March 23rd, 2010 by RamonaBatesMD in Better Health Network, Health Tips, News, Research
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Until recently, the therapeutic use of non-cosmetic Botox (botulinum toxin) for adult upper extremity spasticity was considered off-label use. The U.S. Food and Drug Administration (FDA) has now approved Botox to treat spasticity in the upper extremity flexor muscles in adults.
Spasticity is common after stroke, traumatic brain injury, or the progression of multiple sclerosis. Spasticity is defined as:
“a motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes (muscle tone) with exaggerated tendon jerks, resulting from hyper-excitability of the stretch reflex as one component of the upper motor neuron syndrome.”
Spasticity often creates problems with mobility, self-care, and function. The spastic muscles can become stiff. Associated joints can be affected by lack decreased range-of-motion with contractures forming. Read more »
*This blog post was originally published at Suture for a Living*
March 14th, 2010 by Joseph Scherger, M.D. in Better Health Network, Health Tips, Research
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One of the great fears we all have is to lose our mental ability as we grow old. No one wants to end their life with dementia (such as Alzheimer’s Disease). We all should be highly motivated to do things to avoid this tragic outcome. We already know that regular exercise is good for the mind and may reduce the risk of dementia. Recent evidence shows that the use of statin medications to lower cholesterol may help reduce dementia risk. Now we have evidence that the roll of fat around your waist may be a marker for increased dementia risk.
The University of California, Berkeley Wellness Letter (February, 2010) reports on a study published in the journal Neurology that followed 1500 Swedish women for 30 years. Those with more fat around the waist were twice as likely to have dementia by age 70 compared with thinner women. A 2008 study from Kaiser Permanente that included men and women showed similar results. Read more »
*This blog post was originally published at eDocAmerica*
March 9th, 2010 by Happy Hospitalist in Better Health Network, Opinion
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The CDC has put out an interactive map of heart disease and stroke so you can compare your state or even county with the rest of the country. It offers data on mortality, hospitalizations and even penetration of generalist and subspecialist availability.
What I found interesting was the lack of definitive association between access to generalists or subspecialists and mortality. While rural areas with a low penetration of physicians generally had a higher mortality than urban centers, many urban centers with a high penetration of generalists and subspecialist also had a high mortality as well. One could presume that rural America has many factors separate and independent of health care that affects their mortality rate. The same could be said for urban America. Read more »
*This blog post was originally published at The Happy Hospitalist*
March 4th, 2010 by JessicaBerthold in Better Health Network, Opinion
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Quality and safety metrics that will specifically affect neurologists/neurohospitalists are coming in the next few years, and neurohospitalists need to be involved in the discussion of what those metrics are, warned S. Andrew Josephson of USCF during a neurohospitalists session at the Stroke 2010 conference yesterday.
He urged the audience to consider the current metric of “time to antibiotics administration for pneumonia,” which seems like a reasonable quality metric on the surface. To get compliance rates up, many hospitals give antibiotics to anyone with a little sputum, a cough, a fever, etc., as soon as he/she arrives at the ED. Thus, resistance rates have risen along with administration rates, because people are getting the drugs when they have things like bronchitis, not just pneumonia. Read more »
*This blog post was originally published at ACP Hospitalist*
March 1st, 2010 by JessicaBerthold in Better Health Network, Health Tips
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Some quick tips about medically managing patients with acute intracerebral hemorrhage, courtesy of a talk at Stroke 2010 by Craig Anderson, MD, George Institute for International Health in Sydney NSW, Australia:
–avoid excess elevation of variables like blood pressure, glucose levels and body temperature
–maintain hydration; many of these patients present dehydrated
–elevate the head
–abandon intensive insulin therapy
–In terms of lowering blood pressure, going from 220 mm Hg systolic to 140 mm Hg over one hour appears safe, but it’s still unknown whether more rapid lowering is better, or if it would be better to achieve a lower systolic level.
*This blog post was originally published at ACP Hospitalist*
