Study in Oncologic Surgery Patients Confirms Opioid-Sparing Effects of Hypnosis Anesthesiology News
Read more:
Emergency Docs at "Breaking Point" — Demand Action – Franklin Observer
(Image courtesy of American College of Emergency Physicians)
The overwhelming majority of emergency department (ED)physicians across the country have experienced, witnessed or been subjected to threats, abuse, assault and injury during their shifts, said Dr. Melisa Lai-Becker, chief of Mass General Brigham Community Emergency Medicine. Under existing law, a nurse can be punched and kicked by a patient or visitor and the crime is classified as simple assault, which is a misdemeanor, rather than a felony charge of assault and battery with a dangerous weapon, she said.
"There are, unfortunately, many people who have come at us, who knowingly and willingly have assaulted us and our staff, and they are our patients, and they have committed only a misdemeanor," Lai-Becker said. "And we call the police, and the police are just as frustrated. Our partners in law enforcement, they also tell us, 'I am sorry, this is a misdemeanor, I am not allowed to take them away, I can't take them into custody.'"
Instead, Lai-Becker said, violent patients end up staying at the hospital and taunting health care workers, whose colleagues may be admitted for care themselves after an attack.
Emergency physicians looking to strengthen safety protections for health care workers and stiffen penalties for assault charges had a powerful ally on hand during their Beacon Hill lobby day Thursday.
"I don't sponsor many bills because I'm the majority leader, but this bill was important to me," House Majority Leader Michael Moran said about his bid to crack down on violence in health care settings as he described learning about the issue from advocates. "We have a few months left in this session. It is my hope that we get this out of Health Care Finance -- which I believe is the committee it's in right now; it was reported to that committee from Public Safety -- and see if we can get this across the line between now and the end of July."
Moran's bill (H 2381) was reported favorably out of the Joint Committee on Public Safety and Homeland Security on May 22 and sent to the Joint Committee on Health Care Financing. It would create standards for hospitals to evaluate security risks, require hospitals to develop violence prevention plans, implement mandatory and protected reporting protocols tied to safety incidents, and classify assaults against health care providers and first responders as a felony.
Doctors and residents with the Massachusetts College of Emergency Physicians are also prioritizing their advocacy around overhauling the involuntary commitment landscape for individuals grappling with alcohol and substance use disorders, and establishing a 10-year pilot program for overdose prevention centers to stem the tide of opioid-related overdose deaths. Those proposals have gained some traction among legislators, but still need key committee votes to advance to the floor for debate before the end of formal sessions next month.
Physicians made their requests to lawmakers against the backdrop of deteriorating health care conditions, including the protracted emergency room boarding crisis that's leading to poorer outcomes for patients, avoidable deaths, burnout for providers and a worsening workforce shortage. The circumstances are making physicians feel like they are doing a "terrible" job and that the health care system is collapsing, said Dr. Joseph Kopp, an emergency physician at Faulkner Hospital and Brigham and Women's Hospital.
"It is at a breaking point. We can't solve the issues that we're having right now when we're trying to see patients in the waiting room," Kopp said. "Hospitals are trying different innovative ways to do this; whether it's hallway care upstairs or early discharges, there's lots of things that they can do. But quite frankly, it's going to take the government and legislative processes to actually fix this issue."
During their legislative briefing, MACEP advocates also sought to generate momentum for an involuntary commitment reform bill from Rep. Ruth Balser (H 1966), which is accompanied by a similar proposal from Sen. Cindy Friedman (S 1247). The legislation, which has been in the House Ways and Means Committee since mid-April, would block the state from sending men to correctional facilities when they are committed for alcohol and substance use disorder treatment.
The overhaul to what's known as Section 35, which physicians said is often seen as a last resort for families looking to keep their loved ones safe, would require men instead to go to treatment facilities administered by the Department of Public Health and the Department of Mental Health. Advocates said officials rely on prison beds when there's a shortage of space in more appropriate treatment settings, though Balser's bill would require the state to maintain an adequate bed supply for men under Section 35.
Women who are involuntarily committed under Section 35 stopped being sent to prisons in 2016, advocates said.
