Insidermedicine

Parkinson's Disease Video: Molecular Pathway Linked to Parkinson's Disease, Relationships Boost Survival Odds, Delirium Raises Risk of Death in Older Patients

28 July 2010

From California - Scientists have identified a molecular mechanism that may cause Parkinson's disease, according to a report published in Nature. Researchers found that the LRRK2 genetic mutation results in impaired activity of microRNA molecules. This impairment results in the death of nerve cells that are responsible for secretion of dopamine in the brain--a distinctive feature of Parkinson's disease.

From Utah - Social relationships may extend your life, according to a report published in PLoS Medicine. Conducting a meta analysis of nearly 150 studies, researchers found that social relationships with friends, family, neighbors or colleagues, increased chances of survival by 50%.

And finally, from the Netherlands - According to a report published in the Journal of the American Medical Association, older patients who suffer from delirirum are at increased risk of negative outcomes. Researchers compared over 700 delirium patients to nearly 2300 controls, finding that those who suffered from the condition were at increased risk of institutionalization, dementia and death.

Hands Only CPR as Good As Traditional CPR (Video)

28 July 2010

(July 27, 2010 - Insidermedicine)

According to research published in the New England Journal of Medicine, performing "hands only" CPR by bystanders is as good as traditional CPR which also involves periodic rescue breathing.

Here are some important facts to remember if you come across a person who may require CPR

- First assess the environment. Are there any hazards that can place you or others at risk. Environmental risk factors include ongoing traffic, or exposed electrical wires.

- When responding to a person who is not responsive, go through the ABCs. That is, systematically assess their airway, breathing and circulation. Also remember that the brain can suffer irreparable damage within a 5-8 minutes of not receiving oxygen, so time is of the essence in terms of administering CPR and activating an emergency response system by calling 911.

- Research has shown that stopping chest compression to breathe into the lungs actually lowers the blood flow through the coronary arteries raising the chance of heart damage being done. It also has shown to lower the chances of survival. Because of this many advocate "hands only" CPR, in which chest compression is not interrupted by breathing into a patient's mouth.

In the present study, researchers form Emergency Medical Services Division of Public Health for Seattle and King County performed a mutlicenter study in which people who needed CPR had an equal chance of receiving either "hands only" CPR or CPR that involved both chest compression and periodic ventilation. CPR was delivered by bystanders on the recommendation of a central emergency dispatcher. The study showed that there was no difference in overall survival: 12% of those who received "hands-only" CPR survived as did 11% of those who received CPR with breathing. A trend was noted in which those which a cardiac cause of arrest and shockable heart rhythms to be more likely to survive with compression only CPR.

Today's research shows that ventilation is likely not important in CPR administered by bystanders. This is important because it means that bystanders can administer CPR by using chest compression only and no longer need to periodically stop compressions to breath fresh oxygen into the blood.

Rheumatoid Arthritis Video: Alcohol Linked to Reduced Rheumatoid Arthritis Severity, Three Epilepsy Drugs Raise Suicide Risk, Preterm Newborns and Respiratory Illness

27 July 2010

(July 27, 2010 - Insidermedicine)

From the UK - Alcohol consumption may reduce severity of rheumatoid arthritis, according to a report published in Rheumatology. Researchers compared nearly 900 RA patients to over 100 healthy controls, finding that those who drank alcohol had considerably less problems from their RA than non-drinkers. Results also showed that those who did not drink at all had a 4x increased risk of developing the condition.

From Minnesota - Three epilepsy drugs may raise risk of suicide, according to a report published in Neurology. Studying over 44,000 people who had at least one prescription for an epilepsy drug, researchers found that the newer medications levetiracetam, topiramate and vigabatrin had a 3x increased risk of harming themselves or attempting suicide

And finally, from Chicago - Infants born in the late preterm period are more likely to suffer respiratory illness, according to a report published in the Journal of the American Medical Association. Researchers studied over 230,000 deliveries over a 6 year period, finding that babies born at 34 weeks had a 40x increased risk of respiratory distress syndrome, while the risk of the condition decreased for every additional week spent in the womb.

Bariatric Surgery is Safe, Though Best Undergone With Experienced Surgeon

27 July 2010

(July 27, 2010 - Insidermedicine)

According to research published in the Journal of the American Medical Association, surgery to induce weight loss - called bariatric surgery - is very safe, but the risk of developing a post operative complication is correlated to surgeon experience.

Here are some important things to consider regarding weight loss

- Studies suggest that obesity is linked to genetics. However a series of aerobic activities such as running, swimming and biking can increase the chance of weight loss. Lifting weights can not only increase muscle size, but because creating muscle burns energy, a weight lifting program can also help with weight loss.

