A new study from Johns Hopkins shows that there is little benefit to imaging patients’ backs before treating their pain with an epidural steroid injection.

MRIs are routine before the injections, the most common procedure performed at the nation’s pain clinics, but they do little more than add time and money to treatment, the study suggested.

“If we’re trying to cut back on unnecessary medical costs, we should stop routinely doing MRIs on almost everyone who comes to us needing [such injections],” said study leader Dr. Steven P. Cohen, an associate professor of anesthesiology and critical care medicine at the Hopkins School of Medicine, said in a statement.

The study, published in the Archives of Internal Medicine, found MRIs do not generally avert procedures, lower risks or improve outcomes -- the injections are a short-term fix and don’t work on everyone. And an MRI costs roughly $1,500.

Cohen studied patients being treated for sciatica at pain clinics around the country. With the condition, a nerve at the bottom of the spinal column is pinched and the patient has severe pain and tingling in the lower back and down the leg. Injections reduce inflammation near the source of the pain.

One group had images to help inform the treatment, and the other group was treated based on a physical exam and a description of the pain. The treatment barely varied between the groups, probably because there isn’t always a connection between an abnormal MRI finding and symptoms. And after three months, the patients reported no difference in how they felt.

Posted by Meredith Cohn at 4:05 PM | Permalink | Comments (0)
Categories: Business of health, Medical studies
        

The thousands of people waiting for a new kidney may find hope in a new study that finds older people can safely donate the organs.

Johns Hopkins doctors found that kidney transplants performed using organs from live donors over the age of 70 are safe for the donors and help save lives of those who recieve them.

Although the study found that kidneys from older donors were more likely to fail within ten years of transplant when compared with kidneys from donors ages 50 to 59, patients who received older donated kidneys were no more likely to die within a decade of transplantation than those whose kidney donors were between 50 and 59.

 “A lot of people come up to me and say, ‘I wish I could donate a kidney, but I’m too old’,” Dr. Dorry Segev, an associate professor of surgery at the Johns Hopkins University School of Medicine. “What our study says is that if you’re in good health and you’re over 70, you’re not too old to donate a kidney to your child, your spouse, your friend, anybody.”

Segev acknowledged that “it’s better if you have a younger donor. But not everyone has a younger donor. And an older live donor is better than no live donor at all.”

The research looked at records from 219 living people over age 70 who donated a kidney in the United States between 1990 and 2010. The team matched those donors with healthy people in the same age group and found that the donors actually lived longer than those who had both of their kidneys.

More than 90,000 patients are on the waiting list for kidneys from deceased donors in the United States, and many die waiting for an organ to become available. In some parts of the country, the wait for a kidney can be as long as 10 years, and those who can often turn to living donors, both relatives and friends, to ask for organs.

People can function normally with one working kidney.

Posted by Andrea Walker at 7:00 AM | Permalink | Comments (1)
Categories: Medical studies
        

Headaches are one big reason that troops in Iraq and Afghanistan are medically evacuated, and because they only about a third return to duty in those countries, it’s depleting active-duty ranks. This is according to a new study lead by Dr. Steven P. Cohen, an associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine and a colonel in the U.S. Army Reserves.

“Everyone gets headaches, and there are generally physical or psychological stressors that contribute to them,” he said in a statement. “War amplifies all stressors, which may be why headaches take such a great toll in soldiers overseas.”

For the study, published online in Cephalalgia, the journal of the International Headache Society, Cohen and other researchers looked at the medical records of all 985 military personnel medically evacuated from Iraq and Afghanistan between 2004 and 2009 with a primary diagnosis of headache.

In general, neurological illnesses such as headaches are one of the top three causes of non-combat related loss of unit strengths in those war zones. Half of the headaches studied were the result of physical trauma and only one in five of the sufferers returned to duty. Half who were evacuated with tension headaches went back to the war zone. Those with psychiatric illness or traumatic brain injury or were treated with narcotics were the least likely to return.

Some headaches resulted from damage to or pressure on the occipital nerve in the back of the head, possibly caused by the heavy Kevlar helmets worn in war zones.

Headaches can make it hard to think and work, said Cohen, also director of chronic pain research at Walter Reed National Military Medical Center. He said military doctors need to understand their impact and make an effort to treat them on the ground. Better design of helmets could also reduce some strain.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Medical studies
        

A little child's play may help intensive care patients through their recovery.

A new Johns Hopkins study found that interactive video games may enhance physical therapy for patients in intensive care.

The findings were published online in the Journal of Critical Care. A patient's stamina and balance improved with use of the video games.

The researchers studied 22 patients admitted to ICU for respiratory failure, sepsis, cardiovascular disease and other health problems. The patients participated in 42 physical therapy sessions that included 20 minutes of playing on the Nintendo Wii or Wii Fit video game consoles. Activities included boxing, bowling, balance board use and others games that improved stamina and balance.

The study had some limitations because of its size and scope and the researchers said the next step would be a broader study to look at further benefits of video games.

Video games have also been found to improve motor function in recovering stroke patients.

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Categories: Medical studies
        

Am international panel of ethicists and scientists has recommended the government set up a system to compensate people who suffer research-related harm.

The recommendation by the International Research Panel to the Presidential Commission for the Study of Bioethical Issues is one of five aimed at improving current federal rules and standards for human subjects. It’s only advisory, but could find it’s way into a report to President Obama later this year, according to blog.bioethics.gov, the commission’s blog.

That could have significant implications in this region, where there are plenty of human trials going on.

Unlike other countries, there’s not now such a U.S. system for compensation, and people are generally left to sue. The panel cited the U.S. National Vaccine Injury Compensation Program, which is the alternative system to the regular courts for those injured by vaccines.

Other recommendations include ramping up community engagement as a means of demonstrating respect for human subjects in all stages of trials; supporting ethics training for investigators and other involved; enhancing transparency and monitoring ongoing research to hold researchers and institutions responsible and accountable; and ensuring rules are clear, sound and efficient to promote quality.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Medical studies
        

The Johns Hopkins Evidence-based Practice Center won a $475,000 grant to conduct a study to determine the best care for chronic wounds.

The wounds are a growing problem as the population ages and obesity and diabetes become more prevelant. An estimated $25 billion is spent annually on care in the United States and more than six million pople have such wounds, that can be painful and debilitating. The most common types of wounds and skin ulcers are related to veins that become diseased or abnormal and are often a sign of a greater health problem.

The funds come from the federal Agency for Healthcare Research and Quality, which wanted to know which treatment options were best and should be the standard of care. The study will be conducted by the Johns Hopkins Wound Center and the Hopkins Evidence-based Practice Center.

“The information we gather and present will help countless clinicians and patients to make better, more educated decisions about the best course of treatment to heal wounds,” said Dr. Gerald Lazarus, founder of the Wound Center and professor of dermatology and medicine at Hopkins Bayview Medical Center, who will co-lead study.

The researchers will analyze data from existing trials, studies and other research about wound care and determine the value of such treatments as medications, antibiotics, dressings and surgery for healing the wounds.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (1)
Categories: Medical studies
        

Young African-Americans do much worse on kidney dialysis than their white counterparts, and many more should be referred for transplants rather than staying on the blood-filtering process indefinitely, according to a new study.

The study by Johns Hopkins researchers, and published in the Journal of the American Medical Association, is a reversal of past belief.

Those studies, however, weren’t accounting for age. Blacks over 50 do still have a slightly better outcome on dialysis when they have end-stage kidney disease, the researchers said.

