Nerve Activity Can Predict Life Or Death for Comatose Patients
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Even when patients are unable to respond, physicians can get valuable information from nerves that can assist in determining whether the patient will live or die in nontraumatic comatose patients. Even in a comatose state, electrically induced nerve responses can be interpreted because the nerve responses are not affected by therapeutic muscular paralysis that occurs when sedatives are given at high dosage.
In a recent study, evoked nerve responses were studied to correlate the nerve activity with the liklihood of survival. Researchers studied forty-seven nontraumatic comatose adults. One hundred eighty-eight somatosensory evoked potential (SEP) measurements were taken from comatose patients within 5 days after they became comatose. Eight patients (17%) had bilateral loss of cortical SEPs from the scalp.
Despite long term intensive care unit (ICU) treatment, all eight of these patients died. Nerve activity in the scalp was present in a group of 39 patients. Of those 39, 14 patients (35.8%) survived and 25 patients died (64.1%). The study suggests that bilateral nerve response loss can predict the death of the patient. However, having some nerve response cannot predict whether the patient will live or die.
Diabetes linked to poor weight loss with surgery
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Obese individuals with diabetes lose less weight with gastric bypass surgery than do their peers without diabetes, researchers at the University of California, San Francisco, report.
With gastric bypass surgery, a small stomach pouch is created, which limits food intake by making the patient feel full sooner after eating than he or she otherwise would. In addition, a portion of bowel is connected to the stomach, effectively bypassing the first portion of the bowel where most food absorption occurs.
The new findings, which appear in the Archives of Surgery, also indicate that a bigger stomach pouch leads to inferior weight loss.
Older problem gamblers may face greater suicide risk than younger counterparts, study finds
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Compared to their younger counterparts, older problem gamblers who ask casinos to bar them from returning are three to four times more likely to do so because they fear they will kill themselves if they don’t stop betting, according to a new study.
Researchers Lia Nower, JD, PhD, of the Rutgers University Center for Gambling Studies, and Alex Blaszczynski, Ph.D. of the University of Sydney, Australia, looked at 1,601 self-described problem gamblers who asked between 2001 and 2003 to be banned from Missouri casinos. The results of their study were published in the September issue of Psychology and Aging, published by the American Psychological Association.
Older adults – over age 55 in this study—reported gambling an average of 17 years before “self-exclusion” – more than twice the length of time reported by younger adults. All participants were asked to cite the main reason or reasons why they sought to be barred from casinos. Younger, middle-aged and older adults all gave as the primary reasons gaining control, needing help and hitting rock bottom. However, nearly 14 percent of older adults surveyed – a higher proportion than any other group – indicated they sought help because they wanted to prevent themselves from committing suicide.
3-D MRI technique helps radiologists detect high-risk carotid disease
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Canadian researchers have used three-dimensional magnetic resonance imaging (3-D MRI) to accurately detect bleeding within the walls of diseased carotid arteries, a condition that may lead to a stroke. The results of the study published in the October issue of Radiology suggest the technique may prove to be a useful screening tool for patients at high risk for stroke.
When major arteries are affected by atherosclerosis, fatty deposits, or plaques, accumulate on the inner lining of the vessel walls. Progression of the disease over time leads to narrowing, restricting blood flow or becoming completely blocked.
Until recently, scientists believed that this narrowing, called stenosis, was responsible for most heart attacks or strokes. But new studies have identified the composition of complicated plaques as being a major cause of vascular events and deaths. These complicated plaques are characterized by surface ulcerations, blood clots and bleeding into the vessel wall.
Condom ring-tone a hit in India
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A ring-tone that sings “condom, condom, condom” has attracted over 270,000 downloads since its launch last month and has spread the message of safe sex to many more mobile phone users in India and abroad.
The innovative “Condom a Capella” ring-tone that has the word “condom” sung in many overlapping melodies is the work of an Indian duo, Rupert Fernandes and Vijay Prakash. The website http://www.condomcondom.org, where the ring-tone can be heard, has had over 2 million hits.
The campaign has been produced by the BBC World Service trust in India and aims to target the increasing number of India’s mobile phone users, presently estimated at over 250 million.
Obese have minimal heartbeat response to stress
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Contrary to their expectations, British researchers have found that when exposed to psychological stress, obese people show smaller changes in their heart rate compared with normal-weight individuals.
