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September 15, 2008, 9:34 PM CT

Poor weight loss after gastric bypass surgery

Poor weight loss after gastric bypass surgery
Individuals with diabetes and those whose stomach pouches are larger appear less likely to successfully lose weight after gastric bypass surgery, as per a report in the recent issue of Archives of Surgery, one of the JAMA/Archives journals.

Roux-en-Y gastric bypass surgery is the most common bariatric procedure in North America, as per background information in the article. During the procedure, surgeons create a smaller stomach pouch that restricts food intake and bypasses large sections of the digestive system. "When performed in high-volume centers and with a low rate of complications, gastric bypass provides sustained and meaningful weight loss, significant improvement in quality of life, improvement or resolution of obesity-associated comorbidities and extended life span," the authors write. "However, 5 percent to 15 percent of patients do not lose weight successfully, despite perceived precise surgical technique and regular follow-up".

Guilherme M. Campos, M.D., and his colleagues at the University of California, San Francisco, examined data from 361 patients who underwent gastric bypass at one institution between 2003 and 2006. Poor weight loss was defined as losing 40 percent or less of excess body weight after 12 months and good weight loss as losing more than 40 percent of excess weight.........

Posted by: JoAnn      Read more         Source


September 15, 2008, 9:32 PM CT

Limiting resident surgeon's work hours associated with fewer complications

Limiting resident surgeon's work hours associated with fewer complications
Fewer patients undergoing gallbladder surgery at one major public teaching hospital sustained injuries to their bile ducts or other complications after resident physicians' work hours were limited to 80 per week, as per a report in the recent issue of Archives of Surgery, one of the JAMA/Archives journals.

Concerns about patient safety and resident well-being led to the implementation of the 80-hour workweek in July 2003, as per background information in the article. "However, some surgical educators have expressed misgivings about the restricted hours because of more frequent shift changes, decreased patient exposure for residents, interruption in continuity of care and increased potential for communication breakdown," the authors write.

Arezou Yaghoubian, M.D., and his colleagues at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, Calif., analyzed the medical records of 2,470 patients who underwent laparoscopic cholecystectomy (gallbladder removal)a procedure usually performed by surgical residents nationwidebefore and after the duty hour limitations. "Prior studies using simulators have indicated that sleep deprivation has substantial adverse effects on laparoscopic skills in residents," the authors write. "Bile duct injury [a common complication of cholecystectomy, in which the tubes that transport fluids between the liver and gallbladder are damaged] has a potentially devastating long-term adverse effect on the patient".........

Posted by: Janet      Read more         Source


September 14, 2008, 10:39 PM CT

Extremely exact images from inside the body

Extremely exact images from inside the body
The magnet has reached his final position: it is surrounded by a cage of steel weighin 250 tons which will, in future, be used to protect the surrounding area from the magnetic field. The hole in the center of the magnet will be the "pipe" in which the patient will be pushed in order to be examined.
It will be the only magnetic resonance tomograph of the modern 7 tesla generation in the world, in which a metrology institute is also involved. Magnetic resonance tomographs, which use a magnetic field of 7 tesla, have still not been in operation in hospitals and clinics, but have solely served research. For the first time in the world, cardiovascular research carried out on such a device is now also to play an important role. The magnetic resonance tomograph costing approximately seven million Euros and weighing 35 tonnes was delivered to its new location, the Experimental and Clinical Research Center (ECRC) of the Max Delbrück Center (MDC) for Molecular Medicine in Berlin-Buch on 11th September.

In contrast to the 1.5 and 3 tesla devices which have largely been the norm to date, its higher magnetic field will provide sharper images and better insights into the smallest structures of the human body. The aim is to detect the risk or commencement of an illness at a very early stage in heart, brain and cancer research. Above all, heart research by magnetic resonance tomography is viewed as very difficult. As such, a demanding task will be waiting for PTB researchers from January 2009, when the device has been fully installed: as the partner dealing with physics and technical issues in the joint project, they are responsible for making the unique potential of this tomograph useful for applications in clinics. The PTB will, moreover, find the ideal conditions to advance its work on patient safety in high-field tomographs and on the development of new concepts in MRT imaging. The other partners in the project, besides the Max Delbrück Center and the PTB, are Siemens, the constructors of the 7 tesla device, and the Charite hospital. The new ultra-high-field MRT equipment of the ECRC has been completed with a 9.4 tesla small animal MRT of the Bruker company which was supplied three weeks ago.........

