Psoriasis Linked to AAA – —Shared inflammatory mechanisms may explain the association

April 17, 2016

by Nancy Walsh, Senior Staff Writer, MedPage Today

Patients with psoriasis — whether mild or severe — are at increased risk of abdominal aortic aneurysms (AAA), a Danish nationwide cohort study found.

“These findings add importantly to current evidence of psoriasis as a clinically relevant risk factor for cardiovascular disease and may require increased focus on heightened risk of AAA in patients with psoriasis,” the researchers wrote in Atherosclerosis, Thrombosis, and Vascular Biology.

Systemic inflammatory markers such as C-reactive protein and tumor necrosis factor (TNF)-α also are elevated in patients with AAA and in those with psoriasis.

Reviewed by F. Perry Wilson, MD, MSCE Assistant Professor, Section of Nephrology, Yale School of Medicine and Dorothy Caputo, MA, BSN, RN, Nurse Planner.

Blood Test For Concussion

April 1, 2016

Researchers at Orlando Health detected evidence of concussions in patients up to 7 days after their injury using a simple blood test, according to a new study published in JAMA Neurology. The discovery could greatly expand the window for diagnosing concussions, especially in patients who experience a delayed onset of symptoms.

Science Daily, March 28, 2016.

N.F.L. Great Ken Stabler Had Brain Disease C.T.E.

February 3, 2016

Pro Football by John Branch, February 3, 2016.

Shortly before he died last July, the former N.F.L. quarterback Ken Stablerwas rushed away by doctors, desperate to save him, in a Mississippi hospital. His longtime partner followed the scrum to the elevator, holding his hand. She told him that she loved him. Stabler said that he loved her, too.

“I turned my head to wipe the tears away,” his partner, Kim Bush, said recently. “And when I looked back, he looked me dead in the eye and said, ‘I’m tired.’ ”

They were the last words anyone in Stabler’s family heard him speak.

“I knew that was it,” Bush said. “I knew that he had gone the distance. Because Kenny Stabler was never tired.

The day after Stabler died on July 8, a victim of colon cancer at age 69, his brain was removed during an autopsy and ferried to scientists in Massachusetts. It weighed 1,318 grams, or just under three pounds. Over several months, it was dissected for clues, as Stabler had wished, to help those left behind understand why his mind seemed to slip so precipitously in his final years.

On a scale of 1 to 4, Stabler had high Stage 3 chronic traumaticencephalopathy, or C.T.E., the degenerative brain disease believed to be caused by repeated blows to the head, according to researchers at Boston University. The relationship between blows to the head and brain degeneration is still poorly understood, and some experts caution that other factors, like unrelated mood problems or dementia, might contribute to symptoms experienced by those later found to have had C.T.E.

Drug Overdoses Propel Rise in Mortality Rates of Young Whites

January 22, 2016

The New York Times. By Gina Kolata and Sarah Cohen. January 16, 2016

Drug overdoses are driving up the death rate of young white adults in the United States to levels not seen since the end of the AIDS epidemic more than two decades ago — a turn of fortune that stands in sharp contrast to falling death rates for young blacks, a New York Times analysis of death certificates has found.

The rising death rates for those young white adults, ages 25 to 34, make them the first generation since the Vietnam War years of the mid-1960s to experience higher death rates in early adulthood than the generation that preceded it.

The Times analyzed nearly 60 million death certificates collected by the Centers for Disease Control and Prevention from 1990 to 2014. It found death rates for non-Hispanic whites either rising or flattening for all the adult age groups under 65 — a trend that was particularly pronounced in women — even as medical advances sharply reduce deaths from traditional killers like heart disease. Death rates for blacks and most Hispanic groups continued to fall.

Lawsuit Claims Fitbit Heart Rate Monitor Is Inaccurate

January 12, 2016

CBS/January 8, 2016

SAN FRANCISCO (CBS) — The makers of Fitbit are being sued by people who allege that the popular fitness device isn’t accurately keeping track of their heart rate while exercising.

The lawsuit filed in federal court this week claims that the wrist-based activity tracker is consistently misrecording users’ heart rates by a “very significant margin.” It also takes aim at Fitbit commercials with slogans like “Every Beat Counts” and “Know Your Heart.”

‘Flying ICUs’: Medical helicopters provide advanced care for rural patients

November 29, 2015

Medical helicopters so well-equipped that one hospital leader calls them “flying intensive care units” are helping people in the rural upper Midwest get emergency medical care that otherwise would be out of reach, the Duluth (Minnesota) News Tribune reported.

“There’s some debate as to the value of having a helicopter system in New York City or Detroit or Chicago,” Mark Monte, M.D., chief of trauma surgery at St. Luke’s Hospital in Duluth, told the newspaper. “But we cover a large expanse of open territory. So to have a helicopter which can go out and reach a great distance and bring a patient back is a great advantage.”

