Medical Students Using Facebook and Twitter Can Get Expelled
October 29, 2009
A large number of U.S. medical schools say students have posted unprofessional material on Web sites such as MySpace, Facebook, and Twitter, but few schools have adequate policies in place for dealing with such behavior, a new study found.
Of 78 U.S. medical schools that responded to a survey, 60% reported incidents of students posting unprofessional content online, including material that was classified as profane (52% of the respondents), discriminatory (48%), sexually suggestive (38%), or violated patient confidentiality (13%), according to a report in the Sept. 23 Journal of the American Medical Association.
“While most incidents resulted in informal warnings, some were serious enough to lead to dismissal,” Katherine C. Chretien, MD, of George Washington University School of Medicine and Health Sciences, and colleagues wrote.
Why Antidepressants Don’t Work For So Many
October 28, 2009
For more than half the people who take antidepressants, relief from their symptoms never comes.
Why? Because the cause of depression has been oversimplified and drugs designed to treat it aim at the wrong target, according to new research from the Northwestern University Feinberg School of Medicine. The medications are like arrows shot at the outer rings of a bull’s eye instead of the center.
A study from the laboratory of long-time depression researcher Eva Redei, presented at the Neuroscience 2009 conference in Chicago this week, appears to topple two strongly held beliefs about depression. One is that stressful life events are a major cause of depression. The other is that an imbalance in neurotransmitters in the brain triggers depressive symptoms.
Both findings are significant because these beliefs were the basis for developing drugs currently used to treat depression.
Changing Behavior Helps Patients Take Medication as Prescribed
October 28, 2009
Taking medication as the doctor prescribes is crucial to improving health. However, 26 to 59 percent of older adults do not adhere to instructions, according to a 2003 study published in Drugs and Aging. In a new study, researchers at the University of Missouri found that applying behavior changing strategies, such as using pill boxes or reducing the number of daily doses, can improve patients’ abilities to take their medications as required.
“It is very important for physicians and nurses to move past educating patients about the need for medication and focus on teaching behavior strategies,” said Vicki Conn, associate dean of research and Potter-Brinton professor in the MU Sinclair School of Nursing. “Implementing these strategies can help older adults take their medications, resulting in better health and well-being.”
The Mizzou researchers found that behavior-changing strategies have a greater impact on medication adherence than reinforcing the importance of taking medication to patients. Effective strategies include reducing the number of doses taken daily, prescribing medications so they can be taken at the same time as other medications, and encouraging the use of pill boxes. Giving patients clear, easy to read instructions for the medications also proved to be effective.
Electronic Medical Records Not Seen As A Cure-All
October 28, 2009
In a health-care debate characterized by partisan bickering, most lawmakers agree on one thing: American medicine needs to go digital.
When President Obama designated $19.5 billion to expand the use of electronic medical records, former House speaker Newt Gingrich (R-Ga.) said it was one of only “two good things” in February’s stimulus package.
But such bipartisan enthusiasm has obscured questions about the effectiveness of health information technology products, critics say. Interviews with more than two dozen doctors, academics, patients and computer programmers suggest that computer systems can increase errors, add hours to doctors’ workloads and compromise patient care.
“Health IT can be beneficial, but many current systems are clunky, counterintuitive and in some cases dangerous,” said Ross Koppel, a sociologist at the University of Pennsylvania School of Medicine who published a key study on electronic medical records in 2005.
Under the stimulus program, hospitals and physicians can claim millions of dollars for IT purchases, and will be penalized if they do not go digital by 2015. Obama has said the changes will save billions and will minimize medication errors.
Latest Analysis Confirms Suboptimal Vitamin D Levels In Millions Of U.S. Children
October 26, 2009
Millions of children in the United States between the ages of 1 and 11 may suffer from suboptimal levels of vitamin D, according to a large nationally representative study published in the November issue of Pediatrics, accompanied by an editorial.
The study, led by Jonathan Mansbach, MD, at Children’s Hospital Boston, is the most up-to-date analysis of vitamin D levels in U.S. children. It builds on the growing evidence that levels have fallen below what’s considered healthy, and that black and Hispanic children are at particularly high risk.
Both the optimal amount of vitamin D supplementation and the healthy blood level of vitamin D are under heated debate in the medical community. Currently, the American Academy of Pediatrics recommends children should have vitamin D levels of at least 50 nmol/L (20 ng/ml). However, other studies in adults suggest that vitamin D levels should be at least 75 nmol/L (30 ng/ml), and possibly 100 nmol/L (40 ng/ml), to lower the risk of heart disease and specific cancers.
