The appropriate use of neuroimaging in the diagnostic work-up of dementia: an evidence-based analysis
A diagnosis of reversible dementia is rare. Imaging has the most clinical utility in cases where there is potentially mixed dementia or ambiguity as to the type of dementia despite prolonged follow-up (e.g., 2 years or more). Both CT and MRI are useful for detecting a vascular component of dementia. Health Quality Ontario. Ont Health Technol Assess Ser. 2014 Feb 1;14(1):1-64. eCollection 2014. PMID: 24592296
Wednesday, March 5, 2014
Mixed Bag
Warfarin May Be Good Even With Kidney Disease
Among patients with atrial fibrillation and a recent heart attack, warfarin use was associated with improved outcomes -- without excess bleeding -- regardless of the level of kidney function, a Swedish study showed.
Through 1 year after the myocardial infarction (MI), patients who were prescribed warfarin at discharge had a significantly lower rate of death, readmission due to MI, or ischemic stroke, a finding consistent for those with normal renal function, moderate-to-severe chronic kidney disease, and end-stage renal disease, according to Juan Jesús Carrero, PhD, of the Karolinska Institute in Stockholm, and colleagues. The findings were similar when bleeding was included in the endpoint, they reported in the March 5 issue of the Journal of the American Medical Association. MedPage Today
Lung transplantation: A treatment option in end-stage lung disease
In the past five years, the number of lung transplantations carried out has increased by about 20%. In the end stage of various lung diseases, transplantation is the last remaining option for treatment, and it can both prolong life and improve its quality. Marc Hartert and colleagues have studied how patients do after a lung transplant, and their review appears in the current edition of the Deutsches Ärzteblatt International (Dtsch Arztebl Int 2014; 111(7): 107–16). Eurekalert!
Lipitor Without a Rx? Pfizer Pushes Ahead With OTC Plans
Pfizer, the maker of Lipitor, is pushing forward with efforts to sell its drug to patients without a doctor's prescription, according to the Wall Street Journal.
The company recently launched a 1200-patient study to investigate whether patients could successfully take over-the-counter (OTC) atorvastatin to lower their LDL-cholesterol levels. Patients in the trial, which is currently recruiting at 35 US pharmacies, would get their own blood tests and would make decisions based on those results. Medscape
Screening for Sexual Assault in a Primary Care Setting
In this article, we will review key populations that may be most vulnerable and/or the least likely to report sexual assault and consider how screening for evidence of sexual violence can aid clinicians in the accurate diagnosis, treatment, and referral of victims of sexual assault. Medscape
Among patients with atrial fibrillation and a recent heart attack, warfarin use was associated with improved outcomes -- without excess bleeding -- regardless of the level of kidney function, a Swedish study showed.
Through 1 year after the myocardial infarction (MI), patients who were prescribed warfarin at discharge had a significantly lower rate of death, readmission due to MI, or ischemic stroke, a finding consistent for those with normal renal function, moderate-to-severe chronic kidney disease, and end-stage renal disease, according to Juan Jesús Carrero, PhD, of the Karolinska Institute in Stockholm, and colleagues. The findings were similar when bleeding was included in the endpoint, they reported in the March 5 issue of the Journal of the American Medical Association. MedPage Today
Lung transplantation: A treatment option in end-stage lung disease
In the past five years, the number of lung transplantations carried out has increased by about 20%. In the end stage of various lung diseases, transplantation is the last remaining option for treatment, and it can both prolong life and improve its quality. Marc Hartert and colleagues have studied how patients do after a lung transplant, and their review appears in the current edition of the Deutsches Ärzteblatt International (Dtsch Arztebl Int 2014; 111(7): 107–16). Eurekalert!
Lipitor Without a Rx? Pfizer Pushes Ahead With OTC Plans
Pfizer, the maker of Lipitor, is pushing forward with efforts to sell its drug to patients without a doctor's prescription, according to the Wall Street Journal.
The company recently launched a 1200-patient study to investigate whether patients could successfully take over-the-counter (OTC) atorvastatin to lower their LDL-cholesterol levels. Patients in the trial, which is currently recruiting at 35 US pharmacies, would get their own blood tests and would make decisions based on those results. Medscape
Screening for Sexual Assault in a Primary Care Setting
In this article, we will review key populations that may be most vulnerable and/or the least likely to report sexual assault and consider how screening for evidence of sexual violence can aid clinicians in the accurate diagnosis, treatment, and referral of victims of sexual assault. Medscape
Neurology
Cigarette smoking may cause physical changes in brains of young smokers, study shows
Now, a small study from UCLA suggests a disturbing effect: Young adult smokers may experience changes in the structures of their brains due to cigarette smoking, dependence and craving. Even worse, these changes can occur in those who have been smoking for relatively short time. Finally, the study suggests that neurobiological changes that may result from smoking during this critical period could explain why adults who began smoking at a young age stay hooked on cigarettes. The study appears in the March 3 online edition of the journal Neuropsychopharmacology. MedicalXpress
New evidence confirms link between IQ and brain cortex
The cortex begins to thin after the age of five or six as part of the normal aging process. This study by Professor Karama and his colleagues involved 188 children and adolescents over a period of two years. MRIs of the study participants were taken at six sites across the US. This study is the first to show the association between cortical thickness and development in full scale IQ. They found that within a relatively short period of 2 years:
Research from Karolinska Institutet in Sweden suggests that the expression of the so called MYC gene is important and necessary for neurogenesis in the spinal cord. The findings are being published in the journal EMBO Reports.
The MYC gene encodes the protein with the same name, and has an important role in many cellular processes such as proliferation, metabolism, cell death and the potential of differentiation from immature stem cells to different types of specialized cells . Importantly it is also one of the most frequently activated genes in human cancer. Eurekalert!
UF researchers find drug therapy that could eventually reverse memory decline in seniors
The drug can’t yet be used in humans, but the researchers are pursuing compounds that could someday help the population of aging adults who don’t have Alzheimer’s or other dementias but still have trouble remembering day-to-day items. Their findings will be published in today’s (March 5) issue of the Journal of Neuroscience. University of Florida
Now, a small study from UCLA suggests a disturbing effect: Young adult smokers may experience changes in the structures of their brains due to cigarette smoking, dependence and craving. Even worse, these changes can occur in those who have been smoking for relatively short time. Finally, the study suggests that neurobiological changes that may result from smoking during this critical period could explain why adults who began smoking at a young age stay hooked on cigarettes. The study appears in the March 3 online edition of the journal Neuropsychopharmacology. MedicalXpress
New evidence confirms link between IQ and brain cortex
The cortex begins to thin after the age of five or six as part of the normal aging process. This study by Professor Karama and his colleagues involved 188 children and adolescents over a period of two years. MRIs of the study participants were taken at six sites across the US. This study is the first to show the association between cortical thickness and development in full scale IQ. They found that within a relatively short period of 2 years:
- people with a significant increase in IQ did not have the expected cortical thinning,
- people whose IQ stayed the same had the normal expected cortical thinning,
- people with a significant decrease in IQ had exaggerated cortical thinning. Eurekalert!
Research from Karolinska Institutet in Sweden suggests that the expression of the so called MYC gene is important and necessary for neurogenesis in the spinal cord. The findings are being published in the journal EMBO Reports.
The MYC gene encodes the protein with the same name, and has an important role in many cellular processes such as proliferation, metabolism, cell death and the potential of differentiation from immature stem cells to different types of specialized cells . Importantly it is also one of the most frequently activated genes in human cancer. Eurekalert!
UF researchers find drug therapy that could eventually reverse memory decline in seniors
The drug can’t yet be used in humans, but the researchers are pursuing compounds that could someday help the population of aging adults who don’t have Alzheimer’s or other dementias but still have trouble remembering day-to-day items. Their findings will be published in today’s (March 5) issue of the Journal of Neuroscience. University of Florida
Research
High-sensitivity troponin T and risk stratification in patients with atrial fibrillation during treatment with apixaban or warfarin
Levels of hs-TnT are often elevated in patients with AF. The hs-TnT level is independently associated with an increased risk of stroke, cardiac death, and major bleeding and improves risk stratification beyond the CHA2DS2VASc risk score. The benefits of apixaban as compared with warfarin are consistent regardless of the hs-TnT level. Hijazi Z, Wallentin L, Siegbahn A, Andersson U, Alexander JH, Atar D, Gersh BJ, Hanna M, Harjola VP, Horowitz JD, Husted S, Hylek EM, Lopes RD, McMurray JJ, Granger CB; ARISTOTLE Investigators. J Am Coll Cardiol. 2014 Jan 7-14;63(1):52-61. Epub 2013 Sep 19. PMID: 24055845
Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens
Allocation to the glucosamine-chondroitin combination resulted in a statistically significant reduction in JSN at 2 years. While all allocation groups demonstrated reduced knee pain over the study period, none of the treatment allocation groups demonstrated significant symptomatic benefit above placebo. Fransen M, Agaliotis M, Nairn L, Votrubec M, Bridgett L, Su S, Jan S, March L, Edmonds J, Norton R, Woodward M, Day R; on behalf of the LEGS study collaborative group. Ann Rheum Dis. 2014 Jan 6. [Epub ahead of print] PMID: 24395557
Alzheimer's in a dish: Stem cells from patients offer model and drug-discovery platform for early-onset form of disease
Harvard stem cell scientists have successfully converted skins cells from patients with early-onset Alzheimer's into the types of neurons that are affected by the disease, making it possible for the first time to study this leading form of dementia in living human cells. This may also make it possible to develop therapies far more quickly and accurately than before. MedicalXpress
Levels of hs-TnT are often elevated in patients with AF. The hs-TnT level is independently associated with an increased risk of stroke, cardiac death, and major bleeding and improves risk stratification beyond the CHA2DS2VASc risk score. The benefits of apixaban as compared with warfarin are consistent regardless of the hs-TnT level. Hijazi Z, Wallentin L, Siegbahn A, Andersson U, Alexander JH, Atar D, Gersh BJ, Hanna M, Harjola VP, Horowitz JD, Husted S, Hylek EM, Lopes RD, McMurray JJ, Granger CB; ARISTOTLE Investigators. J Am Coll Cardiol. 2014 Jan 7-14;63(1):52-61. Epub 2013 Sep 19. PMID: 24055845
Glucosamine and chondroitin for knee osteoarthritis: a double-blind randomised placebo-controlled clinical trial evaluating single and combination regimens
Allocation to the glucosamine-chondroitin combination resulted in a statistically significant reduction in JSN at 2 years. While all allocation groups demonstrated reduced knee pain over the study period, none of the treatment allocation groups demonstrated significant symptomatic benefit above placebo. Fransen M, Agaliotis M, Nairn L, Votrubec M, Bridgett L, Su S, Jan S, March L, Edmonds J, Norton R, Woodward M, Day R; on behalf of the LEGS study collaborative group. Ann Rheum Dis. 2014 Jan 6. [Epub ahead of print] PMID: 24395557
Alzheimer's in a dish: Stem cells from patients offer model and drug-discovery platform for early-onset form of disease
Harvard stem cell scientists have successfully converted skins cells from patients with early-onset Alzheimer's into the types of neurons that are affected by the disease, making it possible for the first time to study this leading form of dementia in living human cells. This may also make it possible to develop therapies far more quickly and accurately than before. MedicalXpress
Peds/OB/GYN
As one food allergy resolves, another may develop
Some children who outgrow one type of food allergy may then develop another type of allergy, more severe and more persistent, to the same food. A new study by pediatric allergy experts suggests that health care providers and caregivers carefully monitor children with food allergies to recognize early signs of eosinophilic esophagitis (EoE), a severe and often painful type of allergy that has been increasing in recent years. Eurekalert!
Exercising during pregnancy enhances maternal health
Excessive weight gain during pregnancy increases the risk of suffering illnesses such as hypertension and gestational diabetes, or of having a premature birth or a birth by Caesarean; furthermore, it also has negative effects on the newly-born and increases the risk of infants being overweight by 30%.
