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DiversityNursing Blog

3 Ways to Select ICU Kids for Seizure Monitoring

Posted by Erica Bettencourt

Wed, Dec 10, 2014 @ 01:54 PM

By John Gever

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Not all children with severe brain injuries need to be monitored for subclinical seizures, researchers said here, which means that resources can be focused on those at the highest risk.

Victims of abuse, those younger than 2, and those with bleeding within the brain rather than only in the epidural compartment are the pediatric ICU patients most likely to show significant seizure activity that should be detected and treated, said Rajsekar Rajaraman, MD, of the University of California Los Angeles (UCLA).

A separate study by many of the same investigators also found that, in a broader range of pediatric brain injury cases, risk of seizures could be predicted with "fair-to-good" accuracy on the basis of clinical characteristics that would be recorded routinely at admission.

Both studies were reported at the American Epilepsy Society's annual meeting here.

A senior author on both studies, Nicholas Abend, MD, of Children's Hospital of Philadelphia, said at an AES press briefing that identifying and treating seizures is important in the pediatric ICU. When seizures are extremely frequent or long-lasting -- and these can easily go without detection in hospitalized children who are unconscious or lethargic -- they significantly increase the likelihood of poor short- and long-term outcomes.

Such seizures can only be detected via continuous EEG monitoring, Abend explained, which also requires interpretation from trained electroneurologists.

Another investigator in the studies, UCLA's Jason Lerner, MD, noted that children may appear to be napping peacefully while actually undergoing continuous seizures.

Although it would be desirable to perform intense monitoring on all pediatric cases involving head trauma, that is not feasible at most centers, Abend said. He said the field could benefit from risk-stratification models that would allow the care team to track only those patients at the highest risk for damaging subclinical seizures.

Such models, he added, could be tailored to meet the needs of individual centers on the basis of their patient mix, staffing, and other factors.

In a platform session at AES, Rajaraman described one approach to developing such a model. He and colleagues collected data on 135 consecutive pediatric patients (ranging in age from infant to late adolescent) with traumatic brain injury who were treated in ICUs at UCLA and at Children's Hospital of Colorado in Denver. These children had continuous EEG monitoring for detecting subclinical seizures.

They found that all such seizures occurred in children younger than 2 and in those with intradural bleeding, and that the vast majority also involved abusive head trauma. Rajaraman and colleagues then sought to validate these associations in a separate cohort of 44 pediatric ICU patients with head injuries treated at Children's Hospital of Philadelphia. The same patterns were seen.

Across both cohorts, 81% of those with subclinical seizures were determined to have been victims of abusive head trauma, whereas the prevalence of such trauma in all the patients was 25%. Abend said it was uncertain why abusive trauma should be such a strong predictor of these seizures, but speculated that "shaken baby syndrome" -- the most common form of abuse of infants and toddlers -- may produce fundamentally different injuries in the brain compared with falls and car accidents.

Also, such abuse is often chronic, such that the episode that brings a child to the hospital is only the latest in a series of abusive incidents.

The other study, led by Abend, was aimed at producing a predictive model yielding a risk index score that pediatric centers could use to identify critically ill children who could benefit the most from continuous EEG monitoring. It was based on clinical information to which the attending neurologist would have ready access: age, seizure etiology, presence of clinical seizures prior to beginning continuous EEG, initial EEG background category, and interictal discharge category.

Data to design the model were drawn from a database of 336 patients from 11 centers, and then tested against a separate validation dataset of 222 patients treated at Children's Hospital of Philadelphia.

Normalized scores in the model could range from 0 to 1.0, and Abend and colleagues examined the sensitivity and specificity of various cutoffs. When set at 0.10 in the validation cohort, sensitivity was 86% but sensitivity was only 58% -- the high sensitivity meant that 43% of patients would be identified as candidates for continuous monitoring. At the other end, a cutoff of 0.45 reversed the sensitivity and specificity percentages to 19% and 97%, respectively, such that only 5% of patients would be assigned to monitoring.

Abend said the beauty of this approach is that an individual center could choose its own optimal cutoff depending on the resources it has available to monitor multiple patients at one time. A well-equipped and staffed ICU could thus opt for high sensitivity whereas one with more limited resources could be more restrictive.

