Wednesday, September 10, 2014

Support For Vets During Suicide Prevention Month

Support For Vets During Suicide Prevention Month

The Power of 1 campaign reminds us that just one conversation or one act can have an important effect on the life of a Veteran or Servicemember by offering hope and opening the door to support.
call center workers consult near a woman taking a call

[Articles] Deaths in young people aged 0–24 years in the UK compared with the EU15+ countries, 1970–2008: analysis of the WHO Mortality Database

[Articles] Deaths in young people aged 0–24 years in the UK compared with the EU15+ countries, 1970–2008: analysis of the WHO Mortality Database

The UK has not matched the gains made in child, adolescent, and young adult mortality by other comparable countries in the 40 years since 1970, particularly for infant deaths and mortality from non-communicable diseases, including neuropsychiatric disorders. The UK needs to identify and address amenable social determinants and health system factors that lead to poor health outcomes for infants and for children and young people with chronic disorders.

Dr. Harsh Vardhan Says Mass Awareness Should be Generated on Eye Donation

Dr. Harsh Vardhan Says Mass Awareness Should be Generated on Eye Donation

Dr. Harsh Vardhan, the Union Health Minister of India urges the need to generate a positive attitude towards organ donation in general and eye (cornea) donation in particular among young children.

FDA reminds health care professionals and consumers not to use sterile products from Downing Labs/NuVision Pharmacy of Texas

FDA reminds health care professionals and consumers not to use sterile products from Downing Labs/NuVision Pharmacy of Texas

The U.S. Food and Drug Administration is reminding health care professionals and consumers about safety concerns with all sterile-use drug products made and distributed by Downing Labs LLC, doing business as NuVision Pharmacy, in Dallas, Texas. Health care professionals should not use any NuVision/Downing Labs sterile products for their patients because the firm cannot ensure the safety or quality of these products. Administration of a non-sterile drug product may result in serious and potentially life-threatening infection or death.


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Sunday, September 07, 2014

FDA allows marketing of the first test to assess risk of developing acute kidney injury

FDA allows marketing of the first test to assess risk of developing acute kidney injuryToday the U.S. Food and Drug Administration allowed marketing of the NephroCheck test, a first-of-a-kind laboratory test to help determine if certain critically ill hospitalized patients are at risk of developing moderate to severe acute kidney injury (AKI) in the 12 hours following the administration of the test. Early knowledge that a patient is likely to develop AKI may prompt closer patient monitoring and help prevent permanent kidney damage or death.
The kidneys filter waste and extra water out of the blood and are important in controlling blood pressure and other essential body functions. When kidneys are not functioning properly, waste builds up in the body and can cause serious health problems  ...


Woman describes how she underwent a kidney transplant and then also required a life saving liver transplant.

Woman describes how she underwent a kidney transplant and then also required a life saving liver transplant.
This online report is the story of a Florida woman -Helen Schwarz - (pictured) who has recovered from both a kidney and then subsequently a liver transplant.

Helen who works as an administrative manager for the Tallahassee Democrat newsroom in the United States, was born with the  genetic disorder known as polycystic kidney disease (PCKD).

Initially when Helens own kidneys were no longer functioning adequately, Helen underwent a live donor kidney transplant. Subsequently Helen's liver became markedly enlarged due to there also being multiple cysts within it. This was related to her underlying genetic condition and was contributing to a further deterioration in Helen's physical health. This led to Helen undergoing a life saving liver transplant from which she has now recovered.

Deborah Verran's insight:
Most patients with polycystic kidney disease will only require a kidney transplant when their own kidneys fail. However there are a small number of patients with this condition in whom the liver is also involved and at times liver transplantation may also be required.



Heart Attack Symptoms in Women – Are they Different?

Heart Attack Symptoms in Women – Are they Different?Chest pain is still the most common sign of a heart attack for most women, although studies have shown that women are more likely than men to have symptoms other than chest pain or discomfort when experiencing a heart attack or other form of acute coronary syndrome (ACS), according to an article "Symptom Presentation of Women With Acute Coronary Syndromes – Myth vs. Reality" published online Dec. 10 in the Archives of Internal Medicine. The study was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.
Researchers examined 35 years of research that yielded 69 studies 69 studies and found that, depending on the size of the study (which ranged from large trials to single centers and interviews), between 30 percent and 37 percent of women did not have chest discomfort during a heart attack. In contrast, 17 percent to 27 percent of men did not experience chest discomfort. Overall, the majority of women – and men -- in the reviewed studies had chest discomfort with heart attack (two-thirds to three-quarters, depending on study size...


