Drug Interactions a Serious Health Concern

We live in an age where medical and pharmaceutical research is something we take for granted. The medical procedures and medications we rely on to maintain and improve our health are often seen as safe, reliable and easy to obtain. Yet these advances in medical technology do not come without risks, especially when we take two or more types of drugs. The risk of drugs interacting with one another to cause negative, and potentially deadly, side effects is a very real one, and one that leads to a shockingly high number of deaths and injuries each year.Drug Interactions Deadlier Than Car CrashesAbout 34,000 people die every year as the result of automobile crashes, while more than 2 million people sustain injuries. Meanwhile, the Food and Drug Administration reports that , or ADRs, are responsible for killing nearly three times as many people as those killed in car crashes. The FDA reports that about 100,000 people die from ADRs each year, while another 2 million suffer serious complications.Drugs a Part of Modern LifeThe Centers for Disease Control and Prevention report that about 82 percent of the population takes at least one type of medication, while nearly 30 percent take five or more types of drugs. These figures include both over-the-counter medications, as well as prescription drugs.The CDC also reports that about 700,000 people visit emergency rooms every year because of ADRs, while another 120,000 people have to be hospitalized. The extra expenses caused by ADRs account for an additional $3.5 billion in health care costs every year.A Growing, and Often Preventable, ProblemDrug companies are constantly developing new medications, while researchers are regularly discovering new uses for already existing drugs. The population is, as a whole, becoming much older, and older Americans are much more likely to regularly use both prescription and over-the-counter medications than younger people. When these factors are combined with the fact that physicians are more often prescribing medications as a preventative measure, and more people have access to prescription drug coverage, the trend lines are clear; adverse drug interactions will increase, and continue to do so, for the foreseeable future.Fortunately, there is at least one positive factor in all of this. …

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£6.7 Million Compensation for NHS Medical Mistakes

Home » No Win No Fee » Latest Personal Injury News » 2014 » 7 » £6.7 Million Compensation for NHS Medical Mistakes£6.7 Million Compensation for NHS Medical MistakesA 12-year-old boy is to receive medical negligence compensation after errors by hospital staff left him with serious brain injuries.On a morning in September 2006, the child, who cannot be named for legal reasons, was taken to St Mary’s Hospital in Portsmouth with stomach pains.Staff at the hospital failed to spot that the child, who was aged four at the time, was displaying signs of Congenital Diaphragmatic Hernia.As a result, he did not get the required treatment on time and he suffered a cardiac arrest, which led to him experiencing significant brain damage and serious disabilities.The boy’s family therefore took legal action against Portsmouth Hospitals NHS Trust, the organisation that runs St Mary’s Hospital.A medical negligence compensation settlement in the amount of £6.7 million has now been agreed. This compensation will be used to fund the child’s extensive and long-term care needs, such as round-the-clock assistance and specialist technology to enable him to communicate.The boy will receive £3.2 million compensation in a lump sum up front, while he will be paid £265,000 compensation every year until he is 18. The compensation payments will then rise to £305,000 per annum for the rest of his life.Hospital Trust ApologisesPortsmouth Hospitals NHS Trust has issued a formal apology to the boy and his family for the medical mistakes that were made at St Mary’s Hospital eight years ago. A spokesperson for the hospital confirmed that since liability was resolved in 2012, each party has been working together to agree a suitable compensation package.This was designed with the intention of both compensating the boy and his parents and providing them with adequate financial security for the future.The spokesperson said, “The Trust can confirm that a medical negligence compensation settlement has been reached in this case and that this has been approved by the Court. The Trust wishes them well.”Doctors ‘Should Have Listened’Speaking after the compensation settlement was agreed, the boy’s parents said that doctors should have listened to the concerns they had raised about the condition of their son.In a statement, they insisted that if this had been done, this “tragic” event “would have been easily avoided”. The parents have therefore urged other mothers and fathers to trust their instincts if their child is not well.”If you believe that something is wrong, then insist that action is taken by the doctors,” they commented. “Nothing will ever make up for the life that has been taken away from him.”The boy’s parents said their son’s life has been “completely ruined”, as his condition means he will miss out on a whole host of experiences. For instance, they stated that he will never be able to play on a beach, kick a football around with his friends, or attend his school prom.The parents went on to note that their son and his “enormous daily battle” have proved to be a source of inspiration to everybody that knows or has met him.”This is an absolute tragedy caused by medical mistakes that should never have happened,” they added.By Francesca WitneyOr Call freephone 0800 884 0321SHARE THIS