Source: www.medpagetoday.com

Topics: Children's Hospital, ICU kids, seizure, monitoring, EEG, nursing, health, healthcare, nurse, children, medical, patients, physicians, hospitals

Largest Study On Hospital Alarm Fatigue Records More Than 2.5 Million Alarms In One Month

Posted by Erica Bettencourt

Wed, Dec 10, 2014 @ 01:43 PM

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Jessica Zegre-Hemsey, a cardiac monitoring expert at the University of North Carolina at Chapel Hill, and her colleagues at the University of California San Francisco, revealed more than 2.5 million alarms were triggered on bedside monitors in a single month - the first figure ever reported from a real-world hospital setting.

Alarm fatigue occurs when nurses and other clinicians are exposed to a high number of physiological alarms generated by modern monitoring systems. In turn, alarms are ignored and critical alarms are missed because many alarms are false or non-actionable.

The work, the first of its kind to investigate the frequency and accuracy of alarms, addresses a growing patient safety issue that has gained national attention in recent years when a patient died despite multiple alarms that indicated low heart rate. The issue also addresses hidden downsides to modern monitoring technologies.

"Current technologies have been instrumental in saving lives but they can be improved," said Zègre-Hemsey, who is an assistant professor at the UNC-Chapel Hill School of Nursing. "For example, current monitoring systems do not take into account differences among patients. If alarm settings were tailored more specifically to individuals that could go a long way in reducing the number of alarms health care providers respond to."

Zègre-Hemsey and her colleagues collected alarm data on 461 adults in five intensive care units at the UCSF Medical Center for a period of 31 days. Zègre-Hemsey was one of four scientists who analyzed the alarms and helped to determine if they were true or false.

Investigators analyzed a subset of 12,671 arrhythmia alarms, which are designed to alert providers to abnormal cardiac conditions, and found 88.8 percent were false positives. Most of the false alarms were caused by deficiencies in the computer's algorithms, inappropriate user settings, technical malfunctions, and non-actionable events, such as brief spikes in heart rate, that don't require treatment.

A potential solution the researchers suggested would be to design monitors that could be configured to individual patients. No two bodies are exactly the same, and if the monitors could be adjusted to a patient's unique vital signs, the machines would not mistake a normal condition for an abnormal one. A "gold standard" database of annotated alarms could also help developers create computer algorithms that are less sensitive to artifacts.

According to Zègre-Hemsey, reducing alarm fatigue will ultimately require strong collaborations between clinicians, engineers, and hospital administrators as well as additional research.

"Alarm fatigue is a large and complex problem," she said. "Yet the implications are far-reaching since sentinel events like patient death have been reported. This is a current patient safety crisis."

The study was led by primary investigator Barbara J. Drew at UCSF. Co-authors on the paper include UCSF researchers Patricia Harris, Daniel Schindler, Rebeca Salas-Boni, Yong Bai, Adelita Tinoco, Quan Ding, and Xiao Hu from the UCSF department of physiological nursing and Tina Mammone from the UCSF department of nursing.

Source: www.medicalnewstoday.com

Topics: study, hospital alarm, fatigue, nursing, nurses, doctors, medical, hospital, patient

This 19-Year-Old College Student Built an Artificial Brain That Detects Breast Cancer

Posted by Erica Bettencourt

Wed, Dec 10, 2014 @ 01:35 PM

By Elizabeth Kiefer

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Brittany Wenger is one seriously smart cookie. In 2012, the then-17-year-old submitted her "artificial brain" technology -- which assesses tissue samples for breast cancer -- to the Google Science Fair and walked away with the grand prize. It was no wonder: Her invention, which uses a type of computer program called neural networks, can identify complex data patterns and make breast cancer detection calls with 99 percent accuracy. But she's not stopping there: Brittany hopes to help wipe out cancer completely.

Since she took home the gold two years ago, she's been named one of Time's 30 Under 30, given a truly inspiring TED Talk, and launched her app, Cloud4Cancer, which allows doctors to enter their own data and fuel continued cancer research. And did we mention she's also holding down a full course load at Duke University? Um, yeah. 

We recently chatted with Brittany about how she got started, her challenges along the way, and how she balances being a college student with breaking the barriers of cancer diagnostics.

How did you get into computer programming?

When I was in 7th grade I took an elective class on futuristic thinking. When we were assigned our final paper, I decided to write mine on technology of the future. The moment I started researching artificial intelligence and its transcendence into human knowledge, I was inspired. I went out and bought a coding textbook, and taught myself how to code. I remember one of the first projects that I ever worked on was an artificial neural network that taught people how to play soccer.