“As a medical community, we have been advising young black patients of treatment options for kidney failure based on the notion that they do better on dialysis than their white counterparts,” said the study leader Dorry L. Segev, an associate professor of surgery at the Johns Hopkins, in a statement. “This new study shows that, actually, young blacks have a substantially higher risk of dying on dialysis, and we should instead be counseling them based on this surprising new evidence.”

Researchers looked at 1.3 million patients and found black patients that were aged 18 to 30 were twice as likely to die on dialysis than white patients. Those aged 31 to 40 were 1.5 times as likely to die.

Yet, of the 18-30-year-old black patients, 32 were referred for transplants from 1995-2009 while 55 percent of white patients were referred for transplants.

Segev, a transplant surgeon, wasn’t sure why the disparity exists, though he speculated that blacks may be less likely to have good insurance that would have provided adequate care in earlier stages of their disease or, perhaps, they may have higher rates of hypertension.

Posted by Meredith Cohn at 2:00 PM | Permalink | Comments (0)
Categories: Medical studies
        

John Hopkins researchers are finding an unusually high case of the sexually transmitted parasite Trichomonas vaginalis in older women.

The findings are so large that one of the researchers is calling for all sexually active women older than age 40 to get tested for the parasite. The research found that the STD is more than twice as common in this age group than previously thought.

Screening is especially important because in many cases there are no symptoms.

"We usually think of STDs as more prevalent in young people, but our study results clearly show that with trichomonas, while too many young people have it, even more older women are infected," senior study investigator Charlotte Gaydos, said in a statement.

Results of the study will be presented July 12 at the annual meeting of the International Society for STD Research, in Quebec City, Canada, by Gaydos and her co-investigators.

The study found that among 7,593 U.S. women between the ages of 18 and 89, women 50 and older had the highest trichomonas infection rate, at 13 percent. Women in their 40s were next, at 11 percent. The study collected test samples from women in 28 states and is believed to be the largest and most in-depth analysis of the STD ever performed in the United States.

Overall, the survey results showed that 8.7 percent of all women tested positive for the STD.

Posted by Andrea Walker at 7:10 AM | Permalink | Comments (1)
Categories: Medical studies
        

A simpler and shorter course of antibiotic drugs could prevent tens of millions of people around the globe who have the bacteria that causes tuberculosis from getting full-blown TB, according to Johns Hopkins and South African scientists.

That may be particularly important to those who are HIV positive are at higher risk of catching the lung infections. The regiment could help 50,000 Americans and 22 million in sub-Saharan Africa.

The study, to be published in the New England Journal of Medicine, found the most streamlined combination worked. The does is 900 milligrams of the newer antibiotic rifapentine and the older isoniazid once a week for three months. The gold standard has been a daily dose of isoniazid for six months or longer.

“This new, simpler treatment regimen with rifapentine and isoniazid is highly effective and could transform therapy for latent tuberculosis in both those co-infected with HIV and those not,” said study senior author Dr. Richard Chaisson, a professor of infectious diseases at Hopkins and founding director of its Center for Tuberculosis Research.

“New treatment options are urgently needed to help control TB globally, and simpler regimens will substantially increase the number of people receiving therapy,” he said.

Not even 1 percent of those most likely to develop full-blown TB are getting drug treatment because of inconvenience, drug side effects and difficulty finding nearby health clinics, the scientists said. Yet, TB is the leading cause of death among people co-infected with HIV, which causes AIDS, leading to some half-million deaths annually among those co-infected.

But experts estimate that 2 billion people worldwide are infected with TB. Ten million become sick every year.

For more information, go to www.tbhiv-create.org.

Posted by Meredith Cohn at 5:00 PM | Permalink | Comments (0)
Categories: HIV/AIDS, Medical studies
        

Ever wonder what becomes of those who donate their bodies to science?

In Maryland, they're given a proper burial and a note of thanks.

This Monday, there will be funeral service held at the state's Springfield Hospital Center in Sykesville for these people. The interdenominational service will be conducted at 1:30 p.m. across from the Patterson House. 

Gov. Martin O'Malley's office will present a proclamation recognizing the day as "Anatomical Donor Appreciation Day" in Maryland.

Such services are an annual event. They recognize those donated, as well as unclaimed bodied used by the state's medical and dental education and research programs.

Families and friends of the deceased are invited to attend the services, coordinated by the State Anatomy Board and the Springfield Hospital Center's Office of Volunteer Services. They are officiated by Springfield's clergy.

For information on donations, click here.

AP photo

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Categories: Medical studies
        

The Maryland Stem Cell Research Commission announced Wednesday that it will fund 36 new projects worth $10.4 million.

The competitive grants, funded by the legislature, will focus this year on regenerative medicine by including research that addresses conditions such as osteoporosis, traumatic brain injuries, heart disease, cancer, diabetes, schizophrenia, ALS, autism, DNA damage and intestinal tissue generation.

Ten awardees have proposed collaborations with private biotech companies. Two of the projects are collaborations with the California Institute of Regenerative Medicine studying red blood cell production and traumatic axonal injuries, which are common and potentially deadly brain injuries.

The largest number of awards, 27, was given to researchers at Johns Hopkins School of Medicine. Kennedy Krieger researchers won 3 awards, the University of Maryland, Baltimore, won 5, and the University of Maryland, College Park, won 1.

Last year, the panel funded 42 projects totaling $11.7 million. The program was created in 2006 to fund cutting edge research in the state involving human stem cells.

Posted by Meredith Cohn at 12:08 PM | Permalink | Comments (1)
Categories: Medical studies
        

University of Maryland researchers say they have identified two genes associated with binge drinking that may lead to better treatments for excessive alcohol consumers.

Rodents bred and trained to drink excessively  had a profound reductions in binge drinking after scientists manipulated two receptors in the brain – GABA receptors and toll-like receptor 4(TLR4). The results were published in the journal Proceedings of the National Academy of Sciences.

Close to a third of Americans who drink are excessive drinkers, and about 75,000 die from the effects a year. In treatment, the drugs that aim to ease withdrawal symptoms may lead to addiction themselves.

But those receptors may mean there’s a way to reduce anxiety and control cravings without addiction, according to the lead investigator Harry June, professor of psychiatry and pharmacology and experimental therapeutics at the University of Maryland School of Medicine.

AFP/Getty photo

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Categories: Medical studies
        

Researchers have found that talking on a cell phone for 50 minutes is linked to increased brain activity, but the health risks are still not known.

The study, published today in the Journal of the American Medical Association, found evidence of increased brain activity in the area closest to the antenna. The research, conducted by the National Institutes of Health, is among the first to conclude that the brain appears sensitive to the radiofrequency-modulated electromagnetic fields (RF-EMFs) of cell phones.

While the findings raise questions about the risks of low levels of radiation from mobile phones, researchers cautioned that the results are preliminary and do not explain what the health implications might be. More long-range studies are needed to determine if there is potential for harm, the researchers wrote.

To test the impact of cell phone use on brain activity, researchers recruited 47 men and women. They placed cell phones on their right and left ears and used scans to measure any activity when phones were on and again when phones were off. They found higher activity when the cell phones were on, and in the region closest to the antenna.  

While some medical experts have raised concerns about cell phone safety, studies on the health effects have varied, the paper explains.

