Health and Disability

Researchers at the University of Leeds and the Institute of Cancer Research in London, both in the United Kingdom, found that the naturally occurring virus was able to cross the blood-brain barrier in all who took part in the study.

These findings are significant because it was previously thought that the only way to use the virus to treat brain cancer was to inject it directly into brain tissue. But this approach is limited; it cannot be repeated very often and does not suit all patients.

Reporting in the journal Science Translational Medicine, the researchers explain how the virus — a member of the reovirus family — not only infected cancer cells without affecting healthy cells, but it also helped the immune system to find and attack the cancer cells.

They believe that their study shows how reoviruses might enhance a type of immunotherapy called checkpoint therapy for cancers that start in the brain or spread to the brain from another part of the body.

He and other scientists are running experiments that are yielding some important new clues about fiber’s role in human health. Their research indicates that fiber doesn’t deliver many of its benefits directly to our bodies.

Instead, the fiber we eat feeds billions of bacteria in our guts. Keeping them happy means our intestines and immune systems remain in good working order.

But our bodies make a limited range of enzymes, so that we cannot break down many of the tough compounds in plants. The term “dietary fiber” refers to those indigestible molecules.

But they are indigestible only to us. The gut is coated with a layer of mucus, atop which sits a carpet of hundreds of species of bacteria, part of the human microbiome. Some of these microbes carry the enzymes needed to break down various kinds of dietary fiber.

The shouts of schoolchildren playing outside echoed through the gymnasium where an obstacle course was being set up.

There was the “Belgian sidewalk,” a wooden contraption designed to simulate loose tiles; a “sloping slope,” ramps angled at an ankle-unfriendly 45 degrees; and others like “the slalom” and “the pirouette.”

“It’s not a bad thing to be afraid of falling, but it puts you at higher risk of falling,” said Diedeke van Wijk, a physiotherapist who runs WIJKfysio and teaches the course three times a year in Leusden, a bedroom community just outside Amersfoort, in the center of the country.

Yet falling courses — especially clinically tested ones — are a fairly recent phenomenon, according to Richard de Ruiter, of the Sint Maartenskliniek in Nijmegen, the foundation hospital that developed this particular course.

Virtually unheard-of just a decade ago, the courses are now common enough that the government rates them. Certain forms of Dutch health insurance even cover part of the costs.

The night that Stephen Paddock opened fire on thousands of people at a Las Vegas country music concert, nearby Sunrise Hospital received more than 200 penetrating gunshot wound victims. Dr. Kevin Menes was the attending in charge of the ED that night, and thanks to his experience supporting a local SWAT team, he’d thought ahead about how he might mobilize his department in the event of a mass casualty incident.

This is his story, as told to Judith Tintinalli, MD, MS
Edited by Logan Plaster

I’m a night shift doc. My work week is Friday to Monday, 8 p.m. to 6 a.m. Most people don’t want to work those shifts. But that’s when most of the action comes in, so that’s when I work. It was a Sunday night when the EMS telemetry call came in to alert Sunrise Hospital of a mass casualty incident. All hospitals in Las Vegas are notified in a MCI to prepare for incoming patients.

As I listened to the tele, there happened to be a police officer who was there for an unrelated incident. I saw him looking at his radio. I asked him, “Hey. Is this real?” and he said, “Yeah, man.” I ran down to my car and grabbed my police radio. The first thing that I heard when I turned it on to the area command was officers yelling, “Automatic fire…country music concert.” Ten o’clock at night at an open air concert, automatic fire into 10-20 thousand people or more in an open field—that’s a lot of people who could get hurt.

At that point, I put into action a plan that I had thought of beforehand. It might sound odd, but I had thought about these problems well ahead of time because of the way I always approached resuscitations:

1. Preplan ahead
2. Ask hard questions
3. Figure out solutions
4. Mentally rehearse plans so that when the problem arrives, you don’t have to jump over a mental hurdle since the solution is already worked out

Megan McCormick is a paraeducator — a teacher’s assistant — at Lexington’s Millcreek Elementary. The Fayette County Public Schools employee is passionate about helping students and is pursuing a four-year college degree to further her career..

McCormick, 29, also has Down syndrome. It is a genetic disorder than can result in mild to moderate intellectual disabilities.