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Dr. Robert Cameron Chairs International Panel of Medical Specialists at 4th Annual Symposium on Lung-Sparing Therapies for Malignant Pleural…

Dr. Robert Cameron ThePacific Meso Center, in conjunction with The Office of Continuing Medical Education of the David Geffen School of Medicine at UCLA, held the 4th International Symposium on Lung-SparingTherapies for Malignant Pleural Mesothelioma on June 7, 2014 in Santa Monica, California. TheWorthington & Caron Law Firmwas proud to once again be a platinum sponsor of this unique medical seminar focusing on rational treatment options for patients with pleural mesothelioma.As in years past, the course organizer and chair of the symposium was thoracic surgeon and pleural mesothelioma specialist,Dr. Robert Cameron. An ardent supporter of rational lung-sparing treatments for pleural mesothelioma, and innovator of thepleurectomy/decortication(“PD”) surgical procedure, Dr. Cameron is the founder and director of both theComprehensive Mesothelioma Programat the UCLA Medical Center and…

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New EMS system dramatically improves survival from cardiac arrest

A new system that sent patients to designated cardiac receiving centers dramatically increased the survival rate of victims of sudden cardiac arrest in Arizona, according to a study published online in Annals of Emergency Medicine.”We knew lives would be saved if the hospitals implemented the latest cutting edge guidelines for post-cardiac arrest care and we were able to get cardiac arrest patients to those hospitals, similar to what is done for Level 1 trauma patients,” said lead study author Daniel Spaite, MD, Director of EMS Research at the University of Arizona Emergency Medicine Research Center in Phoenix and Tucson and a professor and distinguished chair of emergency medicine at the University of Arizona College of Medicine. “Taking these patients directly to a hospital optimally prepared to treat cardiac arrest gave patients a better chance of survival and of preventing neurologic damage, a common result of these cardiac events.”Under the study, 31 hospitals, serving about 80 percent of the state’s population, were designated as cardiac receiving centers between December 2007 and November 2010. Approximately 55 emergency medicine service agencies also participated in the study.The study shows that the survival rate increased by more than 60 percent during the four-year period of the study, from 2007 to 2010. More importantly, when the results were adjusted for the various factors that significantly impact survival (such as age and how quickly the EMS system got to the patients after their arrest), the likelihood of surviving an arrest more than doubled. In addition, the likelihood of surviving with good neurological status also more than doubled.This statewide effort was accomplished through the Save Hearts Arizona Registry and Education-SHARE Program, a partnership involving the Arizona Department of Health Services, the University of Arizona, over 30 hospitals and more than 100 fire departments and EMS agencies. The SHARE Program is part of a network of statewide cardiac resuscitation programs dedicated to improving cardiac arrest survival and working together as the HeartRescue Project.”We worked closely with the hospitals around the state to implement these Guidelines and then formally recognized the hospitals as Cardiac Receiving Centers (CRCs) ,” said Ben Bobrow, MD, Medical Director of the Bureau of Emergency Medicine Services and Trauma System for the Arizona Department of Health Services in Phoenix, Ariz. “We then developed protocols for our EMS agencies to transport post-cardiac arrest patients to those centers. Our overarching goal was to have more cardiac arrest victims leave the hospital in good shape and be able to return to their families and careers. As we suspected, ‘regionalizing’ the care for these critically-ill patients markedly increased their likelihood of survival and good neurologic outcome.”Dr. Bobrow, who is also a professor of emergency medicine at the University of Arizona College of Medicine-Phoenix and an emergency physician at Maricopa Medical Center, said the study shows that just transporting these patients to the nearest emergency department does not maximize the likelihood of a positive outcome. …

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New brain pathways for understanding type 2 diabetes and obesity uncovered