Last year, a huge study on whether cell phone use was linked to brain cancer turned up inconclusive. Nevertheless, an emotional debate has been brewing for years about cell phone safety. Just last year, San Francisco passed a law requiring retailers to display how much radiation is emitted from a phone.

What do you make of the debate and the latest findings?

AP photo

Continue reading "Cell phone use linked to brain changes" »

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Categories: Medical studies
        

With autism diagnoses on the rise, services for children have increased as doctors, therapists and parents try to find effective treatment for the complex disorder.

But new research suggests that the wealth of resources targeting children with autism tends to decline after high school, begging the question: what happens to autistic children once they reach adulthood?

Nearly 40 percent of all young adults examined in a survey of 680 19- to 23-year-olds had not received medical services, mental health services, case management or therapy, according to a study published this week in the Archives of Pediatrics & Adolescent Medicine.

African Americans and low-income people with autism were even less likely to access services, the researchers from Washington University in St. Louis found.

Nationwide, as many as 1 in 110 children have an autism spectrum disorder, according to estimates from the Centers for Disease Control and Prevention, which reflect an increase from just a few years ago. The rise in diagnoses is playing out in schools across the country, where the number of students 12 to 17 years old classified as autistic in special education enrollment increased from 15,480 in 1998 to 99,803 in 2007, according to background information in the article.

While state and local health officials and educators have worked hard to meet the needs of these students, services end once they exit high school. Little attention has been paid to continuing therapy and medical services for these children, the authors write.

The study has several limitations, particularly its small sample size and that it was based on a self-reported survey. But it raises an interesting and urgent issue as a generation of autistic children grows up. The National Institutes of Health has begun to call attention to the need for more services and research for adults with autism, but more work is needed, the authors urge.

Continue reading "Resources scarce for young adults with autism" »

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Categories: Autism, Medical studies
        

Life expectancy in the U.S. lags behind other prosperous nations and smoking and obesity are to blame, explains a new report from the National Research Council.

While over the last 25 years, U.S. life expectancy at age 50 has been on the rise, it's still behind such nations as Australia and Japan, despite outspending them on health care, the report explains. Concerned about the trend, the National Institute on Aging asked a global team of researchers for answers. The result is a massive report that delves into the differences and blames much of the disparities on Americans' past smoking habit and the nation's obesity epidemic.

That smoking is to blame in the states may sound odd, considering smoking bans are all the rage in the U.S. while Europe is just catching on. Well, Americans' smoking habit goes back some fifty years when smoking rates were higher here than in Europe or Japan. The consequences of that unhealthy behavior are playing out now, explains a summary of the report.

Nevertheless, the report predicts good news could be down the pike. Since major efforts to reduce smoking are underway now, life expectancy likely will improve 20 to 30 years from now. 

Rising obesity rates, however, paint a gloomier picture. Obesity alone accounts for between a fifth and a third of the shortfall in American's lifespans. And if that problem doesn't improve, it could offset the gains in life expectancy expected from people quitting smoking.

Continue reading "Smoking, obesity causes U.S. life expectancy to lag behind" »

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Categories: General Health, Medical studies
        

The authors of a new study suggest it might be. 

Pet lovers, I know what you're thinking: Kick the world's cutest doggy out of the bed? (Yes, you are! Yes, you are!) That's absurd. Well, the paper coming out in the February in the CDC journal Emerging Infectious Diseases documents cases where humans were likely infected with diseases through their beloved pets.

Even the most well-groomed and healthy-looking pets can carry dangerous bacteria, parasites and viruses that could causes serious illness, the report warns.

The study, which examined illnesses thought to be transmitted by pets in countries around the globe, runs down some pretty creepy examples. A 69-year-old man whose cat licked his hip replacement wound came down with meningitis. And a 9-year-old boy with a cat with fleas got plague. You read that correctly.

The study is quick to point out that zoonotic infections, as they are known, are rare. Good hygiene is key to keeping the risk of infection down, the report states.

But the risk of getting sick from sleeping with, kissing, or being licked by pets is real, especially considering that more than 60 percent of American households have a pet, the study states. According to one survey, among dog owners, 53 percent snuggle up with their pooch and among adult cat owners, 62 percent let their kitty sleep with them.

Continue reading "Could cuddling in bed with your doggy be hazardous to your health?" »

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Categories: Medical studies
        

Antidepressants can reduce hot flashes in menopausal and postmenopausal women, a recent study has found.

Women who took the medicine escitalopram experienced a reduction in the frequency and severity of menopausal hot flashes, compared to women who received a placebo in the study.

The study, conducted by researchers at the University of Pennsylvania School of Medicine, was published in the Januaray 19 issue of JAMA.

Hormone use for hot flashes has been reduced over the years. But no other treatments have worked as well, the researchers said.

The eight-week trial involved 205 women, some who recieved 10 to 20 mg/d of escitalopram or a matching placebo. The average number of hot flashes at the beginning of the study was 9.8 per day. Those taking escitalopram experienced an average of 5.26 hot flashes per day by week 8.

Posted by Andrea Walker at 7:00 AM | Permalink | Comments (0)
Categories: Medical studies
        

Researchers at Johns Hopkins Hospital have determined it is safe to transport kidneys, a finding they believe will allow for more transplants of the organ.

Doctors have worried that the longer a kidney is kept outside the body, the more likelihood there was that it wouldn't function as well than if it came from a live donor.

The Hopkins researchers looked at whether the amount of time a kidney was kept outside the body on ice had any harmful affects - and found there were none.

The findings were published online in the American Journal of Transplantation.

The researchers first tested a kidney shipped from California to The Johns Hopkins Hospital in Baltimore in 2007. Over the next three years they tested 56 other kidneys transported to 30 transplant centers in the United States and Canada.

These kidneys also suffered no harm. Once transplanted the kidneys began allowing the patient to urinate and cleared waste out of his or her system.

The kidneys studied traveled an average of 792 miles and spent an average of 7.6 hours outside of the body.

The researchers said the findings are particularly beneficial for the practice of "kidney paired donations." This process allows a family member to give a kidney that may be incompatible with a loved one to someone else who needs the organ. In exchange, that person's family member will get a compatible organ from someone else. Johns Hopkins pioneered this procedure.

This procedure is accomplished more easily if the kidneys can be transported rather than having the patients travel long distances, the researchers believe.

Until 2007, hosptials and surgeons required patients to travel, rather than have the kidneys shipped.

The Hopkins researchers believe their findings provide more support for transporting kidneys.

Caption (Valerie Eigner, 59, left, and her daughter Jamie Conway, 30, both of Arbutus, recuperate at the University of Maryland Medical Center after a transplant operation  in which Eigner donated her kidney to her daughter. Photo by Amy Davis, The Baltimore Sun)

Posted by Andrea Walker at 10:55 AM | Permalink | Comments (0)
Categories: Medical studies
        

Severely injured patients who get IV fluids ahead of the emergency room are much more likely to die than those who don’t because of the delay in transporting them, according to new Johns Hopkins-led research.

IV fluids are standard care for trauma patients in Maryland and elsewhere, though there isn’t sufficient scientific evidence that it universally helps, says Dr. Elliott R. Haut, an associate professor of surgery, anesthesiology and critical care medicine in Hopkins’ School of Medicine and the study’s leader.

The research, published online in the February issue of Annals of Surgery, could spark changes to the decades-old practice.

“Giving IV fluids to patients before they go to the hospital can delay transport,” says Haut said in a statement. “Our study suggests it may be better to get patients to the hospital faster. Starting fluids takes time and the IV fluids may cause harm on top of the timing issue.”

