U.S. names healthcare spending strategy advisers
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The Health and Human Services Department named a panel of 15 experts on Thursday to advise the government on how to spend $1.1 billion set aside to study which medical treatments work best.
The effort is part of President Barack Obama’s plan to cut excess spending from the U.S. health system.
Experts on the panel include officials at the National Institutes of Health and the Department of Veterans Affairs.
The $787 billion stimulus package passed in February provides $300 million for the Agency for Healthcare Research and Quality, $400 million for the National Institutes of Health, and $400 million for HHS to support comparative effectiveness research.
ACL surgery an option for active older adults
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Active older adults no longer have to settle for a wobbly knee after injuring their anterior cruciate ligament (ACL), according to a new article in the Mayo Clinic Health Letter.
The ACL is the key ligament stabilizing the knee, and is especially important for holding the joint steady during jumping, pivoting and twisting. When a person ruptures the ACL—an injury typically accompanied by a loud popping sound and severe pain—it can be repaired using a piece of tendon from the leg or from a cadaver.
However, until fairly recently, ACL repair hadn’t been considered an option for people over 50, or even in some cases people in their 40s, according to the Health Letter article. Instead, these individuals would undergo physical therapy to restore strength and balance. Non-surgical treatment can improve knee function, but it doesn’t completely restore knee stability, so older patients had to curtail their activity levels.
Pilot study shows effectiveness of new, low-cost method for monitoring hand hygiene compliance
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Epidemiologists and computer scientists at the University of Iowa have collaborated to create a new low-cost, green technology for automatically tracking the use of hand hygiene dispensers before healthcare workers enter and after they exit patient rooms. This novel method of monitoring hand hygiene compliance, which is essential for infection control in hospitals, was released today at the annual meeting of the Society for Healthcare Epidemiology of America (SHEA).
“We know that a range of pathogens are spread from healthcare workers to patients by direct touch and that the current rates of hand hygiene compliance are suboptimal,” said Philip Polgreen, MD, University of Iowa Health Care. “Our new low-cost method of monitoring could potentially reduce cost while increasing compliance rates.” The failure of healthcare workers to perform appropriate hand hygiene is one of the leading preventable causes of healthcare-associated infections.
This new technology marks a major shift from the current method of monitoring hand hygiene compliance that involves direct human observation, which is both costly and labor intensive. With human observation there is also the potential for a “Hawthorne Effect,” which means workers will only clean their hands when being actively observed. Older automated monitoring technology, called radio-frequency identification (RFID) infrastructure, is available, but can be prohibitively costly and consumes far more power than Polgreen’s method.
aking Simple Precautions While Working and Playing Outdoors Can Help Prevent Neurological Injuries
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As warm weather approaches, many people are eager to get back to outdoor activities and projects, such as gardening, home improvement, and workshop activities. But according to the American Association of Neurological Surgeons (AANS), many of these activities actually send thousands of people to U.S. hospital emergency rooms every year. The U.S. Consumer Product Safety Commission (CPSC) tracks product-related injuries through its National Electronic Injury Surveillance System (NEISS).
Every year, an estimated 1.5 million people are treated in U.S. hospital emergency rooms for head injuries and nearly 12,000 are treated for neck fractures. Thousands of these injuries are tied to sports and recreational activities. Not so obvious, however, is that common and often seemingly harmless products found in backyards, gardens, garages, and home workshops also contribute to these injuries.
A few true-life cases reported by the CPSC:
Pathologists Pioneer Biomarker Test to Diagnose or Rule Out Alzheimer’s Disease
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A test capable of confirming or ruling out Alzheimer’s disease has been validated and standardized by researchers at the University of Pennsylvania School of Medicine. By measuring cerebrospinal fluid (CSF) concentrations of two of the disease’s biochemical hallmarks – amyloid beta42 peptide and tau protein – the test also predicted whether a person’s mild cognitive impairment would convert to Alzheimer’s disease over time. Researchers were able to detect this devastating disease at the earliest stages, before dementia symptoms appeared and widespread irreversible damage occurred. The findings hold promise in the search for effective pharmaceutical therapies capable of halting the disease.
