Breakthrough drug-eluting patch stops scar growth, reduces scar tissues

Scars — in particular keloid scars that result from overgrowth of skin tissue after injuries or surgeries — are unsightly and can even lead to disfigurement and psychological problems of affected patients. Individuals with darker pigmentation — in particular people with African, Hispanic or South-Asian genetic background — are more likely to develop this skin tissue disorder. Current therapy options, including surgery and injections of corticosteroids into scar tissues, are often ineffective, require clinical supervision and can be costly.A new invention by researchers from Nanyang Technological University in Singapore (reported in the current issue of TECHNOLOGY) provides a simple, affordable and — most importantly — highly effective way for patients to self-treat keloid scars. The team of scientists and engineers from NTU’s School of Chemical and Biomedical Engineering, in collaboration with clinicians from Singapore’s National Skin Centre, have developed a special patch made from polymers fabricated into microneedles, which are loaded with the US food and drug administration (FDA)-approved scar-reducing drug, 5-fluorouracil. Self-administered by patients, the microneedles attach the patch to scar tissue and allow sustained drug-release (one patch per night). The drug as well as the physical contact of the microneedles with the scar tissue contributes to the efficacy of the device, leading to the cessation of scar tissue growth and a considerable reduction of keloids as demonstrated in laboratory cultures and experiments with animals. “Most patients seek treatment due to disfigurement and/or pain or itch of scars,” says Assistant Professor Xu Chenjie from NTU who leads the study. “We wanted to develop a simple, convenient, and cost-effective device able to inhibit keloid growth in skin tissue and reduce the size of disfiguring scars,” adds Yuejun Kang, another key investigator in the study from NTU.”Self-administered treatment for keloid scars can reduce the economic burden on the healthcare system and provide a treatment option for patients who have limited access to medical care,” comments Professor Jeffrey Karp from Brigham and Women’s Hospital at Harvard Medical School, US, an expert on medical device design who was not involved in this study.Story Source:The above story is based on materials provided by World Scientific. Note: Materials may be edited for content and length.

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Postsurgical pain control linked to patient satisfaction with hospital experience

Postsurgical pain scores were highly correlated with reports of overall patient satisfaction during hospital stays, in a new finding that was true for some types of surgery more than others. The researchers, who presented results in a scientific poster today at the 30th Annual Meeting of the American Academy of Pain Medicine, stressed the importance of improving patient care in the peri-operative setting in alignment with new federal requirements tying performance to pay.The goal of the research by Dermot Maher, MD, and colleagues from Cedars Sinai Medical Center in Los Angeles, Calif., was to clarify the relationship between pain control after surgery and the answers provided by patients on the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS). The HCAHPS is the first national, standardized, publicly reported survey of patients’ perspectives on the care they receive in the hospital and is filled out at the time of discharge. The Affordable Care Act of 2010 makes the 27-question HCAHPS a factor in value-based incentive payments.”This study illustrates the crucial role that pain management in the acute post-operative setting can have, not only on a patient’s perception of pain management, but also on the global perception of their hospitalization,” Dr. Maher said.Investigators examined HCAHPS responses by 2,933 surgical patients who were hospitalized at a single trauma center between March 2012 and February 2013. Four questions (2 assessing satisfaction with in-hospital pain management and 2 addressing general satisfaction) showed a statistically robust relationship when retrospectively compared to patient pain scores as assessed via the post-anesthesia care unit (PACU) visual analog scale.Dr. Maher said the results are important to hospital care providers and patients.”Patients consider a number of factors when evaluating physicians and hospitals. One of the most influential factors is a patient’s perception of pain,” he said. “The universal unpleasantness and complicated nature of pain, especially in the post-operative setting, has the potential to negatively impact overall satisfaction if not optimally managed.”Further analyses of the data showed patients who had surgery related to spine, non-spine orthopedics, and obstetrics and gynecology showed significantly larger correlations of PACU pain scores with HCAHPS responses than did patients who had other types of surgeries. The stronger association between HCAHPS scores and post-operative pain in certain populations calls into question the appropriateness of universal application of patient satisfaction surveys, or at least the pain component, as a means of reimbursement, Dr. …

