Mixed Bag

Traumatic injuries in elderly patients are often underestimated
Traumatic injuries can be more severe for older adults, yet they often do not get the right level of care, according to a study appearing in the October issue of the Journal of the American College of Surgeons. Instead of going to a trauma center, many elderly patients end up in facilities without specialized expertise in trauma care that can treat all of their injuries. Eurekalert!

Fear feeds the pain
During the experiment, the researchers measured the movements of the lower back and the lumbar muscle activity. The - recently published - results were surprising. People in good health are most influenced by the fear of pain: the stronger the fear, the more rigid the muscles become. In patients suffering from chronic lumbago, the anticipation of strong pain leads to less neuromuscular change. The researchers' explanation is that these patients are already stiff when they bend their backs and receive the painless heat. As their movement strategy is more fixed, it adapts less well to the environment. They are trapped within a vicious circle: fearing the suffering linked to movement, they lose their mobility, and the pain persists. MedicalXpress

Retired night shift workers have higher risk of diabetes, study finds
People who regularly work night shifts in their lifetimes are twice as likely to have diabetes, even if they have retired and returned to a normal, daytime schedule, according to a new study released today in the Journal of Biological Rhythms. MedicalXpress

Shellfish toxin spreading to eastern US, report says
An illness-causing bacteria found in shellfish, previously limited to the Pacific Northwest United States, is showing up in East Coast shellfish and in Europe, a new report warns. The bacteria, Vibrio parahaemolyticus, is the most common cause of seafood-linked stomach illness. Until recently, Pacific shellfish harbored the most virulent strains of Vibrio, but outbreaks on the Atlantic coast of the United States and Spain were reported this year and in 2012. MedicalXpress

Female doctors are better than male doctors
According to a University of Montreal research team, the quality of care provided by female doctors is higher than that of their male counterparts while the productivity of males is greater. The research team reached this conclusion by studying the billing information of over 870 Quebec practitioners (half of whom were women) relating to their procedures with elderly diabetic patients. "Women had significantly higher scores in terms of compliance with practice guidelines. They were more likely than men to prescribe recommended medications and to plan required examinations," said lead study author Valérie Martel, who devoted her master's thesis with the Department of Health Administration to the subject. Roxane Borges Da Silva, Professor at the Faculty of Nursing, and Régis Blais, Professor at the Department of Health Administration, co-supervised the study. Eurekalert!

Weighing up blood-thinners: Is warfarin always the best choice?
Patients who are responding below par to the anticoagulant drug warfarin have several options. They can undergo even more blood tests to monitor their response to the different dosages of this medication which is prescribed to prevent strokes, or they could start using one of the newer, yet more expensive, anticoagulants on the market. In the long run, says Joyce You of the Chinese University of Hong Kong in China, the latter option could actually be more cost-effective and improve a patient’s quality of life. Her study¹ appears in the Journal of General Internal Medicine², published by Springer. It is the first of its kind to comprehensively consider all important factors to measure the relative value-for-money of various oral anticoagulants currently on offer to patients and doctors. Springer

Cognition Better in Heart Failure After Diuresis
Congestive heart failure patients performed better on three cognitive tests after diuresis, suggesting noncompliance with medication may initiate cognitive decline, researchers reported here.

Weight loss of at least 1 lb. through diuresis greatly increased the chances of a patient remembering one more number on the digital span backwards test in 29 congestive heart failure patients (OR 66.02, CI 4.90-888.66), according to Rebecca F. Gottesman, MD, PhD, of Johns Hopkins University School of Medicine, and colleagues. MedPage Today