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DiversityNursing Blog

Boy Gets Food Allergies From Blood Transfusion

Posted by Erica Bettencourt

Wed, Apr 08, 2015 @ 11:52 AM

By Laura Geggel

www.foxnews.com

Allergy skin test transfusion resized 600A boy in Canada mysteriously became allergic to fish and nuts after he received a blood transfusion, according to a new case report.

The 8-year-old boy had no history of being allergic to any foods, and was undergoing treatment for medulloblastoma, a type of brain cancer. A few weeks after receiving a blood transfusion, he experienced a severe allergic reaction called anaphylaxis within 10 minutes of eating salmon, according to the report, published online April 7 in the Canadian Medical Association Journal.

His doctors suspected that the blood transfusion had triggered the reaction, they wrote in the report. After treating the patient with a drug containing antihistamines, the doctors advised him to avoid fish and to carry an epinephrine injector in case he had another reaction. [9 Weirdest Allergies]

But four days later, the boy was back in the emergency department after eating a chocolate peanut butter cup. Blood tests and a skin prick test suggested that he was allergic — at least temporarily — to peanuts and salmon, so his doctors advised him to avoid nuts and fish.

"It's very rare to have an allergic reaction to a previously tolerated food," said the report's senior author, Dr. Julia Upton, a specialist in clinical immunology and allergy at the Hospital for Sick Children in Toronto. "The overall idea is that he wasn't allergic to these foods," but in the blood transfusion, he received the protein that triggers an allergic reaction to them, she said.

That protein, called immunoglobulin E, is an antibody associated with food allergies, Upton said. When it encounters a specific allergen, it causes immune cells to release chemicals such as histamine that lead to an allergic reaction. 

However, because the boy's body itself did not make such antibodies against fish and nuts, his doctors said they suspected his allergies would go away within a few months.

Acquiring allergies from a blood donor is rare, but not without precedent. The researchers found two other case reports, both in adults, in which patients acquired temporary allergies from blood plasma. In a 2007 case, an 80-year-old woman had an anaphylactic reaction to peanuts. An investigation showed that her 19-year-old plasma donor had a peanut allergy, according to the report in the journal Archives of Internal Medicine.

In the new case, the 8-year-old also received plasma, the liquid part of blood that contains antibodies. The researchers inquired about the donor to Canadian Blood Services, and found that the donor did have an allergy to nuts, fish and shellfish. The service did not have any more blood from the donor, and subsequently excluded the individual from making future donations, the researchers said. 

About five months later, blood tests showed that the boy's immunoglobulin E levels to salmon and peanut were undetectable. By six months, his parents had gradually and successfully reintroduced nuts and fish back into their son's diet.

However, Upton said, "In general, we would recommend that this be done under medical supervision," just in case there is a medical emergency.

It's unclear how doctors could prevent future cases, she said. Neither Canadian nor American blood service organizations bar people with allergies from donating blood. And testing donated blood for levels of immunoglobulin E doesn't always predict allergies. Some people with high levels of immunoglobulin E don't have allergies, and others with low levels of the protein do, she said.

"Clearly, the safety of the [blood] supply is of everyone's utmost concern," but more research is needed to determine how best to avoid the transfer of allergies, and how frequently this happens, Upton said.

"I think it's hard to make sweeping recommendations based on one case report," Upton said.

In the United States, "If a donor is feeling well and healthy on the day of donation, they are typically eligible to donate," said Dr. Courtney Hopkins, the acting chief medical officer for the east division of the American Red Cross. "We will defer donors on the day of donation if they are not feeling well and healthy, if they have a fever, or if we notice they have problems breathing through their mouth."

Donors can learn more about blood-donation eligibility here. Individuals with allergies shouldn't be dissuaded from donating, Hopkins added.

"We always need blood. We always need blood donors," Hopkins told Live Science.

Topics: emergency, food allergies, health, healthcare, doctors, medical, hospital, brain cancer, medicine, blood transfusion

Cow's Milk Found In Human Breast Milk Purchased Online

Posted by Erica Bettencourt

Wed, Apr 08, 2015 @ 11:31 AM

Written by James McIntosh

www.medicalnewstoday.com 

two cows grazing in a field resized 600Researchers testing the origins of human breast milk samples available for purchase online found that around 10% of the samples they examined contained significant amounts of added cow's milk.

The pressure on parents to feed newborn infants with breast milk may be leading many to purchase human breast milk online. However, the milk they receive from online vendors may not match up to what is being offered.

"They purchase the milk online based on a posted description of the type and quantity of the milk or the health habits of the seller," writes study author Dr. Sarah Keim. "But when they think they're getting nutritious, high-quality breast milk, some of them are actually receiving human milk mixed with cow's milk."

Human breast milk is widely recognized as providing many health benefits to young infants. According to the American Academy of Pediatrics (AAP), breastfeeding can protect against diseases and conditions such as diarrheadiabetes and childhood obesity.

However, many new mothers find themselves unable to breastfeed. In 2012, a survey published in Pediatrics found that two-thirds of mothers nursing newborns are unable to manage breastfeeding for as long as they intended.

"Some women are unable to produce enough milk for their infant or perceive they cannot meet their infant's needs, yet they may be reluctant to feed formula," write the researchers of the new study. For these mothers, the Internet represents an alternative way of providing human milk for their children.