Homing in on a previously suggested pathological CSF biomarker signature, a team of Penn Medicine researchers, led by Leslie M. Shaw, PhD, Co-Director of the Penn Alzheimer’s Disease Neuroimaging Initiative (ADNI) Biomarker Core, found evidence of neuron degeneration – marked by an increase in CSF concentration of tau proteins – and plaque deposition, indicated by a decrease in amyloid beta42 concentration. In addition, people with two copies of the genetic risk factor for Alzheimer’s disease, APOE ε4 , had the lowest concentrations of amyloid beta42, compared to those with one or no copies. The study appears in the online edition of the Annals of Neurology.
“With this test, we can reliably detect and track the progression of Alzheimer’s disease,” said Dr. Shaw. “Validated biomarker tests will improve the focus of Alzheimer’s clinical trials, enrolling patients at earlier stages of the disease to find treatments that can at least delay –and perhaps stop– neurodegeneration. In addition, prevention trials can test methods to delay or block mild cognitive impairment from converting to full-blown Alzheimer’s.”
First sister study results reinforce the importance of healthy living
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Women who maintain a healthy weight and who have lower perceived stress may be less likely to have chromosome changes associated with aging than obese and stressed women, according to a pilot study that was part of the Sister Study. The long-term Sister Study is looking at the environmental and genetic characteristics of women whose sister had breast cancer to identify factors associated with developing breast cancer. This early pilot used baseline questionnaires and samples provided by participants when they joined the Sister Study.
Two recent papers published in Cancer Epidemiology Biomarkers and Prevention looked at the length of telomeres, or the repeating DNA sequences that cap the ends of a person’s chromosomes. Telomere length is one of the many measures being looked at in the Sister Study. Telomeres protect the ends of chromosomes and buffer them against the loss of important genes during cell replication. Over the course of an individual’s lifetime, telomeres shorten, gradually becoming so short that they can trigger cell death. The papers show that factors such as obesity and perceived stress may shorten telomeres and accelerate the aging process.
“Together these two studies reinforce the need to start a healthy lifestyle early and maintain it,” said Linda Birnbaum, Ph.D., the director of the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health. The researchers who published these papers are from the NIEHS which sponsors the Sister Study.
Waking up dormant HIV
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HAART (highly active anti-retroviral therapy) has emerged as an extremely effective HIV treatment that keeps virus levels almost undetectable; however, HAART can never truly eradicate the virus as some HIV always remains dormant in cells. But, a chemical called suberoylanilide hydroxamic acid (SAHA), recently approved as a leukemia drug, has now been shown to ‘turn on’ latent HIV, making it an attractive candidate to weed out the hidden virus that HAART misses.
Matija Peterlin at UCSF and colleagues had previously identified another chemical called HMBA that could activate latent HIV, but the risk of several toxic side effects made HMBA clinically non-viable. However, the chemically similar SAHA had received FDA approval, making it a potentially safer alternate.
Facemasks may help shield the heart from pollution
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Heavy air pollution can have immediate effects on the heart and blood vessels, but a simple facemask may offer some protection, new research suggests.
In one study, researchers found that when young men were exposed to air polluted with diesel exhaust, their arteries temporarily stiffened.
Meanwhile, a second study showed that healthy adults had higher blood pressure and a less healthy heart-rate pattern when they walked through the streets of Beijing without a facemask.
Early pacifier use linked to shorter breastfeeding
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Mothers who want to breastfeed their baby successfully may want to hold off on giving their infant a pacifier, new research from Denmark shows.
Drs. Hanne Kronborg and Michael Vaeth of the University of Aarhus found that women who gave their infant a pacifier in the first weeks of life were less likely to continue breastfeeding their babies.
In Denmark, registered nurses visit newborns and their families soon after the baby is discharged from the hospital. To investigate whether early breastfeeding technique and pacifier use might affect breastfeeding success, the researchers had health visitors specially trained in breastfeeding counseling visit 570 mother-baby pairs.
Ovarian changes may link obesity and infertility
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Obese women have alterations in the environment around the ovary before they ovulate that appear to play a role in the well-documented association between obesity and reduced fertility, according to a report in the Journal of Clinical Endocrinology and Metabolism.
