Migraines linked to bacteria in mouth

People who suffer from migraines have more of certain bacteria in their mouths

People who suffer from migraines have long complained that certain foods trigger the severe headaches. New research suggests the culprit might be the amount of bacteria in the mouth.

Researchers found that the mouths of people who suffer from migraines harboured significantly more of the microbes that break down nitrates found in certain foods.

These bacteria play an important role in processing nitrates so they can then be converted into nitric oxide in the bloodstream, which widens blood vessels and improves circulation.

While this process is helpful for cardiovascular health, the findings suggest an abundance of these bacteria may break down nitrates more quickly, causing blood vessels in the brain and scalp to dilate, triggering migraines.

Nitrates are naturally found in a variety of leafy green vegetables, and they are added to processed meat as a preservative and to improve flavour and colour.

Doctors have been telling people who suffer from migraines to avoid processed foods for years. Dr. Michael Zitney, who leads the Headache & Pain Relief Centre in Toronto, says this research strengthens their case.

“We have long since known that these kinds of foods can trigger migraines, but we haven’t really known how,” he says.

Link to cardiovascular research

The process of how nitrates break down into nitric oxide is well-studied in cardiovascular health.

Nitrate-containing drugs are prescribed to treat chest pain or congestive heart failure. But roughly four out of five cardiac patients who take the drugs report severe headaches as a side-effect.

The study’s authors hope these findings will help link existing cardiovascular research with migraines.

“It opens a full area of research and connects two areas of research that have not been connected before,” says the study’s lead author, Antonio Gonzalez, from the University of California San Diego.

Data collected from ‘citizen scientists’

This study was based on data from the American Gut Project, which crowd sources oral and fecal samples from so-called “citizen scientists.”

Researchers sequenced bacteria found in 172 oral samples and 1,996 fecal samples. They found that the nitrate-reducing microbes were slightly more abundant in the fecal samples of people who suffer from migraines, but significantly more abundant in their oral samples.

Chronic migraines are frequent, severe, pulsating headaches accompanied by nausea, vomiting, and sensitivity to light and sound. They last anywhere from a few hours to several days.

It’s estimated that eight per cent of Canadians have been diagnosed with migraines, although this likely underestimates their prevalence, as some people who suffer from migraines don’t seek professional help.

The study’s authors say they still need to determine whether the bacteria are a cause or a result of migraines, or are indirectly linked in some other way.

For now, Zitney says, the research suggests that some migraines could one day be treated by controlling the bacteria in our mouths.

“This may be just a glimmer of hope in terms of pursuing possible treatments,” he says.

The study was published earlier this week in mSystems, the online journal of the American Society for Microbiology.

Source: http://www.cbc.ca/news/health/bacteria-migraines-1.3811940

Woman dies after injecting Vaseline into breasts

A 39-year-old Argentinean woman died after attempting to enhance the size of her breasts by injecting them with Vaseline

Sonia Perez Llanzon was admitted to the Lucio Molas hospital in Santa Rosa, Argentina after experiencing trouble breathing. Though Llanzon initially denied what she had done, she eventually confessed to doctors that she had injected herself with Vaseline several weeks earlier in the hopes of making her breasts larger. Doctors found several lesions on both breasts as a result of the home injections.

The Vaseline had entered Llanzon’s blood stream, causing blood clots that travelled to her lungs. Llanzon experienced a pulmonary embolism – a blockage of an artery in her lung – which resulted in her death.

“In all my medical career, I’ve never seen a case like this. The human body has antibodies to remove bacteria and viruses, but it hasn’t got any mechanisms against this type of product,” Julio Pla Cardenas, chief of surgery at Lucio Molas told La Capital.

Pla Cardenas said he has noticed an increasing number of people using Vaseline injections as a form of body augmentation, including men who have injected the product in the hopes of enhancing penis size.

Source: Fox news

Laptop theft exposes thousands of hospital records

Computer stolen from Etobicoke General had personal details of 5,500 patients

Medical records for thousands of patients at Etobicoke General Hospital could be in the wrong hands following the theft of a laptop.

The personal details of 5,500 patients — including names, dates of birth and diagnostic reports — were on a laptop that was stolen in mid-January from a lab used to test brain activity.

The lab was locked but the laptop was not password-protected — contrary to hospital policy according to Ann Ford, chief privacy officer for William Osler Health System.

