Archive for the ‘Medicine’ Category
The new flu virus that has exploded onto the global radar is already showing signs that it is adapting to mammals, suggesting what was once a bird virus is now probably spreading in a mammalian host, an influenza expert said Tuesday.
And while it’s not clear what that mammalian host is, the two most obvious choices are pigs or humans, said Dr. Richard Webby, head of the World Health Organization’s influenza collaborating centre at St. Jude Children’s Research Hospital in Memphis, Tenn.
“I think that’s what’s concerning about this …This thing doesn’t any longer look like a poultry virus,” Webby, a swine flu expert, said in an interview.
“It really looks to me like it’s adapted in a mammalian host somewhere.”
Many of the body’s processes follow a natural daily rhythm or so-called circadian clock. There are certain times of the day when a person is most alert, when blood pressure is highest, and when the heart is most efficient. Several rare gene mutations have been found that can adjust this clock in humans, responsible for entire families in which people wake up at 3 a.m. or 4 a.m. and cannot stay up much after 8 at night. Now new research has, for the first time, identified a common gene variant that affects virtually the entire population, and which is responsible for up to an hour a day of your tendency to be an early riser or night owl.
Furthermore, this new discovery not only demonstrates this common polymorphism influences the rhythms of people’s day-to-day lives — it also finds this genetic variant helps determine the time of day a person is most likely to die.
The surprising findings, which appear in the November 2012 issue of the Annals of Neurology, could help with scheduling shift work and planning medical treatments, as well as in monitoring the conditions of vulnerable patients.
“The internal ‘biological clock’ regulates many aspects of human biology and behavior, such as preferred sleep times, times of peak cognitive performance, and the timing of many physiological processes. It also influences the timing of acute medical events like stroke and heart attack,” says first author Andrew Lim, who conducted the work as a postdoctoral fellow in the Department of Neurology at Beth Israel Deaconess Medical Center.
People who have recurring symptoms of Lyme disease after taking a full course of antibiotics most likely have a new infection, according to research that undercuts the theory that the illness can relapse.
The Lyme Disease bacterium is spread by the tick bite that appears in the form of a “bull’s-eye rash,” according to the U.S. Centers for Disease Control and Prevention. If untreated, patients may develop fatigue, fever and muscle aches, palsy and eventually arthritis, nerve and heart disease.
A small number of patients have reported symptoms years after their initial treatment, raising concern that an incurable form of the disease exists, said Robert Nadelman, a researcher at New York Medical College in Valhalla. He analyzed bacteria from 17 people with consecutive episodes of the rash starting in 1991, and found the infections were caused by genetically distinct bacteria. There’s less than a one in five million chance that happened by chance, he said.
“Our data provide compelling evidence that courses of antibiotics that are recommended by Infectious Disease Society of America regularly cure early Lyme disease,” said Nadelman, a professor of medicine in the division of infectious diseases at New York Medical College in Valhalla, in a telephone interview. “When people have early Lyme disease again, it’s likely due to a new infection due to a new tick bite.”
The mentally ill are still neglected and stigmatised – just as I found they were 10 years ago – Health News – Health & Families – The Independent
Ten years ago I spent six months touring the country observing the care provided to people with mental illness for a book I was writing. Pure Madness, published in 2003, described a system “driven by fear”, in which risk reduction and protection of the public was the priority, rather than the care of patients. The public and political focus on the tiny numbers who posed a risk had distracted attention from the “huge majority of frightened, disturbed people whose suffering remains largely hidden”, I wrote.
When I was asked to join the Schizophrenia Commission last year I was delighted to have the chance to look again at the mental health service a decade on from my earlier investigation. What I found was profoundly disheartening.
Despite billions of pounds of extra investment in the NHS, which had brought many improvements in resources, staffing and buildings, the plight of the patients and their carers seemed, depressingly, unchanged.
The death of an ailing woman who was refused an abortion in an Irish hospital has inflamed longstanding concern about Ireland’s tight restrictions on when women can terminate a pregnancy.
Praveen Halappanavar told the Irish Times that his wife, Savita, was suffering intense pain and had been told her baby would not survive. Upset but resigned to losing her child, she was denied an abortion despite repeated pleas with their Galway hospital as she suffered shakes and vomiting, Halappanavar told the newspaper.
