#Telehealth consults improve child abuse exams Telehealth consultations for clinicians at rural hospitals improve their ability to provide forensic examinations for sexual abuse, according to new research.
Published in the journal Child abuse & Neglect, the study shows that clinicians with access to expert nurses provided more thorough
and to make an accurate diagnosis. roviding telehealth support really improves the quality of these forensic exams,
a forensic nurse practitioner and research nurse at the Betty Irene Moore School of nursing at University of California,
Davis."The assumption that hospital nurse staffing can be reduced to save money, without adversely affecting patient outcomes, may be foolish at best
istockphoto) University of Southampton Nurse staffing, education tied to hospital death rate ith this technology, we can help children who might otherwise not receive this level of care.
Provided by advanced practice nurse practitioners and sexual assault nurse examiners with more than 10 years of experience evaluating abuse,
many examiners are prone to assess normal variations as injuries from trauma. n the other hand,
eliminating the added stress for children of having to testify in court. Telehealth offers support and built-in peer review for nurses, physicians,
and other clinicians practicing in relative isolation. The telehealth network uses secure teleconferencing equipment to link UC Davis nurses with rural clinicians.
The systems provide video and audio as well as images from colposcopes (magnifying devices used to examine genitalia) and other equipment.
This advanced technology essentially puts expert nurses in the room with examining clinicians. TELEHEALTH NETWORK To test whether telehealth improved care, the researchers brought in independent experts to review examinations from eight rural hospitals, five
of which had access to telehealth consults. The experts reviewed the health records for 183 patients, 101 of
whom were treated at telehealth hospitals, evaluating the thoroughness, accuracy, and overall quality of these exams.
and accuracy scores were all significantly higher in the telehealth hospitals. The team hopes these findings will spur other hospitals to expand their telehealth capabilities. f we create a statewide network,
we can really improve the quality of these exams in rural communities, says Miyamoto. e can provide a service for many children who don receive this level of care
Mark twain Medical center, Northern Nevada Medical center, and the California Department of public health Material, Child & Adolescent Health Program.
It also has the potential to inspect food and even scan for tumors. Junichiro Kono a physicist at Rice university says the potential to replace magnetic resonance imaging (MRI) technology in screening for cancer
and other diseases is one of the most exciting possible applications. The potential improvements in size ease cost and mobility of a terahertz-based detector are phenomenal Kono says.
With this technology you could conceivably design a handheld terahertz detection camera that images tumors in real time with pinpoint accuracy.
And it could be done without the intimidating nature of MRI technology. Because terahertz waves are much smaller in energy than visible light finding materials that absorb
249 men from 14 fertility clinics in the UK and asked them to fill out detailed questionnaires about their medical history and their lifestyle.
yet faced with a diagnosis of poor sperm morphology, many men are concerned to try and identify any factors in their lifestyle that could be causing this,
in which immune system decline contributes to increased susceptibility to disease as we age. By outlining how prolonged fasting cycleseriods of no food for two to four days at a time over the course of six monthsill older and damaged immune cells
Prolonged fasting also lowered levels of IGF-1, a growth-factor hormone that Longo and others have linked to aging, tumor progression,
and cancer risk. KA is the key gene that needs to shut down in order for these stem cells to switch into regenerative mode.
assistant professor of clinical medicine at the USC Norris Comprehensive Cancer Center and Hospital. ore clinical studies are needed,
The V Foundation and the National Cancer Institute of the National institutes of health funded the clinical trails I
explains Chay Kuo, an assistant professor of cell biology, neurobiology and pediatrics at Duke university. In a study with mice, his team found a previously unknown population of neurons within the subventricular zone (SVZ) neurogenic niche of the adult brain, adjacent to the striatum.
Studies of stroke injury in rodents have noted SVZ cells apparently migrating into the neighboring striatum.
They reported that interestingly in Huntington disease patients, this area seems to lack the newborn interneurons. his is a very important and relevant cell population that is controlling those stem cells,
He says perhaps there will be a way to combine behavioral therapy and stem cell treatments after a brain injury to rebuild some of the damage.
