Prepared Patient: Seeking a Second …or Third …Opinion
|
|
Is it OK to seek a second (or a third, or a fourth) opinion on your diagnosis? Many people feel uncomfortable with the idea that they are questioning the authority or expertise of their physician. Some fear that they will receive worse care if they appear to be pushy or difficult patients. Gathering multiple opinions on your medical condition can be one of the most emotionally fraught decisions that a patient has to make.
When Chip Wells visited a hematologist after learning he had leukemia, the doctor’s attitude struck him as more cavalier than low-key. Wells asked him to recommend another specialist although it wasn’t an easy request to make.
But patients do have to make this decision. Research confirms what most people already feel in their gut: not all doctors are alike. Physicians vary in how they were trained, what they specialize in and where they practice. A decade-long Dartmouth project has documented significant differences in treatment between regions of the country. Major studies suggest that doctors deliver the best, evidence-backed care only half of the time. And it’s a rare medical condition that responds to only one treatment or therapy.
Type 1 diabetic youth often overweight: study
|
|
Children and youth with type 1 diabetes are more likely to be overweight than their counterparts without type 1 diabetes, researchers have found.
Ties between type 2 diabetes and excess weight are well documented, but are less clear in type 1 diabetes, which affects less than 10% of people with diabetes but is more common in children and young people, the researchers explain.
“Traditional teaching in the past has been that youth with type 1 diabetes often present at diagnosis having lost weight or underweight,” Dr. Lenna L. Liu, from Seattle Children’s Hospital Research Institute told Reuters Health. “However, with the rise in childhood obesity, even some youth with type 1 diabetes may be overweight at diagnosis and/or afterwards.”
Doctors probed by state in Michael Jackson’s death
|
|
California’s attorney general said on Wednesday his office has run several doctors’ names and several potential aliases through its prescription drug database to aid police investigating the death of Michael Jackson.
Attorney General Jerry Brown said his office was not the lead agency in probing Jackson’s sudden death—a role it took in the fatal overdose of Playboy model Anna Nicole Smith in 2007—but was assisting other agencies as they try to track down prescription drugs that may have killed the King of Pop.
“We’ve found some things, but this is early on” to provide details, Brown told Reuters.
Kids up to age 12 at risk of car-crash spine injury
|
|
Children younger than 12 are at heightened risk of suffering a spinal injury during a car accident—possibly because standard seat belts often do not fit them properly, researchers report.
In a study of children treated for car accident injuries at two Australian hospitals, researchers found that those younger than 12 were seven times more likely than their older counterparts to sustain a serious spine injury. [abs]
All of the 72 children and teenagers in the study had been restrained at the time of the accident. The higher spine-injury risk before age 12 “may reflect the adequacy of seat belt fit,” the researchers report in the Archives of Disease in Childhood.
Most take news of genetic Alzheimer’s risk well
|
|
Adult children who have a parent with Alzheimer’s disease may want to know if they carry a gene that raises their risk of getting the mind-robbing disease. But can they handle the test result, psychologically? Findings from a study released today hint that most can handle the information.
The e4 version of the apolipoprotein E (APOE) gene is associated with an increased risk of Alzheimer’s disease, as well as impaired memory in people without dementia and with progression to Alzheimer’s disease in people with mild thinking impairment.
In the REVEAL study, researchers found that disclosing APOE test results to adult children of patients with Alzheimer’s disease “did not result in significant short-term psychological risks.”
Muscle, bone problems more common in heavy kids
|
|
Overweight and obese children have more aches and pains in their muscles and bones than their normal-weight peers, Dutch researchers report.
Such musculoskeletal problems may lead normal-weight kids to be less active and put on weight, while such problems can make it more difficult for heavy kids to exercise to trim down, Dr. Marjolein Krul of Erasmus University Medical Center in Rotterdam and her colleagues suggest. “We hypothesize that a vicious circle results wherein being overweight, musculoskeletal problems, and a low fitness level reinforce each other,” they write.