'You do not truly know what you are receiving'

For the study, published in Pediatrics, Dr. Keim and her colleagues purchased 102 samples of what was advertised as human milk from sellers on the Internet. These milk samples were subjected to DNA testing in order to verify their human origins and to assess whether any cow's milk was also present.

While all of the purchased Internet samples contained human DNA, 11 also contained bovine DNA. Of these, 10 contained bovine DNA concentrations significant enough to suggest that cow's milk had been added to human milk, being so high that accidental contamination was unlikely.

The inclusion of cow's milk in human breast milk can be problematic for babies. It can potentially be harmful due to cow's milk allergies, health conditions or formula sensitivities. The inclusion of cow's milk could also reduce a baby's access to the essential nutrients and fats that are in formulas and human breast milk but not cow milk.

"The truth of the matter is that you do not truly know what you are receiving when you buy milk from a stranger over the Internet," explains Dr. Keim.

"Selling breast milk gives people an incentive to add cow's milk or formula to the milk in order to sell more. When money is involved in an unregulated process like this, you cannot know for sure that the milk is safe to give to your baby."

Although the sample used in the study is acknowledged as small by the authors, they state the sample is representative of Internet sellers and has given the researchers findings that may at least generalize to milk being sold via the Internet.

"Our findings confirm the previously theoretical risk that human milk being sold via the Internet may not be 100% human milk," the authors conclude. "Because buyers have little means to verify the composition of the milk they receive, all should be aware of the possibility that it may be adulterated."

Previously, in a report published in The BMJ, experts claimed that breast milk purchased online can pose serious health risks to infants, largely due to a lack of regulation. Human milk is not tested for contamination or disease and could be stored incorrectly.

Topics: infants, newborn, health, online, babies, breast milk, milk, feeding, formulas

New Treatment For Dementia Discovered: Deep Brain Stimulation

Posted by Erica Bettencourt

Mon, Apr 06, 2015 @ 02:04 PM

www.sciencedaily.com

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Pushing new frontiers in dementia research, Nanyang Technological University, Singapore (NTU Singapore) scientists have found a new way to treat dementia by sending electrical impulses to specific areas of the brain to enhance the growth of new brain cells.

Known as deep brain stimulation, it is a therapeutic procedure that is already used in some parts of the world to treat various neurological conditions such as tremors or Dystonia, which is characterised by involuntary muscle contractions and spasms.

NTU scientists have discovered that deep brain stimulation could also be used to enhance the growth of brain cells which mitigates the harmful effects of dementia-related conditions and improves short and long-term memory.

Their research has shown that new brain cells, or neurons, can be formed by stimulating the front part of the brain which is involved in memory retention using minute amounts of electricity.

The increase in brain cells reduces anxiety and depression, and promotes improved learning, and boosts overall memory formation and retention.

The research findings open new opportunities for developing novel treatment solutions for patients suffering from memory loss due to dementia-related conditions such as Alzheimer's and even Parkinson's disease.

This discovery was published in eLife, a peer-reviewed open-access scientific journal published by the Howard Hughes Medical Institute, the Max Planck Society and the Wellcome Trust.

Assistant Professor Ajai Vyas from NTU's School of Biological Sciences said, "The findings from the research clearly show the potential of enhancing the growth of brain cells using deep brain stimulation.

"Around 60 per cent of patients do not respond to regular anti-depressant treatments and our research opens new doors for more effective treatment options."

Dr Lim Lee Wei, an associate professor at Sunway University, Malaysia, who worked on the research project while he was a Lee Kuan Yew Research Fellow at NTU, said that deep brain stimulation brings multiple benefits.

"No negative effects have been reported in such prefrontal cortex stimulation in humans and studies have shown that stimulation also produces anti-depression effects and reduces anxiety.

"Memory loss in older people is not only a serious and widespread problem, but signifies a key symptom of dementia. At least one in 10 people aged 60 and above in Singapore suffer from dementia and this breakthrough could pave the way towards improved treatments for patients."

Growing new brain cells

For decades, scientists have been finding ways to generate brain cells to boost memory and learning, but more importantly, to also treat brain trauma and injury, and age-related diseases such as dementia.

As part of a natural cycle, brain cells constantly die and get replaced by new ones. The area of the brain responsible for generating new brain cells is known as the hippocampus, which is also involved in memory forming, organising and retention.

By stimulating the front part of the brain known as the prefrontal cortex, new brain cells are formed in the hippocampus although it had not been directly stimulated.

The research was conducted using middle-aged rats, where electrodes which sends out minute micro-electrical impulses were implanted in the brains. The rats underwent a few memory tests before and after stimulation, and displayed positive results in memory retention, even after 24 hours.

"Extensive studies have shown that rats' brains and memory systems are very similar to humans," said Prof Ajai who is a recipient of NTU's prestigious Nanyang Assistant Professorship award.

"The electrodes are harmless to the rats, as they go on to live normally and fulfil their regular (adult) lifespan of around 22 months."

The research was funded by the Lee Kuan Yew Research Fellowship which supports and promotes young and outstanding researchers in their respective areas of specialisation.

