Garbled Texting as a Sign of Stroke

MARCH 19, 2013, 12:01 PM

Garbled Texting as a Sign of Stroke

By ANAHAD O’CONNOR

Slurred and incoherent speech is one of the classic signs of a stroke. But new research finds that another symptom may be garbled and disjointed text messages, which could provide early clues to the onset of a stroke.

In Detroit, doctors encountered a 40-year-old patient who had no trouble reading, writing or understanding language. His only consistent problem was that he had lost the ability to type coherent text messages on his phone. An imaging scan showed that he had suffered a mild ischemic stroke, caused by a clot or blockage in his brain.

The case represents at least the second instance of what doctors are calling “dystextia.” In December, a report in The Archives of Neurology described a 25-year-old pregnant woman whose husband grew concerned after she sent him a series of incoherent text messages. Doctors found that the woman had also been experiencing weakness in her right arm and leg, and that she had earlier had difficulty filling out an intake form at her obstetrician’s office.

The case in Detroit was particularly unusual because garbled texting appeared to be the only conspicuous problem, at least initially, said Dr. Omran Kaskar, a senior neurology resident at Henry Ford Hospital who treated the patient in late 2011. “Stroke patients usually present with multiple neurologic deficits,” he said.

The findings suggest that text messaging may be a unique form of language controlled by a distinct part of the brain. And because texts are time-stamped, they may potentially be useful as a way of helping doctors determine precisely when a patient’s stroke symptoms began. Read more of this post

Agencies warn of global TB “powder keg”, funding gap; In some countries, including regions of Russia, up to 35 percent of new cases are multi-drug resistant

Agencies warn of global TB “powder keg”, funding gap

Mon, Mar 18 2013

By Kate Kelland and Stephanie Nebehay

LONDON/GENEVA (Reuters) – Deadly strains of tuberculosis that are resistant to multiple drugs are spreading around the world, and authorities urgently need another $1.6 billion a year to tackle them, global health officials said on Monday.

Donors should step up with “significant funding” to help experts track down all existing cases and treat the most serious ones, the World Health Organization (WHO) and the Global Fund to Fight AIDS, TB and Malaria said in joint statement.

Margaret Chan, WHO director general, said nearly 4 percent of people newly infected with TB worldwide were resistant to multiple drugs from the start – signaling that resistant forms of the disease were being transmitted directly from person to person.

In some countries, including regions of Russia, up to 35 percent of new cases are multi-drug resistant.

“This gives you an idea of powder keg we are sitting on,” Chan told a news briefing in Geneva, where both agencies are based. Read more of this post

Quest Diagnostics’ 5-in-1 Demential Test May Help Rule Out Alzheimer’s

Quest 5-in-1 Demential Test May Help Rule Out Alzheimer’s

As Baby Boomers age, those everyday questions of life — Where are the car keys? What was her name again? — are increasingly followed by another: Can this be Alzheimer’s disease?

Today, Quest Diagnostics Inc. (DGX), in the midst of a company reorganization that seeks to cut costs and boost revenue with improved service, will introduce a panel of tests at the American Academy of Neurology meeting that combines five screens into one to pinpoint potentially treatable conditions.

The concept is that, by simplifying the process and making it more accessible, an increasing number of family doctors will use the test and, in some rare cases, ease the mind of patients by ruling out Alzheimer’s.

“It’s sort of a simple idea, but dementia is a common presentation to primary-care doctors,” said Joseph Higgins, medical director for Quest’s neurology unit, in a telephone interview. “Sometimes they’re at a loss for what type of blood test to perform. This panel puts them all together in one place, with one report.”

Quest, the biggest U.S. operator of medical labs, could use a boost. Its sales have come under pressure as hospitals have sought fewer tests and reimbursement has become more stringent, said Frank Morgan, an analyst with RBC Capital Markets. Read more of this post

Alzheimer’s Kills More in U.S. as Advocates Seek Funding

Alzheimer’s Kills More in U.S. as Advocates Seek Funding

Deaths linked to Alzheimer’s have increased in the last decade while those for stroke, breast cancer and HIV have dropped, said researchers calling for more funding for the memory-robbing disease.