The questions ahead are both upstream from the new Chat+neurons and downstream, Kuo says.
and punches its way into cells Researchers have discovered how the deadly Ebola virus disease that many fear may be used for bioterrorismmashes its way into healthy cells and turns them into virus factories.
and also identifies an important target to block the infection process. After Ebola is engulfed by the cell,
The result is a remarkable new understanding of Ebola infection. By understanding the process, researchers say they are significantly closer to being able to stop Eboland perhaps other viruses with similar structures as well. nce you have visualized the molecular shape changes that these structures undergo upon cell entry,
Researchers say the new optical approach is ideal for children and for patients with electronic implants, such as pacemakers, cochlear implants,
and deep brain stimulators that are used to treat Parkinson disease. The magnetic fields in magnetic resonance imaging (MRI) often disrupt either the function or safety of implanted electrical devices.
associate professor of radiology at Washington University in St louis. t roughly akin to spotting the rush of blood to someone cheeks
and monitor brain disease and therapy. Portable scans Another commonly used method for mapping brain function is positron emission tomography (PET),
multiple scans performed over time could be used to monitor the progress of patients treated for brain injuries, developmental disorders such as autism,
neurodegenerative disorders such as Parkinson, and other diseases. Unlike fmri and PET, DOT technology is designed to be portable,
so it could be used at a patient bedside or in the operating room. ith the new improvements in image quality, DOT is moving significantly closer to the resolution
and when the heart is stopped temporarily during cardiac surgery. Better image quality For the current study, published online in Nature Photonics,
Researchersinterests in these networks have grown enormously over the past decade as the networks have been tied to many different aspects of brain health and sickness, such as schizophrenia, autism and Alzheimer disease.
going forward, could make optical neuroimaging much more useful in research and the clinic. While DOT doesn let scientists peer very deeply into the brain,
The National institutes of health, Autism Speaks, a Fulbright Science and Technology Phd Award, and a Mcdonnell Centre for Systems neuroscience grant funded the research s
#How an app might help screen kids for autism A new video analysis tool may help spot early signs of autism.
tracks and records infantsactivity during videotaped autism screening tests. Results show the program is as effective at spotting behavioral markers of autism as experts giving the test themselves,
and the software performs better than non-expert medical clinicians and students in training. ee not trying to replace the experts,
says Jordan Hashemi, a graduate student in computer and electrical engineering at Duke university. ee trying to transfer the knowledge of the relatively few autism experts available into classrooms and homes across the country.
We want to give people tools they don currently have because research has shown that early intervention can greatly impact the severity of the symptoms common in autism spectrum disorders.
THREE TESTS The study focused on three behavioral tests that can help identify autism in very young children.
In one test, an infant attention is drawn to a toy being shaken on the left side
GENERAL PRACTITIONERS he great benefit of the video and software is for general practitioners who do not have trained the eye to look for subtle early warning signs of autism
says Amy Esler, an assistant professor of pediatrics and autism researcher at the University of Minnesota,
which will appear online in the journal Autism Research and Treatment. he software has the potential to automatically analyze a child eye gaze, walking patterns,
Esler says. hese signs would signal to doctors that they need to refer a family to a specialist for a more detailed evaluation.
it could be useful immediately in homes and clinics. Neither, however, expects it to become widely usedot because clinicians, teachers,
which connects researchers from disparate fields to experts in computer programming to help analyze large data sets. ee currently working with autism experts at Duke Medicine to determine what sorts of easy tests could be used on just a computer
The research has shown that the earlier autism can be spotted, the more beneficial intervention can be.
If there is too much barrier damage before intravenous medicine is administered to a stroke patient, that medicine could seep out of the bloodstream and into the brain, causing major damage.
The drug tpa is given now to patients only within 4. 5 hours of a stroke onset
says study leader Richard Leigh, assistant professor of neurology and radiology at Johns hopkins university School of medicine. Described in the journal Stroke
the brain is open to infection, inflammation, and hemorrhage. Ischemic stroke patients are at risk of bleeding into the brain
when there is damage to the barrier. TIMING IS EVERYTHING In an ischemic stroke, a blood clot is stuck in a vessel, cutting off blood flow to a portion of the brain,
When patients come to the hospital within a few hours of suffering an ischemic stroke, doctors quickly give intravenous tpa,
hoping it will dissolve the clot without causing additional damage. In roughly 30 percent of stroke patients
however, there is already too much damage to the blood-brain barrier and the drug causes bleeding in the brain, severe injury,
But doctors haven known with any precision which patients are likely to suffer a drug-related bleed.
