February 1, 2010, 8:04 AM CT
Most patients gain weight after getting a new knee
You'd think folks who've had knee replacement surgery -- finally able to walk and exercise without pain -- would lose weight instead of put on pounds, but surprisingly that's not the case, as per a University of Delaware study.
Scientists Joseph Zeni and Lynn Snyder-Mackler in the Department of Physical Therapy in UD's College of Health Sciences observed that patients typically drop weight in the first few weeks after total knee arthroplasty (TKA), but then the number on the scale starts creeping upward, with an average weight gain of 14 pounds in two years.
The study, which was sponsored by the National Institutes of Health, is published in the Jan. 15 online edition of Osteoarthritis and Cartilage, the official journal of the Osteoarthritis Research Society International.
The research involved 106 individuals with end-stage osteoarthritis who had knee replacement surgery, and an age-matched, healthy control group of 31 subjects who did not have surgery. Height, weight, quadriceps strength, and self-perceived functional ability were measured during an initial visit to UD's Physical Therapy Clinic, and at a follow-up visit two years later.
"We saw a significant increase in body mass index (BMI) over two years for the surgical group, but not the control group," says Zeni, a research assistant professor at UD. "Sixty-six percent of the people in the surgical group gained weight over the two years -- the average weight gain was 14 pounds".........
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January 29, 2010, 8:18 AM CT
Doctors cut back hours when risk of malpractice suit rises
A newly released study shows that the number of hours physicians spend on the job each week is influenced by the fear of malpractice lawsuits.
Economists Eric Helland and Mark Showalter observed that doctors cut back their workload by almost two hours each week when the expected liability risk increases by 10 percent. The study, reported in the new issue of the Journal of Law and Economics, notes that the decline in hours adds up to the equivalent of one of every 35 physicians retiring without a replacement.
"The effect of malpractice risk on hours worked might seem like a small item in comparison to physicians moving across state borders or avoiding high-risk specialties like obstetrics," said Showalter, an economics professor at Brigham Young University. "However, when you aggregate that across all physicians, the total effect is quite large".
The analysis combined data gathered by insurers about medical liability risks in each state and medical specialty with physicians' responses to surveys about their workload and income.
When something changed the risk of medical liability - such as an adjustment in the maximum amount a jury could award in malpractice cases - doctors adjusted their workload. When liability risk went up, doctors saw fewer patients each week to minimize their chance of a lawsuit. When liability risk went down, doctors saw more patients each week.........
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January 29, 2010, 8:08 AM CT
Change in mammography guidelines
The methodology and evidence behind a widely publicized change in national mammography guidelines is questionable, as per a review in the Journal of Diagnostic Medical Sonography
(JDMS), published by SAGE.
In November 2009, the US Preventive Services Task Force (USPSTF) published a report in the Annals of Internal Medicine discussing the screening techniques for the early detection of breast cancer. A few isolated portions of that report, regarding recommended changes for the use of mammography, were widely discussed in the media, and garnered tremendous public attention.
This new JDMS article provides an evidenced-based review of the work and recommendations contained in the USPSTF report and raises the question whether the controversial conclusions for breast cancer screening were supported by established scientific measurement and research standards. The JDMS review found low methodological scores in the USPSTF report, which may place in question the recommendations generated from the report.
The article concludes that, despite the report's depiction as a systematic review, the USPSTF report was actually just a review of literature, which reduces the overall scientific impact of the report to a much lower level in the hierarchy of evidence.........
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January 28, 2010, 7:37 AM CT
Using computers while suffering from Rheumatoid arthritis
A recent study by scientists from the University of Pittsburgh observed that workers with rheumatoid arthritis (RA) were comparable to non-impaired individuals in keyboarding speed. Individuals who were trained in touch typing demonstrated faster typing speeds than those using a visually-guided ("hunt and peck") method, regardless of impairment. Scientists also noted slightly impaired mouse skills in workers with RA. Results of this study appear in the recent issue of Arthritis Care & Research
, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology.