Aware of the importance of preventing gestational weight gain, both in mother and child, researchers from the University of Granada, Madrid Polytechnic University and the European University carried out a study on the benefits of exercising during pregnancy to prevent weight gain, entitled "Supervised Exercise – Based Intervention to Prevent Excessive Gestational Weight Gain: A Randomized Controlled Trial", which has been published in the journal Mayo Clinic Proceedings. MedicalXpress
Baby 'sleep machines' could damage hearing, study suggests
Some of the "sleep machines" marketed to soothe infants seem capable of generating enough noise to potentially damage a baby's hearing, a new study suggests. The findings, reported online March 3 and in the April print issue of Pediatrics, may not sound sweet to parents' ears. MedicalXpress
Featured in NEJM Journal Watch: Protection Wanes After the First Dose of DTaP
Pertussis protection is good during the first year but wanes without subsequent booster doses, according to a study in Pediatrics. Journal Watch
Study shows male hormones play an important role in female fertility
A new study suggests that male hormones, also called androgens, help drive the development of follicles – structures that contain and ultimately release an egg that can be fertilized by a man's sperm. Published in the Proceedings of the National Academy of Sciences, the research also details how male hormones boost the production of follicles in mice. Authors believe the study provides potential biological targets to enhance fertility in women with diminished ovarian reserve, who produce few or no follicles in response to IVF drugs designed to boost follicle development. MedicalXpress
Half of pregnant women are passive smokers, due to their partners
As shown in a study carried out by researchers at 13 research centres in Asturias, Gipuzkoa, Sabadell and Valencia, over half of non-smoking pregnant women, 55%, are passive smokers.These women are under the effect of tobacco smoke to a considerable extent because a member of the household, their partner in particular, smokes at home.The result of the study has been published in the journal Science of the Total Environment. MedicalXpress
Some children who outgrow one type of food allergy may then develop another type of allergy, more severe and more persistent, to the same food. A new study by pediatric allergy experts suggests that health care providers and caregivers carefully monitor children with food allergies to recognize early signs of eosinophilic esophagitis (EoE), a severe and often painful type of allergy that has been increasing in recent years. Eurekalert!
Exercising during pregnancy enhances maternal health
Excessive weight gain during pregnancy increases the risk of suffering illnesses such as hypertension and gestational diabetes, or of having a premature birth or a birth by Caesarean; furthermore, it also has negative effects on the newly-born and increases the risk of infants being overweight by 30%.
Aware of the importance of preventing gestational weight gain, both in mother and child, researchers from the University of Granada, Madrid Polytechnic University and the European University carried out a study on the benefits of exercising during pregnancy to prevent weight gain, entitled "Supervised Exercise – Based Intervention to Prevent Excessive Gestational Weight Gain: A Randomized Controlled Trial", which has been published in the journal Mayo Clinic Proceedings. MedicalXpress
Baby 'sleep machines' could damage hearing, study suggests
Some of the "sleep machines" marketed to soothe infants seem capable of generating enough noise to potentially damage a baby's hearing, a new study suggests. The findings, reported online March 3 and in the April print issue of Pediatrics, may not sound sweet to parents' ears. MedicalXpress
Featured in NEJM Journal Watch: Protection Wanes After the First Dose of DTaP
Pertussis protection is good during the first year but wanes without subsequent booster doses, according to a study in Pediatrics. Journal Watch
Study shows male hormones play an important role in female fertility
A new study suggests that male hormones, also called androgens, help drive the development of follicles – structures that contain and ultimately release an egg that can be fertilized by a man's sperm. Published in the Proceedings of the National Academy of Sciences, the research also details how male hormones boost the production of follicles in mice. Authors believe the study provides potential biological targets to enhance fertility in women with diminished ovarian reserve, who produce few or no follicles in response to IVF drugs designed to boost follicle development. MedicalXpress
Half of pregnant women are passive smokers, due to their partners
As shown in a study carried out by researchers at 13 research centres in Asturias, Gipuzkoa, Sabadell and Valencia, over half of non-smoking pregnant women, 55%, are passive smokers.These women are under the effect of tobacco smoke to a considerable extent because a member of the household, their partner in particular, smokes at home.The result of the study has been published in the journal Science of the Total Environment. MedicalXpress
Infectious Diseases
A 30000-year-old giant virus comes back to life
Finally, this study demonstrates that viruses can survive in permafrost (the permanently frozen layer of soil found in the Arctic regions) almost over geological time periods, i.e. for more than 30,000 years (corresponding to the Late Pleistocene). These findings have important implications in terms of public health risks related to the exploitation of mining and energy resources in circumpolar regions, which may arise as a result of global warming. The re-emergence of viruses considered to be eradicated, such as smallpox, whose replication process is similar to Pithovirus, is no longer the domain of science fiction. The probability of this type of scenario needs to be estimated realistically. BioScholar
Gonorrhea infections start from exposure to seminal fluid
Researchers have come a step closer to understanding how gonorrhea infections are transmitted. When Neisseria gonorrhoeae, the bacteria responsible for gonorrhea, are exposed to seminal plasma, the liquid part of semen containing secretions from the male genital tract, they can more easily move and start to colonize. The research, led by investigators at Northwestern University in Chicago, appears in mBio®, the online open-access journal of the American Society for Microbiology. Eurekalert!
Bugs in the Back: Is Lumbago an Infectious Disease?
Propionibacterium acnes is often dismissed as a contaminant, but during the past decade or so it has been recognized as an indolent pathogen that can cause problems such as ventriculoatrial shunt infection and perhaps prosthetic joint problems, especially in the shoulder. In addition, a small amount of supportive literature about P acnes infection in the spine has been published. This infection often is not typical; patients have no fever or elevated sedimentation rate. It seems to be fairly rare; however, one review[1] found that 97% of 29 patients with this infection had previously undergone surgery. Paul Auwaerter, from Johns Hopkins, speaking for Medscape Infectious Diseases.
Real-World HPV Study Finds Vaccine Protects Against Cervical Abnormalities
Vaccination with the quadrivalent human papillomavirus (HPV) vaccine was associated with reduced risk for cervical abnormalities in young women presenting for their first cervical screening in Australia. Findings from the case-control study appear in BMJ. Journal Watch
Can low-dose interferon prevent relapse of hepatitis C virus infection?
Chronic hepatitis C virus (HCV) infection can lead to serious diseases such as cirrhosis and cancer of the liver, so viral clearance and prevention of relapse are important treatment goals. Low-dose oral interferon may reduce the risk of HCV relapse in patients with mild liver fibrosis according to a study published in Journal of Interferon & Cytokine Research, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on the Journal of Interferon & Cytokine Research website. Eurekalert!
Scientists identify significant increase in new MRSA strains in non hospital environment
Microbiologists from the Dental School in Trinity College Dublin in collaboration with the National MRSA Reference Laboratory at St. James's Hospital Dublin and Alere Technologies in Germany have identified significant increases in the prevalence, genetic diversity and antimicrobial resistance of PVL-positive MRSA circulating in Ireland in the ten years between 2002-2011. These findings have just been published in the March 2014 issue of a leading, peer reviewed international journal, The Journal of Clinical Microbiology. MedicalXpress
Finally, this study demonstrates that viruses can survive in permafrost (the permanently frozen layer of soil found in the Arctic regions) almost over geological time periods, i.e. for more than 30,000 years (corresponding to the Late Pleistocene). These findings have important implications in terms of public health risks related to the exploitation of mining and energy resources in circumpolar regions, which may arise as a result of global warming. The re-emergence of viruses considered to be eradicated, such as smallpox, whose replication process is similar to Pithovirus, is no longer the domain of science fiction. The probability of this type of scenario needs to be estimated realistically. BioScholar
Gonorrhea infections start from exposure to seminal fluid
Researchers have come a step closer to understanding how gonorrhea infections are transmitted. When Neisseria gonorrhoeae, the bacteria responsible for gonorrhea, are exposed to seminal plasma, the liquid part of semen containing secretions from the male genital tract, they can more easily move and start to colonize. The research, led by investigators at Northwestern University in Chicago, appears in mBio®, the online open-access journal of the American Society for Microbiology. Eurekalert!
Bugs in the Back: Is Lumbago an Infectious Disease?
Propionibacterium acnes is often dismissed as a contaminant, but during the past decade or so it has been recognized as an indolent pathogen that can cause problems such as ventriculoatrial shunt infection and perhaps prosthetic joint problems, especially in the shoulder. In addition, a small amount of supportive literature about P acnes infection in the spine has been published. This infection often is not typical; patients have no fever or elevated sedimentation rate. It seems to be fairly rare; however, one review[1] found that 97% of 29 patients with this infection had previously undergone surgery. Paul Auwaerter, from Johns Hopkins, speaking for Medscape Infectious Diseases.
Real-World HPV Study Finds Vaccine Protects Against Cervical Abnormalities
Vaccination with the quadrivalent human papillomavirus (HPV) vaccine was associated with reduced risk for cervical abnormalities in young women presenting for their first cervical screening in Australia. Findings from the case-control study appear in BMJ. Journal Watch
Can low-dose interferon prevent relapse of hepatitis C virus infection?
Chronic hepatitis C virus (HCV) infection can lead to serious diseases such as cirrhosis and cancer of the liver, so viral clearance and prevention of relapse are important treatment goals. Low-dose oral interferon may reduce the risk of HCV relapse in patients with mild liver fibrosis according to a study published in Journal of Interferon & Cytokine Research, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on the Journal of Interferon & Cytokine Research website. Eurekalert!
Scientists identify significant increase in new MRSA strains in non hospital environment
Microbiologists from the Dental School in Trinity College Dublin in collaboration with the National MRSA Reference Laboratory at St. James's Hospital Dublin and Alere Technologies in Germany have identified significant increases in the prevalence, genetic diversity and antimicrobial resistance of PVL-positive MRSA circulating in Ireland in the ten years between 2002-2011. These findings have just been published in the March 2014 issue of a leading, peer reviewed international journal, The Journal of Clinical Microbiology. MedicalXpress
Medical Care
Everything modern medicine gets wrong
Before there was health insurance, there were almshouses — county hospitals for the chronically ill, available to anyone. And Dr. Victoria Sweet, author of the book “God’s Hotel,” spent 20 years practicing medicine at the last almshouse in America, San Francisco’s Laguna Honda Hospital. So she knows a thing or two about long-term patient care. Market Watch
Sorting Socks Before Surgery: Younger Women Physicians & Domestic Duties
Physician-researchers' use of time shows marked gender differences, according to a study in the Annals of Internal Medicine.
Both men and women without children spent comparable amounts of time on domestic duties. However, among those with children and employed spouses, women spent almost 9 hours per week more on domestic duties than men, who spent more time on research. Women were also more than twice as likely to take time off for disruptions of child-care arrangements. Journal Watch
CDC Has Remedy for Overuse of Antibiotics
Doctors in some hospitals are prescribing three times more antibiotics than physicians treating similar patients in other institutions, according to the CDC. The variation suggests that in several common situations, antibiotic prescribing could be improved by more than 30%, the agency said in a Vital Signs study online in Morbidity and Mortality Weekly Report. MedPage Today
Changes in hospital orders increase pertussis immunization rates
Changing the hospital orders for women who have just delivered a child led to a 69% increase in the new mothers' pertussis vaccination rate, providing protection for themselves and their newborns against the disease, commonly known as whooping cough, according to a study in the March issue of the American Journal of Obstetrics & Gynecology. Eurekalert!
Multidisciplinary teams helped marathon bombing survivors rebuild their lives
The Journal of Orthopaedic & Sports Physical Therapy (JOSPT) and The Journal of Bone & Joint Surgery (JBJS) co-published a Special Report today entitled It Takes a Team: The 2013 Boston Marathon – Preparing for and Recovering from a Mass-Casualty Event. This unique report highlights multidisciplinary planning, integrated clinical teamwork, and continuity of care and is being distributed in a cooperative arrangement to JBJS and JOSPT subscribers. Because it is of interest to all emergency preparedness and health care professionals, both journals are also making it available for download at no cost. Eurekalert!
Centenarians epitomise our fears about growing old
The field of regenerative medicine is trying to hedge our bets. Instead of waiting until we can overhaul our metabolism, it aims to clean up the damage we accumulate in our cells, tissues, and organs. There are several current projects to grow organs from one's own stem cells or even skin cells. There are patients around the world with trachea and cartilage replacements made using this technique. Soon, regenerative medicine will target therapies beyond organs and at the cellular level. If our cells are always in tip-top shape we may not need to replace our organs. MedicalXpress
Nurses can perform colonoscopies as well as docs
Colonoscopy quality and safety are comparable for nurse and physician endoscopy trainees, according to a study published in the March issue of Clinical Gastroenterology and Hepatology. MedicalXpress
Prehospital alerts let stroke patients skip the emergency room
Prehospital stroke alerts by emergency medical services (EMS) personnel can shorten the time to effective treatment with "clot-busting" drugs for patients with stroke, according to a report in the March issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. Eurekalert!
Patients' stories used to improve care on wards
A research project led by Oxford University is showing how patient experiences can be used to improve healthcare – not through targets and surveys, but by getting doctors, nurses and patients talking together about care on the ward. Oxford University
Research shows patient satisfaction can be high, even in emergency care situations
The Minneapolis Heart Institute Foundation (MHIF) today announced the results of survey research aimed at discovering patient and family satisfaction with acute care transfers for patients with STEMI (ST-segment elevation myocardial infarction), a severe heart attack best treated quickly with specialized care. The results, based on 98 patient and 80 family surveys, suggest that patient satisfaction with care decisions and communication can be high, even in emergency care situations that require rapid and complex decision making and, in this case, quick transport to a different hospital for a critically ill patient for whom family may not be present. The full results of this research are published in Circulation: Cardiovascular Quality and Outcomes. Eurekalert!
