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June 18, 2008, 9:06 PM CT

Computers as safe as medical experts

Computers as safe as medical experts
The largest ever study into the administration of blood thinning drugs, principally Warfarin, has concluded that dosages calculated by computer are at least as safe and reliable as those provided by expert medical professionals.

Increasing evidence of the value of these anticoagulant drugs in a wide range of clinical disorders such as abnormal heart rhythm, or atrial fibrillation, has led to a rapid rise in their use around the world.

However, prescribing the right oral dose of anticoagulant to patients, even for experienced medical staff, can be problematic as individuals differ greatly in response to a given dose and a single patient's response can change over the period of an illness. Too high a dose for an individual and the blood becomes too thin and can lead to internal bleeding, too low and the blood clots too readily.

Prior studies supporting the use of computer-assisted dosage have depended solely on laboratory results and have not been sufficiently large to determine whether prolongation of normal blood clotting - measured as the 'international normalised ratio' or INR - resulted in clinical benefit and improved safety.

But now results from the five-year clinical trial have shown that computer-assisted dosage is as good, if not better, at prescribing the correct dosage to prolong the INR in patients as dosages given by expert medical professionals.........

Posted by: Janet      Read more         Source


June 17, 2008, 9:56 PM CT

US could face shortage of 44,000 primary care physicians by 2025

US could face shortage of 44,000 primary care physicians by 2025
By 2025, the wait to see a doctor could get a lot longer if the current number of students training to be primary care physicians doesn't increase soon, as per a new University of Missouri study. Jack Colwill, professor emeritus of family and community medicine in the MU School of Medicine, and his research team observed that the U.S. could face a shortage of up to 44,000 family physicians and general internists in less than 20 years, due to a skewed compensation system that rewards specialists increasingly more than primary care practitioners. The scientists are more optimistic about the future supply of general pediatricians.

Today, generalist physicians are a third of the U.S. doctor workforce and are responsible for more than half of all patient visits at doctors' offices.

"Concern about the supply of generalists is not new," said Colwill, who also is a member of the National Academy of Sciences Institute of Medicine. "It has been with us since the 1960s and was gradually improving. However, during the past decade, the number of generalist graduates has fallen by 22 percent and declines continue as medical school graduates enter other specialties. At the same time, the U.S. population is increasing by about one percent each year, and the baby boomer generation will significantly increase the number of Americans older than 65 by 2025.........

Posted by: Janet      Read more         Source


June 16, 2008, 10:22 PM CT

How safe are medical cannabinoids?

How safe are medical cannabinoids?
Wang and his colleagues performed a systematic review of safety studies of medical cannabinoids published over the past 40 years and observed that short-term use appeared to increase the risk of non-serious adverse events. Of all non-serious adverse events, dizziness was the most common (15.5%).

"We observed that the rate of non-serious adverse events was 1.86 times higher among medical cannabinoid users than among controls," state the authors. "However, we did not find a higher incidence rate of serious adverse events linked to medical cannabinoid use." The authors note that 99% of the serious adverse events from randomized controlled trials were reported in only 2 trials, a fact the authors say suggests that more studies are mandatory to further characterize safety issues.

In a related commentary, Dr. Louisa Degenhardt, Professor of Epidemiology, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia (l.degenhardt@unsw.edu.au), states that, eventhough the side effects of oral cannabis treatment appear to be minor in the short term, their longer-term effects, especially in the setting of chronic illness, have yet to be studied.........

Posted by: Janet      Read more         Source


June 16, 2008, 9:16 PM CT

Hot flashes underreported and linked to forgetfulness

Hot flashes underreported and linked to forgetfulness
Women in midlife underreport the number of hot flashes that they experience by more than 40 percent, and these hot flashes are associated with poor verbal memory, as per a research studyby scientists at the University of Illinois at Chicago.

The study is published online and will appear in the September/recent issue of the journal Menopause

It is the first study to explore the relationship between objectively measured hot flashes and memory performance.

Memory complaints are common at midlife, and prior research indicates that about 40 percent of midlife women report forgetfulness.

Many studies have looked at the relationship between menopausal symptoms (vasomotor symptoms, hot flashes and sleep disturbances that accompany hot flashes) and memory complaints and found no relationship between subjective, or self-reported, hot flashes and objective performance on memory tests in women.

These findings have left a number of to assume that there is no relationship between menopausal symptoms and memory dysfunction in women, said Maki.

"The problem is that the physiology of hot flashes and the science of hot flashes is more complex than we previously understood," she said.