You're a self-taught coder who went on to create a potentially game-changing cancer detection tool. How did that happen?

Well, it definitely didn't happen overnight. I spent over five years working with neural networks, starting with an entire year of research to try and recognize patterns and connect breast cancer to artificial intelligence. I faced a lot of roadblocks along the way, as this was a very complicated program with no predefined solution. I went through thousands of pages of coding and data that was available through public domains, and performed over 7.6 million test trials. I two failed projects before finally succeeding on my third attempt, taking what didn't work the first few times to optimize the code that helped build the Cloud4Cancer app.

Why did you decide on developing breast cancer detection technology?

When I was 15, my cousin was diagnosed with breast cancer. I have a very close-knit family, so seeing the impact that the disease can have on a woman and her family, firsthand, was so real to me. When I learned that one in eight women will be diagnosed with breast cancer in their lifetime, I knew that I wanted to get involved in making the process better for patients. Now, the coding that I first used to help detect breast cancer has been extended into diagnosing other types of cancers, including blood-based diseases like leukemia.

What's been the most rewarding part of the process?

The people. I've already had the opportunity to work with real patients and breast cancer survivors, as well as talk with kids who are interested in doing research or coding in the future. Knowing that my cloud application has the potential to save lives and expedite the process of discovery is so rewarding. I still get chills thinking about how, a couple of years down the line, my research can actually contribute to finding the cure for cancer.

You've got a lot on your plate these days, between Cloud4Cancer and school. How do you balance everything?

The great thing about where I am with school right now is that my schedule is entirely what I make it. I can attend classes during the week and then travel over some weekends. School is not something that I will ever bend on, as I'm actually going for my MD, PhD in pediatric oncology. At the same time, my initiative is so important to me, I don't want either one to ever outweigh the other. Luckily, I think they complement each other well and what I'm learning in my classes helps me improve Cloud4Cancer.

What's one thing you want other young women to know if they're thinking about going the tech route?

If you're interested, go for it! There have never been so many available resources or opportunities -- for women, and for society as a whole -- to pursue a career in the field. I love how technology allows you to make new things by putting together the little pieces and working towards something bigger that can really benefit the world. There's no greater feeling than solving a problem and seeing your code come to life.

Source: www.huffingtonpost.com

Topics: innovation, artificial intelligence, college student, technology, brain, medical, cancer, detection, breast cancer, app

See What Extremely Rare, Nearly 14-Pound Newborn Looks Like

Posted by Erica Bettencourt

Mon, Dec 08, 2014 @ 02:31 PM

By GILLIAN MOHNEY

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A Colorado family welcomed a larger-than-expected bundle of joy when their newborn daughter was born weighing almost 14 pounds.

Mia Yasmin Hernandez tipped the scales at 13 pounds, 13 ounces after her delivery Monday at San Luis Valley Hospital in Alamosa, Colorado. The newborn’s father, Francisco Garcia, said doctors had estimated the baby would weigh 8 pounds at birth.

Mia didn't seem especially large when she was born, Gracia said.

“She was swollen and everything” after delivery, he said. “I thought she was going to [weigh] 10 or 11 pounds.”

But after weighing Mia, the nurse told Garcia the infant’s weight.

“I was like, ‘Whoa, she’s the biggest baby I’ve ever seen,’” Garcia told ABC News.

Even hospital personnel agreed. Garcia said the nurse told hi she’d never seen “a baby that big.”

Dr. Robert Barbieri, chief of obstetrics and gynecology at Brigham and Women’s Hospital in Boston, said in a previous interview about one out of 1,000 babies could weigh 11 pounds, and one out of every 100,000 could weigh 14 pounds. A 14-pound baby, he said, is extremely rare, because usually a doctor will induce labor if a baby appears oversize.

While Mia’s delivery via Caesarean section went smoothly, the infant developed breathing problems and was eventually moved to Children’s Hospital of Colorado in Aurora, Colorado, according to Garcia.

Garcia said Mia is on oxygen and doing well, although they’re not sure when she will get home.

Garcia said the couple has another four daughters at home, which might come in handy for new baby clothes.

“We bought her a lot of stuff like a newborn cap and pampers,” Garcia said. “They don't fit her. She’s too big.”