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Women fare worse than men following stroke

The good news: More people survive stroke now than 10 years ago due to improved treatment and prevention. The bad news: Women who survive stroke have a worse quality of life than men, according to a study published in the Feb. 7 online issue of the journal Neurology.Researchers at Wake Forest Baptist Medical Center compared the quality of life in men and women who had a stroke or transient ischemic attack (TIA). A total of 1,370 patients ages 56 to 77 from the AVAIL registry – a national, multicenter, longitudinal registry of ischemic stroke and TIA patients – were included in the study.The patients’ quality of life was measured at three months and one year after a stroke or TIA using a formula that assesses mobility, self-care, everyday activities, depression/anxiety and pain.“We found that women had a worse quality of life than men up to 12 months following a stroke, even after considering differences in important sociodemographic variables, stroke severity and disability,” said Cheryl Bushnell, M.D., associate professor of neurology at Wake Forest Baptist and senior author of the study.“As more people survive strokes, physicians and other healthcare providers should pay attention to quality of life issues and work to develop better interventions, even gender-specific screening tools, to improve these patients’ lives.”The study findings showed that at three months, women were more likely than men to report problems with mobility, pain/discomfort and anxiety and depression, but the difference was greatest in those over age 75. At one year, women still had lower quality of life scores overall than men but the magnitude of those differences had diminished, Bushnell said.“The reason we do these types of studies is to be able to add different variables sequentially to determine what accounts for these gender differences,” Bushnell said. “We found that age, race and marital status accounted for the biggest differences between men and women at three months, with marital status being the most important. Even though the women in the study were older than the men, our study showed that age really had very little effect on quality of life.”The results suggest that further research on mobility, pain or discomfort and anxiety/depression may provide a clearer understanding for how to improve the lives of women after stroke, Bushnell added.The next step for the Wake Forest Baptist team will be to look at the trajectory of cognitive decline in men and women before and after stroke, she said.Story Source:The above story is based on materials provided by Wake Forest Baptist Medical Center. Note: Materials may be edited for content and length.

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The ACA getting the job done, and a great Health Wonk Review

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Screening guidelines may miss ten percent of colon cancers

Oct. 22, 2013 — For people with a family history of adenomas (colon polyps that lead to colon cancer), up to 10 percent of colorectal cancers could be missed when current national screening guidelines are followed. Colorectal cancer is the third most common cancer in the United States and the second deadliest.In the largest population-based study to date, researchers from Huntsman Cancer Institute (HCI) at the University of Utah made this finding based on nearly 127,000 individuals who underwent colonoscopy in Utah between 1995 and 2009. The results appear online in “Early View” of the journal Cancer.Family history of colon cancer is widely accepted as a factor that increases risk for the disease. This study quantified the increased risk to first-degree relatives (parents, siblings, children) of patients with adenomas or advanced adenomas at 35 to 70 percent higher than in relatives of patients without these conditions. The study also detected smaller percentages of elevated risk in more distant second- (aunts and uncles, grandparents) and third-degree relatives (cousins, nieces and nephews, great-grandparents).“We expected to see increased risk in first-degree relatives, but we weren’t sure the risk would also be higher for more distant relatives in multiple generations,” said N. Jewel Samadder, MD, MSc, principal investigator of the study and an HCI investigator. “The biggest surprise was the percentage of missed cancers under the current guidelines. We figured there would be a few percent, but 10 percent is a large number,” he added.For the general population, current national colon cancer screening guidelines recommend colonoscopy every 10 years starting at age 50. For first-degree relatives of people diagnosed with colorectal cancer or advanced adenomas before they were 60 years old, increased screening is recommended—colonoscopies every five years starting at age 40. …

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Eye contact builds bedside trust

