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2 days ago · FDA To Update Sunscreen Regulations

One in five Americans will develop skin cancer in his or her lifetime, but that risk can be minimized with the use of sunscreen. While sunscreen use has increased over the years, the U.S. Food and Drug Administration (FDA) hasn’t updated some sunscreen requirements in decades. Now, a proposed FDA rule seeks to improve the quality, safety and effectiveness of sunscreens.

Safety of Some Sunscreen Ingredients in Question

The FDA currently lists just two of the existing 16 sunscreen ingredients as safe and effective:  

  • Zinc oxide
  • Titanium dioxide

Under the new rule, two ingredients will no longer be considered safe and effective:

  • PABA (para-aminobenzoic acid), which may not block the damage caused by UV light and may cause skin irritation or inflammation
  • Trolamine salicylate, which may cause nausea, vomiting and ringing in the ears and other negative health effects, such as bleeding

The FDA hasn’t definitively decided whether the 12 remaining ingredients are safe and effective, so the agency has requested additional information through the proposed rule change. In the meantime, choosing sunscreens with zinc oxide or titanium dioxide is the safest choice.

New Options for Sun Protection May be Coming

Some products may be better at filtering UV light and preventing skin cancer. But because they haven’t been through the FDA process, they are not available in the U.S. Instead, they are available to residents of:

  • Canada
  • Australia
  • Japan
  • European countries

As part of the rule change the FDA is accepting comments including the safety and efficacy of potential new over-the-counter sunscreens. Companies who conduct FDA-required testing on newer sunscreens may now get a hearing and go through the FDA process. As a result, Americans may soon gain access to improved sunscreens.

New Sunblock Requirements

The new FDA proposal recommends raising the maximum sun protection factor (SPF) in sunscreen from 50+ to 60+. While this could potentially mean greater protection, the American Academy of Dermatology Association suggests an SPF of 30 will block 98 percent of sun rays.

The proposed new rule has not evaluated wipes and towelettes with sunscreen —instead they will be considered new drugs and have to go through the approval process — but does consider sunscreen safe in these forms:

  • Oils and butters
  • Lotions and creams
  • Gels and pastes
  • Ointments and sticks

The FDA will also require combination sunscreen/insect repellant products to go through the approval process.

The ultraviolet (UV) spectrum contains both UVA (long-wave) and UVB (short-wave) rays. Because skin cancer risks are increased with UVA exposure, the FDA proposes that all sunscreen products with an SPF of 15 or higher now provide broad-spectrum (UVA and UVB) sun protection.  They are considering whether to keep sunscreens with SPF of 2 to 14 available to consumers.

If you want to learn more about skin cancer prevention contact UCLA Dermatology at 310-825-6911. UCLA also offers expert care for people diagnosed with skin cancer in the Melanoma Clinic.

2 days ago · Foundation honors CHD patient Noah Bella Michaelis with gift to UCLA

Noah Bella Michaelis spent 13 years living with health challenges from being born with complex congenital heart defects (CHD) and heterotaxy syndrome. The syndrome involves an abnormal arrangement of internal organs in the chest and abdomen. On January 3, 2017, Noah succumbed to a life-threatening condition she developed, known as plastic bronchitis.

“Noah was unlike anyone I’ve ever known before,” says Cecile Michaelis, Noah’s mother. “Over a period of two years we were at the hospital up to three times a week for eight-hour days of infusions. Not once did she complain. She just knew she couldn’t focus her energy there.”

Instead, Noah chose to give back to other families and children with similar experiences. From 2010 until her passing, Noah raised $100,000 for the Hopeful Hearts Foundation through the “Noah’s Festival of Life” celebration and lemonade stands. 

“When Noah died, I wanted to crawl into a hole and never come out,” says Cecile. “I wondered, ‘What can we do for the rest of our lives?’” I knew giving helped Noah cope and decided we could honor her by also making it our mission to give.”

Cecile and her husband Keith, Noah’s father, started the Live Like Noah Foundation to help create awareness about CHD and to raise funds for CHD-related causes.