Topics: science, health, brain, memory, dementia, medical, treatment, deep brain stimulation, brain cells, electricity

Hayley Okines Dies From Rare Premature Aging Disease Aged 17

Posted by Erica Bettencourt

Mon, Apr 06, 2015 @ 01:53 PM

Written by Honor Whiteman

www.medicalnewstoday.com 

hayley okines resized 600

Progeria or Hutchinson-Gilford Progeria Syndrome (HGPS), affects around 1 in 4-8 million newborns worldwide. There are approximately 200-250 children living with the condition across the globe at any one time.

Progeria is caused by an abnormal protein in the LMNA gene, called progerin, which interferes with the production of lamin A - a protein that stabilizes a cell's nucleus. This disruption causes children with progeria to age up to 10 times faster than normal.

On Thursday evening, it was announced that 17-year-old progeria sufferer Hayley Okines - from Medical News Today's hometown Bexhill in East Sussex, England - had passed away.

Hayley's mother, Kerry Okines, posted the sad news on Facebook: "My baby girl has gone somewhere better. She took her last breath in my arms at 9.39 pm."

Hayley - who BBC News say had the "body of a 104-year-old" - was being treated in the hospital for pneumonia, but she returned home shortly before she died. "She came home for an hour and she saw her puppies, little brother Louie and her sister Ruby," Hayley's father, Mark Okines, told BBC News on Friday.

"I think she wanted to come home to say goodbye to everybody," he continued. "I think she knew that yesterday was going to be the time."

'We remember her tremendous courage and determination'

Children with progeria rarely live past the age of 14, often passing away from ailments that affect the elderly, such as heart disease and stroke. 

Hayley was told she would not live past the age of 13, but in 2007, the teenager began undergoing pioneering treatment at Boston Children's Hospital, MA, as part of the first clinical trial for the condition.

In September 2012, MNT reported on the success of this trial, revealing how a farnesyltransferase inhibitor (FTI) improved the weight, bone structure and cardiovascular health of children with progeria.

In a statement following Hayley's death, the Progeria Research Foundation praised the teenager for her contribution to progeria research:

"The entire PRF community mourns the loss of one of our shining stars, Hayley Okines. Hayley was one of the first participants in the ongoing progeria clinical trials. Hayley was a pioneer - and one of the reasons that we now have the first treatment for progeria. Today we remember her tremendous courage and determination."

Hayley was an avid campaigner for progeria awareness, hailed locally and nationally as an inspiration for people with and without the condition. The teenager penned two books detailing her experiences of living with progeria - "Old Before My Time" and "Young at Heart" - and took part in numerous interviews.

As well as for her contribution to progeria awareness and research, Hayley was highly admired for her positive outlook on life, writing in "Young at Heart:"

"My life with progeria is full of happiness and good memories. Deep inside I am no different from anyone. We are all human."

Our thoughts and prayers are with Hayley's family and friends at this difficult time.

The news of Hayley's death comes just 15 months after it was announced Sam Burns, a boy from Foxborough, MA, had died from progeria aged 17.

Topics: children, Hayley Okines, HGPS, premature aging disease

Hospital Therapy Rabbits on Hand for 'Bunny Day'

Posted by Erica Bettencourt

Mon, Apr 06, 2015 @ 01:46 PM

By SYDNEY LUPKIN

abcnews.go.com

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The Easter Bunny has some sweet competition in the form of two therapy rabbits at NYU Langone Medical Center in Manhattan.

Nutmeg and Clovis, both 5 years old, live on the 13th floor of the hospital, and this week, they visited patients for Bunny Day, the hospital's nondenominational springtime celebration. They wore rabbit ears (yes, really), a bonnet, and sat on a basket of eggs.

"The bunny cart is decorated to the hilt, and then we'll go and see patients and work with patients," said Gwenn Fried, manager of horticultural therapy services at NYU Langone. "The patients adore it."

As she travels the hospital with one rabbit at a time (Rabbits need breaks, too!), she said she hands patients a plastic Easter egg, and it contains either a sticker or a bunny treat.

"The bunny is very excited about the bunny treat," she laughed.

The bunnies visited 15 patients on Thursday and will visit more today and tomorrow, Fried said.

The rabbits are part of a therapy program that's been at the hospital for about 13 years. Sometimes, doctors recommend the bunny therapy, and sometimes patients request it, but Fried said she's seen them work magic on children and adults alike.

"One dad just said, 'I really think Clovis changed our lives,'" Fried told ABC News last year. "He's the most patient animal I've ever seen in my life."

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Topics: therapy, animals, nurse, doctors, medical, patients, hospital, patient, treatment, bunny, Easter

'Miracle Baby' Eli Is One In 197 Million Born With Rare Facial Anomaly

Posted by Erica Bettencourt

Thu, Apr 02, 2015 @ 12:01 PM

By Michelle Matthews

Source: www.al.com

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Shortly before their baby, Eli, was born, Brandi McGlathery and Troy Thompson talked about the physical qualities they hoped he would possess.

"I said I wanted him to have blond hair," Brandi said. "And Troy said, 'I hope he doesn't get my nose.'"

At the time, it was just a joke between two parents anxiously awaiting their baby's arrival. After Eli was born, though, it became the kind of memory that now makes them wince at its irony.

When Eli was born at South Baldwin Hospital on March 4, weighing 6 pounds, 8 ounces, Dr. Craig Brown immediately placed him on Brandi's chest. As the doctor helped Troy cut the cord, Brandi looked at Eli for the first time.

