Day: 11/27/2016

Many LASIK patients may wind up with glare, halos or other visual symptoms, study suggests

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LASIK isn’t always as awesome as we might think.

Millions of Americans each year undergo LASIK surgery to correct their vision. Given how common the procedure has become and how ubiquitous the ads are on radio and TV, you might be tempted to treat the decision to get the treatment pretty casually or think of it as purely a financial decision. A team of researchers from the Food and Drug Administration, the National Eye Institute and the Department of Defense would like to make sure you weigh the potential risks to your eyes more seriously.

In 2009, as LASIK was becoming a household word, the government scientists launched a major study to investigate reports of adverse impacts from the procedure. At the time, there were a lot of anecdotes flying around but little scientific information about patient outcomes. The results, published in October 2014, showed that some patients developed problems that adversely affected their day-to-day lives, such as difficulty driving at night or in sunshine. But it was such a small number — less than 1 percent — of the patients in the study that it was difficult to draw any strong conclusions from that data.

On Wednesday, the group released a follow-up report in JAMA Ophthalmology that provides more sobering information. The study suggests that the percentage of people who undergo LASIK and wind up with new visual symptoms — such as double images, glare, halos or starbursts — may be much higher. The data was based on a questionnaire that looked at patient satisfaction with their vision and at visual and dry-eye symptoms following surgery.

First, the good news. More than 95 percent of participants said they were satisfied with the improvements to their vision. In addition, the prevalence of dry-eye symptoms also decreased after surgery. The bad news is that a “substantial” percentage of the study participants said they had other, new symptoms following the procedure.

The study analyzed outcomes for two groups of LASIK patients. In the first group, which included 262 Navy personnel with an average age of 29.1, it was 43 percent reporting new symptoms. And in the second, consisting of 312 civilians at five practice and academic centers and with a median age of 31.5, it was 46 percent. In addition, about 28 percent of patients who had never had dry-eye symptoms before developed mild, moderate or severe symptoms three months after the procedure.

“To our knowledge, our study is one of the few that have reported the development of new visual symptoms,” Malvina Eydelman of the U.S. Food and Drug Administration and colleagues wrote. “While the overall prevalence of visual symptoms decreased, a large percentage of participants with no symptoms preoperatively reported new visual symptoms postoperatively.”

One interesting component of this study was that the survey showed that the percentage of people with symptoms may be much higher than what has been previously reported in studies involving direct interviews with health-care professionals. The authors of the new study note that the reluctance of patients to tell their doctors about “negative” events has been well documented.

The researchers cautioned that the study may not generalize to the LASIK population as a whole because of its small sample size and short follow-period, which was typically three months. However, they emphasized that “although the magnitude of the development of symptoms is uncertain, patients undergoing LASIK surgery should be adequately counseled about the possibility of developing new visual symptoms after surgery prior to undergoing this elective procedure.”

American Heart Association says Ibuprofen may exacerbate heart failure

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A recent statement from the American Heart Association has revealed that many common drugs, including ibuprofen, may cause or worsen heart failure. The organization is also reportedly urging doctors to thoroughly check over all of their patients’ medications, including those that they take without a prescription, in order to ensure their lives aren’t at risk.

Image: American Heart Association says Ibuprofen may exacerbate heart failure

Heart failure occurs when the heart is unable to efficiently pump blood around the body. Some of the symptoms include extreme tiredness, breathlessness and swelling of the legs. It often develops in patients who have suffered a heart attack or stroke, and the condition tends to deteriorate over time

The CDC reports that nearly 6 million American adults will experience heart failure. Statistics from 2009, indicate that roughly one-in-nine deaths list heart failure as a contributing condition. Nearly half of all people diagnosed with heart failure will die within five years of their diagnosis, according to the CDC. In other words, heart failure is a serious condition. Given that the average heart failure patient takes about seven medications daily, it is easy to see where things could become problematic. This is especially true if their medications are not being managed properly.

The statement from the AHA was released in July, and was also published on the website of the organization’s journal Circulation. Robert L. Page II, the chair of the committee that formulated the statement has commented: “Since many of the drugs heart failure patients are taking are prescribed for conditions such as cancer, neurological conditions or infections, it is crucial but difficult for healthcare providers to reconcile whether a medication is interacting with heart failure drugs or making heart failure worse.” Page is also a professor in the Department of Clinical Pharmacy and the Department of Physical Medicine and Rehabilitation at the University of Colorado Schools of Medicine and Pharmacy.  He also notes that while patients are often instructed to read food labels and be mindful of their diets, they are not often advised to watch what over-the-counter drugs they may be taking.