Haut came to a similar conclusion about cervical collars before transport, saying they may not be necessary for some trauma patients pre-hospital and could delay needed treatment.

Fluids are given immediately to trauma victims whose blood pressure has dropped sharply because of blood loss. The fluids quickly raise pressure and keep the body’s systems working, which is especially helpful to those with traumatic brain injuries. But Haut says the fluids may make matters worse in patients whose low pressure temporarily stops bleeding.

Haut and his colleagues looked at data from 776,734 trauma patients in the American College of Surgeons’ National Trauma Data Bank between 2001 and 2005. About half got fluids pre-hospital. Those who were shot or stabbed were 25 percent more likely to die and those with severe head injuries were 35 percent more likely to die.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Medical studies
        

Researchers at the Kennedy Krieger Institute and four other institutions say they have discovered where the biological process of blinding begins for glaucoma, perhaps leading to new ways to treat the disease and other neurodegenerative diseases.

Glaucoma affects more than 60 million people, including children, and is the world’s second leading cause of blindness.

The biological pathway identified by the researchers is similar to Parkinson’s disease, the researchers said.

 “These findings are very exciting because they give us several novel targets for future interventions,” said Dr. Nicholas Marsh-Armstrong, senior study author and a research scientist at Kennedy Krieger, in a statement. “I believe these findings put us on the cusp of discovering a treatment for glaucoma that may also have relevance for a number of other neurodegenerative diseases.”

The findings were published this week in the Proceedings of the National Academy of Sciences. The researcher said the findings were unexpected.

The blindness from glaucoma is caused by damage to the optic nerve, which sends signals from the eye to the brain. In the latest study, researchers have pinpointed the specific location that appears to play a role.

They say it’s in the optic nerve head, where the information cables headed to the brain first exit the eye. There is a unique class of cells there called astrocytes that appear to be a factor.

Further studies will look at the pathway where things start to go awry and how the disease progression may be slowed.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Medical studies
        

Researchers at the University of Maryland School of Medicine will be coordinating a team of international scientists looking at the genes that may make a person more likely to have a stroke – the nation’s third biggest killer and a leading cause of disability.

They’re specifically looking at the most common type of stroke called an ischemic stroke. It’s caused by a blood clot in the brain and is responsible for 80 percent of cases.

A $3.6 million grant from the National Institutes of Health will fund the research, at 17 sites, including 12 in the United States and 5 in Europe. It’s expected to take about four years and will be one of the largest stroke genetics research projects ever, said Dr. Steven Kittner, principal investigator and professor of neurology at Maryland and a researcher at the Baltimore VA Medical Center, said in a statement.

“Recent studies in conditions such as diabetes and lupus have shown that a large sample size, such as the one we will be using, can be vital in helping to uncover genetic influences in a complex disease, so we are eager to see what genetic variants we may find for stroke and what promise these discoveries may hold for prevention and treatment,” he said.

The researchers will look at DNA from at least 6,000 stroke patients. That will enable them to look at more than a million genetic variants for their association with stroke. They hope to find ones not previously linked to strokes. Researchers say risk factors such as hypertension and cigarette smoking can’t fully explain who will suffer a stroke and genetics may offer better clues.

There are nearly 800,000 strokes a year in the United States. Blood flow to the brain is cut off, increasing the risk of brain damage or death. Symptoms include numbness or weakness on one side, sudden loss of vision, sudden confusion or trouble speaking, dizziness and severe headache.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (1)
Categories: Medical studies
        

What makes a face look human? Some researcher says it’s all in the eyes.

“There's something fundamentally important about seeing a face and knowing that the lights are on and someone is home,” said Thalia Wheatley of Dartmouth College, in a statement.

She cowrote a study with graduate student Christine Looser that was published in Psychological Science, a journal of the Association for Psychological Science.

Wheatley said humans can see faces in the moon, a piece of toast, two dots and a line for a nose. But no one believes they are truly alive.

For the study, the pair photographed doll faces. They paired them with similar-looking human faces and used morphing software to blend them in a series of photos.

Volunteers were asked which ones were human and which ones were dolls. The tipping point, when they decided they were alive, was about two-thirds of the way along the continuum, closer to the human side. Another experiment found that the eyes were the most important feature for determining life.

Researchers said the results suggest that people scrutinize faces, particularly the eyes, for evidence of life.

“I think we all seek connections with others,” Wheatley said. When people see life in a face, they think, “This is a mind I can connect with.”

Posted by Meredith Cohn at 6:39 PM | Permalink | Comments (0)
Categories: Medical studies
        

It's Election Day and maybe you just can't help yourself when you go into the booth.

Researchers at the University of California, San Diego and Harvard say that your surroundings and upbringing certainly do shape your ideology. But a person can also be predisposed to a certain way of thinking.

The researchers matched the genetic makeup of 2,000 people with maps of their social networks and found that those with a varient in a dopamine receptor gene were more likely to be liberals as adults -- but only if they had a lot of friends as kids.

The research builds on past research done on dopamine, a neurotransmitter repsonsible for feeling pleasure and pain. It was published in the Journal of Politics.

The theory is that those with this "novelty seeking" gene variant who had a lot of friends would seek out a lot of their opinions. Being exposed to so many points of view would make them more liberal if they were already predisposed that way. But more study is needed, researchers say.

What do you make of this?

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Categories: Medical studies
        

The buzz phrase in the health industry lately is preventive care.

Visit your primary physician often so he or she can detect health problems early.

The earlier you're treated the less likely you'll have expensive complications later. But at least one new survey is disputing this belief.

Dartmouth Atlas Project found that improving access to primary care alone doesn't necessarily keep people with chronic conditions out of the hospital or improve health outcomes.

The researchers found that the quality of care is more important. They also found that primary care physicians need to coordinate with a patient's specialists, nurses and hospital.

The study looked at the fee-for-service Medicare population from 2003 to 2007.

Among the findings:

1. There was no correlation between rates of breast cancer screening and the amount of primary care delivered.

2. There was no correlation between the rate of leg amputation, a complication of diabetes and other diseases, and a patient having at least one annual visit with a primary care physician.

3. Having an annual primary care visit did not keep patients out of the hospital for ambulatory care-sensitive conditions such as diabetes and congestive heart failure.

The researchers said that the patients who really need primary care may not be receiving it - or not receiving it frequently enough.

They also said primary care is most effective when it’s part of a coordinated effort between specialists and hospitals. That kind of coordination isn't easy to achieve in many areas of the country.

Quality also varies by doctor. Visiting a primary-care doc who’s not giving good care won't improve a person's health, according to the researchers.

Posted by Andrea Walker at 12:00 PM | Permalink | Comments (0)
Categories: Medical studies
        

Liquor companies are using less magazine advertising to entice the nation's youth to imbibe, according to a Johns Hopkins analysis.

But the companies are still largely advertising in publications young people are more likely than adults to read, with 78 percent of the advertising in these publications.

Overall, advertising aimed at youth declined by 48 percent between 2001 and 2008, according to the study by the Center on Alcohol Marketing and Youth at the Johns Hopkins Bloomberg School of Public Health. Advertising exposure to adults over age 21 declined by 29 percent in the same period.

Researchers have found alcohol advertising increases the likelihood of underaged drinking, making it an important public health issue, according to the study.