"Massachusetts is the only state in the country that sends individuals to carceral facilities -- the only one that will send them to jails to have this treatment. No other state does this," Dr. Scott Weiner, an emergency physician at Brigham and Women's Hospital, said.
"It's not the best place to be treated for this disease," Weiner continued. "Does it work? Short answer: No. Systematic reviews show that there's no evidence of benefit, and we know that when people get out of a carceral facility, their risk of overdose markedly increases."
Focusing on prevention strategies to tackle the opioid epidemic, emergency physicians support controversial bills to establish overdose prevention centers, where trained professionals are available and can intervene in overdose situations.
Proposals from Reps. Dylan Fernandes and Marjorie Decker and Sen. Julian Cyr (H 1981 / S 1242) that pave a path for the centers, also known as supervised injection sites, have been lodged in the House and Senate Ways and Means committees for months.
Boston could save $4 million annually if the city had an overdose prevention center, by cutting costs from ambulance rides, emergency department visits and hospitalizations, Weiner said, referencing a past study.
"Large studies have shown that there's no harm in using safe injection facilities. In fact, there are reductions in morbidity and mortality, improvement in harm reduction behaviors, there's more access to addiction treatment programs," Weiner said.
Cities and towns that want to open safe injection sites would still need approval from their local boards of health under the bills.
"It's not a mandate. There's a ton of requirements about what they need to provide to patients," Weiner told advocates ahead of their meetings with lawmakers. "We hope that people in this room to influence policy will help move it forward."
Read the original here:
Emergency Docs at "Breaking Point" -- Demand Action - Franklin Observer
RightCare Clinic offers patients emergency services at better value – Grand Rapids Business Journal
A physician group that staffs emergency rooms at hospitals including Corewell Health plans to open its own Grand Rapids clinic next month offering a new model for care that it hopes could expand to additional locations.
Emergency Care Specialists P.C.s RightCare Clinic will provide a level of care above whats available at an urgent care center, yet below what hospitals provide in an emergency room for cases such as trauma injuries, strokes and heart attacks.
RightCare Clinic will include services such as medical imaging X-ray, CT, and diagnostic ultrasound diagnostic labs and cardiac monitoring that urgent care centers lack and refer patients to a hospital to access.
We know there are a lot of things in the ED that could be seen elsewhere if there was the right provider mix, the right available tests and treatment, and those sorts of things, John Throop, president of Emergency Care Specialists, told Crains Grand Rapids Business. Wereintermediating ourselves between the urgent care and the ED, providing a higher level of service without having to do the strokes and the traumas and the heart attacks and those things.
Keep up with all things West Michigan business. Sign up for our free newsletters today.
Emergency medicine physicians will staff the new RightCare Clinic when it is scheduled to open on July 8 in a former West Michigan Cardiology P.C. location at East Beltline Avenue and Bradford Street NE, just north of I-96.
Emergency Care Specialists projects serving 3,400 patients in the first six months of operations.
Conditions the clinic will handle range from minor injuries and illnesses to evaluations for patients with chest and abdominal pain, cardiac monitoring, and intravenous infusions and medication administration. The clinic will refer patients who need a higher level of care to a hospital.
Lacking the cost structure of a hospital and the facility fees that typically accompany an emergency room visit, which is on top of the physician fee, the clinic can provide much of what patients would otherwise get at an ER and for a lower cost, exexutives at Emergency Care Specialists said.
Where we came up with this concept is in realizing that the emergency department is an expensive place of care, largely from the hospital charge and were not a big portion of that equation on the physician side of things and looking for alternatives as patients and employers and patients look for better costs for areas of care, Throop said. The difference with this is its going to be near-ED clinical services without that large facility fee associated with it. We think its a better value.
A 2023 report by prescription service provider Universal Drugstore estimated the average cost of a Michigan ER visit at $1,273. Another analysis this year by benefits company Mira Health pegs the cost at $1,393. Other studies show the cost is much higher, sometimes double, for patients who lack health insurance.
This is going to save a lot of people a lot of money, said Dr. Todd Chassee, vice president of clinical services at Emergency Care Specialists and medical director for RightCare Clinic.
