Day: 05/27/2015

Removing Mutant p53 Significantly Regresses Tumors, Improves Cancer Survival

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Removing accumulated mutant p53 protein from a cancer model showed that tumors regress significantly and survival increases. This finding, by an international team of cancer researchers led by Ute Moll, MD, Professor of Pathology at Stony Brook University School of Medicine, is reported in a paper published advanced online May 25 in Nature.

For two decades cancer researchers have looked unsuccessfully for ways to develop compounds to restore the function of mutant p53 proteins. This team of researchers discovered that eliminating the abnormally stabilized mutant p53 protein in cancer in vivo has positive therapeutic effects.

p53 is the most important tumor suppressor protein that protects our cells from becoming cancerous. However, mutations in p53 that insert incorrect amino acids can generate aberrant proteins with not only abrogated tumor suppressor function but newly gained oncogenic function (GOF) that promote malignant progression, invasion, metastasis and chemoresistance. Importantly, mutant p53 (mutp53) proteins undergo massive accumulation specifically in tumors, which is the key requisite for GOF. Mutp53 is expressed in 40 to 50 percent of all human tumors and although currently 11 million patients worldwide live with tumors expressing highly stabilized mutp53, it was hitherto unknown whether mutp53 is a therapeutic target to treat cancers.

“Our study clearly shows that mutp53 overexpressing tumors are dependent on continuous overexpression for survival and maintenance,” said Dr. Moll. “This model has direct relevance for similar cancers in humans with the same mutation. Our work may have important clinical implications and be a foundation for a new way to treat mutp53-related cancers.”

Dr. Moll explained that the methods researchers used to treat the mutp53 cancers are two-fold: genetic ablation of the mutp53 gene and pharmacologically attacking the molecular apparatus that is responsible for stabilization of mutp53.

They discovered that, overall, when mutp53 is depleted, tumors regress or stagnate for some time because tumor cells die. This results in mice surviving longer, gaining an increase of 37% to 59% in lifespan.

Dr. Moll added that if cancer researchers are able to identify human p53 tumors that are equally dependent on continuous p53 overexpression, the drug they used in this study could potentially improve clinical survival and/or enhance tumor sensitivity to other anti-cancer drugs.

Don’t Give Heart-Healthy Patients Blood Pressure Drugs Before Surgery.

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A new study questions the practice of giving heart-healthy patients blood pressure drugs before surgeries that do not involve the heart.

While patients with three or four heart risk factors should still be given beta-blockers before an operation, people with no risk for heart disease shouldn’t get the medications because it might lower the odds of a good outcome, the researchers reported.

Previously these drugs were thought to protect the heart during an operation, but their ability to lower blood pressure caused some patients without heart risk factors to develop dangerously low blood pressure and die from strokes, said lead researcher Dr. Mark Friedell, chairman of the department of surgery at the University of Missouri-Kansas City School of Medicine.

“Patients who have significant cardiac risk factors benefit from beta-blockers started before surgery, but patients who don’t have any cardiac risk factors do worse when beta-blockers are started before surgery,” he said.

According to the American Heart Association, those risk factors include high blood pressure, high cholesterol, diabetes, family history of heart disease, smoking and obesity.

Beta-blockers are used to lower blood pressure and slow the heart.

Friedell said that patients with one or two heart risk factors showed no benefit from beta-blockers. However, those with three or four risk factors benefited significantly from the drug.

Conversely, patients with no heart risk factors who were given a beta-blocker were 1.2 times more likely to die during the study period than those not given the drug.

“Beta-blockers should not be started before surgery on those with no cardiac risk factors,” he said.

However, Friedell cautioned that patients already taking a beta-blocker should continue to take it before, during and after surgery.

The report was published online May 27 in the journal JAMA Surgery.

For the study, Friedell’s team collected data on more than 325,000 patients. Just over 96 percent of the study patients had non-cardiac surgery and nearly 4 percent had heart surgery. Among all of the patients, 43 percent were given a beta-blocker.

