Idea #244 for October 20th, 2009: Online Brain Fitness or Getting Seniors Online to Increase Brain Function

A key to keeping minds sharp through the later years might entail getting the elderly population online. In a study of 24 people with an average age of 66, researchers found that engaging in Internet searches, along with other online activity, was associated with increased brain function. Before and after the experiment, the subjects’ brains were scanned with fMRI, which shows blood flow and can be used to assess the activity of areas of the brain.

Half of the study group had little or no experience using the Internet, but with just two weeks practice, their brains were already showing increased activity in the frontal gyrus regions. Those areas are important in decision-making and memory. After the two-week period, the brain scans of the previously inexperienced users were similar to those of the control group, whose subjects were Internet savvy. The findings hold promise that one way to preserve brain function in elderly populations is through something as simple as casual web browsing. Pending more research, it would be a low-cost way of keeping aging minds healthy.

Read more about the study here.

 

Idea #243 for October 19th, 2009: Acing The Exam or Training Residents in Skin Cancer Detection

Among Americans between ages 15-30, the second most common type of cancer is melanoma. Yet not enough medical residents have been adequately trained in detecting the disease, a survey has found. About 75% of residents surveyed had never received training in skin cancer examination. Further, 55% never even observed a skin cancer examination, while only about 16% claimed considered themselves skilled in the examination.

The study also found that when residents performed even just one skin cancer examination each year of their residency, their skills markedly improved. These examinations are important because data show that patients with melanomas that are detected by doctors (rather than patients themselves) have better prognoses, yet only a quarter of the cases are doctor-detected. Two-thirds of melanoma patients have seen a doctor within the year prior to diagnosis. So if more residents are given even basic training on skin cancer examinations, the frequency of detection during routine office visits should increase, and more cases of melanoma can be avoided.

Read more about the study here.

Idea #242 for October 18th, 2009: Big Bucks or The Cost of Antibiotic Resistant Infections

The dire effects that antibiotic resistance can have on public health have been covered in this blog in the past, but there’s another consequence that is a little fuzzier. The economic impact of antibiotic resistance is difficult to pin down, but researchers have come up with an estimate at one Chicago hospital. The cost: $18,000 to $29,000 per infected patient.

The study looked at data from over 1,000 patients at Cook County Hospital in Chicago and found that patients who had antibiotic resistant infections spent on average 6-13 extra days in the hospital. They estimate that the patients and their families were on the hook for an additional $10-15 million in total, for the cost of treating the infections. Also, they found that the death rate for those patients was 6.5%, which is twice that of other patients.

The authors also extrapolated the costs to estimate what the entire nation is spending to treat antibiotic resistant infections. The number is somewhere between $16-26 billion annually, they say. And that’s a conservative estimate. Further, the authors point out that reducing the incidence of these infections by just 20% would save the nation $3-5 billion a year. We have to keep those numbers in mind when we’re developing ways to fight the problem. If a solution costs us a few billion dollars, politicians and the public will balk, but the cost of doing nothing is far greater, both in money and in our health.

Read more about the study here.

Idea #241 for October 17th, 2009: Playing Fair or Disparities in Children ER Visits For Chest Pain

A study in a Cincinnati hospital found a disparity in treatment along racial lines when children are admitted for chest pain. The data come from over 800 ER visits by children over several years at Cincinnati Children’s Hospital Medical Center. Researchers found that black children were less likely to receive tests following complaints of chest pain than white children. Similarly, children without private insurance were less likely to receive tests.

The study showed that 71% of white children admitted were given either an EKG, chest X-ray, or CBC as follow-up tests, while only 59% of black children were given the same tests. Also, 75% of children on private insurance received one of those tests, but only 59% of children on public insurance like Medicaid got the same. The data certainly suggest something is amiss. It should also be pointed out that the number of tests ordered is not indicative of the quality of care given, and other factors may be at play too. However, if there is a race or class element to this, it is something that will have to be addressed not only in this Cincinnati hospital, but everywhere else it exists too.

http://health.usnews.com/articles/health/healthday/2009/10/16/race-insurance-may-affect-testing-of-kids-in-er.html

Idea #240 for October 16th, 2009: An Endless Battle or Keeping Antibiotic Resistance Under Control

Antibiotic resistance is a huge concern in healthcare, with strains of bacteria like MRSA especially troublesome. Despite our efforts, we cannot expect the issue of antibiotic resistance to ever go away completely. Instead, we have to consider ways to lessen its effect, says a new report. The American Academy of Microbiology report makes the point that we can’t expect to win a battle against trillions of microbes and the forces of evolution, but we can employ better ways of managing the inevitable.

The report outlines several suggestions that can reduce the threat of antibiotic resistance. For one, if we have better diagnostic tools available, patients can be treated more promptly with the correct antibiotics, reducing the amount of mis-prescribed medications. The scientists recommend more comprehensive surveillance to ensure we have accurate data on the spread of resistant bacteria. They also want more research into the role that ubiquitous antimicrobial agents found in household products like soap are playing in the rise of resistant strains. And they believe that more time and resources be spent trying to develop new antibiotics that will keep us one step ahead of the bacteria. These methods won’t solve the problem of antibiotic resistance, but they could give us our best chance of keeping it under control.

