DR.NEEDLES MINI-MEDICAL BLOGS,
SEPT. 2008
PREDICTING A CORONARY WITH LIPID MARKERS
Lipoxin comes from EPOA and DHA and arachidonic acid in the presence of aspirin. The reason EPs and ASA work is they form nitro lipids and resolvins and lx in the blood. These are good markers for coronary heart disease.
Patients with a high risk for CHS have low levels of these markers. This group of PUFAs, (polyunsaturated fats may aid in the prediction of prognosis of CHS and also used in the management of the cardiac patient.
Source Lipids in Health and Disease, 7.19.08
HEART INFARCTS SHRINK WITH COOLING
Rapid hypothermia with cold saline and endovascular cooling before reperfusion reduces myocardial infarct size and micro vascular obstruction.
A novel finding is that hypothermia at the onset of reperfusion reduces micro vascular obstruction without reducing myocardial infarct size Intravenous administration of cold saline combined with endovascular hypothermia provides a method for a rapid induction of hypothermia, suggesting a potential clinical application.
Source Cardiovascular disorders, 8.03.2008
ANKLE BLOOD PRESSURE EARLY SIGN OF ARTERY STIFFNESS
The ankle blood pressure is commonly used as a ratio to the brachial blood pressure, called ankle-brachial index (ABI).
Very few studies have considered the independent value of the ankle blood pressure without indexing it to the brachial blood pressure. Results suggest that the ankle blood pressure has an independent value as a marker of arterial stiffness in middle-aged, asymptomatic persons.
Increased carotid intima-media thickness is associated with future cerebrovascular and cardiovascular events. Coronary artery calcium screening is the latest method for evaluating the CVD risk in asymptomatic patients
There is a great need for a simple non-invasive tool that could be used in an office setting to screen for arterial stiffness or sub clinical atherosclerosis.
The ankle blood pressure is usually measured in conjunction with the arm blood pressure and the ankle-brachial pressure index (ABI) is calculated. Decreased index is strongly associated with cardiovascular diseases.
The elevated ankle blood pressure might be one of the earliest signs of adverse changes in the cardiovascular system. Stenotic changes with abnormal ABI are fairly seldom seen in middle-aged persons.
Ankle blood pressure ≤ 175 mmHg but exaggerated elevation of brachial systolic blood pressure at a moderate exercise level reveals those patients in whom stenotic changes along the conduit vessels decrease the ankle blood pressure and this group has to be considered as a separate entity.
FAMILY HISTORY OF BREAST CANCER IMPORTANT
Having a relative diagnosed with breast cancer at an early age is an indication for breast cancer screening. This indication has been derived from estimates based on data from cancer-prone families.
Applying family history related criteria in an unselected population could result in the screening of many women who will not develop breast cancer at an early age.
SOURCE: CANCER 8:203 2008
HELP NEEDED AS PART OF DISCHARGE PLANNING FOR GERIATRIC PATIENTS
Many older adults discharged from ACE programs, independent functioning at home and in the community face serious challenges as they return home. It is not just their acute medical problems that must be addressed, but they require interventions to help them overcome functional impairments as they go back to independent living.
Source: Geriatrics, May 14, 2008
PATIENTS MUST BE TREATED WITH DIGNITY
What does dignity mean? What promotes and diminishes dignity? And how might dignity be functional in the care of older people? The meaning and implications of dignity is important in the care of older people. If nurses are to provide dignified care clarification is an essential first step.
Source: Nursing 7.11.2008
SHOULD MASSAGE BE USED BY NURSES?
Massage is increasingly used to manage chronic pain but how effective is a single session of massage by a nurse to relieve chronic non-malignant pain and anxiety. Massage is effective in the short term for chronic pain of moderate to severe intensity. Should nurses use this treatment as an aid to tense patients?
Source: Nursing 7.11.2008
LET ASTHMATICS EXERCISE
Asthma is the most common chronic illness among children and accounts for 1 in 5 of all child GP consultations
Society places short term barriers to increased activity preventing children and young people with asthma attaining long term physical fitness with all its consequent benefits to lung health, general health, social and psychological well-being.
Activity and physical fitness deserve a place in goal setting for generic and individual asthma management plans. The way young people perceive and respond to physiological signals such as shortness of breath on exercise requires attention.
Source: Family Practice 6.30.2008
IMMIUNE SUPPRESSION IN CANCER TREATMENT
One unsolved problem in current cancer therapeutics is the substantial immune suppression seen in patients.
Conventionally, investigations in this area have focused on antigen-nonspecific immune suppressive molecules such as cytokines and T cell apoptosis inducing molecules such as Fas ligand.
More recently, a novel therapeutic approach to cancer immune suppression is promising, by extracorporeal removal of exosomes using hollow fiber filtration technology.
Studies have demonstrated nanovesicle particles termed exosomes are involved not only in stimulation but also inhibition of immunity in physiological conditions.
Interestingly, exosomes are secreted by cancer cells express tumor antigens, as well as immune suppressive molecules.Concentrations of exosomes from plasma of cancer patients have been associated with spontaneous T cell apoptosis, which is associated in some situations with shortened survival.
Source: Cancer, july22, 2008
ONE SHOT CAN PROTECT AGAINST TB
Protection against tuberculosis can be successful by giving one injection of DENA-hap65 vaccine complex with cathionic liposomes.
Source: Immunology July 17, 2008
KNEE REPLACEMENTS DOUBLE IN BABY BOOMERS
Over the last 5 years, knee replacements have doubled in people fewer than 65. Does this mean doctors are doing earlier replacements to avoid the meager Medicare payments doctors must accept after 65?
FRUIT JUICES CAN BLOCK MEDS
Grapefruit, apple, and orange juice found to block the absorption of over 50 medications from the small bowel, and hence will not be utilized. Take your medications at least 4 hours after you take such juices.
Source: Bailey, Univ. Western Ontario Am. Chemical Society, August 2008
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