Posted by: Scott      Read more         Source


September 14, 2008, 10:34 PM CT

Calcium and exercise to strengthen the bones

Calcium and exercise to strengthen the bones
A stumble, a fall - a broken bone: a number of older people are afraid of this happening. The German Institute for Quality and Efficiency in Health Care published information today about how you can protect yourself. Research shows that regular adequate intake of calcium and exercise can strengthen the bones. But a number of people do not know whether they are getting enough calcium in their diets. The Institute has developed a calculator at www.informedhealthonline.org that can help you estimate if you are getting enough calcium.

Regular intake of calcium protects the bones.

Getting older does not necessarily mean that you will get osteoporosis. However, the risk of osteoporosis does rise as we get older, and people over 70 often have brittle bones. A fall does not only mean bruises then, but it is easier for a bone to break. There are several ways to protect and strengthen bones, even when you are already older.

One important way is to get enough calcium regularly. To stop our bones losing too much strength we need an increasing amount of calcium as we get older. The best way to get it is with a calcium-rich diet. "Older people in particular are often not getting enough calcium," as per the Institute's Director, Professor Peter Sawicki.

The World Health Organization (WHO) recommends a minimum daily intake of calcium of 1,300 mg for women after the menopause and men over the age of 65. The Institute developed an online calculator for its website with the help of the Robert Koch Institute in Berlin. The calculator helps you find out quickly and easily roughly how much calcium you are getting through your diet every day and whether that is enough.........

Posted by: Janet      Read more         Source


September 11, 2008, 9:47 PM CT

The pepperoni pizza hypothesis

The pepperoni pizza hypothesis
What's the worst that could happen after eating a slice of pepperoni pizza? A little heartburn, for most people.

But for up to a million women in the U.S., enjoying that piece of pizza has painful consequences. They have a chronic bladder condition that causes pelvic pain. Spicy food -- as well as citrus, caffeine, tomatoes and alcohol-- can cause a flare in their symptoms and intensify the pain. Scientists had long believed the spike in their symptoms was triggered when digesting the foods produced chemicals in the urine that irritated the bladder.

A surprising new discovery from Northwestern University's Feinberg School of Medicine reveals the symptoms -- pain and an urgent need to frequently urinate -- are actually being provoked a surprise perpetrator. It's the colon, irritated by the spicy food, that's responsible. The finding provides an explanation for how the body actually "hears" pelvic pain.

The discovery also opens up new therapy possibilities for "painful bladder syndrome," or interstitial cystitis, a condition that primarily affects women (only 10 percent of sufferers are men.) During a flare up, the pelvic pain is so intense some women inject anesthetic lidocaine directly into their bladders to get relief. Patients typically also feel an urgent need to urinate up to 50 times a day and are afraid to leave their homes in case they can't find a bathroom.........

Posted by: Janet      Read more         Source


September 11, 2008, 9:43 PM CT

Internet-based health-care teaching

Internet-based health-care teaching
A study led by a team of education scientists from Mayo Clinic and published this week in the Journal of the American Medical Association (JAMA) concludes that Internet-based education generally is effective.

Lead author David Cook, M.D., an associate professor of medicine who practices general internal medicine at Mayo Clinic, worked with scientists from Mayo and McMaster University in Hamilton, Ontario. They evaluated more than 200 studies about Internet-based instruction. The scientists concluded that Internet-based instruction is linked to large learning gains compared with no instruction. The research also showed that Internet-based instruction compared favorably to traditional instructional methods.

"Our findings suggest that Internet-based instruction is an effective way to teach health care professionals," says Dr. Cook. "We now can confirm that, across a wide variety of learners, learning contexts, clinical topics, and learning outcomes, Internet-based instruction can be as effective as traditional methods."

Dr. Cook also notes that Internet-based instruction has unique advantages, including flexible scheduling, adaptability of instruction, and readily available content that is easily updated. "As health care workers balance challenging practice demands, the ever-expanding volume of medical knowledge requires us to find more effective, efficient ways to learn," says Dr. Cook. "Internet-based instruction will be an important part of the solution".........

Posted by: Janet      Read more         Source


September 11, 2008, 9:34 PM CT

Mate selection more biologically determined

Mate selection more biologically determined
Some human populations may rely on biological factors in addition to social factors when selecting a mate. In a recent study, published September 12 in the open-access journal PLoS Genetics, researchers in China, France, and the United Kingdom report genomic data showing that immunity traits may be involved in mate choice in some human populations.

In several species it has been shown that the Major Histocompatibility Complex (MHC), a large genomic region involved in immune response, influences mating selections and that this may be mediated by preferences based on body odor. Some prior studies have reported a tendency for humans to prefer MHC-dissimilar mates, encouraging heterozygosity at MHC loci in offspring and resulting in improved immune response. However, other studies, both directly in couples and also indirectly in "sweaty T-shirts" experiments, have reported conflicting results.