Before there was health insurance, there were almshouses — county hospitals for the chronically ill, available to anyone. And Dr. Victoria Sweet, author of the book “God’s Hotel,” spent 20 years practicing medicine at the last almshouse in America, San Francisco’s Laguna Honda Hospital. So she knows a thing or two about long-term patient care. Market Watch
Sorting Socks Before Surgery: Younger Women Physicians & Domestic Duties
Physician-researchers' use of time shows marked gender differences, according to a study in the Annals of Internal Medicine.
Both men and women without children spent comparable amounts of time on domestic duties. However, among those with children and employed spouses, women spent almost 9 hours per week more on domestic duties than men, who spent more time on research. Women were also more than twice as likely to take time off for disruptions of child-care arrangements. Journal Watch
CDC Has Remedy for Overuse of Antibiotics
Doctors in some hospitals are prescribing three times more antibiotics than physicians treating similar patients in other institutions, according to the CDC. The variation suggests that in several common situations, antibiotic prescribing could be improved by more than 30%, the agency said in a Vital Signs study online in Morbidity and Mortality Weekly Report. MedPage Today
Changes in hospital orders increase pertussis immunization rates
Changing the hospital orders for women who have just delivered a child led to a 69% increase in the new mothers' pertussis vaccination rate, providing protection for themselves and their newborns against the disease, commonly known as whooping cough, according to a study in the March issue of the American Journal of Obstetrics & Gynecology. Eurekalert!
Multidisciplinary teams helped marathon bombing survivors rebuild their lives
The Journal of Orthopaedic & Sports Physical Therapy (JOSPT) and The Journal of Bone & Joint Surgery (JBJS) co-published a Special Report today entitled It Takes a Team: The 2013 Boston Marathon – Preparing for and Recovering from a Mass-Casualty Event. This unique report highlights multidisciplinary planning, integrated clinical teamwork, and continuity of care and is being distributed in a cooperative arrangement to JBJS and JOSPT subscribers. Because it is of interest to all emergency preparedness and health care professionals, both journals are also making it available for download at no cost. Eurekalert!
Centenarians epitomise our fears about growing old
The field of regenerative medicine is trying to hedge our bets. Instead of waiting until we can overhaul our metabolism, it aims to clean up the damage we accumulate in our cells, tissues, and organs. There are several current projects to grow organs from one's own stem cells or even skin cells. There are patients around the world with trachea and cartilage replacements made using this technique. Soon, regenerative medicine will target therapies beyond organs and at the cellular level. If our cells are always in tip-top shape we may not need to replace our organs. MedicalXpress
Nurses can perform colonoscopies as well as docs
Colonoscopy quality and safety are comparable for nurse and physician endoscopy trainees, according to a study published in the March issue of Clinical Gastroenterology and Hepatology. MedicalXpress
Prehospital alerts let stroke patients skip the emergency room
Prehospital stroke alerts by emergency medical services (EMS) personnel can shorten the time to effective treatment with "clot-busting" drugs for patients with stroke, according to a report in the March issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. Eurekalert!
Patients' stories used to improve care on wards
A research project led by Oxford University is showing how patient experiences can be used to improve healthcare – not through targets and surveys, but by getting doctors, nurses and patients talking together about care on the ward. Oxford University
Research shows patient satisfaction can be high, even in emergency care situations
The Minneapolis Heart Institute Foundation (MHIF) today announced the results of survey research aimed at discovering patient and family satisfaction with acute care transfers for patients with STEMI (ST-segment elevation myocardial infarction), a severe heart attack best treated quickly with specialized care. The results, based on 98 patient and 80 family surveys, suggest that patient satisfaction with care decisions and communication can be high, even in emergency care situations that require rapid and complex decision making and, in this case, quick transport to a different hospital for a critically ill patient for whom family may not be present. The full results of this research are published in Circulation: Cardiovascular Quality and Outcomes. Eurekalert!
Tuesday, March 4, 2014
Top Story
New Guidelines Issued for Valvular Heart Disease
The American Heart Association and the American College of Cardiology have released new practice guidelines for the medical, surgical, and postoperative management of patients with valvular heart disease (VHD).Among its notable features, the document includes a new system of classification:
Stage A: people with risk factors that place them at risk for VHD;
Stage B: people with asymptomatic but progressive, mild-to-moderate VHD;
Stage C: people with asymptomatic but severe VHD.
Stage D: people with severe VHD who have developed symptoms. Journal Watch
The American Heart Association and the American College of Cardiology have released new practice guidelines for the medical, surgical, and postoperative management of patients with valvular heart disease (VHD).Among its notable features, the document includes a new system of classification:
Stage A: people with risk factors that place them at risk for VHD;
Stage B: people with asymptomatic but progressive, mild-to-moderate VHD;
Stage C: people with asymptomatic but severe VHD.
Stage D: people with severe VHD who have developed symptoms. Journal Watch
Mixed Bag
Obstructive Sleep Apnea Linked to Pneumonia Risk
Using insurance databases, researchers in Taiwan matched nearly 7000 adults with newly diagnosed sleep apnea to 27,000 controls without apnea. Over 4.5 years of follow-up, patients with sleep apnea had a 19% increased risk for a pneumonia diagnosis, compared with controls. Patients who required use of continuous positive airway pressure had a higher pneumonia risk than apnea patients who didn't use CPAP. Journal Watch
Quality of life improves with minimally invasive surgery for low back pain
Beaumont research findings published in the February online issue of Spine shows that patients who have a low back surgery called minimally invasive transforaminal lumbar interbody fusion, end up better off in many ways than patients who have more invasive surgery to alleviate debilitating pain. Oakland University William Beaumont School of Medicine
Study points to new biological mechanisms, treatment paradigm for kidney disease
New research led by Icahn School of Medicine at Mount Sinai investigators has uncovered abnormal molecular signaling pathways from disease initiation to irreversible kidney damage, kidney failure, and death. Results from their preclinical and human research are published online March 3 in the Journal of Clinical Investigation.
Initially, key cells of the glomerular filtration barrier, also called podocytes, cause alterations in endothelin-1, a vasoconstrictor, activating the endothelin receptor A. The activated endothelin receptor A triggered disturbances manifested as endothelial mitochondrial oxidative stress.
Antioxidants that target the mitochondria and endothelin antagonists would alter the paradigm for preventing cell depletion and scarring of the filtration part of the kidney. "There is a pressing unmet medical need to prevent or reverse chronic kidney disease," Dr. Bottinger stressed. "The renin angiotensin inhibitors and angiotensin receptor blockers that are now widely used have not been proven effective in preventing end stage kidney failure. We need more effective drugs to treat the millions of Americans suffering from chronic kidney disease with the goal to eliminate its progression to end- stage kidney failure and with it the need for chronic dialysis and kidney transplantation." MedicalXpress
Immunotherapy Best for Chronic Rhinitis
Treatment for those conditions was three-fold more likely to decline in the 18 months after immunotherapy than in matched patients treated for rhinitis pharmacologically or otherwise (down 6% versus 2%, P<0.0001), Cheryl Hankin, PhD, of the health research company BioMedEcon in Moss Beach, Calif., and colleagues found. MedPage Today
New markers for acute kidney injury reported
Saeed A. Jortani, Ph.D., associate clinical professor in the University of Louisville's Department of Pathology and Laboratory Medicine, headed up one of three labs in the United States involved in determining two new markers for acute kidney injury (AKI). The research group's paper, "Validation of Cell-Cycle Arrest Biomarkers for Acute Kidney Injury Using Clinical Adjudication," was posted online Feb. 25 by the American Journal of Respiratory and Critical Care Medicine. Eurekalert!
Mistakes may be common in prescribing antibiotics in US
The report was based on data from 183 US hospitals in 2011. More than half (55.7 percent) of the 11,282 hospital patients studied received an antibiotic to treat an active infection, said the CDC.
When experts reviewed two common scenarios, including patients being treated for urinary tract infections and patients being treated with vancomycin, they found that "antibiotic use could potentially have been improved" in 37 percent of cases. The most common potential errors were prescribing antibiotics without proper testing and prescribing them for too long, the CDC said. MedicalXpress
Using insurance databases, researchers in Taiwan matched nearly 7000 adults with newly diagnosed sleep apnea to 27,000 controls without apnea. Over 4.5 years of follow-up, patients with sleep apnea had a 19% increased risk for a pneumonia diagnosis, compared with controls. Patients who required use of continuous positive airway pressure had a higher pneumonia risk than apnea patients who didn't use CPAP. Journal Watch
Quality of life improves with minimally invasive surgery for low back pain
Beaumont research findings published in the February online issue of Spine shows that patients who have a low back surgery called minimally invasive transforaminal lumbar interbody fusion, end up better off in many ways than patients who have more invasive surgery to alleviate debilitating pain. Oakland University William Beaumont School of Medicine
Study points to new biological mechanisms, treatment paradigm for kidney disease
New research led by Icahn School of Medicine at Mount Sinai investigators has uncovered abnormal molecular signaling pathways from disease initiation to irreversible kidney damage, kidney failure, and death. Results from their preclinical and human research are published online March 3 in the Journal of Clinical Investigation.
Initially, key cells of the glomerular filtration barrier, also called podocytes, cause alterations in endothelin-1, a vasoconstrictor, activating the endothelin receptor A. The activated endothelin receptor A triggered disturbances manifested as endothelial mitochondrial oxidative stress.
Antioxidants that target the mitochondria and endothelin antagonists would alter the paradigm for preventing cell depletion and scarring of the filtration part of the kidney. "There is a pressing unmet medical need to prevent or reverse chronic kidney disease," Dr. Bottinger stressed. "The renin angiotensin inhibitors and angiotensin receptor blockers that are now widely used have not been proven effective in preventing end stage kidney failure. We need more effective drugs to treat the millions of Americans suffering from chronic kidney disease with the goal to eliminate its progression to end- stage kidney failure and with it the need for chronic dialysis and kidney transplantation." MedicalXpress
Immunotherapy Best for Chronic Rhinitis
Treatment for those conditions was three-fold more likely to decline in the 18 months after immunotherapy than in matched patients treated for rhinitis pharmacologically or otherwise (down 6% versus 2%, P<0.0001), Cheryl Hankin, PhD, of the health research company BioMedEcon in Moss Beach, Calif., and colleagues found. MedPage Today
New markers for acute kidney injury reported
Saeed A. Jortani, Ph.D., associate clinical professor in the University of Louisville's Department of Pathology and Laboratory Medicine, headed up one of three labs in the United States involved in determining two new markers for acute kidney injury (AKI). The research group's paper, "Validation of Cell-Cycle Arrest Biomarkers for Acute Kidney Injury Using Clinical Adjudication," was posted online Feb. 25 by the American Journal of Respiratory and Critical Care Medicine. Eurekalert!
Mistakes may be common in prescribing antibiotics in US
The report was based on data from 183 US hospitals in 2011. More than half (55.7 percent) of the 11,282 hospital patients studied received an antibiotic to treat an active infection, said the CDC.
When experts reviewed two common scenarios, including patients being treated for urinary tract infections and patients being treated with vancomycin, they found that "antibiotic use could potentially have been improved" in 37 percent of cases. The most common potential errors were prescribing antibiotics without proper testing and prescribing them for too long, the CDC said. MedicalXpress
Neoplasms
Bacteria may assist the immune system response against cancer
The research published in the official journal of the American Association of Immunologists, the Journal of Immunology, demonstrates that bacteria stimulate a type of immune response that results in more effective killer cell attacks against cancer. MedicalXpress
Gut microbes spur development of bowel cancer
It is not only genetics that predispose to bowel cancer; microbes living in the gut help drive the development of intestinal tumors, according to new research in mice published in the March issue of The Journal of Experimental Medicine. MedicalXpress
Higher BPA Levels Associated with Prostate Cancer
Higher urinary levels of bisphenol A (BPA) are linked to early-onset prostate cancer, according to a PLoS ONE study. Researchers measured urinary BPA concentrations in 60 urology patients, about half of whom had prostate cancer. Concentrations were significantly higher in patients with than without cancer, particularly among those younger than 65. Journal Watch
Immune system-based therapy produces lasting remissions in melanoma patients
A drug that unleashes the immune system to attack cancer can produce lasting remissions and hold the disease in check – for more than two years, in some cases – in many patients with advanced melanoma, according to a new study by researchers at Dana-Farber Cancer Institute, Johns Hopkins University, Yale University, and allied institutions.
The study, published online today, March 3, by the Journal of Clinical Oncology, provides the longest-term look so far at how melanoma patients have fared since receiving the drug, nivolumab, in a phase I clinical trial. The results indicate that the benefits of nivolumab not only occur quickly but can persist, even in some cases where use of the drug is discontinued. Eurekalert!