Source: http://abcnews.go.com

Topics: infant, newborn, 14-pounds, health, healthcare, baby, nurses, doctors, medical, hospital

Most Americans Agree With Right-to-Die Movement

Posted by Erica Bettencourt

Mon, Dec 08, 2014 @ 02:26 PM

By Dennis Thompson

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Already-strong public support for right-to-die legislation has grown even stronger in the days since the planned death of 29-year-old brain cancer patient Brittany Maynard, a new HealthDay/Harris Poll has found.

An overwhelming 74 percent of American adults now believe that terminally ill patients who are in great pain should have the right to end their lives, the poll found. Only 14 percent were opposed.

Broad majorities also favor physician-assisted suicide and physician-administered euthanasia.

Only three states -- Oregon, Washington and Vermont -- currently have right-to-die laws that allow physician-assisted suicide.

"Public opinion on these issues seems to be far ahead of political leadership and legislative actions," said Humphrey Taylor, chairman of The Harris Poll. "Only a few states have legalized physician-assisted suicide and none have legalized physician-administered euthanasia."

People responded to the poll in the weeks after Maynard took medication to end her life in early November.

Maynard moved from California to Oregon following her diagnosis with late-stage brain cancer so she could take advantage of the state's "Death With Dignity Act." Her story went viral online, with a video explaining her choice garnering nearly 11.5 million views on YouTube.

A "poster child for the movement," Maynard helped spark conversations that allowed people to put themselves in her shoes, said Frank Kavanaugh, a board member of the Final Exit Network, a right-to-die advocacy group.

"I think it is just a natural evolution over a period of time," Kavanaugh said of the HealthDay/Harris Poll results. "There was a time when people didn't talk about suicide. These days, each time conversations occur, people think it through for themselves, and more and more are saying, 'That's a reasonable thing to me.'"

The poll also found that:

  • Support for a person's right to die has increased to 74 percent, up from 70 percent in 2011. Those opposed decreased to 14 percent from 17 percent during the same period.
  • Physician-assisted suicide also received increased support, with 72 percent now in favor, compared with 67 percent in 2011. Opposition declined from 19 percent to 15 percent.
  • Sixty-six percent of respondents said doctors should be allowed to comply with the wishes of dying patients in severe distress who ask to have their lives ended, up from 58 percent in 2011. Opposition decreased from 20 percent in 2011 to 15 percent now.

"The very large -- more than 4-to-1 and increasing -- majorities in favor of physician-assisted suicide, and the right of terminally ill patients to end their lives are consistent with other liberal social policy trends, such as support for same-sex marriage, gay rights and the decriminalization of marijuana, seen in the results of referendums and initiatives in the recent mid-term elections," Taylor said.

Support for the right-to-die movement cut across all generations and educational groups, both genders, and even political affiliation, the poll found.

Democrats tended to be more supportive of right-to-die legislation, but 56 percent of Republicans said they favor voluntary euthanasia and 63 percent favor physician-assisted suicide.

Kavanaugh was not surprised. "People think of this as a liberal issue. But I find that as I talk to [conservatives], you can appeal to them on the basis of 'get the government the hell out of my life,'" he said.

But the public is split over how such policies should be enacted, with 35 percent saying that the states should decide on their own while 33 percent believe the decision should be made by the federal government, the poll found.

"Most of the people I know in the field whose opinion I put stock in don't feel there's ever going to be federal movement on it," Kavanaugh said. "You're just going to have to suffer through a state-by-state process."

Kavanaugh does believe this overwhelming public support will result in steady adoption of right-to-die laws.

"I think this will become the ultimate human right of the 21st century, the right to die with dignity," he said. "There are good deaths and bad deaths, and it is possible to have a good death."

Despite increasing public support for assisted suicide, stiff opposition remains in some quarters.

"Assisted suicide sows confusion about the purpose of life and death. It suggests that a life can lose its purpose and that death has no meaning," Rev. Alexander Sample, archbishop of the Archdiocese of Portland in Oregon, said in a pastoral statement issued during Maynard's final days.

"Cutting life short is not the answer to death," he said. "Instead of hastening death, we encourage all to embrace the sometimes difficult but precious moments at the end of life, for it is often in these moments that we come to understand what is most important about life. Our final days help us to prepare for our eternal destiny."

Todd Cooper, a spokesman for the Portland archdiocese, said the debate over assisted suicide touches him on a very deep level because of his wife, Kathie.

About 10 years ago, she also was diagnosed with terminal brain cancer. She endured two brain surgeries, two years of chemotherapy and six weeks of radiation therapy, and remains alive to this day.