As per the U.S. Census Bureau the number of workers using computers increased from 46% in 1993 to 56% in 2003 with figures expected to continue climbing higher. For workers with RA the capacity to use computers appears to be limited by impairment in hand range of motion (ROM) and strength caused by inflammation of their joints due to the disease. Previous studies have shown that workers with RA have higher rates of work disability, premature work cessation, and reduced hours on the job.
"With more arthritic workers using computers, understanding the associations between hand function impairment and peripheral device (keyboard and mouse) limitations is essential and the focus of our current study," said main author Nancy Baker, Sc.D., MPH, OTR/L. Scientists recruited 45 participants from the University of Pittsburgh Medical Center (UPMC) Arthritis Network Registry for the study. Those subjects enrolled had an average age of 55, were primarily white females, and had RA for 17 years. Half of all participants worked full or part-time, with 100% of this group using computers at work.........
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January 27, 2010, 8:21 AM CT
Parents' perceptions of their childs competence
As per a newly released study, there is no direct link between parents' own level of physical activity, and how much their child may exercise. In fact, parents' perceptions of their children's athleticism are what have a direct impact on the children's activity.
The study by Oregon State University scientists Stewart Trost and Paul Loprinzi, reported in the journal Preventive Medicine,
studied 268 children ages 2 to 5 in early childhood education centers in Queensland, Australia. Of these children, 156 parents or caregivers were surveyed on their parental practices, behaviors correlation to physical activity and demographic information.
What they found is that parents' level of physical activity is not directly linked to their children, but instead that the direct link was between parental support and a child's level of physical activity.
"Active parents appears to be more likely to have active children because they encourage that behavior through the use of support systems and opportunities for physical activity, but there is no statistical evidence that a child is active simply because they see that their parents exercise," Trost said.
Trost, who is director of the Obesity Prevention Research Core at the new Hallie Ford Center for Healthy Children and Families at OSU, is an international expert on the issue of childhood obesity.........
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January 21, 2010, 8:18 AM CT
Stain repellent may cause thyroid disease
A study by the University of Exeter and the Peninsula Medical School for the first time links thyroid disease with human exposure to perfluorooctanoic acid (PFOA). PFOA is a persistent organic chemical used in industrial and consumer goods including nonstick cookware and stain- and water-resistant coatings for carpets and fabrics.
Reported in the journal Environmental Health Perspectives
, The study revealed that people with higher concentrations of PFOA in their blood have higher rates of thyroid disease. The scientists analysed samples from the US Centers for Disease Control and Prevention's nationally representative National Health and Nutrition Examination Survey (NHANES).
Tamara Galloway, a professor Ecotoxicology at the University of Exeter and the study's senior author, says: "Our results highlight a real need for further research into the human health effects of low-level exposures to environmental chemicals like PFOA that are ubiquitous in the environment and in people's homes. We need to know what they are doing".
"There have long been suspicions that PFOA concentrations might be associated with changes in thyroid hormone levels," adds study author, David Melzer, a professor of Epidemiology and Public Health at the Peninsula Medical School. "Our analysis shows that in the 'ordinary' adult population there is a solid statistical link between higher concentrations of PFOA in blood and thyroid disease."........
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January 19, 2010, 8:35 AM CT
Costs of psoriasis treatment
Findings from a cost model suggest that expenses for systemic psoriasis treatment appear to be increasing at a faster rate than inflation, and newer biologically derived therapys are more expensive than traditional systemic therapies, as per a report in the recent issue of Archives of Dermatology
, one of the JAMA/Archives journals.
Psoriasis is a chronic autoimmune disease that affects an estimated 4.5 million to 7.5 million Americans, costing the health care industry approximately more than $3 billion annually, as per background information in the article. The severity of the disease varies, as do the therapiessome patients with mild, localized disease can use creams or other topical agents, whereas those with more extensive disease typically require phototherapy (exposure to ultraviolet light) or systemic therapies (substances that travel through the bloodstream, such as oral medications).