Plastic bronchitis: a heart surgery complication

Plastic bronchitis is a life-threatening disorder that occurs in 5 to 10 percent of patients following the Fontan procedure, a heart surgery to correct single-ventricle heart defects. It occurs when lymph fluid builds up and creates rubbery plugs known as casts in the airways. The casts block airways and make breathing difficult, which can lead to respiratory failure.

Noah recovering from her Fontan procedure, a heart surgery to correct single-ventricle heart defects / UCLA Mattel Children’s Hospital

“Even
during times when Noah was relatively healthy, she always had this cough. We
called it Noah’s heart cough,” says Keith. “It was like she needed to clear out
her lungs. In August of 2016, she coughed up something foreign that wasn’t
phlegm, it looked like a bronchial branch from her lung.”

Noah
had coughed up an intact cast. Her parents immediately texted Noah’s doctor,
pediatric cardiologist Daniel S. Levi, MD, with a photo asking, “What
is this?”

“Seeing
this was Dr. Levi’s greatest fear because he knew UCLA couldn’t treat Noah’s plastic
bronchitis,” says Keith. At the time, Children’s Hospital of Philadelphia (CHOP)
was the only center in the world with the expertise and a minimally invasive
procedure to treat the rare condition.

In December
2016, Cecile, Keith and Noah flew from Los Angeles to Philadelphia for
treatment. A five- to six-hour flight with a child in vulnerable health is
challenging. The family had to ensure they had portable oxygen and an extra
battery to ensure they could make the entire flight.

But perhaps the hardest part about going to Philadelphia was leaving Noah’s care team. “Our family had developed such a strong, trusting relationship with Dr. Levi and the pediatric cardiology team at UCLA,” says Cecile. “It was hard to say goodbye and put our faith in a new team.”

Noah
never left CHOP. While the procedure for plastic bronchitis was successful —
her parents say Noah felt amazed at how well she could breathe — her body
wasn’t strong enough to endure complications of recovery.

So when it came time for Cecile to ask, “What can we do for the rest of our lives?” she knew part of her mission would be giving back to the newly established Pediatric Lymphatic Intervention Program at UCLA Mattel Children’s Hospital.

Pediatric lymphatic intervention program at UCLA takes shape

Cecile and Keith worked tirelessly to create the Hike for Noah campaign. They pulled together friends and supporters with strong social networks to raise funds for the lymphatic program. 

The Michaelis’ efforts culminated in a 16-mile hike on February 23, 2019 (16 miles because Noah would have turned 16 this year). The event raised more than $20,000 for the new program. On April 9, they presented the check to Dr. Levi and his team, who will use the funds for training.

The Michaelis present a $20,000 check to Dr. Daniel Levi (far right) and his team

“With
the support from the Live Like Noah Foundation, we are building a lymphatic
program on the West Coast similar to the established program in Philadelphia.
We hope that children like Noah can access care much closer to their homes,”
says Dr. Levi. “The same doctors that treated Noah in Philadelphia are helping
us establish the program at UCLA.”

By establishing the lymphatic program, Dr. Levi feels he is honoring Noah and the many other children who lost their lives to CHD, plastic bronchitis or complications.

“Noah was a really amazing girl,” says UCLA pediatric cardiologist Daniel Levi, MD. “Everyone who met her fell in love with her. She was full of life and through the Festival of Life, she did something meaningful for other kids with heart problems. Our lymphatic program is a way of continuing her efforts.”

Foundation raises awareness for CHD

The
Live Like Noah Foundation is intentional in honoring Noah, right down to every detail.
The foundation’s logo includes the geometric image of a moth — a critter Noah
had a connection with.

“Noah
was a nature lover and always felt the moth was something people looked down
upon,” says Cecile. “She didn’t like that people thought of moths as ugly
butterflies because she thought they had inner beauty. I suspect she saw
herself in the moth. She knew she was different and had physical differences
from kids who didn’t have heart problems.”