The research published in the official journal of the American Association of Immunologists, the Journal of Immunology, demonstrates that bacteria stimulate a type of immune response that results in more effective killer cell attacks against cancer. MedicalXpress
Gut microbes spur development of bowel cancer
It is not only genetics that predispose to bowel cancer; microbes living in the gut help drive the development of intestinal tumors, according to new research in mice published in the March issue of The Journal of Experimental Medicine. MedicalXpress
Higher BPA Levels Associated with Prostate Cancer
Higher urinary levels of bisphenol A (BPA) are linked to early-onset prostate cancer, according to a PLoS ONE study. Researchers measured urinary BPA concentrations in 60 urology patients, about half of whom had prostate cancer. Concentrations were significantly higher in patients with than without cancer, particularly among those younger than 65. Journal Watch
Immune system-based therapy produces lasting remissions in melanoma patients
A drug that unleashes the immune system to attack cancer can produce lasting remissions and hold the disease in check – for more than two years, in some cases – in many patients with advanced melanoma, according to a new study by researchers at Dana-Farber Cancer Institute, Johns Hopkins University, Yale University, and allied institutions.
The study, published online today, March 3, by the Journal of Clinical Oncology, provides the longest-term look so far at how melanoma patients have fared since receiving the drug, nivolumab, in a phase I clinical trial. The results indicate that the benefits of nivolumab not only occur quickly but can persist, even in some cases where use of the drug is discontinued. Eurekalert!
Cardiovascular
History of kidney stones may indicate risk for stroke and heart attack
A new study from University of Alberta researchers suggests that patients, particularly women, with a history of kidney stones may be at a higher risk for stroke and heart attack.
The study, published in the Clinical Journal of the American Society of Nephrology, was led by Todd Alexander, associate professor of pediatrics and adjunct professor of physiology in the Faculty of Medicine & Dentistry. MedicalXpress
Study results confirm BMI is a direct cause of Type 2 diabetes and high blood pressure
According to the findings, published online in The American Journal of Human Genetics, for every 1 kg/m2 increase in BMI – equivalent to a 196-pound, 40-year old man of average height gaining seven pounds – the risk of developing type 2 diabetes increases by 27 percent. The same rise in BMI also increases blood pressure by 0.7 mmHg. MedicalXpress
Heart attack risk rises in hours after angry outburst, study finds
Within two hours of an angry outburst, a person's risk of heart attack or acute coronary syndrome increased nearly five-fold, their risk of stroke rose nearly four-fold and their risk of a dangerous heart rhythm disorder called ventricular arrhythmia also rose, the researchers found.
The risk was highest among people who got angry more often and had existing risk factors such as prior heart problems, according to the findings, which were published online March 3 in the European Heart Journal. MedicalXpress
A new study from University of Alberta researchers suggests that patients, particularly women, with a history of kidney stones may be at a higher risk for stroke and heart attack.
The study, published in the Clinical Journal of the American Society of Nephrology, was led by Todd Alexander, associate professor of pediatrics and adjunct professor of physiology in the Faculty of Medicine & Dentistry. MedicalXpress
Study results confirm BMI is a direct cause of Type 2 diabetes and high blood pressure
According to the findings, published online in The American Journal of Human Genetics, for every 1 kg/m2 increase in BMI – equivalent to a 196-pound, 40-year old man of average height gaining seven pounds – the risk of developing type 2 diabetes increases by 27 percent. The same rise in BMI also increases blood pressure by 0.7 mmHg. MedicalXpress
Heart attack risk rises in hours after angry outburst, study finds
Within two hours of an angry outburst, a person's risk of heart attack or acute coronary syndrome increased nearly five-fold, their risk of stroke rose nearly four-fold and their risk of a dangerous heart rhythm disorder called ventricular arrhythmia also rose, the researchers found.
The risk was highest among people who got angry more often and had existing risk factors such as prior heart problems, according to the findings, which were published online March 3 in the European Heart Journal. MedicalXpress
Military/Veterans
Study links poor sleep quality to reduced brain gray matter in Gulf War vets
A new study of Gulf War veterans found an association between poor sleep quality and reduced gray matter volume in the brain's frontal lobe, which helps control important processes such as working memory and executive function. MedicalXpress
Study reveals bird threat to U.S. military helicopters
812 of the records included the type of animals involved, with birds accounting for 91%. The species involved in the collisions varied between services which operate across different habitats. Warblers (16.8%), bats (11..5%), and perching birds (12.0%) were the wildlife groups most commonly struck by the air force, whereas gulls (18.2%), seabirds (14.9%), shorebirds (13.4%), and raptors and vultures (12.6%) were most frequently struck by naval aircraft. PhysOrg
Blasts may cause brain injury even without symptoms
Veterans exposed to explosions who do not report symptoms of traumatic brain injury (TBI) may still have damage to the brain's white matter comparable to veterans with TBI, according to researchers at Duke Medicine and the U.S. Department of Veterans Affairs. The findings, published in the Journal of Head Trauma Rehabilitation on March 3, 2014, suggest that a lack of clear TBI symptoms following an explosion may not accurately reflect the extent of brain injury. Eurekalert!
Psychiatric ills widespread among US soldiers, studies say
Three new studies suggest that a sizeable percentage of American soldiers suffer from some type of mental health issue, at rates higher than those seen in the general population.
"Some of the differences in disorder rates are truly remarkable," Ronald Kessler, a professor of health care policy at Harvard Medical School and senior author of one of the studies, said in a Harvard news release. "The rate of major depression is five times as high among soldiers as civilians, intermittent explosive disorder six times as high, and post-traumatic stress disorder [PTSD] nearly 15 times as high." MedicalXpress
Military dads have to re-learn parenting after deployment
Fathers who returned after military service report having difficulty connecting with young children who sometimes don't remember them, according to a study released this week. While the fathers in the study had eagerly anticipated reuniting with their families, they reported significant stress, especially around issues of reconnecting with children, adapting expectations from military to family life, and co-parenting.
"A service member who deploys when his child is an infant and returns home when the child is a toddler may find an entirely different child," says lead author Dr. Tova Walsh. "Under these circumstances, fathers find that it takes substantial effort to rebuild their relationship with their child." The study was published in a special issue of the journal Health & Social Work devoted to the needs of military families. About 37 percent of the 2 million U.S. children of service members are under age 6, suggesting that such issues are widespread. Eurekalert!
A new study of Gulf War veterans found an association between poor sleep quality and reduced gray matter volume in the brain's frontal lobe, which helps control important processes such as working memory and executive function. MedicalXpress
Study reveals bird threat to U.S. military helicopters
812 of the records included the type of animals involved, with birds accounting for 91%. The species involved in the collisions varied between services which operate across different habitats. Warblers (16.8%), bats (11..5%), and perching birds (12.0%) were the wildlife groups most commonly struck by the air force, whereas gulls (18.2%), seabirds (14.9%), shorebirds (13.4%), and raptors and vultures (12.6%) were most frequently struck by naval aircraft. PhysOrg
Blasts may cause brain injury even without symptoms
Veterans exposed to explosions who do not report symptoms of traumatic brain injury (TBI) may still have damage to the brain's white matter comparable to veterans with TBI, according to researchers at Duke Medicine and the U.S. Department of Veterans Affairs. The findings, published in the Journal of Head Trauma Rehabilitation on March 3, 2014, suggest that a lack of clear TBI symptoms following an explosion may not accurately reflect the extent of brain injury. Eurekalert!
Psychiatric ills widespread among US soldiers, studies say
Three new studies suggest that a sizeable percentage of American soldiers suffer from some type of mental health issue, at rates higher than those seen in the general population.
Military dads have to re-learn parenting after deployment
Fathers who returned after military service report having difficulty connecting with young children who sometimes don't remember them, according to a study released this week. While the fathers in the study had eagerly anticipated reuniting with their families, they reported significant stress, especially around issues of reconnecting with children, adapting expectations from military to family life, and co-parenting.
"A service member who deploys when his child is an infant and returns home when the child is a toddler may find an entirely different child," says lead author Dr. Tova Walsh. "Under these circumstances, fathers find that it takes substantial effort to rebuild their relationship with their child." The study was published in a special issue of the journal Health & Social Work devoted to the needs of military families. About 37 percent of the 2 million U.S. children of service members are under age 6, suggesting that such issues are widespread. Eurekalert!
CAM
Plant extract offers hope for infant motor neurone therapy
A chemical found in plants could reduce the symptoms of a rare muscle disease that leaves children with little or no control of their movements. Scientists have found that a plant pigment called quercetin – found in some fruits, vegetables, herbs and grains – could help to prevent the damage to nerves associated with the childhood form of motor neuron disease,spinal muscular atrophy (SMA). The study is published today in the Journal of Clinical Investigation. Eurekalert!
Yoga regulates stress hormones and improves quality of life for women with breast cancer undergoing
Researchers found that while simple stretching exercises counteracted fatigue, patients who participated in yoga exercises that incorporated controlled breathing, meditation and relaxation techniques into their treatment plan experienced improved ability to engage in their daily activities, better general health and better regulation of cortisol (stress hormone). Women in the yoga group were also better equipped to find meaning in the illness experience, which declined over time for the women in the other two groups. Eurekalert!
Exploring alternative treatments for Helicobacter pylori infection
Alternative therapies have not been effective in eradicating the bacteria but have been shown to maintain low bacterial levels. Nevertheless, some of them are useful in preventing the adverse effects of antibiotics, modulating the immune response, gastroprotection, and the general promotion of health. Therefore, those agents can be used as adjuvants of allopathic anti-H. pylori eradication therapy. Ayala G, Escobedo-Hinojosa WI, de la Cruz-Herrera CF, Romero I. World J Gastroenterol. 2014 Feb 14;20(6):1450-1469. Review. PMID: 24587621
Effectiveness of acupuncture to treat irritable bowel syndrome: A meta-analysis
Acupuncture exhibits clinically and statistically significant control of IBS symptoms. Chao GQ, Zhang S. World J Gastroenterol. 2014 Feb 21;20(7):1871-1877. Review. PMID: 24587665
Meat and cheese may be as bad for you as smoking
Not only is excessive protein consumption linked to a dramatic rise in cancer mortality, but middle-aged people who eat lots of proteins from animal sources — including meat, milk and cheese — are also more susceptible to early death in general, reveals the study to be published March 4 in Cell Metabolism. Protein-lovers were 74 percent more likely to die of any cause within the study period than their more low-protein counterparts. They were also several times more likely to die of diabetes. Eurekalert!
A chemical found in plants could reduce the symptoms of a rare muscle disease that leaves children with little or no control of their movements. Scientists have found that a plant pigment called quercetin – found in some fruits, vegetables, herbs and grains – could help to prevent the damage to nerves associated with the childhood form of motor neuron disease,spinal muscular atrophy (SMA). The study is published today in the Journal of Clinical Investigation. Eurekalert!
Yoga regulates stress hormones and improves quality of life for women with breast cancer undergoing
Researchers found that while simple stretching exercises counteracted fatigue, patients who participated in yoga exercises that incorporated controlled breathing, meditation and relaxation techniques into their treatment plan experienced improved ability to engage in their daily activities, better general health and better regulation of cortisol (stress hormone). Women in the yoga group were also better equipped to find meaning in the illness experience, which declined over time for the women in the other two groups. Eurekalert!
Exploring alternative treatments for Helicobacter pylori infection
Alternative therapies have not been effective in eradicating the bacteria but have been shown to maintain low bacterial levels. Nevertheless, some of them are useful in preventing the adverse effects of antibiotics, modulating the immune response, gastroprotection, and the general promotion of health. Therefore, those agents can be used as adjuvants of allopathic anti-H. pylori eradication therapy. Ayala G, Escobedo-Hinojosa WI, de la Cruz-Herrera CF, Romero I. World J Gastroenterol. 2014 Feb 14;20(6):1450-1469. Review. PMID: 24587621
Effectiveness of acupuncture to treat irritable bowel syndrome: A meta-analysis
Acupuncture exhibits clinically and statistically significant control of IBS symptoms. Chao GQ, Zhang S. World J Gastroenterol. 2014 Feb 21;20(7):1871-1877. Review. PMID: 24587665
Not only is excessive protein consumption linked to a dramatic rise in cancer mortality, but middle-aged people who eat lots of proteins from animal sources — including meat, milk and cheese — are also more susceptible to early death in general, reveals the study to be published March 4 in Cell Metabolism. Protein-lovers were 74 percent more likely to die of any cause within the study period than their more low-protein counterparts. They were also several times more likely to die of diabetes. Eurekalert!
Monday, March 3, 2014
Top Story
Detecting levels of antibiotics in blood paves the way to individualized treatment
The study, published today in Nature Nanotechnology, describes the exploitation of a sensor for measuring the concentration of effective antibiotics in blood, giving an indication of their efficiency against disease causing pathogens, for instance multidrug resistant hospital "superbugs". MedicalXpress
The study, published today in Nature Nanotechnology, describes the exploitation of a sensor for measuring the concentration of effective antibiotics in blood, giving an indication of their efficiency against disease causing pathogens, for instance multidrug resistant hospital "superbugs". MedicalXpress
Mixed Bag
Featured in NEJM Journal Watch: Most Severe Trauma Cases Not Transferred
While insurance status may have played a role in the decision to not transfer patients to trauma centers, hospital capabilities and injury patterns were likely more influential, according to a JAMA Surgery study of some 4500 adults with injury severity scores above 15, less than half of whom were transferred. Journal Watch
The heath concerns in spending the day sitting
Dr. Saunders' research focuses on how sitting, even paired with physical activity, can be bad for our health. It prevents sugar and fat from being pumped out of our blood and into our muscles. He says our muscles are like little vacuum pumps that suck the sugar and fat out of our blood.