Oct. 16, 2013 — Doctors who make a lot of eye contact are viewed as more likable and empathetic by patients, according to a new Northwestern Medicine study.Patients also gave doctors higher empathy scores when their total visit length was longer and when doctors engaged in a few “social touches” such as a handshake or pat on the back. However, more than three social touches in one visit decreased empathy scores. The researchers said it’s possible that too many social touches from a doctor may seem forced and not genuine to a patient.The study, published in the Journal of Participatory Medicine, analyzed videotaped doctors’ visits and reinforces the notion that nonverbal social communication is an important part of doctor/patient relationships that should be thoughtfully managed, especially as more technology and “screen time” is introduced into doctors’ offices.”The goal is to one day engineer systems and technologies that encourage the right amount of physician eye contact and other non-verbal social communication,” said Enid Montague, first author of the study. “As we collect more data we can build models that tell us exactly how much eye contact is needed to help patients trust and connect with a doctor, and design tools and technology that help doctors stay connected to patients.”Montague is an assistant professor in medicine, general internal medicine and geriatrics at Northwestern University Feinberg School of Medicine and an assistant professor in the McCormick School of Engineering and Applied Sciences.The researchers collected data from 110 first-time encounters between patients with common cold symptoms and primary care doctors. All of the doctors used paper charts and spent an average of 3 minutes and 38 seconds with each patient. After each visit, patient participants completed questionnaires to measure their perception of their doctor’s empathy, connectedness with the doctor and how much they liked their doctor.The visits were videotaped and researchers analyzed the recordings second-by-second, documenting what each person was doing, paying special attention to non-verbal communication. The researchers purposely chose to study doctors who used paper charts so they could develop a baseline for nonverbal communication activities without the presence of computerized systems.”Previous studies have found that nonverbal communication is important based on patient feedback, but this is one of the few that have looked at these things more broadly quantitatively,” Montague said. “We rigorously looked at what was happening at every point in time, so we validated a lot of the qualitative studies.”They concluded that while social touch and length of visit can play a role in a patient’s perception of doctor empathy, the amount of eye contact the doctor made was the most important factor for patients.”Simple things such as eye contact can have a big impact on our healthcare system as a whole,” Montague said. “If patients feel like their doctors aren’t being empathetic, then we are more likely to see patients who aren’t returning to care, who aren’t adhering to medical advice, who aren’t seeking care, who aren’t staying with the same providers. …

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The Hard Reality of Birthing Injuries

The unfortunate reality of childbirth is that not every baby is born strong and healthy. While some infants may be born with birth defects (structural or functional abnormalities that are present at or before delivery), others may actually sustain a physical injury during the birthing process. These children often go on to face a lifetime of disability, and in severe cases, may even die as a result of their injury.A recent study suggests that birth-related injuries occur in 29 out of every 1,000 births in the United States, although published rates have historically varied widely. Birth injuries can occur for a number of reasons, including factors related to the baby (size or positioning in the womb), the mother (difficulty or prolonged labor; small pelvis), or even the decision-making of the medical staff assisting with the birth (e.g., negligence).Head and brain trauma, bleeding, nerve damage, and bone fractures are common examples of birth injuries. Severe swelling of the baby’s scalp can occur as the head bears the brunt of the pressure during delivery, and bleeding between the skull and its fibrous covering can also occur. Babies who are delivered with the help of vacuum extraction or forceps may suffer from bruising or even cuts to the head and face. If the positioning of the baby during labor and/or delivery causes facial nerves to be compressed and/or injured, the baby may suffer from facial paralysis. Nerve damage in the arms and hand or fractures to the baby’s collar bone can occur when the mother has difficulty delivering the baby’s shoulder. Under some circumstances, a baby may not receive adequate amounts of oxygen during labor and delivery, which can lead to a wide range of problems. While some babies may be resuscitated quickly and suffer no lasting injuries, others may suffer organ damage, seizures, or even a coma. …

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Accident Health Insurance Plans is drawing lot of concentration