Without treatment breakthroughs, the number of people in the U.S. ages 65 and older whose memories and personalities are claimed by the disease will more than double to 13.8 million in 2050, according to a report released today by the Alzheimer’s Association.

The U.S. in recent years has taken action to address a looming public health crisis tied to the aging of the Baby Boomers, the generation born from 1946 to 1964. While the National Alzheimer’s Project Act was signed into law in January 2011 to coordinate efforts to treat and prevent Alzheimer’s, funding hasn’t caught up, advocates and researchers said. Read more of this post

A Plan to Chart Heart Risk in 1 Million Adults in Real Time; Researchers will marshal the power of smartphones and other personal technologies in an effort to develop new strategies for preventing and managing heart disesase

March 18, 2013, 6:54 p.m. ET

A Plan to Chart Heart Risk in 1 Million Adults in Real Time

By RON WINSLOW

Where It All Started: Patricia McNamara sits for a test in 1952 as part of the Framingham Heart Study. The Health eHeart Study hopes to build off the advances made by that 65-year-old program, which continues today.

Researchers are launching a major study that will marshal the power of smartphones and other personal technologies in an effort to develop new strategies for preventing and managing heart disease.

The project, called the Health eHeart Study, will use tools such as smartphone apps, sensors and other devices to gather data on a wide variety of measures associated with cardiovascular health—including blood pressure, physical activity, diet and sleep habits—all in real time.

The study aims to enroll up to one million participants. Researchers will sift through the huge, accumulating banks of data, looking for patterns that might give advance warning of a heart attack or predict the onset of a dangerous irregular heart beat. Read more of this post

Wheelchair Patients Find Obstacles at Doctor’s Offices

Wheelchair Patients Find Obstacles at Doctor’s Offices

Almost one-fourth of doctors are unable to accommodate and treat patients who use wheelchairs more than 20 years after the passing of the Americans with Disabilities Act, a study found.

About 22 percent of 256 doctor’s offices surveyed said they couldn’t assist people in wheelchairs, with most of those saying it was because they weren’t able to safely transfer the patient to an exam table, according to research published today in the Annals of Internal Medicine. Lack of access to the building was a secondary reason, the researchers said.

The Americans with Disabilities Act, passed by the U.S. Congress in 1990, is aimed at ending discrimination for people with disabilities in everyday activities including access to medical care facilities and the services provided there. Today’s findings are one of the first to show where barriers to medical services remain for wheelchair-bound patients, said Tara Lagu, the study’s lead author.

“This is affecting a large number of patients, certainly the 3 million who use a wheelchair, but many more than that who have difficulty getting up to an exam table,” said Lagu, an academic hospitalist at Baystate Medical Center in Springfield, Massachusetts, and an assistant professor at Tufts University School of Medicine, in a March 15 telephone interview. “The point of the study is to help doctors realize what the problems are and to help them become more aware of the Americans with Disabilities Act and to identify what the difficulties patients who use wheelchairs are having in accessing health care.” Read more of this post

“Off-label” use of anti-drowsiness drug skyrockets 10-fold over the past decade

“Off-label” use of anti-drowsiness drug skyrockets

4:18pm EDT

By Genevra Pittman

NEW YORK (Reuters Health) – The number of Americans taking the narcolepsy and shift work sleep disorder drug modafinil has increased almost 10-fold over the past decade, according to a new study.

What’s more, the majority of those prescriptions were written for so-called off-label conditions, such as depression and multiple sclerosis, researchers found. Read more of this post

Analysis: Antibiotics crisis prompts rethink on risks, rewards

Analysis: Antibiotics crisis prompts rethink on risks, rewards

12:39pm EDT

By Ben Hirschler

LONDON (Reuters) – Thirty years ago, when the world faced the terrifying prospect of an untreatable disease known as AIDS, big drugmakers scented an opportunity and raced to develop new medicines.

Today, as the world confronts another crisis, this time one of antibiotic resistance, the industry is doing the opposite. It is cutting research in a field that offers little scope for making money.