"So when we're sitting for a long time, those pumps shut off and no more sugar and fat are going into your muscles. It just ends up building up in your blood." MedicalXpress
Catastrophizing can predict low back pain, disability
For patients treated for low back pain, catastrophizing may predict the degree of pain and disability, according to a review published in the Feb. 1 issue of Spine. MedicalXpress
While insurance status may have played a role in the decision to not transfer patients to trauma centers, hospital capabilities and injury patterns were likely more influential, according to a JAMA Surgery study of some 4500 adults with injury severity scores above 15, less than half of whom were transferred. Journal Watch
The heath concerns in spending the day sitting
Dr. Saunders' research focuses on how sitting, even paired with physical activity, can be bad for our health. It prevents sugar and fat from being pumped out of our blood and into our muscles. He says our muscles are like little vacuum pumps that suck the sugar and fat out of our blood.
"So when we're sitting for a long time, those pumps shut off and no more sugar and fat are going into your muscles. It just ends up building up in your blood." MedicalXpress
Catastrophizing can predict low back pain, disability
For patients treated for low back pain, catastrophizing may predict the degree of pain and disability, according to a review published in the Feb. 1 issue of Spine. MedicalXpress
Reviews
Cost-effectiveness of cognitive-behavioural therapy as an adjunct to pharmacotherapy for treatment-resistant depression in primary care: economic evaluation of the CoBalT Trial
The addition of CBT to usual care is cost-effective in patients who have not responded to antidepressants. Primary care physicians should therefore be encouraged to refer such individuals for CBT. Hollinghurst S, Carroll FE, Abel A, Campbell J, Garland A, Jerrom B, Kessler D, Kuyken W, Morrison J, Ridgway N, Thomas L, Turner K, Williams C, Peters TJ, Lewis G, Wiles N.
Risk of drug-induced liver injury with the new oral anticoagulants: systematic review and meta-analysis
NOACs are not associated with an increased risk of DILI. The unexpected 'protective' effect of NOAC is probably due to LMWH-associated hepatotoxicity. Caldeira D, Barra M, Santos AT, de Abreu D, Pinto FJ, Ferreira JJ, Costa J. Heart. 2014 Jan 29. [Epub ahead of print] PMID: 24476812
Vegetarian Diets and Blood Pressure: A Meta-analysis
Consumption of vegetarian diets is associated with lower BP. Such diets could be a useful nonpharmacologic means for reducing BP. Yokoyama Y, Nishimura K, Barnard ND, Takegami M, Watanabe M, Sekikawa A, Okamura T, Miyamoto Y. JAMA Intern Med. 2014 Feb 24. [Epub ahead of print] PMID: 24566947
Effectiveness of general practice-based health checks: a systematic review and meta-analysis
General practice-based health checks are associated with statistically significant, albeit clinically small, improvements in surrogate outcome control, especially among high-risk patients. Most studies were not originally designed to assess mortality. Si S, Moss JR, Sullivan TR, Newton SS, Stocks NP. Br J Gen Pract. 2014 Jan;64(618):e47-53. PMID: 24567582
The influence of regular walking at different times of day on blood lipids and inflammatory markers in sedentary patients with coronary artery disease
Our walking program successfully resulted in a favorable change in lipids and inflammatory markers. Patients in the evening walking group gained more benefits than those walking in the morning walking group. Lian XQ, Zhao D, Zhu M, Wang ZM, Gao W, Zhao H, Zhang DG, Yang ZJ, Wang LS. Prev Med. 2014 Jan;58:64-9. Epub 2013 Nov 4. PMID: 24201089
A trial of treatment for acute otorrhea in children with tympanostomy tubes
Antibiotic-glucocorticoid eardrops were more effective than oral antibiotics and initial observation in children with tympanostomy tubes who had uncomplicated acute otorrhea. van Dongen TM, van der Heijden GJ, Venekamp RP, Rovers MM, Schilder AG. N Engl J Med. 2014 Feb 20;370(8):723-33. PMID: 24552319
The addition of CBT to usual care is cost-effective in patients who have not responded to antidepressants. Primary care physicians should therefore be encouraged to refer such individuals for CBT. Hollinghurst S, Carroll FE, Abel A, Campbell J, Garland A, Jerrom B, Kessler D, Kuyken W, Morrison J, Ridgway N, Thomas L, Turner K, Williams C, Peters TJ, Lewis G, Wiles N.
Br J Psychiatry. 2014 Jan;204(1):69-76.Epub 2013 Nov 21. PMID: 24262818
NOACs are not associated with an increased risk of DILI. The unexpected 'protective' effect of NOAC is probably due to LMWH-associated hepatotoxicity. Caldeira D, Barra M, Santos AT, de Abreu D, Pinto FJ, Ferreira JJ, Costa J. Heart. 2014 Jan 29. [Epub ahead of print] PMID: 24476812
Vegetarian Diets and Blood Pressure: A Meta-analysis
Consumption of vegetarian diets is associated with lower BP. Such diets could be a useful nonpharmacologic means for reducing BP. Yokoyama Y, Nishimura K, Barnard ND, Takegami M, Watanabe M, Sekikawa A, Okamura T, Miyamoto Y. JAMA Intern Med. 2014 Feb 24. [Epub ahead of print] PMID: 24566947
Effectiveness of general practice-based health checks: a systematic review and meta-analysis
General practice-based health checks are associated with statistically significant, albeit clinically small, improvements in surrogate outcome control, especially among high-risk patients. Most studies were not originally designed to assess mortality. Si S, Moss JR, Sullivan TR, Newton SS, Stocks NP. Br J Gen Pract. 2014 Jan;64(618):e47-53. PMID: 24567582
The influence of regular walking at different times of day on blood lipids and inflammatory markers in sedentary patients with coronary artery disease
Our walking program successfully resulted in a favorable change in lipids and inflammatory markers. Patients in the evening walking group gained more benefits than those walking in the morning walking group. Lian XQ, Zhao D, Zhu M, Wang ZM, Gao W, Zhao H, Zhang DG, Yang ZJ, Wang LS. Prev Med. 2014 Jan;58:64-9. Epub 2013 Nov 4. PMID: 24201089
A trial of treatment for acute otorrhea in children with tympanostomy tubes
Antibiotic-glucocorticoid eardrops were more effective than oral antibiotics and initial observation in children with tympanostomy tubes who had uncomplicated acute otorrhea. van Dongen TM, van der Heijden GJ, Venekamp RP, Rovers MM, Schilder AG. N Engl J Med. 2014 Feb 20;370(8):723-33. PMID: 24552319
Mental health
The pain of social exclusion
We would like to do without pain and yet without it we wouldn't be able to survive. Pain signals dangerous stimuli (internal or external) and guides our behaviour. Its ultimate goal is to prioritize escape, recovery and healing. That's why we feel it and why we're also good at detecting it in others. Pain in fact protects not only the individual but also his social bonds. The brain contains circuits related to the more physical aspects of pain and others related to affective aspects. As observed in a study just published by Giorgia Silani, Giovanni Novembre and Marco Zanon of the International School for Advanced Studies (SISSA) of Trieste in the journal Social Cognitive and Affective Neuroscience, social pain activates some brain circuits of physical pain whether we feel it personally or when we experience it vicariously as an empathic response to other people's pain. Eurekalert!
Hospitalization increases risk of depression and dementia for seniors
"There appears to be a bidirectional relationship between adverse mental health and bad medical outcomes," said lead study author Dimitry Davydow, M.D., a psychiatrist at the University of Washington. Among older people, dementia and depression appears to increase the risk of hospitalization, which might lead to further cognitive decline or depression and subsequent risk for re-hospitalization, perpetuating a vicious cycle, Davydow explained. MedicalXpress
Researchers identify brain differences linked to insomnia
"Insomnia is not a nighttime disorder," says study leader Rachel E. Salas, M.D., an assistant professor of neurology at the Johns Hopkins University School of Medicine. "It's a 24-hour brain condition, like a light switch that is always on. Our research adds information about differences in the brain associated with it."
Salas and her team, reporting in the March issue of the journal Sleep, found that the motor cortex in those with chronic insomnia was more adaptable to change—more plastic—than in a group of good sleepers. They also found more "excitability" among neurons in the same region of the brain among those with chronic insomnia, adding evidence to the notion that insomniacs are in a constant state of heightened information processing that may interfere with sleep. MedicalXpress
Frequent childhood nightmares may indicate an increased risk of psychotic traits
The study, published today in the journal SLEEP, shows that children reporting frequent nightmares before the age of 12 were three and a half times more likely to suffer from psychotic experiences in early adolescence. Similarly, experiencing night terrors doubled the risk of such problems, including hallucinations, interrupted thoughts or delusions. Younger children, between two and nine years old, who had persistent nightmares reported by parents had up to one and a half times increased risk of developing psychotic experiences. MedicalXpress
The state of mental health treatment in the United States
Paul Summergrad: Probably 25 percent of the U.S. population has some form of mental health disorder. We're not talking about disorders that affect somebody else. It's not like people with mental illness are a special category living someplace else. They are our brothers and sisters, our parents and grandparents, our kids with ADHD or autism, our neighbors with depression or anxiety. MedicalXpress
We would like to do without pain and yet without it we wouldn't be able to survive. Pain signals dangerous stimuli (internal or external) and guides our behaviour. Its ultimate goal is to prioritize escape, recovery and healing. That's why we feel it and why we're also good at detecting it in others. Pain in fact protects not only the individual but also his social bonds. The brain contains circuits related to the more physical aspects of pain and others related to affective aspects. As observed in a study just published by Giorgia Silani, Giovanni Novembre and Marco Zanon of the International School for Advanced Studies (SISSA) of Trieste in the journal Social Cognitive and Affective Neuroscience, social pain activates some brain circuits of physical pain whether we feel it personally or when we experience it vicariously as an empathic response to other people's pain. Eurekalert!
Hospitalization increases risk of depression and dementia for seniors
"There appears to be a bidirectional relationship between adverse mental health and bad medical outcomes," said lead study author Dimitry Davydow, M.D., a psychiatrist at the University of Washington. Among older people, dementia and depression appears to increase the risk of hospitalization, which might lead to further cognitive decline or depression and subsequent risk for re-hospitalization, perpetuating a vicious cycle, Davydow explained. MedicalXpress
Researchers identify brain differences linked to insomnia
"Insomnia is not a nighttime disorder," says study leader Rachel E. Salas, M.D., an assistant professor of neurology at the Johns Hopkins University School of Medicine. "It's a 24-hour brain condition, like a light switch that is always on. Our research adds information about differences in the brain associated with it."
Salas and her team, reporting in the March issue of the journal Sleep, found that the motor cortex in those with chronic insomnia was more adaptable to change—more plastic—than in a group of good sleepers. They also found more "excitability" among neurons in the same region of the brain among those with chronic insomnia, adding evidence to the notion that insomniacs are in a constant state of heightened information processing that may interfere with sleep. MedicalXpress
Frequent childhood nightmares may indicate an increased risk of psychotic traits
The study, published today in the journal SLEEP, shows that children reporting frequent nightmares before the age of 12 were three and a half times more likely to suffer from psychotic experiences in early adolescence. Similarly, experiencing night terrors doubled the risk of such problems, including hallucinations, interrupted thoughts or delusions. Younger children, between two and nine years old, who had persistent nightmares reported by parents had up to one and a half times increased risk of developing psychotic experiences. MedicalXpress
The state of mental health treatment in the United States
Paul Summergrad: Probably 25 percent of the U.S. population has some form of mental health disorder. We're not talking about disorders that affect somebody else. It's not like people with mental illness are a special category living someplace else. They are our brothers and sisters, our parents and grandparents, our kids with ADHD or autism, our neighbors with depression or anxiety. MedicalXpress
Infectious Diseases
Fossilized human feces from 14th century contain antibiotic resistance genes
A team of French investigators has discovered viruses containing genes for antibiotic resistance in a fossilized fecal sample from 14th century Belgium, long before antibiotics were used in medicine. They publish their findings ahead of print in the journal Applied and Environmental Microbiology. Eurekalert!
Unique multi-resistant bacterium difficult to eradicate
A previously unknown multi-resistant bacterium has been sticking around at a Swedish University Hospital for ten years. The reason for this is deficient hygiene routines among the staff, a doctoral thesis at Linköping University shows.