"If she'd given up the fight for life, she wouldn't be here," Cooper said. "That doesn't necessarily happen in every case, but it gives hope for those who struggle to the very end."

source: www.medicinenet.com

Topics: life, pain, choice, assisted suicide, Right-to-die, nursing, nurse, cancer, hospital, patient, death

Care Experience Does Not Make Students Better Nurses, Study Shows

Posted by Erica Bettencourt

Mon, Dec 08, 2014 @ 11:42 AM

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Nursing students with previous caring experience are less likely to perform better academically and clinically than those who have none, research shows.

A study assessing the criteria for selecting nursing students found that high emotional intelligence did not mean students performed better on their courses.

Researchers also found that of the students who have withdrawn from their studies, nearly 60 per cent had previous caring experience.

The ongoing study, led by the University of Edinburgh, is tracking performance and emotional intelligence - the ability to recognise your own and other people's feelings and act accordingly - of nearly 900 nursing and midwifery students from the University of the West of Scotland and Edinburgh Napier University.

Researchers found, however, that performance improved with age and that female trainees scored significantly better than male counterparts.

The findings come after the 2013 Frances Report - which highlighted care failings at the Mid Staffordhire NHS Foundation Trust - recommended an emphasis on creating a more compassionate end empathetic culture in nursing.

As a result, aspiring nurses in England could potentially be required to spend a placement year as a carer before undertaking their training.

Lead researcher Rosie Stenhouse, lecturer in Nursing Studies at the University of Edinburgh, said: "The research should sound a note of caution to such pilot schemes. They are potentially expensive, politically motivated and not backed up by evidence."

Source: www.medicalnewstoday.com

Topics: student nurse, studies, experience, education, nurses, medical, career

'She Can Have Some Of My Hair': After Seeing Girl Without Hair, Toddler Moved To Donate Hers

Posted by Erica Bettencourt

Wed, Dec 03, 2014 @ 12:23 PM

By  Kimberly Yam

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This young girl is truly benevolent beyond her years.

Three-year-old Ariana Smith from Winterport, Maine watched a video from Extra Life, a charity that raises money for Children’s Miracle Network Hospitals through video gaming, that featured a girl who didn't have any hair. The curious kid then decided to ask her parents about what she saw, Josh Smith, Ariana's father, told the Huffington Post in an e-mail.

"She asked why the little girl had no hair. We explained that she was sick and that the medicine they were using made her hair fall out," Smith said.

The chat left a strong impression on Ariana. 

“Without a second thought, Ariana said ‘Oh, well she can have some of my hair,’” Smith told ABC News.

So, on November 21st, the toddler received her first cut, and with the help of her parents, donated her hair to Locks Of Love. The pictures from the milestone, which were posted on Imgur, have since gone viral with over 500,000 views -- an ode to the 3-year-old's generosity. 

"She could be so selfless like that," Smith told ABC News. "Her first reaction is ‘How about I give up something that I have so a little girl can feel pretty'."

While Ariana's act of kindness is a noble one, her father says that he wasn't surprised when she expressed her desire to donate her hair. He told HuffPost that she loves helping others -- even when she's playing.

"I think she’s just a caring person," he wrote. "She has a little play set of medical devices which she uses often. I’ve had my blood pressure and heart rate 'checked' hundreds of times this year."

As for Ariana's new hairstyle, the toddler seems to be adjusting quite nicely to her fashion statement. 

"She loves it," Smith says of her daughter's new hairdo. "She can eat her breakfast without worrying about her hair drooping into it."

Source: www.huffingtonpost.com

Topics: child, hair loss, hair donation, medical, cancer

New Device May Ease Mammography Discomfort

Posted by Erica Bettencourt

Wed, Dec 03, 2014 @ 12:17 PM

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Researchers have developed a new device that may result in more comfortable mammography for women. According to a study being presented next week at the annual meeting of the Radiological Society of North America (RSNA), standardizing the pressure applied in mammography would reduce pain associated with breast compression without sacrificing image quality.

Compression of the breast is necessary in mammography to optimize image quality and minimize absorbed radiation dose. However, mechanical compression of the breast in mammography often causes discomfort and pain and deters some women from mammography screening.