Of the patients who did not get a beta-blocker, 0.5 percent of those who had no heart risk factors died within 30 days after surgery, as did 1.4 percent of those with one or two risk factors and 6.7 percent of those with three to four risk factors, the researchers found.

For those who did get a beta-blocker, 1 percent of those with no heart risk factors died, as did 1.7 percent of those with one or two risk factors and 3.5 percent of those with three to four risk factors, the findings showed.

Dr. Gregg Fonarow, a professor of cardiology at the University of California, Los Angeles, said, “The use of beta-blocker therapy to reduce the risk of cardiovascular events in patients undergoing non-cardiac surgery has been controversial, with guideline recommendations having undergone substantial revision in recent years.”

Initial small studies suggested significant benefits with beta-blockers, but some of these trials were later found to be unreliable, added Fonarow, who was not involved with the new study.

“A more recent, large clinical trial showed lower risk of heart attack and stroke and death with beta-blocker therapy [in patients with heart risk factors], but higher risk of low blood pressure, stroke, and death [in patients without heart risk factors],” Fonarow said. “Earlier studies have suggested a benefit in patients with cardiac risk factors but potential harm in low-risk patients.”

Why do so many people think MSG is bad for you? | Big Think

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In last week’s post, we looked at the placebo effect’s evil cousin, the nocebo effect, which can lead people to experience side effects from placebo pills and believe that WiFi and wind farms are causing them to become sick. A seemingly far more common belief that also appears to be caused by the nocebo effect is the idea that monosodium glutamate (MSG), the common ingredient in oriental foods, can cause headaches and other side effects.

Msg

MSG quickly becomes glutamate when it meets with water, resulting in the taste of “umami” or the savory flavor we associate with foods such as Parmesan, soy sauce, and Roquefort — all natural sources of glutamate. Glutamate is also contained to a lesser extent in plenty of everyday foods including pork, beef, chicken, eggs, potatoes, corn, tomatoes, squid, scallops, and sardines.

Since way back in 1968, anecdotal reports of negative reactions to Chinese food have been attributed to MSG, after a letter to the New England Journal of Medicine in which the phenomenon was branded “Chinese restaurant syndrome.” But despite the apparent popular consensus, this is most likely another syndrome that exists only in the mind. Decades of research summarised in a 2009 review of the literature on MSG refutes the existence of Chinese restaurant syndrome.

Negative symptoms have been reported in past studies involving MSG, but crucially, these studies were all small, uncontrolled, and unblinded, allowing the participants’ expectations to impact the results. When studies have been placebo-controlled and double-blinded, there is no difference in symptoms between participants ingesting normal amounts of MSG and participants who ingested a placebo.

Recent research suggests MSG might not only not be bad for you — it could actually be used to help people eat a healthy diet, as the savory foods that stimulate umami taste buds are important for overall health. A study published recently in the journal Flavour found that old people who had lost the sensitivity of their umami taste buds complained of appetite and weight loss. The researchers measured umami sensation by placing monosodium glutamate (MSG) on specific areas of the mouth and tongue. The researchers found that giving their participants kelp tea, which is rich in MSG, resulted in improvements in salivation, taste function, and appetite.

Next time you are having dinner with someone and they mention they react badly to MSG, you might want to ask them if they have ever heard of the nocebo effect.

 

References:

Sasano, T., Satoh-Kuriwada, S., & Shoji, N. (2015). The important role of umami taste in oral and overall health. Flavour, 4(1), 10.

Williams, A. N., & Woessner, K. M. (2009). Monosodium glutamate ‘allergy’: menace or myth?. Clinical & Experimental Allergy, 39(5), 640-646.

‘Sex-switching’ mosquito gene to fight dengue

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Scientists have identified a gene in the dengue-transmitting mosquitoes that can be used to switch their sex, transforming the deadly disease-carrying females into harmless males.

