35 not focus any more
WASHINGTON - The Associated Press reported there's a big change coming for pregnant women: Down syndrome (DS) testing no longer hinges on age 35. The American College of Obstetricians and Gynecologists now urges every pregnant woman, despite age, be offered a choice of tests for this common birth defect because tests far less invasive than the long-used amniocentesis are now widely available. Some can tell in the first trimester the risk of a fetus having DS or other chromosomal defects. It's a change that promises to decrease unnecessary amnios while detecting DS in moms who would have gone unchecked. The new guideline was in the journal Obstetrics & Gynecology. About one in 800 babies has DS: an extra chromosome causes mental retardation, a characteristic broad, flat face and small head and, often serious heart defects. The older women are, the higher their risk of a DS baby. It's a gradual increase in risk: one in 1,200 at age 25 to about one in 300 at age 35.
ST. LOUIS - Children with Cerebral Palsy (CP) and other neurological problems often have extremely poor eyesight. Their ability to read, pick up objects, and "see" the world is so impaired and complicated to treat many go untreated, even though they may be legally blind. Dr. Janice Brunstrom, assistant professor of neurology and pediatrics at Washington University School of Medicine and a neurologist at St. Louis Children's Hospital, saw firsthand how her patients' poor vision interfered with every aspect of their daily lives. Having CP herself and wanting to help reverse the isolation many of these children endure because of their poor vision, she spoke with pediatric ophthalmologist Dr. Lawrence Tychsen to help devise solutions. As a professor of ophthalmology and visual sciences and ophthalmologist-in-chief at St. Louis Children's Hospital, she developed specialized testing and now does vision correction (refractive) surgery, on children with cerebral CP, Down syndrome, and neurobehavioral disorders such as Autism. To date, St. Louis Children's Hospital is one of the only U.S. medical centers performing refractive surgery on these children and has the highest volume.
GOLDEN, CO - MedPage Today noted more than 300,000 Medicare patients died 2003-2005 because they were hospitalized in institutions that were average or poor on report cards issued today by HealthGrades, a for-profit healthcare quality rating service. HealthGrades, which evaluated Medicare records from 40.6 million hospitalizations during those years, estimated a patient treated at a hospital that received five stars had a 69% lower chance of dying than a similar patient treated at a hospital rated one-star, the poorest, and a 49% lower chance of death than if treated at an average hospital (three stars). The rating service evaluated 5,000 hospitals. A HealthGrades spokesperson said "roughly 15%" of the hospitals received five stars in 28 diagnoses and procedure categories in the report.
If all hospitals that treat Medicare patients performed as well as HealthGrades' five-star rated hospitals, "302,403 Medicare lives could have potentially been saved from 2003 to 2005." Half of the excess Medicare deaths occurred in patients diagnosed with heart failure, community acquired pneumonia, sepsis, and respiratory failure treated in hospitals that received a poor rating for treating those conditions, according to HealthGrades.
WASHINGTON - Monday Morning in Washington, DC noted the Work 27 (disability.law.uiowa.edu/lhpdc/publications/documents/hschartz/Work27_2006.pdf abstract states: “One central component to meaningful employment for people with disabilities is the ADA’s workplace accommodation provision that allows qualified individuals to perform essential job functions. Little empirical evidence is available to evaluate the costs, benefits, and effectiveness of accommodations. Previous research focused on direct costs. This article advocates an inclusive accommodation cost/benefit analysis to include direct and indirect costs and benefits and to differentiate disability-related accommodation costs from typical employee costs. The inclusive cost/benefit analysis is applied to preliminary data from interviews with employers who contacted the Job Accommodation Network. Results suggest accommodations are low cost, beneficial, and effective.
SALT LAKE CITY, UT - Scientists at the John A. Moran Eye Center at the University of Utah identified a gene, HTRA1, that contributes to a major risk of Age-Related Macular Degeneration (AMD), the most common cause of irreversible vision loss in the developed world. The discovery of this gene allows anyone to take a simple blood test to find out if they’re up to 700% more likely to develop AMD than the average person. This is particularly important for individuals who have a family history of blinding eye conditions. This test will allow people with high risk for AMD to adapt diet and lifestyle changes to lower their risk or delay the onset of the disease. Perhaps more significantly, this discovery will very likely lead to new and effective treatments. Lead by Dr. Kang Zhang director of the Division of Ophthalmic Genetics at the Moran Eye Center and Associate Professor of Ophthalmology and Visual Sciences at the University of Utah, the study was published online in the journal Science. AMD is a degenerative disorder affecting a portion of the retina called the macula, responsible for clear, central vision. Individuals with AMD have difficulty with activities like reading, watching television, and seeing faces of people directly across the table. It often leads to legal blindness in patients older than 60.
LAS VEGAS - HealthDay News stated more colonoscopy and other screening seems to have yielded lower colon cancer rates in the U.S., a study shows. Another study finds colonoscopy results are typically valid for at least five years, allaying fears shorter testing intervals might be needed. A third study suggests the end of colonoscopy; instead, a tiny video capsule could help doctors scan the bowel for irregularities. "I think they all are reporting very encouraging information," said Dr. Durado Brooks, director of colorectal cancer at the American Cancer Society. Colorectal malignancies are the second leading cancer killer in the U.S. Unlike many cancers, this one is largely preventable through detection of precancerous polyps. "You could argue no one should get colon cancer at all," said Dr. Jerald Wishner, director of the colorectal cancer program and colorectal surgery at Northern Westchester Hospital in Mt. Kisco, NY. The American College of Gastroenterology urges average-risk individuals start screening at age 50. The preferred method is a colonoscopy once every 10 years. The first study, by a team from the University of California/Irvine, found increased screening for colorectal cancer may have spurred a U.S. decline in the incidence of the disease from 1988 to 2002.
SALT LAKE CITY, UT - A combination of two drugs often used alone increased survival, quality of life, and lung function in patients with chronic obstructive pulmonary disease (COPD), researchers told MedPage Today. Combining Flovent and Serevent in a single formulation resulted in a 17.5% relative risk reduction in all-cause mortality versus placebo, over three years, Dr. Bartolome Celli, of Caritas-St. Elizabeth's Medical Center in Boston, reported at CHEST 2006, the meeting of the American College of Chest Physicians. Dr. Celli told reporters before presenting data from the Towards a Revolution in COPD Health (TORCH) study the issue of significance is likely to be a point of controversy. "Is it a positive trial or a negative trial?" But combined with other analyses, including significant improvements in quality of life, number of exacerbations, and lung function, Dr. Celli said he is "pretty confident" the mortality effect is real.
Doctors with COPD patients should consider prescribing the combination formulation. The multinational TORCH trial enrolled 6,112 patients with moderate-to-severe COPD and randomized them to one of four arms - placebo, Flovent alone, Serevent alone, or the combination formulation.