Accident Health Insurance Plans is drawing lot of concentrationAccident health insurance plans are pulling insurers attentions towards the supplementary fortuity insurance coverage market on account of its usefulness. The personal injury insurance plan falls under the restitution group rather than the insurance group. Restitutes insure you for disability, loss, or accidental injury in cash expenditure to you either directly or through the healthcare provider. These accidental health insurance plans are as if guarantee subject & doesn’t require any wellness queries while inscribing. Those Americans who own this kind of accident insurance plan go through all the advantages concerning with this plan like treatment with any doctor, ER hospital, or urgent and critical care services.Those who have these plans can decide a welfare quantity of amount, policy …

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Innovative ‘pay for performance’ program improves patient outcomes

Sep. 10, 2013 — Paying doctors for how they perform specific medical procedures and examinations yields better health outcomes than the traditional “fee for service” model, in which everyone gets paid a set amount, according to new research conducted by UC San Francisco and the New York City Department of Health and Mental Hygiene.”Pay for performance’ programs shift the focus from basic care delivery to high quality care delivery,” said first author Naomi Bardach, MD, assistant professor in the UCSF Department of Pediatrics. “So they are designed to incentivize people to improve care.”In a study scheduled to be published on Sept. 11 in the Journal of the American Medical Association (JAMA), Bardach and her colleagues tested a tiered pay for performance program at physicians’ offices in New York City with high proportions of Medicaid patients. The program rewarded physicians successful in preventive health care to reduce long-term risks of heart attack and stroke — for instance, in blood pressure control and aspirin prescription for those who need it.The innovative “pay for performance” model they tested rewarded physicians for every single patient who did well, and paid extra for “high-risk” patients who were difficult to treat based on co-morbidities such as diabetes or coronary artery disease or socioeconomic factors (uninsured and Medicaid patients).”The worry about pay for performance programs that pay only if physicians meet the quality target, is that the financial incentive discourages physicians from caring for more complicated patients,” said Bardach. “This program did not penalize physicians for patients they were caring for whose blood pressure might be more difficult to control than others, for medical or for socio-economic reasons. It also recognized, through higher payments, the additional work it might take.”Improvements with Incentivized Patient GroupIn this randomized clustered controlled study conducted from April 2009 through March 2010, improvements in the incentivized group compared to the control group ranged two-fold to eight-fold (9.7 percent versus 4.3 percent, and 9 percent versus 1.2 percent). With the help of electronic medical record data, researchers examined 7,634 patients (4,592 in the incentivized group and 3,042 in the control group) for this study.”The numbers are meaningful because the rates of blood pressure control were so low to begin with, for instance, only 10 to 16 percent of patients with diabetes had normal blood pressure control, so an improvement of even 5 percent of patients is relatively quite large,” Bardach said. This is a high-risk population for heart attack and stroke and so getting their blood pressure under control will make a difference.”While the findings are encouraging, Bardach said further research is needed to determine whether or not this trend can continue over time since these pay for performance programs are intended to remain in place for more than a year.”The hope is to study this over a longer time period, since the goal of health care is to improve long-term outcomes among our patient population,” she said.Bardach is the first author of the paper. Co-authors include Jason J. …

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New MR analysis technique reveals brain tumor response to anti-angiogenesis therapy