"I pulled back and said, 'Something's wrong!' And the doctor said, 'No, he's perfectly fine.' Then I shouted, 'He doesn't have a nose!'"

The doctor whisked Eli away, and for about 10 minutes Brandi was left alone in the delivery room thinking surely she hadn't seen what she thought she saw - or didn't see.

When Dr. Brown returned, he put his arm on her bed and took a deep breath. "He had the most apologetic look," she said. She knew something was wrong with her baby. She started to cry before he said a word.

She looked to Troy, who, she said, never cries. He had tears in his eyes.

She'd been right. Eli didn't have a nose.

Meanwhile, he had started breathing through his mouth right away. She remembers that he was wearing a tiny oxygen mask. Not having a nose "didn't faze him at all," she said.

"I was the first person to see it," she said. "Even when they took him away, my family still didn't know something was wrong, due to being caught up in the excitement of his arrival. It wasn't until they opened the blinds of the nursery that everyone else saw."

Before she knew it, Eli was taken to USA Children's and Women's Hospital in Mobile. Throughout the night, Brandi called the number they'd given her every 45 minutes or so to check on her baby. She wasn't sure he would make it through the night -- but he did.

And her "sweet pea," her "miracle baby," has been surprising his parents and others who love him, as well as the medical staff who have cared for him, ever since.

Nothing unusual

The next day, her doctor checked her out of the hospital in Foley so she could be with her baby in Mobile. The doctor had also had a sleepless night, she said. "He said he'd gone back over every test and every ultrasound," but he couldn't find anything unusual in her records.

There were a few aspects of her pregnancy that were different from her first pregnancy with her 4-year-old son, Brysen.

Right after she found out he was a boy, at around 17 weeks, she said, she lost 10 pounds in eight days because she was so severely nauseated. Her doctor prescribed a medication that helped her gain the weight back and keep her food down. She continued to take the medication throughout her pregnancy, she said.

On a 3D ultrasound, she and Troy even commented on Eli's cute nose. The imaging shows bone, not tissue, she said - and he has a raised bit of bone beneath the skin where his nose should be.

After going into early labor three times, Brandi delivered Eli at 37 weeks. At 35 weeks, her doctor told her that the next two weeks would be critical to the development of the baby's lungs and respiratory system. "He said, 'Let's try to keep him in as long as we can,'" she remembered.

Happy, healthy baby

For the first few days of his life, Eli was in one of the "pods" in USA Children's and Women's Hospital's neonatal intensive care unit. At five days old, he had a tracheotomy. "He has done wonderfully since then," Brandi said. "He's been a much happier baby."

Because of the trach, he doesn't make noise when he cries anymore, so Brandi has to watch him all the time. She has been going back and forth between the Ronald McDonald House and Eli's room during his stay.

"Between the nurses here and Ronald McDonald House, everyone has gone above and beyond," she said. "The nurse from the pod comes to check on her 'boyfriend.' She got attached to him."

Besides not having an external nose, he doesn't have a nasal cavity or olfactory system. (Despite that fact, she said, he sneezes. "The first time he did it, we looked at each other and said, 'You heard that, right?'")

Eli Thompson has an extremely rare condition known as complete congenital arhinia, said Brandi, adding that there are only about 37 cases worldwide like his. The chance of being born with congenital arhinia is one in 197 million, she said.

Even at USA Children's and Women's Hospital, Eli's case has baffled the NICU. "Everyone has used the same words," Brandi said. As soon as they found out he was on his way, she said, the staff started doing research. They only found three very brief articles on the condition. Now, his doctors are writing a case study on him in case they ever encounter another baby like Eli.

After he got the trach, Brandi wanted to start breastfeeding. The lactation consultant encouraged her, and together they searched the Internet for more information. Brandi became the first mother ever to breastfeed a baby with a trach at the hospital, she said - and now the lactation consultant "is actually using him to put an article together about breastfeeding with a trach to encourage mothers of other trach babies to attempt it."

Thanks to her Internet research, Brandi found a mother in Ireland, Gráinne Evans, who writes a blog about her daughter, Tessa, who has the same condition as Eli. She also found a 23-year-old Louisiana native who lives in Auburn, Ala., and a 16-year-old in North Carolina, she said. With every case she found, Brandi started to feel better and more convinced that Eli could not only survive his babyhood, but that he'll grow to adulthood.

Communicating with Tessa's mother in Ireland has been especially gratifying for Brandi. She knows she and Eli are not in this alone.

'He's perfect'

While it would seem easy enough for a plastic surgeon to build a nose for Eli, it's not that simple, Brandi said. "His palate didn't form all the way, so his brain is lower," she said. "It's a wait-and-see game."

His condition affects his pituitary gland, she said. He'll have to be past puberty before his nasal passageways can be built. Until then, she'd like to spare him any unnecessary facial surgeries.

"We think he's perfect the way he is," she says, nodding toward the sweet, sleeping baby in his crib. "Until the day he wants to have a nose, we don't want to touch him. We have to take it day by day."

Within a month after Eli goes back home to Summerdale, he will have to travel to the Shriners Hospital for Children in Houston and Galveston, Texas, to meet with craniofacial specialists. "They will work with him for the rest of his life," she said. "Every three to six months, we'll be going back for scans and checkups for at least the next ten years."