- Bariatric surgery includes several procedures that lessen the size of the stomach and/or re-route the passage of food to limit its absorption. This surgery is not without risk and should be considered only in those whose BMI is very high. It is now the second most commonly performed abdominal surgery in the US.

- Research has shown that bariatric surgery can reverse diabetes and prolong ones lifespan. In addition a study showed that this technique for weight loss can also lower the chance of developing cancer in women.

In the present study, researchers from the University of Michigan were interested in evaluating the complication rate of bariatric surgery. To perform their study they evaluated data from a clinical outcomes registry which contained data from over 15000 patients and 62 surgeons. Overall, complications were noted in 7% of patients, but most were not serious and involved wound infections. Serious complications were noted in 1-3% of patients depending on the type of surgery. Fatalities occured in one in every 7000 cases if the patient received gastric bypass surgery. Serious risk of complication was dependent on surgeon and hopsital experience.

Today's research highlights the growing rate of bariatric surgery. While research shows that this intervention may have numerous longterm health benefits, it, like all surgeries can be associated with serious complications. If you are considering having this surgery performed, it is important to be under the care of an experienced surgeon.

Alteplase For Stroke Best Given Within 3 to 4.5 Hour Window (Video)

26 July 2010

(July 26, 2010 - Insidermedicine)

According to research published in the Lancet Neurology, receiving aggressive blood thinning should be done as fast as possible if you are suffering from a stroke or transient ischemic attack. While it is best to get this treatment done within 3 hours, receiving the medication up to 4.5 hours following the start of symptoms is still beneficial.

Here are some important things to remember about strokes and TIAs:

- Strokes or TIA are caused that then brain does not get enough blood and is deprived of oxygen. Similar to a heart attack, in which an area of the heart muscle dies, an area of the brain can quickly die, leading to profound and irreversible loss of function.

- If you notice any signs of sudden weakness or paralysis, slurring speech or feeling a pins and needle sensation over any part of your body you may be having a TIA or stoke. Time is of the essence as treatments are available that can reverse these symptoms.

- Numerous studies have shown the benefit of an aggressive clot-busting medication called alteplase. This medicine can re-established blood flow in the brain and improve ones chances of getting neurologic function back.

In previous research alteplase was shown to be most beneficial when given within 3 hours of symptoms. But is also had some benefit when given between the 3-4.5 hour window. While many Neurologists and organizations weighed the pros and cons of recommending alteplase for stroke patients who presented to the ER during the later time frame, as recommendation was given to treat both groups.

The present study, using data from the Safe Implementation of Treatment in Stroke-International Stroke Thrombolysis Registry looked to confirm this recommendation. By studying over 23,000 stoke patients some of whom had their strokes prior to the recommendation and others of whom after it, the researchers were able to show no difference in the average time a patient presented to the ER following stroke symptoms. On average this number was 65 minutes both before and after the recommendation.

The study also showed that even though those in the 3-4.5 hour group benefited from treatment, the ideal time remained less than 3 hours. This early group were less likely to have permanent impairment and were less likely to bleeding into the brain, which is a known complication of clot-breaking treatment.

Today's research confirms the recommendation that even patients in the 3-4.5 hour window following stroke symptoms will benefit from the clot-breaking abilities of alteplase. However, time is of the essence and ones best chances of recovery happen if medication is given within the first few hours.

Cancer Video: Childhood Cancer Survivor's Heart Risk, Most Prostate Cancer Patients Get Aggressive Treatment, Education Lowers Risk of Dementia

26 July 2010

(July 26, 2010 - Insidermedicine)

From the Netherlands - According to a report published in the Archives of Internal Medicine, childhood cancer survivors may face long term heart problems. Researchers studied 601 childhood cancer survivors, finding that 27% suffered abnormal cardiac function during long term followup.

From New Jersey - Most low risk prostate cancer patients typically undergo aggressive therapy, according to a report published in the Archives of Internal Medicine. Based on a study of over 123,000 prostate cancer patients, researchers estimate that 83% of men would receive aggressive treatment of the disease, even though only 2% of them would high grade cancer.

And finally, from the UK - Increased education may lower risk of dementia, according to a report published in Brain. Researchers studied nearly 900 people, finding that for every additional year of education, individuals saw their risk of dementia decrease by 11%.

Child Abuse Video: Flying Safe for Heart Patients, PTSD More Common in Older Women than Men, Giving Kids Pharmaceuticals A Form of Abuse (Week in Review)

25 July 2010

(July 25, 2010 - Insidermedicine)

From England - New guidelines published in the journal Heart maintain that flying is safe for heart patients. Experts reviewed several studies, finding that heart disease patients, people with heart rhythm abnormalities and those at high risk for heart attack face no added threat to their heart from air travel.