Dengue is a mosquito-borne disease caused by a virus

Dengue is a mosquito-borne disease caused by a virus

Scientists have identified a gene in the dengue-transmitting mosquitoes that can be used to switch their sex, transforming the deadly disease-carrying females into harmless males.

The gene identified by researchers at the Fralin Life Science Institute at Virginia Tech is responsible for sex determination in mosquitoes that can transmit yellow fever, dengue, and chikungunya viruses.

Only female mosquitoes bite because they need blood for developing eggs, and researchers believe that a higher ratio of males could reduce disease transmission.

Scientists identified a male-determining genetic switch called Nix in Aedes aegypti mosquitoes that underlies the difference between males and females.

These master switches often reside in genomic black holes, which is why none had been found in mosquitoes or other insects before.

“Nix provides us with exciting opportunities to harness mosquito sex in the fight against infectious diseases because maleness is the ultimate disease-refractory trait,” said Zhijian Jake Tu, a professor of biochemistry in the College of Agriculture and Life Sciences.

The scientists injected Nix into mosquito embryos and found more than two-thirds of the female mosquitoes developed male genitals and testes.

When they removed Nix using a genome-editing method known as CRISPR-Cas9, male mosquitoes developed female genitals.

The study provides the foundation for developing mosquito control strategies by converting females into harmless males or selectively eliminating deadly females.

“We’re not there yet, but the ultimate goal is to be able to establish transgenic lines that express Nix in genetic females to convert them to harmless males,” said Zach Adelman, an associate professor of entomology in the College of Agriculture and Life Sciences.

Aedes aegypti is an invasive species originally from Africa that first began to spread around the world by ship in the 1700s.

This species is a major health problem because it is highly adapted to human environments. Aedes aegypti is among the small fraction of mosquito species that transmit pathogens to humans.

“Targeted reduction of Aedes aegypti populations in areas where they are non-native could have little environmental impact, and drastically improve human health,” said Brantley Hall, a PhD student in Tu’s lab and co-first author on the paper.

 

Messenger RNA could serve as biomarker to detect early-stage ovarian cancer, study finds .

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PBS "Cancer: Emperor of All Maladies" Original caption: A scientist labels each protein in the radio nucleotide sequence of human genes to create a unique DNA profile. --- Image by © Dan McCoy - Rainbow/Science Faction/Corbis

Ovarian cancer, one of the most difficult to diagnose and treat, is especially lethal for that reason, but University of California, San Diego School of Medicine and Moores Cancer Center researchers have found biomarkers they believe could be used to diagnose the disease at an early stage.

The researchers identified six Messenger RNA isoforms (bits of genetic material that have similar but not identical amino acid sequences and code for functionally similar proteins) that are produced by ovarian cancer cells — but not normal cells. Their presence could indicate early ovarian cancer, according to a study published the week of May 25 in the Proceedings of the National Academy of Sciences.

And several of the mRNA isoforms code for unique proteins that could be targeted with new therapeutic treatments.

“We were inspired by many studies aimed at using DNA to detect cancer,” said lead author Christian Barrett, bioinformatics expert and project scientist in the UC San Diego School of Medicine Institute for Genomic Medicine.

“But we wondered if we could instead develop an ovarian cancer detection test based on tumor-specific mRNA that has disseminated from cancer cells to the cervix and can be collected during a routine Pap test,” Barrett said in a press release May 25.

DNA, the blueprint for life, contains much more information than just the genes that code for proteins. In contrast, mRNAs, are complementary copies of just the genes. They carry the instructions for every protein that the cell will produce “from the nucleus to the cytoplasm, where cellular machinery can read the recipe and build the corresponding proteins,” the press release said.

According to the study’s authors, the advantage of using cancer mRNA for diagnosis rather than DNA is “the sheer numbers” — a cancer cell might have just one to a few copies of a DNA mutation, but mRNA variants can occur in hundreds to thousands of copies in each cell.

