January 3, 2008, 9:50 PM CT

Hospitals lag in preventing common infection

One in four Americans in the hospital right now has a urinary catheter. One percent of them will get a urinary tract infection from that catheter. All of those will require antibiotics. A few may suffer life-threatening complications.

And with every new case, UTIs will retain their title of most common hospital-acquired infection, responsible for 40 percent of infections correlation to hospitalization.

But despite all this, a new study finds, American hospitals dont seem to have a consistent strategy for preventing catheter-related UTIs. In fact, the study shows, most hospitals arent using basic tactics that have been proven to keep patients from getting catheter-related UTIs in the first place.

The study provides the first-ever national snapshot of hospital efforts to prevent urinary catheter-related infections. Its reported in the recent issue of the journal Clinical Infectious Diseases by a team led by patient safety experts from the University of Michigan Health System and the VA Ann Arbor Healthcare System.

The picture that develops from this snapshot is chaotic, with nearly half of hospitals lacking a system that tells them which patients currently have a catheter, and three-quarters lacking a system that can tell them how long a patient has had a catheter or whether one has been removed. Nearly one-third of hospitals didnt even track the UTI rates in their patient populations......... Posted by: Emily      Read more         Source

January 2, 2008, 10:12 PM CT

MRI techniques for better assessment of liver fibrosis

MRI imagery is emerging as a non-invasive way to determine the existence and extent of hepatic fibrosis. It could eventually help the development of pharmacologic strategies to combat the condition. These findings are in the recent issue of Hepatology, a journal published by John Wiley & Sons on behalf of the American Association for the Study of Liver Diseases (AASLD). The article is also available online at Wiley Interscience (http://www.interscience.wiley.com/journal/hepatology).

Currently, the best way to assess hepatic fibrosis is liver biopsy; however, it is an invasive procedure that can cause serious side effects. Scientists have been studying less invasive techniques, such as blood tests and imaging strategies like ultrasound, but so far, they have not proven sensitive enough to detect the various stages of fibrosis.

Over the past decade, many technological advances have been made in magnetic resonance (MR) imaging of the liver. Scientists led by Jayant Talwalkar of the Mayo Clinic, examined the current state of MR imaging and the studies that looked at its utility in detecting liver fibrosis.

They observed that contrast-enhanced magnetic resonance imaging, magnetic resonance spectroscopy, and diffusion-weighted magnetic resonance imaging have shown promise for detecting hepatic fibrosis, though they require further refinement......... Posted by: Emily      Read more         Source

January 2, 2008, 9:49 PM CT

Older surgical patients at greater risk

Patients over the age of 60 who have elective surgeries such as joint replacements, hysterectomies and other non-emergency, inpatient procedures, are at an increased risk for long-term cognitive problems, as per a new study led by Duke University Medical Center researchers.

The study also observed that elderly patients who developed these postoperative cognitive problems were more likely to die in the first year after surgery.

We have known that patients undergoing heart surgery are at risk for cognitive dysfunction -- problems with memory, concentration, processing of information -- but the effects of non-cardiac surgeries on brain function are not as well-understood, said Terri Monk, M.D., an anesthesiologist at Duke and the Durham Veterans Affairs Medical Center, and lead investigator on the study. Our study observed that increasing age put patients in this population at greater risk for cognitive problems and this is significant because the elderly are the fastest growing segment of the population. We know that half of all people 65 and older will have at least one surgery in their lifetime.

The scientists published their findings in the January 1, 2008 issue of the journal Anesthesiology and the results were published early online on December 27, 2007 on the journals Web site. The article is accompanied by a supportive editorial and a companion article detailing the types of cognitive dysfunction that developed and the effects on patients daily lives. The study was funded by the National Institute on Aging, the Anesthesia Patient Safety Foundation and the I. Heerman Foundation......... Posted by: Emily      Read more         Source

Thu, 27 Dec 2007 16:06:38 GMT

The Body Has a Mind of Its Own

Body maps are areas of the brain that represent all areas of your body inside and out. Most of us recall the goofy pictures of homunculi, the distorted figures that represent the relative space our body parts occupy in the somatosensory cortex. Because sensory schemata of the hands and face occupy relatively large areas of our cortex, they are overrepresented in the physical map.

