Insidermedicine

Football Concussions May Arise From Series of Hits, Not Just One; Novel Stroke Treatment Reduces Brain Damage; Breastfeeding Improves Lungs of Child (Video)

03 February 2012

(February 3, 2012 - Insidermedicine)

From Indianapolis - Football players may suffer concussions from a series of hits rather than just one, according to a report published in the Journal of Biomechanics. Researchers studied a high school football team for two years, using helmet-sensor impact data, MRIs, and cognitive screening tests to assess for any brain changes. Results showed a strong correlation between the totality of hits a player received and changes in brain activity.

From Baltimore - A new report presented at the International Stroke Conference describes a new clot-busting technique that may improve treatment of stroke. Researchers developed a minimally invasive stroke treatment in which a CT guided catheter delivers clot busting drugs directly into the clot causing the stroke. In a study of 93 patients, researchers noted that the minimalist approach cleared the clot and also reduced risk of brain damage.

And finally, from Switzerland - Breastfeeding may improve lung function in the child, according to a report published in the American Journal of Respiratory and Critical Care Medicine. Studying nearly 1500 children, researchers found that those who were breastfed had improved lung function at age 12, while the effect was greatest among children with asthmatic mothers.

Differentiating Between Alzheimer's Disease and Normal Memory Decline (Video)

03 February 2012

(February 3, 2012 - Insidermedicine)

A simple questionnaire may help distinguish patients with normal age-related memory loss from those with amnestic mild cognitive impairment, according to research published in BMC Geriatrics.

Here are some recommendations for the management of Alzheimer’s disease, from the Alzheimer’s Society:

•    Discuss with patient and family the use of cholinesterase inhibitors, N-methyl d-aspartate receptor (NMDA) antagonist, and other medications, if clinically indicated, to treat cognitive decline.

•    Also discuss referral to early-stage groups or adult day services for appropriate structured activities, such as physical exercise and recreation.

•    Treat behavioral symptoms and mood disorders using non-pharmacologic approaches, such as environmental modification, task simplification, appropriate activities, etc and/or referral to social service agencies or support organizations,

Researchers out of Banner Sun Health Research Institute in Sun City conducted a pilot study to determine whether a simple, short questionnaire designed to identify patients with Alzheimer’s disease, could also be used to identify patients with amnestic mild cognitive impairment. The questionnaire consists of 21 yes/no questions designed to be answered by a relative or caregiver in a primary care setting. The questions fall into five categories: memory, orientation, functional ability, visuospatial ability, and language.

While validating the questionnaire, the investigators discovered that four of the questions were strong indicators of the presence of amnestic mild cognitive impairment. These four questions referred to repeating questions and statements, having trouble knowing the date or time, having difficulties managing finances, and having a decreased sense of direction.

Today’s research offers an easy-to-use tool for physicians to identify patients who may require further assessment for a potential diagnosis of Alzheimer’s disease or amnestic mild cognitive impairment.

Malaria Kills 1.2 Million People Each Year; Heart Failure Linked to Thinner Bones, Fractures; Intermittent Exercise Improves Insulin Response in Diabetics (Video)

02 February 2012

(February 2, 2012 - Insidermedicine)

From Seattle - Malaria kills 1.2 million people worldwide every year, according to a report published in the Lancet. Researchers reviewed malaria mortality data from 1980 to 2010, finding that 1.2 million were killed by the virus in 2010--2x more than previously thought--and that 42% of these deaths occurred in children older than 5 and in adults.

From Alberta - Heart failure may increase risk of fractures, according to a report published in the Journal of Clinical Endocrinology & Metabolism. Researchers followed over 45,000 adults who underwent bone density testing for 10 years. They found those who had heart failure had a 30% increased risk of major fractures due to thinning bones.

And finally, from London - Intermittent exercise may improve blood glucose control in diabetics, according to a report published in the Journal of Clinical Endocrinology and Metabolism. Studying 8 men with type 2 diabetes, researchers found that intermittent exercise in a low-oxygen environment improved patient's response to insulin.

Ulipristal Acetate Reduces Fibroid Size, Diminish Uterine Bleeding (Video)

01 February 2012

(February 2012 - Insidermedicine)

Treatment with ulipristal acetate can reduce fibroid size and diminish uterine bleeding among women with symptomatic fibroids, according to research published in the February 2 issue of the New England Journal of Medicine.

Here are some recommendations for the use of uterine artery embolization (UAE) to treat fibroids, from the American College of Radiology:

•    Prior to UAE, all prospective patients should undergo a full gynecologic workup.