We have a policy for protection and in this instance it just was not protected,” said Ford.

The laptop had information on patients who were tested between January 2011 and 2014. The hospital informed patients of the theft over the last two weeks.

There is a risk the information could be used for illegal purposes such as identity theft, but hospital administrators say there is little patients can do.

“We think that there’s no further action they need to take,” said Ford. “But, however, if they feel comfortable contacting their financial institution we leave that up to them.”

The hospital has since beefed up its security. All laptops are now secured by cable locks. Toronto police say the case is still open.

Source: cbc news

Woman donates kidney to stranger online


Most kidney donations come from folks who’ve just died or from living family members or close friends. Not many come from living strangers, just looking to do a good deed but that’s what happened Thursday morning.

Priscilla Naccarelli spent her morning at the hospital, a nervous wreck. Her 28-year-old daughter Lauren had just undergone surgery to surrender a perfectly healthy kidney to someone she doesn’t know and may never meet.

“It was very nerve-racking. I’m very proud of my daughter. I’m not so nervous and scared anymore. Right now, I just want to be with her and make sure she’s getting better,” Naccarelli said.

Lauren first raised the idea of donating to a stranger on her Facebook page last summer. The idea, she said, was simple: “I have a strong desire to help people.”

The thought that she could save somebody’s life is just very important to her. Nearly six months of tests and interviews and hospital visits later, she landed on the operating table for the two hour procedure. Shortly after noon, Lauren reported via
Facebook, “Totally tired and confused but I’m out of surgery and doing okay. Thanks everybody.”

Source: Fox news


Parabens in Our Lotions and Shampoos

Are parabens dangerous?

Parabens are old-time chemical preservatives – they were first introduced in the 1950s after bacteria-contaminated facial lotions caused a small outbreak of blindness. Today, they are used in a wide range of personal care items – from cosmetics to toothpaste, as well as some foods and drugs.

It is partly because of their stable history that the Food and Drug Administration describes them as safe, at least in the trace amounts – 0.01 to 0.3 percent – found in most consumer products.

However, and here’s where the answer gets complicated, in recent years, environmental health advocates have challenged that conclusion. Their concerns grew after a 2004 study found paraben compounds in breast cancer tumors.

Although no real link to the cancer was established, research has also found that parabens are weak estrogen mimics, capable of altering cell growth in culture, and may also act as endocrine disruptors, which can disrupt the normal function of hormones and interfere with development. The F.D.A.’s position is that parabens are too weak in this regard to cause any real concern.

The primary issue has become their ubiquity. “Parabens are found in between 13,000 and 15,000 personal care products,” said Janet Gray, director of the science, technology and society program at Vassar College. “So we are not talking about a single exposure but a more pervasive one.”

A 2006 analysis by the Centers for Disease Control and Prevention found evidence of parabens in more than 90 percent of people tested, with women – who use more cosmetics – registering higher levels than men. And a recent report in Environmental Science & Toxicology found that parabens were so common in products like baby lotion that infants may also receive a relatively high dose.

Researchers like Dr. Gray say we need to get a much better sense of such potentially riskier exposures. “The standard model of studying one paraben at a time isn’t telling us what we need to know,” she said. “It’s the bigger picture that matters.”

Source: New York Times


Obesity Is Found to Gain Its Hold in Earliest Years

For many obese adults, the die was cast by the time they were 5 years old. A major new study of more than 7,000 children has found that a third of children who were overweight in kindergarten were obese by eighth grade. And almost every child who was very obese remained that way.

Some obese or overweight kindergartners lost their excess weight, and some children of normal weight got fat over the years. But every year, the chances that a child would slide into or out of being overweight or obese diminished. By age 11, there were few additional changes: Those who were obese or overweight stayed that way, and those whose weight was normal did not become fat.

“The main message is that obesity is established very early in life, and that it basically tracks through adolescence to adulthood,” said Ruth Loos, a professor of preventive medicine at the Icahn School of Medicine at Mount Sinai in New York, who was not involved in the study.

These results, surprising to many experts, arose from a rare study that tracked children’s body weight for years, from kindergarten through eighth grade. Experts say they may reshape approaches to combating the nation’s obesity epidemic, suggesting that efforts must start much earlier and focus more on the children at greatest risk.