Hike Like Noah event in Los Angeles raises funds for UCLA Mattel Children’s Hospital

“Another
lovely parallel is that moths always look for the light when they are in
darkness. In Noah’s darkest times — and she had quite a few — she always looked
for the light at the end of the tunnel and focused on that instead of dwelling
on the negative.”

The
Live Like Noah Foundation has plans for future fundraising events, probably
another hike. They also want to create opportunities for parents to connect
with others who have similar experiences.

“So often you feel alone in the process of raising a child with CHD. It’s not a visible disease so it’s hard to find other parents with shared experiences,” says Keith. “When you do get to interact with others who get it, you’re able to laugh at some of the crazy things you do on a daily basis. It’s a bonding experience.”

In addition to raising funds for the UCLA program, the foundation seeks to raise awareness for CHD and to advocate for additional research funding. Although advancements in treatment and care have improved dramatically, CHD research is still grossly underfunded.

The healing power of giving back

While
running the foundation, Cecile and Keith are also chasing a toddler. Cecile was
seven months pregnant when Noah passed away. Noah named her brother Henry after
the lead character in the Boxcar Children books, who was resourceful and
protective.

She would read to Henry in his mother’s belly and tell her parents, “He’s going to be so different from me. He’ll never want to listen, and he’ll go nonstop.” According to Cecile, Noah was spot on.

Cecile & Keith Michaelis with Noah’s baby brother, Henry

Another
thing Noah right about all along was the power of giving.

You can learn more about the Live Like Noah Foundation and read Noah’s Story on the foundation’s website.

“I can’t tell you how healing it’s been,” says Keith. “I feel her pushing us and telling us that we need to keep talking about CHD and giving back. Noah chose to be vocal. We don’t want her voice to be silenced just because she’s no longer here.”

If you’d like to honor Noah, please consider donating to the pediatric lymphatic program at UCLA (select In Memory: Noah Michaelis on the Gift Review screen)

5 days ago · A Possible Link Between Diet Beverages and Stroke

A recent study of postmenopausal women age 50 to 79 in the United States found those who consumed two or more artificially sweetened beverages per day were at a higher risk for the most common type of stroke — ischemic stroke.

Are Diet Drinks Bad for Your Health?

The Women’s Health Initiative Observational Study (WHI-OS) included 81,000 postmenopausal women enrolled from 1993-1998. Researchers tracked each participant for close to 12 years.

Researchers asked the study participants to self-report their use of artificially sweetened (diet) beverages. About 5 percent of respondents reported consuming two or more 12-ounce soda servings per day. Those who consumed more soda were:

  • 31 percent more likely to experience a stroke as the result of a blood clot
  • 29 percent more likely to have heart disease
  • 16 percent more likely to die from any condition than those who never drank diet beverages or only had them once a week 

Researchers Account for Factors That May Cause Health Risks of Diet Beverages

To ensure the comparisons between frequent diet soda drinkers and low-to-average consumers were accurate, researchers took these factors into account when analyzing the results:

  • Age
  • Ethnicity
  • Body mass index (BMI), a measure of body fat based on weight and height
  • Stroke risk factors such as diabetes and history of stroke or heart disease 
  • Physical activity and diet

Because of this, researchers were confident that other factors weren’t responsible for the increased risk found in the group that consumed two or more diet drinks per day.

Some Women May be More Vulnerable to Artificially Sweetened Beverages

The study further examined who was most vulnerable to the risk associated with artificially sweetened beverages. Researchers found:

  • African-American women were four times as likely to have a clot-based stroke as Caucasian women. 
  • Obese women (defined as having a BMI over 30) were twice as likely to have a clot-based stroke or ischemic stroke. 

Only Association, Not Cause, Found Between Diet Drinks and Stroke

At least two previous studies suggested a link between diet soda and stroke. While the WHI-OS results showed an association between diet sodas and health risk, it wasn’t intended to prove that diet sodas cause the increased risk for stroke, heart disease or death. Researchers continue to study the linkage. 

If you’re concerned you might be at risk for stroke, learn more about the UCLA Stroke Center or contact us for appointments and referrals.