Aug. 18, 2013 — A new way of analyzing data acquired in MR imaging appears to be able to identify whether or not tumors are responding to anti-angiogenesis therapy, information that can help physicians determine the most appropriate treatments and discontinue ones that are ineffective. In their report receiving online publication in Nature Medicine, investigators from the Martinos Center for Biomedical Imaging at Massachusetts General Hospital (MGH), describe how their technique, called vessel architectural imaging (VAI), was able to identify changes in brain tumor blood vessels within days of the initiation of anti-angiogenesis therapy.”Until now the only ways of obtaining similar data on the blood vessels in patients’ tumors were either taking a biopsy, which is a surgical procedure that can harm the patients and often cannot be repeated, or PET scanning, which provides limited information and exposes patients to a dose of radiation,” says Kyrre Emblem, PhD, of the Martinos Center, lead and corresponding author of the report. “VAI can acquire all of this information in a single MR exam that takes less than two minutes and can be safely repeated many times.”Previous studies in animals and in human patients have shown that the ability of anti-angiogenesis drugs to improve survival in cancer therapy stems from their ability to “normalize” the abnormal, leaky blood vessels that usually develop in a tumor, improving the perfusion of blood throughout a tumor and the effectiveness of chemotherapy and radiation. In the deadly brain tumor glioblastoma, MGH investigators found that anti-angiogenesis treatment alone significantly extends the survival of some patients by reducing edema, the swelling of brain tissue. In the current report, the MGH team uses VAI to investigate how these drugs produce their effects and which patients benefit.Advanced MR techniques developed in recent years can determine factors like the size, radius and capacity of blood vessels. VAI combines information from two types of advanced MR images and analyzes them in a way that distinguishes among small arteries, veins and capillaries; determines the radius of these vessels and shows how much oxygen is being delivered to tissues. The MGH team used VAI to analyze MR data acquired in a phase 2 clinical trial — led by Tracy Batchelor, MD, director of Pappas Center for Neuro-Oncology at MGH and a co-author of the current paper — of the anti-angiogenesis drug cediranib in patients with recurrent glioblastoma. The images had been taken before treatment started and then 1, 28, 56, and 112 days after it was initiated.In some patients, VAI identified changes reflecting vascular normalization within the tumors — particularly changes in the shape of blood vessels — after 28 days of cediranib therapy and sometimes as early as the next day. Of the 30 patients whose data was analyzed, VAI indicated that 10 were true responders to cediranib, whereas 12 who had a worsening of disease were characterized as non-responders. …

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Study debunks controversial multiple sclerosis theory

Aug. 14, 2013 — There is no evidence that impaired blood flow or blockage in the veins of the neck or head is involved in multiple sclerosis, says a McMaster University study.The research, published online by PLOS ONE today, found no evidence of abnormalities in the internal jugular or vertebral veins or in the deep cerebral veins of any of 100 patients with multiple sclerosis (MS) compared with 100 people who had no history of any neurological condition.The study contradicts a controversial theory that says that MS, a chronic, neurodegenerative and inflammatory disease of the central nervous system, is associated with abnormalities in the drainage of venous blood from the brain. In 2008 Italian researcher Paolo Zamboni said that angioplasty, a blockage clearing procedure, would help MS patients with a condition he called chronic cerebrospinal venous insufficiency (CCSVI). This caused a flood of public response in Canada and elsewhere, with many concerned individuals lobbying for support of the ‘Liberation Treatment’ to clear the veins, as advocated by Zamboni.”This is the first Canadian study to provide compelling evidence against the involvement of CCSVI in MS,” said principal investigator Ian Rodger, a professor emeritus of medicine in the Michael G. DeGroote School of Medicine. “Our findings bring a much needed perspective to the debate surrounding venous angioplasty for MS patients.”In the study all participants received an ultrasound of deep cerebral veins and neck veins as well as a magnetic resonance imaging (MRI) of the neck veins and brain. Each participant had both examinations performed on the same day. The McMaster research team included a radiologist and two ultrasound technicians who had trained in the Zamboni technique at the Department of Vascular Surgery of the University of Ferrara.The research was funded by a collection of private donors including the Harrison McCain Foundation, W. Garfield Weston Foundation, Charity Intelligence and St. Joseph’s Healthcare Foundation as well as many concerned individuals.