Brandi said that, of the people she's found online, some are opting to have noses and nasal passageways built (including Tessa), while others haven't.

"We're going to do our best to make sure he's happy," she said. "The rest of him is so cute, sometimes you don't realize he doesn't have a nose."

Brandi's older son, Brysen, and Troy's four-year-old daughter, Ava, are too young to interact with Eli in the hospital. Brandi was grateful to one of the nurses who unhooked him and let the kids see him. "Ava asked me, 'When you were little, did you have a nose?'" Brandi said. "She said, 'I think he's cute.'"

Brysen pressed his hands against the window separating him from his baby half-brother and said, "He's perfect!"

'Facebook famous'

Brandi, who got pregnant with Brysen when she was a senior in high school, had planned to start going to school to become an LPN like Troy's sister and his mother. "That's all on the back burner now," she said. Because of her experience at USA Children's and Women's, she said she now wants to be a NICU nurse.

Her best friend, Crystal Weaver, logged onto Brandi's Facebook account and created the Eli's Story page to let friends and family members know what was going on. "It's easier that way to update everyone at once rather than to call everyone individually," Brandi said. "It's overwhelming. It's all on my shoulders." Within a day, she said, Eli's Story had 2,000 likes (it now has around 4,500). "People I didn't know were sending messages," she said.

Crystal also started a Go Fund Me account, which has raised about $4,300. "We've got years and years of surgeries and doctor's appointments nowhere close to us," said Brandi, who returned to her job as a bartender this past weekend. She plans to keep working two nights a week for a while. Being around her work family, she said, helps her maintain a sense of normalcy.

A fish fry is planned as a fundraiser for Eli's medical fund on April 11 at Elberta Park in Elberta, with raffles for prizes including a weekend stay at a condo in Gulf Shores and a charter fishing trip.

"It makes me feel really good that I have a support system," Brandi said. "Everybody's been awesome."

Updating Eli's page, adding photos and reading the positive, encouraging comments from hundreds of people, as well as reaching out to others who have been through what she's going through "keeps me sane," Brandi said.

Recently, Brandi posted a video of Eli waking up from a nap. From Ireland, Gráinne Evans commented: "I've actually watched this more times than I could admit!"

Eli is "100 percent healthy," she said. "He just doesn't have a nose. He has a few hormone deficiencies, but other than that he's healthy."

Brandi seems wise beyond her years. She is already worried about "the day he comes home and someone has made fun of his nose," she said. "We don't want anyone to pity him. We never want anyone to say they feel sorry for him. If other people express that, he'll feel that way about himself."

She jokes that Eli is "Facebook famous" now. "I can't hide him," said Brandi, who is a singer. "Eli's gotten more publicity in the past two weeks than I have in my whole life!"

She's been putting together a "journey book" full of medical records and mementoes to give Eil one day. "I'm excited to show him one day, 'Look, from the moment you were born people were infatuated with you.'"

'I'm doing something right'

In his short time on earth so far, Eli has brought his family together, Brandi said. She and Troy had been engaged, then called off the wedding and were "iffy," and then they broke up. A week later, she found out she was pregnant.

"Eli has made Troy my best friend," she said. "He has brought us closer than when we were engaged. To see Troy with him is really awesome."

Troy has been her rock, reassuring her since Eli was born, she said. "He tells me, 'Brandi, it's OK. It will end up happening the way it's supposed to be."

Last Thursday, Brandi posted on the Eli's Story page that Eli had passed his car seat trial and newborn hearing screening. "He now weighs 7 pounds, and we'll be meeting with home health to learn how to use all of his equipment so we can go home Monday."

Everyone in their family has taken CPR classes, and Brandi and Troy have learned how to care for Eli's trach. The couple has extended family nearby, and Troy's father and stepmother plan to move to Baldwin County from Mobile to be closer to Eli.

As she prepared to take her baby home from the hospital on Monday morning, almost four weeks since he came into the world, Brandi was excited to take care of him for the first time in the comfort of her own home, and to finally introduce him to his big brother and sister.

Though Brandi said her heart melts when Eli's little hand wraps around her finger, he's the one who already has her wrapped completely around his. He recognizes his parents' voices, and seems comforted by them. "As soon as he hears us, he looks around for us, finds us, then stares at us smiling," she said. "It makes me feel like I'm doing something right, that through the ten to twelve other women, the nurses who have been caring for him for the past month, he still knows who Mommy is!"

Topics: Nicu Nurse, infant, newborn, breastfeeding, baby, pregnancy, nurse, doctors, medication, hospital, treatment, NICU, rare, tracheotomy, Ronald McDonald House, children's hospital, nose, delivery room, facial, trach, congenital arhinia

Despised Hospital Gowns Get Fashion Makeovers

Posted by Erica Bettencourt

Wed, Apr 01, 2015 @ 02:06 PM

Shefali Luthra

Source: www.cnn.com

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Whether a patient is in the hospital for an organ transplant, an appendectomy or to have a baby, one complaint is common: the gown.

You know the one. It might as well have been stitched together with paper towels and duct tape, and it usually leaves the wearer's behind hanging out.

"You're at the hospital because something's wrong with you -- you're vulnerable -- then you get to wear the most vulnerable garment ever invented to make the whole experience that much worse," said Ted Streuli, who lives in Edmond, Okla., and has had to wear hospital gowns on multiple occasions.

