time, however, her major symptom was a severe headache, the doctors wrote.

 

“Like a tornado”

When a person has quinine-induced TMA, he or she has a particular type of “auto-antibody” in the blood, George told Live Science. Auto-antibodies, which are found in people with autoimmune disease, attack the body as if it were a “foreign” invader.

Normally, these particular auto-antibodies are not very active in the body, George said.

Cencer Treatment Advance

Deaths from cancer in the United States have dropped 25 percent since hitting a peak in 1991, a new report finds.

The drop means that 2.1 million fewer people died from cancer between 1991 and 2014 than would have died if cancer death rates had remained at their 1991 level, the researchers said.

In the report, the researchers attributed the drop in death rates to reductions in smoking and advances in early detection and treatment. The report was published today (Jan. 5) by the American Cancer Society.

“The continuing drops in the cancer death rate are a powerful sign of the potential we have to reduce cancer’s deadly toll,” Dr. Otis Brawley, the chief medical officer of the American Cancer Society, said in a statement. “Continuing that success will require more clinical and basic research to improve early detection and treatment, as well as strategies to increase healthy behaviors nationwide.” [The 10 Deadliest Cancers and Why There’s No Cure]

The decline in cancer death rates was fairly steady for more than two decades, decreasing by about 1.5 percent each year during the study period, according to the report, which was published in the journal CA: A Cancer Journal for Clinicians.

The cancer death rate declined from 215 deaths per 100,000 people in 1991 to 161 deaths per 100,000 people in 2014, according to the report.

A reduction in deaths from four types of cancer — lung, breast, prostate and colorectal — played a key part in the overall decline, the researchers said. For example, lung cancer deaths in men decreased by 43 percent between 1990 and 2014, and in women by 17 percent between 2002 and 2014. The rates of death from colorectal cancer decreased by 51 percent between 1976 and 2014.

Looking ahead to 2017, the researchers estimated that there will be more than 1.6 million new cases of cancer in the U.S., or about 4,600 new diagnoses each day, and more than 600,000 cancer deaths, or about 1,650 deaths each day.

 

Gender and racial differences

In the report, the researchers noted a number of gender and racial differences in both the rates of cancer and the rates of cancer deaths.

Men are 20 percent more likely to get cancer than women, and 40 percent more likely to die from cancer, according to the report. This difference is due in part to the different types of cancer that affect men and women, the researchers said. For example, liver cancer, which is particularly deadly, is three times more common in men than in women, the researchers wrote. And men are four times more likely to get and die of esophageal, laryngeal or bladder cancers compared with women.

Talk About Frequent Headaches

Men who have low levels ofvitamin D may be at increased risk for frequent headaches, a new study from Finland suggests.

The study analyzed information from about 2,600 Finnish men ages 42 to 60 who gave blood samples and answered questions about the frequency of their headaches. The men were originally part of a study on risk factors for heart disease, and were assessed in the years 1984 to 1989.

Nearly 70 percent of the men in the study had blood vitamin D levels below 20 nanograms per milliliter (50 nanomoles per liter), which is generally considered the threshold for vitamin D deficiency. Low vitamin D levels are a particular concern in Finland and other Nordic countries, because these countries are farther north and have less exposure to sunlight, which the body needs to make vitamin D, the researchers said. [9 Good Sources of Disease-Fighter Vitamin D]

On average, men with frequent headaches — occurring at least once a week — had vitamin D levels of 15.3 ng/ml (38.3 nmol/L), compared to 17.6 ng/ml (43.9 nmol/L) among those men without frequent headaches. (In the United States, vitamin D levels are usually reported in ng/ml, while in other parts of the world, they are reported in nmol/L.)

Men with the lowest vitamin D levels (below 11.6 ng/ml or 28.9 nmol/L) were about twice as likely to have frequent headaches, compared to men with the highest vitamin D levels (above 22 ng/ml or 55 nmol/L.)

The study adds to a growing body of evidence linking low vitamin D levelsto an increased risk of certain diseases and conditions, including headaches. The new study is one of the largest to look at the link between vitamin D and headaches, the researchers said.

