DiversityNursing Blog

By: ActiveBeat Author

Several researchers believe that a significant heart problem could represent a critical factor in determining Ludwig van Beethoven’s success in music.

Many people are aware that, when he died in 1827, Beethoven was deaf. But he also struggled with a serious heart condition known as arrhythmia, or an irregular heartbeat. (It’s also worth noting that experts suspect Beethoven was suffering from cirrhosis of the liver, lead poisoning, and syphilis when he passed away.)

Joel D. Howell, an internal medicine specialist, says he believes this irregular heartbeat can be detected in Beethoven’s work. “When your heart beats irregularly from heart disease, it does so in some predictable patterns,” Howell says. “We think we hear some of those patterns in his music.”

The researchers also point to Beethoven’s String Quartet No. 13 in B flat major (Opus 130), which they say features “a short paroxysm of atrial tachyarrhythmia.” Beethoven even wrote that the song should be played with a “heavy heart”.

Howell and the other researchers recognize that their findings will encounter skepticism. However, they feel that, “in highly charged passages of certain pieces, the possibility of cardiac arrhythmia can lend a quite physical aspect to one’s interpretation of the music in question. These passages can seem, in an unexpected literal sense, to be heartfelt.”

Source: www.activebeat.com

A paralysed woman who controlled a robotic arm using just her thoughts has taken another step towards restoring her natural movements by controlling the arm with a range of complex hand movements.

Thanks to researchers at the University of Pittsburgh, Jan Scheuermann, who has longstanding quadriplegia and has been taking part in the study for over two years, has gone from giving "high fives" to the "thumbs-up" after increasing the manoeuvrability of the robotic arm from seven dimensions (7D) to 10 dimensions (10D).

The extra dimensions come from four hand movements--finger abduction, a scoop, thumb extension and a pinch--and have enabled Jan to pick up, grasp and move a range of objects much more precisely than with the previous 7D control.

It is hoped that these latest results, which have been published today, 17 December, in IOP Publishing's Journal of Neural Engineering, can build on previous demonstrations and eventually allow robotic arms to restore natural arm and hand movements in people with upper limb paralysis.

Jan Scheuermann, 55, from Pittsburgh, PA had been paralysed from the neck down since 2003 due to a neurodegenerative condition. After her eligibility for a research study was confirmed in 2012, Jan underwent surgery to be fitted with two quarter-inch electrode grids, each fitted with 96 tiny contact points, in the regions of Jan's brain that were responsible for right arm and hand movements.

After the electrode grids in Jan's brain were connected to a computer, creating a brain-machine interface (BMI), the 96 individual contact points picked up pulses of electricity that were fired between the neurons in Jan's brain.

Computer algorithms were used to decode these firing signals and identify the patterns associated with a particular arm movement, such as raising the arm or turning the wrist.

By simply thinking of controlling her arm movements, Jan was then able to make the robotic arm reach out to objects, as well as move it in a number of directions and flex and rotate the wrist. It also enabled Jan to "high five" the researchers and feed herself dark chocolate.

Two years on from the initial results, the researchers at the University of Pittsburgh have now shown that Jan can successfully manoeuvre the robotic arm in a further four dimensions through a number of hand movements, allowing for more detailed interaction with objects.

The researchers used a virtual reality computer program to calibrate Jan's control over the robotic arm, and discovered that it is crucial to include virtual objects in this training period in order to allow reliable, real-time interaction with objects.

Co-author of the study Dr Jennifer Collinger said: "10D control allowed Jan to interact with objects in different ways, just as people use their hands to pick up objects depending on their shapes and what they intend to do with them. We hope to repeat this level of control with additional participants and to make the system more robust, so that people who might benefit from it will one day be able to use brain-machine interfaces in daily life.

"We also plan to study whether the incorporation of sensory feedback, such as the touch and feel of an object, can improve neuroprosthetic control."

Commenting on the latest results, Jan Scheuermann said: ""This has been a fantastic, thrilling, wild ride, and I am so glad I've done this."

"This study has enriched my life, given me new friends and co-workers, helped me contribute to research and taken my breath away. For the rest of my life, I will thank God every day for getting to be part of this team."

Source: www.sciencedaily.com

By Marie Ellis

Imagine swallowing a pill with tiny needles instead of getting an injection. Then again, imagine swallowing a pill with tiny needles. It may sound painful, but according to the researchers who developed the novel capsule - which could replace painful injections - there are no harmful side effects.

The researchers, from the Massachusetts Institute of Technology (MIT) and Massachusetts General Hospital (MGH), have published the results of their study - which tested the microneedle pill in the gastrointestinal (GI) tracts of pigs - in the Journal of Pharmaceutical Sciences.

Though most of us would probably prefer swallowing a pill over having an injection, many drugs cannot be given in pill form because they are broken down in the stomach before being absorbed.

Biopharmaceuticals made from large proteins, such as antibodies - known as "biologics" - are used to treat cancer, arthritis and Crohn's disease, and also include vaccines, recombinant DNA and RNA.