The research team developed an algorithm to explore two large public genetic databases, The Cancer Genome Atlas (TCGA) and the Genotype-Tissue Expression (GTEx) program, both sponsored by the National Institutes of Health

TCGA is a catalog of RNA and DNA from 500 tumors including many types of cancer, and GTEx is a database of RNA and DNA from normal tissues. The researchers were able to analyze mRNA sequences from 296 ovarian cancers and 1,839 normal tissue samples.

The researchers found six mRNA isoform molecules that have the tumor specificity required for an early detection diagnostic of ovarian cancer.

“Our experimental findings were made in a laboratory and were performed on ovarian cancer cells from cell lines,” said study co-author Dr. Cheryl Saenz, clinical professor of reproductive medicine who specializes in treating gynecologic cancers. “Clinical trials will need to be conducted on women to confirm the presence of these markers in women that we know have cancer, as well as to document the absence of the markers in women that do not have ovarian cancer.”

The authors acknowledge limitations in their approach, including “technical limitations in detecting mRNA isoforms, a shortage of normal ovarian and fallopian tube control samples and the possibility that tumor cells that disseminate to the cervix may not genetically act the same as the primary tumor.”

Yet results are so promising the researchers recommend expanding their process for identifying tumor-specific mRNA isoforms to other tumor types.

Proficiency vs Deficiency… The Art Of Electrocardiography Analysis | EMS 12 Lead

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Understanding the different types of  assessments, assessment tools, and findings acquired from these assessment , are all part of proper patient care in both acute and chronic emergency medicine management, in every realm of the term “PATIENT CARE”. One of the most important tools, in both the prehospital setting and long term care, is the 12 lead ECG, which just like any other tool, requires attention to detail, probably even more so than other tools. We have to know when to use it, why to use it, and be able to recognize the information given to use through its use.

ECG INTERPRETATION IS MORE THAN A SKILL, IT’S AN ART!

It’s an art which requires never-ending practice and will never reach a limit.  We will never know it all, and we will never be able to say, “I have seen it all”. Over the years we have seen providers and clinicians, in every setting and level of care, both being proficient and completely lacking ECG interpretation skill. Often, many clinicians, from Paramedics to Physicians, rely on the computerized ECG interpretation for proper patient care and management.

But how do we truly define “PROPER“?

Let’s discuss some scenarios…

This 93 year old male has been brought to the Emergency Department by a family member after complaining of sudden dizziness spells. He is overall healthy considering the age, with minimal pertinent history and just takes daily vitamins, at least per the family. The following 12 lead ECG was obtainedScan_20150522There appears to be sinus bradycardia with variant AVB (Atrioventricular Block), IVCD (both RBBB and LBBB morphologies) with Leftward frontal axis (Left Anterior Fascicular Block) at approximately -70 degrees (aVR is the most isoelectric lead perpendicular to aVL), aberrantly conducted impulses during the 2nd and 7th beats, with a QTc (using Bazett’s formula) of approximately 400 ms, not taking into consideration the slight afterdepolarizations which cause a false QT prolongation)

Because of the initial computerized ECG interpretation of “EXTREME TACHYCARDIA WITH WIDE COMPLEX”, lack of awareness (for professionalism’s sake) by the receiving physician, and chief complaint of dizziness, the patient was initially on the verge of receiving a full Amiodarone drip of 150 mg over 10 min, but thank goodness for compensatory hypertension. In this case, there were multiple things wrong with the computerized interpretation, and treatment to be followed.