"In connection with the MRSA outbreak, an increased occurrence of MSSA was discovered, a strain that was sensitive to methicillin but resistant to many other types of antibiotic. This was a completely new find," says Maria Lindqvist, a PhD student in clinical microbiology. The results are set out in her doctoral thesis. MedicalXpress
Researchers release first risk-assessment predictions for West Nile virus
Now, a team of researchers from the Center for Tropical Research at UCLA's Institute of the Environment and Sustainability has created a model to help predict where the disease may occur under future climate change. Their findings were published Feb. 27 in the journal Global Change Biology. MedicalXpress
How a single pathogen could dramatically alter migratory pattern risks today
In 2013, cities are no longer the death traps they once were, even accounting for the millions of migrants who live in poor, often slum-like conditions. But will cities always be better places to live? What could eliminate the 'urban advantage' and what might the future of our cities look like if antibiotics stop working? MedicalXpress
In first moments of infection, a division and a decision
Using technologies and computational modeling that trace the destiny of single cells, researchers at the University of California, San Diego School of Medicine describe for the first time the earliest stages of fate determination among white blood cells called T lymphocytes, providing new insights that may help drug developers create more effective, longer-lasting vaccines against microbial pathogens or cancer. The findings are published in the March 2, 2014 online issue of Nature Immunology. MedicalXpress
A team of French investigators has discovered viruses containing genes for antibiotic resistance in a fossilized fecal sample from 14th century Belgium, long before antibiotics were used in medicine. They publish their findings ahead of print in the journal Applied and Environmental Microbiology. Eurekalert!
Unique multi-resistant bacterium difficult to eradicate
A previously unknown multi-resistant bacterium has been sticking around at a Swedish University Hospital for ten years. The reason for this is deficient hygiene routines among the staff, a doctoral thesis at Linköping University shows.
"In connection with the MRSA outbreak, an increased occurrence of MSSA was discovered, a strain that was sensitive to methicillin but resistant to many other types of antibiotic. This was a completely new find," says Maria Lindqvist, a PhD student in clinical microbiology. The results are set out in her doctoral thesis. MedicalXpress
Researchers release first risk-assessment predictions for West Nile virus
Now, a team of researchers from the Center for Tropical Research at UCLA's Institute of the Environment and Sustainability has created a model to help predict where the disease may occur under future climate change. Their findings were published Feb. 27 in the journal Global Change Biology. MedicalXpress
How a single pathogen could dramatically alter migratory pattern risks today
In 2013, cities are no longer the death traps they once were, even accounting for the millions of migrants who live in poor, often slum-like conditions. But will cities always be better places to live? What could eliminate the 'urban advantage' and what might the future of our cities look like if antibiotics stop working? MedicalXpress
In first moments of infection, a division and a decision
Using technologies and computational modeling that trace the destiny of single cells, researchers at the University of California, San Diego School of Medicine describe for the first time the earliest stages of fate determination among white blood cells called T lymphocytes, providing new insights that may help drug developers create more effective, longer-lasting vaccines against microbial pathogens or cancer. The findings are published in the March 2, 2014 online issue of Nature Immunology. MedicalXpress
CAM
Ancient Chinese medicine put through its paces for pancreatic cancer
The bark of the Amur cork tree (Phellodendron amurense) has traveled a centuries-long road with the healing arts. Now it is being put through its paces by science in the fight against pancreatic cancer, with the potential to make inroads against several more.
UT Health Science Center researcher A. Pratap Kumar was already exploring the cork tree extract's promise in treating prostate cancer when his team found that deadly pancreatic cancers share some similar development pathways with prostate tumors.
In a paper published today in the journal Clinical Cancer Research, the researchers show that the extract blocks those pathways and inhibits the scarring that thwarts anti-cancer drugs. Dr. Jingjing Gong, currently pursuing post-doctoral studies at Yale University, conducted the study as a graduate student in Dr Kumar's laboratory in the Department of Pharmacology. Eurekalert!
Increased intake of fish can boost good cholesterol levels
Increasing the intake of fatty fish increases the number of large HDL particles, according to a recent study completed at the University of Eastern Finland. People who increased their intake of fish to a minimum of 3-4 weekly meals had more large HDL particles in their blood than people who are less frequent eaters of fish. Large HDL particles are believed to protect against cardiovascular diseases. The results were published in PLOS ONE. MedicalXpress
Seaweeds high in guluronate inhibit fat absorption
New research published today in Food Chemistry and funded by BBSRC has identified the chemical properties of alginates which prevent fat from being digested by our bodies and this has allowed scientists to produce a league table of the most effective seaweeds. If added to everyday foods these seaweeds could prevent us absorbing much of the fat from our diets. MedicalXpress
DASH diet may lower risk of recurrent kidney stones
The Dietary Approaches to Stop Hypertension (DASH) diet might be an effective alternative to the low-oxalate diet for reducing risk of kidney stone recurrence, according to research published in the March issue of the American Journal of Kidney Diseases. MedicalXpress
A Science-Based Discussion of the Role of Magtein(tm), a Novel Compound of Magnesium -L-threonate, For Cognitive Health, including Dementia and Alzheimer's Disease
Dr. Guosong Liu, one of the world’s leading cognitive health researchers said, “There is general scientific agreement that magnesium is an essential cofactor for more than 300 enzymes involved in biosynthesis processes and energy metabolism. In addition, it plays an important role in many of the brain’s functions; but most magnesium compounds have low brain bioavailability and severe gastrointestinal side effects.
“However, a significant number of health care providers are unaware that Magtein, is the only magnesium compound that has been shown to effectively raise the brain’s magnesium levels, which leads to enhanced learning abilities, working memory, and short- and long-term memory in both young and aged animals. Four published preclinical studies found that Magtein improved memory, and help prevent the decline and reverse the symptoms of Alzheimer’s. ”1 NewsWise
The bark of the Amur cork tree (Phellodendron amurense) has traveled a centuries-long road with the healing arts. Now it is being put through its paces by science in the fight against pancreatic cancer, with the potential to make inroads against several more.
UT Health Science Center researcher A. Pratap Kumar was already exploring the cork tree extract's promise in treating prostate cancer when his team found that deadly pancreatic cancers share some similar development pathways with prostate tumors.
In a paper published today in the journal Clinical Cancer Research, the researchers show that the extract blocks those pathways and inhibits the scarring that thwarts anti-cancer drugs. Dr. Jingjing Gong, currently pursuing post-doctoral studies at Yale University, conducted the study as a graduate student in Dr Kumar's laboratory in the Department of Pharmacology. Eurekalert!
Increased intake of fish can boost good cholesterol levels
Increasing the intake of fatty fish increases the number of large HDL particles, according to a recent study completed at the University of Eastern Finland. People who increased their intake of fish to a minimum of 3-4 weekly meals had more large HDL particles in their blood than people who are less frequent eaters of fish. Large HDL particles are believed to protect against cardiovascular diseases. The results were published in PLOS ONE. MedicalXpress
Seaweeds high in guluronate inhibit fat absorption
New research published today in Food Chemistry and funded by BBSRC has identified the chemical properties of alginates which prevent fat from being digested by our bodies and this has allowed scientists to produce a league table of the most effective seaweeds. If added to everyday foods these seaweeds could prevent us absorbing much of the fat from our diets. MedicalXpress
DASH diet may lower risk of recurrent kidney stones
The Dietary Approaches to Stop Hypertension (DASH) diet might be an effective alternative to the low-oxalate diet for reducing risk of kidney stone recurrence, according to research published in the March issue of the American Journal of Kidney Diseases. MedicalXpress
A Science-Based Discussion of the Role of Magtein(tm), a Novel Compound of Magnesium -L-threonate, For Cognitive Health, including Dementia and Alzheimer's Disease
Dr. Guosong Liu, one of the world’s leading cognitive health researchers said, “There is general scientific agreement that magnesium is an essential cofactor for more than 300 enzymes involved in biosynthesis processes and energy metabolism. In addition, it plays an important role in many of the brain’s functions; but most magnesium compounds have low brain bioavailability and severe gastrointestinal side effects.
“However, a significant number of health care providers are unaware that Magtein, is the only magnesium compound that has been shown to effectively raise the brain’s magnesium levels, which leads to enhanced learning abilities, working memory, and short- and long-term memory in both young and aged animals. Four published preclinical studies found that Magtein improved memory, and help prevent the decline and reverse the symptoms of Alzheimer’s. ”1 NewsWise
eMedicine/Devices/Procedures
Pentagon testing low-level electroshocks to keep soldiers awake
For some modern soldiers, caffeine is just not enough to stay vigilant, especially for the growing ranks of digital warriors who must spend hours monitoring spy drone footage and other streams of surveillance data. So the Pentagon is exploring a novel way to extend troops’ attention spans and sharpen their reaction times: stimulate the brain with low levels of electricity, a.k.a. Transcranial direct-current stimulation (TDCS). Neurogadget
Johns Hopkins ABX Guide for Android helps health providers determine correct antibiotic choices
Johns Hopkins ABX Guide contains good information about treatments. It is a shame it doesn’t takes advantages of multimedia resources like pictures and images which would be great for aiding in diagnosing diseases. Price $29.95 iMedicalApps
Chest x-ray training app tests and teaches you radiology skills
Good for a quick review of chest x-rays. Use it a few times to get your bearings and learn the cases and then likely move on. As of publish, there is no Android version available. iMedicalApps
Researchers starting clinical trials of low cost holographic test that monitors diabetes
Researchers at the University of Cambridge recently published a paper in the journal Advanced Optical Materials on a test they created that uses responsive holograms to monitor conditions such as diabetes, cardiac function, infections, electrolyte or hormones imbalance. iMedicalApps
For some modern soldiers, caffeine is just not enough to stay vigilant, especially for the growing ranks of digital warriors who must spend hours monitoring spy drone footage and other streams of surveillance data. So the Pentagon is exploring a novel way to extend troops’ attention spans and sharpen their reaction times: stimulate the brain with low levels of electricity, a.k.a. Transcranial direct-current stimulation (TDCS). Neurogadget
Johns Hopkins ABX Guide for Android helps health providers determine correct antibiotic choices
Johns Hopkins ABX Guide contains good information about treatments. It is a shame it doesn’t takes advantages of multimedia resources like pictures and images which would be great for aiding in diagnosing diseases. Price $29.95 iMedicalApps
Chest x-ray training app tests and teaches you radiology skills
Good for a quick review of chest x-rays. Use it a few times to get your bearings and learn the cases and then likely move on. As of publish, there is no Android version available. iMedicalApps
Researchers starting clinical trials of low cost holographic test that monitors diabetes
Researchers at the University of Cambridge recently published a paper in the journal Advanced Optical Materials on a test they created that uses responsive holograms to monitor conditions such as diabetes, cardiac function, infections, electrolyte or hormones imbalance. iMedicalApps
Friday, February 28, 2014
Top Story
Early atherosclerotic plaques regress when cholesterol levels are lowered
Early but not advanced forms of atherosclerotic plaques in the vessel wall disappear when the levels of 'bad' cholesterol are lowered, according to a study in mice from Karolinska Institutet, Sweden. The findings, published in PLoS Genetics, indicate that preventative cholesterol-lowering treatment could prevent more advanced, clinically relevant plaque to develop. MedicalXpress
Early but not advanced forms of atherosclerotic plaques in the vessel wall disappear when the levels of 'bad' cholesterol are lowered, according to a study in mice from Karolinska Institutet, Sweden. The findings, published in PLoS Genetics, indicate that preventative cholesterol-lowering treatment could prevent more advanced, clinically relevant plaque to develop. MedicalXpress
Mixed Bag
High-calorie feeding may slow progression of ALS
Increasing the number of calories consumed by patients with amyotrophic lateral sclerosis (ALS) may be a relatively simple way of extending their survival. A phase 2 clinical trial led by Massachusetts General Hospital (MGH) physicians found that ALS patients receiving a high-calorie, high-carbohydrate tube-feeding formula lived longer with fewer adverse events than participants who received a standard formula designed maintain their weight. While the small size of the trial indicates results need to be interpreted with caution, the authors are optimistic that improved nutrition could make a significant difference for patients with ALS. MedicalXpress
Do obesity, birth control pills raise risk of multiple sclerosis?
For the obesity study, BMI was calculated for 210 people with MS and 210 people of the same age and sex who did not have MS at ages 15 and 20 and at the time of the study. The study found that people who are obese at age 20 are twice as likely to later develop MS as people who are not obese. The study found that people with higher BMI levels also had higher levels of leptin, a hormone made by fat tissue that regulates weight, appetite and immune response.
