Neck Ultrasound Helps Predict Stroke

Deadly strokes may be prevented if people at high risk already know that they would suffer from it. Necessary medications and surgery may be done before such a terrible thing befall. A light to that has came this way already. A study published in Neurology found non-invasive imaging tests or neck ultrasound to be capable of predicting if a person is highly likely to suffer stroke, thus would need surgery to lower risk.

Identifying who’s at high risk of stroke can be predicted by the use of ultrasound and Doppler ultrasound tests. Common neck ultrasound helps determine whether the patient has ACS or asymptomatic carotid stenosis or narrowing of carotid arteries, the ones responsible for bringing blood into the brain. When the inner lining of a carotid artery is blocked with plaque build-up or fat deposits, the patient would eventually get stroke. If diagnosed with such condition, experts will have to wear their lab coats of their nursing scrubs to necessarily open their carotid arteries. And through Doppler ultrasound tests, microemboli or tiny blood clots or blood particles that may travel from the arteries to the brain may be detected, allowing doctors to prevent occurrence of stroke.

Pin-pointing patients who are at risk of stroke is not as easy as it seems, though. It’s a long and complex procedure that may yield different results, depending on the technician who performed the test. The composition of the plaque must be identified to be potential for embolization. Thorough medical history and neurological tests are necessary for patients with ACS. And depending on results, the patient may only need medications, closely monitored dietary program, and necessary physical activities, and not surgery at all.

Pre-Antibiotic Era Dawns at Emergence of Gonorrhea Superbug

Penicillin class gonorrhea drug introduced about 70 years ago lost its power against the sexually transmitted disease. Class 1, 2, and 3 were also rendered useless by continual development of Neisseria gonorrhoeae drug-resistant strains. All of cephalosporin-class antibiotics, the class 4, which is the last remaining effective gonorrhea treatment is also now losing grip as an extremely drug-resistant gonorrhea strain emerged.

Dubbed as H041, the gonorrhea superbug, first identified in Japan, is resistant to all cephalosporin-class antibiotics. Experts are alarmed that if no immediate effective treatment is developed, it will spread rapidly. In other countries, such as Canada, health agencies are not aware of any existence of the superbug as of now. Significantly, the best teams of men and women in nursing scrubs and lab coats from different countries are expected to hand over reports in the coming months.

Gonorrhea is a genital disease considered to be among the most common sexually transmitted bacterial disease. Caused by gonococcus bacterium, gonorrhea causes inflammation of the genital mucous membrane, burning pain when urinating, and a discharge. Chronic gonorrhea is associated with neonatal infections, infertility, increased risk of ectopic pregnancy, and chronic pelvic pain. People with gonorrhea are also more likely to infect or get infected with HIV/AIDS. Expectant mothers can also pass on to the child the disease during delivery. It can also cause blindness, joint infection and fatal blood infection in the baby.

Diet Alone Undermine Diet and Exercise for Type 2 Diabetes Patients

A recent study found a very unlikely result about the effectiveness of diet and exercise combo. Researchers from the University of Bristol, England, reports diet alone did no better than diet and physical activity for type 2 diabetes patients. It further says that diet is better than the standard care being received by such patients.

The results followed three groups of recently diagnosed type 2 diabetes patients, numbering to 500 30 to 80-year-old participants. Individuals in the first group received regular help and advice on improving their diet. The second group was given the same dietary advice, but also received help to increase their daily levels of exercise. The final group, which served as control group, received standard care only. At the end of one whole year, blood sugar levels of those in standard care group spiked and the mean HbA1c rose. On the other hand, the diet only group as well as the diet and exercise group had mean HbA1c drop.

The study faces more questions, though, than the results that it considered as light shed. First question concerns the significantly short period of study. It doesn’t necessarily spell the long term effect of combined diet and exercise versus the diet only and or the standard and diet care. There was not even a plausible suggestion as to what these groups will be able to achieve in a period of more than one year.

Scrutinizing the picture more critically, the study did not consider the effects that could have been achieved if participants did undergo more intense exercise and other physical activities. Neither did the study consider whether there has been any kind of reward system, such as food reward, which could have affected the results of the study.

As for the researchers, the findings must be treated as suggestion that intervention at the early stage of type 2 diabetes should focus on improving diet, since the additional cost of training health-care workers to promote activity might not be justified.

“Translation of these results into community settings requires concerted efforts by patients, dietitians, and clinicians... There is little doubt that improved nutrition and physical activity are beneficial for individuals with or without diabetes, and research into the most effective way to deliver these benefits (including individual behavioural changes and creation of a supportive food and social environment) deserves high priority," the researchers admitted.

Note: The research is not recommended by any medical institution or authorized health care organizations. Patients view of the treatment that they are currently receiving should unnecessarily be affected. Otherwise, both the patients and out dedicated professionals in nursing scrubs will have to deal with needless burden.

Health Care Overhaul to Limit Hospital Readmissions

Readmission to hospital is first of all costly, but patients would have no other choice if their condition needs close medical attention. But why has this really been happening significantly? What’s the reason behind avoidable readmission of patients who have just been discharged from a hospital?

According to the 2007 report of Medicare Payment Advisory or MedPAC, and independent agency that advises the Congress, about three-quarters of readmission cases may have been prevented. The possible solution is achieving better handoff from hospital to people or institutions that will be with the patient as he recovers. In fact, proper coordination of the patient care has showed significant improvements in hospitals that have already been practicing the method, like Piedmont Hospital in Atlanta.

Piedmont Hospital first looks into the high-risk of readmission, and provides a checklist of logistical and psychosocial issues that needs to be addressed before letting go of these patients. Schedule of follow-up visit is also ensured. Also provided is an easily understandable form explaining reasons of hospitalization as well as necessary things for recovery, which include medications, diet restrictions, and warning signs. The form also contains details about whom to call for related problems. Further, there is a nurse who will call to check on the patient after 3 days.

Although it means additional budget for doctors to buy scrubs, new scrub tops, scrubs pants, drinks and vacations, the health-care overhaul would penalize hospitals having higher-than-expected readmission rates for Medicare patients who had been treated for heart failure, heart attack, or pneumonia. More conditions that could result to penalties will be specified as the law expands in the coming years. In the meantime, hospitals are expected to have 1% reduction on Medicare payments by 2012, 2% in 2013, and 3% in 2014.

The said program is expected to put additional baggage for healthcare workers, especially on the adjustment period, but will surely pay off. 30-day readmission among patients under 70 years of age as well as those ageing above 70 declined in the said hospital.