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How superbug spreads among regional hospitals: A domino effect

July 30, 2013 — A moderate increase in vancomycin-resistant enterococci (VRE) at one hospital can lead to a nearly 3 percent increase in VRE in every other hospital in that county, according to a study in the August issue of the American Journal of Infection Control, the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC).VRE is one of the most common bacteria that cause infections in healthcare facilities.Researchers from the Johns Hopkins Bloomberg School of Public Health, Pittsburgh Supercomputing Center (PSC), University of Pittsburgh, and University of California, Irvine created the Regional Healthcare Ecosystem Analyst (RHEA), a mathematical and computational model, to track the movement between hospitals of VRE-colonized patients (patients carrying the organism but not yet infected) over the course of a year in Orange County, Calif. Using this model, they were able to assess how increases or decreases in one hospital’s VRE affected neighboring hospitals.Not only did the investigators find that a moderate increase in VRE at any one hospital caused an average 2.8 percent increase throughout the county (range: 0 percent to 61 percent), they also discovered that hospitals in the most populated area of the county had an even greater likelihood of spreading VRE throughout the network. Additional modeling identified a potential for “free-riders” — hospitals that will experience decreases in VRE incidence due to other hospitals’ infection control efforts without initiating any infection prevention measures of their own.The study points to the underutilization of patient-sharing data between regional hospitals, the importance of inter-hospital communication and collaboration in decreasing VRE rates, and the scope of variables that must be considered in analyzing the outcome of any one infection prevention initiative.”Our study demonstrates how extensive patient sharing among different hospitals in a single region substantially influences VRE burden in those hospitals,” states Bruce Y. Lee, MD, MBA, lead author and Associate Professor of International Health and Director of Operations Research, International Vaccine Access Center, at the Johns Hopkins Bloomberg School of Public Health. “Lowering barriers to cooperation and collaboration among hospitals, for example, developing regional control programs, coordinating VRE control campaigns, and performing regional research studies, could favorably influence regional VRE prevalence.”Vancomycin-resistant enterococci are resistant to vancomycin, the drug often used to treat serious infections for which other medicines may not work. VRE can live in the human intestines and female genital tract without causing disease. However, sometimes they can cause infections of the urinary tract, the bloodstream, or of wounds associated with catheters or surgical procedures. There are an estimated 20-85,000 cases of VRE each year in U.S. hospitals.

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Missed diagnoses and drug errors make up bulk of primary care malpractice claims

July 19, 2013 — Missed diagnoses―particularly of cancer, heart attack, and meningitis―and drug errors make up the bulk of malpractice claims brought against doctors in primary care, finds an analysis of published data in the online journal BMJ Open.The risk of litigation has not been given a great deal of attention in primary care, say the authors. But with most healthcare contacts taking place in primary care, it is important to characterise the causes and types of claims arising from these encounters, they add.They carried out an extensive trawl of published research in English about the number and causes of malpractice claims in primary care in April 2012 and again in January 2013.Out of a total of 7152 studies, 34 were eligible for inclusion in the analysis. Fifteen studies were based in the US, nine in the UK, seven in Australia, two in France, and one in Canada.In the US, studies indicate that malpractice claims brought against primary care doctors accounted for between 7.6% and 16% of the total. In the UK, GPs made up the greatest proportion of an overall 20% increase in claims between 2009 and 2010, with claims against them more than doubling between 1994 and 1999.And in Australia, GPs accounted for the highest proportion of claims and the highest number of new claims on the national Medical Indemnity National Collection database for both 2009 and 2010.Missed diagnoses were the most common source of malpractice claims, accounting for between a quarter (26%) and almost two thirds (63%) of the total. And the most common consequence of this in the claims filed was death, ranging from 15% to 48% of claims made for missed diagnoses.Among adults, cancer and heart attack were the most commonly missed diagnoses in the claims made. Others that cropped up frequently included appendicitis, ectopic pregnancy, and fractures. Among children, the most frequent claims related to meningitis and cancers.The second most common sources of malpractice claims were drug errors, the proportion of which ranged from 5.6% to 20% across all the studies.A substantial proportion of claims were unsuccessful, with only one third of US claims and half of UK claims ending up in a pay-out. But while the number of claims brought against US doctors has remained fairly stable over the past two decades, those brought against Australian and UK GPs have been rising.The authors acknowledge that it may be difficult to generalise their findings as the term ‘primary care’ does not mean the same thing in all the countries studied, and none of the healthcare systems is the same. Using legal claims as a proxy for adverse events also has its limitations, they add.But they point out that the threat of litigation can result in “defensive medicine” and over diagnosis and treatment, and that doctors who find themselves on the end of a malpractice claim, often find the process very distressing.