Adding to this debate is the recent study by Raphalle Chaix, Chen Cao and Peter Donnelly. The testing employed genome-wide genotype data and HLA types in a sample of African and a sample of European American couples, enabling the scientists to distinguish MHC-specific effects from genome-wide effects. The group examined whether husband-wife couples were more MHC-similar or MHC-dissimilar compared to random pairs of individuals.........

Posted by: Janet      Read more         Source


September 10, 2008, 7:28 PM CT

Individuals vary their immune response

Individuals vary their immune response
Is it always good to respond maximally when pathogens or disease strike, or should individuals vary their immune response to balance immediate and future costs? This is the question evolutionary physiologists Oliver Love, Katrina Salvante, James Dale, and Tony Williams asked when they examined how a simple immune response varied at different life stages across the life-span of individual zebra finches (Taeniopygia guttata), as per a research findings reported in the recent issue of the American Naturalist

When transitioning from nest-bound juveniles to adults, female immune responses matured slowly whereas males showed dramatic variation potentially due to the costs of molting into their colorful sexually dimorphic plumage. Adult males showed little variation in immune response despite changes in resource quality. Likewise, when females laid eggs under high-quality resource conditions, immune responses were also consistent with those during non-breeding and similar to male responses. However, when laying on reduced resources females reduced their immune response and their reproductive output consistent with a facultative (resource-driven) effect of reproductive effort on immunity. Moreover, even under high-resource conditions during the chick-rearing stage mothers showed reduced immune responses in comparison to fathers suggesting a residual energetic cost of egg-laying. Perhaps most importantly, immune responses of juveniles of both sexes did not predict their subsequent adult responses. Immune responses of adult females were only predictable when the quality of the environment remained constant; as soon as conditions deteriorated, individual females mandatory flexibility in both the immune and reproductive systems. However, the degree of flexibility came at a cost as only individuals with high immune responses as non-breeders had the capacity to reduce responses when times became tough. These results underlie the fact that immunity is a highly plastic trait that can be modulated in a sex- and context-dependent manner. Given the need for individual flexibility in the immune system, this suggests that an immune response at one stage may provide limited information about immune response at future stages.........

Posted by: Janet      Read more         Source


September 9, 2008, 10:04 PM CT

Older adults can take medicines more safely

Older adults can take medicines more safely
Elderly adults may be better able to comply with medicine regimens by working with providers to fill out simple paper tables that track what they take and when they take it. Recent experiments observed that use of a "medtable" may help to prevent medication-related problems. A report appears in the recent issue of Journal of Experimental Psychology: Applied, published by the American Psychological Association.

As they age, people often take several different prescription medications. Yet about half of elderly adults are found to take medicine incorrectly and up to one in three of their hospital admissions is blamed on faulty medicine use. Weak collaboration with health-care providers, along with cognitive problems and lower health literacy, are viewed as contributors.

Psychology experts at the University of Illinois at Urbana-Champaign led by Daniel Morrow, PhD, observed that when pairs of elderly adults filled out a written matrix listing medications and instructions by days and times to take them, they solved medication-related problems more efficiently and accurately, particularly for the complex medicine schedules increasingly common among elderly adults.

In Experiment 1, 96 participants averaging 69 years in age were randomly assigned to the role of patient or provider. These pairs were randomly assigned to use a pre-designed medtable, a blank piece of paper or no aid. To simulate real life, the scientists varied information about both medicine and patient.........

Posted by: Janet      Read more         Source


September 8, 2008, 6:28 PM CT

'Healthy' individuals may be at risk for heart disease

'Healthy' individuals may be at risk for heart disease
In the face of a growing obesity epidemic in the United States, scientists at Wake Forest University Baptist Medical Center have new study results that indicate that how much fat a person has is not as important as where that fat is located when assessing risk for cardiovascular events and metabolic disease.

"We are facing an obesity epidemic, which obviously affects a number of things metabolic abnormalities, cardiovascular disease, etc.," said Jingzhong Ding, M.D., lead researcher and an assistant professor of gerontology. "Now we are finding out that where the fat is distributed is of high importance."

The findings of the study, funded by the National Heart, Lung and Blood Institute and the National Institutes of Health, will appear in the recent issue of the American Journal of Clinical Nutrition, a publication of the American Society for Nutrition.

For the study, scientists used cardiac and Computerized axial tomography scans to measure multiple fat depots in 398 white and black participants from Forsyth County, N.C., ages 47-86. They observed that the amount of fat a person had deposited around organs and in between muscles (nonsubcutaneous fat) had a direct related to the amount of hard, calcified plaque they had. Calcified plaque itself is not considered risky, but it is linked to the development of atherosclerosis, or the presence of less stable, fatty deposits in the blood vessels that can lead to heart attack and stroke.........

Posted by: Daniel      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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