An additional problem associated with compression is the variation that occurs when the technologist adjusts compression force to breast size, composition, skin tautness and pain tolerance. Over-compression, or unnecessarily high pressures during compression, is common in certain European countries, especially for women with small breasts. Over-compression occurs less frequently in the United States, where under-compression, or extremely low applied pressure, is more common.

"This means that the breast may be almost not compressed at all, which increases the risks of image quality degradation and extra radiation dose," said Woutjan Branderhorst, Ph.D., researcher in the Department of Biomedical Engineering and Physics at the Academic Medical Center in Amsterdam.

Overall, adjustments in force can lead to substantial variation in the amount of pressure applied to the breast, ranging from less than 3 kilopascals (kPa) to greater than 30 kPa.

Dr. Branderhorst and colleagues theorized that a compression protocol based on pressure rather than force would reduce the pain and variability associated with the current force-based compression protocol. Force is the total impact of one object on another, whereas pressure is the ratio of force to the area over which it is applied.

The researchers developed a device that displays the average pressure during compression and studied its effects in a double-blinded, randomized control trial on 433 asymptomatic women scheduled for screening mammography.

Three of the four compressions for each participant were standardized to a target force of 14 dekanewtons (daN). One randomly assigned compression was standardized to a target pressure of 10 kPa.

Participants scored pain on a numerical rating scale, and three experienced breast screening radiologists indicated which images required a retake. The 10 kPa pressure did not compromise radiation dose or image quality, and, on average, the women reported it to be less painful than the 14 daN force.

The study's implications are potentially significant, Dr. Branderhorst said. There are an estimated 39 million mammography exams performed every year in the U.S. alone, which translates into more than 156 million compressions. Pressure standardization could help avoid a large amount of unnecessary pain and optimize radiation dose without adversely affecting image quality or the proportion of required retakes.

"Standardizing the applied pressure would reduce both over- and under-compression and lead to a more reproducible imaging procedure with less pain," Dr. Branderhorst said.

The device that displays average pressure is easily added to existing mammography systems, according to Dr. Branderhorst.

"Essentially, what is needed is the measurement of the contact area with the breast, which then is combined with the measured applied force to determine the average pressure in the breast," he said. "A relatively small upgrade of the compression paddle is sufficient."

Further research will be needed to determine if the 10 kPa pressure is the optimal target.

The researchers are also working on new methods to help mammography technologists improve compression through better positioning of the breast.

Source: www.sciencedaily.com

Topics: mammography, tests, screenings, technology, health, healthcare, nurses, doctors, medical, breast cancer

CDC Endorses Circumcision for Health Reasons

Posted by Erica Bettencourt

Wed, Dec 03, 2014 @ 12:11 PM

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U.S. health officials are poised to endorse circumcision as a means of preventing HIV and other sexually transmitted diseases.

The U.S. Centers for Disease Control and Prevention on Tuesday released its first-ever draft guidelines on circumcision that recommend that doctors counsel parents and uncircumcised males on the health benefits of the procedure.

The guidelines do not outright call for circumcision of all male newborns, since that is a personal decision that may involve religious or cultural preferences, Dr. Jonathan Mermin, director of the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, told the Associated Press.

Discussion board is open for inputs on this subject.

But "the scientific evidence is clear that the benefits outweigh the risks," Mermin said.

Circumcision involves the surgical removal of the foreskin covering the tip of the penis. Germs can collect and multiply under the foreskin, creating issues of hygiene.

Clinical trials, many done in sub-Saharan Africa, have demonstrated that circumcision reduces HIV infection risk by 50 percent to 60 percent, the CDC guidelines note. The procedure also reduces by 30 percent the risk of contracting herpes and human papilloma virus (HPV), two pathogens believed to cause cancer of the penis.

The guidelines do point out that circumcision has only been proven to prevent HIV and sexually transmitted diseases in men during vaginal sex. The procedure has not been proven to reduce the risk of infection through oral or anal sex, or to reduce the risk of HIV transmission to female partners.

The scientific evidence is mixed regarding homosexual sex, the guidelines say, with some studies having shown that circumcision provides partial protection while other studies have not.

Circumcision does reduce the risk of urinary tract infections in infants, according to the CDC guidelines.

The most common risks associated with the procedure include bleeding and infection.

Male circumcision rates in the United States declined between 1979 and 2010, dropping from almost 65 percent to slightly more than 58 percent, according to a CDC report issued last year.

The new draft guidelines mirror an updated policy on circumcision released by the American Academy of Pediatrics in 2012.