Researchers at UT Southwestern Medical Center have identified neural pathways that increase understanding of how the brain regulates body weight, energy expenditure, and blood glucose levels — a discovery that can lead to new therapies for treating Type 2 diabetes and obesity.The study, published in Nature Neuroscience, found that melanocortin 4 receptors (MC4Rs) expressed by neurons that control the autonomic nervous system are key in regulating glucose metabolism and energy expenditure, said senior author Dr. Joel Elmquist, Director of the Division of Hypothalamic Research, and Professor of Internal Medicine, Pharmacology, and Psychiatry.”A number of previous studies have demonstrated that MC4Rs are key regulators of energy expenditure and glucose homeostasis, but the key neurons required to regulate these responses were unclear,” said Dr. Elmquist, who holds the Carl H. Westcott Distinguished Chair in Medical Research, and the Maclin Family Distinguished Professorship in Medical Science, in Honor of Dr. Roy A. Brinkley. “In the current study, we found that expression of these receptors by neurons that control the sympathetic nervous system, seem to be key regulators of metabolism. In particular, these cells regulate blood glucose levels and the ability of white fat to become ‘brown or beige’ fat.”Using mouse models, the team of researchers, including co-first authors Dr. Eric Berglund, Assistant Professor in the Advanced Imaging Research Center and Pharmacology, and Dr. Tiemin Liu, a postdoctoral research fellow in Internal Medicine, deleted MC4Rs in neurons controlling the sympathetic nervous system. …

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Take the bat, leave the candy: The food environment of youth baseball

‘Take me out to the ballgame’ doesn’t exactly conjure up images of apple slices and kale chips. The more likely culprits include French fries, soda and the occasional box of Crackerjacks.Unfortunately for children who play youth baseball, eating unhealthy food during practices and games may be contributing to weight problems, according to researchers at Wake Forest Baptist Medical Center. The study, published in the current online edition of Childhood Obesity, found that high-calorie snacks and sugar-sweetened drinks dominate the youth baseball scene.“Though youth sports are an excellent way to promote physical activity, social interaction and positive health behaviors, the food environments are often characterized by less healthy food options with high calorie contents and lower nutrient density,” said Joseph Skelton, M.D., associate professor of pediatrics at Wake Forest Baptist and senior author of the study.In this observational study, the research team conducted an environmental scan of foods consumed by players and family members during 12 games at a youth baseball field in northwest North Carolina. The players were boys 8 to 11 years old on six teams.The researchers found that most snacks were high-calorie food items, including French fries, candy and cookies and most beverages were sugar-sweetened. Nearly 90 percent of food and beverage items purchased were from the concession stand.“Team sports like baseball are still very important for children’s activity and development,” said Megan Irby, M.S, co-author and research program manager of Brenner FIT, a multidisciplinary pediatric obesity program at Wake Forest Baptist.“But as seen in this study, games and practices can be upwards of two to three nights a week, and many children participate on multiple sports teams each year. Parents should plan ahead for these busy times and even advocate in their local sports leagues for policies that address snacks and drinks.”This research was the first step in exploring the question of whether children and families attending youth sporting events may be increasing their risk for being overweight or obese as a result of chronic unhealthy food behaviors associated with sports participation, Skelton said. Contrary to the intent of youth sports, these findings indicate that children may be leaving the ball field having consumed more calories than they expended.“Despite the benefits of participating in sports, the increased exposure to unhealthy foods and disruption of meal times may increase children’s risk for poor nutritional habits that can contribute to weight management issues,” Skelton said.A limitation of the study was the ability to accurately document all foods consumed at the ballpark without being intrusive.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 mammography dilemma: 50 years of analysis

A comprehensive review of 50 year’s worth of international studies assessing the benefits and harms of mammography screening suggests that the benefits of the screening are often overestimated, while harms are underestimated. And, since the relative benefits and harms of screening are related to a complex array of clinical factors and personal preferences, physicians and patients need more guidance on how best to individualize their approach to breast cancer screening.The results of the review by researchers at Harvard Medical School’s Department of Health Care Policy and Brigham and Women’s Hospital are published today in JAMA.The American Cancer Society estimates that about 40,000 U.S. women will die of breast cancer this year. In 2009, based on evidence that the benefit-risk ratio for mammography screening is higher among women over 50 and with less frequent screening, the U.S. Preventive Services Task Force (USPSTF) reversed its previous recommendation of mammography every one to two years beginning at age 40, and recommended routine screening every two years starting at age 50, the researchers noted. The recommendations remain controversial among the general public and the medical community. Recent evidence suggests that use of mammography in the U.S. has not changed following the updated recommendations.”What I tell my patients is that the mammogram is not a perfect test,” said Nancy Keating, co-author of the report, associate professor of Health Care Policy at HMS and associate professor of medicine at Brigham and Women’s. “Some cancers will be missed, some people will die of breast cancer regardless of whether they have a mammogram, and a small number of people that might have died of breast cancer without screening will have their lives saved.”The authors report that the best estimate of the reduction in mortality from breast cancer due to annual screening for women overall is about 19 percent. For women in their 40s, the reduction in risk was about 15 percent, and for women in their 60s, about 32 percent. …