Put another way: "They are horrible. They are demeaning. They are belittling. They are disempowering," said Camilla McRory of Olney, Md.

Hospital gowns have gotten a face-lift after some help from fashion designers like these from Patient Style and the Henry Ford Innovation Institute.

The gowns are among the most vexing parts of being in the hospital. But if efforts by some health systems are an indicator, the design may be on its way out of style.

The Cleveland Clinic was an early trendsetter. In 2010, it introduced new gowns after being prompted by the CEO, who often heard patient complaints when he was a practicing heart surgeon. That feedback led to a search for something new, said Adrienne Boissy, chief experience officer at the hospital system.

The prominent academic medical center ultimately sought the help of fashion icon Diane von Furstenberg, settling on a reversible gown with a front and back V-neck, complete derriere coverage, and features such as pockets, softer fabric and a new bolder print pattern.

Patients "loved the gowns," Boissy said. "People felt much more comfortable in the new design, not just physically but emotionally." In recent years, she added, "hospitals are looking at everything they do and trying to evaluate whether or not it contributes to enhancing the patient experience." 

It's all part of a trend among hospitals to improve the patient reviews and their own bottom lines -- fueled in part by the health law's focus on quality of care and other federal initiatives. The Centers for Medicare & Medicaid Services increasingly factors patients' satisfaction into its quality measures, which are linked to the size of Medicare payments hospitals get.

Sometimes the efforts involve large capital improvement projects. But they can also mean making waiting rooms more comfortable, improving the quality of food served to patients or, as in this case, updating hospital gowns.

Ultimately, this focus leads to "a better patient experience," said John Combes, senior vice president of the American Hospital Association.

The Detroit-based Henry Ford Health System is in the process of updating its gowns, an initiative that began when the system's innovation institute challenged students at the city's College for Creative Studies to identify and offer a solution to one hospital problem.

The students responded with the suggestion to redo the garment that has often been described by patients as flimsy, humiliating, indecent and itchy. The process took three years, but last fall, the institute unveiled a new and improved version. It's made of warmer fabric -- a cotton blend -- that wraps around a patient's body like a robe and comes in navy and light blue, the hospital's signature colors.

Patient expectations are part of the calculus. They "are demanding more privacy and more dignity," said Michael Forbes, a product designer at the Henry Ford Innovation Institute.

When the institute tested his gown design, Forbes said, patient-satisfaction scores noticeably increased in a few days.

The new gown "was emblematic...of an attitude that was conveyed to me at the hospital -- that they cared about me as a whole human being, not just the part they were operating on," said Dale Milford, who received a liver transplant during the time the redesign was being tested. "That was the subtext of that whole thing, was that they were caring about me as a person and what it meant for me to be comfortable."

But replacing the traditional design is no easy task. What patients wear needs to be comfortable yet allow health professionals proper access during exams, meaning it must open and close easily. The gowns also need to be easily mass-manufactured, as well as efficiently laundered and reused.

New designs, though, can be expensive. After Valley Hospital of Ridgewood, N.J., switched to pajamas and gowns that provide extra coverage, costs went up $70,000 per year, said Leonard Guglielmo, the facility's chief supply chain officer, because the new garments cost more to buy and maintain.

Beyond cost, more ingrained cultural expectations might also play a role in what hospitals think patients should wear, said Todd Lee, an assistant professor of medicine at McGill University, who co-authored a 2014 study in the journal JAMA Internal Medicine, examining whether gowns were important and whether patients might be fine wearing their own or hospital-provided pants, instead of or along with gowns.

Often, doctors reported that pants or undergarments beneath gowns would have been okay, but patients said they were never given those options. Traditional gowns make it easier to examine patients quickly, and several doctors Lee spoke to seemed shocked at the idea that patients might wear garments other than the open-backed gown during their stay.

But the most common challenge isn't necessarily doctor expectations or costs. It's navigating hospital bureaucracies, said Dusty Eber, president of the California-based company PatientStyle, which designs and sells alternative gowns. In his company's experience, hospital decisions are often made by committees, not individuals.

"There's a lot of bureaucratic runaround," Eber said.

Topics: surgery, nurses, doctors, medical, patients, hospital, medicine, patient, hospital gown

Indiana Couple Welcomes 'One in a Million' Set of Triplets

Posted by Erica Bettencourt

Mon, Mar 30, 2015 @ 01:57 PM

By GILLIAN MOHNEY

Source: http://abcnews.go.com

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An Indiana couple is celebrating an extra-special arrival with the birth of their identical triplet daughters.

Ashley and Matt Alexander of Greenfield, Indiana, were surprised weeks ago when they learned they were expecting three new additions to their family during a routine sonogram, according to ABC affiliate WRTV-TV in Indianapolis, Indiana.

"She was checking [Ashley] and right away there were twins, and she goes, 'Let me check for a third,'" Matt Alexander told WRTV-TV in an earlier interview. "I'm like, she's just joking. I said, 'You're joking,' and she said, 'No, we don't joke about this stuff.' So [Ashley] about came off the table."

The couple, who already have a son, had conceived the triplets naturally, so they were not expecting to see three heartbeats on the sonogram.

Ashley Alexander told WRTV-TV she has a plan to tell the girls apart.

"I'm painting their nails," she said. "One's going to be pink, one purple, and the other probably pale blue."