Women who had used hormonal contraceptives were 35 percent more likely to develop MS than those who did not use them. Those who had used the contraceptives but had stopped at least one month before symptoms started were 50 percent more likely to develop MS. MedicalXpress
Transplanting thymus cells into patients may repair and restore the immune system
Studies show that transplanting thymus cells into patients can be an effective way to repair and restore the immune system; however the lack of a source for these specialised cells represents a major barrier. In the previous studies, scientists used cells from newborn babies that had been removed as a normal part of heart surgery. Cells from adult donors are shown not to have the same effect. The THYMISTEM team seeks to overcome this by finding new methods of producing thymus stem cells in the lab as an alternative source of cells for therapy. MedicalXpress
Increasing the number of calories consumed by patients with amyotrophic lateral sclerosis (ALS) may be a relatively simple way of extending their survival. A phase 2 clinical trial led by Massachusetts General Hospital (MGH) physicians found that ALS patients receiving a high-calorie, high-carbohydrate tube-feeding formula lived longer with fewer adverse events than participants who received a standard formula designed maintain their weight. While the small size of the trial indicates results need to be interpreted with caution, the authors are optimistic that improved nutrition could make a significant difference for patients with ALS. MedicalXpress
Do obesity, birth control pills raise risk of multiple sclerosis?
For the obesity study, BMI was calculated for 210 people with MS and 210 people of the same age and sex who did not have MS at ages 15 and 20 and at the time of the study. The study found that people who are obese at age 20 are twice as likely to later develop MS as people who are not obese. The study found that people with higher BMI levels also had higher levels of leptin, a hormone made by fat tissue that regulates weight, appetite and immune response.
Women who had used hormonal contraceptives were 35 percent more likely to develop MS than those who did not use them. Those who had used the contraceptives but had stopped at least one month before symptoms started were 50 percent more likely to develop MS. MedicalXpress
Transplanting thymus cells into patients may repair and restore the immune system
Studies show that transplanting thymus cells into patients can be an effective way to repair and restore the immune system; however the lack of a source for these specialised cells represents a major barrier. In the previous studies, scientists used cells from newborn babies that had been removed as a normal part of heart surgery. Cells from adult donors are shown not to have the same effect. The THYMISTEM team seeks to overcome this by finding new methods of producing thymus stem cells in the lab as an alternative source of cells for therapy. MedicalXpress
Neoplasms
The only top 10 cancer where survival rates are falling
Of the top 10 cancers in the UK, bladder cancer is only one where survival rates have been shown to be getting worse. New figures published this month in the Journal of Clinical Urology confirm in a study of cases of bladder cancer in England over a 19 year period (from 1990 until 2009) that survival rates here in the UK are falling and are worse than in than in other European countries with similar incidence rates. Eurekalert!
Cancer vaccine could use immune system to fight tumors
Researchers used IL-15 to develop a whole tumor cell vaccine to target breast (TS/A) and prostate (TRAMP-C2) cancer cells in animal models; results showed that tumor cells stopped growing after the vaccine was introduced and that beneficial effects were enhanced further when IL-15Rα was co-produced by the vaccine cells. MedicalXpress
Surgery better for most men with localised prostate cancer
Surgery offers better survival rates for most men with localised prostate cancer than radiotherapy, according to one of the largest studies of its type. The study, led by an Oxford University researcher, found that surgery as the first-line treatment offered greatest benefits for younger men in good general health.
The international research team from the UK, Sweden and the Netherlands compared data on what happened to more than 34,000 Swedish men over a 15-year period after they had been treated for prostate cancer. It is hoped the findings, published online today in the British Medical Journal, could help inform treatment choice. MedicalXpress
Of the top 10 cancers in the UK, bladder cancer is only one where survival rates have been shown to be getting worse. New figures published this month in the Journal of Clinical Urology confirm in a study of cases of bladder cancer in England over a 19 year period (from 1990 until 2009) that survival rates here in the UK are falling and are worse than in than in other European countries with similar incidence rates. Eurekalert!
Cancer vaccine could use immune system to fight tumors
Researchers used IL-15 to develop a whole tumor cell vaccine to target breast (TS/A) and prostate (TRAMP-C2) cancer cells in animal models; results showed that tumor cells stopped growing after the vaccine was introduced and that beneficial effects were enhanced further when IL-15Rα was co-produced by the vaccine cells. MedicalXpress
Surgery better for most men with localised prostate cancer
Surgery offers better survival rates for most men with localised prostate cancer than radiotherapy, according to one of the largest studies of its type. The study, led by an Oxford University researcher, found that surgery as the first-line treatment offered greatest benefits for younger men in good general health.
The international research team from the UK, Sweden and the Netherlands compared data on what happened to more than 34,000 Swedish men over a 15-year period after they had been treated for prostate cancer. It is hoped the findings, published online today in the British Medical Journal, could help inform treatment choice. MedicalXpress
Reviews
Workplace interventions for smoking cessation
1. We found strong evidence that some interventions directed towards individual smokers increase the likelihood of quitting smoking. These include individual and group counselling, pharmacological treatment to overcome nicotine addiction, and multiple interventions targeting smoking cessation as the primary or only outcome. All these interventions show similar effects whether offered in the workplace or elsewhere. Self-help interventions and social support are less effective. Although people taking up these interventions are more likely to stop, the absolute numbers who quit are low.2. We failed to detect an effect of comprehensive programmes targeting multiple risk factors in reducing the prevalence of smoking, although this finding was not based on meta-analysed data. 3. There was limited evidence that participation in programmes can be increased by competitions and incentives organized by the employer, although one trial demonstrated a sustained effect of financial rewards for attending a smoking cessation course and for long-term quitting. Further research is needed to establish which components of this trial contributed to the improvement in success rates.4. Further research would be valuable in low-income and developing countries, where high rates of smoking prevail and smoke-free legislation is not widely accepted or enforced. Cahill K, Lancaster T. Cochrane Database Syst Rev. 2014 Feb 26;2:CD003440. [Epub ahead of print] PMID: 24570145
Probiotics for preventing gestational diabetes
One trial has shown a reduction in the rate of GDM when women are randomised to probiotics early in pregnancy but more uncertain evidence of any effect on miscarriage/IUFD/stillbirth/neonatal death. There are no data on macrosomia. At this time, there are insufficient studies to perform a quantitative meta-analysis. Further results are awaited from four ongoing studies. Barrett HL, Dekker Nitert M, Conwell LS, Callaway LK. Cochrane Database Syst Rev. 2014 Feb 27;2:CD009951. [Epub ahead of print] PMID: 24574258
Mechanical versus manual chest compressions for cardiac arrest
Evidence from RCTs in humans is insufficient to conclude that mechanical chest compressions during cardiopulmonary resuscitation for cardiac arrest are associated with benefit or harm. Widespread use of mechanical devices for chest compressions during cardiac events is not supported by this review. More RCTs that measure and account for the CPR process in both arms are needed to clarify the potential benefit to be derived from this intervention. Brooks SC, Hassan N, Bigham BL, Morrison LJ. Cochrane Database Syst Rev. 2014 Feb 27;2:CD007260. [Epub ahead of print] PMID: 24574099
Psychological therapies (Internet-delivered) for the management of chronic pain in adults
There is insufficient evidence to make conclusions regarding the efficacy of psychological therapies delivered via the Internet in participants with headache conditions. Psychological therapies reduced pain and disability post-treatment; however, no clear evidence of benefit was found for depression and anxiety. For participants with non-headache conditions, psychological therapies delivered via the Internet reduced pain, disability, depression, and anxiety post-treatment. The positive effects on disability were maintained at follow-up. These effects are promising, but considerable uncertainty remains around the estimates of effect. These results come from a small number of trials, with mostly wait-list controls, no reports of adverse events, and non-clinical recruitment methods. Due to the novel method of delivery, the satisfaction and acceptability of these therapies should be explored in this population. These results are similar to those of reviews of traditional face-to-face therapies for chronic pain. Eccleston C, Fisher E, Craig L, Duggan GB, Rosser BA, Keogh E. Cochrane Database Syst Rev. 2014 Feb 26;2:CD010152. [Epub ahead of print] PMID: 24574082
Light therapy for improving cognition, activities of daily living, sleep, challenging behaviour, and psychiatric disturbances in dementia
There is insufficient evidence to justify the use of bright light therapy in dementia. Further research should concentrate on replicating the suggested effect on ADLs, and establishing the biological mechanism for how light therapy improves these important outcomes. Forbes D, Blake CM, Thiessen EJ, Peacock S, Hawranik P. Cochrane Database Syst Rev. 2014 Feb 26;2:CD003946. [Epub ahead of print] PMID: 24574061
1. We found strong evidence that some interventions directed towards individual smokers increase the likelihood of quitting smoking. These include individual and group counselling, pharmacological treatment to overcome nicotine addiction, and multiple interventions targeting smoking cessation as the primary or only outcome. All these interventions show similar effects whether offered in the workplace or elsewhere. Self-help interventions and social support are less effective. Although people taking up these interventions are more likely to stop, the absolute numbers who quit are low.2. We failed to detect an effect of comprehensive programmes targeting multiple risk factors in reducing the prevalence of smoking, although this finding was not based on meta-analysed data. 3. There was limited evidence that participation in programmes can be increased by competitions and incentives organized by the employer, although one trial demonstrated a sustained effect of financial rewards for attending a smoking cessation course and for long-term quitting. Further research is needed to establish which components of this trial contributed to the improvement in success rates.4. Further research would be valuable in low-income and developing countries, where high rates of smoking prevail and smoke-free legislation is not widely accepted or enforced. Cahill K, Lancaster T. Cochrane Database Syst Rev. 2014 Feb 26;2:CD003440. [Epub ahead of print] PMID: 24570145
Probiotics for preventing gestational diabetes
One trial has shown a reduction in the rate of GDM when women are randomised to probiotics early in pregnancy but more uncertain evidence of any effect on miscarriage/IUFD/stillbirth/neonatal death. There are no data on macrosomia. At this time, there are insufficient studies to perform a quantitative meta-analysis. Further results are awaited from four ongoing studies. Barrett HL, Dekker Nitert M, Conwell LS, Callaway LK. Cochrane Database Syst Rev. 2014 Feb 27;2:CD009951. [Epub ahead of print] PMID: 24574258
Mechanical versus manual chest compressions for cardiac arrest
Evidence from RCTs in humans is insufficient to conclude that mechanical chest compressions during cardiopulmonary resuscitation for cardiac arrest are associated with benefit or harm. Widespread use of mechanical devices for chest compressions during cardiac events is not supported by this review. More RCTs that measure and account for the CPR process in both arms are needed to clarify the potential benefit to be derived from this intervention. Brooks SC, Hassan N, Bigham BL, Morrison LJ. Cochrane Database Syst Rev. 2014 Feb 27;2:CD007260. [Epub ahead of print] PMID: 24574099
Psychological therapies (Internet-delivered) for the management of chronic pain in adults
There is insufficient evidence to make conclusions regarding the efficacy of psychological therapies delivered via the Internet in participants with headache conditions. Psychological therapies reduced pain and disability post-treatment; however, no clear evidence of benefit was found for depression and anxiety. For participants with non-headache conditions, psychological therapies delivered via the Internet reduced pain, disability, depression, and anxiety post-treatment. The positive effects on disability were maintained at follow-up. These effects are promising, but considerable uncertainty remains around the estimates of effect. These results come from a small number of trials, with mostly wait-list controls, no reports of adverse events, and non-clinical recruitment methods. Due to the novel method of delivery, the satisfaction and acceptability of these therapies should be explored in this population. These results are similar to those of reviews of traditional face-to-face therapies for chronic pain. Eccleston C, Fisher E, Craig L, Duggan GB, Rosser BA, Keogh E. Cochrane Database Syst Rev. 2014 Feb 26;2:CD010152. [Epub ahead of print] PMID: 24574082
Light therapy for improving cognition, activities of daily living, sleep, challenging behaviour, and psychiatric disturbances in dementia
There is insufficient evidence to justify the use of bright light therapy in dementia. Further research should concentrate on replicating the suggested effect on ADLs, and establishing the biological mechanism for how light therapy improves these important outcomes. Forbes D, Blake CM, Thiessen EJ, Peacock S, Hawranik P. Cochrane Database Syst Rev. 2014 Feb 26;2:CD003946. [Epub ahead of print] PMID: 24574061
Military/Veterans
Fast method to detect sepsis derived from missile launch technology
Using analytical technology developed to detect launched missiles, Lockheed Martin [NYSE: LMT] has discovered a way to identify sepsis, a potentially fatal blood condition, between 14 to 16 hours earlier than physicians currently do. MedicalXpress
Phantom limb pain relieved when amputated arm is put back to work (w/ Video)
The new method uses muscle signals from the patient´s arm stump to drive a system known as augmented reality. The electrical signals in the muscles are sensed by electrodes on the skin. The signals are then translated into arm movements by complex algorithms. The patient can see himself on a screen with a superimposed virtual arm, which is controlled using his own neural command in real time. MedicalXpress
Inflammation May Be PTSD Risk Factor (CME/CE)
Among U.S. Marines and Navy personnel who consented to participate in a prospective study, each 10-fold increment in CRP levels at pre-deployment baseline was associated with a 51% increased likelihood of showing at least one PTSD symptom after deployment to Iraq or Afghanistan (odds ratio 1.51, 95% CI 1.15-1.97, P=0.003), reported Dewleen Baker, MD, of the VA Healthcare System in San Diego, and colleagues. Writing online in JAMA Psychiatry, the researchers proposed that inflammation may predispose people to develop PTSD. MedPage Today
Using analytical technology developed to detect launched missiles, Lockheed Martin [NYSE: LMT] has discovered a way to identify sepsis, a potentially fatal blood condition, between 14 to 16 hours earlier than physicians currently do. MedicalXpress
Phantom limb pain relieved when amputated arm is put back to work (w/ Video)
The new method uses muscle signals from the patient´s arm stump to drive a system known as augmented reality. The electrical signals in the muscles are sensed by electrodes on the skin. The signals are then translated into arm movements by complex algorithms. The patient can see himself on a screen with a superimposed virtual arm, which is controlled using his own neural command in real time. MedicalXpress
Inflammation May Be PTSD Risk Factor (CME/CE)
Among U.S. Marines and Navy personnel who consented to participate in a prospective study, each 10-fold increment in CRP levels at pre-deployment baseline was associated with a 51% increased likelihood of showing at least one PTSD symptom after deployment to Iraq or Afghanistan (odds ratio 1.51, 95% CI 1.15-1.97, P=0.003), reported Dewleen Baker, MD, of the VA Healthcare System in San Diego, and colleagues. Writing online in JAMA Psychiatry, the researchers proposed that inflammation may predispose people to develop PTSD. MedPage Today
CAM
The role of nutrition and nutraceutical supplements in the treatment of hypertension
Macronutrients and micronutrients can prevent, control and treat hypertension through numerous mechanisms related to vascular biology. Oxidative stress, inflammation and autoimmune dysfunction initiate and propagate hypertension and cardiovascular disease. There is a role for the selected use of single and component nutraceutical supplements, vitamins, antioxidants and minerals in the treatment of hypertension based on scientifically controlled studies which complement optimal nutrition, coupled with other lifestyle modifications. Mark Houston; World J Cardiol. Feb 26, 2014; 6(2): 38–66.