The scientists enrolled 29 midlife women with moderate to severe hot flashes in an observational study. The women wore monitors that measured changes in skin conductance during a hot flash. Both subjective and objective hot flashes were recorded during a 24-hour period. The average number of objective hot flashes was 19.5 per day.........

Posted by: Janet      Read more         Source


June 11, 2008, 8:42 PM CT

Normal sleep linked to successful aging

Normal sleep linked to successful aging
A research abstract that will be presented on Wednesday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS), finds a link between normal sleep and healthy aging.

The study, authored by Sonia Ancoli-Israel, PhD, of the University of California at San Diego, and his colleagues, focused on 2,226 women 60 years of age or older. Reports of use of sleeping aids, daytime somnolence, napping, sleep latency, sleep maintenance insomnia, early morning awakening, snoring, overall perceived sleep quality, and sleep duration were all assessed.

As per the results, 20.8 percent of the women were categorized as successful agers. Items correlation to less daytime napping and fewer complaints of sleep maintenance insomnia best predicted successful aging. There was no direct relationship between use of sedative-hypnotics and successful aging. Increased severity of sleep disturbance also predicted lower self-rated successful aging and a greater difference between perceived and actual age, and this result again remained significant after controlling for depressive symptom severity.

Our findings that reports of better sleep are correlation to successful aging reinforce the idea that good sleep is of utmost importance for good health, said Dr. Ancoli-Israel. Health care professionals need to ask their patients of all ages about sleep and help those with poor sleep to find ways for improvement.........

Posted by: Janet      Read more         Source


June 11, 2008, 8:26 PM CT

Vitamin supplement little more than 'snake oil'

Vitamin supplement little more than 'snake oil'
A popular vitamin supplement is being advertised with claims that are demonstrably untrue, as revealed by research reported in the open access journal BMC Pharmacology

Benfotiamine is a synthetic derivative of thiamine (vitamin B1). It is marketed heavily as a dietary supplement using a selection of unsubstantiated, 'not-quite-medical' claims that tend to characterize this field. A large part of this campaign has been built around the belief that benfotiamine is lipid-soluble and, therefore, more physiologically active. Scientific research led by Dr Lucien Bettendorff of the Center for Cellular and Molecular Neurobiology at the University of Lige, Belgium, has entirely disproved these claims.

A severe deficiency of thiamine is known to cause weight loss, emotional disturbances, impaired sensory perception, weakness and pain in the limbs, and periods of irregular heart rate. Deficiencies can occur as a result of alcoholism or malnutrition. As thiamine itself is very poorly absorbed by the body, it must be taken in as various precursor forms. This research shows that benfotiamine may not be as effective in this regard as has been claimed, in particular concerning its ability to raise effective thiamine levels in the central nervous system.

As per Bettendorff, "We suspect that those companies selling benfotiamine have poisoned much of the recent literature in an attempt to bestow it with properties that it does not have". Benfotiamine has been previously shown to prevent several diabetic complications in experimental animal models. The scientists carried out experiments in mice in which benfotiamine was administered using several different techniques and the resulting levels of thiamine were measured in various parts of the body. Contrary to other claims about its solubility, the results show that benfotiamine is only sparingly soluble in water under physiological conditions and cannot be dissolved in octanol or oils.........

Posted by: Janet      Read more         Source


June 9, 2008, 9:25 PM CT

Women worrying about cancer

Women worrying about cancer
A significant number of women worrying about cancer may be experiencing sleep disturbances, even without a breast cancer diagnosis, as per a research abstract that will be presented by Amita Dharawat, MD, on Monday at SLEEP 2008, the 22nd Annual Meeting of the Associated Professional Sleep Societies (APSS).

This collaborative study, from the Brooklyn Health Disparities Center at SUNY Downstate Medical Center and Long Island University in Brooklyn, New York, focused on 1,038 community-based residents, between 50 and 70 years of age; none of whom had a history of a physician-diagnosed cancer. Sleep complaint was defined as a report of either difficulty initiating sleep, maintaining sleep, or early morning awakening.

As per the results, 65 percent of the women reported that they worried about developing breast cancer, and 49 percent reported a sleep complaint. Twenty-seven percent indicated that cancer worry affected their mood, while 25 percent indicated that it affected their daily activity. The odds of reporting sleep complaints for women who worry about cancer were nearly 50 percent greater than odds for women who reported no cancer worry, independent of several confounders.