The 40-year-old Emergency Care Specialists staffs emergency rooms at 13 hospitals across the state, including Corewell Health and McLaren Health Care. The group employs nearly 200 physicians and 100 advanced practitioners who treat about 500,000 patients annually. The group also contracts with Cherry Health in Grand Rapids.
RightCare will not operate as a walk-in clinic, but rather focus on same- or next-day patient referrals and appointments, although staff will still accept patients who come in without scheduling an appointment or calling ahead of time, Throop said.
He added that Emergency Care Specialists is close to finalizing agreements with Priority Health and Blue Cross Blue Shield of Michigan to reimburse for members care.
Emergency Care Specialists also has been examining direct contracting with employers, particularly with large self-funded employers who operate their own on-site of near-site employee primary care clinics, Throop said.
If the RightCare Clinic model proves successful, Emergency Care Specialists will examine whether to open more locations in the region.
If this goes how we think it is going to go, therell be more RightCares, Throop said. Well need to see that its sustainable financially. It doesnt have to be operating with a huge margin. It needs to be sustainable and needs to be providing a quality service and doing what we envision that it was going to do in terms of access, convenience and cost.
Expanding hours beyond whats presently planned or adding additional locations will hinge on validating the model behind RightCare, Chassee said.
If we can prove the concept, then we can grow, he said.
More from Crains Grand Rapids Business:
Property managers are a dying breed. Anne Ficeli wants to change that.
Office conversions seen as a path to vibrancy in downtown Kalamazoo
Child-friendly play cafe in Eastown offers space for working parents to gather
Read the original:
RightCare Clinic offers patients emergency services at better value - Grand Rapids Business Journal
New study finds significant increase in heat-related ER visits last year: ‘Every year now we’re doing this earlier and earlier’ – The Cool Down
In 2023, record-breaking heat caused an increase in the number of people visiting the emergency room with heat-related illnesses, according to a Centers for Disease Control and Prevention study detailed by The New York Times.
A recent study by the CDC found that the rate of emergency room visits caused by heat illness increased significantly last year in many areas of the country compared to the previous five years.
The data, collected from an electronic surveillance program used by the government to detect the spread of diseases, showed nearly 120,000 heat-related emergency room visits. More than 90% of these occurred between May and September. The highest number of visits were recorded in the South, in states such as Arkansas, Louisiana, New Mexico, Oklahoma, and Texas.
2023 broke a lot of heat records. According to information from the National Oceanic and Atmospheric Administration, 2023 was the warmest year on Earth since global record-keeping began, and the U.S. experienced its 15th-hottest summer since record-keeping began. Some states felt the heat more than others Louisiana recorded its hottest summer ever, and it was among the top 10 hottest summers in six other states, per Yale Climate Connections.
Climate scientists have been warning for decades about the dangers of a warming planet. Every year we are seeing more deadly heat-related events, such as the astonishing 125-degree heat index that occurred in Puerto Rico last June.
This is having an impact on health. Heat illness often creeps up on people gradually over a few hours and requires immediate attention to cool the body down. Without treatment, it can cause major damage to the body's organs.
Join our newsletter Good news, green hacks, and the latest cool clean tech straight to your inbox every week!
Early symptoms of heat exhaustion include fatigue, dehydration, nausea, headaches, increased heart rate, and muscle spasms.
Trying to keep cool as the temperatures soar is the best way to avoid harm. State officials are working to coordinate cooling shelters in some areas, while in others hospitals are already trying to ensure they are ready to cope with the number of heat illness patients they are expecting this year.
Dr. Aneesh Narang, an emergency medicine specialist at Banner-University Medical Center in Phoenix, told the Times: "Every year now we're doing this earlier and earlier. We know that the chances are it's going to be the same or worse."
There are several ways we can all contribute to reducing the pollution that is causing global warming.
Using public transport or driving electric vehicles, reducing energy consumption, switching to renewable energies, and buying local produce are all steps that one can take to help cool the planet down.Voting for pro-climate candidates and taking local action can also ensure that our governments are working to reduce climate issues and help secure a more sustainable future for our planet.
