Spray-on Skin May Promote Wound Healing

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Experts Predict Role for Spray-on Skin in Slow-Healing Wounds

By Denise Mann
WebMD Health News

Reviewed by Louise Chang, MD

Aug. 2, 2012 -- An experimental spray-on skin product may help people with chronic leg wounds heal faster and more effectively than available treatments, a new study suggests.

The spray-on skin is made up of skin cells and suspended in a mixture of different types of proteins. The participants in this study all had venous leg ulcers, which are shallow wounds that occur in people who have a circulation problem in their veins. These wounds tend to develop on the inside of the lower leg. Most at risk for venous ulcers are inactive and obese people, as well as people with varicose veins.

People in the study who used the new treatment experienced a greater reduction in wound size than those who didn't use it.

The findings appear in the Lancet.

Healthpoint Biotherapeutics of Fort Worth, Texas, is developing the new product and sponsored the study.

As it stands, most venous leg ulcers are treated with compression bandages. Some doctors also use skin grafts in which skin is taken from another area of the body and used to resurface the wound. Skin grafts involve surgery, and people can develop a wound at the skin donation site, too.

"If you don't get these to heal, they become chronic, and the older the wounds are, the harder they become to heal with anything," says researcher Herbert B. Slade, MD. He is a pediatrician at the University of North Texas Health Science Center in Fort Worth and is also the chief medical officer at Healthpoint Biotherapeutics. "Compression bandages work for 30% to 70% of people, but are not 100% effective."

That is where the spray-on treatment may come in.

In the 12-week study of 205 people, those who received the spray-on treatment and compression bandaging had a greater reduction in wound size than those who used compression bandaging without the test treatment.

Researchers tested two strengths of the new therapy, along with compression bandages. The biggest improvements were seen in the lower-strength dose given every two weeks; there was a 16% greater reduction on average of the wound area, compared to a group that was given a spray that didn't contain the new therapy, after 12 weeks.

Side effects were similar in the different groups. The spray-on treatment sped wound closure by an average of 21 days compared to the comparison group.

Slade and colleagues are now assessing its safety and conducting studies to determine exactly how it works. "The FDA wants us to better define what it is that is happening when the cells get on the surface of the wound," he says. "We know it works, we just need to know more about how."

According to Slade, the sprayed-on cells help the tissue learn how to regenerate itself. If the findings are confirmed by follow-up studies, "it's going to be an off-the-shelf product." No information is available about cost at this time.

The need for new products to treat these wounds is tremendous, Matthias Augustin, MD, says in an email. "A significant number of patients fail to respond to any therapy."

Augustin, the director of the Institute for Health Services Research in Dermatology and Nursing at the University Clinics of Hamburg in Hamburg, Germany, wrote an editorial accompanying the new study.

"New treatments with improved healing and healing rates are needed to reduce the burden of ulcers for patients, [and] while more research is needed I believe that this product could ultimately make a significant difference for these patients."

John Lantis, MD, is one of the investigators on the study. "This could be used in any place that artificial skin is needed, such as diabetic foot ulcers," says Lantis, who is the chief of the vascular surgery division at St. Luke's-Roosevelt Hospital in New York City.

It will not be a stand-alone treatment. "If you have a diabetic foot ulcer, you will still have to wear special diabetic shoes," he says. "It's not like you can just spray it on and go about your business. It will always be used in conjunction with current standard of care."

It seems to perform better than any other artificial skin products out there or in the pipeline, Lantis says.

Maja Zaric, MD, says there may well be a role for this product. She is an interventional cardiologist at Lenox Hill Hospital in New York City. "The spray can be applied in various doses and it is very user-friendly, unlike a skin graft."

Still, not every person with a venous leg ulcer would benefit from the new spray-on skin. "Those who would benefit the most have extremely large ulcers and decreased blood flow," she says. Before treating these wounds, Zaric always does a vein-mapping study to see which veins are causing the problem.

Neil Sadick, MD, is a New York City dermatologist and clinical professor of dermatology at Weill Cornell Medical College. "This treatment provides a cocktail of cells and growth factors," he says. "These ingredients can stimulate new collagen, which would improve wound healing and also help recover the skin." Collagen is the main structural protein in skin.

"It could well be helpful in wound healing and it could be helpful in any area where we need to replace the skin surface," Sadick says.