Friday, September 05, 2014

Researchers Develop Innovative Imaging System to Study Sudden Cardiac Arrest

Researchers Develop Innovative Imaging System to Study Sudden Cardiac Arrest

A research team at Vanderbilt University has developed an innovative optical system to simultaneously image electrical activity and metabolic properties in the same region of a heart, to study the complex mechanisms that lead to sudden cardiac arrest. Tested in animal models, the system could dramatically advance scientists' understanding of the relationship between metabolic disorders and heart rhythm disturbances in humans that can lead to cardiac arrest and death, and provide a platform for testing new treatments to prevent or stop potentially fatal irregular heartbeats, known as arrhythmias.
The research is supported in part by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.

The design and use of the dual camera system is described in the Nov.1 issue of Experimental Biology and Medicine. Additional support for the project has also been provided by the Vanderbilt Institute for Integrative Biosystems Research and Education (VIIBRE), the American Heart Association, and the Simons Center for Systems Biology at the Institute for Advanced Study...

NIH Launches Multicenter Clinical Trial to Test Blood Pressure Strategy

NIH Launches Multicenter Clinical Trial to Test Blood Pressure Strategy

To those interested in participating in the SPRINT study: we will not be recruiting participants until the fall of 2010.  Please check www.clinicaltrials.gov at that time for information on enrolling in this study. 
The National Institutes of Health is launching a large multicenter randomized clinical trial to determine whether maintaining blood pressure levels lower than current recommendations further reduces the risk of cardiovascular and kidney diseases, or age-related cognitive decline.

Called the Systolic Blood Pressure Intervention Trial (SPRINT), the nine-year, $114 million study will be conducted in more than 80 clinical sites across the United States...   read more

Potassium-rich Foods and Stroke Risk

Potassium-rich Foods and Stroke Risk

Atomato a day may help keep the doctor away - Or how about a sweet potato a day? Both of these foods are rich in potassium and a new study suggests that postmenopausal women who eat foods higher in this dietary mineral are at lower risk of having a stroke.
The researchers studied more than 90,000 women ages 50 to 79 for an average of 11 years. The team looked at how much potassium they consumed, as well as if they had strokes or passed away during the study period. The results showed that those who ate the most potassium were 12 percent less likely to suffer stroke in general and 16 percent less likely to suffer an ischemic stroke, the most common kind. .. read more


Vets Roll In to Richmond for "The Games"

Vets Roll In to Richmond for "The Games"
More than 500 athletes participate in the National Veterans Wheelchair Games, largest wheelchair sports event in the world. Sports and rehab program is for military service Veterans who use wheelchairs for sports competition...
Three Veterans in wheelchairs play basketball


Thursday, September 04, 2014

Creatinine 1.29 is It Serious in Chronic Kidney Disease

Creatinine 1.29 is It Serious in Chronic Kidney Disease

Creatinine 1.29 is It Serious in Chronic Kidney Disease As we all know the normal creatinine level is different from male(0.5-1.5) and female(0.7-1.2), so if your creatinine level is higher than it, you should make further diagnosis in time so as to avoid big disease. Compared to the normal level, creatinine 1.29 is not very high, even this you can not sure whether your kidneys are damaged or not. You need to do some tests to make more accurate diagnosis. If you want to know more details directly, you can chat with our online doctor.
First you need to make sure whether you have ate much foods with high protein in a short time, or got an infection or cold or fever recently, all of them may increase your creatinine level in a while. If you have experience the above things, you need to take the test one weeks later to make further diagnosis...

Thirty years survivor on hemodialysis: A case report

Thirty years survivor on hemodialysis: A case reportSaudi Journal of Kidney Diseases and Transplantation 2014 25(5):1056-1058

Hemodialysis is a widely performed and safe procedure; therefore, the numbers of long-term survivors on hemodialysis therapy have been increasing. We present a woman who had been on uninterrupted hemodialysis for 30 years and did well for much of her time on hemodialysis, despite a long-standing uneven course. The literature of extremely long-lived patients on un-interrupted hemodialysis is reviewed and the clinical characteristics and complications encountered in these patients are discussed...