In The Body Has a Mind of Its Own mother-son science writing team Sandra and Matthew Blakeslee write about these and other body maps as revealed by cutting edge neuroscience. My first impression on reading was that neuroscience and, by extension, the authors were overselling body maps and their implications. But after reading a few chapters, I was impressed.
While the authors freely admit, "certain details and caveats that a specialist would consider vital have been condensed, glossed over, or shoehorned into metaphors", their ability to summarize the complex and confusing field of neuroscience is admirable. Granted much of the information is highly speculative, but as an introduction to the field of body maps, I found the book highly informative and entertaining. The take home message is that body maps and the brain are far more plastic than most of us are aware of.

Some of the best topics include:

Can sports players improve their "games" by mental means alone?
How do body maps figure into eating disorders?
What causes phantom limbs?
Can you fool your body into regaining body areas lost to strokes?
What are the "yips"?
Why do video game players move their bodies to the action on the screen?
What happens when you have an "out of body" experience?
Can inanimate objects become part of your "body"?

The book contains many interesting anecdotes, such as:

“Carter” was a master chef at a well-known New York restaurant when, in late 1994, a blood clot in his brain almost cost him his livelihood. Rushed to the hospital in time to receive state-of-the-art clot dissolving care, Carter was left with a potentially devastating problem: He could no longer recognize fruits and vegetables. He couldn’t tell a banana from a leek, though he could still tell a bread knife from a butcher knife and a hawk from a handsaw. He could use English fluently, and his senses were all intact. He had no discernible problems naming or thinking about any other categories of object—just fruits and veggies.

It sounds like a career killer for a chef, but Carter managed to get by. You see, his brain''s network body maps still knew what to do with each item. There was nothing wrong with the body maps containing his visual-motor templates for how to manipulate objects. And there was nothing wrong with the body maps that storehoused his library of well-practiced motor sequences involved in food prep. He could still peel a carrot, slice a tomato, or dice an onion—but first he had to be told what each thing was. He would simply query the kitchen staff: “Hey, Jane, is this a cucumber?

"Yeah? Thanks.” Chop chop chop.

On the whole, this book is an excellent introduction to a complex and important topic of science. The prose is lively and easy to read, and once I got going, I was able to finish it in a matter of days. The book is intended for a wide audience, and other than the occasional jargony neuroanatomy term, it is accessible to anyone with a high school education. The only notable failure of this book is to make clearer distinctions on the science that is well-established and the science that is pure speculation. I''m no specialist, yet I would have liked to have seen more pointers to primary sources; an appendix containing citations and/or pointers for further reading would have been highly appropriate and useful.

Clay model on display at the Natural History Museum in London. Posted by: Dennehy      Read more     Source

December 20, 2007, 9:17 PM CT

New Way To Sort Stem Cells

UC Irvine researchers have found a new way to sort stem cells that should be quicker, easier and more cost-effective than current methods. The technique could in the future expedite therapies for people with conditions ranging from brain and spinal cord damage to Alzheimer's and Parkinson's diseases.

The method uses electrodes on a tiny, inch-long glass slide to sort cells by their electric charges and has been used in cancer research. The stem cell field suffers from a lack of tools for identifying and sorting cells. This important discovery could add a new tool to current sorting methods, which generally require expensive, bulky equipment.

"For therapeutic purposes, we want stem cells to turn into specific cell types once they have been transplanted. The trick to doing this is identifying beforehand which cells will become the desired cell type, such as a neuron," said Lisa Flanagan, lead author of the study and a stem cell biologist at UCI. "We have discovered a new, potentially better way to do this by focusing on the electric properties of the cells".

This study appears online Dec. 20 in the journal Stem Cells.