Dr. William Gilbert, the director of women's services for Sutter Health in Sacramento, California, said in an earlier interview with ABC News there was no definite rate for the number of identical triplets born every year.

"It's hard to calculate a conservative estimate," Gilbert said about the rate of naturally conceived identical triplets. "One in 70,000 - that would be on the low end. The high end is one in a million."

Topics: health, nurses, doctors, hospital, newborns, babies, identical, sonogram, triplets

5 Reasons Radiation Treatment has Never Been Safer (Op-Ed)

Posted by Erica Bettencourt

Mon, Mar 30, 2015 @ 01:40 PM

Dr. Edward Soffen

Source: www.livescience.com

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Dr. Edward Soffen is a board-certified radiation oncologist and medical director of the Radiation Oncology Department at CentraState Medical Center's Statesir Cancer Center in Freehold, New Jersey. He contributed this article to Live Science's Expert Voices: Op-Ed & Insights.

As a radiation oncologist, my goal is to use radiation as an extremely powerful and potent tool to eradicate cancer tumors in the body: These techniques save and extend patients' lives every day. 

Historically, radiation treatments have been challenged by the damage they cause healthy tissue surrounding a tumor, but new technologies are now slashing those risks.

How radiation therapies work

High-energy radiation kills cancer cells by damaging DNA so severely that the diseased cells die. Radiation treatments may come from a machine (x-ray or proton beam), radioactive material placed in the body near tumor cells, or from a fluid injected into the bloodstream. A patient may receive radiation therapy before or after surgery and/or chemotherapy, depending on the type, location and stage of the cancer. 

Today's treatment options target radiation more directly to a tumor — quickly, and less invasively — shortening overall radiation treatment times. And using new Internet-enabled tools, physicians across the country can collaborate by sharing millions of calculations and detailed algorithms for customizing the best treatment protocols for each patient. With just a few computer key strokes, complicated treatment plans can be anonymously shared with other physicians at remote sites who have expertise in a particular oncologic area. Through this collaboration, doctors offer their input and suggestions for optimizing treatment. In turn, the patient benefits from a wide community of physicians who share expertise based upon their research, clinical expertise and first-hand experience. 

The result is safer, more effective treatments. Here are five of the most exciting examples:

1. Turning breast cancer upside down

When the breast is treated while the patient is lying face down, with radiation away from the heart and lungs, a recent study found an 86 percent reduction in the amount of lung tissue irradiated in the right breast and a 91 percent reduction in the left breast. Additionally, administering prone-position radiation therapy in this fashion does not inhibit the effectiveness of the treatment in any way.

2. Spacer gel for prostate cancer

Prostate cancer treatment involves delivering a dose of radiation to the prostate that will destroy the tumor cells, but not adversely affect the patient. A new hydrogel, a semi-solid natural substance, will soon be used to decrease toxicity from radiation beams to the nearby rectum. The absorbable gel is injected by a syringe between the prostate and the rectum which pushes the rectum out of the way while treating the prostate. As a result, there is much less radiation inadvertently administered to the rectum through collateral damage. This can significantly improve a patient's daily quality of life — bowel function is much less likely to be affected by scar tissue or ulceration. [Facts About Prostate Cancer (Infographic )]

3. Continual imaging improves precision

Image-Guided Radiation Therapy (IGRT) uses specialized computer software to take continual images of a tumor before and during radiation treatment, which improves the precision and accuracy of the therapy. A tumor can move day by day or shrink during treatment. Tracking a tumor's position in the body each day allows for more accurate targeting and a narrower margin of error when focusing the beam. It is particularly beneficial in the treatment of tumors that are likely to move during treatment, such as those in the lung, and for breast, gastrointestinal, head and neck and prostate cancer. 

In fact, the prostate can move a few millimeters each day depending on the amount of fluid in the bladder and stool or gas in the rectum. Head and neck cancers can shrink significantly during treatment, allowing for the possibility of adaptive planning (changing the beams during treatment), again to minimize long term toxicity and side effects.

4. Lung, liver and spine cancers can now require fewer treatments 

Stereotactic Body Radiation Therapy (SBRT) offers a newer approach to difficult-to-treat cancers located in the lung, liver and spine. It is a concentrated, high-dose form of radiation that can be delivered very quickly with fewer sessions. Conventional treatment requires 30 radiation treatments daily for about six weeks, compared to SBRT which requires about three to five treatments over the course of only one week. The cancer is treated from a 3D perspective in multiple angles and planes, rather than a few points of contact, so the tumor receives a large dose of radiation, but normal tissue receives much less. By attacking the tumor from many different angles, the dose delivered to the normal tissue (in the path of any one beam) is quite minimal, but when added together from a multitude of beams coming from many different planes, all intersecting inside the tumor, the cancer can be annihilated. 

5. Better access to hard-to-reach tumors

Proton-beam therapy is a type of radiation treatment that uses protons rather than x-rays to treat cancer. Protons, however, can target the tumor with lower radiation doses to surrounding normal tissues, depending on the location of the tumor. It has been especially effective for replacing surgery in difficult-to-reach areas, treating tumors that don't respond to chemotherapy, or situations where photon-beam therapy will cause too much collateral damage to surrounding tissue. Simply put, the proton (unlike an x-ray) can stop right in the tumor target and give off all its energy without continuing through the rest of the body. One of the more common uses is to treat prostate cancer. Proton therapy is also a good choice for small tumors in areas which are difficult to pinpoint — like the base of the brain — without affecting critical nerves like those for vision or hearing. Perhaps the most exciting application for this treatment approach is with children. Since children are growing and their tissues are rapidly dividing, proton beam radiation has great potential to limit toxicity for those patients. Children who receive protons will be able to maintain more normal neurocognitive function, preserve lung function, cardiac function and fertility. 