Clinical investigation of the acute effects of pomegranate juice on blood pressure and endothelial function in hypertensive individuals
PJ has promising acute hypotensive properties. Consumption of PJ could be considered in the context of both dietary and pharmacological interventions for hypertension. Asgary S, Keshvari M, Sahebkar A, Hashemi M, Rafieian-Kopaei M. ARYA Atheroscler. 2013 Nov;9(6):326-31. PMID: 24575134
A U-shaped association between consumption of marine n-3 fatty acids and development of atrial fibrillation/atrial flutter--a Danish cohort study
We found a U-shaped association between consumption of marine n-3 PUFA and risk of incident AF, with the lowest risk close to the median intake of total marine n-3 PUFA (0.63 g/day). Rix TA, Joensen AM, Riahi S, Lundbye-Christensen S, Tjønneland A, Schmidt EB, Overvad K. Europace. 2014 Feb 26. [Epub ahead of print] PMID: 24574493
Beneficial anti-inflammatory effects observed when plant extracts fed to sick pigs
The researchers conducted two experiments to test the beneficial effects of adding plant extracts to pig diets to combat PRRS and E. coli. In both experiments, researchers used four diets in weanling pigs, including a control diet and three additional diets that included garlic botanical extracted from garlic, turmeric oleoresin extracted from ginger, or capsicum oleoresin from pepper. In both experiments, half of the pigs in each dietary treatment were challenged with either E. coli or PRRS virus while the other half of the pigs were non-challenged. PhysOrg
Macronutrients and micronutrients can prevent, control and treat hypertension through numerous mechanisms related to vascular biology. Oxidative stress, inflammation and autoimmune dysfunction initiate and propagate hypertension and cardiovascular disease. There is a role for the selected use of single and component nutraceutical supplements, vitamins, antioxidants and minerals in the treatment of hypertension based on scientifically controlled studies which complement optimal nutrition, coupled with other lifestyle modifications. Mark Houston; World J Cardiol. Feb 26, 2014; 6(2): 38–66.
Clinical investigation of the acute effects of pomegranate juice on blood pressure and endothelial function in hypertensive individuals
PJ has promising acute hypotensive properties. Consumption of PJ could be considered in the context of both dietary and pharmacological interventions for hypertension. Asgary S, Keshvari M, Sahebkar A, Hashemi M, Rafieian-Kopaei M. ARYA Atheroscler. 2013 Nov;9(6):326-31. PMID: 24575134
A U-shaped association between consumption of marine n-3 fatty acids and development of atrial fibrillation/atrial flutter--a Danish cohort study
We found a U-shaped association between consumption of marine n-3 PUFA and risk of incident AF, with the lowest risk close to the median intake of total marine n-3 PUFA (0.63 g/day). Rix TA, Joensen AM, Riahi S, Lundbye-Christensen S, Tjønneland A, Schmidt EB, Overvad K. Europace. 2014 Feb 26. [Epub ahead of print] PMID: 24574493
Beneficial anti-inflammatory effects observed when plant extracts fed to sick pigs
The researchers conducted two experiments to test the beneficial effects of adding plant extracts to pig diets to combat PRRS and E. coli. In both experiments, researchers used four diets in weanling pigs, including a control diet and three additional diets that included garlic botanical extracted from garlic, turmeric oleoresin extracted from ginger, or capsicum oleoresin from pepper. In both experiments, half of the pigs in each dietary treatment were challenged with either E. coli or PRRS virus while the other half of the pigs were non-challenged. PhysOrg
Thursday, February 27, 2014
Top Story
U.K. Geriatrician: Statins, Antihypertensives "Greatly" Overprescribed for Adults 80 and Older
"The data strongly suggest that we are over-treating many healthy patients aged 80+ regarding stroke prevention," concludes U.K. geriatrician Kit Byatt in a perspective published in Evidence-Based Medicine.
Byatt offers a brief review of the evidence, noting that the large HYVET study in China and Europe showed only modest stroke-prevention benefits with antihypertensive therapy in those aged 80 and older. Similarly, the PROSPER trial, a large study of pravastatin in patients aged 70 to 82 in Europe, failed to find a significant stroke-prevention benefit with treatment. Byatt also notes that morbidity associated with statins may be underestimated. Journal Watch
"The data strongly suggest that we are over-treating many healthy patients aged 80+ regarding stroke prevention," concludes U.K. geriatrician Kit Byatt in a perspective published in Evidence-Based Medicine.
Byatt offers a brief review of the evidence, noting that the large HYVET study in China and Europe showed only modest stroke-prevention benefits with antihypertensive therapy in those aged 80 and older. Similarly, the PROSPER trial, a large study of pravastatin in patients aged 70 to 82 in Europe, failed to find a significant stroke-prevention benefit with treatment. Byatt also notes that morbidity associated with statins may be underestimated. Journal Watch
Medical Care
One in 5 US hospitals don't put hand sanitizer everywhere needed to prevent infections
Approximately one in five U.S. health facilities don't make alcohol-based hand sanitizer available at every point of care, missing a critical opportunity to prevent health care-associated infections, according to new research from Columbia University School of Nursing and the World Health Organization (WHO) published in the American Journal of Infection Control. The study, which examined compliance with WHO hand hygiene guidelines in the U.S., also found that only about half of the hospitals, ambulatory care, and long-term care facilities had set aside funds in their budgets for hand hygiene training. Eurekalert!
Physicians' stethoscopes more contaminated than palms of their hands
Although healthcare workers' hands are the main source of bacterial transmission in hospitals, physicians' stethoscopes appear to play a role. To explore this question, investigators at the University of Geneva Hospitals assessed the level of bacterial contamination on physicians' hands and stethoscopes following a single physical examination. The study appears in the March issue of Mayo Clinic Proceedings. Eurekalert!
Health systems in context: a systematic review of the integration of the social determinants of health within health systems frameworks
Abstract
OBJECTIVE: To systematically review and analyze various ways that health systems frameworks interact with the social determinants of health (SDH), as well as the implications of these interactions.
Approximately one in five U.S. health facilities don't make alcohol-based hand sanitizer available at every point of care, missing a critical opportunity to prevent health care-associated infections, according to new research from Columbia University School of Nursing and the World Health Organization (WHO) published in the American Journal of Infection Control. The study, which examined compliance with WHO hand hygiene guidelines in the U.S., also found that only about half of the hospitals, ambulatory care, and long-term care facilities had set aside funds in their budgets for hand hygiene training. Eurekalert!
Physicians' stethoscopes more contaminated than palms of their hands
Although healthcare workers' hands are the main source of bacterial transmission in hospitals, physicians' stethoscopes appear to play a role. To explore this question, investigators at the University of Geneva Hospitals assessed the level of bacterial contamination on physicians' hands and stethoscopes following a single physical examination. The study appears in the March issue of Mayo Clinic Proceedings. Eurekalert!
Health systems in context: a systematic review of the integration of the social determinants of health within health systems frameworks
Abstract
OBJECTIVE: To systematically review and analyze various ways that health systems frameworks interact with the social determinants of health (SDH), as well as the implications of these interactions.
METHODS: This was a review of the literature conducted in 2012 using predetermined criteria to search three comprehensive databases (PubMed, the Cochrane Database for Systematic Reviews, and the World Bank E-Library) and grey literature for articles with any consideration of the SDH within health systems frameworks. Snowball sampling and expert opinion were used to include any potentially relevant articles not identified by the initial search. In total, 4 152 documents were found; of these, 27 were included in the analyses.
RESULTS: Five main categories of interaction between health systems and SDH emerged: Bounded, Production, Reciprocal, Joint, and Systems models. At one end were the Bounded and Production models, which conceive the SDH to be outside the health system; at the other end, the Joint and Systems models, which visualize a continuous and dynamic interaction.
CONCLUSIONS: Considering the complex and dynamic interactions among different kinds of organizations involved in and with the health system,the Joint and Systems models seem to best reflect these interactions, and should thereby guide stakeholders in planning for change.
RESULTS: Five main categories of interaction between health systems and SDH emerged: Bounded, Production, Reciprocal, Joint, and Systems models. At one end were the Bounded and Production models, which conceive the SDH to be outside the health system; at the other end, the Joint and Systems models, which visualize a continuous and dynamic interaction.
CONCLUSIONS: Considering the complex and dynamic interactions among different kinds of organizations involved in and with the health system,the Joint and Systems models seem to best reflect these interactions, and should thereby guide stakeholders in planning for change.
Russell E, Johnson B, Larsen H, Novilla ML, Olmen Jv, Swanson RC. Rev Panam Salud Publica. 2013 Dec;34(6):461-7. PMID: 24569976
Cardiovascular
Blood transfusion for PCI associated with increased risk of cardiac event
In an analysis that included more than two million patients who underwent a percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries), there was considerable variation in red blood cell transfusion practices among hospitals across the U.S., and receiving a transfusion was associated with an increased risk of in-hospital heart attack, stroke or death, according to a study in the February 26 issue of JAMA. MedicalXpress
Is therapeutic hypothermia beneficial in all patients following cardiac arrest?
Whole body cooling in comatose patients who have suffered a heart attack can limit the damage to brain tissue caused by the restoration of blood flow and oxygen. But new data indicate that in certain patients therapeutic hypothermia is less effective and may even worsen neurological outcomes, as described in an article in Therapeutic Hypothermia and Temperature Management, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. Mary Ann Liebert, Inc
Young steroid users at increased risk of heart disease
Steroid abuse is associated with increased risk of heart disease in otherwise healthy young men, an Australian study of deaths involving the drugs has found.
Researchers at the National Drug and Alcohol Research Centre (NDARC) at UNSW and the New South Wales Department of Forensic Medicine examined all 24 steroid-related deaths in NSW between 1996 - 2012. Extensive heart disease, including left ventricular hypertrophy and thickening of the arteries, was present in half the cases. This is notable considering the sample comprised exclusively of men aged 22-48 years, with an average age of 32. MedicalXpress
In an analysis that included more than two million patients who underwent a percutaneous coronary intervention (PCI; procedures such as balloon angioplasty or stent placement used to open narrowed coronary arteries), there was considerable variation in red blood cell transfusion practices among hospitals across the U.S., and receiving a transfusion was associated with an increased risk of in-hospital heart attack, stroke or death, according to a study in the February 26 issue of JAMA. MedicalXpress
Is therapeutic hypothermia beneficial in all patients following cardiac arrest?
Whole body cooling in comatose patients who have suffered a heart attack can limit the damage to brain tissue caused by the restoration of blood flow and oxygen. But new data indicate that in certain patients therapeutic hypothermia is less effective and may even worsen neurological outcomes, as described in an article in Therapeutic Hypothermia and Temperature Management, a peer-reviewed journal from Mary Ann Liebert, Inc., publishers. Mary Ann Liebert, Inc
Young steroid users at increased risk of heart disease
Steroid abuse is associated with increased risk of heart disease in otherwise healthy young men, an Australian study of deaths involving the drugs has found.
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