Tag Archives: alabama

Breast conserving therapy shows survival benefit compared to mastectomy in early-stage patients with hormone receptor positive disease

The study findings defy the conventional belief that the two treatment interventions offer equal survival, and show the need to revisit some standards of breast cancer practice in the modern era. The research was presented at the 2014 Breast Cancer Symposium by Catherine Parker, MD, formerly a fellow at MD Anderson, now at the University of Alabama Birmingham. In the 1980s, both US-based and international randomized clinical studies found that BCT and mastectomy offered women with early stage breast cancer equal survival benefit…

Changes in gene explain more of inherited risk for rare disease

The formation of multiple schwannomas is one sign that a person has the genetic disorder called schwannomatosis, which is one of the three major forms of neurofibromatosis, besides neurofibromatosis types 1 and 2. The condition is so named because the tumors originate in Schwann cells that form in sheaths that insulate nerves to cause severe, chronic pain in many patients. To date, physicians cannot give most patients a confirmed diagnosis for schwannomatosis, even if they show symptoms, because changes in genes linked to the condition by past studies explain only about 50 percent of familial and less than 10 percent of sporadic cases. …

Depression treatments: Brain scans may suggest best course

For people with depression, brain activity can predict whether talk therapy or medication will better relieve their symptoms, a new study suggests. In the study, published June 12 in the journal JAMA Psychiatry, people whose brain scans showed an overactive insula, a brain region involved in emotional processing, tended to improve with medication, but not talk therapy, whereas the reverse was true for those with an underactive insula. The study was small and the findings are preliminary. But if the results are confirmed in a larger trial, the technique could be used to help guide treatment decisions for people with depression, the researchers said. An evaluation of a depression patient, in a doctor's office, “doesn't really help us to know very well whether they should receive talk therapy or a medication,” said study co-author Dr. Boadie Dunlop, a psychiatrist at Emory University in Atlanta. But the new findings, “based on the activity of the brain, that could help us pick the best treatment for an individual,” he said. Poor success Depression treatments such as talk therapy or medication have a poor success rate, with only 40 percent of people typically seeing their symptoms resolve with the first treatment, Dunlop said. Spending two to three months on ineffective treatments can lead to lost productivity, higher risk of suicide, and continued suffering for patients and their families. [Where is the Suicide Belt?] To see whether there was a way to identify the best treatment for patients, Dunlop and his colleagues measured the brain activity of 82 patients with major depression using positron emission tomography (PET) scans. Afterward, they randomly assigned the participants to receive 12 weeks of a common antidepressant escitalopram (brand name Lexapro), or 12 weeks of cognitive behavioral therapy, a talk therapy that has been shown to improve depression. Of the original cohort, 67 people completed the study. Afterward, the researchers assessed the roughly 40 percent of people who were completely free of depression, as well as the approximately 25 percent who had hardly improved at all. (About 35 percent of people improved somewhat, but not enough to be considered symptom-free.) They found that people with an overactive brain region called the insula improved dramatically on medication, but not at all with talk therapy. People with an underactive insula improved with cognitive behavioral therapy, but not with medication, according to the study. Dunlop said that the people who improved somewhat showed the same trends, but to a lesser extent. Future applications It's not clear exactly why the insula, which processes bodily experiences of emotion, predicted people's response to treatment, but past studies had shown it was tied to depression, Dunlop said. The new research is based on a small number of people and must be confirmed in a larger trial, Richard Shelton, a psychiatrist at the University of Alabama at Birmingham, wrote in an email to LiveScience. In addition, Shelton noted that PET scans are expensive, costing about $1,500. They also involve low doses of radiation. “In an age of cost-containment, it seems unlikely that every person with depression entering treatment would undergo a brain scan first to guide treatment selection,” said Shelton, who was not involved in the study. But if the findings are confirmed, it would raise the possibility that PET scans could be used in some circumstances, to determine treatments for the patients with certain needs, Dunlop said. Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.source : http://www.foxnews.com/health/2013/06/13/depression-treatments-brain-scans-may-suggest-best-course/