SOURCES: Herbert B. Slade, MD, pediatrician, University of North Texas Health Science Center, Fort Worth, Texas; chief medical officer, Healthpoint Biotherapeutics. Neil Sadick, MD, clinical professor of dermatology, Weill Cornell Medical College, New York City. Maja Zaric, MD, interventional cardiologist at Lenox Hill Hospital, New York City. John Lantis, MD, chief, Vascular Surgery Division, St. Luke's-Roosevelt Hospital in New York City. Kirsner, R.S. Lancet, 2012, study received ahead of print.

©2012 WebMD, LLC. All Rights Reserved.

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Options Increasing for Coping With Kids' Food Allergies

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By Serena Gordon
HealthDay Reporter

FRIDAY, Aug. 3 (HealthDay News) -- Kids with a serious food allergy generally have to steer clear of the offending food, but methods now under development could change that common scenario.

More than 3 million American youths -- about one of every 25 -- have a food allergy of some sort, usually to milk, eggs or peanuts, according to U.S. government statistics. For them, "avoidance has been the mainstay of treatment for a long time," said Dr. William Silvers, an allergist in private practice in Vail, Colo., and a spokesman for the American College of Allergy, Asthma and Immunology.

"Now what we're seeing is an increased interest in oral immunotherapy," Silvers said. "This means giving small and slowly increased doses orally of foods that children are allergic to, and building up the amount ingested over time to desensitize the child to the food so they can tolerate it."

That doesn't come string-free, though. Dr. Carla Davis, an allergist at Texas Children's Hospital in Houston, noted that once children have been desensitized to a certain food, they have to continue eating it regularly or they'll become allergic to the food again.

"There isn't a maintenance of tolerance if you avoid the foods," she explained.

Along with desensitization, another potential new treatment for food allergies is a drug called omalizumab (Xolair). Silvers said that it works by blocking the activity of the allergy-causing substance known as immunoglobulin E (IgE) so that an allergic reaction never starts.

However, the food allergy would come back if a person were to stop using the drug, which is currently available only in an injectable form and has not been approved by the U.S. Food and Drug Administration for use in children younger than 12.

Some researchers, though, think that a combination of the two treatments might be better than either alone. Early reports from a very small study found that nine of 11 children who were given Xolair and then desensitized to milk were able to consume up to 12 ounces of dairy a day without a reaction.

Davis said that researchers also are testing herbal formulations and that one particular combination of nine herbs was able to prevent a serious allergic reaction, known as anaphylaxis, in mice. "It's another one of the treatments that may be up-and-coming," she said, though there's no evidence in humans yet.

What has been proven true, though, is that many kids simply outgrow their food allergies, even some of the most deadly ones. Davis said that as many as one in five youngsters may outgrow an allergy to peanuts but that allergies to eggs, milk, soy and wheat are most often outgrown. In general, peanuts, tree nuts and seafood allergies tend to stay with children as they grow, she said.

To know whether a child has outgrown a food allergy requires repeated skin and blood tests, Silvers said. "If IgE levels in the blood decrease over time, or if skin testing comes back negative or a very small reaction, a child or adult can be given a food challenge to see if they'll react," he said.

To be safe, though, the testing "must be done under a physician's supervision," Davis said, because a serious reaction could occur if the youngster has not outgrown the allergy.

For kids with lingering food allergies, Silvers recommended that the child or parent always carry the antihistamine Benadryl and an epinephrine injection pen. If it's suspected that the child accidentally ingested an allergy-inducing food, the youngster should take the antihistamine right away. If the allergic reaction worsens, administer the epinephrine and get to an emergency room as quickly as possible.

It's important to go to the hospital after a serious allergic reaction, Davis said, because there can be a second wave to the reaction about four to six hours later.

Many children have their own epinephrine pens at their school nurse's office. In Chicago, the public school system recently decided to take the next step and keep a supply of epinephrine pens in every school, and train school personnel in their use, so that they're prepared for any serious allergic reactions.

"This is a good idea because about one in five children have their first serious reaction in school," Davis said.

For those living with food allergies, Davis said, it's important to find a balance between being vigilant and being overanxious. Parents should be "prepared for a reaction, but shouldn't expect one all the time," she said. "Some parents become extremely anxious about the contact their child may have with food. Health vigilance is important, but so is quality of life."