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Have a brain injury? You may be at higher risk for stroke

June 26, 2013 — People who have a traumatic brain injury (TBI) may be more likely to have a future stroke, according to research that appears in the June 26, 2013, online issue of Neurology®, the medical journal of the American Academy of Neurology.”Both stroke and traumatic brain injury are common, costly, and leading causes of severe disability in adults, and approximately 20 percent of strokes occur in adults under age 65,” said study author James F. Burke, MD, MS, of the University of Michigan and the Ann Arbor VA Healthcare System and a member of the American Academy of Neurology. “A large proportion of stroke risk is unexplained, especially in the young, so if we can identify new risk factors, we have the potential to prevent more strokes and improve outcomes.”For the study, researchers looked at the records of adults who went to the emergency department or were admitted to a hospital for TBI or other trauma with no brain injury in the state of California during a five-year period.A total of 435,630 people with traumatic brain injury were studied, along with 736,723 people with trauma with no brain injury. Over an average of 28 months following the injury, 11,229 people, or 1 percent, had an ischemic stroke. A total of 1.1 percent of those with TBI suffered a stroke, compared to 0.9 percent of those with trauma with no brain injury. With an ischemic stroke, blood flow to part of the brain is blocked. Eighty percent of strokes are ischemic.After adjusting for factors that can affect stroke risk, such as age, high blood pressure and high cholesterol, as well as other disorders such as heart disease and the severity of the trauma, the researchers found that people with traumatic brain injury were 30 percent more likely to develop a stroke than those with trauma with no brain injury.”While the stroke risk of one person with TBI is small, the overall link between TBI and stroke was substantial — as large as the link between the strongest stroke risk factor, high blood pressure, and stroke,” Burke said. “If further research establishes TBI as a new risk factor for stroke, that would stimulate research to help us understand what causes stroke after TBI and help us learn how to prevent these strokes.” The study was supported by an advanced fellowship through the Department of Veterans Affairs.

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Americans’ vitamin D levels are highest in August, lowest in February, study shows

June 22, 2013 — UC Irvine and Mayo Clinic researchers have found that vitamin D levels in the U.S. population peak in August and bottom out in February. The essential vitamin — necessary for healthy bones — is produced in the skin upon exposure to ultraviolet B rays from the sun.Vitamin D helps bones absorb calcium and can protect against osteoporosis. It’s also thought to play a role in seasonal illnesses, such as the flu. Low levels of vitamin D are believed to impair “innate immunity” i.e., the body’s first line of defense against pathogens. To further study this link, good estimates of the cyclicality of the vitamin are necessary. Solar exposure — a timely topic since June 21 marks the first day of summer — is the most important way people acquire vitamin D. But certain foods, including egg yolks and oil-rich fish like mackerel, salmon, sardines and herring contain the nutrient. In addition, milk and cereal are often enriched with vitamin D.”Even with food fortification, vitamin D levels in the population show a high level of seasonality due to the influence of sunlight,” said Amy Kasahara, a UC Irvine graduate student in public health and first author on the paper, which appears in the journal PLOS ONE.”The exact biochemical pathways from UVB rays to vitamin D were discovered in the 1970s,” she said. “In this study, we have shown that vitamin D levels lag the solar cycle, peaking in August and troughing in February.”The correlation between the seasons and vitamin D has been known for some time. …

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Flu shot likely prevented 13 million illnesses, 110,000 hospitalizations from 2005-2011