“The consultant said it was the law, that this is a Catholic country. Savita said, ‘I am neither Irish nor Catholic,’ but they said there was nothing they could do,” Halappanavar told the newspaper from India.
As long as the fetus still had a heartbeat, the husband said they were told, an abortion was illegal. Days later, the heartbeat stopped and the remains were removed, but Halappanavar grew sicker, eventually dying of blood poisoning, her husband told the Irish Times.
The Galway Roscommon University Hospitals Group said it could not discuss the details of her case with reporters, but was reviewing the unexpected death in line with its usual procedures to establish what had happened. It extended its sympathy to her husband, family and friends. The Health Service Executive, a national body that oversees Irish healthcare, is also carrying out a review and will recommend any changes needed to prevent similar incidents, it said.
After 55 years, the final patrol for cases of the mysterious ‘laughing death’ in remote Papua New Guinea has returned from the highlands. From this pursuit came Nobel-winning science, clues to ‘mad cow’ and insights into Alzheimer’s disease. It also revealed a little bit of cannibal hidden in us all.
Reboxetine is a drug I have prescribed. Other drugs had done nothing for my patient, so we wanted to try something new. I’d read the trial data before I wrote the prescription, and found only well-designed, fair tests, with overwhelmingly positive results.
Reboxetine was better than a placebo, and as good as any other antidepressant in head-to-head comparisons. It’s approved for use by the Medicines and Healthcare products Regulatory Agency (the MHRA), which governs all drugs in the UK. Millions of doses are prescribed every year, around the world. Reboxetine was clearly a safe and effective treatment. The patient and I discussed the evidence briefly, and agreed it was the right treatment to try next. I signed a prescription.
There has been no general agreement on the best way to adjust the dosage of inhaled corticosteroids used by adults with asthma. Doctors determine the dose by assessing symptoms like lung function or by using biomarkers like exhaled nitric oxide, or they simply let patients decide how much is needed.
A study published last week in The Journal of the American Medical Association found little difference in the three methods.
Researchers randomly assigned 342 adults with mild to moderate asthma to three groups. Those in the first had their doses adjusted by symptom assessment and those in the second by nitric oxide measurement. Those in the third group were allowed to decide on their own. The scientists recorded how long it took before a mild asthma attack occurred.
When the federal government began providing billions of dollars in incentives to push hospitals and physicians to use electronic medical and billing records, the goal was not only to improve efficiency and patient safety, but also to reduce health care costs.
Mr. Burleigh keeps a spreadsheet of the charges and payments for his overbilled emergency room visit.
But, in reality, the move to electronic health records may be contributing to billions of dollars in higher costs for Medicare, private insurers and patients by making it easier for hospitals and physicians to bill more for their services, whether or not they provide additional care.
Hospitals received $1 billion more in Medicare reimbursements in 2010 than they did five years earlier, at least in part by changing the billing codes they assign to patients in emergency rooms, according to a New York Times analysis of Medicare data from the American Hospital Directory. Regulators say physicians have changed the way they bill for office visits similarly, increasing their payments by billions of dollars as well.
The most aggressive billing — by just 1,700 of the more than 440,000 doctors in the country — cost Medicare as much as $100 million in 2010 alone, federal regulators said in a recent report, noting that the largest share of those doctors specialized in family practice, internal medicine and emergency care.
For instance, the portion of patients that the emergency department at Faxton St. Luke’s Healthcare in Utica, N.Y., claimed required the highest levels of treatment — and thus higher reimbursements — rose 43 percent in 2009. That was the same year the hospital began using electronic health records.
A laser device for less painful injections has been developed by South Korean scientists.
The system could replace traditional needles, with a jab as painless as being hit with a puff of air.
The laser is already used in aesthetic skin treatments. The aim now is to make low-cost injectors for clinical use.
A team from Seoul National University in South Korea describe the process in the Optical Society’s journal Optics Letters.
The researchers write that the laser, called erbium-doped yttrium aluminium garnet, or Er:YAG, propels a stream of medicine with the right force to almost painlessly enter the skin.
The jet is slightly larger than the width of a human hair and can reach the speed of 30m (100ft) per second.
“The impacting jet pressure is higher than the skin tensile strength and thus causes the jet to smoothly penetrate into the targeted depth underneath the skin, without any splashback of the drug,” said Prof Jack Yoh of Seoul National University, who led the study.