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Good diet boosts health but not wealth

The idea that a good diet means a healthy population with lower health costs only holds true when it comes to emergency care, a study shows.Researchers from Monash University, the National Defense Medical Centre, Taiwan, and the National Health Research Institutes, Taiwan, found that although men and women aged over 65 years who ate healthily had shorter stays in hospital, they were strong users of other medical services. In fact, they tended to make greater use of outpatient services, preventive care and dental care than those who did not follow a healthy eating regime.Emeritus Professor Mark Wahlqvist from Monash University’s Department of Epidemiology and Preventive Medicine and the Monash Asia Institute said individuals with a higher socioeconomic status usually followed a healthier diet and took better care of their health needs, while those on lower incomes were more likely to cut back on basic needs like food and medication.”A diverse diet can be quite costly, which can lead to food insecurity for low socioeconomic groups who cannot afford it,” Professor Wahlqvist said.”This may partly explain the greater expenditure on acute care that they incur.”Professor Walhlqvist said that economic factors played an inescapable role in the development of health policies, but the medical costs of diet-related and nutritionally related diseases were rarely given attention.The findings have important implications for nutrition-related health service policy given that most countries are facing increased medical expenditure as their population ages.”Such a policy should pay close attention to socially disadvantaged groups with poorer dietary quality,” Professor Wahlqvist said.Story Source:The above story is based on materials provided by Monash University. Note: Materials may be edited for content and length.

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Genetic cause of heart valve defects revealed

Heart valve defects are a common cause of death in newborns. Scientists at the University of Bonn and the caesar research center have discovered “Creld1” is a key gene for the development of heart valves in mice. The researchers were able to show that a similar Creld1 gene found in humans functions via the same signaling pathway as in the mouse. This discovery is an important step forward in the molecular understanding of the pathogenesis of heart valve defects. The findings have been published in the journal “Developmental Cell.”Atrioventricular septal defect (AVSD) is a congenital heart defect in which the heart valves and cardiac septum are malformed. Children with Down’s syndrome are particularly affected. Without surgical interventions, mortality in the first months of life is high. “Even in adults, unidentified valve defects occur in about six percent of patients with heart disease,” says Prof. Dr. Michael Hoch, Executive Director of the Life & Medical Sciences (LIMES) Institute of the University of Bonn.For years, there have been indications that changes in the so-called Creld1 gene (Cysteine-Rich with EGF-Like Domains 1) increase the pathogenic risk of AVSD. …

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Can vitamin A turn back the clock on breast cancer?

A derivative of vitamin A, known as retinoic acid, found abundantly in sweet potato and carrots, helps turn pre-cancer cells back to normal healthy breast cells, according to research published this month in the International Journal of Oncology. The research could help explain why some clinical studies have been unable to see a benefit of vitamin A on cancer: the vitamin doesn’t appear to change the course of full-blown cancer, only pre-cancerous cells, and only works at a very narrow dose.Because cells undergo many changes before they become fully aggressive and metastatic, Sandra V. Fernandez, Ph.D., Assistant Research Professor of Medical Oncology at Thomas Jefferson University, and colleagues, used a model of breast cancer progression composed of four types of cells each one representing a different stage of breast cancer: normal, pre-cancerous, cancerous and a fully aggressive model.When the researchers exposed the four breast cell types to different concentrations of retinoic acid – one of the chemicals that the body converts vitamin A into – they noticed a strong change in the pre-cancerous cells. Not only did the pre-cancerous cells begin to look more like normal cells in terms of their shape, they also changed their genetic signature back to normal. Dr. Fernandez’s pre-cancerous cells had 443 genes that were either up or downregulated on their way to becoming cancerous. All of these genes returned to normal levels after treatment with retinoic acid. “It looks like retinoic acid exerts effects on cancer cells in part via the modulation of the epigenome,” says Fernandez.“We were able to see this effect of retinoic acid because we were looking at four distinct stages of breast cancer,” says Dr. Fernandez. “It will be interesting to see if these results can be applied to patients.”Interestingly, the cells that were considered fully cancerous did not respond at all to retinoic acid, suggesting that there may be a small window of opportunity for retinoic acid to be helpful in preventing cancer progression. …

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Combating obesity with new Okinawan rice