Copyright © 2012 HealthDay. All rights reserved. SOURCES: Carla Davis, M.D., assistant professor, pediatrics, section of allergy and immunology, department of pediatrics, Texas Children's Hospital, Houston; William Silvers, M.D., allergist, Allergy Asthma Colorado, Vail, Colo.

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Onions recalls continue

Listeria in onions Cut salads, Salsas, triggers, like zaniki, more

By Daniel J. DeNoon
WebMD Health News

Reviewed by Louise Chang, MD

2 Aug. 2012--tons of ready-to-eat foodstuffs and ready to cook have been recalled because of listeria in plant onions California.

Gillis onions Oxnard, Calif., processes more than 90 000 tonnes of red and yellow onions per year. A wide range of products, which the plant chopped, slivered and peeled onions.

How many products? After the July 25 announcement reminds flood gills develop earlier references to include all the onions made in the establishment. On 2 Aug. was at least 15 separate recalls involving major brands like Trader Joe 's, whole foods, Wegmans, and Publix.

Foods containing onions fresh chicken salad ranged from salsa to the bean dip. All references, including a description of all the products, sales dates and product codes are available on the FDA web site.

Although the gills onions were sold only in 12 u.s. States and in Canada, products containing onions were sent to additional countries. For example, the appeal yesterday's Garden-fresh salads, salsa, beans, slaw and onion dip products containing gills on the 14 States Stronger…. Nine of these countries were not included in the appeal, the gills.

The appeal began on July 18, the day after a random test bag of yellow onions in the gills in the retail sales showed listeria bacteria. Gills, immediately closed its plant on 17 July as the only recognized studies the FDA. After finding the object, the company voluntarily listeria expanded its withdrawal. The plant remains closed.

Not yet have been linked to diseases of withdrawn products. Many, but not all the withdrawn products have reached their sell-by date. Gill says that its products are of relevance of the 16-day.

Serious cases of Listeriosis-listeria infection---are relatively rare. People at high risk are the elderly and people with weakened immune system. Pregnant women usually do not get a serious illness of the same, but the infection can cause miscarriage, abortion, premature infant infections or critical.

People from listeria food poisoning usually decreased with the case of diarrhea, often with fever. Over days or weeks, may develop more severe symptoms: fever, stiff neck, confusion, weakness of muscles or vomiting.

Although the symptoms may appear as soon as possible after three days after eating contaminated food, the Symptoms usually appear within one to three weeks. However, some people become ill two months after eating contaminated food.

Sources: FDA web site. The CDC web site. Gills onions web site. Releases, FDA. Releases, gills onions.

© 2012 WebMD, LLC. All rights reserved.

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Options for increasing the coping with allergies Kids

By Serena Gordon
HealthDay Reporter

FRIDAY, Aug. 3, HealthDay News)--Children with a food allergy, a serious violation of the food, but usually have to methods currently in the process of development can change the common scenario.

More than 3 million young American,--approximately one of every 25--have an allergy of a particular type, usually for milk, eggs or peanuts, according to U.S. Government statistics. For them, "avoiding was the mainstay of treatment for a long time," said Dr. William Silvers, an allergist in private practice in Vail, Colorado, Idaho and spokesman, the American College of Allergy, asthma and Immunology.

"Now what we see is the increased interest in oral Immunotherapy," silvers said. "This means giving oral small and slowly increased doses of the food, which children are allergic to and building of the amount ingested food at time to desensitize the child so they sabotage."

That does not come from a string of slow, though. Dr. Carla Davis, allergist in the Texas children's Hospital in Houston, noted that after the children have been desensitized to certain foods, must continue to eat them regularly or they will again, allergic to food.

"No maintenance of tolerance If you avoid the food," she explained.

Together with the Desensitization of another potential new treatment for food allergies is omalizumab (Xolair) drug named. Silvers said that works by blocking the activity of substances that cause allergies known as immunoglobulin E (IgE) Allergic reactions, so will never be started.

However, the Allergy would come again if the person stop using the drug, which is currently only available in the form of inject and have not been previously approved by the U.S. Food and Drug Administration for use in children younger than 12.

Some scholars, however, believe that the combination of the two treatments may be better than either alone. The first test reports were very small, said that nine of the 11 children who were given Xolair and then desensitized to milk could exploit to 12 ounces of dairy per day without reaction.

