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Conference Highlights: AAIC 2016

Conference Highlights: AAIC 2016

New research was presented at AAIC 2016, the annual Alzheimer’s Association International Conference, from July 22 to 28 in Toronto. The features below highlight some of the studies emerging from the conference.   Protecting Against Cognitive Decline & Dementia Prior research indicates that lifelong learning and certain types of cognitive training may reduce one’s risk of cognitive decline. Whether these approaches also reduce risk of dementia has yet to be determined. For a study, researchers assessed the effect of three cognitive training programs—memory, reasoning, or speed-of-processing training—on time to incident dementia in more than 2,700 community-dwelling adults aged 65 and older with no baseline evidence of cognitive impairment or dementia. After 10 years, only speed-of-processing training had a statistically significant effect on cognition, with patients in this group 33% less likely to develop cognitive impairment or dementia when compared with controls. Speed training reduced dementia by 8% per completed session and by 48% for those who completed 11 or more sessions. —————————————————————-   Smell Test Predicts Memory Decline A reduced ability to identify odors has been seen in patients who are later diagnosed with Alzheimer’s disease at autopsy. This phenomenon has also been seen in patients with mild memory loss and in those who develop Alzheimer’s disease dementia. However, few studies have compared the predictive utility of odor identification impairment with that of amyloid status in predicting memory decline. Study investigators assessed this link using the University of Pittsburgh Smell Identification Test (UPSIT) among elderly patients with either mild cognitive impairment or normal memory at baseline. Participants had also undergone amyloid PET scanning or lumbar puncture. Amyloid positivity and...
Shocker: Hospitalists’ “Unprofessional” Behavior Is Normal

Shocker: Hospitalists’ “Unprofessional” Behavior Is Normal

By their own admission, medical hospitalists are guilty of many types of unprofessional behavior, says a paper published a in the Journal of Hospital Medicine. A group of researchers from the University of Chicago surveyed medical hospitalists from three major Chicago area teaching institutions. The respondents themselves rated each listed behavior on a professionalism scale. There were 77 responses from a pool of 101 hospitalists who were sent the questionnaires. The study asked respondents to state whether they had either engaged in and/or observed unprofessional conduct. The key findings were as follows: Most of the respondents had engaged in at least one unprofessional behavior. The most common unprofessional behavior was (I hope you are sitting down) having non-medical/personal conversations, such as discussing plans for the evening, in hospital corridors. [Gasp!] Over 60% of these doctors admitted that they ordered a routine test as “urgent” as a way of obtaining results more quickly. (Can you believe it?) My favorite is that 40% confessed that they had made fun of or disparaged the emergency department team for missing findings. (Unreported but very likely true is that 60% of those questioned committed another unprofessional act, which was lying by claiming they had never made fun of or disparaged any ED MDs. The only physicians I know who do not routinely make fun of the ED staff are pathologists because they never deal directly with the ED. Before all you ED docs get your panties in a knot, I am certain all of you disparage all of us too.) Other alleged unprofessional behaviors were celebrating a blocked admission, going to work when ill,...
Conference Highlights: AIDS 2016

Conference Highlights: AIDS 2016

New research was presented at AIDS 2016, the International AIDS Conference, from July 18 to 22 in Durban, South Africa. The features below highlight some of the studies that emerged from the conference.   Comparing TB Treatment Approaches in HIV Patients Research has yet to determine whether an intensified daily regimen or intermittent therapy delivering less medicine for tuberculosis (TB) is more effective for patients diagnosed with TB and HIV. For a study, patients with HIV and TB were assigned to anti-TB drugs daily for 6 months, daily for 2 months followed by three times a week for 4 months, or three times a week for 6 months. All participants also received anti-HIV medication. At 6 months, 98% of patients in daily regimen group had negative TB cultures, compared with a rate of 92% observed in the thrice-weekly group. In the daily regimen group, 98% of patients achieved negative TB cultures at 2 months, compared with a rate of 87% observed in the thrice-weekly group. Patients on the partial daily schedule did better than those on the intermittent schedule overall. Adverse reactions were experienced by 24% of patients on the daily regimen, 19% for those on the partial daily regimen, and 15% for those on the intermittent regimen. —————————————————————-   PrEP Use Among Teens Use of oral pre-exposure prophylaxis (PrEP) has increased substantially among patients at high risk for contracting HIV since being approved by the FDA in 2012. However, use among teens is not FDA approved. As a result, little is known regarding PrEP use in this population. For a study, researchers in Chicago provided PrEP to boys...
“Keep Your Mouth Closed” – Aquatics Olympians Warned