The findings, to be published Thursday in The New England Journal of Medicine, do not explain why the effect occurs. Researchers say it may be a combination of genetic predispositions to being heavy and environments that encourage overeating in those prone to it. But the results do provide a possible explanation for why efforts to help children lose weight have often had disappointing results. The steps may have aimed too broadly at all schoolchildren, rather than starting before children enrolled in kindergarten and concentrating on those who were already fat at very young ages.

Previous studies established how many children were fat at each age but not whether their weight changed as they grew up. While valuable in documenting the extent of childhood obesity, they gave an incomplete picture of how the condition developed, researchers said.

“What is striking is the relative decrease in incidence after that initial blast” of obesity that occurs by age 5, said Dr. Jeffrey P. Koplan, the vice president of the Emory Global Health Institute in Atlanta. “It is almost as if, if you can make it to kindergarten without the weight, your chances are immensely better.”

Dr. Koplan, a former director of the Centers for Disease Control and Prevention, was not associated with the new study, although its lead author, Solveig A. Cunningham, is an assistant professor in the School of Public Health at Emory.

The study involved 7,738 children from a nationally representative sample. Researchers measured the children’s height and weight seven times from kindergarten to eighth grade.

When the children entered kindergarten, 12.4 percent were obese — defined as having a body mass index at or above the 95th percentile — and 14.9 percent were overweight, with a B.M.I. at or above the 85th percentile. By eighth grade, 20.8 percent were obese and 17 percent were overweight. Half of the obese kindergartners were obese when they were in eighth grade, and nearly three-quarters of the very obese kindergartners were obese in eighth grade. The risk that fat kindergartners would be obese in eighth grade was four to five times that of their thinner classmates, the study found.

Race, ethnicity and family income mattered in younger children, but by the time the overweight children were 5 years old, those factors no longer affected their risk of being fat in later years.

The study did not track the children before kindergarten, but the researchers had their birth weights. Overweight or obese children often were heavy babies, at least 8.8 pounds, something other studies have also found.

The study’s results, Dr. Koplan and others said, “help focus interventions.”

Most efforts to reduce childhood obesity concentrate on school-age children and apply the steps indiscriminately to all children, fat and thin — improving meals in schools, teaching nutrition and the importance of physical activity, getting rid of soda machines.

“This suggests that maybe one reason it didn’t work so well is that by the time kids are 5, the horse is out of the barn,” said Leann L. Birch, a professor in the department of foods and nutrition at the University of Georgia, who was not involved with the study.

The most rigorous studies of efforts for school-age children, conducted in the 1990s, randomly assigned thousands of children to either participate in intensive programs that encouraged them to exercise and improve their diets, or go on as usual.

One study involved 1,704 third graders in 41 elementary schools in the Southwest, where most of the students were Native Americans, a group that is at high risk for obesity. A second study included 5,106 children in 96 schools in California, Louisiana, Minnesota and Texas.

Neither study found any effect on children’s weights.

Some obesity researchers said the new study following kindergartners over the years also hinted at another factor: the powerful influence of genetics on obesity, something that can be a challenge to overcome.

Source: New York Times


Man dies after 8 hours in ER waiting room

Reports have emerged that a man died in a hospital waiting room in New York City more than eight hours after he sought emergency care.

According to multiple reports, 30-year-old John Verrier entered the emergency room of St. Barnabas Hospital in the Bronx at around 10 p.m. on Jan. 12 complaining about a rash. He was found dead in the waiting room about 6:40 a.m. the next day when a guard failed to wake him up.

St. Barnabas Hospital spokesperson Steve Clark confirmed the timeline around Verrier’s death.

“Probably this scenario in this shape and form has happened in any big hospital in New York City,” he said.

When Verrier arrived at St. Barnabas, he had his vitals taken in the triage area and was told to wait in the waiting room until his name was called to see a doctor, according to Clark. At 12:35 p.m., his name was called for the first time, but Verrier did not respond. That night, his name was called two more times to see the doctor, but the patient did not acknowledge his name was being called.

“People have personal responsibility when your name is called, you have to get up and see the doctor,” Clark said.

It was determined through employee accounts and security footage that Verrier was alive at least until 3:45 a.m. A security guard woke him up after he had fallen asleep, and he had been recorded walking around the waiting room.

The cause of death for Verrier has yet to be determined, pending a medical examiners report.