•    Cross-sectional imaging, preferably ultrasound (US) or magnetic resonance imaging (MRI), should be done to confirm the diagnosis of uterine leiomyomas and exclude other pelvic pathology.

•    Viable pregnancy and active infection are two absolute contraindications for the procedure and must be excluded.

Researchers out of the Cliniques Universitaires Saint-Luc Catholic University of Louvain randomized 242 women with symptomatic fibroids, excessive uterine bleeding, and a hemoglobin level of 10.2 g/dL to received treatment for up to 13 weeks with ulipristal acetate 5 or 10 mg daily or a placebo. All women also received iron supplements. At the end of 13 weeks, patients were eligible to undergo surgery.

By the end of the 13 week treatment period, 91% of women taking the 5 mg dose of ulipristal and 92% of those on the 10 mg dose had their uterine bleeding under control, compared with only 19% of those on placebo. Rates of amenorrhea were 73% with the low dose, 82% with the high dose, and 6% with placebo. When it did occur in women on active therapy, amenorrhea usually developed within 10 days. Total fibroid volume decreased by a median of 21% among the women on low dose ulipristal and 12% for the women on the high dose. In contrast, total fibroid volume actually increased by a median of 3% among women on placebo. Treatment with ulirpristal was associated with benign histologic endometrial changes that resolved within six months of discontinuing therapy. Uterine hemorrhage occurred in one woman taking 10 mg of ulirpristal.

Today’s research suggests that treatment with ulipristal can provide relief for women with symptomatic fibroids, at least until surgery is performed. The risks and benefits of long-term ulipristal therapy require further study.

Diabetes Video: New Medicine for Type 1 Diabetes Fails in Trials; Surgical Breast Biopsy Numbers Skewed; Eating Fish While Pregnant May Boost Cognitive Development in Child

01 February 2012

(February 1, 2012 - Insidermedicine)

From Sweden - A developmental medicine for type 1 diabetes has failed to show significant effects in a phase 3 trial published in the New England Journal of Medicine. Researchers randomized over 300 patients recently diagnosed with type 1 diabetes to either 4 doses of the novel medicine, 2 doses of the medicine plus placebo or 4 doses of placebo. Results showed some positive changes to C-peptide levels, but no significant effects.

From Philadelphia - According to a report published in the Journal of the American College of Radiology, surgical breast biopsies are not being overused. Researchers found that 30% of breast biopsies were classified as surgical, when in fact the amount of true surgical biopsies was somewhere between 2 and 18%.

And finally, from Spain - Eating fish while pregnant may improve cognitive development in the child, according to a report published in the American Journal of Clinical Nutrition. Researchers collected blood samples from 2,000 women at 20 weeks gestation and from the infant's umbilical cord. They found that women who consumed the most fish during pregnancy had children that scored higher in verbal intelligence and fine motor skills tests and demonstrated increased prosocial behaviour.

Heart Failure Linked to Mental Decline; Exercise Improves Health, Quality of Life in Cancer Patients; New Drug May Improve Survival in Advanced Prostate Cancer Patients (Video)

31 January 2012

(January 31, 2012 - Insidermedicine)

From Australia - A new report published in the European Heart Journal finds that heart failure may cause mental decline. Researchers used MRI scans to study the brains of 35 heart failure patients, 56 heart disease patients and 64 healthy controls. Imaging revealed that the heart failure patients had worse memory than controls, and also reduced grey matter in brain regions associated with cognitive and emotional activity.

From Hong Kong - Exercise can improve health in cancer patients, according to a report published in the BMJ. Results of a meta-analysis examining over 30 trials found that exercise benefited cancer patients by improving their BMI and blood sugar control, reducing depression and greatly enhancing quality of life.

And finally, from Maryland - A novel drug may improve survival in advanced prostate cancer patients, according to a report presented at the American Society of Clinical Oncology meeting. Researchers randomized men with drug-resistant prostate cancer to treatment with the drug MDV3100 or placebo. They found that the novel drug improved survival in the patients, resulting in a 37% reduced risk of death.
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Milk May Boost Brain Function; Difference in Blood Pressure Between Arms May Predict Heart Disease, Death; Family Doctors in UK Experiencing High Burnout Rates (Video)

30 January 2012

(January 30, 2012 - Insidermedicine)

From Maine - A daily glass of milk may boost memory and brain function, according to a report published in the International Dairy Journal. Researchers studied nearly 1,000 men and women ages 23 to 98, administering a series of tests that measure visual-spatial, verbal and working memory ability. Results showed that individuals who drank the most milk scored the highest on the tests--while milk drinkers were 5x less likely to fail the tests than non-milk drinkers.

