Health and Medical News and Resources

General interest items edited by Janice Flahiff

Schools Losing Ground in HIV, STD, and Pregnancy Prevention Education

April 6, 2012 Posted by | Public Health | , , , | Leave a comment

Why the Fragility of Health Outcomes Research May Be a Good Outcome for Health One Comment

From the 5 April 2012 article by DAVID SHAYWITZ, MD at The Health Care Blog

Durably improving health is really, really hard.
I’ve discussed this in the context of drug discovery, which must contend with the ever-more-apparent reality that biology is incredibly complex, and science remarkably fragile.  I’ve discussed this in the context of patient behavior, focusing on the need to address what Sarah Cairns-Smith and I have termed the “behavior gap.”
Here, I’d like to focus on a third challenge: measuring and improving the quality of patient care.
I’ve previously highlighted the challenges faced by Peter Pronovost of Johns Hopkins in getting physicians to adhere to basic checklists, or to regularly do something as simple and as useful as washing hands, topics that have been discussed extensively and in a compelling fashion by Atul Gawande and others….

…Consider the recent JAMA article (abstract only) by Lindenauer et al. analyzing why the mortality rate of pneumonia seems to have dropped so dramatically from 2003-2009.  Originally, this had been attributed to a combination of quality initiatives (including a focus on processes of care) and clinical advances.  The new research, however, suggests a much more prosaic explanation: a change in the way hospitals assign diagnostic codes to patients; thus, while rates for hospitalization due to a primary diagnosis of pneumonia decreased by 27%, the rates for hospitalization for sepsis with a secondary diagnosis of pneumonia increased by 178%, as Sarrazin and Rosenthal highlight in an accompanying editorial (public access not available).
Why did the coding pattern change? Multiple explanations were proposed by the authors; possibilities range from the benign — changes in diagnostic guidelines, greater awareness of sepsis, etc. – to the cynical (and quite likely) — utilizing different coding to maximize reimbursement.
One key take-home is that reliable measurement of health variables is so much more of a challenge than is typically appreciated, and ensuring that we’re robustly measuring what we think we’re measuring, rather than a paraphenomenon, is going to be very important.  We’re learning this lesson the hard way in so many areas of science, and health outcomes research is unlikely to be the solitary exception.
A second and equally important lesson is to remember that in many cases in health outcome research, the people who are doing the measurements and assessments often have a significant stake in the results, introducing the very real possibility of data distortion….

 

April 6, 2012 Posted by | health care | , , | Leave a comment

Disarming Disease-Causing Bacteria

From the 5 April 2012 Science Daily article

New treatments that combat the growing problem of antibiotic resistance by disarming rather than killing bacteria may be on the horizon, according to a new study.

Published in Nature Structure and Molecular Biology, research led by Monash Universityshowed a protein complex called the Translocation and Assembly Module (TAM), formed a type of molecular pump in bacteria. The TAM allows bacteria to shuttle key disease-causing molecules from inside the bacterial cell where they are made, to the outside surface, priming the bacteria for infection.
Lead author and PhD student Joel Selkrig of the Department of Biochemistry and Molecular Biology at Monash said the work paves the way for future studies to design new drugs that inhibit this process.
“The TAM was discovered in many disease-causing bacteria, from micro-organisms that cause whooping cough and meningitis, to hospital-acquired bacteria that are developing resistance to current antibiotics,” Mr Selkrig said.
“It is a good antibacterial target because a drug designed to inhibit TAM function would unlikely kill bacteria, but simply deprive them of their molecular weaponry, and in doing so, disable the disease process.”
“By allowing bacteria to stay alive after antibiotic treatment, we believe we can also prevent the emergence of antibiotic resistance, which is fast becoming a major problem worldwide.”…

April 6, 2012 Posted by | Medical and Health Research News | , , , | Leave a comment

Special Class Of Natural Fats Discovered That Stimulates Immune Cells To Fight Diseases

Killer T cells—also called cytotoxic T lymphoc...

Killer T cells—also called cytotoxic T lymphocytes or CTLs-directly attack other cells carrying certain foreign or abnormal molecules on their surfaces. CTLs are especially useful for attacking viruses because viruses often hide from other parts of the immune system while they grow inside infected cells. CTLs recognize small fragments of these viruses peeking out from the cell membrane and launch an attack to kill the cell. (Photo credit: Wikipedia)

The early-responding immune cells investigated in this study, called the invariant natural killer T (iNKT) cells, are important as first line of defence against infectious and foreign agents. When stimulated, iNKT cells secrete large amounts of biological chemicals, and are capable of influencing the responses of other immune cells in the body. …

April 6, 2012 Posted by | Consumer Health | Leave a comment

   

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