Common

health

Skin Symptoms Common in COVID ‘Long-Haulers’

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

A small subset of SARS-CoV-2 patients with “COVID toes” can be categorized as COVID long-haulers, with skin symptoms sometimes enduring for more than 150 days, a new analysis revealed.

Evaluating data from an international registry of COVID-19 patients with dermatologic symptoms, researchers found that retiform purpura rashes are linked to severe COVID-19, with 100% of these patients requiring hospitalization and 82% experiencing acute respiratory distress syndrome (ARDS).

Meanwhile, pernio/chilblains rashes, dubbed “COVID toes,” are associated with milder disease and a 16% hospitalization rate. For all COVID-related skin symptoms, the average duration is 12 days.

“The skin is another organ system that we didn’t know could have long COVID” effects, said principal investigator Esther Freeman, MD, PhD, from Massachusetts General Hospital and Harvard Medical School in Boston.



Dr Esther Freeman

“The skin is really a window into how the body is working overall, so the fact that we could visually see persistent inflammation in long-hauler patients is particularly fascinating and gives us a chance to explore what’s going on,” Freeman told Medscape Medical News. “It certainly makes sense to me, knowing what we know about other organ systems, that there might be some long-lasting inflammation” in the skin as well.

The study is a result of the collaboration between the American Academy of Dermatology and the International League of Dermatological Societies, the international registry launched this past April. While the study included provider-supplied data from 990 cases spanning 39 countries, the registry now encompasses more than 1000 patients from 41 countries, Freeman noted.

Freeman presented the data at the virtual 29th European Academy of Dermatology and Venereology (EADV) Congress.

Many studies have reported dermatologic effects of COVID-19 infection, she said, but information was lacking about duration. The registry represents the largest dataset to date detailing these persistent skin symptoms and offers insight about how COVID-19 can affect many different organ systems even after patients recover from acute infection, Freeman said.

Eight different types of skin rashes were noted in the study group, of which 303 were lab-confirmed or suspected COVID-19 patients with skin symptoms. Of those, 224 total cases and 90 lab-confirmed cases included information on how long skin symptoms lasted. Lab tests for SARS-CoV-2 included PCR and serum antibody assays.

Freeman and her team defined “long haulers” as patients with dermatologic symptoms of COVID-19 lasting 60 days or longer. These “outliers” are likely more prevalent than the registry suggests, she said, since not all providers initially reporting skin symptoms in patients updated that information over time.

“It’s important to understand that the registry is probably significantly underreporting the duration of symptoms and number of long-hauler patients,” she explained. “A registry is often a glimpse into a moment in time to these patients. To combat that, we followed up by email twice with providers to ask if patients’ symptoms were still ongoing or completed.”

Results showed a wide spectrum in average duration of symptoms among lab-confirmed

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fitness

The Top 10 Health & Fitness Apps Of 2020 Have One Thing In Common (Mostly)

Health and fitness apps are winning the Covid-19 era, thanks to closed gyms. But a certain kind of health and fitness app is winning mobile, according to a new report from Apptopia.

“Six out of ten of the top Health & Fitness apps are apps that offer video workouts or video-guided exercises,” Apptopia says. “If non-workout apps like Calm, Headspace, and Flo were not included here, the ratio of video to non-video fitness apps would be even greater.”

Indeed.

Listen to this story on the TechFirst podcast:

Without those wellness apps, six of the top seven fitness apps include video components. Which says something about fitness in the Coronavirus era.

The top 10 health and fitness apps in the U.S. by downloads in the first half of 2020, according to Apptopia, are:

  1. Calm: 8.6 million installs
  2. Fitbit: 4.8 million installs
  3. MyFitnessPal: 3.9 million installs
  4. Headspace: 3.8 million installs
  5. Flo: 3.6 million installs
  6. Muscle Booster Workout: 3.4 million installs
  7. BetterMe: 3.2 million installs
  8. Fitness Coach: 2.9 million installs
  9. Samsung Health: 2.8 million installs
  10. Home Workout – No Equipment: 2.7 million installs

Video workout apps got 65% more downloads than non-video-based workout apps, Apptopia says. What’s more, they had almost 40% more daily active users, and generated 15% more revenue.