Already, more young people drink alcohol then smoke cigarettes or use illegal drugs, according to the study. About 10.1 million people between the ages of 12 and 20 reported drinking in the past month in 2008. About 6.6 million young people reported binge drinking.

Alcohol companies made a pledge in 2003 to voluntarily eliminate liquor advertising in magazines with 30 percent or more youth readership - a goal the alcohol companies did meet. However, the 30 percent standard affected just 9 of the 160 magazine where alcohol companies advertised during the time period studied.

Just 16 brands made up half the alcohol advertising more likely to be read by youth. The brands included Patron Silver Tequila, Absolut Vodka, Kahlua Liqueurs, Ketel One Vodka and Jim Beam Bourbon Whiskey.

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Categories: Medical studies
        

Johns Hopkins Medicine, Greater Baltimore Medical Center and Anne Arundel Health System have formed a partnership that they say will help bring cutting edge research into use with patients faster.

The new network, called the Johns Hopkins Clinical Research Network, will hook up academic and community-based clinical researchers.

A main purpose of the group will be to make clinical trials available to patients who don’t usually have access to them at their community hospital. That will also create a larger patient pool for research.

The end result, the hospitals say, will be moving diagnostic, treatment and disease-prevention advances from the research phase to patient use more quickly.

More institutions will be added over time.

 “The JHCRN is a unique research resource that increases patient access to innovative therapies and outcomes research in their own local communities. It also empowers physicians to design and conduct a broad array of research projects relevant to their communities,” said Dr. Charles M. Balch, the group’s director and professor of surgery and oncology at the Johns Hopkins University School of Medicine, in a statement.

The initial focus of the group will be on expanding cancer-related clinical trials and diabetes and surgical studies. Other areas for the future include intensive care; cardiovascular, neuropsychiatric, brain and spine diseases; and radiology and nuclear medicine studies.

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Categories: Medical studies
        

A vaccine against dengue fever, a potentially serious flu-like infection that is on the rise, is undergoing tests at Johns Hopkins Bloomberg School of Public Health.

If it’s eventually proven effective, it could have far-reaching implications. About 2.5 billion people in more than 100 countries are at risk of such an infection – including some in the United States. It’s been discovered in Florida.

The vaccine has been in development for more than a decade at the National Institute of Allergy and Infectious Diseases and is finally ready for the first phase of clinical study – the safety phase.
Dengue fever is caused by any of four viruses and is carried by Aedes mosquitoes. It infects about 50-100 million people a year in mostly tropical regions, causing 25,000 deaths, mostly in children, according to the institute.

Some people get flu-like symptoms or worse, and others experience a mild fever or nothing.
For now, there’s no vaccine to prevent the infection and no treatment other than bed rest and fever medicine. And it’s pretty hard to avoid getting bit by a mosquito.

“Controlling the mosquito vector can work, but it is very expensive and difficult to sustain,” Dr. Anna Durbin, who is leading the study at Johns Hopkins, said in a statement. “In the long run, vaccination would be a more efficient and cost-effective approach.”

There will be a second phase of testing with more participants to check the effectiveness of the vaccine. If all goes as planned, a final phase of testing could start in three to four years.

For more information, go to the institute's dengue fever website. 

Getty Images picture of worker looking for mosquito larvae in Miami Beach, Fla.

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Categories: Medical studies
        

Michael Phelps’ Olympic success may come down to biology.

Some academics took a look at the record books from the past 100 years and the bodies of the athletes and made this determination. It wasn’t about race, but body type – though the fastest sprinters tended to be of West African ancestry and the fastest swimmers tended to be white.

A Duke engineer and a couple of fellow researchers say it’s about an athlete’s center of gravity. The center tends to be slightly higher in the bodies of blacks (longer limbs and smaller circumferences) than whites (longer torsos) – giving an advantage to blacks in running and an advantage to whites in swimming.

“Locomotion is essentially a continual process of falling forward,” said Adrian Bejan, professor of engineering at Duke's Pratt School of Engineering and a study author. “Body mass falls forward, then rises again. Mass that falls from a higher altitude falls faster. In running, the altitude is set by the location of the center of gravity. For the fastest swimmers, longer torsos allow the body to fall forward farther, riding the larger and faster wave.”

This is not to say there aren’t cultural factors, such as lack of access to swimming pools and lower socioeconomic status, said Edward Jones, a Ph.D. candidate at Cornell University who is teaching at Howard University and was another study author.

And, he said, encouragement can make the difference. “Just look at the Williams sisters in tennis or Tiger Woods in golf.”

Associated Press photo of Michael Phelps

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Categories: Medical studies
        

In the wake of the H1N1 flu pandemic, you would think everyone had learned to cover their mouths when they sneezed or coughed.

But researchers in New Zealand found that one in four people observed in a public setting did not. And of those who did, only 5percent covered their mouth in a way recommended by public health officials.

Those officials had been telling people they could avoid spreading infection if they would cough or sneeze into a tissue or their elbows. This way, they wouldn’t get germs on their hands and spread them around.

Researchers did their study in three public areas in the New Zealand capital city of Wellington – a train station, a hospital and a shopping mall. This was after a bunch of public service advertisements in the newspaper and on radio telling people about proper infection control, much like public health officials did in the United States.

The most common response to a sneeze or cough was covering the mouth with the hands.
“This study showed a low prevalence of recommended respiratory hygiene behaviors suggesting that hygiene messages promoted in mass media campaigns have not been seen and/or have not been readily adopted by the public in this city,” said Nick Wilson of Otago University Wellington in New Zealand, an author on the study.

They presented the finding to the International Conference on Emerging Infectious Diseases, which was organized by the U.S. Centers for Disease Control and Prevention, the American Society for Microbiology, the Council of State and Territorial Epidemiologists, the Association of Public Health Laboratories and the World Health Organization.

So, how do you cover your mouth? Or do you?

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Categories: Medical studies
        

Johns Hopkins University was chosen as one of 10 International Centers of Excellence for Malaria Research by the National Institutes of Health, the agency reported today.

NIH’s National Insitute of Allergy and Infectious Diseases is trying to accelerate the control of malaria and eventually eradicate it. So, officials put up $14 million in the first year of funding. The grants will continue for seven years.

There are about 240 million cases of infection from malaria-causing parasites every year and more than 850,000 deaths. The new funding will go directly to some of  the regions where malaria is the greatest problem, including parts of Africa, Asia, the Pacific Islands and Latin America.

Teams will conduct research in more than 20 countries.

 “One of our primary goals with these centers is to fund cutting-edge research in malaria-endemic areas that will keep up with the rapidly changing epidemiology of the disease,” said the agency director, Dr.  Anthony S. Fauci.

About 40 percent of the world’s population lives in an area where they are at risk for malaria, though it has been eliminated from many parts of the world.

The new centers will aim to produce intervention and control measures, officials said.

Continue reading "Hopkins wins grant to fight malaria around the globe" »

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Categories: Medical studies
        

Crayfish are surprisingly complex decision makers, according to a new study from University of Maryland researchers, who believe the information may help the understanding human brains.

The Maryland psychologists say it's tough to study the human brain this way. And they have concluded that they may be able to adapt what they learn about the neural circuitry and neurochemistry of decision making in the crayfish.

Specifically they took a look at individual crayfish neurons invovled in value-based decisions by presenting a food source and a predator that was either very threatening or less threatening.

The study was published in the Proceedings of the Royal Society B.

