June 13, 2011, 7:41 AM CT

Reducing avoidable rehospitalizations

The rehospitalization of senior patients within 30 days of discharge from a skilled nursing facility (SNF) has risen dramatically in recent years, at an estimated annual cost of more than $17 billion. A newly released study from Hebrew Rehabilitation Center (HRC), an affiliate of Harvard Medical School, demonstrates improvements in discharge disposition following a three-pronged intervention that combines standardized admission templates, palliative care consultations, and root-cause-analysis conferences.

The study, reported in the recent issue of the Journal of the American Geriatrics Society, compared patients' discharge disposition from HRC's Recuperative Services Unit (RSU) in Boston, a skilled nursing facility, before and after implementation of the intervention. The rate of patient rehospitalization fell from 16.5 percent to 13.3 percent, a drop of nearly 20 percent. Discharges to home increased from 68.6 percent to 73.0 percent, and discharges to long-term care dropped to 11.5 percent from 13.8 percent.

"The change in discharge disposition observed between the two periods, we believe, reflects an improvement in patient outcomes," says main author Randi E. Berkowitz, M.D., a geriatrician at Hebrew Rehabilitation Center and medical director of the RSU. "Specifically, a lower acute transfer rate likely reflects improved processes of care in the SNF"......... Posted by: Janet      Read more         Source

June 5, 2011, 8:59 PM CT

New generation asthma drug could improve metabolism

Formoterol, a new generation asthma medication, shows great promise for improving fat and protein metabolism, say Australian researchers, who have tested this effect in a small sample of men. The scientists presented their results on Saturday 4 June 2011 at The Endocrine Society's 93rd Annual Meeting in Boston.

The research team comprises members of Professor Ken Ho's lab from Sydney's Garvan Institute of Medical Research as well as Professor Ric Day, a clinical pharmacologist from St. Vincent's Hospital.

Study leader, endocrinologist Dr Paul Lee, focused his PhD research on how various hormones affect metabolism. Of central importance is a class of hormones called catecholamines, which regulate heart rate, metabolism and breathing.

Formoterol is a synthetic catecholamine, the metabolic effects of which have not previously been studied in people. Therapy doses given to animals, however, have shown that it stimulates metabolism without affecting the heart.

"We have known for a long time that catecholamine influences the way the body handles nutrients, in particular fat and protein," said Lee.

"The generation of drugs before formoterol was exploited in the livestock industry around 20 years ago � to reduce the fat and increase the protein content of meat. Unfortunately, these older drugs also caused a faster heart rate"......... Posted by: JoAnn      Read more         Source

June 5, 2011, 8:48 PM CT

Flaxseed no benefit for hot flashes

Flaxseed provides no benefit in easing hot flashes among patients with breast cancer and postmenopausal women, as per a Mayo Clinic and North Central Cancer Treatment Group (NCCTG) study. The randomized, placebo-controlled study was conducted on 188 women between October and December 2009 and found no statistically significant difference in mean hot flash scores between women taking flaxseed and those taking a placebo. Preliminary data published in 2007 by Mayo Clinic researchers suggested consuming 40 grams of crushed flaxseed daily might help manage hot flashes.

VIDEO ALERT: Additional audio and video resources are available at the Mayo Clinic News Blog. Password: Pruthi.

The scientists presented their new findings during the American Society of Clinical Oncology Annual Meeting in Chicago.

"Hot flashes are a common symptom during the menopause transition or following breast cancer therapy," says Sandhya Pruthi, M.D., of Mayo Clinic's Breast Diagnostic Clinic and a researcher with NCCTG. "While our preliminary data from our 2007 pilot study showed a reduction in hot flashes linked to the consumption of ground flaxseed, our newly released study did not result in a significant decrease in hot flashes with eating flaxseed in comparison to placebo".

Dr. Pruthi says patients shouldn't give up flaxseed if they enjoy it. Flaxseed appears to be beneficial for people who want to add fiber and bulk to their diet to manage constipation, she says. Dr. Pruthi says more studies are needed to identify whether flaxseed has any other health benefits......... Posted by: Emily      Read more         Source

June 2, 2011, 8:06 AM CT

Women with BRCA mutations can take hormone-replacement therapy

Women with the BRCA1 or BRCA2 gene mutations, which are associated with a very high risk of breast and ovary cancer, can safely take hormone-replacement treatment (HRT) to mitigate menopausal symptoms after surgical removal of their ovaries, as per new research from the Perelman School of Medicine at the University of Pennsylvania which will be presented Monday, June 6 during the American Society for Clinical Oncology's annual meeting (Abstract #1501). Results of the prospective study indicated that women with BRCA mutations who had their ovaries removed and took short-term HRT had a decrease in the risk of developing breast cancer.