Most travelers survive in-flight medical emergencies, study shows

Is there a doctor on board? Surprisingly often, there is - in half of in-flight medical emergencies - and sick airline passengers almost always survive, a new study finds. The research is the largest look yet at what happens to people who develop a medical problem on a commercial flight - about 44,000 of the 2.75 billion passengers worldwide each year, researchers estimate. Most cases don't require diverting a plane as the study's leader, Dr. Christian Martin-Gill, advised a pilot to do two years. He works for MD-STAT, a service at the University of Pittsburgh Medical Center that advises about 20 major airlines on how to handle in-flight emergencies. Another large service is based in Phoenix. Martin-Gill handled a call when a passenger seemed to be having a heart attack on a flight from Europe to the U.S. The man's implanted defibrillator had shocked his heart five times to try to restore normal rhythm. “The aircraft was in the middle of its destination, flying over the Atlantic,” so he recommended landing at Newfoundland off the Canadian coast to get the man to the nearest hospital, Martin-Gill said. The federally funded study reviewed about 12,000 cases handled by the Pittsburgh center over nearly three years. Results are in Thursday's New England Journal of Medicine. Researchers found: -The odds of a medical emergency are 1 per 604 flights, or 16 per 1 million passengers. -Planes had to be diverted for emergency help in only 7 percent of cases. -Doctors were on board and volunteered to help in 48 percent of cases; nurses and other health workers were available in another 28 percent. Only one-third of cases had to be handled by flight attendants alone. -The most common problems: Dizziness or passing out (37 percent of cases); trouble breathing (12 percent) and nausea or vomiting (10 percent). -About one-fourth of passengers were evaluated at a hospital after landing and 9 percent were admitted, usually with stroke, respiratory or cardiac symptoms. -Out of nearly 12,000 cases, a defibrillator was applied 137 times, including in 24 cases of cardiac arrest, where the heart had stopped. (Sometimes defibrillators are used to analyze an irregular heart rhythm to help doctors figure out what to do, not necessarily to deliver a shock.) -Of the cases in this study, only 36 deaths occurred, 30 of them during the flight and the others after landing. -Pregnancy-related problems were generally rare - 61 cases, in this study - and two-thirds of them involved women less than 24 weeks along with possible miscarriages. Air travel is considered safe up to the 36th week, or the last month, of pregnancy. Only three cases of women in labor beyond 24 weeks of pregnancy led to a plane being diverted. Dr. Lisa Rosenbaum, a University of Pennsylvania cardiologist, helped in a case like that in 2007, on a flight from Boston to Portland, Ore. The passenger was three months from her due date but was having contractions every minute - something that can often be stopped with drugs and treatment at a hospital but not in midair. “It was clear to me that labor was imminent and that we needed to land the plane,” so, on her advice, the pilot diverted to upstate New York, Rosenbaum said. “It was one of the scariest experiences of my life. It's not like taking care of a patient in the hospital.” Dr. David Rogers, a pediatric surgeon at the University of Alabama at Birmingham School of Medicine, felt that fear five years ago when an elderly woman had trouble breathing during a flight to Atlanta from Toledo, Ohio. Being a specialist at treating children rather than adults, “my first reaction was to look around and hope there would be somebody else” more qualified to help, he said. Luckily, a flight attendant had already given the woman an oxygen mask and she seemed to be improving, so he felt the plane could continue to Atlanta, the woman's home. Trying to determine whether to divert a plane was a tough call, he said. “I'm making a decision that's going to affect a plane full of people,” not just the patient, Rogers said. Some passengers may fear liability if they help in such situations, but a Good Samaritan law protects those who do so, the study notes. And although health workers are not legally obliged to help, they have a moral obligation to do so, the authors write. And you never know what kind of help will be requested. Martin-Gill said a partner once was consulted when a dog suffered a cardiac arrest during a flight. He didn't know how things turned out.source : http://www.foxnews.com/health/2013/05/30/most-travelers-survive-in-flight-medical-emergencies-study-shows/

Mystery illnesses in Alabama mostly colds and flu, tests show

Officials investigating a cluster of mysterious illnesses in Alabama have so far found only cold and flu viruses. In tests on seven of the nine patients, the Centers for Disease Control and Prevention found no sign that the illnesses were caused by any single germ, CDC spokeswoman Sharon Hoskins said in an email. Meanwhile, Alabama officials said they had added two more cases to the cluster, which included two earlier deaths. Seven of the cases were reported last week, including the deaths. The two new illnesses were reported this week. Most of the nine were treated at Southeast Alabama Medical Center in Dothan, but one was seen at a hospital in Crenshaw County. Health officials have described the patients as ranging in age from 20 to more than 80. The nine people suffered a flu-like illness with symptoms like fever, cough and shortness of breath. Mysterious illnesses are always unnerving, but the cluster report came at a particularly sensitive time. Health officials have been monitoring two deadly new illnesses that recently surfaced in different parts of the world — one a deadly form of bird flu that has appeared in China, the other a SARS-like coronavirus that seems to have originated in the Middle East. The bird flu has caused 131 illnesses and 32 deaths since the beginning of the year, according to the World Health Organization. The SARS-like virus (called MERS) has been identified as the cause of 44 illnesses, including 22 deaths, the WHO said. Neither seems to be highly contagious so far, and neither illness has been reported in the United States. But in a world of daily international air travel, it's always possible that a concerning new germ will hitchhike on an infected globetrotter and enter this country. The CDC tested the Alabama patients for MERS, for different forms of flu and for more than a dozen other illnesses, the agency spokeswoman said.source : http://www.foxnews.com/health/2013/05/23/mystery-illness-in-alabama-mostly-colds-and-flu-tests-show/

Mysterious respiratory illness kills 2, leaves 5 others hospitalized in Alabama

MONTGOMERY, Ala. – & A mysterious respiratory illness has left five people hospitalized and two dead in southeast Alabama, state health officials said Tuesday. Seven people have been admitted to hospitals with a fever, cough and shortness of breath in recent weeks, Alabama Department of Public Health spokeswoman Mary McIntyre said in a statement. Two of the seven have died. The Alabama Department of Public Health and the Centers for Disease Control Respiratory Laboratory are analyzing lab tests from all seven patients. McIntyre says officials hope to have preliminary results on the samples back by Wednesday or Thursday morning. The illness was first reported late last week and the last of the seven patients was hospitalized Monday, McIntyre said. It wasn't immediately clear which municipalities the illnesses were concentrated in. “We're only aware of the Southeast, but we don't know -- we haven't received reports from anywhere else,” McIntyre said. “That's why we're trying to get the information out.” McIntyre said it's unclear what's causing the illness but some of the seven patients also had the flu. Authorities are urging hospital staff to wear masks when caring for patients who appear to be suffering from respiratory illnesses. The Centers for Disease Control referred all questions to Alabama health officials.source : http://www.foxnews.com/health/2013/05/22/mysterious-illness-kills-2-in-southeast-alabama/