In recent years, Okinawa has recorded the dubious distinction of having the highest obesity rate in Japan. Preventing obesity-related diseases is an urgent issue. Professor Hidetoshi Saze of the OIST Plant Epigenetics Unit is leading a new research project to develop a new strain of rice that produces digestion-resistant starch to prevent these diseases. The project, fostered by the Okinawan government, involves three activities by the medical, agricultural, and food industries: development of the new rice strain, nutritional and physiological analyses, and processing and sales.Nanshoka-Mai, or rice with digestion-resistant starch is a new breed of rice rich in starch that does not as readily break down into glucose. This rice strain was first developed by a research team at Kyushu University 30 years ago. The starch from most grains, which consist largely of an unbranched glucose polymer known as amylose, is normally broken down into glucose during the digestive process and serves as our primary energy source. However, excessive consumption of sugars (simple carbohydrates) can cause life-style-related diseases, such as obesity and diabetes. This new strain of rice is expected to serve as an alternative preventative measure. In addition to its anti-obesity effect, gathering evidence suggests that the rice with digestion-resistant starch may also provide other benefits, such as lower blood sugar levels, reduced neutral fat, and harmful cholesterol levels, and prevention of lipid accumulation in the liver.Despite its great promise, when researchers planted the original strain of resistant-starch rice in Okinawa, the yield per hectare was about half that achieved in mainland Japan. Prof. …

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Number of babies mom has may play role in future cardiovascular health

Women who give birth to four or more children are much more likely to have evidence of plaque in their heart or thickening of their arteries — early signs of cardiovascular disease — compared with those having fewer pregnancies, according to research to be presented at the American College of Cardiology’s 63rd Annual Scientific Session.While earlier studies have shown an association between several aspects of pregnancy — physiological changes, complications, number of pregnancies — and future heart disease risk, many questions remain about how pregnancy might affect cardiovascular risk. To better understand the potential link, researchers at the University of Texas Southwestern Medical Center set out to determine whether the number of live births is associated with early signs of cardiovascular disease.”This is not a recommendation for women to only have two or three children,” said Monika Sanghavi, M.D., chief cardiology fellow, University of Texas Southwestern Medical Center, and lead investigator of the study. This is the first study to look at two markers of subclinical atherosclerosis — a gradual narrowing and hardening of the arteries that can eventually block blood flow and lead to stroke and heart attack.”Our findings add to the growing body of evidence that the changes associated with pregnancy may provide insight into a woman’s future cardiovascular risk and deserves further attention.”The study included 1,644 women from the Dallas Heart Study, a multiethnic population-based cohort, who had both self-reported information about the number of live births and relevant imaging study data available. The average age at the time of analysis was 45 years and slightly more than half of the women (55 percent) were African-American. Coronary artery calcium (CAC) scores were measured using computed tomography imaging and aortic wall thickness (AWT) by magnetic resonance imaging to determine whether or not women had evidence of subclinical atherosclerosis in the heart and artery walls. CAC was positive if it was greater than 10 and AWT was abnormal if it was greater than the 75th percentile for age and gender. These tests were done as part of standard subject participation in the Dallas Heart Study.Using women who had two or three live births as a reference, women who had given birth to four or more children had an approximately two-fold increased risk of having abnormal CAC or AWT. This association remained even after adjusting for socioeconomic status, education, race and factors known to heighten the risk of cardiovascular disease. Women who had more babies were more likely to be older, Hispanic, have high blood pressure, higher body mass index and lower socioeconomic status.Curiously, women who had zero or just one live birth were also more likely to show evidence of subclinical atherosclerosis — revealing a U-shaped relationship.Authors say it is unclear why this might be the case. But Sanghavi and others speculate they may have captured some women in this group who have an underlying condition that prevents them from carrying a first or second pregnancy to term, which may also predispose them to cardiovascular disease or risk factors. …

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Learn More about Wrongful Death