“Keep Your Mouth Closed” – Aquatics Olympians Warned

A body was just found floating in Rio’s Guanabara Bay GamesHealth experts Olympic marathon swimmers, sailors and windsurfers competing in the bay to be ultra careful as the waters are much more contaminated than was previously thought, the Sydney Morning Herald reports. Health concerns have been ongoing for the Games, with recent tests revealing a variety of pathogens in Rio’s waters. Despite recent efforts to clean up household debris, efforts have fallen short. Recent tests by government and independent scientists revealed a veritable petri dish of pathogens in many of the city’s waters, from rotaviruses that can cause diarrhea and vomiting to drug-resistant “superbacteria” that can be fatal to people with weakened immune systems. “They can try to block big items like sofas and dead bodies, but these rivers are pure sludge, so the bacteria and viruses are going to just pass through,” said Stelberto Soares, a municipal engineer who has spent three decades addressing the city’s sanitation crisis. Government officials and the International Olympic Committee acknowledge that, in many places, the city’s waters are filthy. But they say the areas where athletes will compete — like the waters off Copacabana Beach, where swimmers will race — meet World Health Organization safety standards. Continue reading the main story  ...
We Need to Stand United on Herd Immunity

We Need to Stand United on Herd Immunity

We should hold those responsible for spreading false medical information accountable for their actions. Rumors and falsities abound regarding immunizations. Many people refuse to vaccinate their children for untrue reasons, with perhaps the biggest unfounded concern being the risk of autism. Many people feel that vaccinations should be a choice and no one should be allowed to tell them what to do with their own children. But, the fact remains that if we want vaccines to be effective, we need herd immunity (or a general immunity of the entire population). A big argument of the anti-vaxxers is that they are not harming anyone else by their ill-founded decisions. But, the reality of the need for herd immunity struck home with me a few weeks ago when I diagnosed a baby under 12 months old with varicella. This baby was not old enough to receive the varicella vaccination so depended on herd immunity to be protected. As an infant, he was at much greater risks of developing complications from this infection. He remained severely sick for over a week and lost weight because he was not eating. Thankfully, he recovered but why would anyone think it is alright for a baby to be this sick to develop a natural immunity? With a shot, we can provide immunity without the risk of the severe complications that varicella can cause, such as sepsis, dehydration, pneumonia, encephalitis, and others. Why do some think chickenpox parties are a good idea to provide their kids with natural immunity? Do these parents not understand they are placing their child at risk of these serious complications? My...
Malaria drug may help in cancer fight, early research finds

Malaria drug may help in cancer fight, early research finds

An off-patent malaria drug could help to destroy cancer cells by making them more susceptible to radiotherapy, according to early work that has prompted British scientists to start a clinical trial. Researchers reported on Monday that atovaquone boosted oxygen levels in tumor cells in mice, making radiotherapy more effective against a range of cancer types, including lung, bowel, brain and head and neck cancer. Cancer cells with low oxygen levels are more difficult to treat with radiotherapy and are more likely to spread to other parts of the body. “We have now started a clinical trial …to see if we can show the same results in cancer patients,” said lead researcher Gillies McKenna of the Cancer Research UK Radiation Research Centre in Oxford. “We hope that this existing low-cost drug will mean that resistant tumors can be re-sensitized to radiotherapy. And we’re using a drug that we already know is safe.” His team’s findings were published in the journal Nature Communications. The idea of repurposing existing drugs to fight cancer is gaining traction as scientists realize that older medicines can sometimes complement other therapies. The fact that such drugs are already off patent means they are cheap, but the lack of patent protection is also a potential problem because drug companies investing in late-stage research have less certainty of a commercial payback. Atovaquone is used to both treat and prevent malaria. It is usually prescribed to travelers as Malarone, a combination of atovaquone and proguanil developed by...
Scientists find new antibiotic in the human nose