In adults, being overweight or obese is known to contribute to musculoskeletal problems, especially in the legs and feet, Krul and her team note in the Annals of Family Medicine, but less is known about how excess weight might affect children’s muscles and bones.
Bottle-feeding moms lack info, may overfeed kids
|
|
Many moms who bottle-feed lack important information on how to feed their infants safely, which could lead to overfeeding and heavy kids, new research from the UK shows
Formula-fed kids are more likely to be too heavy, Dr. Rajalakshmi Lakshman of the University of Cambridge, a researcher on the study, told Reuters Health, so she and her colleagues set out to investigate why.
They reviewed 23 studies involving 13,263 people. What they found surprised them, the researcher said. Many mothers who used formula felt “guilt, anger, worry, uncertainty and a sense of failure,” she and her colleagues note in the Archives of Diseases in Childhood.
Weak Support for Workplace Hearing Loss Programs
|
|
A new review of existing research says there is little evidence to support mandatory hearing-loss prevention programs at the workplace.
Workers could simply wear earplugs and other devices that protect hearing, but even those are not always effective, the review authors found.
In the big picture, “We still rely too much on hearing protection, which is not sufficient,” said review lead author Jos Verbeek, a researcher at the Finnish Institute of Occupational Health in Kuopio, Finland.
Study Continues to Refine Most Effective Methods to Predict Alzheimer’s Disease
|
|
A new Mayo Clinic study found that the clinical criteria for mild cognitive impairment is better at predicting who will develop Alzheimer’s disease than a single memory test. This is one more piece of information to aid in the identification and early treatment of individuals most likely to develop Alzheimer’s disease. This study will be presented at the Alzheimer’s Association International Conference on Alzheimer’s Disease on July 14 in Vienna.
Alzheimer’s disease is a degenerative disorder of the brain in which nerve cells die over time, resulting in a steady loss of memory and other thinking abilities. An estimated 5.3 million Americans are living with Alzheimer’s disease, and it is the sixth-leading cause of death in the U.S. Mild cognitive impairment is a transitional state between normal aging and the earliest features of Alzheimer’s disease.
“The goal of this research is to try to predict who is going to develop Alzheimer’s disease in the future,” says Ronald Petersen, M.D., Ph.D., a neurologist at Mayo Clinic and the lead author of this study. “Ideally, we’d like to identify individuals before any damage is done in the brain. The sooner we intervene on this process with medications or other therapies, the greater impact we can have on lessening the number of people who will ultimately develop Alzheimer’s disease.”
Scientist First to Characterize Novel Syndrome of Allergy, Apraxia, Malabsorption
|
|
A landmark study conducted by Children’s Hospital & Research Center Oakland is the first to reveal a new syndrome in children that presents with a combination of allergy, apraxia and malabsorption. Autism spectrum disorders were variably present. Verbal apraxia has until now been understood to be a neurologically based speech disorder, although hints of other neurological soft signs have been described. The new study, led by Children’s Hospital & Research Center Oakland scientist and pediatric emergency medicine physician, Claudia Morris, MD, and Marilyn C. Agin, MD, a neurodevelopmental pediatrician at Saint Vincent Medical Center in New York, however, suggests that the symptoms of verbal apraxia are, at least for a sub-group of children, part of a larger, multifactorial, neurologic syndrome involving food allergies/gluten-sensitivity and nutritional malabsorption.
“While it is critical to treat verbal apraxia symptoms that often include severe delays in expressive speech production with speech therapy, we need to start asking why these kids are having these problems in the first place so that we can identify mechanisms we can actually target to treat the cause of the symptoms,” says Dr. Morris.
Published in the July/August issue of Alternative Therapies in Health and Medicine, the new study takes a major step toward identifying the potential mechanisms that may contribute to apraxia symptoms. In the study, Dr. Morris collected information from nearly 200 families with children who suffered from verbal apraxia in order to better characterize the symptoms and metabolic anomalies of a subset of children.
