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September 3, 2009, 7:33 AM CT

Resident duty-hour reform increased complication rate

Resident duty-hour reform increased complication rate
A newly released study finds a 2003 reform of the length of resident on-duty hours has led to an increase in the rate of perioperative (the span of all three phases of surgery: before, during and after) complications for patients treated for hip fractures. Among other restrictions, this reform limited the resident workweek to 80 hours. The resulting complications vary significantly, with an increasing rate of worse outcomes seen in teaching hospitals, as per a research studyreported in the September 2009 issue of the Journal of Bone and Joint Surgery (JBJS).

"The data suggests a statistically significant increase in selected complications after implementation of the duty-hour reforms in teaching hospitals, where residents help deliver care, in comparison to non-teaching hospitals. This may go against common assumptions regarding outcomes as they relate to the length of resident hours," said study main author James M. Browne, MD, an orthopaedic surgeon currently completing a fellowship in Rochester, Minnesota. The study waccording toformed at Duke University Medical Center.

On July 1, 2003, The Accreditation Council for Graduate Medical Education implemented a resident duty-hour reform for all medical and surgical residents, including orthopaedic resident surgeons, in the U.S. Dr. Browne and his co-authors at Duke evaluated data from teaching and nonteaching hospitals for 48,430 patients treated for hip fractures in a nationwide inpatient sample database, reviewing two groups:.........

Posted by: Janet      Read more         Source


August 24, 2009, 10:44 PM CT

Higher level of testosterone in women

Higher level of testosterone in women
The battle of the sexes rages on, this time from the trading floor. While there has long been debate about the social and biological differences between men and women, new research by the Kellogg School of Management at Northwestern University, the University of Chicago Booth School of Business and the University of Chicago's Department of Comparative Human Development explores how the hormone testosterone plays an important role in gender differences in financial risk aversion and career choice.

Previous research has shown that testosterone enhances competitiveness and dominance, reduces fear, and is linked to risky behaviors like gambling and alcohol use. However, until now, the impact of testosterone on gender differences in financial risk-taking has not been explored.

The new paper, "Gender differences in financial risk aversion and career choices are affected by testosterone," has been reported in the Aug. 24, 2009 early edition of the Proceedings of the National Academy of Sciences (PNAS). The research was conducted by Paola Sapienza, Associate Professor, Kellogg School of Management at Northwestern University; Luigi Zingales, Robert McCormick Professor, University of Chicago Booth School of Business; and Dario Maestripieri, Professor in Comparative Human Development, University of Chicago.........

Posted by: Janet      Read more         Source


August 24, 2009, 10:41 PM CT

Low-carb diets linked to atherosclerosis

Low-carb diets linked to atherosclerosis
Even as low-carbohydrate/high-protein diets have proven successful at helping individuals rapidly lose weight, little is known about the diets' long-term effects on vascular health.

Now, a study led by a scientific team at Beth Israel Deaconess Medical Center (BIDMC) provides some of the first data on this subject, demonstrating that mice placed on a 12-week low carbohydrate/high-protein diet showed a significant increase in atherosclerosis, a buildup of plaque in the heart's arteries and a leading cause of heart attack and stroke. The findings also showed that the diet led to an impaired ability to form new blood vessels in tissues deprived of blood flow, as might occur during a heart attack.

Described in today's Online Version of the Proceedings of the National Academy of Sciences (PNAS), the study also observed that standard markers of cardiovascular risk, including cholesterol, were not changed in the animals fed the low-carb diet, despite the clear evidence of increased vascular disease.

"It's very difficult to know in clinical studies how diets affect vascular health," says senior author Anthony Rosenzweig, MD, Director of Cardiovascular Research in BIDMC's CardioVascular Institute and Professor of Medicine at Harvard Medical School. "We, therefore, tend to rely on easily measured serum markers [such as cholesterol], which have been surprisingly reassuring in individuals on low-carbohydrate/high-protein diets, who do typically lose weight. But our research suggests that, at least in animals, these diets could be having adverse cardiovascular effects that are not reflected in simple serum markers".........

Posted by: Daniel      Read more         Source


August 21, 2009, 7:11 AM CT

Universal Influenza Vaccination

Universal Influenza Vaccination
We all know that influenza vaccination helps prevent disease, but a newly released study from Canada suggests it may also prevent another public health problem: inappropriate antibiotic use. The findings come from a newly released study in the September 1, 2009 issue of Clinical Infectious Disease, which is now available online.