While cancer will strike more than 1.6 million Americans in 2015, treatments like these are boosting survival rates. In January 2014, there were nearly 14.5 million American cancer survivors. By January 2024, that number is expected to increase to nearly 19 million

But make no mistake — radiation therapy, one of the most powerful resources used to defeat cancer, is not done yet. As we speak, treatment developments in molecular biology, imaging technology and newer delivery techniques are in the works, and will continue to provide cancer patients with even less invasive treatment down the road.

Source: www.livescience.com

Topics: surgery, physician, innovation, oncology, technology, health, healthcare, nurse, medical, cancer, patients, hospital, medicine, treatments, radiation, chemotherapy, doctor, certified oncologist, oncologist, x-ray

What Happens With Data From Mobile Health Apps?

Posted by Erica Bettencourt

Mon, Mar 30, 2015 @ 01:03 PM

By Kenneth Corbin

Source: www.cio.com

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There is no shortage of interest in mobile health applications, which span everything from pedometers to Wi-Fi-enabled pacemakers, but what happens with all that data?

The New American Foundation, a Washington think tank, waded into that debate with a pair of recent panel discussions where experts acknowledged that the security risks around health IT systems are high, and the medical profession, as a whole, has a ways to go to get its cyber house in order.

Kevin Fu, who directs the Archimedes Research Center for Medical Device Security at the University of Michigan, argues that within the medical community -- as in many other industries -- there is a broad lack of awareness about basic cybersecurity practices, often enabling garden-variety malware to infiltrate systems that house sensitive data.

All industries need better cybersecurity hygiene

"Medical professionals are not too different from every other person in the country when it comes to cybersecurity hygiene. So they're taught to wash their hands in between patient encounters, but they're not taught as well as to the cybersecurity hygiene. I'd say we have a very long way to go," Fu says. "The bar is very low right now."

The glut of health data being generated and collected by mobile devices and applications also raises some significant privacy concerns, particularly when that information is outside of the scope of HIPAA and other federal statutes governing personal information.

"I think the key risk that we have is that we will create a pool of extremely sensitive health data that is totally unregulated and that is shared broadly without our knowledge and used in ways that we do not know," says Alvaro Bedoya, executive director of the Center on Privacy and Technology at Georgetown University.

Some mobile health apps are protected by privacy law, some are not

"We tend to talk about m-health apps and devices as if they're one thing. When it comes to privacy, there's two kinds of mHealth apps and devices. There's the kind that's protected by privacy law, and there's a kind that's not," Bedoya says.

Many consumers, Bedoya argues, consider the information collected by popular fitness applications like Fitbit as benign, taking innocuous measurements of things like steps and distance walked. However, he maintains that mobile health applications as a class are becoming more sophisticated, and vacuuming up information like glucose levels, heart rate and fertility, all while operating unchecked by the statutory restrictions that apply to information collected in a medical setting.

Pooled together, those data points could provide potential indicators for conditions such as obesity or Alzheimer's. But the market for that data is fairly opaque, and Bedoya fears that health information in the hands of data brokers could be sold to businesses for dubious purposes, such as insurance companies that might deny applicants coverage or charge steeper premiums based on information collected through health apps.

"Frankly, I'm quite scared about what's happening today," Bedoya said. "We don't know what these folks do with this data."

And yet, the policy response has been lacking. Consumer privacy legislation that would set new parameters for the commercial sector hasn't seen serious consideration in recent sessions of Congress, and the near-term prospects for breaking that "legislative stasis," as Bedoya puts it, are not bright.

"There is a sad fact in commercial privacy," he says. "Nothing's happening and nothing's going to happen" in the U.S. Congress.

Privacy advocates call on FTC to pursue consumer protections from mobile device data brokers

As a privacy advocate, Bedoya is calling on state legislatures and regulators at the Federal Trade Commission, which has signaled its concerns about both mobile devices and the practices of data brokers, to take up the issue and press forward with consumer protections.

However, some officials at the federal level caution that the promise of health IT applications has always been hampered by interoperability issues, and that that challenge could only be exacerbated should states go in their own direction in passing privacy laws.

"As we try to build standards for how the healthcare system will operate with technology, if we have rules that vary from state to state, it's just monumentally harder to build a nationwide system because Texas is doing something different from California," says Lucia Savage, chief privacy officer at the Office of the National Coordinator for Health IT, a division of the Department of Health and Human Services.

Nevertheless, experts stress the importance of getting the legal and regulatory structure right. Fu makes the practical point that the adoption of health IT applications, and their potential to improve care and even save lives, could flag if consumers and providers are spooked about privacy and security issues.

"My biggest concern is what happens if patients begin to not accept medical care because of fears of cybersecurity problems," Fu said. "I think it will be a real tragedy if we are not able to give patients the confidence to accept the recommendations of their physicians and their medical teams."

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