Research has shown that in women who carry the BRCA mutations, the single most powerful risk-reduction strategy is to have their ovaries surgically removed by their mid-30s or early 40s. The decrease in cancer risk from ovary removal comes at the cost of early menopause and menopausal symptoms including hot flashes, mood swings, sleep disturbances and vaginal dryness � quality-of-life issues that may cause some women to delay or avoid the procedure.

"Women with BRCA1/2 mutations should have their ovaries removed following child-bearing because this is the single best intervention to improve survival," says main author Susan M. Domchek, MD, an associate professor in the division of Hematology-Oncology and director of the Cancer Risk Assessment Program at Penn's Abramson Cancer Center. "It is unfortunate to have women choose not to have this surgery because they are worried about menopausal symptoms and are told they can't take HRT. Our data say that is not the case � these drugs do not increase their risk of breast cancer"......... Posted by: Janet      Read more         Source

June 2, 2011, 8:00 AM CT

Source of key brain function

Researchers at the University of Southern California have pinned down the region of the brain responsible for a key survival trait: our ability to comprehend a scene�even one never previously encountered�in a fraction of a second.

The key is to process the interacting objects that comprise a scene more quickly than unrelated objects, as per corresponding author Irving Biederman, professor of psychology and computer science in the USC Dornsife College and the Harold W. Dornsife Chair in Neuroscience.

The study appears in the June 1 issue of The Journal of Neuroscience

The brain's ability to understand a whole scene on the fly "gives us an enormous edge on an organism that would have to look at objects one by one and slowly add them up," Biederman said. What's more, the interaction of objects in a scene actually allows the brain to identify those objects faster than if they were not interacting.

While prior research had already established the existence of this "scene-facilitation effect," the location of the part of the brain responsible for the effect remained a mystery. That's what Biederman and main author Jiye G. Kim, a graduate doctoral student in Biederman's lab, set out to uncover with Chi-Hung Juan of the Institute of Cognitive Neuroscience at the National Central University in Taiwan......... Posted by: Daniel      Read more         Source

June 2, 2011, 7:51 AM CT

Single moms entering midlife may lead to public health crisis

Unwed mothers face poorer health at midlife than do women who have children after marriage, as per a new nationwide study, which appears in the June 2011 issue of the American Sociological Review

Scientists observed that women who had their first child outside of marriage described their health as poorer at age 40 than did other moms.

This is the first U.S. study to document long-term negative health consequences for unwed mothers, and it has major implications for our society, said Kristi Williams, main author of the study and associate professor of sociology at Ohio State University.

About 40 percent of all births in the United States now occur to unmarried women, in comparison to less than 10 percent in 1960, Williams said. That suggests there will soon be a population boom in the United States of single mothers suffering middle-aged health problems.

"We are soon going to have a large population of single mothers who are entering midlife, when a number of health problems just begin to emerge," Williams said. "This is a looming public health crisis that has been pretty much ignored by the public and by policymakers".

Moreover, the study suggests that later marriage does not generally help reverse the negative health consequences of having a first birth outside of marriage. This calls into question the value of government efforts to promote marriage, among low-income, single mothers, at least in terms of their consequences for these women's health......... Posted by: JoAnn      Read more         Source

June 2, 2011, 7:48 AM CT

Children of divorce fall behind peers in math, social skills

Divorce is a drag on the academic and emotional development of young children, but only once the breakup is under way, as per a research studyof elementary school students and their families.

"Children of divorce experience setbacks in math test scores and show problems with interpersonal skills and internalizing behavior during the divorce period," says Hyun Sik Kim, a Ph.D. candidate in sociology at the University of Wisconsin-Madison. "They are more prone to feelings of anxiety, loneliness, low self-esteem and sadness".

Kim's work, reported in the recent issue of American Sociological Review, makes use of data from the Early Childhood Longitudinal Study describing more than 3,500 U.S. elementary school students who entered kindergarten in 1998. The study, which also made subjects of parents while checking in periodically on the children, gave Kim the opportunity to track the families through divorce � as well as through periods before and after the divorce.