"Matching individual neurons to the decision making processes in the human brain is simply impractical for now," said University of Maryland psychologist Jens Herberholz, the study's senior author, in a statement. "History has shown that findings made in the invertebrate nervous systems often translate to more complex organisms. It's unlikely to be exactly the same, but it can inform our understanding of the human brain, nonetheless.

He said the researcher may inform other studies in rodents and primates.

In the crayfish study, the tanks were wired to pick up electrical signals that allowed researchers to identify activation patterns of specific neurons as the crayfish made decisions.

A presence of a strong predator overrode the crayfish's desire for its next meal, showing that the crayfish actually consider the circumstances. A judgement, just like a human.

Photo courtesy of David D. Yager/Jens Herberholz

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Categories: Medical studies
        

A new study has discovered that there is a biological reason why women have more stress-related problems then men.

Women suffer from more depression and stress-related disorders and researchers at the Children's Hospital of Philadelphia took a look at animals to understand why.

They studied stress signaling systems in rat brains and found that females are more sensitive to low levels of a hormone called corticotropin-releasing factor (CRF), which organizes stress responses in mammals.

“This is the first evidence for sex differences in how neurotransmitter receptors traffic signals,” said study leader Rita J. Valentino, a behavioral neuroscientist at hospital, in a statement.  “Although more research is certainly necessary to determine whether this translates to humans, this may help to explain why women are twice as vulnerable as men to stress-related disorders.”

The research was published online Wednesday in Molecular Psychiatry.

Rats were given a swim test, and researchers discovered that in female rats were not only more responsive to the hormone but after exposure to stress, male rats had more of an adaptive response in their brain cells.

Past stress studies focused on males and this response may have gone unnoticed. Treatment may in the future consider the sex of the patient, researchers said. 

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Categories: Medical studies
        

Scientists at the University of Maryland have discovered a hormone that regulates blood sugar also may connect to people's sense of sweetness.

The discovery means it may be possible to adjust how food tastes to people, and how much they enjoy it. That could lead to additives that help treat obesity, metabolic disorders and diabetes, according to the study published online June 14 in the Federation for American Societies for Experimental Biology Journal.

“An interesting possibility resulting from our research is that the development of new food additives could change the way you perceive your food, making it taste more or less sweet,” said senior author Steven D. Munger, associate professor of anatomy and neurobiology at the University of Maryland School of Medicine, in a statement.

“From a food industry perspective, such additives could be used to enhance flavor. From a therapeutic perspective, they could be used to treat patients who under-eat or overeat.”

How would you like to just turn off your ability to taste sweet foods? Would that help your diet?

Baltimore Sun file photo/Kim Hairston

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Categories: Medical studies
        

Major League Baseball pitchers who are 'morning types' generally perform better than the 'night owls,' according to a paper presented at the Associated Professional Sleep Societies LLC, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society.

In general, the study (abstract here) showed that sleep preferences can predict performance during games, said the principal investigator and lead author W. Christopher Winter, MD, medical director of the Martha Jefferson Hospital Sleep Medicine Center in Charlottesville, Va.

Statistically, the study indicated the morning types did better in games before 7 p.m. and night owls did better in night games, but not as much better:  In early games, the earned run average (ERA) of pitchers who were morning types (3.06) was lower than the average ERA of pitchers who were evening types (3.49); and in games that started at 7 p.m. or later, pitchers who were evening types performed slightly better (4.07 ERA) than morning types (4.15 ERA).

"We were surprised to see that chronotype did affect pitching," Winter said in a statement. "We were also surprised to see that pitchers who were more 'morning type' seemed to do better overall."

The study supported other research that showed peak performance for most athletes is between mid-afternoon and early evening.

This study looked at 2009 stats from 18 pitchers from five MLB teams: the Los Angeles Dodgers, New York Mets, Philadelphia Phillies, San Francisco Giants and Tampa Bay Rays. Ten were found to be evening types and 8 morning types.

The researchers said managers could use the information to decide when a pitcher would perform his best.

Perhaps the Orioles need only to get the right pitchers in at the right times? 

Baltimore Sun photo of Orioles starting pitcher Chris Tillman/Kenneth K. Lam

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Categories: Medical studies
        

Chocolate milk may be a good alternative for post-exercise hydration, according to two studies presented a the American College of Sports Medicine's annual meeting in Baltimore last week.

The studies were funded by a grant from the National Dairy Council and National Fluid Milk Processor Promotion Board, but the research was conducted by researchers came up with some interesting findings.

Researchers in one study found that drinking chocolate milk after a run helped the muscles repair. They measured the responses in eight male runners in good training shape. They all consumed healthy diets, and then after runs drank fat-free chocolate milk or the same amount of calories of a carbohydrate-oriented beverage.

They took muscle biopsies during a three-hour recovery period and those of the chocolate milk drinkers had "heightened markers of muscle protein repair" compared with those who had the carb drink (which is a standard sports drink). 

The researchers said the milk is relatively cheap and easy to make at home, and may be a good option post activity.

The second study measured glycogen stores in muscles. That the source of fuel during during prolonged exercise. The milk drinkers had more 30 and 60 minutes after drinking milk verses the carb drinks.

The studies were conducted in the lab of Nancy Rodriguez, professor of nutritional sciences at the University of Connecticut.

Will you give chocolate milk a try or stick with Gatorade?

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Categories: Medical studies
        

A Canadian researcher has begun looking into those pesky "earworms," the songs that just won't get out of your head.

The University of Montreal study found that 98 to 99 percent of the population has gotten "infected" at one time or another. 

Andréane McNally-Gagnon, a PhD student at the University of Montreal Department of Psychology, found in most cases the earworms disappear after a few minutes.

As many of you probably know, they can last hours or days.

The researcher asked French-speaking Internet uses to rank 100 pop songs according to their ability to repeat the lyrics. Even though they are French, you'll probably recognize the top songs (full list here):

Singing in the Rain by Gene Kelly; Live Is Life by Opus; Don't Worry, Be Happy by Bobby McFerrin; and I Will Survive by Gloria Gaynor. 

She's also found that earworms lasted longer in musicians, and they usually happened when people were in positive moods and busy with non-intellectual, low-concentration activities such as walking.  

The researcher plans to keep studying the phenomenon. Perhaps she'll come up with a cure.

AP photo of Gloria Gaynor

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Categories: Medical studies
        

There's no doubt that having a child with autism can put stress on a marriage. The same can be said for any number of puzzling childhood diseases. But a common perception that parents of autistic kids have high divorce rates -- as much as 80 percent -- is a myth, according to a new study from Kennedy Krieger researchers.

Using data from nearly 78,000 children ages 3 through 17 recorded by the 2007 National Survey of Children's Health, researchers found that the parents of autistic children are just as likely to be married as the parents of their peers.

Some 64 percent of children with an autism spectrum disorder have two married biological or adoptive parents, compared with 65 percent of children without autism, researchers found.

Brian Freedman, the lead researcher at the Baltimore-based Kennedy Krieger Institute, said that parents of children recently diagnosed with the disorder often quote the 80 percent divorce rate figure and feel an instant sense of hopelessness. But there's no reason to believe that their marriage is likely doomed, he said. (In fact, no one knows for sure where the 80 percent figure first came from. But it's been perpetuated for years.)

Continue reading "Autism in kids doesn't drive parents to divorce" »

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Categories: Medical studies, Pediatrics
        

When it comes to lowering the number of repeated teenage births, University of Maryland School of Medicine, Baltimore researchers found that computer-assisted, home-based intervention appears to reduce the risk among low-income teens and at a reasonable cost.