However, the study was conducted at a single point in time, so the researchers cannot tell which came first, the low vitamin D levels or headaches, the scientists said. It’s possible that people with frequent headaches may be less likely to spend time outside, and so they have less exposure to sunlight, the researchers said. However, this explanation may be less likely in Finland, where people overall have less exposure to sunlight, the researchers said.

In addition, because the study involved only men, it’s not clear if the findings also apply to women, the scientists said.

The Liquid After Medication

A 6-year-old girl in Oregon experienced severe nicotine poisoning after her parents accidentally gave her liquid nicotine meant for electronic cigarettes instead of a children’s liquid pain reliever, according to a new report of the girl’s case.

The child survived, but nicotine poisoning can be fatal, and the researchers warned that such cases could become more common as e-cigarettes rise in popularity.

“As electronic cigarette use proliferates, children are now increasingly at risk of toxicity from ingestions of much larger quantities of nicotine from highly concentrated refill liquid, as in our case study,” Dr. Matthew Noble, an emergency medicine physician at Oregon Health and Science University, and a co-author of the report, said in a statement.

The girl had previously sprained her ankle, and was taking children’s Motrin (which contains ibuprofen) for pain relief. But when the bottle was finished, the girl’s mother used it to store some liquid nicotine that she had bought online to use in an e-cigarette.

The child’s father didn’t know the Motrin bottle contained nicotine, and he gave the child a 10-milliliter dose of the liquid for her pain, according to the report. The girl immediately felt a burning sensation in her mouth and throat, which led the father to take a small sip of the liquid. He realized it was liquid nicotine and immediately called poison control and an ambulance, the report said. [27 Oddest Medical Cases]

Before the paramedics arrived, the girl lost consciousness and began involuntarily jerking her limbs. She later regained consciousness, but did not respond to questions or commands, the report said.

The girl was taken to the emergency room, where she began vomiting and sweating, and her pulse dropped from 150 beats per minute to 60 beats per minute, the report said.

Doctors gave her an anti-nausea medication and a sedative, and placed a tube in her throat to keep her airway open. They also gave her a medical form of charcoal used to help treat drug overdoses, because it absorbs nicotine and other drugs.

About an hour after she arrived at the ER, the girl was admitted to the intensive care unit and placed on a ventilator overnight. The next day, she was taken off the breathing support and was able to respond to commands. Doctors gave her a physical exam, which showed normal results, and she was released from the hospital.

The researchers estimated that the child consumed about 700 milligrams of liquid nicotine. Some studies have estimated that ingesting as little as 500 mg of nicotine can kill an adult. An average regular cigarette delivers about 0.2 to 2.4 mg of nicotine. [10 Scientific Quit-Smoking Tips]

In addition, a blood test done about an hour after the girl arrived at the hospital showed she had a blood level of nicotine of 348 nanograms per milliliter. The level of nicotine in the blood after an adult smokes a regular cigarette is about 12 to 54 ng/ml, the report said.

The researchers also tested the liquid nicotine that the child ingested, and they estimated that the concentration of nicotine in the original product was more than double the concentration that was listed on the product label.

“This finding supports previous work demonstrating that electronic cigarette refill containers may have unreliable commercial labeling and widely variable actual nicotine concentration compared with that advertised,” the researchers wrote in their report.

Growing in Adulthood

The part of the brain that specializes in recognizing faces becomes denser with tissue over time, new research finds.

The discovery is surprising to researchers, because brain development from childhood into adulthood was long thought to happen mostly through the pruning of synapses, the connections between neurons. In other words, the brain was thought to develop by becoming more streamlined, not by growing new tissue.

The study also showed that these changes in brain structure correlated with the ability to recognize faces. In general, adults are better at recognizing faces than children are, said study leader Jesse Gomez, a doctoral candidate in neuroscience at Stanford University.

But development is personalized. “There are some kids that have adult-like tissue values, but those kids also have adult-like brain function,” Gomez told Live Science. Likewise, some adults who were bad at recognizing faces showed child-like density in their face-recognition region, he said. [Inside the Brain: A Photo Journey Through Time]

 

The changing brain

The textbook explanation of brain development is that infants are born with a riot of neurons and connections that get snipped away over time, Gomez said. Useful connections strengthen, while those that are underutilized get pruned. As a result, the brain becomes more efficient.

