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DiversityNursing Blog

Low-Cost Incubator May Save More Babies

Posted by Erica Bettencourt

Wed, Nov 19, 2014 @ 02:11 PM

By George Putic

MOM inclubator press resized 600

Each year, about one million babies throughout the world die of complications due to premature birth. Many of them could have been saved if given access to an incubator. But this expensive device is sorely lacking in developing countries. A young British researcher says he has found a solution -- a low-cost inflatable incubator.

Doctors say many expectant mothers in developing countries give birth prematurely, especially in refugee camps, largely because of poor diet and unhealthy living conditions.

Premature birth is the biggest killer of children worldwide. Because these tiny babies are born before their lungs are fully developed, they are more susceptible to often deadly infections. But they could survive if placed in an incubator, where they would continue to develop in the closed chamber and warm, controlled environment.

However with a price tag of around $50,000, incubators are out of reach even for some hospitals.

Design engineering student James Roberts, 23,  of Britain says his $400 inflatable incubator may help solve this problem.

“It's basically an insulated piece of air, so it's like the difference between double and single glazing, so it's easier to keep the inside at a stable heat environment, heat temperature," he said.

The inflated incubator is collapsible and when folded resembles an ordinary travel bag.

It is powered through a regular electrical line, but Roberts said he has found a solution in case there is a power outage, which often happens in refugee camps.

“I thought 'why not car batteries?' There's loads of cars out there, they're pretty readily available. So you can plug this into a car battery. It will run for 24 hours and then when the mains [regular electrical line] comes back on, the mains can then charge this battery, and then that can run the incubator," he said.

Roberts' won the $47,000 James Dyson Award earlier this year for his incubator design. He said the project is still in the development phase, but the prize money will help him start a company for the mass manufacturing of inflatable incubators.

Source: www.voanews.com

Topics: premature birth, incubator, life saving, developing countries, technology, health, healthcare, medical, patients, babies

Three Tips for Better Nurse–Physician Communication In The Digital Age

Posted by Erica Bettencourt

Mon, Nov 17, 2014 @ 12:58 PM

By Melissa Wirkus

Milisa Manojlovich resized 600

“HIT has been shown to help some patients, but it has also been shown to perhaps provide some complications in care, or less than adequate care, when messages are not received, when messages are interrupted or when messages are routed to the inappropriate person,” explained Milisa Manojlovich, PhD, RN, CCRN, associate professor at the University of Michigan School of Nursing (UMSN) and member of U-M’s Institute for Healthcare Policy and Innovation.

Manojlovich will serve as the primary investigator on a new $1.6 million grant from the federal Agency for Healthcare Research and Quality (AHRQ) that will focus on health IT’s effects on nurse–physician communication. Manojlovich and her co-investigators will look at how communication technologies make it easier or harder for doctors and nurses to communicate with each other. They hope their research will identify the optimal way to support effective communication while fostering improved and positive interdisciplinary team-based care.

Until the research is completed, Manojlovich offers some simple procedures clinicians can begin to adopt right now to help alleviate common problems with digital communication:

1.   Use multiple forms of technology  

Just like there is more than one way to treat a cold, there is more than one way to communicate electronically. Utilizing multiple forms of technology to communicate important information, or sometimes even reverting back to the “old-fashioned” ways of making a phone call or talking in person, can help ensure the receipt of a message in an environment that is often inundated.

“One of the things we are going to investigate is this idea of matching the message to the medium,” Manojlovich said. “So depending on the message that you want to send, you will identify what is the best medium to send that message.”

Using the current Ebola situation in Texas as an example, Manojlovich explained that using multiple forms of technology as a back-up to solely documenting the information in the EHR system could have mitigated the breakdown in communication that occurred. “Although the clinician did her job by entering the information into the EHR, she maybe should have texted or emailed the physician with the information or found someone to talk to in person about the situation. What we are trying to do with this study is see if there is another way that messages like this could have been transmitted better.”

2.   Include the whole message 

Reducing fragmented messages and increasing the aggregation of key data and information in communications may be one of the most critical pieces to improving communication between nurses and physicians. Manojlovich has been passionate about nurse–physician communication throughout her career and has conducted several previous studies on communication technologies.