Antibiotics have become victims of their own success. Seen as cheap, routine treatments, they are overprescribed and taken haphazardly, creating “superbugs” they can no longer fight.

These “superbugs” are growing, but are not yet widespread, so the costly research needed to combat them is not worthwhile. Medical experts say this dilemma could return medicine to an era before Alexander Fleming discovered penicillin in 1928.

Fixing the problem will need both faster approval of last-resort drugs and new ways to guarantee rewards for companies, according to both industry leaders and public health officials who have been sounding the alarm. Read more of this post

China is engineering genius babies; NYU Geoff Miller: BGI Shenzhen the biggest genetic research center in China, and I think the biggest in the world, by a considerable margin

CHINA IS ENGINEERING GENIUS BABIES

By Aleks Eror

It’s not exactly news that China is setting itself up as a new global superpower, is it? While Western civilization chokes on its own gluttony like a latter-day Marlon Brando, China continues to buy up American debt and lock away the world’s natural resources. But now, not content to simply laugh and make jerk-off signs as they pass us on the geopolitical highway, they’ve also developed a state-endorsed genetic-engineering project.

At BGI Shenzhen, scientists have collected DNA samples from 2,000 of the world’s smartest people and are sequencing their entire genomes in an attempt to identify the alleles which determine human intelligence. Apparently they’re not far from finding them, and when they do, embryo screening will allow parents to pick their brightest zygote and potentially bump up every generation’s intelligence by five to 15 IQ points. Within a couple of generations, competing with the Chinese on an intellectual level will be like challenging Lena Dunham to a getting-naked-on-TV contest.

Geoffrey Miller, an evolutionary psychologist and lecturer at NYU, is one of the 2,000 braniacs who contributed their DNA. I spoke to him about what this creepy-ass program might mean for the future of Chinese kids.

VICE: Hey, Geoffrey. Does China have a history of eugenics?
Geoffrey Miller: As soon as Deng Xiaoping took power in the late 70s, he took the whole focus of the Chinese government from trying to manage the economy, to trying to manage the quality and quantity of people. In the 90s, they started to do widespread prenatal testing for birth defects with ultrasound, and more recently, they’ve spent a lot of money researching human genetics to figure out which genes make people smarter.

What do you know about BGI Shenzhen?
It’s the biggest genetic research center in China, and I think the biggest in the world, by a considerable margin. They’re not just doing human genetics; BGI is also doing lots of plant genetics, animal genetics, anything that’s economically relevant or scientifically interesting. Read more of this post

‘Nightmare’ superbug alarm; Patients fall ill with ”nightmare bacteria” that caused the deaths of many people worldwide.

‘Nightmare’ superbug alarm

Date

March 18, 2013

Julia Medew

A widely feared superbug has contaminated hand-washing sinks in Dandenong Hospital’s intensive care unit, causing 10 patients to fall ill with the ”nightmare bacteria” that have killed many people worldwide.

A report published in the Medical Journal of Australia on Monday says the 440-bed hospital in Melbourne’s south-east has been struggling to contain the multi-drug-resistant bacteria since 2009. Ten patients have been infected since then, but none died from the infection.

An infectious disease physician at the hospital, Rhonda Stuart, said doctors had been concerned about a string of cases in the intensive care unit between 2009 and last year, but only acquired the technology last August to test surfaces for the bacteria known as CRE. Associate Professor Stuart said the tests revealed the bacteria were in the sinks where healthcare workers washed their hands. While it could not be proved, she said, this might have spread the infection to patients because the sinks’ poor design caused water to splash back off the drain. Read more of this post

Mayo Prostate Cancer Test Gives Hope When Tumors Return

Mayo Prostate Cancer Test Gives Hope When Tumors Return

Mike Hawker travels 3,200 miles from his home in Anchorage to the Mayo Clinic every six months to get a test for microscopic signs that a rare form of prostate cancer he beat three years ago may have returned.

For Hawker, a Republican state representative in Alaska, the trips are a matter of life and death. About 200,000 men who had been treated for prostate cancer learn each year, sometimes too late, that their malignancies have returned. The Mayo Clinic test offers the promise of catching recurring tumors early, before they can kill.