New treatment against transplantation complications tested

New treatment against transplantation complications tested


A class of biotechnology drugs called monoclonal antibodies is now being tested in clinical studies to treat an unmet medical need post-transplantation, called delayed graft function
It is not uncommon for kidney transplants to fail. Once transplanted, the kidney must connect back with the blood supply to start working properly and be truly accepted by the body. Delays can cause complications. An example, known as delayed graft function (DGF), is where the new kidney can become inflamed while starved of blood supply. This serious complication affects over half of those who receive kidneys from deceased donors.
Now, a solution may be in sight. A new drug candidate, belonging to the family of monoclonal antibodies, called OPN-305 is capable of dampening down the body's immune response to a donated kidney. Developed since 2005 by a biopharmaceutical company in Dublin, Ireland, called Opsona Therapeutics, studies have confirmed that it works in animals and is not toxic. An initial clinical trial in healthy humans, referred to as phase I study, has shown it is safe. Now, as part of the EU-funded project MABSOT, the drug will be tested on a number of patients. This will be a proof-of-concept, so-called Phase II, clinical trial... 

Brazil's Maternal Milk Banks Model for Globe

Brazil's Maternal Milk Banks Model for Globe

Thirty years ago, poor Brazilian women were paid for their breast milk, leaving their children at risk of malnourishment. Equipment at the few milk collection centers was so costly it limited the country's ability to expand the program's reach.
That has changed dramatically, thanks in part to Joao Arigio Guerrade Almeida, a chemist who has turned the Brazilian Milk Bank Network into a model studied by other countries and credited with helping slash infant mortality by two thirds.

"Brazil is really the world leader in milk bank development," said Dr. Lisa Hammer, a University of Michigan pediatrician who was part of a team visiting the Rio de Janeiro-based network last week..

Monday, September 01, 2014

What is the Difference Between Kidney Cysts and Polycystic Kidney Disease

What is the Difference Between Kidney Cysts and Polycystic Kidney Disease


In a study of dialysis patients, those who reported that they had discussed the option of transplantation with clinicians were more likely to be put on the transplant waiting list; however, clinician-reported discussions of transplantation did not increase patients' likelihood of being waitlisted. The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), indicate that better ways of informing patients about kidney transplantation may be needed.
One of the key principles of informed consent is describing alternative treatments. So when starting someone on hemodialysis, it is imperative to discuss the alternatives to hemodialysis, for example peritoneal dialysis and kidney transplantation. The Centers for Medicare & Medicaid Services (CMS) believe the discussion of kidney transplantation is so important that they mandate it. Unfortunately, though, there is no guidance as to what kind of discussion is required.

Dorry Segev, MD, PhD (Johns Hopkins University School of Public Health) and his colleagues asked 388 patients if providers (kidney specialists or dialysis staff) had discussed transplantation with them, and then they looked to see whether the providers reported to CMS that they had discussed transplantation with those patients.

Discordance between patient and provider in discussions about kidney transplantation

Discordance between patient and provider in discussions about kidney transplantation

In a study of dialysis patients, those who reported that they had discussed the option of transplantation with clinicians were more likely to be put on the transplant waiting list; however, clinician-reported discussions of transplantation did not increase patients' likelihood of being waitlisted. The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), indicate that better ways of informing patients about kidney transplantation may be needed.
One of the key principles of informed consent is describing alternative treatments. So when starting someone on hemodialysis, it is imperative to discuss the alternatives to hemodialysis, for example peritoneal dialysis and kidney transplantation. The Centers for Medicare & Medicaid Services (CMS) believe the discussion of kidney transplantation is so important that they mandate it. Unfortunately, though, there is no guidance as to what kind of discussion is required.

Dorry Segev, MD, PhD (Johns Hopkins University School of Public Health) and his colleagues asked 388 patients if providers (kidney specialists or dialysis staff) had discussed transplantation with them, and then they looked to see whether the providers reported to CMS that they had discussed transplantation with those patients... read more ...