The technique used by the scientists, called dielectrophoresis, is based on the premise that different types of cells have different electric properties. Stem cells that are destined to become neurons, for example, have a different electric charge than stem cells that will become astrocytes, another type of brain cell. The researchers discovered that the cells react differently when electric fields are applied. At one frequency, a neuron will be attracted to an electrode but an astrocyte will not, and at a different frequency, an astrocyte will be attracted but a neuron will not......... Posted by: Emily      Read more         Source

Thu, 20 Dec 2007 05:06:34 GMT

The Hidden Workings of Our Minds

How do great artists create? How do brilliant scientists solve the hardest problems in their field? Listen to them try to explain and you''ll probably be disappointed. Artists say mysterious things like: "The picture just formed in my mind." Writers tell us that: "I don''t know where the words come from." Scientists say they: "Just had a hunch."

Of course, not all scientists, artists and writers give such mysterious answers. Some talk about the processes they went through or what inspired their conceptual jump. But their explanations are almost invariable unsatisfying. They usually can''t really explain how they made that vital leap of the imagination. This is strange. Why is it that otherwise brilliant and articulate people seem unable to adequately explain their thought processes? Don''t they know how they did it?

What is true of great scientific and artistic leaps of imagination is also true in everyday life. When people are asked why they chose one career over another, one partner over another or one flavour of ice-cream over another, the same problems emerge. Often, people''s answers are unconvincing or they just don''t know.

Psychologists no longer find this inability to explain our internal mental processes strange. Like Freud all those years ago, modern cognitive psychologists have come to accept that a lot of the time we don''t have much of a clue what''s going on in our own minds, and there''s evidence to prove it.

Mysterious thoughts
In a classic review of the literature, Nisbett and Wilson (1977) looked at many, many cognitive and social psychology studies conducted in the 1960s, 70s and earlier. These studies involved manipulating participants'' behaviour. For an example, have a look at my report of this classic study of cognitive dissonance.

After reviewing all these studies where experimenters are messing with participants'' minds, Nisbett and Wilson came to the following conclusions:

People are mostly unaware that their behaviour or thought processes have been changed by the experimenter.

Even if they are aware of the manipulation, they can''t identify the process of change that occurred.

Most people cannot connect their changed thought or behaviour with the experimenter''s manipulation.

Frustratingly, it seems that the most powerful workings of the mind are hidden away from view, even when we go rummaging around. If this is true, what about the explanations that people actually give for their behaviour? Where do these come from and are they ever right?

Nisbett and Wilson reach two further disturbing conclusions:

When coming up with their explanations, people don''t seem to access the correct thought process(es). If they do then it only happens when the explanation is plausible.

Sometimes people do report the correct reason for what they''ve done, but it''s probably only a coincidence.

If Nisbett and Wilson are right it has profound implications for what we can know about our own thoughts and whether we can believe what other people say about theirs.

The evidence
In the next few posts I''ll explain some of the evidence for these claims. But in the meantime think about a relatively common experience like driving. Most drivers have had the experience of having driven for a length of time without noticing any traffic signals, yet they still stop at every red light. Posted by: Jerry      Read more     Source

December 18, 2007, 8:42 PM CT

New online tool in fight against spread of HIV

A new Web-based software program is the latest tool University of Minnesota scientists are using to help fight the spread of HIV. A multidisciplinary team of scientists led by Joseph Konstan, a professor in computer science and engineering, and B. R. Simon Rosser, a professor in the School of Public Health, are embarking on a clinical trial this month to test a software program that aims to reduce risk-taking behavior linked to the spread of HIV and other sexually transmitted infections.

Konstan and Rossers research team have been working for more than five years to create computer programs that assess risks undertaken by men seeking sex with other men through online venues. The team is now testing an online intervention program designed to reduce sexual risk-taking and the spread of sexually transmitted infections.

The software program asks users questions about issues such as body image, self esteem, sexual health and risk-taking behaviors. The program then offers information about HIV/AIDS related stories. The goal of this research is to create a genuine online experience that promotes healthier sexual behavior and encourages people to take fewer risks in sexual encounters outside of cyberspace, Konstan said.