Starting in 2000, the Canadian province of Ontario introduced a universal immunization program offering free influenza vaccines to anyone 6 months of age or older. Other provinces continued to target only high-risk groups and their contacts for vaccination. The authors compared prescription rates for influenza-associated respiratory antibiotics before and after the Ontario program began, and compared the Ontario prescription rates with those of other provinces.

The broader immunization effort in Ontario was linked to a 64 percent decline in these antibiotic prescriptions compared with the other provinces that maintained targeted vaccination programs. Additionally, influenza-associated mortality fell 39 percent. Flu-related hospitalizations, emergency department use, and doctors' office visits also fell an average of 52 percent.

Influenza and upper respiratory conditions account for a substantial number of antibiotic prescriptions, even though antibiotics don't work against viruses such as the flu. The overuse of antibiotics and the development of antibiotic-resistant bacteria continue to be serious public health problems. As per study author Fawziah Marra, PharmD, of the University of British Columbia, the study's findings suggest that "jurisdictions wishing to decrease antibiotic use might consider programs to increase influenza vaccination".........

Posted by: Mark      Read more         Source


August 21, 2009, 7:10 AM CT

Alcohol advertising reaching too many teens on cable

Alcohol advertising reaching too many teens on cable
A newly released study from the Center on Alcohol Marketing and Youth, in collaboration with UCLA, has found a striking connection between teenage viewership and the frequency of alcohol advertising on cable television. The findings show that ads for beer, spirits and "alcopop" aired much more frequently when more teens were watching.

While prior studies have shown that the average adolescent is exposed to well over 200 alcohol ads on television each year, this is the first to demonstrate an association between ad placement and teen cable TV viewership. Cable TV attracts about 95 percent of all nationally televised alcohol ads.

The study would be reported in the recent issue of the American Journal of Public Health and is currently available online by subscription.

"Alcohol advertisers have pledged to avoid audiences made up of more than 30 percent underage viewers such as children's programming," said David H. Jernigan, director of the Center on Alcohol Marketing and Youth and an associate professor at the Johns Hopkins Bloomberg School of Public Health. "However, a number of other shows have adolescent appeal. This research suggests that ads are aimed at groups that include a disproportionate number of teens and that the alcohol industry's voluntary self-monitoring is not working to reduce adolescent exposure to ads."........

Posted by: Janet      Read more         Source


August 21, 2009, 7:08 AM CT

Evolution of the appendix

Evolution of the appendix
The lowly appendix, long-regarded as a useless evolutionary artifact, won newfound respect two years ago when scientists at Duke University Medical Center proposed that it actually serves a critical function. The appendix, they said, is a safe haven where good bacteria could hang out until they were needed to repopulate the gut after a nasty case of diarrhea, for example.

Now, some of those same scientists are back, reporting on the first-ever study of the appendix through the ages. Writing in the Journal of Evolutionary Biology, Duke researchers and collaborators from the University of Arizona and Arizona State University conclude that Charles Darwin was wrong: The appendix is a whole lot more than an evolutionary remnant. Not only does it appear in nature much more frequently than previously acknowledged, but it has been around much longer than anyone had suspected.

"Maybe it's time to correct the textbooks," says William Parker, Ph.D., assistant professor of surgical sciences at Duke and the senior author of the study. "A number of biology texts today still refer to the appendix as a 'vestigial organ.'".

Using a modern approach to evolutionary biology called cladistics, which utilizes genetic information in combination with a variety of other data to evaluate biological relationships that emerge over the ages, Parker and his colleagues observed that the appendix has evolved at least twice, once among Australian marsupials and another time among rats, lemmings and other rodents, selected primates and humans. "We also figure that the appendix has been around for at least 80 million years, much longer than we would estimate if Darwin's ideas about the appendix were correct".........

Posted by: Janet      Read more         Source


August 21, 2009, 7:05 AM CT

Off-label use: Oft not evidence based

Off-label use: Oft not evidence based
In a recent national survey, a substantial minority of physicians erroneously believed that certain off-label uses of prescription drugs were approved by the Food and Drug Administration. This mistaken belief could encourage them to prescribe these drugs, despite the lack of scientific evidence supporting such use.

"Off-label prescribing is common, but scientists have not always known why. Our research shows that some off-label prescribing might be driven by mistaken beliefs about FDA approval and the level of evidence supporting off-label drug use," said G. Caleb Alexander, MD, MS, Assistant Professor of Medicine at the University of Chicago Medical Center and corresponding author of the research, which will be published under an embargo in Pharmacoepidemiology and Drug Safety on August 21, 2009. "The results indicate an urgent need for more effective methods of informing physicians about the level of evidence supporting off-label drug useparticularly for common off-label uses that are ineffective or carry unacceptable risks of harm".