Study Finds Best Use of Insulin As Diabetes Progresses
October 26, 2009
A large-scale trial in diabetes patients has provided new evidence on how best to add insulin to standard drugs to control blood sugar levels as type 2 diabetes progresses.
The University of Oxford research was published in the New England Journal of Medicine to coincide with presentation of the final trial results at the World Diabetes Congress in Montreal, Canada.
Patients who added insulin, either through once-a-day (basal) insulin injections or three injections at mealtimes, to their oral anti-diabetes drugs showed better control of their blood sugar levels than those adding twice daily insulin injections.
Those starting with a single insulin injection each day also had fewer hypoglycaemic episodes (when blood sugar levels are too low) and gained less weight.
Affordable Anti-Rejection Drug As Effective as Higher Cost Option
October 26, 2009
A newer, less expensive drug used to suppress the immune system and prevent organ rejection in kidney and pancreas transplant patients works just as well as its much more expensive counterpart, according to a new study by researchers at Wake Forest University Baptist Medical Center.
Such discoveries are vital in an era of skyrocketing health care costs and debate over health reform, said lead investigator Alan C. Farney, M.D., Ph.D., an associate professor of surgery in the Department of General Surgery, Transplantation Services.
“I think it’s very important that the public consider cost, and that they ask their doctors if there are alternatives for them that are less expensive,” he said. “Why should we use one drug or intervention over another that is equally effective and a fraction of the cost?”
Could Some Forms of Mental Retardation Be Treated with Drugs?
October 25, 2009
Growth factors. They are the proteins that trigger a countless number of actions in cells. Drugs that increase or decrease certain growth factors have lead to treatments for cancer and cardiovascular diseases. Georgetown University Medical Center researchers say a new understanding of a growth factor implicated in some mental retardation disorders could lead to a novel treatment.
Abnormalities in the number and shape of dendritic spines, the protrusions that allow communication between brain neurons, have been observed in patients with mental retardation. Previous research led by Baoji Xu, PhD, associate professor in the department of pharmacology, has shown that brain-derived neurotrophic factor (BDNF), a growth factor synthesized in dendrites, regulates the number and shape of dendritic spines required for spatial learning and memory.
In this work, presented during a symposium at the 39th annual meeting of the Society for Neuroscience, Xu and his colleagues halted the transport of BDNF to dendritic spines in mice. They found similar abnormalities in dendritic spine development seen in humans with some forms of mental retardation, such as fragile X syndrome. The mice also exhibited impaired learning and memory.
Could Drugs Used to Treat Mood Disorders, Pain and Epilepsy Cause Psychiatric Disorders Later In Life?
October 25, 2009
Young animals treated with commonly-prescribed drugs develop behavioral abnormalities in adulthood say researchers at Georgetown University Medical Center. The drugs tested include those used to treat epilepsy, mood disorders and pain.
GUMC neuroscientists and others have previously shown that neurons die after these drugs are administered to immature preclinical animal models. They say the regions of the brain where this drug-induced cell death takes place are important in the regulation of mood, cognition, and movement. In the research presented at the 39th annual meeting of the Society for Neuroscience, the scientists examined if behavioral function would be affected by the drugs.
Using behavioral tests to detect characteristics of autism and schizophrenia, the researchers found that when given to infant rats, the drugs caused behavioral abnormalities later in life. What’s more, the abnormalities were not limited to the drugs known to cause neuronal cell death.
One Shot of Gene Therapy and Children with Congenital Blindness Can Now See
October 25, 2009
Born with a retinal disease that made him legally blind, and would eventually leave him totally sightless, the nine-year-old boy used to sit in the back of the classroom, relying on the large print on an electronic screen and assisted by teacher aides. Now, after a single injection of genes that produce light-sensitive pigments in the back of his eye, he sits in front with classmates and participates in class without extra help. In the playground, he joins his classmates in playing his first game of softball.
We are collecting resources and information about how patients and their family members can learn more about enrolling in studies related to the one described here and other clinical trials for vision loss. Please check back on or after October 26, 2009, for more information.
His treatment represents the next step toward medical science’s goal of using gene therapy to cure disease. Extending a preliminary study published last year on three young adults, the full study reports successful, sustained results that showed notable improvement in children with congenital blindness.
The study, conducted by researchers from the University of Pennsylvania School of Medicine and the Center for Cellular and Molecular Therapeutics at The Children’s Hospital of Philadelphia, used gene therapy to safely improve vision in five children and seven adults with Leber’s congenital amaurosis (LCA). The greatest improvements occurred in the children, all of whom are now able to navigate a low-light obstacle course—one result that the researchers call “spectacular.”