New tests may help spot early-stage Alzheimer’s
|
|
New tests assessing brain changes and body chemistry are showing promise at diagnosing Alzheimer’s disease in its earliest stages, aiding the search for new drugs, researchers said on Tuesday.
In one study, Irish researchers found scans measuring brain volume and a combination of memory tests accurately identified nearly 95 percent of people who had progressed from mild cognitive impairment to early Alzheimer’s disease.
In another study, U.S. researchers found that a type of brain scan that measures glucose combined with low scores on memory tests was a strong predictor of disease progression.
Recession Stressful for Many Kids, Toughest on Poor and Uninsured
|
|
As the economy continues to falter, a poll released today shows that parents must make harder choices about how to spend what money they have, and children – especially those who are uninsured or who are among the lowest income bracket - are more at risk because of it.
The C.S. Mott Children’s Hospital National Poll on Children’s Health taken in May 2009 shows 44 percent of families’ financial situations have worsened in the last six months. To make ends meet, many have cut back on extras (65 percent), applied for government health coverage (24 percent), applied for free or reduced lunch programs (27 percent), and delayed taking their children to the doctor (11 percent) or dentist (16 percent).
“In particular, we found that if a family’s financial situation had worsened over the last 6 months and their children were uninsured, 40 percent of those parents had delayed taking their children to the doctor,” says Matthew Davis, M.D., director of the poll. “This is a particularly concerning statistic when we consider that some of these kids whose care is being delayed may be particularly vulnerable or at risk for serious health problems.”
Study finds citrus-derived flavonoid prevents obesity
|
|
A flavonoid derived from citrus fruit has shown tremendous promise for preventing weight gain and other signs of metabolic syndrome which can lead to Type 2 Diabetes and increased risk of cardiovascular disease. The study, led by Murray Huff of the Robarts Research Institute at The University of Western Ontario looked at a flavonoid (plant-based bioactive molecule) called naringenin. The findings are published online in the journal Diabetes.
In the study one group of mice was fed a high-fat (western) diet to induce the symptoms of metabolic syndrome. A second group was fed the exact same diet and treated with naringenin. Naringenin corrected the elevations in triglyceride and cholesterol, prevented the development of insulin resistance and completely normalized glucose metabolism. The researchers found it worked by genetically reprogramming the liver to burn up excess fat, rather than store it.
“Furthermore, the marked obesity that develops in these mice was completely prevented by naringenin,” says Huff, Director of the Vascular Biology Research Group at Robarts and Professor of Medicine and Biochemistry at the Schulich School of Medicine & Dentistry.
Swiss group agrees on rules for assisted suicide
|
|
Swiss right-to-die group Exit has agreed to rules to govern the practice of assisted suicide with prosecutors in the city of Zurich that it hopes might eventually form the basis of national regulation, they said on Friday.
The rules include that assisted suicide is only allowed for those in serious suffering due to health problems, accident or disability; all other options must be exhausted and only a deadly dose of anaesthetic sodium pentobarbital can be used.
The deal, which was signed on Tuesday, said Exit was not allowed to make a profit from helping people die and can charge a maximum of 500 Swiss francs ($461) per assisted suicide.
Lawmakers reject tax to pay for health reform
|
|
U.S. lawmakers on Sunday criticized a plan to raise taxes on the wealthy to pay for a $1 trillion healthcare overhaul and warned Congress was unlikely to meet President Barack Obama’s goal of passing the measure by August.
Republican Senator Judd Gregg said finishing a healthcare bill by Congress’ August recess was “highly unlikely” because the Senate Finance Committee had not yet completed a draft. Senator John Kyl, the Republican whip, said there was “no chance” it would be done before the break.
“President Obama was right about one thing. He said if it’s not done quickly, it won’t be done at all. Why did he say that? Because the longer it hangs out there, the more the American people are skeptical, anxious and even in opposition to it,” Kyl told ABC’s “This Week” program.