Dr. Douglas Carroll at the University of Birmingham, and colleagues there and at the University of Glasgow, examined the association between obesity and the magnitude of heart reactions to stress in 1,647 adults living in the community.
Blood pressure and heart rate were measured at rest and in response to psychological stress—performing mental math problems under a time deadline. Measurements were taken when the study began and 5 years later.
Say ‘goodbye’ to back fat rolls
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Even as many of us yearn to wear the sheer, body-hugging fashions available today, we are stopped by our rear reflection and the sight of dreaded back fat rolls and lumps. A study published in the October issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS), reveals a new back lift procedure that removes these unsightly bumps and bulges while hiding the scar under the bra line.
“For many patients—even the very fit ones, such as an aerobics instructor—the upper to mid-line back where the rolls and bulges form was very frustrating,” said senior author Joseph Hunstad, MD and ASPS Member Surgeon. “This redundancy of skin occurs generally from aging and cannot be exercised away. For those who desire to wear form-fitting outfits, this procedure eliminates the problem.”
The study reviewed seven female patients who had the bra-line back lift between 2001 and 2007 with an average follow-up of 22 months. Pre-operative marks were placed to outline the patient’s brassiere, as well as delineate the excess back tissue to be removed. The procedure removed the redundant skin, sometimes up to 8 or 10 inches wide, and connected the remaining tissue together. According to the study, the procedure takes about an hour from start to finish. The authors have completed the bra-line back lift on 20 patients to date.
Smoking during pregnancy can put mums and babies at risk
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Pregnant women who suffer from the high risk condition pre-eclampsia — which leads to the death of hundreds of babies every year — are putting the lives of their unborn children at significantly increased risk if they continue to smoke during pregnancy.
But experts at The University of Nottingham have also shown that if women give up smoking before or even during pregnancy they can significantly reduce these risks.
The study linking smoking and pre-eclampsia was carried out by the Genetics of Pre-Eclampsia Consortium (GOPEC) and was funded by the British Heart Foundation. The results have just been published in the journal Hypertension.
Violence against women impairs children’s health
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Violence against women in a family also has serious consequences for the children’s growth, health, and survival. Kajsa Åsling Monemi from Uppsala University has studied women and their children in Bangladesh and Nicaragua and shows, among other things, that children whose mothers are exposed to violence grow less and are sick more often than other children.
Kajsa Åsling Monemi, paediatrician, the Department of Women’s and Children’s Health, monitored more than 3,000 children in Bangladesh from the women’s pregnancy tests till when the children were two years old. The study shows that children to women exposed to some form of violence had lower birth weights and grew less as infants and toddlers. They also got sick more often than other children with diseases like diarrhea and pneumonia.
“Both in Bangladesh and Nicaragua deaths before the age of five were more common among children whose mothers had been exposed to violence than among children of women who had never been subjected to violence,” she reports.
A stronger future for the elderly
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Experts at The University of Nottingham are to investigate the effect of nutrients on muscle maintenance in the hope of determining better ways of keeping up our strength as we get old.
The researchers, based at the School of Graduate Entry Medicine and Health in Derby, want to know what sort of exercise we can take and what food we should eat to slow down the natural loss of skeletal muscle with ageing.
The team from the Department of Clinical Physiology, which has over 20 years experience in carrying out this type of metabolic study, need to recruit 16 healthy male volunteers in two specific age groups to help in it’s research.
Making snack food choices
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People who are asked whether they would choose between a “good” snack and a “bad” snack might not follow their intentions when the snacks arrive. In an article in the September/October 2008 issue of the Journal of Nutrition Education and Behavior, Dutch researchers found that there is a substantial inconsistency between healthful snack choice intentions and actual behavior.
Participants were asked about their intentions in choosing among four snacks: an apple, a banana, a candy bar and a molasses waffle. About half of the participants indicated they would choose the apple or banana—a “healthy” snack. But when presented, one week later, with the actual snacks, 27% switched to the candy bar or waffle. Over 90% of the unhealthy-choice participants stuck with their intentions and chose the unhealthy snack. The study included 585 participants who were office employees recruited in their worksite cafeterias.
Although intentions are often tightly linked to what people really do, it doesn’t always work that way. One explanation is that intentions are usually under cognitive control while actual choices are often made impulsively, even unconsciously.