“What we’ve noticed, for example, is that nurses will sometimes use the same form of communication over and over again. In one of the studies we actually watched a nurse page the same physician three times with the same question within an hour period.”

The physician did not answer any of the messages, and Manojlovich concluded it was because the pages were missing critical components of information related to the patient’s care plan. Increasing the frequency of communications can be beneficial, but only if the entire message and all important facets of information are relayed.

“If you do what you’ve always done, you’re going to get what you’ve always gotten. If you don’t alter or change the communication technology you are using, you are going to get the same results,” she added.

3.   Incorporate a team-based approach 

“At a really high level the problem is that a lot of these computer and electronic health record technologies are built with individuals in mind,” Manojlovich said. “When you talk about care process and team processes, that requires more interaction than the technologies are currently able to give us. The computer technologies are designed for individual use, but health care is based on the interaction of many different disciplines.”

Infusing this collaborative mindset into the “siloed” technology realm will undoubtedly help to improve the communication problems between providers and clinicians at all levels and all practice settings--which is especially important in today’s environment of co-morbidities and coordinating care.

Nurses play a critical role in improving communication as frontline care providers. “Nurses are the 24-hour surveillance system for hospitalized patients. It is our job to do that monitoring and surveillance and to let physicians know when something comes up.”

“I believe that for quality patient care, a patient needs input from all disciplines; from doctors, nurses, pharmacists, nutritionists--everyone,” Manojlovich said. “We are being trained separately and each discipline has a different knowledge base, and these differences make it difficult for us to understand each other. Developing mutual understanding is really important because when we have that mutual understanding I think outcomes are better and it can be argued that the quality of care is better when you have everyone providing input.”

Source: www.nursezone.com

Topics: physician, digital, technology, health, healthcare, nurses, patients, hospital, communication

Health Literacy And The Use Of The Internet Lacking Among Seniors

Posted by Erica Bettencourt

Mon, Nov 17, 2014 @ 12:17 PM

By  John DeGaspari

EHR Lead Art

Using the Internet to access health information may be out of reach for many older Americans, according to a study by researchers at the University of Michigan. According to the study, less than one-third of Americans age 65 and older use the Web. Within that age group less than 10 percent of those with low health literacy, or who lack the ability to navigate the healthcare system, go online for health-related matters.

The results of the study have been published in the Journal of Internal Medicine. Data was analyzed from the 2009 and 2010 Health and Retirement Study, a nationally representative survey of older adults; about 1,400 of the participants were asked about how often they use the Internet for any purpose, and, in particular, how often they search for health and medical information.

Health literacy was found to be a significant predictor or what people do once they are online. Elderly Americans with low health literacy are less likely to use the Internet at all, according to the researcher; and if members of this group do surf the Web, it is not generally to search for medical or health information.

“In recent years, we have invested many resources in Web-based interventions to help improve people’s health, including electronic health records designed to help patients become more active participants in their care,” according to lead author of the study Helen Levy, Ph.D., research associate professor at the University of Michigan Institute for Social Research, in a prepared statement. “But many older Americans, especially those with low health literacy, may not be prepared for these tools.”

Senior author Kenneth Langa, M.D., a professor of Internal Medicine at the University of Michigan Medical School, cautions that as the Internet becomes more central to health literacy, older Americans face barriers that may sideline them. He recommends that “Programs need to consider interventions that target health literacy among older adults to help narrow the gap and reduce the risk of deepening disparities in health access and outcomes.”

Source: www.healthcare-informatics.com

Topics: studies, EHR, technology, health, healthcare, patients, elderly, seniors, Internet

Microneedles For Easy Delivery Of Drugs Into Eye

Posted by Erica Bettencourt

Mon, Nov 17, 2014 @ 11:52 AM

microneedles

A number of eye conditions can be treated by administering drugs directly into the eye. Yet, conventional needles have a bunch of drawbacks, including the patients’ fear of needles entering such fragile parts of the body and the difficulty of accurately administering medication into a targeted region of the eye. For glaucoma, for example, eye drops are prescribed which have a shorter active lifetime and are often skipped by the patients. An easy injection that works for months at a time would help control the disease considerably better.