MORE FROM FORBES7 Key Differences Between Fitbit Sense And Apple Watch

The United States led the world in fitness and health app installs so far in 2020, with 146% more app downloads than India, and almost 300% more than Brazil or Russia. 64% of us are spending more time in fitness apps than we were last year, according to the report.

One caveat about this data: Chinese mobile app installs are typically not well-represented in mobile analytics companies’ data, since Google Play is not available in China, and many Chinese consumers install apps from a wide range of mobile app stores.

When you just look at video fitness apps, Fitbit’s app is a clear winner.

The Fitbit app has the most installs, the highest number of daily active users, and ranks fourth in in-app purchase revenue at $4.4 million, according to Apptopia. Video is a core part of the Fitbit app, which also has a premium version.

Fitbit is about to experience increased competition, however, as Amazon has started a paid subscription health service paired with its Halo Band and Apple has announced Fitness+, which will include personalized workouts and recommendations in nine categories and “world-class trainers.”

It’s always a good time to be fit.

And while now appears to be a particularly bad time to be an in-person gym, it also seems to be a good time to have a next-generation video-based fitness app.

The full report is available here.

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health

Study: Loss of smell in COVID-19 far more common than thought

Loss of smell is common in COVID-19, but fewer people say they have this symptom than objective tests reveal, a new study finds.

In fact, about 77% of COVID-19 patients who were directly measured had smell loss, but only 44% said they did, researchers found.

Direct measures of smell involve having patients smell and report on actual odors, while self-reporting includes getting data through patient questionnaires, interviews or electronic health records, the study authors explained.

“Objective measures are a more sensitive method to identify smell loss related to COVID-19,” said study co-author Mackenzie Hannum, a postdoctoral fellow at Monell Chemical Senses Center in Philadelphia.

Subjective measures, “while expedient during the early stages of the pandemic, underestimate the true prevalence of smell loss,” said Vicente Ramirez, a doctoral student at the University of California, Merced, and summer intern at Monell.

The research suggests subjective measures underestimate the true extent of smell loss and that it may be an effective tool for diagnosing COVID-19 early, the authors said in a Monell news release.

For the study, the researchers reviewed previously published studies on COVID-19 and loss of smell.

Their findings were published online recently in the journal Chemical Senses.

Senior author Danielle Reed, associate director at Monell, suggested that “measuring people for smell loss may become as routine as measuring body temperature for fever.”

More information

For more on COVID-19, head to the U.S. Centers for Disease Control and Prevention.

Copyright 2020 HealthDay. All rights reserved.

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dentist

Dentist dispels common MYTHS that may be putting you off going fora check-up

One of the most common reasons people fear the dentist is from horror stories that have spread through the gripe vine.

Dentist Dr Safa Al-Naher, who works at The Care Dental Practice and Care Dental Platinum in Hammersmith, West London, which specialises in the treatment of nervous patients, has debunked several myths that may be putting you off booking a check-up. 

Speaking exclusively to FEMAIL, Dr Safa, who provides treatments as well as facial aesthetics to those who normally struggle with fear, has explained why going to the dentist shouldn’t be ‘scary’ – adding that the professionals are not ‘money grabbers’ – despite what people may think. 

The expert has also offered her top tips to overcome fears of going to the dentist – including seeing a therapist to help you talk through your phobias or trying Cognitive Behavioural Therapy.