Clinicians Debate Use of Arthroscopy in Patients with Osteoarthritis
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In a study published in the New England Journal of Medicine (NEJM) issue of Sept. 11, 2008, investigators concluded that arthroscopic surgery for osteoarthritis of the knee provides no additional benefit to optimized physical and medical therapy. In an accompanying editorial, however, Robert G. Marx, M.D., an associate attending orthopedic surgeon at Hospital for Special Surgery (HSS) in New York, points out that the study has some weaknesses and argues strongly that arthroscopy does have a role in some patients with osteoarthritis.
“Arthroscopy is still valuable and you have to know when to use it,” said Dr. Marx, who is also director of the Foster Center for Clinical Outcome Research at HSS. “While I do not recommend arthroscopy as a treatment for an arthritic knee, it can be extremely helpful for people with arthritis who also have a co-existing knee problem such as a meniscal tear or a loose piece of cartilage that is causing the majority of their symptoms.”
In the study reported in the NEJM, investigators randomized 92 individuals to arthroscopic surgery and 86 to non-operative treatment for osteoarthritis of the knee. The non-operative treatments included one physical therapy session per week for twelve weeks with a home physical therapy program, patient education, and the step-wise use of acetaminophen, non-steroidal anti-inflammatory drugs, glucosamine and an injection of hyaluronic acid. The study did not identify any benefit in the group that received surgery.
New marker for raised intracranial pressure
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Magnetic resonance imaging (MRI) measurements of the thickness of the optic nerve sheath are a good marker for raised intracranial pressure (ICP). New research published today in BioMed Central’s open access journal Critical Care shows that a retro-bulbar optic nerve sheath diameter (ONSD) above 5.82mm predicts raised ICP in 90% of cases.
The dural sheath surrounding the optic nerve communicates with the subarachnoid space and distends when ICP is elevated. Thomas Geeraerts, from Addenbrooke’s Hospital, Cambridge, led a team who investigated whether MRI can be used to precisely measure the diameter of the optic nerve and its sheath. He said, “Raised ICP is frequent in conditions such as stroke, liver failure and meningitis. It is associated with increased mortality and poor neurological outcomes. As a result, the early detection and treatment of raised ICP is critical, but often challenging. Our MRI-based technique provides a useful, non-invasive solution”.
The early detection of raised ICP can be very difficult when invasive devices are not available. As the authors report, “Clinical signs of raised ICP such as headache, vomiting and drowsiness are not specific and are often difficult to interpret. In sedated patients, clinical signs frequently appear well after the internal damage has been done. Optic nerve sheath distension could be an early, reactive and sensitive sign of raised ICP”.
Bleeding gums linked to heart disease
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Bad teeth, bleeding gums and poor dental hygiene can end up causing heart disease, scientists heard today (Thursday 11 September 2008) at the Society for General Microbiology’s Autumn meeting being held this week at Trinity College, Dublin.
People with poor dental hygiene and those who don’t brush their teeth regularly end up with bleeding gums, which provide an entry to the bloodstream for up to 700 different types of bacteria found in our mouths. This increases the risk of having a heart attack, according to microbiologists from the University of Bristol and the Royal College of Surgeons in Ireland.
“The mouth is probably the dirtiest place in the human body,” said Dr Steve Kerrigan from the Royal College of Surgeons in Dublin, Ireland. “If you have an open blood vessel from bleeding gums, bacteria will gain entry to your bloodstream. When bacteria get into the bloodstream they encounter tiny fragments called platelets that clot blood when you get a cut. By sticking to the platelets bacteria cause them to clot inside the blood vessel, partially blocking it. This prevents the blood flow back to the heart and we run the risk of suffering a heart attack.”
McCain and Obama on same side in US war on cancer
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If there is one war John McCain and Barack Obama agree on, it’s the one against cancer.
Thirty-seven years after President Richard Nixon launched the “war on cancer,” the two U.S. presidential candidates agree on a need to fight the disease that kills more than 560,000 Americans each year.
The close personal ties each candidate has to the disease ensures that cancer advocates will find support in the White House regardless who wins the Nov. 4 election.
McCain, the 72-year-old Republican presidential nominee, survived multiple skin cancers. Democratic nominee Barack Obama, 47, lost his grandfather to prostate cancer and watched his young mother die from ovarian cancer.