Mayo’s medical center in Rochester, Minnesota, is the only facility in the Western Hemisphere to offer the 20-minute scan, enhanced by an injected radioactive drug that lets doctors see rapidly dividing cancer cells. Demand is surging, though scans are limited to eight patients a day, three days a week.

Hawker, who survived an aggressive form of prostate cancer in 2010 that invaded everything from his knees to his eye sockets, sees the twice-yearly visits as his best hope.

“No one can figure out quite why I am alive,” said Hawker in an interview. “That machine is one of the diagnostic tools that is keeping me alive.”

Prostate cancer is the most commonly diagnosed malignancy, killing about 28,000 men last year. Lung cancer, the second-most common cancer is more deadly and claimed the lives of about 88,000 men. For at least one-quarter of the men whose prostate cancer recurs, the reappearance of the disease is life- threatening, said Eugene Kwon, a urologist and cancer researcher at the Mayo Clinic. Read more of this post

Too many drug types are compromising heart health; About 80 million Americans suffer from heart disease, the nation’s No. 1 killer, and most are on multiple drugs

Too many drug types are compromising heart health: doctors

3:53am EDT

By Debra Sherman

(Reuters) – About 80 million Americans suffer from heart disease, the nation’s No. 1 killer, and most are on multiple drugs.

Some cardiologists think prescribing has gotten out of hand.

The criticism was voiced by a number of leading heart doctors who attended the annual scientific sessions of the American College of Cardiology, held on March 9-11 in San Francisco. They said eliminating certain drugs could potentially improve care without compromising treatment. Evidence is growing that some medications are not effective.

Patients who need multiple daily doses of a given drug often fail to take them, said Dr. Steven Nissen, head of cardiology at the Cleveland Clinic and a past president of the ACC. “There is also the question about whether the benefits are additive.” Read more of this post

A new invention lets pacemakers scavenge the energy to power their circuitry from the motion of the beating heart itself

Let’s have a heart-to-heart

Medical technology: A new invention lets pacemakers scavenge the energy to power their circuitry from the motion of the beating heart itself

Mar 9th 2013 |From the print edition

IN 1958 a priest named Gerardo Flórez, then 70 years old, was blessed with the world’s first artificial pacemaker. The device kept his heart ticking in good order for another 18 years. It connected to the heart externally, weighed 45kg (100lb) and was powered by a 12-volt battery that had to be lugged around on a cart and recharged every 72 hours.

Since the 1950s pacemakers, which use electrical impulses to regulate a beating heart, have shrunk substantially, as have their power packs. But scientists would dearly love to get rid of the batteries altogether. Even the best modern ones run out every 7-10 years and patients must undergo surgery to have replacements installed. The process can be painful, expensive and can lead to infection.

One approach, being pursued by some researchers, is to deliver the necessary energy wirelessly. Some designs beam energy to a receiving coil in an implanted device, and others use an external pacemaker that wirelessly stimulates an electrode implanted in the heart.

Another possibility is to scavenge energy from the natural processes occurring in the patient’s body. In 2011 a group of Swiss engineers installed a tiny turbine inside a simulated artery which was propelled by a bloodlike fluid flowing through it. And now Amin Karami and his colleagues at the University of Michigan have figured out a way to power a pacemaker by harvesting energy produced by the very heart it is nudging along.

This is not a new idea, and Dr Karami’s approach, like previous attempts, relies on so-called piezoelectric materials, which produce a current when subjected to mechanical stress—in this case the vibrations caused by a beating heart. Those earlier efforts stumbled, however, because the piezoelectric components were only able to harvest enough energy to power a pacemaker if the vibrations fell within a narrow frequency range. As a result, they worked for a limited range of heart rates, typically between 58 and 63 beats per minute. Any lower (as when sleeping) or higher (during physical exertion, say) and the piezoelectric elements did not produce enough oomph. Dr Karami’s “non-linear harvester”, by contrast, still works at heart rates of 20 to 600 beats per minute. Read more of this post

New tricks allow hearing aids to cope better with high frequencies, making speech and music more comprehensible

Music to the ear

Medical technology: New tricks allow hearing aids to cope better with high frequencies, making speech and music more comprehensible

Mar 9th 2013 |From the print edition

THE human voice, like any sound produced by thrumming a stretched string, has a fundamental frequency. For voice, the centre of that frequency lies mostly below 300Hz depending on the speaker’s sex and the sounds in question. Information is conveyed through simultaneous higher-frequency overtones and additional components that can stretch up to 20,000Hz (20kHz). Modern hearing aids are able to distinguish only a small part of that range, typically between 300Hz and 6kHz, reducing noise and amplifying those frequencies where the wearer’s hearing is weakest.