Join our free newsletter for cool news and cool tips that make it easy to help yourself while helping the planet.
Go here to read the rest:
Phoenix using ice immersion to treat heat stroke victims as Southwest bakes in triple digits – Bay to Bay News
By ANITA SNOW
PHOENIX (AP) The season's first heat wave is already baking the Southwest with triple-digit temperatures as firefighters in Phoenix America's hottest big city employ new tactics in hopes of saving more lives in a county that saw 645 heat-related deaths last year.
Starting this season, the Phoenix Fire Department is immersing heatstroke victims in ice on the way to area hospitals. The medical technique, known as cold water immersion, is familiar to marathon runners and military service members and has also recently been adopted by Phoenix hospitals as a go-to protocol, said Fire Capt. John Prato.
Prato demonstrated the method earlier this week outside the emergency department of Valleywise Health Medical Center in Phoenix, packing ice cubes inside an impermeable blue bag around a medical dummy representing a patient. He said the technique could dramatically lower body temperature in minutes.
Just last week we had a critical patient that we were able to bring back before we walked through the emergency room doors, Prato said. That's our goal to improve patient survivability.
The heatstroke treatment has made ice and human-sized immersion bags standard equipment on all Phoenix fire department emergency vehicles. It is among measures the city adopted this year as temperatures and their human toll soar ever higher. Phoenix for the first time is also keeping two cooling stations open overnight this season.
Emergency responders in much of an area stretching from southeast California to central Arizona are preparing for what the National Weather Service said would be easily their hottest weather since last September.
Excessive heat warnings were issued for Wednesday morning through Friday evening for parts of southern Nevada and Arizona, with highs expected to top 110 degrees Fahrenheit (43.3 Celsius) in Las Vegas and Phoenix. The unseasonably hot weather was expected to spread northward and make its way into parts of the Pacific Northwest by the weekend.
Officials in Maricopa County were stunned earlier this year when final numbers showed 645 heat-related deaths in Arizona's largest county, a majority of them in Phoenix. The most brutal period was a heat wave with 31 subsequent days of temperatures of 110 degrees Fahrenheit (43.4 Celsius) or higher, which claimed more than 400 lives.
Weve been seeing a severe uptick in the past three years in cases of severe heat illness, said Dr. Paul Pugsley, medical director of emergency medicine with Valleywise Health. Of those, about 40% do not survive.
Cooling down patients long before they get to the emergency department could change the equation, he said.
The technique is not very widely spread in non-military hospitals in the U.S., nor in the prehospital setting among fire departments or first responders, Pugsley said. He said part of that may be a longstanding perception that the technique's use for all cases of heatstroke by first responders or even hospitals was impractical or impossible.
Pugsley said he was aware of limited use of the technique in some places in California, including Stanford Medical Center in Palo Alto and Community Regional Medical Center in Fresno, and by the San Antonio Fire Department in Texas.
Banner University Medical Center in Phoenix embraced the protocol last summer, said Dr. Aneesh Narang, assistant medical director of emergency medicine there.
This cold water immersion therapy is really the standard of care to treat heatstroke patients, he said.
See the original post:
Using SI and DSI to Predict Septic Shock in Patients with Sepsis at ED Triage – Physician’s Weekly
The following is a summary of Predicting septic shock in patients with sepsis at emergency department triage using systolic and diastolic shock index, published in the April 2024 issue of Emergency Medicine by Jeon, et al.
Identifying patients at high risk of progressing to septic shock is crucial for timely intervention and improved outcomes. In the pathophysiology of septic shock, systemic vasodilation plays a pivotal role, prompting interest in utilizing diastolic blood pressure (DBP) as a potential predictor. For a study, researchers hypothesized that initial shock index (SI) and diastolic SI (DSI) measured at the emergency department (ED) triage could serve as predictive indicators for septic shock.
The observational study utilized data from a prospectively collected sepsis registry. The primary outcome assessed was the progression to septic shock, while secondary outcomes included time to vasopressor requirement, vasopressor dose, and disease severity based on SI and DSI. Patients were categorized into tertiles based on the first principal component of the shock index and diastolic shock index.
