health

Electric Blankets May Be Cozy, but They Can Be Dangerous

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | May 22nd, 2019

Dear Doctor: My wife and I sleep with an electric blanket for heat. Is there a health hazard in using it too long at night?

Dear Reader: Considering the extreme weather that froze wide swaths of the nation this past winter -- including many usually temperate areas -- it’s not surprising to learn that electric blankets have been pressed into service. Your question about safety of the devices echoes the concerns of many readers.

One of the potential risks of using electric blankets is inadvertently overheating the body. Electric bedding should never be used for an infant or someone who is immobile.

Certain medical conditions, including diabetes, can result in neuropathy, which arises from damage to the peripheral nerves. Neuropathy causes pain, tingling and prickling sensations, most commonly in the feet and hands. It can also result in numbness. Any of these symptoms can have the net effect of interfering with an individual’s sensitivity to heat, particularly while sleeping. This makes it possible to become overheated while sleeping with an electric blanket, or even suffer burns in areas of direct contact with the appliance. While there have been several reports over the years of heat stroke deaths caused by elevated core body temperatures due sleeping with an electric blanket, these are exceedingly rare.

Less dramatic but still important is the potential for heated blankets to affect sleep. Numerous studies over the decades have shown that our core body temperature drops a few degrees as we sleep. Lower body temperature has also been linked to a faster onset and better quality of sleep. By creating a continuously heated environment, electric blankets may interfere with the body’s nocturnal temperature cycles, thus interfering with sleep.

The topic that seems to generate the most controversy about electric blankets is the question of electromagnetic fields, or EMFs. These are areas of energy that are present in the natural world as well as in the man-made one. In the built world, EMFs are generated by power lines, the electric wiring within a home, wireless communication devices and equipment, and electrical appliances, including the electric blanket. The concern is that, because our bodies generate billions of tiny electrical impulses that are capable of being influenced by external EMFs, exposure may present a health hazard. Although the issue continues to generate numerous studies and an ocean of ink with impassioned arguments on both sides, a definitive conclusion has not yet been reached.

One potential compromise is to use the electric blanket to preheat the bed. Turn it on an hour or so before you retire for the night, and turn it off before getting into bed. With a snug and cozy start to the night, we think you’ll find a few layers of quilts and blankets will keep you warm until morning. In the meantime, if you do use an electric blanket, be sure it’s in good working order. Address any potential tripping hazards presented by the controls and wires, and follow the manufacturer’s directions regarding placement, maintenance and cleaning.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Cellulitis Is a Common but Serious Condition

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | May 20th, 2019

Dear Doctor: It took visiting four different doctors to get an accurate diagnosis of cellulitis. From what I've read, that’s pretty common. There are many troubling things about it, including recurrence. Would you please cover it in your column?

Dear Reader: Cellulitis is a condition that occurs when bacteria find a way into the deeper layers of the skin and the layer of fat just beneath them, causing a spreading infection. (And to be clear, this has nothing to do with cellulite, a term for areas of skin that appear lumpy or dimpled due to subcutaneous fat distribution.)

Most often, cellulitis is caused by the strep or staph bacteria that are naturally present on the skin’s surface. Many other bacteria can cause the condition, too. In cellulitis, bacteria typically enter the body through breaks, cracks, cuts or abrasions to the skin. Conditions such as athlete’s foot, psoriasis, eczema, shingles and even dry skin can also provide entry points. Individuals with lymphedema, which is the buildup of fluid in soft body tissues due to damage or blockage in the lymphatic system, and edema, which is swelling due to excess fluids trapped beneath the skin, are also at higher risk of cellulitis.

While cellulitis can occur anywhere, it is most often seen on the legs and feet. Symptoms often begin with an area of red, tender skin, which usually expands beyond its starting point. Swelling, local warmth and pain, all signs of inflammation, are also common. In some cases, people with cellulitis will respond to the infection with fever, chills, swollen glands or swollen lymph nodes. The condition usually affects only one side of the body at a time.