Overall, physicians were able to correctly identify the FDA-approval status of just over half (mean 55%) of the 22 drug-indication pairs (i.e., a particular drug prescribed for a particular condition) that were included in the survey.........

Posted by: Janet      Read more         Source


August 20, 2009, 6:48 AM CT

Living longer and happier

Living longer and happier
A newly released study from the University of Missouri may shed light on how to increase the level and quality of activity in the elderly. In the study, published in this week's edition of Public Library of Science ONE, MU scientists observed that gene treatment with a proven "longevity" gene energized mice during exercise, and might be applicable to humans in the future.

"Aging is one of the biggest challenges to a modern society. A pressing issue in the elderly is the loss of activity. What one really wants is not a simple lifespan prolongation but rather a health span increase," said Dongsheng Duan, an associate professor of molecular microbiology and immunology. "After gene treatment with a 'longevity' gene, we studied how well the mice performed on treadmill exercises. We observed that the gene treatment worked well and the mice functioned better after the therapy".

Earlier studies have observed that mice would live longer when their genome was altered to carry a gene known as mitochondria-targeted catalase gene, or MCAT. However, such approaches would not be applicable to human. Duan and Dejia Li, a post-doctoral researcher working with Duan, took a different approach and placed the MCAT gene inside a non-malignant virus and injected the virus into the mice.........

Posted by: Janet      Read more         Source


August 20, 2009, 6:45 AM CT

Anti-Aging Gene Linked to High Blood Pressure

Anti-Aging Gene Linked to High Blood Pressure
Scientists at the University of Oklahoma Health Sciences Center have shown the first link between a newly discovered anti-aging gene and high blood pressure. The results, which appear this month in the journal Hypertension, offer new clues on how we age and how we might live longer.

Persistent hypertension, or high blood pressure, is a risk factor for stroke, heart attack, heart failure, arterial aneurysm and is the leading cause of chronic kidney failure. Even a modest elevation of arterial blood pressure leads to shortened life expectancy.

Researchers, led by principal investigator Zhongjie Sun, tested the effect of an anti-aging gene called klotho on reducing hypertension. They observed that by increasing the expression of the gene in laboratory models, they not only stopped blood pressure from continuing to rise, but succeeded in lowering it. Perhaps most impressive was the complete reversal of kidney damage, which is linked to prolonged hypertension and often leads to kidney failure.

"One single injection of the klotho gene can reduce high blood pressure for at least 12 weeks and possibly longer. Klotho is also available as a protein and, conceivably, we could ingest it as a powder much like we do with protein drinks," said Sun, M.D., Ph.D., a cardiovascular expert at the OU College of Medicine.........

Posted by: Janet      Read more         Source


August 20, 2009, 6:41 AM CT

Majority of US hospitals will have smoke-free campuses

Majority of US hospitals will have smoke-free campuses
While hospital buildings are often smoke-free, a newly released study finds that by February 2008, 45 percent of US hospitals had adopted "smoke-free campus" policies, meaning that all the property owned or leased by the hospital, both indoors and outdoors, was smoke-free and there were no designated smoking areas on those properties.

The study, "The Adoption of Smoke-Free Hospital Campuses in the United States," is the first of its kind to examine the national prevalence of smoke-free hospital campus policies. It was conducted by The Joint Commission, the world's largest healthcare standards setting and accrediting body, and scientists from the Henry Ford Health System's Center for Health Promotion and Disease Prevention. The study was funded by the Substance Abuse Policy Research Program of the Robert Wood Johnson Foundation and appears in the online version of the peer-evaluated journal Tobacco Control

"Besides the 45 percent that already had smoke-free campuses, another 15 percent indicated that they would be implementing similar policies in the near future. Hence, it is safe to assume on the basis of these results that the majority of US hospitals will have smoke-free campuses by the end of 2009," as per Scott C. Williams, PsyD, of The Joint Commission.........

Posted by: Janet      Read more         Source



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Did you know?
Adolescents who suffer physical injuries are vulnerable to emotional distress in the months following their hospitalization, yet almost 40 percent of hospitalized adolescents interviewed for a new study had no source for the follow-up medical care that could diagnose and treat symptoms of post-traumatic stress. These young trauma survivors are at risk for high levels of post-traumatic stress and depressive symptoms, as well as high levels of alcohol use, according to research by researchers at the Harborview Injury Prevention and Research Center.

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