Dentist Dr Safa Al-Naher, who works at The Care Dental Practice and Care Dental Platinum in Hammersmith, West London, has debunked common misconceptions about dentists and treatment. Pictured, stock image

Dentist Dr Safa Al-Naher, who works at The Care Dental Practice and Care Dental Platinum in Hammersmith, West London, has debunked common misconceptions about dentists and treatment. Pictured, stock image

1. GOING TO THE DENTIST IS SCARY

This is a completely understandable fear that many people have, and most of the time dental anxiety and phobias are a result of a particularly bad past experience. 

Dentists know this and are highly trained in the psychology of dental phobias, how to spot them, and how to manage them. 

Dentists receive experience in sedation and the management of nervous patients during their university training. 

No two dental phobias are the same, and they range in severity, triggers and experiences. 

Most people are afraid of pain, but other reasons for being afraid of the dentist include the feeling of loss of control, the fear of being told off and the various sounds and smells inside a dental practice. 

Making an appointment and turning up is often the first step and usually an in-depth discussion takes place about what your problems are, what you would like to achieve and whether they are able to help you or need to refer you to someone who can.  

2. PATIENT CAN’T GET OVER BAD EXPERIENCE THEY HAD AS A CHILD 

This is the most common cause of dental phobias that we treat. As a child you don’t understand strange situations and cannot rationalise that sometimes it is necessary to experience pain for the greater good, so you develop an irrational fear of certain aspects of visiting the dentist. 

There are many ways this can be addressed. The simplest way is by many small visits and discussions about your fears, and slowly becoming more familiar and comfortable with the dental environment and treatment. 

Dr Safa Al-Naher (pictured), is a Dentist and Facial Aesthetics Practitioner and Trainer, and is Clinical Lead at her family-run dental clinics - The Care Dental Practice and Care Dental Platinum in Hammersmith, West London

Dr Safa Al-Naher (pictured), is a Dentist and Facial Aesthetics Practitioner and Trainer, and is Clinical Lead at her family-run dental clinics – The Care Dental Practice and Care Dental Platinum in Hammersmith, West London

This is a form of Cognitive Behavioural Therapy, and hypnosis with a registered Hypnotherapist can also help. 

You can have dental sedation with ‘happy air’ or nitrous oxide sedation,

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health

Older adults using marijuana for common health problems, survey shows

Marijuana is fast becoming a favorite medication among older Americans, a new study finds.

Cannabis is being used to ease problems such as pain, sleep disturbances and psychiatric conditions like anxiety and depression, researchers say.

Among more than 550 patients surveyed, 15% had used cannabis within the past three years, and 50% of users said they used it regularly and mostly for medical purposes.

“Pain, insomnia and anxiety were the most common reasons for cannabis use and, for the most part, patients reported that cannabis was helping to address these issues, especially with insomnia and pain,” said researcher Christopher Kaufmann. He’s an assistant professor in the Division of Geriatrics and Gerontology in the Department of Medicine at the University of California, San Diego.

Also, 61% of the patients who used cannabis had started using it after age 60.

“Surprisingly, we found that nearly three-fifths of cannabis users reported using cannabis for the first time as older adults. These individuals were a unique group compared to those who used cannabis in the past,” said researcher Kevin Yang, a third-year medical student at UCSD.

“New users were more likely to use cannabis for medical reasons than for recreation. The route of cannabis use also differed with new users more likely to use it topically as a lotion rather than by smoking or ingesting as edibles. Also, they were more likely to inform their doctor about their cannabis use, which reflects that cannabis use is no longer as stigmatized as it was previously,” Yang said in a university news release.

The report was published online recently in the Journal of the American Geriatrics Society.

“There seems to be potential with cannabis, but we need more evidence-based research,” Kaufmann added. “We want to find out how cannabis compares to current medications available. Could cannabis be a safer alternative to treatments, such as opioids and benzodiazepines? Could cannabis help reduce the simultaneous use of multiple medications in older persons?

“We want to find out which conditions cannabis is most effective in treating,” Kaufmann said in the release. “Only then can we better counsel older adults on cannabis use.”

More information

Harvard University has more on medical marijuana.