From the UK - Checking blood pressure in both arms may help detect heart disease, according to a report published in the Lancet. Results of a meta-analysis found that a difference of 15mm Hg in systolic blood pressure between arms raised risk of heart disease and mortality.

And finally, from the UK - Family doctors in the UK have high levels of burnout, according to a report published in BMJ Open. Researchers surveyed over 550 general practitioners , finding that 46% said they were emotionally exhausted, 42% were depersonalized and 34% felt like they were not achieving anything

Risk of Congenital Heart Abnormalities Raised When Mother is Overweight and Smokes During Pregnancy (Video)

30 January 2012

(January 30, 2012 - Insidermedicine)

Overweight and smoking during pregnancy work synergistically to boost the risk of congenital heart abnormalities in offspring, according to research published online ahead of print in Heart.

Here are some recommendations for managing obesity in pregnancy, from the Society of Obstetricians and Gynaecologists of Canada

•    Encouraged women to enter pregnancy with a body mass index (BMI) <30 kg/m2, and ideally <25 kg/m2

•    BMI should be calculated from pre-pregnancy height and weight. Those with a pre-pregnancy BMI >30 kg/m2 are considered obese.

•    Ensure obese pregnant women receive counseling about weight gain, nutrition, and food choices

Researchers out of the University Medical Centre in Groningen compared pre- and postnatal medical and lifestyle data on nearly 800 infants who were born with congenital heart abnormalities but no other defects between 1997 and 2008 with that of 322 infants who were born with chromosomal abnormalities but no heart defects.

After controlling for other factors affecting the risk of congenital heart abnormalities, mothers who both smoked during pregnancy and who had a BMI of 25 or more were more than 2.5 times more likely to have a child with a congenital heart defect than women who either smoked but were not overweight or women who were overweight but did not smoke. Moreover, the risk of outflow tract obstructive abnormalities was more than tripled among babies born to mothers who smoked and were overweight during pregnancy.

Today’s research suggests that both smoking and overweight are involved in the same biologic pathways that lead to congenital heart abnormalities, resulting in an interactive effect. The combinations of these two risk factors in pregnancy should therefore be avoided whenever possible.

Anaphylaxis After Vaccine Very Rare; Working 11 Hour Days May Cause Depression; Many Smokers Do Not Quit, Even After Lung Cancer Diagnosis (Week in Review)

29 January 2012

(January 29, 2012 - Insidermedicine)

From the UK - Anaphylactic shock following vaccination is an extremely rare event, according to a report published in the Archives of Disease in Childhood. From 2008-2009, researchers noted only 7 confirmed cases of anaphylaxis following vaccination among over 5.5 million children vaccinated.

From London - A new report published in PLoS ONE finds that people who work too much are at raised risk of depression. Studying 2000 civil servants, researchers found that individuals who worked 11 or more hours a day had a twofold increased risk of suffering a major depressive episode.

And finally, from Boston - Research published in CANCER finds that many patients continue to smoke even after being diagnosed with cancer. Examining nearly 5,500 colorectal and lung cancer patients, researchers found that a substantial minority of these patients continued smoking 5 months after their diagnosis.

Elderly at Raised Risk of Infection Following ER Visit; Brain Activities May Ward off Alzheimer's Disease; Oral HPV Infection More Common in Men than Women (Week in Review)

28 January 2012

(January 28, 2012 - Insidermedicine)

From Montreal - The elderly are at significantly increased risk of infection following a visit to the emergency department, according to a report published in CMAJ. Studying over 1200 elderly residents of long term care facilities, researchers found that individuals were at 3x increased risk of a new respiratory or GI infection in the week following an emergency department visit.

From California - Keeping your brain active may reduce risk of Alzheimer's disease, according to a report published in the Archives of Neurology. Researchers studied 65 healthy elderly patients, as well as 10 Alzheimer disease patients and 11 young controls. They found that individuals who participated in more brain stimulating activities throughout their life, particularly in their early and middle years, had reduced levels of β-amyloid protein--a major component of AD development.

And finally, from Ohio - A new report presented at the Multidisciplinary Head and Neck Cancer Symposium finds that HPV-related cancers are more common in men than women. Studying over 5,500 adult men and women, researchers found that oral HPV infections were 3x more common in men than women, and that men were 5x more likely to have an HPV 16 infection--a form of the virus that raises risk of head and neck cancer by 14x