A death caused by the negligent or unjust actions of another individual is referred to as a wrongful death. While all deaths are devastating to the family and friends of the deceased, wrongful deaths can be exceptionally traumatic due to the fact that they could have been prevented. A variety of accidents and intentional harms can lead to the wrongful death of others, including car accidents, medical malpractice, product liability, workplace negligence, and even acts of violence or murder. When the numbers are added up, it is clear to see how unfortunately common wrongful deaths can be.According to the Centers for Disease Control and Prevention, over 37,000 prescription drug-related fatalities occurred in 2009. The Department of Transportation reports that for the same year, 33,883 traffic accident fatalities occurred. Workplace accidents also contribute significantly, with over 4,500 accident-related fatalities reported in 2010 by the Bureau of Labor Statistics. And, research published in the Journal of the American Medical Association suggests that approximately 225,000 individuals die each year as a result of medical malpractice.When an individual suffers a wrongful death, a personal representative of the deceased’s estate is allowed under law to bring forth a civil case against the individual (or individuals) who were either partially or fully responsible for the death. In order to be successful, the plaintiff must prove that the defendant was either negligent, acted with intent to cause harm, or was strictly to blame regardless of any fault attached to their actions (or failure to take action).Each state has its own wrongful death statutes that define time limits within which a wrongful death suit can be filed, and which often place specific regulations on the damages that can be pursued for individual types of accidents. In the aftermath of an unexpected and tragic death, bereaved family and friends are distraught, angry, and often in shock at what has transpired to their loved one. The complexity and individualistic nature of wrongful death laws and lawsuits underscore the importance just how important it is for grieving families to secure the help of a qualified attorney. …

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Migraine attacks increase following stress ‘let-down’

Migraine sufferers who experienced reduced stress from one day to the next are at significantly increased risk of migraine onset on the subsequent day, according to a new study conducted by researchers at the Montefiore Headache Center and Albert Einstein College of Medicine at Yeshiva University. Stress has long been believed to be a common headache trigger. In this study, researchers found that relaxation following heightened stress was an even more significant trigger for migraine attacks. Findings may aid in recommending preventive treatments and behavioral interventions. The study was published online in Neurology, the medical journal of the American Academy of Neurology.Migraine is a chronic condition that affects approximately 38 million Americans. To examine headache triggers, investigators at the Montefiore Headache Center and Einstein conducted a three month electronic daily diary study which captured 2,011 diary records and 110 eligible migraine attacks in 17 participants. The study compared levels of stress and reduction in stress as predictors of headache.”This study demonstrates a striking association between reduction in perceived stress and the occurrence of migraine headaches,” said study lead author Richard B. Lipton, M.D., director, Montefiore Headache Center, professor and vice chair of neurology and the Edwin S. Lowe Chair in Neurology, Einstein. “Results were strongest during the first six hours where decline in stress was associated with a nearly five-fold increased risk of migraine onset. …

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New approach to leukemia testing may better define prognosis, treatment

Nearly half of patients with the most common form of adult leukemia are said to have normal chromosomes but appear instead to have a distinct pattern of genetic abnormalities that could better define their prognosis and treatment, researchers report.Using microarray technology that probes millions of genes within chromosomes, researchers found the unique pattern in the leukemia cells of 22 patients diagnosed with cytogenetically normal acute myelogenous leukemia, said Dr. Ravindra Kolhe, molecular pathologist at the Medical College of Georgia at Georgia Regents University.”This is a total game changer,” Kolhe said. “We have to use more sensitive tests to give patients the proper answer.”Kolhe, Director of the Georgia Esoteric, Molecular Labs, LLC, Department of Pathology, presented the findings March 29 during the American College of Medical Genetics and Genomics Annual Clinical Genetics Meeting in Nashville.Acute myelogenous leukemia, the most common type of acute leukemia in adults, has about 20 subtypes, according to the National Cancer Institute. Patients with cytogenetically normal acute myelogenous leukemia experience widely varying outcomes following chemotherapy and bone marrow transplants. Ideally, identifying the causative genes will lead to a more targeted therapy and definitive prognosis, Kolhe said.”The technology we currently use can’t identify specifically what’s wrong,” Kolhe said. Patients have high percentages of cancer-producing cells called blasts in their blood and bone marrow but they do not show the distinctive chromosomal alterations that typically help characterize the leukemia and strategize therapy.Genetic abnormalities, inherited and/or caused by environmental exposures — including previous chemotherapy and radiation treatment — are thought to cause leukemia. The result is that a disproportionate number of stem cells get stuck in the blast, or cancerous, stage, rather than maturing to white blood cells that actually fight cancer and other invaders.Patients often feel tired and feverish and blood tests reveal high blast levels. Pathologists then take about 20 leukemia cells, chemically block their constant division, open the nucleus, and spread the chromosomes on a slide. They examine the chromosomes with a microscope and in-situ hybridization technology, which helps detect small deletions or rearrangements.”(Cytogenetically normal patients) show a normal chromosomal picture but they are clearly sick,” Kolhe said. Frustrated at being unable to give these patients better information, he partnered with California-based Affymetrix to look directly at the genes within chromosomes using CytoScanHD microarray technology.When he put cell contents instead on a computer chip with 2.7 million genetic probes, small, previously undetectable changes in the DNA became apparent in patients who had been classified as cytogenetically normal. …