Read the report from the American Academy of Microbiology here.

Idea #239 for October 15th, 2009: Hit Me With Your Best Shot or Allergies Shouldn’t Stand In The Way Of Immunizations

Before receiving immunization or vaccine shots, patients are asked about previous adverse reactions to shots. But past reactions should not necessarily prevent patients from receiving shots in the future. New guidelines published in “Annals of Allergy, Asthma & Immunology” say that local, injection site reactions and symptoms like fever are actually common following vaccinations and should not force most people to avoid subsequent vaccinations.

Serious adverse reactions to vaccines are very rare. Anaphylaxis occurs in only about 0.0001% of the 235 million patients who are vaccinated annually. The vast majority of reactions fall outside that group, and evidence suggests that steps can be taken to avoid those reactions. Most reactions are not to the active ingredient of the vaccine, but instead to other ingredients like egg protein, gelatin, or even latex.

People with egg or gelatin allergies should be evaluated by an allergist before receiving shots, but should not skip shots altogether. The same goes for patients who are allergic to latex. Avoiding shots because of minor adverse reactions can create bigger headaches down the line if the patient ends up contracting influenza, measles, or any other disease that should be prevented with vaccines or immunizations.

Read the story about this in US News.

Idea #238 for October 14th, 2009: Working Past 65 or Post-Retirement Work Makes For Healthier Lives

Seniors who keep at least a part-time job during their retirement age will not only have better financial standing, but also tend to have fewer health problems. In a study of over 12,000 people nearing retirement age, researchers found that people who maintained a part-time role during their transition into retirement had fewer diseases and better mental health than those who were totally retired.

Researchers speculate that the reason continued employment makes for healthier lives is related to the ongoing physical and mental tasks that the jobs demand. The constant social contact and activities associated with work help keep minds sharp, they believe. The one caveat is that people who worked part-time after retirement, but in a different job than they had previously worked, did not enjoy the same health benefits as those who maintained the same or similar job. The stress of switching jobs and learning the ropes may be responsible. Regardless, it makes sense financially and health-wise for people nearing retirement to consider a transition phase in which they reduce their workload before diving into full-fledged retirement.

Read about this study here.

Idea #237 for October 13th, 2009: Dirty Needles or The Case of The Contaminated Syringes

In late 2007, there were over 150 cases of bloodstream infections from the bacterium S. marcescens in nine different states. The culprit was contaminated syringes pre-filled with heparin and saline, produced by a company operating in violation of safety guidelines. The failures that led to the contamination and the difficulty in tracking down the parties responsible have caused some to rethink the ways these kinds medical products should be tracked.

After determining the source of the outbreak, agents discovered that proper protocol consistent with the FDA’s Good Manufacturing Practices was not being followed, which led to the contamination. But an even bigger problem was the difficulty in identifying the source. The syringes themselves did not have the manufacturer’s name on them, but names of subsidiaries instead. Further complicating the matter was the large number of middlemen that stand between the manufacturer and healthcare providers. The FDA should devise rules to ensure that manufacturers of medical supplies can be easily identified during a crisis like this, when time is critical. It may take more funding or staff, but it’s essential that sources of outbreaks be uncovered promptly in the future.

Read more about this story in the Atlanta Journal Constitution.

Idea #236 for October 12th, 2009: Shooting Up or Vaccine For Cocaine Addiction

A promising new development suggests that in the future, options for treating cocaine addiction will include not only therapy and counseling, but vaccines too. Vaccines are usually thought of as defensive measures against infectious diseases like influenza, but research shows that an anti-cocaine vaccine can also prove effective. It works in a similar way to conventional vaccines: the immune system is coaxed into producing antibodies against a foreign agents. In this case, the immune system attacks cocaine molecules in the blood and prevents them from getting to the brain, thus blocking the effect of the drug.

In a study, over 100 patients were given the vaccine in a series of five shots over 12 weeks. Afterward, thirty-eight percent of them had high enough levels of antibodies to block the effects of cocaine. Those with the highest antibody levels were more likely to stop using cocaine than others. The results are remarkable because it is the first time a vaccine has been shown to stop the use of illicit drugs. It could potentially work as a new way to treat addicts and pave the way for vaccines to be used for other addictive drugs.

Read more about the research here.

Idea #235 for October 11th, 2009: Dial “N” for Nicotine or New Telephone Therapy Helps Teens Quit Smoking

New research suggests that an effective way to help teens quit smoking involves counseling over the phone. In a study involving 2,000 high school students in Washington, teens who received motivational and cognitive behavioral skills training telephone counseling fared better than those in the control group. Ten percent of teens who were daily smokers quit for a period of at least six months (a year after beginning the program), while that rate was six percent for the control group.

For the teen smokers, the methods used over the phone included help with anticipating and dealing with stress, identifying the need to quit, and making plans to quit. The telephone intervention showed evidence of being successful within just 7 days for some subjects. Such methods may make more sense than prescribing anti-smoking medications to teens, and phone counseling is more convenient than visits to a psychologist. Still, only ten percent of the smokers in the study quit within a year. But any ground gained in the fight against teen smoking is a major victory in preventing smoking-related ailments in the future.

For more, read this article about the subject.