"The American public should take confidence that these are pretty much converging guidelines. There is no doubt that it [circumcision] does confer health benefits and there is no doubt it can be performed safely, with a less than 1 percent risk of complications," Dr. Susan Blank, chair of the task force that authored the AAP policy statement, said Tuesday. "This is one thing a parent can do to protect the future health of their children."

In its policy statement, the AAP declared that the health benefits are great enough that infant male circumcision should be covered by insurance, which would increase access to the procedure for families who choose it, said Blank, who is also assistant commissioner of STD Control and Prevention at the New York City Department of Health and Mental Hygiene.

"The push from the academy's point of view is to really have providers lay out for parents what are the risks, what are the benefits, and give the parents the information they need to make a decision," Blank said. "And the academy feels strongly that since there are proven health benefits, the procedure should be covered by insurance."

The guidelines are expected to spur a response from anti-circumcision groups.

"There are certainly groups that are troubled by circumcision of an individual who is not in a position to provide their own consent," Blank said.

The public can comment on the draft guidelines through Jan. 16, according to the CDC.

Source: www.nlm.nih.gov

Topics: surgery, circumcision, STD, health, healthcare, nurses, doctors, CDC, medical, hospitals, HIV, newborns

Majority Of People Ignore Cancer Warning Signs, Study Finds

Posted by Erica Bettencourt

Wed, Dec 03, 2014 @ 11:54 AM

By Honor Whiteman

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Cancer is one of the leading causes of morbidity and mortality worldwide. In 2012, there were around 14 million new cases of cancer and around 8.2 million deaths from the disease. But despite such alarming numbers, a new study by researchers from the UK finds that most people ignore cancer warning signs, attributing them instead to symptoms of less serious illnesses.

Lead study author Dr. Katriina Whitaker, senior research fellow at University College London in the UK, analyzed the responses of 1,724 people aged 50 and over to a health questionnaire that was sent to them in April 2012.

The questionnaire asked participants whether they had experienced any of 17 symptoms, 10 of which are defined as cancer "alarm" symptoms by Cancer Research UK. These symptoms include unexplained cough, changes in mole appearance, unexplained bleeding, persistent change in bowel habits, unexplained weight loss, difficulty swallowing and unexplained lumps. 

Participants were not told which symptoms are cancer warning signs.

The respondents were also asked what they thought was the cause of any symptoms they experienced, whether they deemed the symptoms to be serious and whether they visited their doctor as a result of their symptoms.

Only 2% of respondents considered warning symptoms to be cancer-related

Results of study - published in the journal PLOS ONE - revealed that 53% of participants reported that they had experienced at least one cancer warning sign over the past 3 months.

The most common cancer warning symptoms reported were persistent cough and persistent change in bowel habits, while unexplained weight loss and problems swallowing were the least common.

However, the researchers were surprised to find that of the respondents who reported cancer warning symptoms, only 2% considered cancer to be a potential cause.

What is more, Dr. Whitaker says that of participants who reported the most obvious signs of cancer - such as unexplained lumps or changes in mole appearance - most did not consider them to be cancer-related.

"Even when people thought warning symptoms might be serious, cancer didn't tend to spring to mind," adds Dr. Whitaker. "This might be because people were frightened and reluctant to mention cancer, thought cancer wouldn't happen to them or believed other causes were more likely."

On a positive note, respondents did deem the cancer warning signs to be more serious than symptoms not linked to cancer - such as shortness of breath, fatigue and sore throat- and 59% of those who experienced cancer warning signs visited their doctor.

But the researchers say their findings show that the majority of people are dismissing potential warning signs of cancer, which could be putting their health at serious risk. Dr. Whitaker says:

"Most people with potential warning symptoms don't have cancer, but some will and others may have other diseases that would benefit from early attention. That's why it's important that these symptoms are checked out, especially if they don't go away. But people could delay seeing a doctor if they don't acknowledge cancer as a possible cause."

"Most cancers are picked up through people going to their general practitioner (GP) about symptoms, and this study indicates that opportunities for early diagnosis are being missed," adds Sara Hiom, director of early diagnosis at Cancer Research UK. "Its results could help us find new ways of encouraging people with worrying symptoms to consider cancer as a possible cause and to get them checked out straight away with a GP."

Source: www.medicalnewstoday.com

Topics: risk, signs, symptoms, nursing, health, healthcare, research, doctors, medical, cancer

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