Scientists find new antibiotic in the human nose

Scientists have discovered a bacteria living inside the human nose that produces an antibiotic capable of killing one of the most hard-to-treat pathogens, which causes serious, even deadly skin and wound infections, bloodstream infections and pneumonia. German researchers found that this antibacterial substance was effective in treating skin infections in mice caused by Staphylococcus aureus bacteria, according to a study published Wednesday in Nature. The scientists said the substance, which they named lugdunin, has potent antimicrobial effects against a wide range of bacteria, including antibiotic-resistant strains such as methicillin-resistant S. aureus, or MRSA, and vancomycin-resistant Enterococcus bacteria. The number of MRSA infections is among the highest of all antibiotic-resistant threats. The Centers for Disease Control and Prevention estimates more than 80,000 invasive MRSA infections and more than 11,000 related deaths occurred in 2011, the last year for which data are available. The scientists said their find represents the first known example of a new class of antibiotics. That’s seen as particularly welcome news given the urgent global problem of antibiotic-resistant superbugs and the dwindling arsenal of drugs to replace ones that no longer work. Until now, conventional antibiotic discovery has focused on looking for compounds from bacteria living in dirt. But identifying novel compound structures from soil microbes has been getting harder. The research from Andreas Peschel and colleagues at the University of Tubingen suggests that the immense variety of microorganisms living in the human body, particularly in the nose, may be a potential source of new antibiotics. “These organisms, or the antibiotics they produce, might serve as drug-discovery leads,” Kim Lewis of Northeastern University in Boston wrote in...
Chlorhexidine Dressing Reduces Incidence of Catheter-related Bloodstream Infections

Chlorhexidine Dressing Reduces Incidence of Catheter-related Bloodstream Infections

he application of chlorhexidine dressings may reduce the incidence of definite or probable catheter-related bloodstream infections (CRBSI) in patients with chemotherapy-induced neutropenia, according to a study published in the journal Annals of Oncology. CRBSI frequently causes morbidity and mortality of patients with cancer who experience neutropenia during chemotherapy. Because chlorhexidine-containing catheter securement dressings may reduce the risk of CRBSI, researchers evaluated dressing efficacy by enrolling 613 patients who received care in 10 German hematology departments. Patients with neutropenia were randomly assigned to receive chlorhexidine-containing dressings or control dressings. Incidence of definite CRBSI within the first 14 days of central venous catheter placement was 2.6% in the chlorhexidine group and 3.9% in the control group (P = .375), which did not meet the study’s primary endpoint. It was found, however, that the combined incidence of definite or probable CRBSI within 14 days and the overall incidence of definite or probable CRBSI were significantly lower for patients who received chlorhexidine dressings, versus those who had control dressings (P = .047 and P = .019, respectively). The frequency of dressing intolerance with cutaneous and soft tissue abnormalities at the contact area was similar in both arms (P = .901). Although the study did not achieve its primary endpoint, the findings suggest that the use of chlorhexidine dressings decreases the incidence of definite or probable CRBSI in this at-risk patient...
Biotech Firm Develops First Urine Test for Malaria

Biotech Firm Develops First Urine Test for Malaria

A Nigerian biotechnology firm has come up with a new simple method for diagnosing malaria. This marks the first time urine, and not blood, is being used to test for malaria. The new technology called Urine Test for Malaria (UMT), is a non-invasive bloodless rapid test that can diagnose malaria in less than 25 minutes. UMT uses a simple dip-stick and unlike the old method which requires health personnel, people can self-diagnose for the disease at home. Eddy Agbo, is a biochemist, and the founder of Fyodor, the biotechnology firm that developed this urine test kit. He says that the technology that took him 8 years of research and development, detects malaria parasite proteins in a patient’s urine. “Urine is acidic sample , usually when a protein is present in an acidic environment, it unravels, it becomes difficult to detect by conventional approach, so we had to re-engineer the tool so as to be able to fish it out be it even in that unconventional state,” says Dr. Agbo. This innovation gained international and local recognition after winning the inaugural 2015 Health Innovation Challenge awards in Nigeria. It was also nominated for the African Innovation Foundation (AIF) award in collaboration with the Government of Botswana. Africa continues to bear the brunt of the global burden of malaria. According to the World Health Organization, 88% of global cases and 90% of global deaths occurred in the African Region in 2015. Between the years 2000 and 2015, the number of malaria cases worldwide also declined by 42% while the malaria death rate declined by 66% in Africa. Source:...
The Good, the Bad, and the Ugly: Major Study on Global Burden of HIV Released