A total of 1,267 patients were analyzed. The area under the receiver operating characteristic curve (AUC) for predicting progression to septic shock was 0.717 for DSI and 0.707 for SI. These AUC values were significantly higher than those for conventional early warning scores. The middle tertile exhibited an adjusted odds ratio (aOR) of 1.448 (95% CI 1.0741.953), while the upper tertile showed an aOR of 3.704 (95% CI 2.2994.111) for progression to septic shock.
Both SI and DSI emerged as significant predictors of progression to septic shock, with DSI also showing an association with vasopressor requirement. Stratifying patients into lower, middle, and upper tertiles based on these indices could provide a simple risk assessment tool at the ED triage, facilitating early identification and intervention for patients at high risk of septic shock.
Reference: sciencedirect.com/science/article/abs/pii/S0735675724000287
Read the original here:
Using SI and DSI to Predict Septic Shock in Patients with Sepsis at ED Triage - Physician's Weekly
Should neonatal-perinatal medicine move to two-year fellowships? | Journal of Perinatology – Nature.com
Keller DM, Davis MM, Freed GL. Access to pediatric subspecialty care for children and youth: possible shortages and potential solutions. Pediatr Res. 2020;87:11512.
Article PubMed Google Scholar
Bethell CD, Read D, Blumberg SJ, Newacheck PW. What is the prevalence of children with special health care needs? Toward an understanding of variations in findings and methods across three national surveys. Matern Child Health J. 2008;12:114.
Article PubMed Google Scholar
Stoll BJ, Hansen NI, Bell EF, Walsh MC, Carlo WA, Shankaran S, et al. Trends in Care Practices, Morbidity, and Mortality of Extremely Preterm Neonates, 1993-2012. Jama. 2015;314:103951.
Article CAS PubMed PubMed Central Google Scholar
National Academies of Science, Engineering, and Medicine. The Future of Pediatric Subspecialty Physician Workforce: Meeting the Needs of Infants, Children and Adolescents. Consensus Study Report 2023. https://nap.nationalacademies.org/read/27207/chapter/1.
Shah S, Cheng TL. Optimizing the childrens hospitals graduate medical education payment program at a time of pediatric workforce challenges and health need. J pediatrics. 2022;245:46.e2.
Article Google Scholar
Rimsza ME, Ruch-Ross HS, Clemens CJ, Moskowitz WB, Mulvey HJ. Workforce trends and analysis of selected pediatric subspecialties in the United States. Acad Pediatr. 2018;18:80512.
Article PubMed Google Scholar
Catenaccio E, Rochlin JM, Simon HK. Differences in lifetime earning potential for pediatric subspecialists. Pediatrics 2021;147:e2020027771.
Article PubMed Google Scholar
Rochlin JM, Simon HK. Does fellowship pay: what is the long-term financial impact of subspecialty training in pediatrics? Pediatrics 2011;127:25460.
Article PubMed Google Scholar
Catenaccio E, Rochlin JM, Simon HK. Association of lifetime earning potential and workforce distribution among pediatric subspecialists. JAMA Pediatr. 2021;175:10539.
Article PubMed Google Scholar
Accreditation Council for Graduate Medical Education. ACGME Program Requirements for Graduate Medical Education in Pediatric Hospital Medicine 2022. https://www.acgme.org/globalassets/pfassets/programrequirements/334_pediatrichospitalmedicine_2022v2.pdf.
Cleveland WW, Brownlee RC. Future training of pediatricians: summary report of a series of conferences sponsored by the American Board of Pediatrics. Pediatrics. 1987;80:4517.
Article CAS PubMed Google Scholar
Freed GL, Dunham KM, Switalski KE, Jones MD Jr, McGuinness GA. Pediatric fellows: perspectives on training and future scope of practice. Pediatrics. 2009;123:S317.
Article PubMed Google Scholar
Health Resources and Services Administration. Physician Workforce: Projections, 2020-2035; 2022. https://bhw.hrsa.gov/sites/default/files/bureau-healthworkforce/Physicians-Projections-Factsheet.pdf.