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Medical marijuana may ease some MS; Little evidence for other complementary or alternative therapies

A new guideline from the American Academy of Neurology suggests that there is little evidence that most complementary or alternative medicine therapies (CAM) treat the symptoms of multiple sclerosis (MS). However, the guideline states the CAM therapies oral cannabis, or medical marijuana pills, and oral medical marijuana spray may ease patients’ reported symptoms of spasticity, pain related to spasticity and frequent urination in multiple sclerosis (MS). The guideline, which is published in the March 25, 2014, print issue of Neurology, the medical journal of the American Academy of Neurology, states that there is not enough evidence to show whether smoking marijuana is helpful in treating MS symptoms.The guideline looked at CAM therapies, which are nonconventional therapies used in addition to or instead of doctor-recommended therapies. Examples include oral cannabis, or medical marijuana pills and oral medical marijuana spray, ginkgo biloba, magnetic therapy, bee sting therapy, omega-3 fatty acids and reflexology.”Using different CAM therapies is common in 33 to 80 percent of people with MS, particularly those who are female, have higher education levels and report poorer health,” said guideline lead author Vijayshree Yadav, MD, MCR, with Oregon Health & Science University in Portland and a member of the American Academy of Neurology. “People with MS should let their doctors know what types of these therapies they are taking, or thinking about taking.”For most CAM therapies, safety is unknown. There is not enough information to show if CAM therapies interact with prescription MS drugs. Most CAM therapies are not regulated by the Food and Drug Administration (FDA). Dronabinol and nabilone are synthetic forms of key ingredients in marijuana. The FDA approved both drugs as treatments for nausea and vomiting associated with cancer chemotherapy that do not respond to standard treatments. Dronabinol also is approved for loss of appetite associated with weight loss in patients with AIDS.The guideline found that certain forms of medical marijuana, in pill or oral spray form only, may help reduce patients’ reported spasticity symptoms, pain due to spasticity, and frequent urination but not loss of bladder control. …

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Tumor suppressor gene linked to stem cells, cancer biologists report

Just as archeologists try to decipher ancient tablets to discern their meaning, UT Southwestern Medical Center cancer biologists are working to decode the purpose of an ancient gene considered one of the most important in cancer research.The p53 gene appears to be involved in signaling other cells instrumental in stopping tumor development. But the p53 gene predates cancer, so scientists are uncertain what its original function is.In trying to unravel the mystery, Dr. John Abrams, Professor of Cell Biology at UT Southwestern, and his team made a crucial new discovery — tying the p53 gene to stem cells. Specifically, his lab found that when cellular damage is present, the gene is hyperactive in stem cells, but not in other cells. The findings suggest p53’s tumor suppression ability may have evolved from its more ancient ability to regulate stem cell growth.”The discovery was that only the stem cells light up. None of the others do. The exciting implication is that we are able to understand the function of p53 in stem cells,” said Dr. Abrams, Chair of the Genetics and Development program in UT Southwestern’s Graduate School of Biomedical Sciences. “We may, in fact, have some important answers for how p53 suppresses tumors.”The findings appear online in the journal eLife, a joint initiative of the Howard Hughes Medical Institute, the Max Planck Society, and the Wellcome Trust.p53 is one of the hardest working and most effective allies in the fight against cancer, said Dr. Abrams. …

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Biological testing tool, ScanDrop, tests in fraction of time and cost of industry standard

Northeastern University professor of pharmaceutical sciences, Tania Konry, has developed a single instrument that can conduct a wide range of biological scans in a fraction of the time and cost of industry standard equipment. That’s because it uses considerably less material and ultra-sensitive detection methods to do the same thing.Currently, researchers face enormous time constraints and financial hurdles from having to run these analyses on a regular basis. Hundreds of dollars and 24 hours are what’s required to scan biological materials for important biomarkers that signal diseases such as diabetes or cancer. And suppose you wanted to monitor live cancer cells. For that you’d have to use an entirely different method. It takes just as long but requires a whole other set of expensive top-end instrumentation. Want to look at bacteria instead? Be prepared to wait a few days for it to grow before you can get a meaningful result.Konry’s creation, ScanDrop, is a portable instrument no bigger than a shoebox that has the capacity to detect a variety of biological specimen. For that reason it will benefit a wide range of users beyond the medical community, including environmental monitoring and basic scientific research.The instrument acts as a miniature science lab, of sorts. It contains a tiny chip, made of polymer or glass, that is connected to equally tiny tubes. …