The researchers' report can be found in the April issue of "Archives of Pediatrics & Adolescent Medicine." 

The researchers note that after 14 years of decline, the U.S. Teenage birth rate increased in 2006 and 2007. Multiple teen births among African American and Hispanic girls are more common and hard to prevent, the researchers said. And the results can be devastating to them and the public.

"Both first and subsequent births to U.S. teenages produce substantial detrimental health, social and economic burdens," according to the report. "Repeated childbearing during adolescence compounds the risk of academic failure for the teenage mother and increases the public costs associated with child welfare, criminal justice system involvement and long-term poverty." 

Dr. Beth Barnet of the University of Maryland School of Medicine and her colleagues assessed costs associated with an intervention that achieved a 45 percent reduction in repeated births within 2 years in a previous study. The mothers were low-income African American teens.

The pregnant girls, 235 of them 18 or younger, were recruited and assigned to usual care or one of two home-based interventios, a quarterly computer-assisted motivational intervention or that intervention plus two visits by a counselor. After 24 months, teens receiving either intervention were significantly less likely to have another baby. The average cost per teen was $2,064.

Few studies have been evaluated for costs and benefits, according to the researchers. They said their findings suggest that computer-assisted motivational intervention is "at least as cost-effective as these programs and warrents replication in larger samples."

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Categories: Medical studies
        

Go ahead and enjoy some Easter candy. Not a lot. And make sure it's chocolate. The dark kind.

A new study published online Wednesday in the European Heart Journal says small quantities of dark chocolate -- just one small square a day, or this week, one small egg -- can lower your blood pressure and reduce your risk of heart disease.

This is the latest study to make such a finding, but I thought that I'd give it some play since the Easter baskets are coming.

Researchers in Germany followed more than 19,000 people who were between 35 and 65 for at least 10 years and found that those who ate the most amount of chocolate had the lower blood pressure and and a 39 percent lower risk of having a heart attack or stroke. The good amount was an average of 7.5 grams a day. Those with worse result ae 1.7 grams a day. (The 6-gram difference was equal to less than one small square of a 100 gram bar.)

Dr Brian Buijsse, a nutritional epidemiologist at the German Institute of Human Nutrition, Nuthetal, Germany, who led the research, warned that it was important that people did not increase the overall amount of calories or reduce their intake of healthy foods. Sorry, can't live on chocolate alone.

As in other studies, the researcher say it's the flavanols in cocoa that are likely behind the lower blood pressure. There's more cocoa in dark chocolate, explaining the increased benefits of that kind. The flavanols appear to increase the availability of nitric oxide in the cells that line the inner wall of blood vessels. That nitric oxide causes the smooth muscle cells of the blood vessels to relax and widen, leading to lower blood pressure. It also improves platelet function.

But again, moderation. About 100 grams of dark chocolate contains roughly 500 calories. 

McClatchy-Tribune photo

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Categories: Medical studies
        

TV medical shows are full of salacious story lines and over-the-top drama. So perhaps it's no surprise that a new study by Johns Hopkins researchers finds them full of bioethical breaches and questionable professional conduct.

Researchers admit that their findings shed light on the expected. But they also point out that some 80 percent of medical and nursing students watch TV medical dramas.

Sure, people watch these programs for entertainment, but researchers point out they may also be influenced by the unsavory on-screen depictions. Such programs, while clearly not educational in themselves, could be used to provide a starting point for discussion about thorny ethical topics, the researchers suggest.

The research, appearing in the April issue of the Journal of Medical Ethics, didn't intend to find out whether the portrayals were accurate or not. (Other folks have been quick to blast TV portrayals of medical professionals) Rather, the Hopkins researchers wanted to offer a thorough review to find out the nature and extent of the depictions.

In a study of full seasons of Grey's Anatomy and House, researchers found lack of informed consent as the most frequent bioethical issue. Researchers examined 49 incidents and found 47 percent of them to be "inadequate" conversations of consent with "hurried and one-sided discussions, refusal by physicians to answer questions and even an entire lack of informed consent for risky procedures," the authors write. 

Another big problem was physicians endangering patients unnecessarily, and in many cases not being penalized for it. And, not surprising, sexual misconduct was another big issue found in the review, researchers said.

I'm not a big TV person, so I've never seen either show. But fans, particularly if you're in the medical field, what do you make of the findings? 

AP photo of the drama unfolding on Grey's Anatomy

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Categories: Medical studies
        

Foodborne illness in the United States is a costly matter, in terms of health, money for treatment and quality of life losses.

Official government estimates of costs range from $6,9 billion to $35 billion, but a new report says those estimates don't take all costs into account and puts the tab much higher.

The report is authored by a former U.S. Food and Drug Administration economist and is being released by the Produce Safety Project, which is supported by The Pew Charitable Trusts and Georgetown University. The new report says costs are more like $152 billion.

Many illnesses' causes are unknown, but there are some usual and coslty suspects: Campylobacter-related costs are more than $18.8 billion, Salmonella's costs approach $14.6 billion and Listeria-associated costs were an estimated at $8.8 billion. 

States with the highest foodborne illness costs are California with $18.6 billion, Texas with $11.3 billion and New York with $10.4 billion. Maryland ranked 20, with costs at $2.9 billion.

Per case foodborne illness, the costliest states are Hawaii at $2,008, Florida at $1,984 and Connecticut at $1,949. Maryland ranked 17th at $1,871.

Here is an interactive map of state findings. 

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Categories: Medical studies
        

Howard County was the healthiest county in the state and Baltimore City was the least healthy, according to a story in The Sun today.

The information is based on a study by the Robert Wood Johnson Foundation and the Univeristy of Wisconsin Population Health Institute.

The study ranked all the counties in Maryland and used data on health outcomes and the length and quality of people's lives. Researchers looked at behaviors such as smoking, clinical care, social and economic circumstances and environmental factors.  

In the Baltimore area, Howard was first, Frederick County third, Carroll was fifth, Harford ninth, Anne Arundel 11th, Baltimore County 15th and Baltimore City was 24th.

Howard health officer Dr. Peter L. Beilenson, formerly Baltimore's health officer, said that general wealth and high educational levels helped the county in the survey, but so did public policies like the smoking ban and efforts at getting the uninsured health care.

So, is it any surprise wealthier counties ranked higher than lower-income ones?

Associated Press photo of a smoker

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Categories: Medical studies
        

Some patients diagnosed as being in a vegetative state showed signs of brain activity during brain scans, according to a new study that researchers said could change the way science views patients thought to have lost all awareness.

It was a small study -- of just 54 patients with severe brain injury, 23 in a vegetative state and the rest in a less severe "minimally conscious state." But the British and Belgian researchers think the findings could be quite significant, offering clues for better diagnosis of people with brain injuries and development of a technique to communicate with them.

Patients were placed in an MRI scanner and asked to imagine hitting a tennis ball and walking from room to room in their homes. Four of the 23 vegetative patients responded to the commands by showing brain activity on the scanners.

And one man was even able to detailed yes and no questions about his life before his injury.

The research, appearing in the latest New England Journal of Medicine, also raises ethical dilemmas about how modern medicine should treat such patients, this NYT story explains. 

It also comes with plenty of caveats: Only a small number of patients responded. The scanning technology needs work and isn't ready to be a diagnostic tool just yet. And as an accompanying editorial by Dr. Allan H. Ropper of Brigham and Women's Hospital in Boston states, brain activity as seen on the scanner is not indicative of a "stream of thought," i.e. memory, self-awareness and reflection. 