Ibuprofen is cited as being especially problematic for patients with heart failure. Patients who take ibuprofen or similar drugs are 10 times more likely to experience flare-ups. It’s estimate that they are also about 33 percent more likely to require a hospital admission.

This underlines how very dangerous just about any drug can be, especially if you have a preexisting health condition.

Stunning new data indicates El Nino drove record highs in global temperatures.

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  • Global average temperatures over land have plummeted by more than 1C 
  • Comes amid mounting evidence run of record temperatures about to end
  • The fall, revealed by Nasa satellites, has been caused by the end of El Nino

Global average temperatures over land have plummeted by more than 1C since the middle of this year – their biggest and steepest fall on record.

The news comes amid mounting evidence that the recent run of world record high temperatures is about to end.

The fall, revealed by Nasa satellite measurements of the lower atmosphere, has been caused by the end of El Nino – the warming of surface waters in a vast area of the Pacific west of Central America.

Global average temperatures over land have plummeted by more than 1C since the middle of this year – their biggest and steepest fall on record

Global average temperatures over land have plummeted by more than 1C since the middle of this year – their biggest and steepest fall on record

Some scientists, including Dr Gavin Schmidt, head of Nasa’s climate division, have claimed that the recent highs were mainly the result of long-term global warming.

Others have argued that the records were caused by El Nino, a complex natural phenomenon that takes place every few years, and has nothing to do with greenhouse gas emissions by humans.

The new fall in temperatures suggests they were right.

Big El Ninos always have an immense impact on world weather, triggering higher than normal temperatures over huge swathes of the world. The 2015-16 El Nino was probably the strongest since accurate measurements began, with the water up to 3C warmer than usual.

It has now been replaced by a La Nina event – when the water in the same Pacific region turns colder than normal.

Last week, Mr Trump’s science adviser Bob Walker said he was likely to axe Nasa’s $1.9 billion (about £1.4 billion) climate research budget

Last week, Mr Trump’s science adviser Bob Walker said he was likely to axe Nasa’s $1.9 billion (about £1.4 billion) climate research budget

This also has worldwide impacts, driving temperatures down rather than up.

The satellite measurements over land respond quickly to El Nino and La Nina. Temperatures over the sea are also falling, but not as fast, because the sea retains heat for longer.

This means it is possible that by some yardsticks, 2016 will be declared as hot as 2015 or even slightly hotter – because El Nino did not vanish until the middle of the year.

But it is almost certain that next year, large falls will also be measured over the oceans, and by weather station thermometers on the surface of the planet – exactly as happened after the end of the last very strong El Nino in 1998. If so, some experts will be forced to eat their words.

Last year, Dr Schmidt said 2015 would have been a record hot year even without El Nino.

‘The reason why this is such a warm record year is because of the long-term underlying trend, the cumulative effect of the long-term warming trend of our Earth,’ he said. This was ‘mainly caused’ by the emission of greenhouse gases by humans.

Dr Schmidt also denied that there was any ‘pause’ or ‘hiatus’ in global warming between the 1998 and 2015 El Ninos.

But on its website home page yesterday, Nasa featured a new study which said there was a hiatus in global warming before the recent El Nino, and discussed why this was so. Last night Dr Schmidt had not returned a request for comment.

However, both his own position, and his Nasa division, may be in jeopardy. US President-elect Donald Trump is an avowed climate change sceptic, who once claimed it was a hoax invented by China.

Last week, Mr Trump’s science adviser Bob Walker said he was likely to axe Nasa’s $1.9 billion (about £1.4 billion) climate research budget.

The Pacific warming can trigger floods, such as those in Peru, pictured above

The Pacific warming can trigger floods, such as those in Peru, pictured above

Other experts have also disputed Dr Schmidt’s claims. Professor Judith Curry, of the Georgia Institute of Technology, and president of the Climate Forecast Applications Network, said yesterday: ‘I disagree with Gavin. The record warm years of 2015 and 2016 were primarily caused by the super El Nino.’

The slowdown in warming was, she added, real, and all the evidence suggested that since 1998, the rate of global warming has been much slower than predicted by computer models – about 1C per century.

David Whitehouse, a scientist who works with Lord Lawson’s sceptic Global Warming Policy Foundation, said the massive fall in temperatures following the end of El Nino meant the warming hiatus or slowdown may be coming back.

‘According to the satellites, the late 2016 temperatures are returning to the levels they were at after the 1998 El Nino.

The data clearly shows El Nino for what it was – a short-term weather event,’ he said.