Keels EL, Goldsmith JP. Neonatal provider workforce. Pediatrics 2019;144:e20193147.
Article PubMed Google Scholar
American Board of Internal Medicine. Critical Care Medicine Policies 2023. https://www.abim.org/certification/policies/internal-medicine-subspecialty-policies/criticalcaremedicine/#:~:text=Candidates%20certified%20in%20internal%20medicine,the%20critical%20care%20medicine%20examination.
Cordero L, Hart BJ, Hardin R, Mahan JD, Giannone PJ, Nankervis CA. Pediatrics residents preparedness for neonatal resuscitation assessed using high-fidelity simulation. J graduate Med Educ. 2013;5:399404.
Article Google Scholar
Freed GL, Dunham KM, Loveland-Cherry C, Martyn KK, Moote MJ. Private practice rates among pediatric subspecialists. Pediatrics 2011;128:6736.
Article PubMed Google Scholar
Pineda R, Kati K, Breault CC, Rogers EE, Mack WJ, Fernandez-Fernandez A. NICUs in the US: levels of acuity, number of beds, and relationships to population factors. J Perinatol : Off J Calif Perinat Assoc. 2023;43:796805.
Article Google Scholar
The American Board of Pediatrics. Pediatric Subspecialists Ever Certified 2023. https://www.abp.org/dashboards/pediatric-subspecialists-ever-certified.
Gamber RA, Blonsky H, McDowell M, Lakshminrusimha S Declining birth rates, increasing maternal age and neonatal intensive care unit admissions. Journal of perinatology :official journal of the California Perinatal Association. (2023).
Orr CJ, Turner AL, Ritter VS, Gutierrez-Wu JC, Leslie LK. Educational debt and subspecialty fellowship type. Pediatrics 2023;152:e2023062318.
Article PubMed Google Scholar
National Resident Matching Program. Fellowship Match Data and Reports 2023. https://www.nrmp.org/match-data-analytics/fellowship-data-reports/.
Backes CH, Bonachea EM, Rivera BK, Reynolds MM, Kovalchin CE, Reber KM, et al. Preparedness of pediatric residents for fellowship: a survey of US neonatal-perinatal fellowship program directors. J Perinatol: Off J Calif Perinat Assoc. 2016;36:11327.
Article CAS Google Scholar
Dyess NF, Keels E, Myers P, French H, Reber K, LaTuga MS, et al. Optimizing clinical care and training in the neonatal intensive care unit: the relationship between front line providers and physician trainees. J Perinatol: Off J Calif Perinat Assoc. 2023;43:15139.
Article Google Scholar
Myers P, Gupta AG. Impact of the revised NRP meconium aspiration guidelines on term infant outcomes. Hosp Pediatr. 2020;10:2959.
Article PubMed Google Scholar
Marx AA, Horton C, Amon RL, Joseph K, Carlson N, Decreasing J. neonatl intubation rates: trends at a community hospital. J Neonatal Nurs. 2016;22:2315.
Article Google Scholar
NYU Grossman School of Medicine Accelerated Three-Year MD 2023. https://med.nyu.edu/education/md-degree/accelerated-three-year-md.
Campoamor D Idaho closes its maternity ward, citing the states political climate2023 Date Accessed: 12/12/23. https://www.today.com/parents/pregnancy/idahosbonner-general-hospital-closes-maternity-ward-rcna75776.
Machut KZ, Kushnir A, Oji-Mmuo CN, Kataria-Hale J, Lingappan K, Kwon S, et al. Effect of Coronavirus Disease-2019 on the workload of neonatologists.J Pediatr.2022;242:14551.e1.
Article CAS PubMed Google Scholar
Schell GJ, Lavieri MS, Jankovic F, Li X, Toriello A, Martyn KK, et al. Strategic modeling of the neonatal nurse practitioner workforce. Nurs Outlook. 2016;64:38594.
Article PubMed Google Scholar
Lakshminrusimha S, Olsen SL, Lubarsky DA. Behavioral economics in neonatology balancing provider wellness and departmental finances. J Perinatol: Off J Calif Perinat Assoc. 2022;42:6838.