Duluth News Tribune/John Lundy/November 23, 2015

Cases of Pulmonary Hypertension Grow in Children

September 22, 2015

September 20, 2015 By Andrea K. McDaniels of The Baltimore Sun

At 3 months old, Gabrielle John’s daughter would wake up gasping for air and sweating profusely. Baby Stella’s heart rate was also much higher than normal.

“Her little body was working so hard to do anything,” John said.

After several emergency trips to different hospitals, doctors at Johns Hopkins Hospital finally diagnosed Stella with pulmonary hypertension, a potentially fatal condition in which blood pressure is abnormally elevated in the arteries of the lungs. These pulmonary arteries narrow, causing the heart to work harder to pump blood through the lungs to collect oxygen and possibly leading to heart failure.

People Who Suffer Depression And Anxiety After A Traumatic Brain Injury May Have Damaged White Matter

June 24, 2015

Jun 16, 2015 12:00 AM By  for Medical Daily/The Grapevine

Over the past few years, it’s become widely known among the scientific community that traumatic brain injuries, or concussions as they’re more often called, can result in lasting physical and mental damage for the sufferer — a reality that only entered the public consciousness with the emergence of lawsuits filed against the NFL, alleging that they had ignored the evidence showing this when it came to their own players.

But while we know that a concussion can leave you with more than dizziness and a temporary headache, it’s been harder to understand exactly why. Now, new research published in the Radiological Society of North America claims to have possibly figured out part of the mystery. The study authors say they were able to detect unique brain patterns among people suffering from depression or anxiety as a result of their concussion when compared to the brains of those concussion sufferers with no reported mental problems — in some cases, these patterns resembled the brains of those whose mental illness wasn’t caused by head trauma.

Source: Alhilali, L, Delic J, Gumus S, et al. Evaluation of White Matter Injury Patterns Underlying Neuropsychiatric Symptoms after Mild Traumatic Brain Injury. Radiological Society of North America. 2015.

See Medical Daily/The Grapevine for full report.

3 ways providers can mitigate health IT harm

April 1, 2015

Susan D. Hall/Fierce Healthcare 4/01/15

Electronic health records introduce new kinds of risks into an already complex healthcare environment, according to a new Sentinel Event Alert published this week by the Joint Commission.

The alert addresses several socio-technical factors at work with health IT that could lead to sentinel events, including usability issues leading to data-related errors; workflow and communication issues; internal/organizational policies; and hardware/software problems, among others.

To that end, suggested actions should focus on three areas, according to the Joint Commission:

  1. Safety culture: Efforts should include creation of an organization-wide “collective mindfulness” focused on identifying, reporting, analyzing and reducing health IT-related hazardous conditions, close calls or errors; comprehensive systematic analysis of each adverse event causing patient harm to determine whether health IT played a role; and shared involvement and responsibility for the safety of health IT.
  2. Process improvement: It involves development of a proactive, methodical approach that includes assessing patient safety risks; ensuring health IT hardware and software are safe and free from malfunctions and that they’re used in safe and appropriate ways; and using IT to monitor and improve safety.
  3. Leadership: It also calls for enlisting multidisciplinary representation and support; examining workflow processes and procedures for risks and inefficiencies to be resolved before any technology implementation; involving frontline health IT users in system planning and design; and making modifications to the health IT system in a controlled manner.

The alert points organizations to Joint Commission standards on the safe use of health IT.

An evaluation of the graphical displays of lab test results in eight EHRs found they don’t do a good job of creating accurate and clear graphs of patient information, which may adversely affect patient safety, according to a new article in the Journal of the American Medical Informatics Association (JAMIA).

Meanwhile, an editorial at BMJ Quality and Safety states EHRs have not made as much progress in patient safety as the industry had hoped, and calls for collaborative research in a “reinvigorated” need for improvement.

To learn more:
– read the alert (.pdf)
– find the standards

Why A Clean House May Not Lower Asthma, Allergy Risk

March 26, 2015

Despite the widely accepted assumption that the rise in allergic disorders may be due to improved hygiene, a new study has found no connection between development of allergies and asthma and personal hygiene or home cleanliness. This research appears in the March issues of the American Journal of Respiratory and Critical Care Medicine.

Personal cleanliness was found to be inversely related to bacterial compounds on floors and mattresses, but home cleanliness did not reduce microbial markers (only dust amount). Muramic acid exposure was associated with a lower rate of school-age asthma, and mattress endotoxin in the first year of life was inversely linked to atopic sensitization and asthma at school age. However, the development of allergies was not related to home and personal cleanliness despite the associations of dust with cleanliness and allergic health conditions. Bacterial exposure in house dust was a factor in the development of childhood allergic disorders and asthma, but neither personal nor home cleanliness was associated with an increased risk for these disorders.


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