"The large size of these biologic drugs makes them nonabsorbable," explains lead author MIT graduate student Carl Schoellhammer. "And before they even would be absorbed, they're degraded in your GI tract by acids and enzymes that just eat up the molecules and make them inactive."

In an effort to design a capsule that is capable of delivering a wide range of drugs - while preventing degradation and effectively injecting the medicine into the GI tract - Schoellhammer and colleagues constructed the capsule from acrylic, including a reservoir for the drug that is coated with hollow, 5 mm long needles made of stainless steel.

The capsule measures 2 cm long and 1 cm in diameter.

Needle capsule worked safely and effectively in pigs

The team notes that previous studies involving humans who have accidentally swallowed sharp objects have suggested swallowing a capsule coated with short needles could be safe. They explain that there are no pain receptors in the GI tract and that, as a result, patients would not feel any pain.

But to assess whether their capsule could safely and effectively deliver the drugs, the researchers tested the pill in pigs, using insulin in the drug reservoir.

The capsules took more than a week to move through the whole digestive tract, and there were no traces of tissue damage, the researchers say. Additionally, the microneedles effectively injected insulin into the lining of the pigs' stomachs, small intestines and colons, which resulted in their blood glucose levels dropping.

Co-lead author Giovanni Traverso, a research fellow at MIT's Koch Institute for Integrative Cancer Research and gastroenterologist at MGH, notes that the pigs' reduction in blood glucose was faster and larger than the drop observed from insulin injection.

"The kinetics are much better and much faster-onset than those seen with traditional under-the-skin administration," he says. "For molecules that are particularly difficult to absorb, this would be a way of actually administering them at much higher efficiency."

'Oral delivery of drugs is a major challenge'

Though they used insulin for their tests in pigs, the researchers say they envision their capsule being used to deliver biologics to humans.

"This could be a way that the patient can circumvent the need to have an infusion or subcutaneous administration of a drug," says Traverso.

Prof. Samir Mitragotri, a professor at the University of California-Santa Barbara - who was not involved in the research - says:


"This is a very interesting approach. Oral delivery of drugs is a major challenge, especially for protein drugs. There is tremendous motivation on various fronts for finding other ways to deliver drugs without using the standard needle and syringe."

In terms of future modifications, the team plans to alter the capsule so that contractions of the digestive tract slowly squeeze the drug out of the capsule as it travels through the body, and they also want to make the needles out of degradable polymers and sugar that break off, becoming embedded in the gut lining and slowly disintegrating.

Source: http://www.medicalnewstoday.com

By: Healthday

Odds are small, but family, doctors should keep possibility in mind, researchers say.

Babies born prematurely appear to have a slightly increased risk of potentially fatal blood clots that they will carry into adulthood, Swedish researchers report.

Doctors have previously suspected that babies born earlier than 37 weeks' gestation have a raised risk of deep vein thrombosis and pulmonary embolism, two serious conditions caused by blood clotting in the veins, the researchers noted in background information.

This new study confirms that link, and takes it even further. Premature birth appears to be linked to an increased chance of blood clots in the veins in childhood and early adulthood, according to findings published online July 28 in the journal Pediatrics.

The researchers also reported that a baby's chances of blood clot-related illnesses are directly related to the degree of prematurity. "The more premature, the higher the risk," said Dr. Edward McCabe, chief medical officer of the March of Dimes. A full-term pregnancy lasts from 39 to 40 weeks.

While parents and doctors should keep this risk in mind, they should also be aware that the risk is not huge, said Dr. Kristi Watterberg, chair of the American Academy of Pediatrics' committee on the fetus and newborn. Watterberg and McCabe were not involved with the study.

The association between premature birth and clot risk seen in the study does not prove a cause-and-effect relationship.

The study involved 3.5 million babies born in Sweden between 1973 and 2008, including almost 207,000 born preterm. Out of all the births, only about 7,500 children -- 0.2 percent -- suffered either deep vein thrombosis or pulmonary embolism later in life.

"I think it's important scientifically to know, but it's such a low incidence phenomenon that there are a lot of things to think about before that," said Watterberg, a professor of pediatrics and neonatology at the University of New Mexico School of Medicine.

Deep vein thrombosis involves blood clots that form in a vein deep in the body. If these clots aren't treated and dissolved, they can break off and travel through the bloodstream to the lungs, causing a blockage called a pulmonary embolism. Such a blockage can be deadly.

For the study, Dr. Bengt Zoller, of the Center for Primary Health Care Research at Lund University in Malmo, Sweden, and colleagues used records from the Swedish Birth Registry to track the babies' health. The researchers found that premature babies had an increased risk of blood clots in their veins in infancy, but also from ages 1 to 5 and from 18 to 38.

Very preterm births -- before 34 weeks of gestation -- also had a risk of blood clot-related illness in adolescence, from age 13 to 17.

Boys had an increased risk of blood clots in infancy, while girls were more likely to carry the risk into adolescence and adulthood, the study authors reported.

No one knows why this increased risk exists, but it could be due to genetic factors that caused the mother to deliver prematurely in the first place, Watterberg and McCabe said.

Diseases such as diabetes, thyroid problems and obesity are genetic in nature and can cause preterm delivery, McCabe said.