This is a unique and important finding because sleep-related complaints have never been studied in women who worry about cancer, without a diagnosis, and it provides practitioners with knowledge with regards to identifying and targeting women who report sleep-related complaints with cognitive behavioral treatment, said Dr. Dharawat, who is a second year medical resident, working with Dr. Girardin Jean-Louis on an NIH funded Womens Health Project.........

Posted by: Janet      Read more         Source


June 5, 2008, 10:22 PM CT

Revision of osteoporosis guidelines

Revision of osteoporosis guidelines
Tufts University researcher Bess Dawson-Hughes, M.D., chaired the committee that recently updated the National Osteoporosis Foundation (NOF) Clinician's Guide to Prevention and Treatment of Osteoporosis. The new Clinician's Guide incorporates the World Health Organization (WHO) absolute fracture prediction algorithm (FRAX), a computer-based tool expected to increase the identification of patients at risk for osteoporosis.

"The introduction of the WHO's fracture prediction algorithm necessitated the revision of the Clinician's Guide," says Dawson-Hughes, director of the Bone Metabolism Laboratory at the Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University. "The algorithm tells clinicians how likely a patient is to fracture a bone due to osteoporosis or low bone mass in the 10 years following examination, also known as 10-year fracture risk. This can help clinicians decide whether a patient needs to be treated or simply monitored."

Writing in the April 2008 issue of the journal Osteoporosis International, corresponding author Dawson-Hughes and his colleagues describe how to apply FRAX in the United States. Clinicians estimate a patient's 10-year fracture risk using a computer program that considers bone mineral density (BMD) score, or T-score, and nine clinical risk factors including personal fracture history, family fracture history, weight, race and gender. Notably, FRAX and the new Clinician's Guide now apply to men over 50 and post-menopausal non-Caucasian women, including African-Americans, Asians and Latinas. Prior versions applied only to post-menopausal Caucasian women, the group at highest-risk for osteoporosis.........

Posted by: Janet      Read more         Source


June 5, 2008, 10:21 PM CT

Primary care visits reduce hospital utilization

Primary care visits reduce hospital utilization
Scientists from Boston University School of Medicine (BUSM) have observed that primary care visits reduce hospital utilization among Medicare beneficiaries at the end of life. The recently published study appears in the Journal of General Internal Medicine.

As per researchers, medical therapys for the six percent of Medicare beneficiaries who die each year comprise almost 30 percent of Medicare expenditures. In addition, the quality of end-of-life care is often poor. Problems include late referrals to hospice, undertreatment of pain, overtreatment with unwanted or ineffective procedures, poor communications regarding prognosis and therapy preferences, and in-hospital deaths that are inconsistent with stated preferences.

Scientists measured hospital utilization during the final six months of life and the number of primary care doctor visits in the 12 preceding months for 78,356 Medicare beneficiaries age 66 +. Hospital days, costs, in-hospital death, and presence of two types of preventable hospital admissions also were studied.

Thirty-eight percent of adults did not have any primary care visits during their final six months of life, 22 percent had one to two primary care visits, 19 percent had three to five visits, 10 percent had six to eight visits and 11 percent had nine or more visits. More primary care visits in the preceding year were linked to fewer hospital days (15.3 days for those with no primary care visits vs. 13.4 days for those with nine or more visits) lower costs ($24,400 vs. $23,400) less in-hospital death (44 percent vs. 40 percent) and fewer preventable hospitalizations for those with congestive heart failure or chronic obstructive pulmonary disease.........

Posted by: Janet      Read more         Source


June 5, 2008, 10:18 PM CT

How to lose weight without losing bone

How to lose weight without losing bone
A higher-protein diet that emphasizes lean meats and low-fat dairy foods as sources of protein and calcium can mean weight loss without bone loss--and the evidence is in bone scans taken throughout a new University of Illinois study.

The research, which compared the results of a high-protein, dairy-intensive diet with a conventional weight-loss diet based on the food-guide pyramid, was published in this month's Journal of Nutrition.

"This is an important finding because a number of people, particularly women in mid-life, are concerned with both obesity and osteoporosis," said Ellen Evans, a U of I associate professor of kinesiology and community health and member of the U of I Division of Nutritional Sciences.

"Furthermore, treating obesity often increases risk for osteoporosis. A number of people lose bone mass when they lose weight," she said.

Co-author of study Donald Layman, a U of I professor of nutrition, has previously reported that protein-rich weight-loss diets preserve muscle mass, help lower blood sugar and lipids, and improve body composition by targeting weight carried in the abdomen.

In the recent study, Layman's diet prescribed approximately 30 percent of all calories from protein, with an emphasis on lean meats and low-fat dairy products.........

Posted by: JoAnn      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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