The case has been investigated internally, and the hospital said it was determined that officials had done everything according to protocol.

“This could have happened anywhere outside in the cold,” said Clark.

He couldn’t confirm the reason Verrier was asking to see a doctor, citing patient confidentiality laws. He did say that Verrier was called for as soon possible, after more pressing cases were attended to.

“It was a busy night, waiting 2 hours and 30 minutes is not that long a time considering what his complaint was,” Clark said.

He added that on many cold nights in New York City, many people use the hospital as shelter and stay in the waiting room to keep warm. People aren’t allowed to loiter or sleep in the facilities, however. In order to stay inside the hospital, the patients have to come in with a medical complaint. Many of the times, the issue they present with is just a ruse in order not to be kicked out, he said.

He emphasized that this scenario may or may not relate to Verrier’s case, but could explain why some people spend time sitting in a waiting room without entering the hospital, even if their name was called multiple times.

“People come in with no desire to see the doctor,” he said.

An anonymous St. Barnabas Hospital emergency room employee told WABC that despite Verrier’s name being called three times, he had not been checked on personally. The employee added he or she believed Verrier died because there was “not enough staff to take care of the number of patients we see each day.”

Clark dismissed the comments, saying that the hospital did not think staff numbers played a role in this scenario.

“It is a tragedy that a young man died, yet following an internal review, it was concluded that all hospital guidelines were met,” the hospital said.

According to a ProPublica report, the average person in New York spends 2 hours and 35 minutes waiting in the emergency room to see a doctor, and about 1 percent leave without being seen. The report determined that St. Barnabas patients waited 5 hours and 6 minutes on average before seeing a doctor, and 18 percent left without being seen.

Source: fox news

Healthy lifestyle to improve oral health in diabetics

Diabetics, who are at a higher risk of suffering from oral health problems, can avoid these by adopting a healthy lifestyle.

Researchers at the University of Copenhagen have helped a large group of diabetics to markedly improve their oral health through health coaching.

“Diabetics are at a higher risk of suffering oral health issues like periodontitis and caries and other problems like dry mouth, fungal infections and poor wound healing,” said Ayse Basak Cinar, assistant professor at department of odontology at the university.

In all, 186 patients with type 2 diabetes participated in the study done in Turkey – the first in the world – to demonstrate the role of health coaching in improving dental health.

The patients with diabetes were divided into two groups.

One group was given traditional health information, for example a brochure on good dental hygiene.

The other group was offered motivational health coaching in the form of 3-6 sessions over a six-month period, focusing on diet, stress management and dental care, said the research published in the journal Clinical Oral Investigations.

“In patients who were given personal health coaching, biological markers for periodontitis – also known as loose teeth disease – were reduced by as much as 50 percent over a six-month period,” the research noted.

“The patients in the trial group saw a significant decline in long-range blood sugar levels, whereas figures for the control group were unchanged,” said.

“Health coaching is a resource-intensive intervention. However, dishing out brochures to patients with diabetes and thinking that this would help is also a costly approach for the society,” he added.

Source; Business standard

Hitachi unveils medical content management blueprint


Hitachi Data Systems (HDS), a wholly owned subsidiary of Hitachi, on Wednesday announced the first medical content management blueprint for Electronic Medical Records Adoption Model (EMRAM). The model, devised by Healthcare Information and Management Systems Society (HIMSS) in Asia Pacific helps health organizations optimize their IT investments on the journey to full electronic medical records (EMR) adoption.

“Medical content is the lifeblood of health organizations. To ensure it runs smoothly, health organizations need a robust system to manage and control its storage, operation and security,” said Steven Yeo, vice president and executive director of HIMSS Asia Pacific. “It is encouraging that HDS has developed solutions with each stage of the EMR Adoption Model in mind.”

Health organizations around the world are fast adopting EMR applications to enhance care quality and efficiency. To support and guide these organizations, HIMSS offers an eight-stage Asia Pacific EMRAM which helps healthcare professionals understand their EMR needs.

Many physicians and managers find it challenging to identify the appropriate solutions to store and manage medical content when they adopt EMR. Drawing on its expertise in information innovation, HDS developed the new medical content management blueprint for HIMSS EMRAM.