Article Google Scholar
Mercurio MR. Neonatologys race to the bottom: RVUs, cFTEs, and physician time. J Perinatol: Off J Calif Perinat Assoc. 2021;41:25613.
Article Google Scholar
Omahen DA. The 10,000-hour rule and residency training. CMAJ. 2009;180:1272. 38.5 -7.7 -25%
Article PubMed PubMed Central Google Scholar
Read the rest here:
Vigorous exercise may preserve cognition in high-risk patients with hypertension – EurekAlert
image:
Richard Kazibwe, M.D., assistant professor of internal medicine at Wake Forest University School of Medicine
Credit: Wake Forest University School of Medicine
WINSTON-SALEM, N.C. June 6, 2024 People with high blood pressure have a higher risk of cognitive impairment, including dementia, but a new study from researchers at Wake Forest University School of Medicine suggests that engaging in vigorous physical activity more than once a week can lower that risk.
The findings appear online today in Alzheimers & Dementia: The Journal of the Alzheimers Association.
We know that physical exercise offers many benefits, including lowering blood pressure, improving heart health and potentially delaying cognitive decline, said Richard Kazibwe, M.D., assistant professor of internal medicine at Wake Forest University School of Medicine and lead author of the study. However, the amount and the intensity of exercise needed to preserve cognition is unknown.
In 2015, published findings from the landmark Systolic Blood Pressure Intervention Trial (SPRINT) showed that intensive blood pressure management reduced cardiovascular disease and lowered the risk of death.
SPRINT began in the fall of 2009 and included more than 9,300 participants with hypertension ages 50 and older, recruited from about 100 medical centers and clinical practices throughout the United States. Participants were randomly assigned to a systolic blood pressure goal of either less than 120 mm Hg (intensive treatment) or less than 140 mm Hg (standard treatment). The National Institutes of Health (NIH) stopped the blood pressure intervention earlier than originally planned to quickly disseminate the significant preliminary results, resulting in a new set of guidelines for controlling blood pressure.
In 2019, results of the ancillary SPRINT MIND trial, led by Wake Forest University School of Medicine, showed that intensive control of blood pressure in older people significantly reduced the risk of developing mild cognitive impairment, a precursor of early dementia.
In a secondary analysis of the SPRINT MIND study, Kazibwe and team examined the effect of self-reported sessions of vigorous physical activity (at least once a week) on the risk of mild cognitive impairment and dementia.
People who engaged in one or more sessions of vigorous physical activity per week had lower rates of mild cognitive impairment and dementia.
Kazibwe said that nearly 60% of study participants reported vigorous physical activity at least once a week, even among those aged 75 and up.
It is welcome news that a higher number of older adults are engaging in physical exercise. This also suggests that older adults who recognize the importance of exercise may be more inclined to exercise at higher intensity, Kazibwe said.
However, the research team found the protective impact of vigorous exercise was more pronounced for those under 75.
While this study provides evidence that vigorous exercise may preserve cognitive function in high-risk patients with hypertension, more research is needed to include device-based physical activity measurements and more diverse participant populations, Kazibwe said.
Alzheimer s & Dementia
People
Effect of vigorous-intensity physical activity on incident cognitive impairment in high-risk hypertension
6-Jun-2024
Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.
See more here:
Vigorous exercise may preserve cognition in high-risk patients with hypertension - EurekAlert
Pride Celebrated at UConn Health – UConn Today – University of Connecticut
UConn Health believes in health care for all and provides equitable and inclusive care to lesbian, gay, bisexual, transgender, and queer/questioning+ members of our community.
Students from Reach Out, a student organization at UConn Health dedicated to LGBTQIA+ awareness, education, and activism in the UConn medical and dental communities, proudly raised the flag. The UConn School of Medicine students were fourth-year medical students Cailyn Regan, Sarah Hartmann, and Ryan Hannon.
Reach Out aims to bring students of any gender or sexual identity together, make an impact through service in the greater Hartford community, and provide education amongst the next generation of clinicians who strive for excellence in well-rounded patient care.