Thu, May 16 1:46pm · 5 Steps to Lower Your Risk of Eye Disease

By age 65, one in three Americans will have a vision-impairing eye disease. Many sight-robbing conditions can be effectively treated if detected early enough, in many cases limiting or eliminating the damage to eyesight. During the month of May, the UCLA Stein Eye and Doheny Eye Institutes  join the American Academy of Ophthalmology in sharing valuable information about how to take care of your vision.

Four eye diseases — age-related macular degeneration (AMD), diabetic retinopathy, glaucoma and cataracts — account for most cases of adult blindness and low vision among people in developed countries. Because these eye diseases cause no pain and often have no early symptoms, they do not automatically prompt people to seek medical care. But a thorough checkup by an ophthalmologist — a physician who specializes in medical and surgical eye care — can detect them in their earliest stages. Early treatment is vital because it can slow or halt disease progression or, in the case of cataracts, restore normal vision.

A thorough eye exam can also detect other health conditions, such as
stroke, cardiovascular disease, diabetes, high blood pressure, autoimmune
diseases, sexually transmitted diseases and some cancers. It’s not uncommon for
a trip to the ophthalmologist to actually save a life.

The Academy offers five simple steps to take control of your eye health
today:

  1. Get a comprehensive medical eye exam at age 40. Early signs of disease or changes in vision may begin at this age. An exam by an ophthalmologist is an opportunity to carefully examine the eye for diseases and conditions that may have no symptoms in the early stages.
  2. Know your family history. Certain eye diseases can be inherited. If you have a close relative with macular degeneration, you have a 50 percent chance of developing this condition. A family history of glaucoma increases your glaucoma risk by four to nine times. Talk to family members about their eye conditions. It can help you and your ophthalmologist evaluate your risk.
  3. Eat healthy foods. A diet low in fat and rich in fruits, vegetables, and whole grains, benefits the entire body, including the eyes. Eye-healthy food choices include citrus fruits, vegetable oils, nuts, whole grains, dark green leafy vegetables and cold water fish.
  4. Stop smoking. Smoking increases the risk for eye diseases such as cataract and age-related macular degeneration. Smoking also raises the risk for cardiovascular diseases which can indirectly influence your eye health. Tobacco smoke, including second-hand smoke, also worsens dry eye.
  5. Wear sunglasses. Exposure to ultraviolet UV light raises the risk of eye diseases, including cataract, fleshy growths on the eye and cancer. Always wear a hat and sunglasses with 100 percent UV protection while outdoors.

To learn more ways to keep your eyes healthy or to find an ophthalmologist near you, visit uclahealth.org/eye.

Wed, May 15 3:00pm · How to Get Relief from Childhood Headaches

Headaches are one of the most common complaints in children and adolescents. By age 18, 90 percent of kids have experienced a headache. Before age 12, the incidence of headaches is equal among boys and girls. But after age 12, headaches are more common in girls.

What Causes Headaches in Kids?

There are two types of headache, characterized by what causes them: 

Primary headache 

A primary headache occurs when something inside the brain causes the headache. Types of primary headache include:

  • Migraine headache 
  • Tension headache
  • Cluster headache

Secondary headache

A secondary headache occurs when something acts on the brain to cause the headache. Causes of secondary headache include:

  • Cold, flu or sinusitis
  • Trauma to the head
  • Medication side effects or overuse
  • Brain tumor

Kinds of Headache in Children

While headache symptoms in children aren’t always “classic,” these are what to look for:

Migraine headache

A migraine headache is the most common type of headache in children and teens. It causes moderate-to-severe pain that:

  • Lasts 2 to 72 hours if not treated
  • Occurs on one side of the head
  • Throbs
  • Worsens with activity
  • Causes nausea or vomiting
  • Occurs with light or sound sensitivity
  • Comes with an aura (visual or sensory disturbance) in 10 percent of kids

Tension headache

A tension headache is the second most common type of headache in youth. It causes mild-to-moderate pain that:

  • Covers the entire head (diffuse)
  • Doesn’t throb
  • Doesn’t worsen with activity (though the child may not feel like being active) 

Cluster headache

Cluster headaches are very rare in children, they cause a sharp pain that:

  • Occurs on one side of the head, usually in the face
  • Comes with tearing eyes or a runny nose
  • May result in one pupil being a different size than the other
  • May cause an eyelid to droop 

UCLA family medicine physician Roya Mojarrad, MD, gives an overview of headaches in children and preventative treatment options.