Copyright 2020 HealthDay. All rights reserved.

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health

Scientists Failed to Use Common Sense Early in the Pandemic

As a scientist and historian of science, I get asked a lot by friends and family to comment on scientific questions. Are vaccines safe? Is red meat bad for you? How much time do we have left to fix climate change? Many of these matters are not nearly as complicated as they have sometimes been made out to be. Vaccination is broadly safe for most people; eating large amounts of red meat is associated with higher rates of death from a number of cancers; and scientists think we have about a decade left to get greenhouse gas emissions under control and avoid the worst consequences.

Lately nearly all the questions involve COVID-19—particularly the matter of masks. The argument for wearing them is pretty straightforward: viruses are spread in droplets, which are expelled when an infected person talks, shouts, sings or just breathes. A properly constructed and fitted mask can prevent the spread of those droplets and therefore the spread of the virus. That is why surgeons have been routinely wearing medical-grade masks since the 1960s (and many doctors and nurses wore cloth masks long before then). It is also why in many parts of Asia, people routinely wear masks in public. A flimsy or poorly fitting face covering may not be much use, but—barring the risk of generating a false sense of security—it is unlikely to do harm. So it stands to reason that, when in public, most people should wear masks. The U.S. Centers for Disease Control and Prevention summarizes: “Masks are recommended as a simple barrier to help prevent respiratory droplets from traveling into the air…. This is called source control.”

So why are people confused? One reason is that we have been getting conflicting messages. In April the World Health Organization told the general public not to mask, while the CDC told us we should. In June the WHO adjusted its guidance to say that the general public should wear nonmedical masks where there was widespread community transmission and physical distancing was difficult. Meanwhile CDC director Robert R. Redfield declared that “cloth face coverings are one of the most powerful weapons we have to slow and stop the spread of the virus—particularly when used universally.” Today government guidance around the globe varies from masks only for sick people to masks mandatory for all.

Why the contradictory messaging? In particular, why did the WHO say in April not to wear masks? At the time, there was a severe shortage of personal protective equipment; the WHO evidently feared that ordinary people would rush out to buy masks, denying them to medical personnel. According to one report, officials were also concerned that widespread masking would lead to a false sense of security, leading people to ignore other safety measures, such as handwashing and self-isolation.

If the WHO had simply said this, there would have been a lot less confusion. But apparently there was another problem. At the time, no direct evidence existed regarding community spread of this particular virus, and

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fitness

Two Virtual Trainers Share The Most Common Home Fitness Mistakes

The at-home fitness industry has had an explosive year. Dumbells are sold out at major retailers, fitness streaming apps are reporting record memberships, and luxe gyms are sailing on troubled waters. All signs indicate that yoga mats on living room floors could be a mainstay for a new wave of fitness enthusiasts finding their groove during the pandemic.

Taking the matter of personal fitness into your own hands is certainly more cost effective—and these days, poses a lower risk of COVID-19 exposure than venturing into your gym. But if you’ve recently had your first foray into home fitness, there’s also a bit of a learning curve. Certain mistakes can inhibit or prolong results, cause muscle strain, or even lead to injury. So ahead, two group fitness instructors from Obé Fitness—Walter Kemp and Alex Scolari—share the most common at-home fitness mistakes they see among trainees.

Failure to Devise a Consistent (and Varied) Workout Schedule

Both trainers agree that consistency is key. In order to optimize results, you should devise a workout schedule that features a variety of workout types and targeted muscle groups—then stick to it. “Don’t let your body get too comfortable; challenge yourself and mix things up,” says Scolari. “Varying workouts will help you target your full body.” If you’re on a five workouts per week schedule, Kemp recommends scheduling in three full body classes, plus two classes that target specific muscle groups. For example, you might complete a 30 minute HIIT class three days a week, then a targeted arms class one day and a targeted abs class another day.