But differentiating elements of many common parts of speech occur in higher frequencies. This is the result both of harmonics that ripple out from the main tone, and from non-voiced elements used to utter consonants, which employ the tongue, teeth, cheeks and lips. Take the words “sailing” and “failing”. Cut off the higher frequencies and the two are indistinguishable. The problem is compounded on telephone calls, which do not transmit frequencies below 300Hz or above 3.3kHz, resulting in the need for cues like “S for Sierra, F for Foxtrot”.

People with hearing aids experience this problem constantly, says Brian Moore of the University of Cambridge. Typical hearing loss tends to be most acute at frequencies above 10kHz, which contain quieter sounds but where speech can still include important cues (as well as progressively less important ones extending up to 20kHz). Older hearing aids cut off at no higher than 6kHz, but much modern equipment stretches this range to 8-10kHz. However, a problem remains, Dr Moore says, because bespoke hearing-aid calibrations for individual users, called “fittings”, do not properly boost the gain of these higher frequencies. So Dr Moore and his colleagues have come up with a better method. Their approach can be applied to many existing devices, and is also being built into some newer ones.

A key step in any fitting involves testing an individual’s ability to hear sounds in different frequency bands. Each hearing loss is unique, and for most users a standard profile would be too loud in some ranges and too soft in others. But current tests pay scant attention to the higher frequencies that a device’s tiny speaker can produce, regardless of whether the user needs a boost. Dr Moore’s new test, known as CAM2, which is both a set of specifications and an implementation in software, extends and modifies fittings to include frequencies as high as 10kHz. When the results are used to calibrate a modern hearing aid, the result is greater intelligibility of speech compared with existing alternatives. CAM2 also improves the experience of listening to music, which makes greater use of higher frequencies than speech does. Read more of this post

Spending on Traditional Drugs Drops as Specialty Medicines Rise

Spending on Traditional Drugs Drops as Specialty Medicines Rise

Americans are spending less on pills and other conventional medications for the first time in two decades, and more on complex injected drugs, a study has found.

Use of pills and other non-injected, non-specialty drugs fell 1.5 percent last year, according to the report by the pharmacy management company Express Scripts Holding Co. Traditional drugs are medicines like pills that don’t require special means of administration or frequent monitoring.

The drop is a reflection of trends in the pharmaceutical industry that include development of biotechnology drugs made from living organisms that require injection as well as expensive injectable or infused “specialty” medications that require special care. Wider use of cheaper generic equivalents of pills has helped reduce spending on conventional medicines, even as total pharmaceutical spending continues to rise. Read more of this post

New Drugs Slow a Fast-Spreading Cancer

Updated March 4, 2013, 8:51 p.m. ET

New Drugs Slow a Fast-Spreading Cancer

By JONATHAN ROCKOFF

New generations of drugs have helped given victims of multiple myeloma hope for longer survival. WSJ’s Jonathan Rockoff and International Myeloma Foundation co-founder and chairman Dr. Brian Durie discuss on Lunch Break. Photo: AP.

Two new drugs for multiple myeloma, approved in recent months, promise to extend life expectancy for patients with the blood cancer.

They follow new treatments that over the last decade have transformed the prognosis for multiple myeloma—once a short death sentence—into a manageable condition that can be survived for up to seven years or more. There is still no cure for the disease.

The new drugs were approved for patients whose blood cancer returned after developing resistance to older treatments. Read more of this post

Nurses Spar With Doctors as 30 Million Insured Seek Care

Nurses Spar With Doctors as 30 Million Insured Seek Care

Christy Blanco’s health clinic in El Paso, Texas, is sitting empty. Blanco, a nurse practitioner, says she has a waiting list of patients, all the necessary equipment, and a Ph.D. in nursing that gives her the training to start treating patients.