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Strictly limiting hours surgical residents can work has not improved patient safety

Strictly limiting the number of hours surgical residents can work has not improved patient outcomes but may have increased complications for some patients and led to higher failure rates on certification exams, a research paper concludes.Traditionally, doctors in the residency phase of their training spent very long hours in a hospital — often around-the-clock — so they could see a wide variety and high volume of patients. In the last 10 years, health authorities started limiting those hours in the hopes of improving patient safety and the education and well-being of doctors.In 2003, the Accreditation Council for Graduate Medical Education in the United States limited residents’ hours to 80 per week. In 2011, the council prohibited first-year residents from working 24 shifts.In Canada, on-call shifts were limited to 16 hours in Quebec after a provincial arbitrator ruled that in 2011 that a 24-hour on-call shift posed a danger to residents’ health and violated the Charter of Rights. Last year a National Steering Committee on Resident Duty Hours said the status quo was unacceptable and that shifts of 24 hours or longer without sleep should be avoided. It urged all provinces and health care institutions to develop comprehensive strategies to minimize fatigue and fatigue-related risks during residency.Dr. Najma Ahmad, a trauma surgeon at St. Michael’s Hospital who was a member of the national group, published a paper today in the Annals of Surgery that found the too-restricted hours may work for some residents, but not for surgical residents.”A one-size fits all approach to resident duty hours may not be appropriate for all specialties,” said Dr. Ahmed, noting that the American College of Surgeons Division of education has stated that mastery in surgery requires “extensive and immersive experiences.”She said the emphasis should be on reducing the amount of non-educational work residents do and to find ways to manage fatigue such as making sure they get enough uninterrupted sleep. Dr. Ahmed, who is also director of the University of Toronto’s General Surgery Program, conducted a meta-analysis of 135 articles on the impact of resident duty hours on clinical and educational outcomes in surgery.”In surgery, recent changes in hours for residents are not consistently associated with improved resident well-being and may have negative impacts on patient outcomes and performance on certification exams,” she said.Dr. …

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Doctors raise blood pressure in patients

Doctors routinely record blood pressure levels that are significantly higher than levels recorded by nurses, the first thorough analysis of scientific data has revealed.A systematic review led by the University of Exeter Medical School, and supported by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care in the South West Peninsula (NIHR PenCLAHRC), has discovered that recordings taken by doctors are significantly higher (by 7/4mmHg) than when the same patients are tested by nurses.Dr Christopher Clark, of the University of Exeter Medical School, said the findings, published in the British Journal of General Practice, should lead to changes in clinical practice. “Doctors should continue to measure blood pressure as part of the assessment of an ill patient or a routine check-up, but not where clinical decisions on blood pressure treatment depend on the outcome. The difference we noted is enough to tip some patients over the threshold for treatment for high blood pressure, and unnecessary medication can lead to unwanted side-effects. Some patients may be erroneously asked to continue to monitor their own blood pressure at home, which can build anxiety. These inappropriate measures could all be avoided by the simple measure of someone other than a doctor taking the blood pressure recording.””Researchers should also think carefully about how to account for this effect in studies that compare treatment by doctors and nurses. Some studies have concluded that nurses are better at treating hypertension, when in fact those findings could be down to this recording bias.”The phenomenon of doctors recording higher blood pressure is known as the “white coat effect,” and is thought to result from the patient’s physical response to being assessed by a doctor. It has previously been noted in a number of studies, but Dr Clark’s research is the first comprehensive analysis of available data to quantify this effect.The team examined the blood pressure levels of 1,019 individuals whose measurements had been taken by both doctors and nurses at the same visit. Dr Clark said: “Our results were pooled from different settings across ten countries, so we can be confident that they can be generalised to any healthcare environment where blood pressure is being measured. These results were all from research trials — our next task will be to examine data from GP surgeries.”Professor John Campbell, Professor of General Practice and Primary Care at the University of Exeter Medical School and a co-author on the study said: “This interesting study forms part of our portfolio of primary care research examining factors which might need to be considered when doctors and other healthcare professionals undertake assessments of patient’s risk of cardiovascular disease. Increasing doctor’s awareness of factors which might affect the accurate assessment of blood pressure is of great importance since this is one of the commonest clinical assessments undertaken, and one where important decisions regarding a patient health and well-being may follow.”The University of Exeter Primary Care Research Group is part of the Medical School’s Institute of Health Research. …

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