This process certainly takes place over the first three years of life, Gomez said, but little is known about development after age 3. He and his colleagues are tackling the question by scanning the brains of elementary-school children again and again over time, and comparing those children’s brains to the brains of young adults.

While comparing the child brains with the adult brains, the researchers found increasing density with age in the posterior part of a brain region called the fusiform face area, located in the visual cortex, near the back of the brain. This brain region specializes in differentiating human faces.

 

Excitable brains

To detect these changes in density, researchers used a method called qualitative magnetic resonance imaging (qMRI). Standard MRI can differentiate between different brain tissues, like white matter and gray matter, Gomez said, but it can’t give any sort of absolute values of brain-cell density that can be compared between people. The new method, qMRI, can. It works by exciting protons in the water in brain tissue. The time it takes for those protons to calm back down to their resting state provides some information about brain density, Gomez explained.

He compared the excited protons to spinning tops.

“You can think, if a top is on a cluttered table, it’s going to slow down more quickly and bump into things and fall down more quickly,” Gomez said. In the same way, if a proton is in an area dense with tissue, it will settle down more quickly. Thus, a quicker time to relaxation means a denser brain region.

Blood Test May Tell You

“We can now detect and measure thousands of biomarkers from a small amount of blood, with the idea of eventually being able to predict who is at risk of a wide range of diseases, long before any clinical signs become apparent,” senior study author Dr. Thomas Perls, a professor of medicine at the Boston University School of Medicine, said in a statement.

In the study, the researchers measured the levels of 19 biomarkers in the blood samples of more than 4,700 people who were enrolled in an ongoing international research project called the Long Life Family Study. The people in the study ranged in age from 30 to 110.

The biomarkers included in the study were linked to many functions in the body, including those of the immune system, the endocrine system and the kidneys, and metabolism. Previous research had shown that the levels of these biomarkers vary with age, the researchers wrote.

Using a type of algorithm, the researchers determined that there were 26 different biomarker signatures among the study participants. Then, the researchers compared the participants’ signatures with their rates of various diseases, and their overall health.

About half of the people in the study had “signature 1,” the researchers found. This signature was deemed to be the reference point for all of the other signatures in the study, because the levels of the biomarkers lined up with what researchers would expect based on people’s age and sex. For example, biomarkers associated with inflammation are thought to increase with age, while biomarkers associated with certain aspects of kidney function are thought to decrease with age.

Signature 2 was the “healthy aging” signature, and was found in about one quarter of the participants, according to the study. This signature was associated with better physical and cognitive functioning, a lower risk of type 2 diabetes and a lower risk of death over the 8-year study period compared with signature 1, the researchers found. [8 Tips for Healthy Aging]

Another eight signatures were associated with higher levels of risk for different diseases and outcomes compared with signature 1, according to the study.  The remaining 16 signatures were not associated with people’s risk of disease as they aged.

You need to know about cancer warning

A woman’s microbiome may signal if cancer is lurking in her body, a small new study suggests.

In the study, researchers at the Mayo Clinic looked at the microbes found in women’s reproductive tracts, and found that women with one type ofuterine cancer had different microbes than women without this cancer.

The cancer, called endometrial cancer, is the most common type of gynecological cancer, according to the National Cancer Institute. But little is known about what causes it, the researchers wrote in the study, which was published Thursday (Jan. 5) in the journal Genome Medicine.

The microbiome is the community of microorganisms that live in and on human bodies. In previous studies, researchers have linked people’s microbiomes to other types of cancer, the new study said. For example, there is a well-established link between the bacteria known asHelicobacter pylori and stomach cancer, the researchers wrote.

In the new study, the researchers looked at 31 white women who had been scheduled to have a hysterectomy, which is a surgery to remove the uterus, at the Mayo Clinic in Minnesota. Among these women, 17 had been diagnosed with endometrial cancer and four had been diagnosed with a condition called endometrial hyperplasia, which can be precursor to endometrial cancer. The remaining 10 women were undergoing hysterectomies for other reasons — they did not have the cancer or the precancerous condition — and were therefore the control group. [5 Myths About Women’s Bodies]

During the procedure, the surgeons took swabs of the women’s vaginas and cervixes. Then, after the surgery, the organs that had been removed — including the women’s uteruses, fallopian tubes and ovaries, were swabbed as well — according to the study.