While the children fell behind their peers in math and certain psychological measures during the period that included the divorce, Kim was surprised to see those students showing no issues in the time period preceding the divorce.

"I expected that there would be conflict between the parents leading up to their divorce, and that that would be troublesome for their child," Kim says. "But I failed to find a significant effect in the pre-divorce period"......... Posted by: JoAnn      Read more         Source

May 29, 2011, 2:18 PM CT

Why does flu trigger asthma?

When children with asthma get the flu, they often land in the hospital gasping for air. Scientists at Children's Hospital Boston have found a previously unknown biological pathway explaining why influenza induces asthma attacks. Studies in a mouse model, published online May 29 by the journal Nature Immunology, reveal that influenza activates a newly recognized group of immune cells called natural helper cells � presenting a completely new set of drug targets for asthma.

If activation of these cells, or their asthma-inducing secretions, could be blocked, asthmatic children could be more effectively protected when they get the flu and possibly other viral infections, says senior investigator Dale Umetsu, MD, PhD, of Children's Division of Immunology.

Eventhough most asthma is allergic in nature, attacks triggered by viral infection tend to be what put children in the hospital, reflecting the fact that this type of asthma isn't well controlled by existing drugs.

"Virtually 100 percent of asthmatics get worse with a viral infection," says Umetsu. "We really didn't know how that happened, but now we have an explanation, at least for influenza".

Natural helper cells were first, very recently, discovered in the intestines and are recognized to play a role in fighting parasitic worm infections as part of the innate immune system (our first line of immune defense)......... Posted by: JoAnn      Read more         Source

May 29, 2011, 2:14 PM CT

What is a laboratory mouse?

Mice and humans share about 95 percent of their genes, and mice are recognized around the world as the leading experimental model for studying human biology and disease. But, says Jackson Laboratory Professor Gary Churchill, Ph.D., scientists can learn even more "now that we really know what a laboratory mouse is, genetically speaking."

Churchill and Fernando Pardo-Manuel de Villena, Ph.D., of the University of North Carolina, Chapel Hill, leading an international research team, created a genome-wide, high-resolution map of most of the inbred mouse strains used today. Their conclusion, published in Nature Genetics: Most of the mice in use today represent only limited genetic diversity, which could be significantly expanded with the addition of more wild mouse populations.

The current array of laboratory mouse strains is the result of more than 100 years of selective breeding. In the early 20th century, America's first mammalian geneticists, including Jackson Laboratory founder Clarence Cook Little, sought to understand the genetic processes that lead to cancer and other diseases. Mice were the natural experimental choice as they breed quickly and prolifically and are small and easy to keep.

Lacking the tools of molecular genetics, those early researchers started by tracking the inheritance of physical traits such as coat color. A valuable source of diverse-looking mouse populations were breeders of "fancy mice," a popular hobby in Victorian and Edwardian England and America as well as for centuries in Asia......... Posted by: Scott      Read more         Source

May 19, 2011, 8:56 AM CT

Snapshots of Huntington's disease protein

Scientists at the Department of Energy's Oak Ridge National Laboratory and the University of Tennessee have for the first time successfully characterized the earliest structural formation of the disease type of the protein that causes Huntington's disease. The incurable, hereditary neurological disorder is always fatal and affects one in 10,000 Americans.

Huntington's disease is caused by a renegade protein "huntingtin" that destroys neurons in areas of the brain concerned with the emotions, intellect and movement. All humans have the normal huntingtin protein, which is known to be essential to human life, eventhough its true biological functions remain unclear.

Christopher Stanley, a Shull Fellow in the Neutron Scattering Science Division at ORNL, and Valerie Berthelier, a UT Graduate School of Medicine researcher who studies protein folding and misfolding in Huntington's, have used a small-angle neutron scattering instrument, called Bio-SANS, at ORNL's High Flux Isotope Reactor to explore the earliest aggregate species of the protein that are thought to bethe most toxic.

Stanley and Berthelier, in research published recently in Biophysical Journal, were able to determine the size and mass of the mutant protein structures―from the earliest small, spherical precursor species composed of two (dimers) and three (trimers) peptides―along the aggregation pathway to the development of the resulting, later-stage fibrils. They were also able to see inside the later-stage fibrils and determine their internal structure, which provides additional insight into how the peptides aggregate......... Posted by: Daniel      Read more         Source