  • There Heart Rate is not 283 beats/min, but in the 30′s
  • The QTc is not 1121 ms
  • There is AV dissociation, with variant blocks throughout ED visit, from 1st degree to 3rd degree AVB
  • Amiodarone is definitely not indicated in bradycardias or high degree AVBs

Click on the highlighted title for an Amiodarone breakdown, UNDERSTANDING AMIODARONE   One tool I use in these cases of bradycardia, is SPo2 monitoring. Remember, with every systole achieving arterial pressures, the Pulse Oximeter will provide a value and waveform. We are not focusing on oxygenation values right now, just the presence of an SPo2 pleth coinciding with each QRS on the cardiac monitor.

Conclusion to 1st case:

This patient was admitted to the cardiovascular unit,  awaiting pacemaker placement.

 

Another example of why we should not solely rely on the computerized ECG interpretation:

wrong interpt.There is a sinus rhythm with LVH, physiologic Leftward axis (aVF is the isoelectric lead perpendicular to Lead I) at approximately -10 degrees. No primary (ischemic) ST-T changes with normal R wave progression and QT prolongation.

The computerized ECG interpretation is  SINUS TACHYCARDIA WITH 2nd DEGREE AV BLOCK 2:1 AV CONDUCTION”

Does this mean that we will give Atropine or stand by pacing for the 2nd degree AVB? If you answer is NO, then you’re on the right track…

 

Now, in most instances, the computerized interpretation is accurate and useful:

  EMS HUMOR!!!

While other times, it may not be as specific, depending on variations, most commonly movement and poor lead placement leading to Artifact:

77yof-unresponsive-12L    Artifact is one of the most common causes of inaccurate Atrial Fibrillation and Atrial Flutter computerized interpretation

Other causes of inaccurate computerized interpretation include:

  • QRS width
  • Intrinsic rate and irregularity
  • ST segment and T wave morphology

This is taking into consideration that each system has an analysis algorithm, like the Physio-Control’s Lifepak 15, one of the most common cardiac monitors used prehospitally, which uses the Glasgow Analysis Algorithm, which gives us the computerized interpretations based on calculations and measurements of the recorded waves from parameters set by the creators.12-Lead ECG Analysis Algorithms_2_450

 

KEY POINTS:

 

1.We should not base our ECG interpretation and our patient’s care and treatments solely on the computerized interpretation provided.

2. The computerized interpretation gives us a second opinion on cardiac electrical system analysis, and is not a confirmed statement.

 

Newer Birth Control Pills May Pose Health Risk

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Newer versions of the Pill may raise a woman’s risk ofdangerous blood clots even more than older versions, a large U.K. study suggests.

Newer Birth Control Pills May Pose Health Risk

Women taking any combined oral contraceptive pills — containing both estrogen and progestin — were three times as likely to develop a blood clot in a deep vein in the leg or pelvis, compared to women not on the Pill. The risk was higher still with all the newer Pill versions except one, researchers found.

“This association is between 1.5 and 1.8 times higher for the newer formulations,” said lead author Yana Vinogradova, a research fellow in medical statistics at the University of Nottingham.

The blood clots, known as venous thromboembolisms(VTEs), are common and can be deadly if the clot dislodges and travels to the heart, brain or lungs. They are more common among women taking estrogen medicines, and the risk is even higher if the woman smokes, according to theNational Library of Medicine.

But the overall risk of a blood clot for women on any combined oral contraceptives is still relatively low: between six and 14 extra cases per year per 10,000 women taking the drugs, Vinogradova told Reuters Health by email.

Newer combined pills, including the progestins drospirenone, desogestrel, gestodene or cyproterone acetate, have been suspected of carrying an even higher clot risk compared to older versions that include levonorgestrel and norethisterone. But most past studies have been small or flawed by not taking into account certain other risk factors for clots, the study team writes in BMJ.

To assess VTE risk in women on both older and newer-generation pills, the researchers analyzed U.K. general practice databases covering the period between 2001 and 2013. They found 5,062 cases of VTE among women ages 15 to 49, and matched each of these women with up to five women who did not have a blood clot in the same year, but were of similar age and treated at a similar medical practice.

