Some medications are well known for being risky, especially for older people. Certain antihistamines, barbiturates, muscle relaxants—take too much of them, or take them with certain other medications, and you can wind up in serious trouble (and possibly in the back of ambulance).
But researchers from the federal Centers for Disease Control and Prevention (CDC) and Emory University reported in this week’s New England Journal of Medicine that those high-risk medications are not the ones that most commonly put older Americans (ages 65 and older) in the hospital.
Warfarin is #1
Instead, they found that warfarin is the most common culprit. Warfarin (the brand-name version is called Coumadin) reduces the blood’s tendency to clot. Many older people take it to lower their risk of getting a stroke.
After warfarin, different Read more »
*This blog post was originally published at Harvard Health Blog*
The Society for Participatory Medicine was well represented last week at the 14th ICSI/IHI Colloquium. (ICSI is the Institute for Clinical Systems Improvement, a small midwestern think tank that’s way too poorly known.) SPM members who presented:
- Jane Sarasohn-Kahn of Health Populi gave the keynote for Day 2
- Jessie Gruman, four time cancer patient and founding co-editor of our journal, gave an important breakout session, about which I’ll be writing soon. (Jessie is founder and president of the excellent Center For Advancing Health.)
- Brian Ahier presented on the status of health IT, as Meaningful Use rolls out. (“You can’t measure the improvements that you gotta measure, unless you have computers keeping track of it.”)
- I gave a half-day pre-conference workshop titled “Participatory Health: Reshaping Patient Care.” I’m told the workshop had 40-50% higher registration than usual: interest in participatory medicine is strong.
An unexpected bonus was that right outside the workshop door, a poster presentation addressed some questions people often ask about patient participation and online health records:
- Will patients with problems actually use a PHR (personal health record)? (Many observers say PHRs are a non-starter, a pointless exercise.) Read more »
*This blog post was originally published at e-Patients.net*
Our modern armamentarium for treating cancer is impressive, but sometimes despite our best treatments, tumor cells continue to lurk in the bloodstream, seeding metastases throughout the body. Researchers at Emory have developed a way to monitor for these circulating tumor cells using gold nanoparticles.
This technique has been used before, but difficulty was encountered because white blood cells are close to the same size as some tumor cells, so they would both be tagged, necessitating a laborious multi-antibody staining process.
“The key technological advance here is our finding that polymer-coated gold nanoparticles that are conjugated with low molecular weight peptides such as EGF are much less sticky than particles conjugated to whole antibodies,” says Shuming Nie, Ph.D., a professor in the Wallace H. Coulter Department of Biomedical Engineering at Georgia Tech and Emory University. “This effect has led to a major improvement in discriminating tumor cells from non-tumor cells in the blood.”
Once these tumor cells are tagged with the gold nanoparticles, laser illumination reveals which cells are tumors in the bloodstream. This technique was tested on 19 patients with head and neck cancer, and showed excellent correlation with previous techniques. If this method can be validated in larger studies, it shows promise as a faster, more economical method to detect circulating tumor cells.
Full story: Nanoparticles May Enhance Circulating Tumor Cell Detection …
Abstract in Cancer Research : Quantification of circulating tumor cells in peripheral blood using EGFR-targeting gold nanoparticles
*This blog post was originally published at Medgadget*
This is a guest post by Dr. Juliet Mavromatis:
The emergence of a new generation of anticoagulants, including the direct thrombin inhibitor, dabigatran and the factor Xa inhibitor, rivaroxaban, has the potential to significantly change the business of thinning blood in the United States. For years warfarin has been the main therapeutic option for patients with health conditions such as atrial fibrillation, venous thrombosis, artificial heart valves and pulmonary embolus, which are associated with excess clotting risk that may cause adverse outcomes, including stroke and death. However, warfarin therapy is fraught with risk and liability. The drug interacts with food and many drugs and requires careful monitoring of the prothrombin time (PT) and international normalized ratio (INR).
Recently, when I applied for credentialing as solo practioner, I was asked by my medical malpractice insurer to detail my protocol for monitoring patients on anticoagulation therapy with warfarin. When I worked in group practice at the Emory Clinic in Atlanta I referred my patients to Emory’s Anticoagulation Management Service (AMS), which I found to be a wonderful resource. In fact, “disease management” clinics for anticoagulation are common amongst group practices because of the significant liability issues. Protocol based therapy and dedicated management teams improve outcomes for patients on anticoagulation with warfarin. Read more »
*This blog post was originally published at ACP Hospitalist*