“Characteristics of eggs are influenced by the environment in which they develop within the ovary,” lead author Dr. Rebecca Robker, from Adelaide University, Australia, said in a statement. “Our study found that obese women have abnormally high levels of fats and inflammation in the fluid surrounding their eggs, which can impact an egg’s developmental potential.”
Stigma worse for “gender-typical” mentally ill
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How we feel towards a mentally ill person has a lot to do with how closely that person’s symptoms hew to gender stereotypes, new research shows.
People “don’t have much sympathy” for someone with more stereotypical problems, specifically a woman with major depression or an alcoholic man, Dr. Galen V. Bodenhausen of Northwestern University in Chicago explained in an interview. But when a person’s symptoms are out of line with these stereotypes—say, an alcoholic woman or a depressed man—we will view them more positively, and want to help them, he said.
Stereotypes of the mentally ill fall into two categories: “violence/dangerousness” or “dependency/incompetence,” Bodenhausen and Dr. James H. Wirth of Purdue University in West Lafayette, Indiana note. Men are more likely to be seen as violent, while women are typically seen as dependent.
A new measure for the malignancy of melanoma
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Every tumor, starting from a size of a few millimeters, depends on a supply of nutrients and oxygen. Therefore, using special growth factors, it induces vascular wall cells of neighboring blood vessels to sprout new capillaries in order to get connected to the blood circulation.
This process called angiogenesis involves a number of different growth factors and their respective receptors on the vascular wall cells. The departments of Prof. Dr. Hellmut Augustin and Prof. Dirk Schadendorf of DKFZ and Mannheim Medical Faculty of the University of Heidelberg have investigated the role of a growth factor called angiopoietin-2 (Ang2) in malignant melanoma. The docking station of Ang2 is the receptor Tie2 on the surface of endothelial cells, which form the inner lining of blood vessels. Together with other signaling molecules, Ang2 induces sprouting of endothelial cells and the formation of new capillaries.
When measuring the Ang2 concentrations in blood samples of melanoma patients, the investigators discovered that larger tumors and more advanced disease stages correlate with high levels of Ang2. If one tracks the Ang2 levels of individual patients over time, a rise parallel to disease progression can be observed. In contrast, patients who have lived with the disease for a long time, i.e., whose disease is not or only slightly progressive, have lower Ang2 levels. The scientists found out that Ang2 concentration in blood serum is a more precise indicator of the progression and stage of the disease than previously used biomarkers.
Studying the female form
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Researchers in Japan have turned to mathematics to build a computerized 3D model of the female trunk that could help lingerie and other clothes designers make more sensuous, comfortable, and better fitting product ranges.
According to Kensuke Nakamura of Kyoto Institute of Technology and Takao Kurokawa of Osaka University, identifying body shape components is critical for designing close-fitting products, whether underwear, everyday clothes, or safety garments.
However, conventional body measurements, photographic images, and silhouette do not provide complete three-dimensional data with which modern designers could work to improve their products and tailor specific ranges to particular body shapes. The study might also have implications for research into body image disorders and ergonomics.
Need for control drives assisted suicide seekers
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People who request a doctor’s help in dying are doing so out of a desire to remain independent and in control, new research from Oregon shows.
At the time the study was done, Oregon was the only state in the US where physician-assisted suicide was legal; Washington state has since passed a nearly identical law, Dr. Linda Ganzini of Oregon Health & Science University noted in an interview with Reuters Health.
When Oregon passed its law in 1994, Ganzini added, the perception had been that people seeking help in dying would be vulnerable minority women without access to good end-of-life care. But these findings show that the real story is quite different, she said; “these are overwhelmingly white, well-educated, economically advantaged people who have a strong need to be in control.”
Congress moves as stem cell limits lifted
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President Barack Obama signed an order lifting eight years of restrictions on federal funding of human embryonic stem cell research on Monday as scientists gushed, activists cheered and shares in stem cell companies rose.
Members of Congress and executives at the National Institutes of Health said they would act swiftly to turn the new policy into law and into cash for laboratories.
Obama’s executive order reversed and repudiated restrictions placed on the research by his predecessor, George W. Bush, freeing labs across the country to start working with the valued cells, which give birth to all cells and tissues in the body.