The Good, the Bad, and the Ugly: Major Study on Global Burden of HIV Released

Here are the highlights from a study just published in The Lancet HIV, which provide national estimates of levels and trends of HIV/AIDS incidence, prevalence, coverage of antiretroviral therapy (ART), and mortality for 195 countries and territories from 1980 to 2015. Finding Highlights ♦  Global HIV incidence peaked in 1997, at 3.3 million new infections, decreasing by 4.8% per year to 2005. ♦  Annual incidence has stayed relatively constant at about 2.6 million per year since 2005. ♦  Prevalence of people living with HIV increased rapidly, from 2.4 million in 1985, to 28.0 million in 2000. ♦  From 2000 to 2015, the number of people living with HIV increased by 0.8%per year, reaching 38.8 million in 2015. ♦  Global mortality peaked in 2005, at 1.8 million and subsequently fell by 5.5% per year to 1.2 million in 2015. ♦  The proportion of people living with HIV and receiving ART increased rapidly for both sexes between 2005 and 2015, from 6.4% to 38.6% of men, and from 3.3% to 42.4% of women Substantial heterogeneity was reported in the levels and trends of HIV/AIDS across countries. Although many countries have experienced decreases in HIV/AIDS mortality and in annual new infections, other countries have had slowdowns or increases in rates of change in annual new infections. Interpretation Scale-up of ART and prevention of mother-to-child transmission has been one of the great successes of global health in the past two decades. However, in the past decade, progress in reducing new infections has been slow, development assistance for health devoted to HIV has stagnated, and resources for health in low-income countries have grown slowly....
Vaccine strategy induces antibodies that can target multiple influenza viruses

Vaccine strategy induces antibodies that can target multiple influenza viruses

Scientists have identified three types of vaccine-induced antibodies that can neutralize diverse strains of influenza virus that infect humans. The discovery will help guide development of a universal influenza vaccine, according to investigators at the National Institute of Allergy and Infectious Diseases (NIAID), and the National Human Genome Research Institute (NHGRI), both part of the National Institutes of Health (NIH), and collaborators who conducted the research. The findings appear in the July 21st online edition of Cell. The seasonal influenza vaccine must be updated each year because flu viruses mutate. However, the stem region of the virus typically remains unchanged, making it an ideal target for antibodies induced by a universal flu vaccine. Such a vaccine would be effective against multiple subtypes of influenza and therefore would eliminate the need to update the vaccine each year. Until now, scientists had only identified broadly neutralizing antibodies targeting the flu virus stem in humans following natural infection. The new research provides clear evidence that these antibodies can be induced by a vaccine. The investigators examined blood samples from six people who had received a vaccine against H5N1 influenza, commonly known as the bird flu virus. In the blood samples they identified B cells (a type of white blood cell that responds to infection by secreting antibodies) that reacted to various subtypes of influenza virus, and then characterized and classified the cells’ antibody genetic sequences. The scientists discovered the B cells encoded three classes of antibodies — seen among multiple participants — that can neutralize diverse influenza virus subtypes and, therefore, could form the basis of a universal flu vaccine. Researchers can...
CME: Migraine & Stroke Risk