“We are very proud of Megan,” Millcreek principal Greg Ross said. “She does a phenomenal job. She does whatever we ask of her.”

When it comes to hospice patients with type 2 diabetes, avoiding hypoglycemia may be more important than strict glycemic control, researchers argued.

When it comes to hospice patients with type 2 diabetes, avoiding hypoglycemia may be more important than strict glycemic control, researchers argued.

As for severe hypoglycemia -- a glucose reading under 50 mg/dL -- this was experienced by approximately 5% of hospice patients in nursing homes within 180 days of admission, reported Laura A. Petrillo, MD, of Massachusetts General Hospital in Boston, and colleagues.

The risk was even greater for those receiving insulin: cumulative incidence of 38% for all hypoglycemia and 18% for severe episodes within 180 days of admission, with the peak risk occurring during the initial 20 days. Hyperglycemia incidence was 9% overall; 35% among those on insulin.

"[H]ypoglycemia is not consistent with a goal of comfort, and these data demonstrate suboptimal avoidance of dysglycemia among patients with type 2 diabetes on hospice in nursing homes," wrote Petrillo and colleagues.

Throughout the trial, there was a marked increase in the use of newer AEDs: the first decade was dominated by carbamazepine, valproate, and phenytoin as initial therapy, while the latter decade was dominated by valproate, levetiracetam, and lamotrigine as initial monotherapy.

"The results of this study suggest that the advent of new pharmacological therapies has had little impact on the proportion of newly diagnosed people rendered seizure-free" -- a finding that "is not new and should not be surprising."

“I think it’s, in general, a good thing,” said co-author David Slusky, an assistant professor of economics at the University of Kansas, speaking to Futurism over the phone. “Certainly, we can think of cases where it’s a worrying trend, but in general, it’s a good thing.” Slusky went on to acknowledge the importance of “bending the cost curve” for healthcare in the U.S., given that residents spend more per capita on healthcare than anywhere else in the world.

Of course, it’s crucial that people are only using Uber drivers as an impromptu ambulance when it’s safe to do so. While in some cases it makes sense to save money using this strategy, there are certain situations when it would be ineffective or even downright dangerous to do so.

For example, you may end up in the wrong hospital, said Marc Eckstein, the Los Angeles City Fire Department’s medical director, speaking with CBS.

Not all hospitals offer the same services, so if you get a ride to the nearest one which is not equipped to treat your problem, that hospital will then call 911 and move you to the right facility. “That difference of 30 minutes or more could mean the difference between life and death,” Eckstein said.

AMBULANCE APP

The fact that the cost of taking an ambulance to the hospital is inaccessible for a lot of people in the U.S. is a big problem, and the use of ride-sharing services is a workaround at best. However, there are certain advantages to the idea of people taking an Uber when an ambulance isn’t necessary.

“If ambulances aren’t used when they’re less needed, that improves response time when they are needed,” explained Slusky. Again, it’s troubling to think that people might have to weigh the financial repercussions of getting to the hospital in an emergency, but there could be a benefit to giving people a less expensive alternative in non-emergency situations.

Slusky argues that educating the public about what sort of conditions need immediate treatment, as well as an effective method of remote triage before the patient ever reaches the hospital, could help modernize our emergency healthcare. Some kind of sanctioned ride-sharing service could play a role, with ambulances serving as one component of a broader fleet of vehicles with various levels of specialization.

For the treatment of hypoglycemia, glucagon may be underused in outpatient settings, researchers argued.

In some states, emergency medical service responders aren't even permitted to check blood glucose levels, according to a research letter online in Annals of Internal Medicine.

"Patients receiving insulin or certain oral hypoglycemic agents are at increased risk for hypoglycemia, which results in more than 100,000 emergency department visits incurring approximately $120 million in costs annually," Kahn's group wrote, adding that family members often routinely administer glucagon.

The analysis included cases of glucagon administration from the National EMS Information System between 2013 to 2015, as well as prescriptions of glucagon from 2014 Medicare Part D data.

Within this time frame, glucagon was administered in only 89,263 cases in a prehospital setting. Among such instances where glucagon was administered, the average response time to calls for emergency medical services was 15.34 minutes (SD 11.50). Of these, only 3,944 patients reported having any adverse events due to glucagon.