Researchers at Georgia Tech and Emory University have been working on microneedles and formulations to safely and effectively deliver drugs into the eye. The microneedles are designed to only penetrate to the correct depth and the formulations need to be viscous enough to stay in place and release their therapeutic compounds in a controlled fashion. The researchers have already tested the microneedles on laboratory animals and showed that they can place drugs within the targeted sections of the eye.

More from Georgia Tech:

The microneedle therapy would inject drugs into space between two layers of the eye near the ciliary body, which produces the aqueous humor. The drug is retained near the injection side because it is formulated for increased viscosity. In studies with an animal model, the researchers were able to reduce intraocular pressure through the injections, showing that their drug got to the proper location in the eye.

Because the injection narrowly targets delivery of the drug, researchers were able to bring about a pressure reduction by using just one percent of the amount of drug required to produce a similar decline with eye drops.

To treat corneal neovascularization, the researchers took a different approach, coating solid microneedles with an antibody-based drug that prevents the growth of blood vessels. They inserted the coated needles near the point of an injury, keeping them in place for approximately one minute until the drug dissolved into the cornea.

In an animal model, placement of the drug halted the growth of unwanted blood vessels for about two weeks after a single application.

Source: www.medgadget.com

Topics: needles, drugs, microneedles, eyes, technology, health, healthcare, medical, patients, medicine

'Kissing Bug' Now Spreading Tropical Disease in U.S.

Posted by Erica Bettencourt

Wed, Nov 05, 2014 @ 11:52 AM

By Steven Reinberg

kissing bug

Residents of the southern United States may be at risk for a parasitic infection that can lead to severe heart disease and death, three new studies suggest.

Chagas disease, which is transmitted by "kissing bugs" that feed on the faces of humans at night, was once thought limited to Mexico, Central America and South America.

That's no longer the case, the new research shows.

"We are finding new evidence that locally acquired human transmission is occurring in Texas," said Melissa Nolan Garcia, a research associate at Baylor College of Medicine in Houston and the lead author of two of the three studies.

Garcia is concerned that the number of infected people in the United States is growing and far exceeds the U.S. Centers for Disease Control and Prevention's estimate of 300,000.

In one pilot study, her team looked at 17 blood donors in Texas who tested positive for the parasite that causes Chagas disease.

"We were surprised to find that 36 percent had evidence of being a locally acquired case," she said. "Additionally, 41 percent of this presumably healthy blood donor population had heart abnormalities consistent with Chagas cardiac disease."

The CDC, however, still believes most people with the disease in the United States were infected in Mexico, Central and South America, said Dr. Susan Montgomery, of the agency's parasitic diseases branch.

"There have been a few reports of people becoming infected with these bugs here in the United States," she said. "We don't know how often that is happening because there may be cases that are undiagnosed, since many doctors would not think to test their patients for this disease. However, we believe the risk of infection is very low."

Maybe so, but kissing bugs -- blood-sucking insects called triatomine bugs -- are found across the lower half of the United States, according to the CDC. The insects feed on animals and people at night.

The feces of infected bugs contains the parasite Trypanosoma cruzi, which can enter the body through breaks in the skin. Chagas disease can also be transmitted through blood.

It's a silent killer, Garcia said. People don't feel sick, so they don't seek care, but it causes heart disease in about 30 percent of those who get infected, she said.

In another study, Garcia's team collected 40 insects in 11 Texas counties. They found that 73 percent carried the parasite and half of those had bitten humans as well as other animals, such as dogs, rabbits and raccoons.

A third study found that most people infected with Chagas aren't treated.

For that project, Dr. Jennifer Manne-Goehler, a clinical fellow at Harvard Medical School and Beth Israel Deaconess Medical Center in Boston, collected data on nearly 2,000 people whose blood tested positive for Chagas.

Her team found that only 422 doses of medication for the infection were given by the CDC from 2007 to 2013. "This highlights an enormous treatment gap," Manne-Goehler said in a news release.

The findings of all three studies, published recently in the American Journal of Tropical Medicine and Hygiene, were to be presented Tuesday in New Orleans at the annual meeting of the American Society of Tropical Medicine and Hygiene.

Symptoms of Chagas can range from none to severe with fever, fatigue, body aches and serious cardiac and intestinal complications.

"Physicians should consider Chagas when patients have swelling and enlargement of the heart not caused by high blood pressure, diabetes or other causes, even if they do not have a history of travel," Garcia said.