Vivianne Beyer, M.D., now at St. Vincent Hospital, Indianapolis, and Stephen E. Wolverton, M.D., of the Indiana University School of Medicine, Indianapolis, constructed a cost model to analyze the current total cost of systemic treatment for psoriasis. Costs for each treatment were assessed by using the average wholesale price of each drug, as paid by third-party payers, and costs of related office visits, laboratory tests and related monitoring procedures were determined using Medicare fee schedules. Trends were analyzed by calculating the change in average wholesale price from the prior year and then were in comparison to the Consumer Price Index for urban areas.........
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January 15, 2010, 8:08 AM CT
Fit to drive?
A number of healthcare professionals are failing to advise people with medical conditions that could affect their ability to drive whether they should get behind the wheel, as per research from the University of Warwick.
Scientists from the University's Warwick Medical School have found a number of healthcare professionals are failing to tell patients with certain conditions such as diabetes or visual impairment if they are not fit to drive.
In a study undertaken for the Department for Transport, the research team explored the knowledge and attitudes of healthcare professionals towards advising patients about their fitness to drive. The scientists recruited 1519 health professionals, 358 patients and 55 medical school personnel to the study.
The research team, led by Dr Carol Hawley, Principal Research Fellow at Warwick Medical School, found doctors in training received little tuition on medical aspects of fitness to drive.
They also observed that eventhough most healthcare professionals were aware of the Driving and Vehicle Licensing Agency (DVLA) guidelines stipulating fitness to drive, a number of were unable to reliably distinguish between medically unfit drivers, borderline drivers and fit drivers. When presented with paper case studies of patients only 7.5% scored all of them correctly.........
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January 12, 2010, 8:38 AM CT
'Weekend Effect' Makes People Happier
From construction laborers and secretaries to physicians and lawyers, people experience better moods, greater vitality, and fewer aches and pains from Friday evening to Sunday afternoon, concludes the first study of daily mood variation in employed adults to be reported in the January 2010 issue of the Journal of Social and Clinical Psychology. And that 'weekend effect' is largely linked to the freedom to choose one's activities and the opportunity to spend time with loved ones, the research found.
"Workers, even those with interesting, high status jobs, really are happier on the weekend," says author Richard Ryan, a professor of psychology at the University of Rochester. "Our findings highlight just how important free time is to an individual's well-being." Ryan adds. "Far from frivolous, the relatively unfettered time on weekends provides critical opportunities for bonding with others, exploring interests and relaxing - basic psychological needs that people should be careful not to crowd out with overwork," Ryan cautions.
The study tracked the moods of 74 adults, aged 18 to 62, who worked at least 30 hours per week. For three weeks, participants were paged randomly at three times during the day, once in the morning, the afternoon and the evening. At each page, participants completed a brief questionnaire describing the activity in which they were engaged and, using a seven-point scale, they rated their positive feelings like happiness, joy, and pleasure as well as negative feelings of anxiety, anger, and depression. Physical symptoms of stress, such as headaches, digestive problems, respiratory ills, or low energy, also were noted.........
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January 11, 2010, 8:00 AM CT
Why migraine headaches get worse with light exposure?
BOSTON Ask anyone who suffers from migraine headaches what they do when they're having an attack, and you're likely to hear "go into a dark room." And eventhough it's long been known that light makes migraines worse, the reason why has been unclear.
Now researchers at Beth Israel Deaconess Medical Center (BIDMC) have identified a new visual pathway that underlies sensitivity to light during migraine in both blind individuals and in individuals with normal eyesight. The findings, which appear today in the Advance On-line issue of Nature Neuroscience
, help explain the mechanism behind this widespread condition.
A one-sided, throbbing headache linked to many symptoms, including nausea, vomiting, and fatigue, migraines are notoriously debilitating and surprisingly widespread, affecting more than 30 million individuals in the U.S. alone. Migraine pain is believed to develop when the meninges, the system of membranes surrounding the brain and central nervous system, becomes irritated, which stimulates pain receptors and triggers a series of events that lead to the prolonged activation of groups of sensory neurons.
"This explains the throbbing headache and accompanying scalp and neck-muscle tenderness experienced by a number of migraine patients," explains the study's senior author Rami Burstein, PhD, Professor of Anesthesia and Critical Care Medicine at BIDMC and Harvard Medical School.........
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