The research teams work has become a multi-phased, interdisciplinary project, called the Mens Internet Study (MINTS). The group is also partnering with a technology company -- Allen Interactions -- to develop the intervention techniques. Konstan and Rosser hope these trials will show that the Web-based program is effective in the prevention of risk-related behavior leading to sexually transmitted infections......... Posted by: Emily      Read more         Source

December 18, 2007, 8:17 PM CT

Genetic Link to Spina Bifida

Scientists at The University of Texas Medical School at Houston have discovered an association between genes regulating glucose metabolism and spina bifida. The decade-long study looked at more than 1,500 DNA samples from parents and their children with that birth defect.

UT Medical School scientists tested variants in a dozen genes that take part in glucose metabolism to look for a link between genetic variation in affected children and spina bifida. Each affected child's parents were also studied, as well as DNA from unaffected control samples. The samples were gathered from study participants in Houston, Los Angeles and Toronto.

Reported in the Jan. 2008 issue of the journal Reproductive Sciences, the study titled "Genes in Glucose Metabolism and Association with Spina Bifida," found an association between variants in three glucose metabolism genes and spina bifida. Glucose metabolism is the way the body uses its major fuel, which is sugar.

"We are trying to find out what causes this neural tube defect. It has been recognized through epidemiological studies for many years that there was a correlation between high glucose levels, either due to maternal diabetes or obesity and having a child with spina bifida," said co-author Hope Northrup, M.D., professor and director of medical genetics in the Department of Pediatrics at the UT Medical School. "Our goal is to identify variations in specific genes of glucose metabolism that are important in the process, thus enabling us to more specifically determine the underlying problem"......... Posted by: Emily      Read more         Source

December 17, 2007, 9:28 PM CT

Pain treatment in the field

Noncombat-related acute and recurrent chronic pain are the leading causes of soldier attrition in modern war, with the return-to-duty rate as low as 2 percent when these soldiers are treated outside the theaters of operation. However, that rate jumps to 95 percent when troops and officers are treated and managed for pain in the field of instead of being sent elsewhere for treatment, as per a new study from a Johns Hopkins anesthesiologist.

The main factor seems to be rapid diagnosis and therapy of pain syndromes, says co-author of study Colonel Steven Cohen, M.D., of the Department of Anesthesiology and Critical Care Medicine at the Johns Hopkins University School of Medicine.

Establishing pain therapy centers in combat areas gets care to soldiers fast and could dramatically increase the militarys ability to maintain troop levels and succeed militarily in places like Iraq, says Cohen.

The report, appearing in the recent issue of Anesthesiology, shows that 107 out of 113 soldiers suffering from noncombat-related pain were able to return to duty after being treated at the Ibna Sina Hospital in Baghdad between October 2005 and September 2006.

In contrast, a prior study by Cohen and his colleagues showed that of 162 soldiers with similar kinds of pain evacuated from Iraq for therapy at Walter Reed Army Medical Center in Washington, D.C., or the Landstuhl Regional Medical Center in Gera number of between April 2003 and July 2004, only three returned to active duty......... Posted by: Emily      Read more         Source

December 17, 2007, 8:54 PM CT

Overexcited neurons not good for cell health

Neurotransmitters have consequences. They initiate events that are critical to a healthy life, giving us the ability to move, to talk, to breathe, to think. But thats if the neurotransmitters are getting it right and sending proper signals downstream to muscle cells, neurons or other cells.

Now a Northwestern University study reports that a mutation in a transcription factor that controls a neurotransmitter in the nematode C. elegans causes an imbalance in neuronal signaling that results in protein damage in target cells. Similar results and consequences on protein folding were found to occur upon exposure to the common toxins nicotine and lindane (a pesticide).

Whether due to genetic mutation or exposure to small molecules, the neurons become overexcited and fire incorrect signals too rapidly, resulting in proteins in target muscle cells becoming stressed, misfolding and becoming non-functional.

To find that small molecules reproduce our genetic observations -- that both environment and genetics cause a molecular defect in the ability of proteins to function in muscle cells -- was not expected, said Richard I. Morimoto, Bill and Gayle Cook Professor of Biochemistry, Molecular Biology and Cell Biology in Northwesterns Weinberg College of Arts and Sciences, who led the research team......... Posted by: Emily      Read more         Source