Davis said that researchers are also testing herbal preparations and this one a combination of nine herbs was able to prevent serious allergic reactions known as Anaphylaxis, in mice. "Is another treatment, which may be their", she said, although as yet there is evidence in humans.

What was true, however, that many children simply expanded their food allergies, even some of the most deadly of these. Davis said that one in five of the discounts they can overcome the allergic to peanuts, but no longer meet the requirements that allergies to eggs, milk, soy and wheat are the most common enterprise. The tree generally peanuts, nuts and seafood allergies usually stay with the children, as they grow, said.

To know whether a child has a firm no longer complies with the requirements of the food allergies requires repeated skin and blood tests, silvers said. "If the IgE levels in the blood decrease in time, or if the skin comes back negative or very small response, child or adult may be given food challenge to see if you respond," he said.

To be certain, though the study "must be done under the supervision of a physician," Davis said, because of serious reaction can occur if the House Bunny is not no longer complies with the requirements of companies of allergies.

For children with food allergies lingering silver medals recommended that the child or parent will always have the antihistamine Benadryl and Epinephrine injection Pen. If it is suspected that the child inadvertently ingested food that causes allergies, House Bunny should be taken immediately antihistamine. If it worsens, administer epinephrine and allergic reactions for the emergency room as soon as possible.

It is important to go to the hospital after a serious allergic reactions, Davis said, because it may be the second wave reaction approximately four to six hours later.

Many children have their own pen, Epinephrine in the Office of their school nurse. In the Chicago public school system recently decided to take the next step and keep the supply of Epinephrine pens in each school and train school staff in their use, so that it is prepared to any serious allergic reactions.

"This is a good idea, because their first serious response is approximately one in five children in school," Davis said.

For those living with food allergies Davis said, it is important to find the balance between being vigilant and overanxious. Parents should be "prepared to respond, but you should not expect one all the time," she said. "Some parents are extremely anxious to contact their child may have with food. Health vigilance is important, but so is the quality of life. "

Copyright © 2012 HealthDay. All rights reserved. SOURCE: Carla Davis, M.D., Assistant Professor, Pediatrics, Allergy and Immunology section, Department of Pediatrics, Texas children's Hospital, Houston; William Silvers, M.D., an allergist, Allergy Asthma Colorado, Vail, Santiago.

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Health Tip: Protect Your Child in Extreme Heat

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(HealthDay News) -- Extreme heat can make people sick, especially children. That's why parents should be prepared to get overheated kids out of the hot sun and into an air-conditioned building.

The American Academy of Pediatricians offers this advice:

If your home isn't air conditioned, visit a pubic building such as a library.Encourage your child to drink plenty of fluids all day long. Offer a drink before your child asks for one.Allow more naps and rest time than usual, as heat can make children feel tired.Have your child take a cool bath.Don't ever leave your child inside a hot car.

-- Diana Kohnle Copyright © 2012 HealthDay. All rights reserved.

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Modest weight loss can benefit long-term health

THURSDAY, Aug. 2 HealthDay News)--even modest weight loss can include the overweight and obese important health benefits worth a decade, according to new research.

Study included 3,000 people overweight impaired glucose tolerance--a condition of pre-diabetic--who demonstrated how to change their behavior instead of the recommended drugs.

Behavioral strategies used by participants to help them with everything turned on weight maintenance, reducing the amount they ate unhealthy food, kept in their home and increase their amount of physical activity.

Even modest weight loss--an average of 14 pounds--reduced the risk of type 2 diabetes by 58%. Weight loss and health benefits lasted for 10 years, even if the people regain the weight, "said study Author Rena Wing, a Professor of Psychiatry and human behavior at Brown University in Providence, R.I.

The test is scheduled for presentation Thursday at the American Psychological Association annual meeting in Orlando, Fla file.

"Help people find ways of changing their eating and activity behaviors and develop intervention other than medication to strengthen healthy lifestyles have made a huge difference in preventing one of the health problems in this country," Wing, who is also Director of the weight control and Diabetes Research Center at the Miriam Hospital in Providence, said in a news release.

"Weight loss of only 10 percent of body weight a person ... have also been shown the long-term impact on team sleep, sleep, hypertension and the quality of life and to release the decrease in mobility that occurs with age," she noted.