Skipping Rest Days

Recovery is an often overlooked part of a balanced fitness routine. “Recovery is a key aspect of training. I’d say it’s the key aspect of training,” says Kemp. “You aren’t gaining muscle or losing fat in the gym or after all your grueling at home workouts. It [happens during] your recovery process. Proper sleep and adequate protein, water, mineral, and vitamin intake are vital for not only changing one’s physique but keeping your body strong and resilient.” Scolari echoes this sentiment, but notes that a rest day doesn’t mean spending the day on the couch. Scolari works out five days a week, then uses the remaining two days to take a restorative yoga class or long walk as her recovery days.

Disregarding Nutrition

While it can be tempting to indulge after a tough workout, Kemp underscores the importance of fueling your body properly in conjunction with your fitness routine. “Movement and effort is great, but follow that up with general lethargy and a poor diet after every workout and you have a recipe for not achieving your goals,” he says.

Skipping a Warm-Up to Save Time

According to Kemp, skipping a warm-up is one of the most common home fitness mistakes that leads to injury. “You have to get the blood flowing to the areas of your body that are about to endure the stress you’re going to give to your body during

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dentist

Dentist Dr. Frank Roach Atlanta Explains the Field’s Most Common Area of Practice, Centered Around Preventive and Restorative Care

Press release content from Accesswire. The AP news staff was not involved in its creation.

ATLANTA, GA / ACCESSWIRE / October 9, 2020 / Focused on preventive and restorative services intended to promote optimum oral health, general dentists make up more than two-thirds of the profession. A popular dentist based in the so-called Peach State of Georgia, Dr. Frank Roach Atlanta explains more about the field.

“Often I’m asked, ‘What is general dentistry?’” says Dr. Frank Roach Atlanta, speaking from his office in the Gwinnett County city of Norcross.

According to Dr. Frank Roach Atlanta, as many as 80 percent of all qualified individuals-those using their dental degree in some fashion-in the United States are considered general dentists. “Distinct from those who are focused primarily on one area of dental practice, such as periodontics, general dentists handle an array of different services, vital to the continued oral health of their patients,” he explains.

The general dentistry field, Dr. Frank Roach Atlanta goes on to illustrate, primarily covers preventive and restorative services. “General dentists may also take care of cosmetic procedures,” adds the expert, “as well as overall health concerns, such as in the case of obstructive sleep apnea.”

For many people, the one healthcare provider that they see more than any other is their dentist. Invariably, this will be a general dentist, says Dr. Frank Roach Atlanta. “As general dentists, we are the primary providers of dental care to patients of all ages,” he points out.

Routine visits, Dr. Frank Roach Atlanta suggests, to a family dentist, are the most common occurrence in a general dentistry practice, followed by professional cleaning, and, in the presence of decay, the process of filling an affected tooth.

The majority of patients are advised, Dr. Roach says, to visit their dentist at regular intervals to keep their pearly whites in tip-top condition. “Anywhere from quarterly to once or twice per year should be the norm for a typical patient,” proposes Dr. Frank Roach Atlanta, “although a quick conversation with your chosen dentist will provide a more concrete idea.”

All general dentists, Dr. Frank Roach Atlanta reports, have successfully completed four years of education at an accredited dental school. “They will also have fulfilled the requirements of their local state licensing board,” he explains, “including testing and, in some instances, continuing education.”

Proudly practicing dentistry for more than two decades, Dr. Frank Roach is based in the Atlanta-Sandy Springs-Marietta metropolitan statistical area city of Norcross. Norcross, in turn, is located in Gwinnett County – a suburban county of Atlanta in the north-central portion of Georgia. Home to almost a million people, Gwinnett County is the second-most populous in the so-called Peach State after Fulton County.

In addition to general dentistry, Dr. Frank Roach Atlanta also focuses on dental implants, veneers, and teeth whitening, among a number of other services. In his spare time, Dr. Roach is a keen scuba diver, an avid tennis player, and is the proud guardian

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