However, the two treatments for this disease are "only available [in the United States] via an investigative drug protocol regulated by the CDC," Garcia said. They are not yet approved by the Food and Drug Administration.

Efforts are under way to develop other treatments for Chagas disease, Montgomery said.

"Several groups have made some exciting progress in drug development," she said, "but none have reached the point where they can be used to treat patients in regular clinical practice."

Source: health.usnews.com

Topics: health, healthcare, nurses, CDC, medical, medicine, treatment, hospitals, practice, infection, bug, tropical disease, clinical, kissing bug

Leadership and Hierarchy in Hospitals (Infographic)

Posted by Erica Bettencourt

Wed, Nov 05, 2014 @ 10:49 AM

Leadership and Hierarchy

Source: Norwich University's Master of Science in Nursing online program

Topics: education, nursing, health, healthcare, leadership, nurses, medical, hospitals

Pronouncing The Patient Dead

Posted by Erica Bettencourt

Mon, Nov 03, 2014 @ 11:25 AM

By DANIELA J. LAMAS, M.D.

pronouncing patient resized 600

One recent night I was asked to declare the death of a woman I had never met.

“Ms. L. passed,” the nurse said. “Could you pronounce her?”

The online medical record told me that she was 32 years old, one year younger than me. She had been in the hospital for months with leukemia that had progressed despite every possible chemotherapy regimen and a failed bone marrow transplant. And now someone needed to perform a death exam.

Declaring death is not technically hard but it is weird and sad and requires reams of paperwork. It is usually done by an intern, but my intern was busy so I said I would do it.

The first time I declared a patient dead was nearly six years earlier. I had been a doctor for a few months when I was summoned overnight with a page that told me that my patient’s heart had stopped. When I got to his room I was out of breath and his nurse smiled at me and told me that there really wasn’t urgency; he wasn’t going anywhere.

It was only when I walked into the room and saw my patient still and utterly silent, his tired family sitting around the bed, that I realized no one had ever told me precisely how to declare death. I wished I could come back later, but it didn’t seem right to leave him there, so I thumbed through my pocket-sized intern survival guide. The manual was alphabetized, and the discussion about declaring death came somewhere before a section on diabetes management.

The instructions were clear and began with the directive to express sympathy. I turned to the family to tell them how sorry I was. Listen for heart sounds and watch to see if the patient is breathing. I placed my stethoscope on the patient’s still chest and waited, watching for him to take a breath, and wondering what I would do if I heard something. But there was nothing. Feel for a pulse. I placed my hand on his neck and there was not even a quiver. And that was that. He was dead.

I looked at the clock and spoke the time out loud and said I was sorry again. And then I left the room.

Later I would face the inevitable pile of paperwork, which one hospital I worked at labeled the “Final Discharge Packet,” and another, in bold letters on a red binder, the “Death Binder.” That was followed by calls to admitting to report the death, minutes that felt like hours on hold with the medical examiner, death certificates returned to me because I had signed on the wrong dotted line. By the end of my intern year, one of the worst parts of having a patient die was those bureaucratic forms and phone calls.

Now, years later, I paused outside the room of Ms. L. before pulling back the curtain.

Until then, most of the patients I had been called to declare looked much as they did in life, only vacant. But this woman had been destroyed by illness. She was bald and yellow and bloated. She must have suffered. I took out my stethoscope as I had learned to do, rested it on her chest and listened to the silence that had taken the place of her heartbeat. I laid my fingers on her neck and there was no pulse. I looked up at the clock and said the time out loud.

As I turned to leave, I couldn’t help but note the wall of cards and photographs next to her hospital bed. She must have run a marathon to raise money for cancer research, for one photo captured her healthy and smiling, arms lifted victoriously as she crossed the finish line. Someone who loved her must have been there, waiting to take that photo.

“She must have been cool,” I said to her nurse. “I bet I would have liked her.”

“She was awesome.”

No one spoke. Two nurses gently pulled out the intravenous lines that had once run antibiotics and fluids into her veins and, one by one, removed the stickers on her chest that had recorded her heartbeat. One of the nurses paused and caught my eye.

“It’s so humid out,” she said. “How do you keep your hair from getting frizzy in this humidity?” I had showered just before my shift, I told her, and then I had come right to work so I hadn’t been outside much. When I caught a glimpse of myself in the mirror, my hair didn’t even look that good.