AFP/Getty images

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Categories: Medical studies
        

B'More Green has just posted about a new report out today says that toxic chemical exposure is costing Americans big in terms of their health and the dollars they spend on health care. 

The study by the Safer Chemicals Health Families Coalition and sent to us by the Maryland Public Interest Research Group called “The Health Case for Reforming the Toxic Substances Control Act,” concludes that the country could curtail the rising rates of chronic disease and reduce health care costs by overhauling federal chemical policy.

The report is based on analysis of peer-reviewed scientific studies, the groups said.

At a time when Congress and the nation debate health care reform, the report says many common diseases and conditions are linked to chemical exposure, including cancer, learning and developmental disabilities and asthma.

The authors call on Congress to update toxic chemical laws. It cites estimates showing that reducing the incidence of these diseases by 0.1 percent could save $5 billion in health care costs. This is based on expected health care costs projected for 2020, and assumes full implementation of the new legislation by then.

In Maryland, the savings would be more than $94 million a year, the study says. (In addition to Congressional action, Mary PIRG is also is supporting legislation in the Maryland General Assembly to curb use of chemicals including Bisphenol A, found in polycarbonate plastic including baby bottles and most food cans. The Food and Drug Administration just reversed itself and said there may be reason to be concerned about the chemical and is studying the issue.)

See the full report at www.saferchemicals.org.

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Categories: Medical studies
        

Your ability to resist eating a cookie, or your inability to control yourself, may have a lot to do with who you hang out with, according to a new study from the University of Georgia.

Researchers say self-control is contagious. Ditto for lack of self control.

The series of studies involved hundred of volunteers. They found that watching or even thinking about someone with good self-control made them more likely to exert their own self control. The opposite was also true -- so much so that seeing the name of someone with good or bad self-control flashing on a screen for just 10 milliseconds changed behavior.

"The take home message of this study is that picking social influences that are positive can improve your self-control," said lead author Michelle vanDellen, a visiting assistant professor in the Georgia department of psychology, in a statement. "And by exhibiting self-control, you're helping others around you do the same."

It's been known that people tend to mimic behavior. This is true when it comes to smoking, drug use and obesity, the researcher said. But the new study is thought to be the first to show that self-control is contagious across behaviors.

Researchers said that means that thinking about someone who regularly exercises can make a person more likely to stick with his financial goals, career goals or other things that involve self-control.

The finding were published in the early online edition of the journal "Personality and Social Psychology Bulletin".

VanDellen said the findings, however, do not absolve people of accountability for their actions. She said it was more of a "nudge" toward or away from temptation.

So eat the cookie, but don't blame the baker.

Baltimore Sun file photo/Amy Davis

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Categories: Medical studies
        

After a six-year study, surgeons at the University of Maryland Medical Center in Baltimore have determined that they have found a better way to repair the mitral valve, which is key to proper blood flow.

The mitral valve is the "inflow valve" for the left ventricle, the heart’s main pumping chamber, Maryland officials explain. Blood flows from the lungs, where it picks up oxygen, across the open mitral valve and into the left ventricle. When the heart squeezes, the two leaflets of the mitral valve snap shut and prevent blood from backing up into the lungs. Blood is directed out of the heart to the rest of the body through another valve, the aortic valve.

Until now, surgical treatment meant repairing the diseased valve or replacing it with a metal one or one made from animal tissue. And the majority required open-heart surgery. Doctors concluded in their study -- which began in 2003 and ended in March -- that they could do a minimally invasive repair job by making a two-inch incision on the right side of the chest. The results of the study are published in the September issue of the Annals of Surgery.

The study of 187 patients showed the procedure is safe and effective and requires just a short hospital stay and rapid recovery, said lead author James S. Gammie, a cardiac surgeon at the University of Maryland Medical Center and associate professor of surgery at the University of Maryland School of Medicine. There were no strokes, kidney failures or infections, which are the most common complications from surgery. Almost all of the patients are still alive.

The doctors said repair is also better than replacement, which tends to cause blood clots. Animal tissue replacement valves also only last 10-15 years. Repairs can last a patient’s lifetime.

The procedure further advances the trend in minimally invasive techniques across most areas of surgery. Very few surgeons across the country perform the procedure now, according to E. Albert Reece, vice president for medical affairs at the University of Maryland and dean of the University of Maryland School of Medicine. Perhaps that now will change.

Read the abstract here.

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Categories: Medical studies
        

The internet will get you into trouble. Everyone knows this, don't they? And yet, time and again we hear embarrassing tales of how someone posted a drunken photo or a dimwitted email on the web only to encounter the wrath of their employer.

Count medical students among the latest perpetrators. Sixty percent of medical schools reported incidents of students posting unprofessional content online, according to a new study in the Journal of the American Medical Association.  Nearly half reported use of discriminatory language, while 39 percent had depictions of intoxicated students and another 38 percent had reports of "sexually suggestive material." And perhaps most worrisome to medical schools, 13 percent reported incidents where doctors-in-training violated patient confidentiality online.

The study was based on a survey of medical schools nationwide to gauge how the proliferation of Facebook, Twitter and YouTube had affected professionalism for soon-to-be physicians. The survey also gathered information on policies regarding online conduct. Few schools, it turns out, (less than 10 percent) had any formal policies on internet use.

"The social contract between medicine and society expects physicians to embody altruism, integrity and trustworthiness. Furthermore, ethical and legal obligations to maintain patient confidentiality have unique repercussions," the study says.

But just what does "professionalism" mean when it comes to medical students and the wild wild west of the interwebs? Medical schools aren't quite sure.

Continue reading "Medical students behaving badly" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Medical studies
        

Two new studies shed light on the safety of the vaccine to protect women from cervical cancer and call into question the ethics behind the marketing of the shot.

Gardasil, the blockbuster vaccine to combat the human papillomavirus (HPV), which can cause cervical cancer, is linked to complications, including 32 deaths, according to an analysis in today's Journal of the American Medical Association. But researchers note that the rate of side effects is low and the safety record is not out of line from other similar vaccines. The most common side effects are fainting, nausea and dizziness at a rate of about 40 to 80 cases per 1 million girls vaccinated.

Raising more eyebrows, however, is an accompanying JAMA article revealing that the makers of Gardasil, Merck & Co, provided grants to professional medical associations to help promote the vaccine.

"However, much of the material did not address the full complexity of the issues surrounding the vaccine and did not provide balanced recommendations on risks and benefits," the authors note.

Continue reading "HPV vaccine promoted with drug company money" »

Posted by Kelly Brewington at 12:22 PM | Permalink | Comments (6)
Categories: Medical studies, Pediatrics
        

If you carried a gene that made it more likely you would someday get Alzheimer's disease, would you want to know?

How would you react to knowing that your risk for getting the progressive, fatal brain disorder was 50 percent?

A University of Michigan study out in today's New England Journal of Medicine suggests that people react much better to the news than expected. Disclosure of the genetic testing results in adult children of Alzheimer's patients did not have short-term psychological effects -- even in those who were told they carried the gene. Those who found out they did not carry the gene were relieved, though even without the gene, someone can still get Alzheimer's.

Continue reading "Would you want to know you have an Alzheimer's gene?" »

Posted by Stephanie Desmon at 8:30 AM | Permalink | Comments (2)
Categories: Medical studies