Although cellulitis can occur in anyone, risk factors for the condition include a weakened immune system, IV drug use and diabetes. The latter is due to two factors. One is diabetic neuropathy, which is damage to the peripheral nerves. Neuropathy results in tingling and numbness, which can make it difficult to be aware of injuries. The other is high blood sugar, which impedes the effectiveness of the immune system.

You’re correct that cellulitis is common. It’s also potentially serious. That’s because if left untreated, the infection can spread to the lymph nodes, bloodstream and deeper tissues of the body. When cellulitis is caught early and treated quickly, it can generally be cleared up without long-term complications.

Treatment consists of antibiotics, as well as measures to reduce swelling and increase circulation. These include compression and elevation to address swelling, and cool compresses, which can help relieve pain and itching. Because some conditions make it more difficult for the body to fend off ongoing or new infections, recurrent episodes of cellulitis can be common. It’s important to always finish the entire course of antibiotics that has been prescribed, even if the infection appears to have cleared up. Keep skin clean and well-moisturized in order to prevent cracks or splits. If signs of a recurrence flare up, see your family doctor right away.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

health

Asthma Medications May Reduce the Risk of Parkinson's

Ask the Doctors by by Eve Glazier, M.D. and Elizabeth Ko, M.D
by Eve Glazier, M.D. and Elizabeth Ko, M.D
Ask the Doctors | May 17th, 2019

Dear Doctor: Can asthma medications really reduce the risk of Parkinson’s disease? It runs in my family, so should I start taking the medications as a preventive?

Dear Reader: A few years ago, research published in the journal Science revealed a surprising property of several drugs, including those that contain compounds known as beta-2 adrenergic agonists. These are found in drugs like salbutamol, also known as albuterol, a bronchodilator used to help open the airways of people with asthma and other respiratory diseases.

The stated goal of the research was to identify any existing drugs or compounds that could diminish or eliminate the presence of alpha-synuclein, a protein that accumulates in the brains of people with Parkinson’s disease. To that end, the team of researchers cultured human nerve cells in the lab and exposed them to more than 1,100 different medications, dietary supplements and vitamins. In the course of their testing, they identified several compounds that interfered with the production of that protein. These included asthma medications that contain beta-2 adrenergic agonists. This suggested that certain asthma meds may have potential in the management of Parkinson’s disease.

Parkinson’s disease is a progressive neurological disorder that affects the areas of the brain that control movement and balance. An estimated 1 million Americans are currently living with the disease. The disease develops gradually and is most often diagnosed in later years, at around age 60 or older. Symptoms can include tremors, slowed movement, muscle stiffness or rigidity, difficulty standing, poor balance, difficulty walking, changes to speech and vocal expression, changes to handwriting and in some cases, loss of cognitive function.

Although it is known that the symptoms of Parkinson’s are linked to changes in the brain that cause certain cells and tissues to malfunction and die, the reason this happens is not yet known. However, scientists have observed a buildup of protein clumps, known as Lewy bodies, in the brains of Parkinson’s patients. It’s because Lewy bodies consist mainly of alpha-synuclein that the researchers we’re discussing began their search for compounds to interfere with that specific protein.

Once the researchers isolated the drugs that interfere with alpha-synuclein, they needed a way to identify asthma patients and their health outcomes. They found what they needed in a database in Norway, which tracks all prescription medications. The researchers selected a group of 600,000 individuals who had used the asthma drug that we in the United States know as albuterol. When they looked at the incidence of Parkinson’s disease among all individuals in the drug database over the course of an 11-year period, it turned out that people who had used albuterol were 30 percent less likely to develop Parkinson’s than those who had never used the asthma medication. Those who used the highest doses of albuterol had half the incidence of Parkinson’s disease, according to the study.

As to your question about using asthma meds as a preventive, the researchers say -- and we wholeheartedly agree -- the answer is no. The origins of Parkinson’s disease are unclear, and the findings from the study are not fully understood. However, this new research is promising and is likely headed to clinical trials. We haven’t heard the last of it.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10880 Wilshire Blvd., Suite 1450, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

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