And then, because I didn’t know what else to say in front of this 32-year-old woman I would never meet, I offered only: “You know, I’ve always wanted to run a marathon.”

I left the room to begin the paperwork .

Source: nytimes.com

Topics: health, healthcare, nurse, patient, death, intern, profession, duties, declaring death

Predicting The Top Medical Innovations For 2015

Posted by Erica Bettencourt

Mon, Nov 03, 2014 @ 11:05 AM

By Sara Cheshire

medical future resized 600

Can we predict the future of medicine? Although designer babies and a disease-free world may or may not come to pass, you can get a glimpse of the most promising and upcoming medical innovations each year, via the Cleveland Clinic.

The clinic's Top 10 Medical Innovations list, which has been an annual undertaking since 2007, contains treatments and technologies that are expected to significantly change patient care and save lives.

To be considered, each innovation must have a good chance of being available to the public in the upcoming year, says Dr. Michael Roizen, chief wellness officer at the Cleveland Clinic and chairman of the committee that decides the list. The committee must also expect it to have a significant impact on a large part of the population.

The process starts with a panel of Cleveland Clinic physicians and scientists who submit their ideas. These suggestions, which Roizen said totaled about 700 for the 2015 list, are then narrowed down and voted on by 40 physicians in a variety of health fields.

Here's what they selected for 2015:

1. Mobile stroke unit

Videoconferencing has made its way into ambulances, specifically for treating stroke victims on the go. Hospital stroke neurologists can interpret symptoms via a broadband video link and instruct an onboard paramedic, critical care nurse and CT technologist on treatment. This new technology should improve the speed of medical care, which is important as strokes quickly damage and kill brain cells.

2. Dengue fever vaccine

The World Health Organization reports that about half of the world's population is now at risk for dengue fever, which up until now was preventable only by avoiding mosquito bites. The disease is a leading cause of death and illness in children in some countries. A new vaccine has been developed and tested, and is expected to be available in 2015.

3. Painless blood testing

For those who hate large needles, a nearly painless way to sample blood will be a welcome relief. Plus, it will be cheaper and provide faster results than today's blood test. The new technology takes blood from your fingertip, and the Cleveland Clinic reports that over 100 tests can be performed on just one drop of blood.

4. New way to lower cholesterol

New self-injectable drugs called PCSK9 inhibitors have shown to be very effective in lowering cholesterol. These drugs may prove to be helpful for people with high LDL cholesterol who don't have good results with statins. The FDA is expected to approve the first PCSK9 in 2015.

5 ways to lower cholesterol

5. Cancer drug that doesn't harm healthy tissue

Although chemotherapy can save lives, it can be hard on the body and attack healthy cells as well as cancerous ones. A welcome breakthrough in the world of cancer treatment, antibody-drug conjugates can deliver targeted treatment without damaging healthy tissue.

6. Immune booster for cancer patients

Immune checkpoint inhibitors have been shown to prevent cancer cells from "hiding" from the immune system, allowing the body to more effectively fight these abnormal cells. Combined with chemotherapy and radiation treatment, the drugs have shown significant, long-term cancer remissions for patients with metastatic melanoma, one of the most deadly forms of cancer.

7. Wireless cardiac pacemaker

Until this point, wires have been a necessary component in pacemakers. A new wireless pacemaker about the size of a vitamin can now be implanted in the heart without surgery. Its lithium-ion battery is estimated to last about seven years.

8. New medications for idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis is a life-threatening disease that causes scarring in the lungs, leading to breathing difficulties and a shortage of oxygen in the brain and other organs. Life expectancy is only three to five years after diagnosis, but those numbers may change now that the FDA has approved two experimental drugs that slow the disease: pirfenidone and nintedanib.

9. Single-dose radiation therapy for breast cancer

The National Cancer Institute estimates that 40,000 women in the United States will die from breast cancer in 2014. The Cleveland Clinic cites multiple chemotherapy appointments, sometimes requiring the patient to travel long distances, as a hindrance to successful treatment. Intraoperative radiation therapy is a new solution. It treats a breast cancer tumor during surgery in a single dose, reducing time and cost spent on treatment.

