December 5th, 2011 by RyanDuBosar in News, Research
Tags: Atrial Fibrillation, Cardiac Electrophysiology, Cardiology, Heart Disease, Risk, Supplements, Vitamin D
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Too much vitamin D can lead to 2.5 times the risk of atrial fibrillation, researchers found.
To determine if there is a correlation between too much vitamin D and increased heart risk, researchers examined blood tests from 132,000 patients in the Intermountain Healthcare Center database. Results were presented at the American Heart Association Scientific Sessions in November, and appeared at the Intermountain website.
Patients did not have any known history of atrial fibrillation, and all had previously received a vitamin D assessment as part of their routine care. Patients were then placed into categories to compare levels of vitamin D: low (less than 20 ng/dL), low/normal (21-40 ng/dL), normal (41-80 ng/dL), high/normal (81-100 ng/dL), and excess (more than 100 ng/dL).
Patients with low, low-normal, normal and high-normal levels of vitamin D had no increased risk of atrial fibrillation. However, atrial fibrillation risk Read more »
*This blog post was originally published at ACP Hospitalist*
December 5th, 2011 by ErikDavis in Opinion, Quackery Exposed, Research
Tags: Alternative Medicine, Andrew Wakefield, Autism, Chicken Pox, Chickenpox, Measles, Parents, Pediatrics, Pox Parties, Pseudoscience, Rubella, Skepticism, Statistics, Vaccines
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Source
There has been much abuzz about “pox parties” – the practice of parents getting a bunch of unvaccinated kids together with an infected one (pick one, really, though chicken pox is the focus of the recent article in Time) in the hope that their little sweethearts become ill and therefore “naturally” immune to the disease. This deliberate infection involves things as seemingly innocent as breathing the same air as the infected to the stomach-turning sharing of bodily fluids (Saliva lemonade, anyone?). To compound the issue, it seems that parents aren’t always taking into account how the viruses are transmitted, and end up trying oral transmission to transmit a disease that is transmitted through the air. And yes, the whole thing is as stupid as it seems.
Given that the people partaking in these events have likely not vaccinated their children against anything else, these parties could be a source point for multiple highly contagious infections. Most of us have had chicken pox as children and don’t remember it fondly – now imagine having chicken pox with mumps, mono, and maybe a little hepatitis A to top it off. It is also easy to forget in Western luxury that these innocuous childhood illnesses are actually lethal. Just measles? Well, one death per 3000 measles infections might not seem like much, until you consider the fact that in 2008, 164,000 people died of the measles worldwide – approximately the same number of civilians that have died in the entire length of the current Iraq war. That’s an annual number, and it’s gone down by almost 80% over 10 years. How? Read more »
*This blog post was originally published at Skeptic North*
December 4th, 2011 by DavedeBronkart in News, Research
Tags: decision-making, EHR, EMR, Evidence Based Medicine, HIT Exchange, Lupus, Medical Records, NEJM, Record Sharing, Similar Patients
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Wow. Todd Park, Chief Technical Officer at HHS, ought to be jumping out of his skin with joy at this one.
This time, House, M.D. fans, it was lupus. The article “Evidence-Based Medicine in the EMR Era” published in the Nov. 10 issue of the New England Journal of Medicine might have read like a House television script, but it was a real-life glimpse of what the most optimistic health IT advocates are hoping will become commonplace in U.S. health care: Mining EHR data to arrive at treatment decisions.
In a Health IT Exchange piece (on TechTarget) EHR data spurs real-time evidence-based medicine, Don Fluckinger summarizes (and dramatizes, accurately) this early specimen of care being transformed – beyond the literature – by looking at past records. Faced with a 13 year old lupus patient with a complex problem (see article for details)…
In four hours, they did a retrospective study of similar patients in the hospital’s data warehouse…, and decided to move ahead with the treatment based on the previous results of 98 [similar patients] … The authors said they will never know if they made the “correct” decision, but they did know that — in absence of randomized trial research to support their decision — they acted on the evidence of the best data available, coupled with their experience.
“Our case is but one example of a situation in which the existing literature is insufficient to guide the clinical care of a patient,” the authors wrote. …
What are we waiting for, people?? Imagine if Read more »
*This blog post was originally published at e-Patients.net*
December 4th, 2011 by Medgadget in Expert Interviews, Research
Tags: Cancer, Detection, Dr. Hisataka Kobayashi, FITC, Fluorescence, Genetics, National Cancer Institute, Nature Medicine, Oncology, Ovarian Cancer, Research, Science Translational Medicine, Spray, Study, Tumor
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Two months ago we reported on the first ovarian cancer surgeries performed with fluorescence guidance. As described in the Nature Medicine paper, the international team of researchers from The Netherlands, Germany, and Indiana used folate coupled to fluorescein isothiocyanate (FITC) to make ovarian cancer cells glow so they could be easily identified.
Now, in this week’s issue of Science Translational Medicine, another international team from Japan and Maryland reports their development of a spray-on probe that may provide even better sensitivity and fluorescent contrast than the folate-FITC counterpart. The editors of STM summarize this work well in the following note: Read more »
*This blog post was originally published at Medgadget*
December 3rd, 2011 by Elaine Schattner, M.D. in Opinion, Research
Tags: Annals Of Internal Medicine, Cancer Diagnosis, Cancer Screening, Cervical Cancer, Cytology, DNA Testing, Gynecology, HPV, Human Papillomavirus, Pap Smear, Pap Test, Pathology, Under-The-Radar, USPSTF, Women's Health
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The latest issue of the Annals of Internal Medicine contains 2 noteworthy papers on cervical cancer screening. The first, a systematic review of studies commissioned by the USPSTF, looked at 3 methods for evaluating abnormalities in women over 30 years:
high-grade cervical cell dysplasia (Dr. E. Uthman, Wikimedia Commons)
1. Conventional cytology (as in a Pap smear; the cervix is scraped and cells splayed onto a microscope slide for examination);
2. Liquid-based cytology (for LBC, the NHS explains: the sample is taken as for a Pap test, but the tip of the collection spatula is inserted into fluid rather than applied to slides. The fluid is sent to the path lab for analysis);
3. Testing for high-risk HPV (human papillomavirus). Currently 3 tests have been approved by the FDA in women with atypical cervical cells or for cervical cancer risk assessment in women over the age of 30: Digene Hybrid Capture 2 (manufactured by Quiagen), Cobas 4800 HPV (Roche) and Cervista HR HPV (Hologic); another Roche Diagnostics assay, Amplicor HPV, awaits approval.
These HPV assays use distinct methods to assess DNA of various HPV strains.
There’s a lot of jargon here, and I have to admit some of this was new to me despite my nearly-due diligence as a patient at the gynecologist’s office and my familiarity as an oncologist with the staging, clinical manifestations and treatment of cervical cancer. Who knew so many decisions were made during a routine pelvic exam about which manner of screening? Read more »
*This blog post was originally published at Medical Lessons*