The researchers accounted for smoking, alcohol consumption, race, body mass index and other health problems, and found that women taking any combined oral contraceptive were almost three times as likely to suffer ablood clot as those not taking contraceptive pills.

Women taking older-generation drugs were about 2.5 times as likely to have a blood clot as women not taking any oral contraceptives over the previous year. Those taking newer types of combined pills were about four times as likely to suffer a clot compared to women not taking oral contraceptives.

The exception among the newer formulations was norgestimate, with a risk profile more similar to the older drugs.

The results would translate to a number of “extra” cases of VTE among women taking the combined pills versus women not on the Pill. These numbers were lowest for the older drug levonorgestrel and the newer norgestimate, with an additional six cases per 10,000 women per year, and highest for two newer drugs, desogestrel and cyproterone, with an extra 14 cases each.

“However,” Vinogradova noted, “these increased risks of (venous thromboembolism) associated with both the older and the newer pills are lower than those associated with pregnancy,” which may increase clot risk tenfold.

The newer pills carry higher clot risk, but were introduced as potentially having new benefits as well, including reduced acne, headache, depression, weight-gain, breast symptoms andbreakthrough bleeding, she said.

The association between different oral contraceptives andblood clot risk has been controversial and previous study results have been mixed, but the new findings help to clarify those inconsistencies, Susan Jick, a professor at BostonUniversity School of Public Health wrote in an editorial accompanying the new results.

About nine percent of women worldwide take birth control pills, including 28 percent of women in the U.K., the authors write.

Any women who are concerned should discuss treatment options with their doctor at their next routine appointment, Vinogradova said.

“Some women are at higher risk of (blood clot) because of family history or other medical conditions and doctors will already take account of these factors when advising women regarding their options for contraception,” she said.

Pentagon mistakenly sends live anthrax to as many as nine states

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Anthrax cells and spores
Anthrax cells and spores
Bacillus anthracis vegetative cells and spores are pictured in this photomicrograph from the Defense Department anthrax information website. (Anthrax Vaccine Immunization Program)
By W.J. HENNIGAN contact the reporter Crime Diseases and Illnesses U.S. Centers for Disease Control and Prevention

Army facility mistakenly sent live anthrax to labs in up to nine states
The Centers for Disease Control and Prevention is trying to determine how many labs received live anthrax
The Army mistakenly sent live anthrax samples from a testing facility in Utah to commercial laboratories in as many as nine states, including California, as part of an effort to improve field testing for biological threats.

Pentagon officials said the accidental transfer of the potentially deadly biological agent Bacillus anthracis, better known as anthrax, had not caused any known infections.

Night raid in Syria: The special-forces op that killed Islamic State’s money man
Night raid in Syria: The special-forces op that killed Islamic State’s money man
“There are no suspected or confirmed cases of anthrax infection in potentially exposed lab workers,” Col. Steve Warren, a Pentagon spokesman, said in a statement.

The Centers for Disease Control and Prevention said it was working with state and federal agencies to investigate the error. The CDC said it had launched its inquiry based on a request from a private commercial lab, not from the Army.

“At this time we do not suspect any risk to the general public,” the CDC said in a statement.

The CDC said it had sent investigators to all the labs and was trying to determine whether they also received live samples.

Officials said the commercial laboratories are in California, Delaware, Maryland, New Jersey, New York, Tennessee, Texas, Virginia and Wisconsin. They did not identify the specific labs.

The Pentagon said one sample of anthrax also was sent to Osan Air Base in South Korea. A program there aims to boost biosurveillance capabilities on the Korean peninsula.

Under military research programs, anthrax spores must be inactive before they are sent to labs for study.
In this case, live spores were accidentally sent from the Army’s vast Dugway Proving Ground, about 85 miles southwest of Salt Lake City, to labs working to develop a new diagnostic test for anthrax.

Dugway is used to test defense systems for chemical and biological weapons agents, including lethal viruses and bacteria.