Treatments for Childhood Headaches

Using over-the-counter (OTC) medications is often all that is needed to treat secondary headaches in children. You may have limited success using OTC meds to treat primary headaches. It is important not to overuse pain relievers for more than two days per week since overuse can actually cause headaches. Other pain relief options include:

Migraine pain relief

The OTC drugs ibuprofen and naproxen sodium are more effective than acetaminophen at reducing migraine-associated pain. Some prescription triptan medications can be used safely, and there is a prescription nasal spray approved to treat migraines in children. 

It is also important to try and prevent migraines. Experts recommend keeping a calendar or headache diary to record when headaches occur and what may trigger them. For example:

  • Poor quality sleep may be prevented by emphasizing good sleep hygiene.
  • Menstruation-related migraines can be prevented by taking naproxen 1 to 2 days before the expected onset of a period-related headache, and for the duration of menstruation.
  • Anxiety may be managed with behavioral treatments like cognitive behavioral therapy, biofeedback or relaxation exercises.

Other general prevention tips for migraines include:

  • Routinely eating meals
  • Regular exercise
  • Adequate intake of fluid
  • Supplements like magnesium and riboflavin
  • Preventive prescription medications like topiramate or amitriptyline taken 1 to 2 times per week

Tension headache pain relief

As with a migraine, reach for ibuprofen and naproxen sodium rather than acetaminophen to reduce headache pain.  

Preventing tension headaches with prescription medicines may not be as effective, though your child’s provider may try them if the potential benefit outweighs the risk. Another prevention approach is teaching methods to alleviate stress and anxiety, including biofeedback and relaxation exercises.

When your child experiences a tension headache, they may get relief by:

  • Relaxing or laying down
  • Having a cool wet cloth on their forehead
  • Stretching their neck and shoulder muscles, or having a caregiver offer gentle massage
  • Eating a snack
  • Taking in more fluid so they don’t become dehydrated

When to Worry About Headaches in Children

If your child tells you they have the worst headache of their life, seek care urgently. While unlikely, they could be experiencing a brain hemorrhage. Other signs that your child needs to see a provider for a headache evaluation include:

  • Pain that consistently wakes your child from sleep or causes them to miss school
  • Early morning vomiting without nausea
  • Headache pain that is different from before, is worsening or is occurring 3 to 4 times a month
  • A fever or stiff neck 
  • Personality changes
  • A headache that begins after an injury

If your child experiences frequent headaches, talk to their pediatrician for support and advice. If you need a pediatrician, contact the UCLA Division of General Pediatrics or request an appointment by calling 310-825-0867.

Wed, May 15 11:17am · The Real MVP: Dodgers Recognize Bruin Breast Cancer Survivor

At 29 years old, Jessica Krouner was diagnosed with stage 2 breast cancer.  She is happy to be cancer free after a year of intense treatment including 6 rounds of chemotherapy and 6 weeks of daily radiation. Having completed her undergraduate degree, law degree, and now treatment at UCLA, she’s proud to be a triple Bruin!

Jessica was recognized by MLB as an Honorary Bat Girl at the Mother’s Day Dodgers Day game on Sunday, May 12th, where she celebrated the day surrounded by family and friends. Major League Baseball and all 30 MLB Clubs champion Mother’s Day every year to raise awareness and support for the fight against breast cancer. 

Jessica feels incredibly lucky to be surrounded by an amazing support system.  She couldn’t have done it without the love and support of her all-star team, which includes: her parents, her sister, who was a top-5 fundraiser in the Chicago Susan G. Komen Race for the Cure only 4 weeks after Jessica’s diagnosis last spring, her coworkers, her doctors and nurses, and her amazing group of friends. This all-star team helped Jessica approach every aspect of her treatment with strength, spirit and courage.