Study Underlines Need for Improvement in Doctor-Patient Discussions About Transplantation

Study Underlines Need for Improvement in Doctor-Patient Discussions About Transplantation


Underlining the need for better ways through which patients can be informed about kidney transplantation; a new study reveals that dialysis patients who said that they had discussed the option of transplantation with their doctors were more likely to be put on the transplant waiting list though it did not increase their likelihood of being waitlisted.
 Study Underlines Need for Improvement in Doctor-Patient Discussions About Transplantation
One of the key principles of informed consent is describing alternative treatments. So when starting someone on hemodialysis, it is imperative to discuss the alternatives to hemodialysis, for example peritoneal dialysis and kidney transplantation. The Centers for Medicare & Medicaid Services (CMS) believe the discussion of kidney transplantation is so important that they mandate it. Unfortunately, though, there is no guidance as to what kind of discussion is required. Dorry Segev, MD, PhD (Johns Hopkins University School of Public Health) and his colleagues asked 388 patients if providers (kidney specialists or dialysis staff) had discussed transplantation with them, and then they looked to see whether the providers reported to CMS that they had discussed transplantation with those patients... read more

Wednesday, August 27, 2014

Gene therapy trial aims to find alternative to heart transplants

Gene therapy trial aims to find alternative to heart transplants

The first study of its kind will investigate the effectiveness of gene therapy for patients with a left ventricular assist device
British scientists have launched a pioneering trial to see whether gene therapy can potentially replace heart transplants.
Lee Adams, a 37-year-old carpenter from Hertfordshire, is the first of 24 patients with advanced heart failure to be recruited....read more


Hypothermic organ preservation studies presented at the World Transplant Congress 2014

Hypothermic organ preservation studies presented at the World Transplant Congress 2014

There were several presentations at the recent World Transplant Congress in San Francisco that discussed the latest developments in hypothermic organ preservation techniques. Using the Scientific Registry of Transplant Recipients, Gill et al of the Vancouver group examined the impact of Hypothermic Machine Perfusion (HMP) on the risk of DGF depending on the Kidney Donor Profile Index (KDPI). When corrected for confounders, HMP was associated with approximately 20-30% reduction in odds of DGF in all but the lowest KDPI decile; If KDPI was less than 0.3 and CIT less than 12 hours, there was no reduction in DGF.
A paired DCD kidney study from Guangzhou, China (Yuan et al) compared HMP with static cold storage (40 donors). Unfortunately the study was small and 16 kidneys were discarded before transplantation, resulting in overall low rates of DGF, but no discernible difference between the two arms of the study. In another paired DCD kidney study, Zhong et al of the Hunan group, China, presented reduced rates of DGF with HMP. In a parallel laboratory study they showed reduced vasospasm and oedema of sertoli cells/renal tubular epithelial cells as a potential mechanism of action.
Considerable experience with HMP for liver preservation was presented by James Guarrera and the Columbia University group. The so-called “orphan” extended criteria donor livers used had been turned down by all other centres in the UNOS region. The livers were perfused with vasosol for 3-7 hours and transplanted into recipients with MELD scores less than 35. These cases were matched to historical controls preserved by static cold storage. Biliary complications were significantly lower in the HMP group, as was post-operative stay. Patient survival and early allograft dysfunction were not significantly affected however. Sanna op den Dries and a collaboration between Groningen and Harvard Universities have added to our understanding of non-anastomotic biliary strictures by demonstrating that injury to peri-biliary glands and vascular plexus before liver transplantation was predictive of later stricture formation....

Heart transplant patients benefit from high-intensity interval exercise

Heart transplant patients benefit from high-intensity interval exercise

High-intensity interval training can help clinically stable heart transplant recipients achieve increased exercise capacity, maintain control of blood pressure and gain improved resting heart rate when compared with moderate exercise, according to a new study published in the American Journal of Transplantation.
A heart transplant is an operation to replace a damaged or failing heart with a healthy human heart from a donor who has recently died. A heart transplant may be needed when a person's heart can no longer work effectively, potentially putting their life at risk.
A heart transplant is usually recommended if a person:
  • Has severe heart failure - when the heart is having trouble pumping enough blood around the body
  • Is expected to die within in a year without a transplant
  • Has not responded to conventional treatments for heart failure.
There are over 2,000 heart transplants that take place in the US annually, most occurring between the ages of 50-64 years, with around 70% of cases male.

Survival rates in solid organ transplant - for example heart, liver and kidney - have improved significantly, with around 88% of patients surviving the first year after transplant surgery and 75% surviving for 5 years. The 10-year survival rate is around 56%....