Also, some mothers who suffer a genetic deficiency in a key protein that controls blood clotting may be predisposed to give birth prematurely, Watterberg said.

"It may be that maternal genetics are a setup for preterm delivery, and those problems are passed along to the infant," she said.

The mother's wellness and lifestyle also play a role in a baby's lifelong health, and could influence their risk of blood clots, McCabe said.

Finally, this link might arise because the babies are born prematurely, and are robbed of maternal hormones and nutrition in the womb that could have decreased their future risk of blood clots.

"We are not as good at getting nutrition into those babies as the mother and placenta are, and we do know that hormones have something to do with the predisposition to clotting," Watterberg said. "It makes sense to me you'd have changes in those long-term outcomes as well."

In any case, it is something for the family and doctor of a person born prematurely to keep in mind, McCabe said.

"If a patient has a history of preterm birth, and the more preterm, the more attention it needs to have," he said. "It helps us be better prepared. If a patient comes in with unusual findings, this provides us some clue."

Source: http://healthfinder.gov

By Robert Preidt

Surviving a life-threatening illness or injury may be more likely if you're treated at a busy emergency department instead of one that handles fewer patients, a new study finds.

Researchers analyzed data on 17.5 million emergency patients treated at nearly 3,000 hospitals across the United States. The overall risk of death in the hospital was 10 percent lower among those who initially went to the busiest emergency departments rather than to the least busy ones, the study found.

"It's too early to say that based on these results, patients and first responders should change their decision about which hospital to choose in an emergency," said the study's lead author, Dr. Keith Kocher, an assistant professor of emergency medicine at the University of Michigan Medical School.

"But the bottom line is that emergency departments and hospitals perform differently, there really are differences in care and they matter," he added.

The survival difference was even greater for patients with serious, time-sensitive conditions. Death rates were 26 percent lower for sepsis patients and 22 percent lower for lung failure patients who went to the busiest emergency departments, compared to those who went to the least busy ones.

Heart attack patients were also more likely to survive if they went to the busiest emergency departments, according to the study published July 17 in the journal Annals of Emergency Medicine.

If all emergency patients received the kind of care provided at the busiest emergency departments, 24,000 fewer patients would die each year, the researchers said.

The finding held even when the researchers accounted for differences in the patients' health, income level, hospital location and technology, they said.

But the study wasn't designed to look into the reasons for the finding; it only found an association between better survival rates and busier ERs.

"The take-home message for patients is that you should still call 911 or seek the closest emergency care, because you don't know exactly what you're experiencing. What makes one hospital better than another is still a black box, and emergency medicine is still in its infancy in terms of figuring that out," Kocher said in a university news release.

"For those who study and want to improve emergency care and post-emergency care, we hope these findings will inform the way we identify conditions in the pre-hospital setting, where we send patients, and what we do once they arrive at the emergency department and we admit them to an inpatient bed," he added.

Source: http://www.medicinenet.com

By Serusha Govender and Sara Cheshire

(CNN) -- Do you tend to forget things when you're stressed? Like when you're late for a meeting and can't remember where you left your car keys? Or when you have to give a big presentation and suddenly forget all your talking points seconds before you start?

There's nothing like stress to make your memory go a little spotty. A 2010 study found that chronic stress reduces spatial memory: the memory that helps you recall locations and relate objects.

Hence, your missing car keys.

University of Iowa researchers recently found a connection between the stress hormone cortisol and short-term memory loss in older rats. Their findings, published in the Journal of Neuroscience this week, showed that cortisol reduced synapses -- connections between neurons -- in the animals' pre-frontal cortex, the area of the brain that houses short-term memory.

But there's a difference between how your brain processes long-term job stress, for example, and the stress of getting into a car accident. Research suggests low levels of anxiety can affect your ability to recall memories; acute or high-anxiety situations, on the other hand, can actually reinforce the learning process.

Acute stress increases your brain's ability to encode and recall traumatic events, according to studies. These memories get stored in the part of the brain responsible for survival, and serve as a warning and defense mechanism against future trauma.

If the stress you're experiencing is ongoing, however, there can be devastating effects.

Neuroscientists from the University of California, Berkeley,found that chronic stress can create long-term changes in the brain. Stress increases the development of white matter, which helps send messages across the brain, but decreases the number of neurons that assist with information processing.

The neuroscientists say the resulting imbalance can affect your brain's ability to communicate with itself, and make you more vulnerable to developing a mental illness.

Defects in white matter have been associated with schizophrenia, chronic depression, bipolar disorder, obsessive-compulsive disorder and post-traumatic stress disorder. Research on post-traumatic stress disorder further shows that it can reduce the amount of gray matter in the brain.

The Berkeley researchers believe their findings could explain why young people who are exposed to chronic stress early in life are prone to learning difficulties, anxiety and other mood disorders.

To reduce the effects of stress, the Mayo Clinic recommends identifying and reducing stress triggers. Eating a healthy diet, exercising, getting enough sleep and participating in a stress-reduction activity such as deep breathing, massage or yoga, can also help.

Stress may harm the brain, but it recovers.

Source: www.cnn.com