10. New drug for heart failure

About 5.1 million people in the United States suffer from heart failure, according to the National Heart, Lung and Blood Institute. It is managed with a combination of drugs, but a new drug, angiotensin-receptor neprilysin inhibitor, has been granted fast-track status by the FDA because of its ability to cut the risk of dying from heart failure more effectively than current treatments.

For more information on the annual medical innovations list, including descriptions and videos, download the "Innovations" app or visit the website. A "where is it now" feature also includes updates on innovations that made the top 10 list in prior years.

"We look in past to see what we voted on to improve the process," Roizen said. "With one exception, we've been pretty good."

Source: www.cnn.com

Topics: technology, healthcare, health care, future, medical, cancer, vaccine, patient care, medicine, testing, treatments, innovations, diseases

Google[x] Reveals Nano Pill To Seek Out Cancerous Cells

Posted by Erica Bettencourt

Wed, Oct 29, 2014 @ 03:11 PM

By Sarah Buhr

BBbKI0E

Detecting cancer could be as easy as popping a pill in the near future. Google’s head of life sciences, Andrew Conrad, took to the stage at the Wall Street Journal Digital conference to reveal that the tech giant’s secretive Google[x] lab has been working on a wearable device that couples with nanotechnology to detect disease within the body.

“We’re passionate about switching from reactive to proactive and we’re trying to provide the tools that make that feasible,” explained Conrad. This is a third project in a series of health initiatives for Google[x]. The team has already developed a smart contact lens that detects glucose levels for diabetics and utensils that help manage hand tremors in Parkinson’s patients.

The plan is to test whether tiny particles coated “magnetized” with antibodies can catch disease in its nascent stages. The tiny particles are essentially programmed to spread throughout the body via pill and then latch on to the abnormal cells. The wearable device then “calls” the nanoparticles back to ask them what’s going on with the body and to find out if the person who swallowed the pill has cancer or other diseases.

“Think of it as sort of like a mini self-driving car,” Conrad simplified with a clear reference to Google[x]‘s vehicular project. “We can make it park where we want it to.” Conrad went on with the car theme, saying the body is more important than a car and comparing our present healthcare system as something that basically only tries to change our oil after we’ve broken down. “We wouldn’t do that with a car,” he added.

Bikanta’s tiny diamonds luminesce cells in the body.

Similar to Y Combinator-backed Bikanta, the cells can also fluoresce with certain materials within the nanoparticles, helping cancer cells to show up on an MRI scan much earlier than has been possible before.

This has all sorts of implications in medicine. According to a separately released statement from Google today, “Maybe there could be a test for the enzymes given off by arterial plaques that are about to rupture and cause a heart attack or stroke. Perhaps someone could develop a diagnostic for post-surgery or post-chemo cancer patients – that’s a lot of anxious people right there (note: we’d leave this ‘product development’ work to companies we’d license the tech to; they’d develop specific diagnostics and test them for efficacy and safety in clinical trials.”

We essentially wouldn’t need to go into the doctor and give urine and blood samples anymore. According to Conrad, we’d simply swallow a pill and monitor for disease on a daily basis. We’d also be able to upload that data into the cloud and send it to our doctor. “So your doctor could say well for 312 days of this year everything looks good but these past couple of months we’re detecting disease,” Conrad said.

Privacy and security, particularly in health care is essential. Google came under fire in the last couple of years for handing over information to the U.S. government. Conrad was quick to mention that a partner, not Google would be handling individual data. “It’d be like saying GE is in control of your x-ray. We are the creators of the tech and they are the disseminators,” Conrad clarified.

The U.S. government has an active interest in this space, as well. It’s invested over $20 billion in nanotechnology research since 2013.

This project is in the exploratory phases but Conrad was hopeful that we’d be seeing this technology in the hands of every doctor within the next decade. He also mentioned that his team has explored ways of not just detecting abnormal cells but also delivering medicine at the same time. “That’s certainly been discussed,” he said, but cautioned that this was something that needed to be carefully developed so that the nanoparticles had a chance to show what was happening in the body before destroying the cells.

So far 100 Google employees with expertise in astrophysics, chemistry and electrical engineering have taken part in the nanoparticle project. “We’re trying to stave off death by preventing disease. Our foe is unnecessary death,” Conrad added.

