May 23, 2007, 9:51 PM CT

Closing Accidental Colonoscopy Wounds

To prevent colon cancer, the second leading cause of United States cancer deaths, the American Cancer Society recommends that after age 50 people undergo colonoscopies every ten years to detect signs of that disease either actual tumors or premalignant polyps.

But in one out of every 1,000 to 2,000 colonoscopies, doctors inadvertently perforate or puncture the colon. Most of these patients need urgent surgery to close the wound and spend 10 days in the hospital. One in 10 dies, commonly because delays in closing perforations allow colon contents to leak into the abdominal cavity, causing deadly conditions such according toitonitis and sepsis.

Now, however, in a series of animal studies, scientists at the University of Texas Medical Branch at Galveston (UTMB) have developed a technique for closing perforations promptly after they are recognized by using clips or sutures that can be inserted through the anus via endoscope, thus avoiding invasive surgery. Similar clips and sutures have been used for some time by surgeons performing minimally invasive laparoscopic procedures including several gynecological operations and other procedures such as gall bladder removal.

Today [Wednesday, May 23, 2007] at the annual meeting of the American Society of Gastrointestinal Endoscopy, UTMB professor G.S. Raju, the principal investigator for the wound-repair studies, presented a summary of his experimental endoscopic research over the last three years......... Posted by: Emily      Read more         Source

May 23, 2007, 8:24 PM CT

Stem cells may look malignant, not act it

Bone marrow stem cells attracted to the site of a malignant growth frequently take on the outward appearance of the cancerous cells around them, University of Florida scientists report in a paper would be reported in the recent issue of Stem Cells.

But whether that enables them to fuel cancer's ability to develop and then spread, as some researchers suspect, is not entirely clear. The findings, available early in this month's online edition of the journal, actually contest the increasingly popular theory that bone marrow stem cells seed cancer. Instead, these cells might simply look like cancer, not act like it.

"They have the same kind of surface proteins," said study author Chris Cogle, M.D., an assistant professor of medicine at the UF's College of Medicine Program in Stem Cell Biology and Regenerative Medicine. "They have the same skin. The next question is 'Do they have the same guts"'.

"Our results indicate these cells act as developmental mimics; they come in and look like the surrounding neoplastic tissue, but they aren't actually the seed of cancer," said Cogle, who also is affiliated with the UF Shands Cancer Center. "At the worst, these cells could help support malignant tissue by providing it with growth factors or proteins that help the cancer grow and survive. At the very least, these marrow cells are just being tricked into coming into the malignant environment and then made to walk and talk like they don't commonly do"......... Posted by: Emily      Read more         Source

May 23, 2007, 8:19 PM CT

Adult brain cells rediscover their inner child

You may not be able to relive your youth, but part of your brain can. Johns Hopkins scientists have observed that newly made nerves in an adult brain's learning center experience a one-month period when they are just as active as the nerves in a developing child. The study, appearing this week in Neuron, suggests that new adult nerves have a deeper role than simply replacing dead ones.

Song and colleagues tracked the chemical signals received by newly made nerve cells in the adult mouse hippocampus, a brain structure dedicated to learning and memory, by injecting virus particles to light up nerve progenitor cells. Any freshly made nerves glowed green and become permanently marked for later identification.

"In essence, we stamped a birth date on new adult nerve cells," says Hongjun Song, Ph.D., assistant professor of neurology at Johns Hopkins' Institute for Cell Engineering. "The brief heightened activity we saw may help explain how adults continue to adapt to new experiences even though adult brains are more hardwired than children's brains," he adds. The slow and gradual addition of new nerve cells may be like a fine-tuning system, allowing adults to incorporate fresh information without altering our basic brain circuitry.

When they looked at brains from these mice, the scientists noticed that hippocampal nerves that were between 1 and 2 months old could dramatically increase or decrease the amount of signaling chemicals they receive from neighboring nerves. This ability of nerves to modulate their chemical inputs, known as synaptic plasticity, is particularly high in developing brains but tends to become less intense in adults......... Posted by: Emily      Read more         Source

May 22, 2007, 9:53 PM CT

New Mayo Clinic MRI technology

Two recent Mayo Clinic studies have observed that magnetic resonance elastography (MRE), a new imaging technique invented at Mayo Clinic, is an accurate tool for non-invasive diagnosis of liver diseases. The findings will be presented this week at the International Society for Magnetic Resonance in Medicine Annual Meeting in Berlin, Gera number of, and Digestive Disease Week 2007 in Washington, D.C.

The liver responds to a number of diseases that damage its cells by developing scar tissue or fibrosis. MRE uses a modified form of magnetic resonance imaging (MRI) to accurately measure the hardness or elasticity of the liver. By applying vibrations to the liver, MRE obtains pictures of the mechanical waves passing through the organ. The wave pictures are then processed to generate a quantitative image of tissue stiffness.