The researchers found that women with either endometrial cancer or endometrial hyperplasia had significantly higher levels of two types of bacteria, called Atopobium vaginae and Porphyromonas species, in their uteruses compared to the women in the control group.

In addition, these same microbes were found in higher levels in the vaginal tracts of the women with either endometrial cancer or endometrial hyperplasia compared with the women in the control group, although the researchers noted that the association in this case was not as strong.

The researchers also found that the association between the microbes in the reproductive tract and uterine cancer was even stronger among the women who also had a high vaginal pH. [7 Facts Women (And Men) Should Know About the Vagina]

It’s unclear what role the two types of microbes play in the development of endometrial cancer, the researchers said. However, they hypothesized that one type of bacteria, A. vaginae, may be a cause of chronicinflammation, which could make cells in the reproductive tract more vulnerable to the Porphyromonas species of bacteria. This, in turn, could disrupt the cells and lead to the development of cancer, the authors said.

Home Was a Former Meth Lab

A family in Australia who developed health problems found out their sickness had an unusual cause: They had unknowingly moved into a home that was a former meth laboratory, according to a new report of the case.

Just months before the family moved in, the home was the site of a clandestine drug laboratory, where the owner made methamphetamine.

Police discovered the laboratory in May 2013, arrested the owner and notified other authorities that the home needed to be decontaminated because it contained harmful chemicals. The local council issued a notice for the cleaning of the property, but this cleaning wasn’t performed, the report said.

The property was sold a few months later, but the new owners were never informed that the home had previously been a meth laboratory. In October 2013, the family of five — a mother, father and their three children — moved in. [‘Breaking Bad’: 6 Strange Meth Facts]

Seven months passed before the local council contacted the family and told them that their home was a former drug laboratory. Testing of the home took place from May to October 2014, and revealed that methamphetamine was present on surfaces in the home. The levels ranged from 11.7 micrograms per 100 cubic centimeters to 26.0 micrograms per 100 cubic centimeters — well above the Australian limit of 0.5 micrograms per 100 cubic cm, the report said. The family vacated the property in March 2015.

While living in the home, all of the family members experienced health problems, which continued for some time after they moved out. The mother reported a persistent cough, along with weight loss and excess energy, and the father reported worsening memory, dizziness and blurry vision.

The youngest child, a 7-year-old boy, developed asthma-like symptoms, as well as behavioral changes, including anxiety and symptoms ofattention deficit hyperactivity disorder (ADHD), which he did not have before the family lived in the home. All of the family members reported having sore, watery eyes, and several members reported trouble sleeping.

Exposure to methamphetamine residues can cause symptoms similar to those seen in people actually taking meth, according to the Illinois Department of Public Health (IDPH). These include high energy, anxiety, trouble sleeping, increased distractibility, weight loss and memory troubles, according to the National Institutes of Health. Exposure to the chemicals involved in making meth can cause other symptoms, including nose and throat irritation, dizziness and breathing difficulties, IDPH says.

The report highlights the importance of effectively identifying and decontaminating clandestine drug laboratories, the researchers said.

“If properties formerly used for the clandestine manufacture of methamphetamine are not properly cleaned, the public might be unknowingly exposed to drug residues,” the researchers who reported the family’s case wrote in the Jan. 6 issue of the journal Morbidity and Mortality Weekly Report, which is published by the Centers for Disease Control and Prevention. “Appropriate identification and management of these properties, including measures by authorities to prevent the sale of unremediated homes, are important to prevent exposures and adverse health effects.”

All of the family members had samples of their hair tested for methamphetamine one week after they moved out, to better determine their level of exposure to the drug. The tests showed that the family’s two youngest children, both boys, had the highest levels of methamphetamine in their hair, with 330 and 460 picograms per milligram. Previously, studies have found that children living in clandestine drug laboratories can have levels of methamphetamine in their hair ranging from 100 to 131,000 pg/mg, the report said.