The students were supported by the newly appointed UConn Health CEO Dr. Andy Agwunobi, Chief Diversity Officer Dr. Jeffrey Hines, and their Reach Out faculty advisor Zita Lazzarini, JD, MPH.
Also, in attendance were Internal Medicine Resident Dr. Nicholas Harriel, who will be entering his third year of graduate medical education training (GME) at UConn Health and Ian Shick, assistant director of the Rainbow Center at UConn.
A special thanks to UConn Fire Departments Captain Anthony Ruggiero and Deputy Chief Christopher Renshaw for their special assistance of the UConn Health students with the flag raising, along with UConn Police Officer Nolan Hurst.
This month UConn Healths campus is also being illuminated in rainbow.
Learn more about UConn Health and its LGBTQIA+ Services.
Continued here:
Pride Celebrated at UConn Health - UConn Today - University of Connecticut
Studying the effects of probiotics for idiopathic epilepsy – DVM 360
Soloviova Liudmyla / adobe.stock.com
Canine idiopathic epilepsy (IE) is one of the most commonly diagnosed and treated chronic neurological conditions, according to Zoe Bailey, DVM, neurology/neurosurgery resident at the University of Wisconsin-Madison.1 The cause of this epilepsy type is unknown, but a higher prevalence has been seen in purebred dogs vs mixed breed dogs, and male dogs are more commonly affected than females.2
To treat IE, starting an antiepileptic drug (AED) is the most common route and usually the first line therapy. However, this is not always the best option for every patient and client. Bailey explained in her lecture at the 2024 American College of Veterinary Internal Medicine Forum in Minneapolis, Minnesota, that adverse effects of this medication can negatively impact the clients perception of their dogs quality of life. Additionally, approximately 30% of dogs will be drug resistant to this specific treatment.1 Bailey noted some other therapies for this condition can include dietary changes, use of cannabidiol products, neurostimulation, and more.
Bailey participated in a study aimed at investigating the microbiota-gut-brain axis and its impact on epilepsy. In humans, probiotics have been found to decrease seizure frequency and severity,3 however, there has yet to be a large-scale study on dogs with IE. Bailey and other researchers used a probiotic (Visbiome Vet) with 42-client owned dogs previously diagnosed with IE and already taking a prescription AED. Dogs in this study were between the ages of 1 and 9 years and had a seizure history of at least 6 months, with a frequency of at least 1 every 3 months. Dogs were enrolled on a rolling basis from January 2022 through May of 2023. So we did a prospective, placebo controlled, masked, crossover clinical trial, both with a 9- or 12-month period, there was a total of 3 or 4 phases, each of which was 3 months in duration, Bailey explained during the ACVIM session.1
The first phase was used as an observational period, also to have some control data as a basis before moving forward in the study. The second phase administered a daily placebo capsule provided by Visbiome Vet to the enrolled dogs. A daily dose of the probiotic from Visbiome Vet was given during phase 3 and adjusted based on the dogs body weight. The study concluded with phase 4 in which dogs were observed again, now evaluating any changes in data with the introduction of a regular dose of probiotics.
By the end of the study, only 21 dogs had completed all 4 phases. The other 21 dogs were excluded at various time points throughout the study due to the development of new diseases, the need for additional non-AED medications, dietary modifications, owner compliance, and death due to other circumstances, said Bailey.
Seizure logs were maintained by owners and every seizure was documented. At the start of the study, 17 of the 21 completed dogs were on 2 or more AEDs and 12 of 21 dogs had their AED prescription adjusted by their veterinarian.
The study results revealed the following:
Bailey concluded that, although there was some improvement discovered, the measurement of seizure frequency was not statistically significant enough to prove the use of probiotics improves the outcomes of dogs with IE. Some of the limitations of this particular study was a small population size and reliance on owners for seizure detection and documentation. So really, the next steps that we're still in progress with are evaluating the microbiome of this population of dogs with refractory idiopathic epilepsy. And then [also] to determine if this biome alters their microbiome, Bailey said.
References
View original post here:
Studying the effects of probiotics for idiopathic epilepsy - DVM 360