“Healthcare is a big data industry that is experiencing a rapid, exponential increase in both the volume and variety of data when adopting EMR applications. As patient data continues to grow, health organizations need highly scalable, available IT infrastructures to support patient care as well as lower the total cost of ownership,” said Johnny Ma, general manager, APAC Industry Solutions, Hitachi Data Systems. “Through HIMSS consulting services, we ensure that we help healthcare organizations optimize their IT assets and manage costs while delivering excellent services.”

HDS content management solutions for EMRAM include seven elements, namely business continuity, file and content, unified storage, storage economics, cloud enablement, virtualization, and enterprise-class storage platforms. Health organizations can implement each element separately according to their adoption stage or deploy an integrated infrastructure with multiple solutions to support their specific environment and growth plan.

By referring to the medical content management requirements for EMRAM, health organizations can formulate a solution algorithm to architect the best solution to meet the specific requirements of each stage. This solution algorithm comprises all the essential components to not only meet the needs of that individual EMRAM stage, but to integrate with the solutions implemented at later stages, according to a statement by HDS.

Source: India medical Times


Reduction in hospital medical errors with improved handoff communication

A new study from Boston Children’s Hospital’s division of general paediatrics — published by the Journal of the American Medical Association (JAMA) — indicates that improving verbal and written communication during patient handoffs can reduce medical errors substantially without burdening existing workflows.

Medical errors are a leading cause of death and injury in the US, with an estimated 80 per cent of serious medical errors involving some form of miscommunication, particularly when care is transferred in a hospital setting from one provider to the next.

“By introducing more standardized communication during patient handoffs for this study, Boston Children’s saw a substantial drop in the overall number of medical errors,” says the study’s principal investigator Dr Christopher Landrigan.

“We believe if other medical centres adopted similar protocols it could have a positive and significant impact on patient safety.”

Error types included those with little or no potential for harm, intercepted potential adverse events, non-intercepted potential adverse events and preventable adverse events. Preventable adverse events decreased from 3.3 per 100 admissions to 1.5 per 100 admissions following intervention.

With the goal of improving provider-to-provider communication, Dr Landrigan and Dr Amy Starmer, lead author of the study, designed a multi-faceted, bundled handoff system consisting of three key components: standardized communication and handoff training, a verbal mnemonic and a new team handoff structure.

“Traditionally, doctors are trained in medical school to interview a patient and write daily summaries of the care plan, but though vital to patient care, rarely receive communication or handoff training,” says Dr Starmer. “We sought to rectify that omission with this study.”

The researchers examined 1,255 patient admissions that occurred during the implementation of the handoff bundle to measure how it impacted patient care and clinician workflow across two separate inpatient units at Boston Children’s.

Implementation of the new system began with an interactive workshop for all participating clinicians, during which they practiced giving and receiving handoffs under different clinical and real-world scenarios. The workshop was based on best practices for handoffs using elements of the TeamSTEPPS communication programme, developed by the military and the US Agency for Healthcare Research and Quality.

Secondly, participants adopted an easy-to-remember mnemonic to ensure all relevant information was verbally communicated during the handoff. Face-to-face handoffs were also restructured to involve all team members and minimize interruptions and distractions.

Finally, in conjunction with Boston Children’s informatics team, the researchers created a structured handoff tool within the electronic medical record (EMR) to standardize the documentation of patient information that is transmitted at change of shift. The electronic handoff tool self-populates with standard patient information. This replaced the previous method of information exchange that required clinicians to manually enter and re-enter information in a word processing document, increasing the potential for human error.

After implementation of the communication bundle there were fewer omissions or miscommunications about important data during handoffs, which led to positive results. Of the 1,255 patient admissions studied, medical errors decreased 45.8 per cent. In addition, following the intervention, providers spent more time communicating face-to-face in quiet areas conducive to conversation, and spent more time at the bedside with patients.

“We believed these systems would lead to a reduction in medical errors, but did not expect to see a change of this magnitude,” Dr Starmer says. “And even more surprising was that the systems were introduced so easily. Participants embraced the new systems, became more productive, and could then focus more energy to the job at hand.”

Based on the results of this study, Dr Landrigan and team developed I-PASS, a handoff bundle rolling out to 10 teaching hospitals across North America.

“Our ultimate goal,” says Dr Landrigan, “is to develop a robust handoff programme that can be broadly disseminated across hospitals and specialties to reduce medical errors and optimize patient safety.”

Source: India Medical Times