"Healthy liver tissue is very soft, while a liver with fibrosis is firmer, and a liver with cirrhosis is almost rock-hard," says Richard Ehman, M.D., lead researcher on the MRE project. "If detected early, fibrosis of the liver can be treated, but once the disease has progressed to cirrhosis, the condition is irreversible".

Dr. Ehman and his imaging research team collaborated with Mayo Clinic gastroenterologists to study whether MRE could provide reliable and accurate diagnoses in patients with varying degrees of liver disease......... Posted by: Emily      Read more         Source

May 22, 2007, 9:44 PM CT

Hand dexterity determines susceptibility to PTSD

A recent study conducted by researchers with the Geisinger Center for Health Research shows a clear link between combat veterans' use of both hands for common tasks and the likelihood that they will experience post-traumatic stress disorder (PTSD).

Combat veterans with an extreme level of mixed handedness are nearly twice as likely to develop (PTSD) after combat in comparison to veterans who use both hands less often, as per the study, which is being reported in the recent issue of Psychosomatic Medicine.

The study also observed that veterans with extreme mixed handedness and high combat exposure were nearly five times more likely to have PTSD than those with lower degrees of mixed handedness.

Joseph Boscarino, PhD, MPH and Stuart Hoffman, DO of the Geisinger Center for Health Research measured PTSD and handedness among a national sample of 2,490 Vietnam veterans exposed to combat.

"These findings suggest the possibility of a pre-existing biological vulnerability for PTSD," said Boscarino, the study's principal investigator. "We know generally what type of soldier is likely to suffer from PTSD, before they go into combat".

While other studies on handedness and PTSD have yielded similar results, those previous studies were too small to draw significant conclusions. Boscarino's groundbreaking study examined a much larger group of patients, and therefore the results are more applicable to a large group of veterans......... Posted by: Emily      Read more         Source

May 21, 2007, 12:21 AM CT

Statin use linked with decreased prostate cancer mortality

Urologists and scientists have postulated in recent years that statin medications could have an impact on the growth and progression of prostate cancer. Cholesterol is a primary building block for testosterone, which has in turn been linked with prostate tumor growth (less testosterone results in slower-growing tumors). In recent years, research has indicated a possible link between dietary fat intake and prostate cancer. Research presented today at the 102nd Annual Scientific Meeting of the American Urological Association explores the effect statin medications (which work to reduce low-density lipoprotein, or LDL, levels) may have on prostate-specific antigen, the occurence rate of prostate cancer, and mortality due to prostate cancer. A special session for members of the media was held on May 20 at 11:00 a.m. and moderated by AUA spokesman Anthony Y. Smith, M.D. of the University of New Mexico, Albuquerque.

---

EXPLORING CAUSES FOR DECLINING PROSTATE CANCER MORTALITY RATES IN THE UNITED STATES BETWEEN 1993 AND 2003 (Abstract 203)

Scientists from the University of Alabama, Birmingham, sought to compare declining prostate cancer mortality rates with the independent epidemiological variables including prostate-specific antigen (PSA) screening, insurance coverage, obesity, diabetes and hyperlipidemia (high cholesterol levels). Results of the study showed a direct connection between prostate-cancer mortality rates with hyperlipidemia and PSA screening in white men, and health insurance coverage in black men. The link between high cholesterol and declining mortality was unexpected, and scientists attribute this relationship to the increased use of statin medications to treat high cholesterol......... Posted by: Emily      Read more         Source

May 21, 2007, 12:19 AM CT

Approved medical resident hours still resulting in sleepy doctors

Medical residents working within the mandated maximum of 80 hours per week experience severe sleepiness, a finding that may have implications for both patient care and resident safety, as per a new study presented at the American Thoracic Society 2007 International Conference, on Sunday, May 20.

Prior studies have shown that sleep-deprived residents perform poorly in several areas like judgment and concentration and are at risk for motor vehicle accidents. There have been several instances where sleep-deprived residents have committed serious mistakes in patient care. This led the ACGME (Accreditation Council for Graduate Medical Education), in 2003, to limit their work hours to not more than 80 hours a week and 24 hours at a stretch. The impact of this standard has not been well studied.

"We need to be aware that, though residents are working within guidelines, they are reporting to work for a 24-hour shift already sleepy and, on post-call, exhibit sleepiness in the pathologic range. This degree of sleepiness is seen in medical conditions such as obstructive sleep apnea and narcolepsy. This has the potential to impact decisions about patient care, particularly on a post-call day and has a bearing on their safety in driving home," says lead researcher Shyam Subramanian, M.D., Director of Sleep Services at the Baylor College of Medicine in Houston......... Posted by: Emily      Read more         Source

May 21, 2007, 11:11 AM CT

For Patients With Painful Bowel Inflammation

Inflammatory bowel disease, or IBD, is an umbrella term referring to a group of disorders that cause inflammation of the intestines, including ulcerative colitis, diverticular disease and perianal fistula. Nearly one million Americans experience some form of IBD every year, which is often chronic or recurring. Research presented today at Digestive Disease Week 2007 (DDW) looks at preventative measures and potential therapy options for these painful and debilitating conditions. DDW is the largest international gathering of physicians and scientists in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery.