Source: www.msn.com

Topics: technology, health, healthcare, research, Google, disease, medical, cancer, nano pill, cancerous cells

Diet Stops Seizures When Epilepsy Drugs Fail

Posted by Erica Bettencourt

Wed, Oct 29, 2014 @ 02:48 PM

By JESSICA FIRGER

jackson small

When Jackson Small began having seizures at 7, his parents hoped and assumed at least one of the many epilepsy drugs on the market would be enough to get things under control. But one seizure quickly spiraled to as many as 30 a day.

"He would stop in his tracks and not be aware of what was going on for 20 or 30 seconds or so," his mother Shana Small told CBS News. Jackson was eventually diagnosed with juvenile myoclonic epilepsy, a type of epilepsy characterized by brief but often frequent muscle jerking or twitching.

But a number of medications typically prescribed to patients with this type of epilepsy were not effective. And so the quest to help Jackson gain control over his seizures led the family from their home in Orlando, Florida, to the office of a registered dietician at the NYU Langone Comprehensive Epilepsy Center in New York City.

They were there to discuss the medical benefits of heavy cream, mayonnaise, eggs, sausage, bacon and butter.

A lot of butter.

The plan was to treat Jackson with a diet that is heavy in fat, low in protein and includes almost no carbohydrates. It's known as the ketogenic diet and has long been in the arsenal of last-resort options for patients with epilepsy who are unresponsive to medication. Doctors may recommend a patient go on this special diet after unsuccessfully trying two or three prescriptions.

The diet works by putting the body in a "fasting" state, known as ketosis. "When we're fasting the body needs to find fuel so our body will break down fat storage and break down their own fat and enter a state of ketosis," Courtney Glick, the registered dietician who coordinated and fine-tuned Jackson's diet plan, told CBS News. "But with this diet, instead of breaking down the body's fat, the body breaks down dietary fat."

The ketogenic diet consists of as much as 90 percent fat. Some patients who feel they can't make such an extreme change adopt a modified Atkins diet, which is between 65 and 70 percent fat. It can be nearly as effective for controlling seizures, though every patient is different.

Though experts don't know everything about why this diet is effective for seizure control, they do know that eating mostly fat causes the body to fuel on ketones rather than glucose, which ultimately lowers insulin levels. This can have an anti-inflammatory effect on the body and may prevent seizures by calming the brain, said Glick.

One study by researchers at Dana-Farber Cancer Institute and Harvard Medical School found that a child's ability to stave off seizures is tied to a protein that affects metabolism in the brain. The protein, called BCL-2-associated Agonist of Cell Death, or BAD, also regulates metabolism of glucose. The researchers discovered that by modifying this, they switched metabolism in brain cells from glucose to ketone bodies, which are fat byproducts.

Glick said the diet plan didn't work for Jackson until he tried the most strict version, which was a 4 to 1 ratio of fat to protein and carbohydrates. Each day, he ate approximately 160 grams of fat, 8 to 10 grams of carbohydrates and 30 grams of protein, all of which amounted to about 1,700 calories a day.

Four months into the program, Jackson was seizure-free. He remained on the strict diet for two years with no return of seizures. His mother prepared foods from special recipes such as "keto" pizza made with a macadamia nut crust or chicken nuggets with coconut flour.

Over the summer -- after receiving a green light from his doctors -- Jackson, now 10 years old, began to wean himself off the diet, and his mother has slowly introduced foods such as breads and ice cream. He has maintained seizure-free and takes very little anti-seizure medication.

Research has found that for pediatric patients the anti-seizure effects of the diet often continue long after the child stops following the food plan, though the reason why remains unclear. This is typically not the case for adults, who may need to stay on the diet for life in order to control seizures.

"We've probably seen more kids go on the diets than adults, and adults are really set on their eating patterns," said Glick, adding that social obligations can make the diet difficult to fit into a grown person's lifestyle.

Jackson's mother said his doctors are hopeful that in the near future he may no longer need medication -- or a keto diet -- to stay seizure-free. "I think it's taught him a very important lesson about how food is as important as medicine, and how food affects the chemistry of your body," she said.

Source: www.cbsnews.com and http://www.dana-farber.org/

Topics: health, healthcare, health care, medication, children, diet, medical, food, seizures, Epilepsy

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