Jessica feels it is important to create awareness of breast cancer in young women.  She is involved with the Simms/Mann-UCLA Center for Integrative Oncology, the UCLA Jonsson Comprehensive Cancer Center and Sharsheret, a nationwide breast cancer support organization for women. Through these connections, she hopes to broaden awareness surrounding breast cancer in young women and work on ways to support others in similar situations.

Jessica celebrates with her family at the Dodgers game on Mother’s Day

Tue, May 14 2:00pm · Defeat Depression With A Healthy Diet

Healthy Foods to Fight Depression

Research over the past ten years suggests that you can prevent depression with a healthy diet.

Some studies suggest a healthy diet, like a Mediterranean-style eating plan, can even treat depression once it’s been diagnosed. 

Improving Brain Health Through Diet

At the root of depression is an unhealthy brain. Improving your diet can increase brain health by providing it with the nutrients it needs to thrive. 

To receive mood-boosting effects from your diet, emphasize these “mood foods”:

  • Fruits and vegetables
  • Extra virgin olive oil
  • Yogurt and cheeses
  • Legumes and nuts
  • Whole grains
  • Seafood
  • Lean red meats in small servings

Research Shows Link Between Mood and Diet 

An Australian study that included 67 people with depression confirmed the mood-boosting effects of diet. Through the study, half of the people were counseled in nutrition by a dietitian. The remaining half were given one-on-one support in the form of someone to talk or play games with.

After 12 weeks, the people who most improved their diets also had the greatest improvements in mood. In addition, those who received diet-focused support showed a much-improved mood over those who received the social support.

Some Foods are Natural Mood Lifters

Nutrient-poor foods such as processed foods or those high in trans fats may promote inflammation, which causes depression or makes it worse. A bad diet also affects the gut bacteria involved in the production of brain chemicals like serotonin and dopamine. 

These nutrients are particularly helpful to feeding the brain, supporting good gut bacteria and regulating inflammation:

Vitamin B6

The brain needs vitamin B6 to produce serotonin, the brain chemical responsible for mood and sleep. Serotonin-producing foods include:

  • Salmon
  • Tuna
  • Spinach
  • Avocados
  • Whole grains 

DHA

The primary omega-3 fat found in the brain, DHA protects existing brain cells and promotes the creation of new cells. Find it in foods such as:

  • Salmon
  • Oysters
  • Mussels

Prebiotics and probiotics

Foods that support the good bacteria and microbes in the gut have the potential to change mood for the better. Find prebiotics and probiotics in:

  • Bananas
  • Asparagus
  • Oats
  • Yogurt
  • Fermented food and drink 

A Brain-Friendly Diet Can Prevent Other Diseases

If you’re at risk for depression or are experiencing mood concerns, emphasizing the best nutrition for brain health makes good sense because you:

  • May be able to limit or avoid antidepressant medications (and their side effects)
  • Can improve your general health while preventing heart disease, obesity and diabetes

If you’re concerned you might be depressed, take our depression quiz. If you need help or want to learn more about UCLA Department of Psychiatry and Biobehavioral Sciences call the ACCESS center at 310-825-9989.

Mon, May 13 2:58pm · Parents Creating Peace

Monique Rosenthal, a member of the Parent Association Council at UCLA Health

“We’re parents who came together to support each other and to look at how the next generation can benefit from the hospital,” says Monique Rosenthal, a member of the Parent Association Council at UCLA Health. “My daughter is a patient under the care of Neurology and Immunology for a rare autoimmune disorder. We come once a month to the Infusion Center. One thing I did change was to make it better for the kids to sleep. The EEG monitor has a big, bright light, and it causes a lot of anxiety. I brought it up, and someone can safely turn it off while someone else monitors it on the other side. Now, you can sleep better and it’s more peaceful. It’s something very small, but it makes it better for the kids. Every parent can bring something to the table. The council hopes to relieve some of the stress on parents and help make the environment better.”