Pretransplant Dialysis Duration and Risk of Death After Kidney Transplantation in the Current Era

Pretransplant Dialysis Duration and Risk of Death After Kidney Transplantation in the Current Era
imageBackgroundAlthough longer pretransplant dialysis has been associated with poor kidney transplant outcome, no data about this association exist from the current era or from Europe. We studied the association of pretransplant dialysis duration on outcomes after kidney transplantation across two different time periods. MethodsAll recipients of first kidney transplantation between 1990 and 2010 in Finland were included (N=3,105) in this observational follow-up study of an inception cohort. The association of the duration of pretransplant dialysis with patient and graft survival after transplantation was analyzed with multivariable Cox regression and competing risk analyses. The association of pretransplant dialysis duration with the risk of specific causes of death (cardiovascular, infectious, or other) was analyzed using competing risk analysis. ResultsLonger duration of pretransplant dialysis was an independent risk factor for patient death after transplantation (risk ratio [RR] 1.14 per 1-year increase) in the whole study population, but not for graft loss. Risk of death was increased in patients with greater than 12 months of pretransplant dialysis. After further adjustment in patients transplanted in 2000 to 2010, longer duration of dialysis remained an independent risk factor (RR 1.23 per 1-year increase). Longer duration of dialysis was an independent predictor of death resulting from cardiovascular diseases (RR 1.14 per 1-year increase), but not for other causes. ConclusionsThe risk of death associated with longer duration of dialysis has not decreased over time, but remains an independent predictor of patient death after kidney transplantation because of increased risk of death resulting from cardiovascular diseases

Graft Survival After Cardiac Transplantation for Alcohol Cardiomyopathy

Graft Survival After Cardiac Transplantation for Alcohol Cardiomyopathy

Brinkley, D. Marshall; Novak, Eric; Topkara, Veli K.; Geltman, Edward M.
imageBackgroundAlcohol cardiomyopathy (ACM) constitutes up to 40% of patients with non-ischemic dilated cardiomyopathy. Transplant-free survival is worse for patients with ACM versus idiopathic dilated cardiomyopathy (IDCM) with continued exposure. The prognosis for patients with ACM after cardiac transplantation is unknown. MethodsWe evaluated adults who underwent single-organ, cardiac transplantation from 1994 to 2009 with a diagnosis of ACM (n=134) or IDCM (n=10,243) in the Organ Procurement Transplantation Network registry. Kaplan-Meier curves were generated by cohort for time until graft failure, cardiac allograft vasculopathy, and hospitalization for rejection. A Cox proportional hazards model was created to determine factors associated with each outcome. ResultsPatients with ACM were more likely to be males (P<0.0001), minorities (P<0.0001), and smokers (P=0.0310) compared with IDCM. Overall graft survival was lower for the ACM cohort (P=0.0001). After multivariate analysis, ACM was not independently associated with graft survival (HR 1.341, 95% CI 0.944–1.906, P=0.1017). Creatinine, total bilirubin, minority ethnicity, graft under-sizing, life support, diabetes, and donor age were independent predictors of graft failure. There were no significant differences between primary cause of death, vasculopathy, or rejection. ConclusionsThere was no association between ACM and graft survival in this large registry study, but poorer overall survival in the ACM cohort was associated with other recipient characteristics.

Tuesday, August 26, 2014

Pitt Analysis Questions Use of Acute Hemodialysis Treatment

Pitt Analysis Questions Use of Acute Hemodialysis Treatment

 A common approach to treating kidney failure by removing waste products from the blood did not improve survival chances for people who suddenly developed the condition, in an analysis led by experts at the University of Pittsburgh School of Medicine.
Their findings, published online in the journal PLOS One, suggest acute hemodialysis, an aggressive method that is standardly used for people with sudden kidney failure, may not provide a definitive benefit to the patient.

“Our findings question the accepted notion that acute hemodialysis decreases mortality,” said Amber Barnato, M.D., senior author of the study and associate professor of clinical and translational science at the Pitt School of Medicine. Dr. Barnato acknowledges that the study is far from conclusive because it lacks detailed clinical data. “It is impossible to draw conclusions based on an observational study, but I do wonder whether it is time to do a clinical trial on the timing and delivery of acute hemodialysis in the context of acute renal failure and critical illness.”...

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