Wing is currently a study of 13 years 5000 people with type 2 diabetes to determine whether intensive behavioral intervention can reduce the risk of heart disease and heart.

"We want to show that behavior change not only creates healthier reduce risk factors for heart disease, but actually can make them live longer," she said.

Because the study was presented at the meeting of the medical data and conclusions should be seen as a preliminary to the time of publication in peer-reviewed Journal.

--Robert Preidt Copyright © 2012 HealthDay. All rights reserved. Source: American Psychological Association, news release, Aug. 2, 2012

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Some Improvement in Heart Risk Factors for Americans: CDC

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By Steven Reinberg
HealthDay Reporter

FRIDAY, Aug. 3 (HealthDay News) -- About 47 percent of American adults have at least one risk factor for heart disease, according to a new report released Friday.

These risk factors include uncontrolled high blood pressure, uncontrolled high levels of "bad" LDL cholesterol and smoking, according to the U.S. Centers for Disease Control and Prevention.

"We have seen declines [in risk factors], but there's still work to be done," said the report's lead author, CDC health statistician Cheryl Fryar.

Findings of the report, culled from data gathered from the U.S. National Health and Nutrition Examination Survey, included:

A drop in the rate of adults with at least one risk factor from 58 percent in 1999 to 46.5 percent in 2010.Men (52 percent) are more likely than women (41 percent) to have one of these risk factors.From 1999 to 2010, there was a drop in the percentage of whites and Mexican Americans who had at least one risk factor (about 47 percent and 45 percent respectively).There was no decline in the percentage of blacks with these risk factors, which remained at 58 percent.The prevalence of uncontrolled high blood pressure and uncontrolled high LDL cholesterol dropped between 1999 and 2010 (almost 8 percent and 9 percent, respectively).There was no drop in the percentage of adult cigarette smokers, which remained at 25 percent of adults 20 and older.Disparities remain among people of different income levels and racial and ethnic groups.

"Cardiovascular disease and stroke are largely preventable, with uncontrolled high blood pressure, uncontrolled high LDL cholesterol levels and smoking representing major modifiable risk factors in men and women of all racial and ethnic groups and all income levels," said Dr. Gregg Fonarow, spokesman for the American Heart Association and professor of cardiovascular medicine at the University of California, Los Angeles.

"It is concerning that some of the early gains in lowering the rates of uncontrolled high LDL cholesterol appeared heading in the wrong direction in 2009 and 2010," Fonarow said. "This may represent recent misguided efforts to discredit the substantial cardiovascular benefits of LDL-lowering therapy."

The report found that there are significant disparities in risk factors by age, sex, race and income levels, Fonarow noted.

"African Americans and those with incomes of less than 130 percent of the poverty level had higher prevalence of risk factors and made less progress over the study period," he said. "The reasons behind these disparities in risk factor control are likely complex, but deserving of further study."

"Substantially increased efforts to reduce or eliminate these uncontrolled cardiovascular disease and stroke risk factors at the individual, community, national and global level are clearly needed," Fonarow added.

Reasons for the stalled decline in smoking rates are not clear. Possible explanations include less money spent by states on antismoking campaigns and more advertising dollars spent by tobacco companies.

The CDC recently launched a campaign of graphic ads to get smokers to quit. Early results indicate the campaign is working.

"We have to have sustained efforts like this if we are going to have an impact on decreasing the number of smokers in this country," Dr. Len Lichtenfeld, deputy chief medical officer at the American Cancer Society, said at the time of the campaign's launch. "One of the sad facts is that although we had success a number of years ago in getting people to stop smoking, we have hit a roadblock where 20 percent of Americans still smoke."

One of the major problems is that tobacco companies easily outspend the government's efforts to curb smoking with vast sums devoted to promoting their products, Lichtenfeld said.

Copyright © 2012 HealthDay. All rights reserved. SOURCES: Cheryl Fryar, M.S.P.H., U.S. Centers for Disease Control and Prevention; Gregg Fonarow, M.D., spokesman, American Heart Association, professor, cardiovascular medicine, University of California, Los Angeles; Aug. 3, 2012, report, Prevalence of Uncontrolled Risk Factors for Cardiovascular Disease: United States, 1999-2010

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