In 2011, Dugway was put on lockdown overnight when a vial of deadly VX nerve agent went missing. The vial later was found, but had been mislabeled.

The nation’s worst biological attack involved anthrax created in an Army facility.

Weeks after the Sept. 11, 2001, attacks, five envelopes containing anthrax spores were sent to several members of Congress and the media, sparking widespread fear of another act of terrorism.

At least 22 people contracted anthrax, and five died from the infection. About 35 post offices and mail rooms were contaminated along with seven buildings on Capitol Hill.

After years of false starts, the FBI concluded in 2008 that Dr. Bruce Ivans, a researcher at the Army’s Medical Research Institute of Infectious Diseases in Frederick, Md., was responsible. He committed suicide before he was charged.

Rhode Island Finds Increase in STDs After Rise of Social Media Dating .

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Increases in the rates of three major sexually transmitted diseases in Rhode Island have led local health officials to warn that high-risk behaviors could be to blame, including the use of social media to “arrange casual and often anonymous sexual encounters.”

Among the statistics, HIV rates have risen 33 percent, gonorrhea cases are up 30 percent andsyphilis cases are up a whopping 79 percent.

“These data send a clear signal that despite the progress we have made in reducing STDs and HIV over the years, there is more work to do,” Dr. Nicole Alexander-Scott, director designee at the Rhode Island Department of Health, said in a statement. “This trend reminds us that we cannot become complacent.”

The department, according to a written statement, found that high-risk behavior, including “using social media to arrange casual and often anonymous sexual encounters, having sex without a condom, having multiple sex partners, and having sex while under the influence of drugs or alcohol,” as well as increased testing, was the likely cause for the spike in STDs. While the department was able to track STD rates from 2013 through 2014, national data is only available until 2013 and it’s unclear if STDs are going up nationally, as well.

At least one other county has seen a startling rise in STDs, and it is such a problem that health officials at the STD clinic for Salt Lake County, Utah, have started to ask about specific dating apps when meeting with patients.

Lynn Beltran, an epidemiologist at the clinic, said she’s not surprised to see a rise in STDs, given the rise of those dating apps and what she sees as changing attitudes on sexual relations.

“It’s been the perfect storm,” said Beltran. “Our attitude kind of shifted, where it became more acceptable to engage in casual sex … then to find someone in a certain mile radius.”

Beltran said she and her team ask about the dating apps to understand if patients’ partners could be at risk. She said that when websites were more popular, she and her staff would register as users to reach out to people who may have been exposed to STDs, including HIV. Now that apps are more popular, she said, it is more difficult to reach out and alert users of potential exposure.

“My staff would register as users on those on sites and go in and send them a message,” she told ABC News. “They would go on and say, ‘Can you please call me? I have some important medical information for you.’”

In her county, she said, she has seen an uptick in syphilis and gonorrhea, and many of the newly diagnosed patients say they are sexually active through dating apps.

Some HIV experts say the dating apps likely are not to blame, but instead blame a lack of funding for education and prevention.

“Don’t blame social media — this is about our failure to provide young people with comprehensive, effective sex education and access to condoms” and affordable medical care, said Anthony Hayes, managing director of public affairs and policy for the Gay Men’s Health Crisis

He also cited lack of available medications that can help stop an HIV infection after exposure.

“Until we make these crucial investments that will save lives and money, these numbers are going to keep going up,” he said.

Beltran added that the Rhode Island report does not mean people should be shamed for using dating sites, but that they should be educated on staying safe.

“I think this is the wave of the future, and we need to approach it not with a shame,” she said.

She said it will be important for health departments are able to “help people be informed and know what their risks are.”

Bleeding, Recurrent Venous Thromboembolism, and Mortality Risks During Warfarin Interruption for Invasive ProceduresRisks During Warfarin Interruption for Invasive ProceduresRisks During Warfarin Interruption for Invasive Procedures

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