CME: Migraine & Stroke Risk

Migraines affect more than 10% of all Americans and are three times more common in women than in men, according to data from the National Institute of Neurological Disorders and Stroke (NINDS). Although the link between migraine and stroke is not fully understood, research suggests that the two conditions have some clinical features that overlap. The NINDS has reported that risk factors for stroke with migraine-like features include being female, being older than 40, and having low cardiovascular risk profiles. Over the years, many studies have suggested that migraine is a risk factor for stroke. Some analyses have shown that stroke risks are twice as high in people who suffer from migraine with aura than those without aura. For women, stroke risks have been reported to be three times higher when they have migraine with aura. “To date, most of the research examining the link between stroke and migraine has shown that there is a correlation in migraineurs with aura,” says Teshamae S. Monteith, MD.   Taking a Deeper Look For a study published in Neurology, Dr. Monteith and colleagues aimed to determine the association between migraine and stroke and a combination of vascular events, including stroke, heart attack, and death. Participants in the study were from the Northern Manhattan Study, a population-based cohort of stroke incidence. The participants were from an older, ethnically-diverse community in which the population was predominately Hispanic, a patient group that has historically been at a higher risk for stroke. The association between migraine and the combination of vascular events was estimated over an average follow-up of 11 years. After reviewing 1,292 people who reported...
Top 6 Factors Critical to Predicting Pneumonia in Older Adults

Top 6 Factors Critical to Predicting Pneumonia in Older Adults

Data commonly available in EMRs can stratify older adults into groups with varying subsequent 2-year pneumonia risk. Researchers have developed a ‘prediction score’ to help healthcare professionals determine which older adults might be most at risk for developing pneumonia. In a study published in the Journal of American Geriatrics Society, researchers developed a “prediction score” to help healthcare professionals determine which older adults might be most at risk for developing pneumonia. Pneumonia is a leading cause of sickness and death among older adults. About 40 percent of older adults with pneumonia are hospitalized and face high rates of complications and death. Risk factors for pneumonia include increasing age, chronic lung disease, smoking, being underweight, and having difficulty functioning. To determine their prediction score, researchers studied older adults enrolled in the Adult Changes in Thought (ACT) study. The study’s participants included 3,392 older adults living in the Seattle area. They were 65-years-old or older, dementia-free, and did not have any cognitive (thinking) problems. During the study, 642 participants were diagnosed with pneumonia; 574 died. The researchers determined that the six factors critical to a pneumonia prediction score included: ♦  Age ♦  Sex ♦  Chronic obstructive pulmonary disease (or COPD, a group of lung diseases that block airflow and make it difficult to breathe) ♦  Congestive heart failure ♦  Body mass index (being underweight or overweight) ♦  Prescriptions for inhaled or oral corticosteroids (a class of steroid hormones used to treat a variety of conditions including some skin diseases, certain allergic reactions, asthma, and joint pain or inflammation, among other health concerns) Doctors could potentially use the pneumonia prediction score to...
Vaccine to prevent meningitis added to school requirements

Vaccine to prevent meningitis added to school requirements

For the first time in 10 years, a new vaccine has been added to the requirements for Missouri schoolchildren. Students entering the eighth and 12th grades will need to have a meningococcal vaccine before school starts this fall. Meningococcal disease causes meningitis, a highly contagious bacterial disease that starts with flulike symptoms of fever, fatigue and body aches but can escalate quickly to swelling of the brain and spinal cord. It can cause nerve damage and loss of limbs, and leads to death in 10 percent to 15 percent of patients. The disease can be treated with antibiotics if caught early, but the vaccine is the best way to prevent it. With the new rule, Missouri joins a majority of states that have adopted the recommendations of the Centers for Disease Control and Prevention and the American Academy of Pediatrics. Meningitis vaccines for children start about age 11 with a booster dose after age 16. Illinois started requiring the meningitis vaccine for sixth- and 12th-graders in 2015. In the last decade, there have been an estimated 162 cases of meningococcal disease in Missouri and 23 deaths, according to the state health department. Between 1,000 and 2,600 Americans are infected each year. “By requiring the meningococcal vaccination, we will help prevent deaths and life-long consequences for individuals contracting the disease,” said Ryan Hobart, a spokesman for the Missouri Department of Health and Senior Services, which implemented the new rule. Teenagers and college students living in close quarters are high risk groups for meningitis. The bacteria are primarily spread through the exchange of airway secretions and saliva through kissing or sharing...
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