June 19, 2013 — Approximately 13 million illnesses and over 110,00 hospitalizations may have been averted by the flu vaccine over the last 6 years in the U.S, according to calculations published June 19 in the open access journal PLOS ONE by Deliana Kostova and colleagues from the U.S Centers for Disease Control and Prevention.Share This:The researchers calculated the healthcare burden of flu cases that would have occurred in the absence of vaccination based on factors such as illness and hospitalization rates during the flu season, vaccination coverage and vaccine effectiveness. Based on these data, Kostova and colleagues estimate that flu vaccines averted several million instances of illness and over 110,000 flu-related hospitalizations in the flu seasons of 2006 to 2011. The largest number of averted cases occurred during the most recent period studied, 2010-2011, when 5 million flu cases, 2.1 million medical visits and 40,400 hospitalizations were prevented by vaccination.The U.S is the only country with universal influenza vaccine recommendations that suggest everyone aged 6 months and older should receive an annual dose of the vaccine. However, previous studies have not provided ways to reliably assess the number of flu cases or hospitalizations that are prevented by vaccination each year. Senior author on the study Joseph Bresee adds, “”These results confirm the value of influenza vaccination, but highlight the need for more people to get vaccinated and the imperative for vaccines with greater efficacy, especially in the elderly.”Share this story on Facebook, Twitter, and Google:Other social bookmarking and sharing tools:|Story Source: The above story is reprinted from materials provided by Public Library of Science. Note: Materials may be edited for content and length. For further information, please contact the source cited above. Journal Reference:Deliana Kostova, Carrie Reed, Lyn Finelli, Po-Yung Cheng, Paul M. Gargiullo, David K. Shay, James A. …

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Austerity cuts to Spanish healthcare system are ‘putting lives at risk’, experts say

June 13, 2013 — A series of austerity reforms made by the Spanish government could lead to the effective dismantling of large parts of the country’s healthcare system, with potentially detrimental effects on the health of the Spanish people, according to new research published in BMJ.National budget cuts of 13.65% (€365m) and regional budget cuts of up to 10% to health and social care services in 2012 have coincided with increased demands on the health system, particularly affecting the elderly, disabled and those with poor mental health. The authors, led by the London School of Hygiene & Tropical Medicine, also highlight the increase in depression, alcohol related disorders and suicides in Spain since the financial crisis hit and unemployment increased.Spain already has one of the lowest public expenditures on healthcare for its GDP in the European Union. Further cuts of €1108m will be made to the dependency fund for elderly and disabled people in 2013, putting these vulnerable people even more at risk.Key changes made by the Spanish government include excluding undocumented immigrants from accessing free healthcare services and increasing co-payments that patients must make for extra treatments such as drugs, prosthetics, and some ambulance trips. Authorities with devolved powers in 17 regions across Spain have also been required to make further cuts. In Madrid and Catalonia this has led to a move towards privatisation of hospitals, increases in waiting times, cutbacks in emergency services and fewer surgical procedures.Lead author Dr Helena Legido-Quigley, Lecturer in Global Health at the London School of Hygiene & Tropical Medicine, said: “Our analysis is the first to look at the overall impact of austerity measures in Spain on the healthcare system and the findings are of great concern. Many of the measures taken to save money do not have a strong evidence-base. We are seeing detrimental effects on the health of the Spanish people and, if no corrective measures are implemented, this could worsen with the risk of increases in HIV and tuberculosis — as we have seen in Greece where healthcare services have had severe cuts­ — as well as the risk of a rise in drug resistance and spread of disease.”As part of the analysis, researchers conducted interviews with 34 doctors and nurses across Catalonia. Many reported feeling ‘shocked’, ‘numbed’ and ‘disillusioned’ about the cuts and expressed fears that ‘the cuts are going to kill people’. Some also raised concerns around the ‘clear intention to privatise and… make money on health and social services’ and made allegations of corruption and conflicts of interest.Co-author Martin McKee, Professor of European Public Health at the London School of Hygiene & Tropical Medicine, said: “For five years, policies to address the financial crisis have focussed almost entirely on economic indicators. …

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