"Inflammatory bowel diseases are serious and complex diseases with varied preventative and therapy options, and we are pleased to see more attention directed toward improving the lives of people suffering from these conditions," said Mara Abreu, M.D., Director, Inflammatory Bowel Disease Center, Associate Professor of Medicine, Mount Sinai School of Medicine. "The studies presented today provide evidence that researchers are beginning to capitalize on prior research to better understand, prevent and treat intestinal inflammation".



Can Patients with Diverticular Disease Eat Nuts, Corn and Popcorn" (Abstract #769)........ Posted by: Emily      Read more         Source

Mon, 21 May 2007 15:23:21 GMT

"Dumbing down" the nursing profession

Nurses are to be replaced by robots. No, really, it is not April Fool's Day. It is going to happen in a hospital near you. Soon.
Nurses, those caring people who have pulled many a patient back from the brink with their expertise, brow-wiping and tender words, are likely to be replaced soon by yards of wiring, transistors, hydraulics, a motherboard and light-emitting diodes. Enter the Robo-nurse. (Independent)

As we report today, a medication-dispensing machine is coming soon to a ward near you. Robot nurses to take your temperature and blood pressure cannot be far behind. Makes sense, though, does it not? (Leader in Independent)
And the girls and boys at Dr Crippen's favourite website, the wonderful Center for Nurse Advocacy are going to love this one. In the USA they have flirtatious robo-nurses.

Sexy robo-nurse

Pearl flirts with old men. But women like her too. Her wide eyes and smiling lips lend her face an expression that hovers between vacuous gaiety and humble servility. But don't let the vacant look fool you. Pearl is one sharp cookie. (The Mature Market)
The Salt Lake Tribune tells us thatRobot 'Nurse' Puts a Human Face on Elderly Health Career....as opposed to what real nurses used to do?

But no sooner have robo-nurses, flirtatious or not, been introduced than already the boffins are working on robo-nurse specialists.

Robo-nurse specialist

Robo-nurse specialist does not flirt. She does not do hands on nursing. Robo-nurse specialist keeps doctors under surveillance to ensure that they are sticking to their protocols.

There is no escape.Labels: dumbing down, robots Posted by: Dr John Crippen      Read more     Source

Mon, 21 May 2007 12:58:27 GMT

What Health Procedures Cost and Why You Should Care

A few years ago I was woefully underinsured with a high deductible for the measly health insurance I did have. Basically I had bought a catastrophic policy in case I fell off a bridge or something, but I wasn't getting much coverage otherwise. I can't remember what I needed done, possibly a mole removal, but here's the conversation I had with the person at my doctor's office:

ME: Can you tell me what that would cost?

HER: We can't tell you what it costs until after it's been done.

ME: Well, I'd like to have an idea of what it costs BEFORE it's done so I can make some decisions on when to have it done. You can't even give me a ballpark on what this would cost?

HER: We won't know until after the doctor sees it and decides what to do about it.

ME: Fine, but you can't even give me a ballpark estimate here on what the general cost is?

HER: No, we can't. Why do you care about the cost? Your insurance will pay for it.

ME: No, my insurance won't pay for it. That's why I need to know what it costs.

This went on for a couple of more minutes and not once would she give me any idea of what the procedure cost. What really burned me up was the question about why I cared about the cost when insurance would just handle it all. It's like the medical and insurance professions have just decided no one but them needs to bother with this stuff, but in the meantime millions of people have no health insurance and get jacked-up rates when they need health care because they don't get the discounted rate that insurance companies get from doctors and hospitals.

But it's getting harder and harder to be one of those blissfully unaware people when it comes to health care. Because no matter who you are, more and more of the cost of health care is being pushed onto your shoulders. Your job may not offer health insurance, or, if it does, it's probably making you pay more for it than in the past, or maybe the company's not paying into it at all, but simply giving you a small break on the insurance by allowing you to get into the company's group plan (which is usually cheaper than an individual policy).

If it hasn't happened yet, it won't be long before all of us are asking doctors and hospitals what a procedure costs before they just get started, assuming that our insurance will take care of it and so there's no need to bother discussing it.

What started me on this rant was actually something good I found. It's a sVimo, which shows you the costs of many different hospital procedures, including the nationwide averages, who's cheapest, which hospitals do the procedures the most, and what kind of negotiated discount you can expect to get if you end up paying out of pocket for this stuff.

The site needs to beef up its stats to be truly useful across the board, but it already offers a lot, and I'm sure it will grow and have even more information over time. In a future where more and more of us will have to think about the costs of our health care, Vimo and its inevitable competitors could make the slog through comparison shopping for health care a lot easier. Posted by: Justin McHenry      Read more     Source