From Denmark - Women are more prone to PTSD later in life than men, according to a report published in the Annals of General Psychiatry. Researchers studied over 6500 adults, finding that PTSD was 2x more common in women than men, and that women were most vulnerable between ages 51 to 55 compared with ages 41-45 in men.

And finally, from Denver - Parents giving their children medications for non-therapeutic reasons is a common, but largely unreported, form of abuse, according to a report published in the Journal of Pediatrics. Researchers reviewed data from US poison control, finding 160 cases yearly of malicious pharmaceutical use in young children.

Cesarean Section Video: Vaginal Birth Safe After Cesarean Section, Sitting Too Much May Mean Higher Risk of Death, Malicious Pharmaceutical Use in Children

24 July 2010

(July 24, 2010 - Insidermedicine)

From Washington - The American College of Obstetricians and Gynecologist have released new guidelines regarding vaginal birth after cesarean. The organization now states that most women who have previously undergone a c-section are safe to attempt vaginal birth in a subsequent pregnancy. Evaluation of risks/benefits in each patient, however, is essential.

From Atlanta - Sitting too much during down time may increase risk of death, according to a report published in the American Journal of Epidemiology. Researchers studied over 120,000 adults for 14 years, finding that people who sat over 6 hours per day during their spare time were much more likely to die during the study period.

And finally, from Denver - Parents giving their children medications for non-therapeutic reasons is a common, but largely unreported, form of abuse, according to a report published in The Journal of Pediatrics. Researchers reviewed data from US poison control, finding 160 cases yearly of malicious pharmaceutical use in young children.

Diabetes Video: Bone Resorption Regulates Blood Sugar, African Descent Increases Risk of Aggressive Breast Cancer, Blood Test for Depression Possible

23 July 2010

(July 23, 2010 - Insidermedicine)

From New York – According to a report published in Cell, scientists have discovered that bone resorption regulates blood sugar. Researchers found that when skeleton regrowth triggers destruction of old bone, it also stimulates the body to release insulin and thereby improve glucose uptake. These results could lead to a new target in the fight against diabetes.

From Michigan – African and African American women are more likely to develop high risk breast cancer, according to a report published in Cancer. Researchers compared over 500 African American and 75 African breast cancer patients with over 1000 white American breast cancer patients They found that 82% of the African women 26% of the African American women had triple negative breast cancer, compared with only 16% of the white American women.

And finally, from the Netherlands – Scientists may be close to a blood test for depression, according to a report published in Biological Psychiatry. Researchers compared unmedicated major depressive disorder patients to healthy controls, finding that an experimental blood test was able to identify seven genes that could distinguish the depressed patients from the controls.

Irritable Bowel Syndrome Linked to Brain Changes (Video)

23 July 2010

(July 23, 2010 - Insidermedicine)

While irritable bowel syndrome, or IBS, has largely been classified as a "functional" condition as opposed to being associated with organic pathology, new research published in the journal Gastroenterology suggests otherwise, as an analysis of the brains of these patients demonstrates structural changes in their brains.

Here are some important facts about irritable bowel syndrome:

- Patients with irritable bowel syndrome usually have abdominal pain, bloating, diarrhea or constipation. Blood or mucous in the stool is not a feature. If they are present inflammatory bowel diseases like Crohn's or ulcerative colitis may be present.

- Any change in bowel habits should warrant medical attention as this could represent an inflammatory bowel condition or cancer. If you notice blood in your stool you should tell your doctor.

- Your doctor may order a colonoscopy to look at the inside lining of your bowel if you have changes in bowel habits. This allows a specialist to search for inflamed areas or tumors. In patients with irritable bowel, no abnormal areas are detected.

Researchers from UCLA and McGill University hypothesized that IBS may be related to structural changes in the brain. To perform their study, they looked at brain images from 55 female IBS patient and compared them to images of 48 control subjects who did not have this condition. They found that the brains of those with IBS had more grey matter in certain areas, and less in others. Specifically, increased grey matter was seen in the prefrontal and parietal cortex and in the posterior insula. The posterior insula is known to play a role in central pain amplification and may serve to heighten pain signals in patients with IBS.

They were also able to show that other areas of the brain had less grey matter. Some of these areas are important in attention and pain suppression.

Today's research is a step forward in showing that irritable bowel syndrome is a medical condition that is not "functional" but rather one that is rooted in changes in the area of the brain that are involved in how we interpret pain.