About 50 miles (80 kilometers) away in Las Cruces, New Mexico, dozens of nurse practitioners at clinics like Blanco’s are busy caring for patients with a range of diseases from diabetes to asthma to depression.

The only difference between the El Paso and Las Cruces facilities is that in Texas, nurse practitioners are required to have a doctor under contract to sign off on 10 percent of medical charts and spend 1 of 10 days at the clinic. In New Mexico, no doctor is needed.

“I just want to get started,” said Blanco, who has spent about two years seeking a doctor for her clinic geared for low- income women. “I’m trying to work for the poor. I’ve spent thousands of dollars of my own money. I have a waiting list of patients, and I have to tell them I can’t practice yet.”

Blanco is caught in the middle of a tug-of-war between doctors and nurses over who will provide basic primary care for the 30 million U.S. citizens expected to get health insurance under the 2010 health-care law.

Nurse practitioners say they can do their jobs just fine without doctors and they’re lobbying lawmakers to end restrictions in more than a dozen of the 34 states that require physician oversight. Despite the need for increased care, doctors are pushing back, fighting for restrictions with their own lobbying efforts as well as with lawsuits across the country, arguing that patients’ basic care is at risk. Read more of this post

Baby Cured of HIV for the First Time, Researchers Say; Success With Aggressive Drug Regimen Could Spur Wider Use of Such Treatment

Updated March 3, 2013, 4:33 p.m. ET

Baby Cured of HIV for the First Time, Researchers Say

Success With Aggressive Drug Regimen Could Spur Wider Use of Such Treatment

By RON WINSLOW

A Mississippi baby born with the AIDS virus appears to have been cured after being treated with an aggressive regimen of drugs just after her birth 2½ years ago, an unusual case that could trigger changes in care for hundreds of thousands of babies born globally each year with HIV.

The findings, reported Sunday by researchers, mark only the second documented case of a patient being cured of infection with the human immune-deficiency virus. The first, an adult man known as the Berlin patient, was cured as a result of a 2007 bone-marrow transplant.

The new case was discovered after the baby girl’s mother stopped treatment on her, and doctors realized that the virus was undetectable even without drugs, which HIV patients normally must take for the rest of their lives. Read more of this post

Why some cells survive strokes while others don’t; “Medical science is often concerned with working out why cells die. We thought we’d look at why some seem to survive.”

Why some cells survive strokes while others don’t

Mar 2nd 2013 |From the print edition

WHEN dealing with a stroke—a loss of blood supply to the brain—time is of the essence. If the cause is a blocked artery, blood flow can often be restored using clot-busting drugs. If those drugs are swallowed too late, however, they can do more harm than good. In one of nature’s crueller ironies, the metabolic changes that take place in cells after about three hours without oxygen or glucose mean that restoring blood flow becomes damaging in itself. This is called a “reperfusion” injury. Doctors have long searched for ways to extend the period during which clot-busting pills might help. They have tried drugs and even artificially induced hypothermia to help the brain protect itself from the consequences of oxygen and sugar deprivation. Now, in a paper inNature Medicine, a group of researchers led by Alastair Buchan, a neurologist at the University of Oxford, describe a new idea. Dr Buchan’s team began with an old medical mystery. It has been known since the 1920s that some nerve cells, or neurons, are more susceptible to stroke damage than others. In particular, a group of neurons called CA3 cells that live in the hippocampus—a seahorse-shaped chunk of brain tissue involved in forming memories—are much hardier than another sort called CA1 cells, even though the two types are neighbours. “Medical science is often concerned with working out why cells die,” says Dr Buchan. “We thought we’d look at why some seem to survive.” The researchers compared versions of both types of cells taken from rats, looking for differences in their chemistry after they had been subjected to an artificial stroke. One conspicuous difference involved a protein called hamartin, which was present in larger amounts in the hardy CA3 cells than in the fragile CA1 cells.  Read more of this post