Most stroke patients, Leigh notes, don get to a hospital within the window for optimal tpa use
if he or she has visible bleeding before administering tpa. Leigh says his computer program, working with an MRI scan, can detect subtle changes to the blood-brain barrier that are otherwise impossible to see.
doctors should consider changing their practice. f we could eliminate all intracranial hemorrhages, it would be worth it,
the National Institute on Deafness and Other Communication Disorders, and the Seton Healthcare Family supported the research.
and efficacy requirements for using this wireless charging system in commercial medical devices. But it has the potential to eliminate bulky batteries
and lead to a type of medicine where physicians treat disease and alleviate pain with electronics instead of drugs. e need to make these devices as small as possible to more easily implant them deep in the body
and create new ways to treat illness and alleviate pain, says Ada Poon, assistant professor of electrical engineering at Stanford university.
and drug delivery systems to apply medicines directly to affected areas, Poon says. The work creates the potential to develop lectroceuticaltreatments as alternatives to drug therapies,
says William Newsome, professor of neurobiology and director of the Stanford Neurosciences Institute. Newsome, who was involved not in Poon experiments
Either way, far-field electromagnetic waves have been ignored as a potential wireless power source for medical devices. Near-field waves can be used safely in wireless power systems.
Some current medical devices like hearing implants use near-field technology. But their limitation is implied by the name:
In the experiment, Poon used her midfield transfer system to send power directly to tiny medical implants.
we can safely transmit power to tiny implants in organs like the heart or brain,
Theye hopeful it could be a tool to detect mood shifts in people with bipolar disordernd perhaps changes seen in conditions like PTSD and Parkinson disease.
because they hope it will yield a biological marker to prioritize bipolar disorder care to those who need it most urgently to stabilize their moodsspecially in regions of the world with scarce mental health services.
Bipolar disorder affects tens of millions of people worldwide, and can have devastating effects, including suicide. hese pilot study results give us preliminary proof of the concept that we can detect mood states in regular phone calls by analyzing broad features and properties of speech,
Because other mental health conditions also cause changes in a person voice the same technology framework developed for bipolar disorder could prove useful in everything from schizophrenia and posttraumatic stress disorder to Parkinson disease,
the researchers say. RESULTS SO FAR The first six patients all have a rapid-cycling form of Type 1 bipolar disorder
and a history of being prone to frequent depressive and manic episodes. The researchers showed that their analysis of voice characteristics from everyday conversations could detect elevated and depressed moods.
The researchers study patients as they experience all aspects of bipolar disorder mood changes from mild depressions and hypomania (mild mania) to full-blown depressed and manic states.
Over time, they hope to develop software that will learn to detect the changes that precede the transitions to each of these states.
Applications for HIV and cancer In a random access memory chip, similar logic circuits manipulate electrons on a nanometer scale, controlling billions of compartments in a square inch.
As an example, Yellen points to cells afflicted by HIV or cancer. In both diseases, most afflicted cells are active
and can be targeted by therapeutics. A few rare cells, however, remain dormant, biding their time and avoiding destruction before activating
and bringing the disease out of remission. With the new technology, the researchers hope to watch millions of individual cells,
pick out the few that become dormant, quickly retrieve them and analyze their genetic activity. aybe then we could find a way to target the dormant cells,
ur technology can offer new tools to improve our basic understanding of cancer metastasis at the single cell level,
That process, known as syneresis, defeats the purpose of defining the space doctors hope to fill with new tissue. f the transition gellation temperature is one or two degrees below body temperature
and a medical degree in a joint program with nearby Baylor College of Medicine. hese chemical crosslinks are attached by phosphate ester bonds,
the Keck Center Nanobiology Training program of the Gulf coast Consortia and the Baylor College of Medicine Medical scientist Training program supported the research.
The breakthrough of knowing where the gene pools that created your DNA were mixed last has massive implications for lifesaving personalized medicine
Medical screening Elhaik coauthor Tatiana Tatarinova developed a website making GPS accessible to the public. o help people find their roots,
an associate professor of research pediatrics at the Keck School of medicine of the University of Southern California. e were surprised by the simplicity and precision of this method.
this kind of screening has huge, important medical implications. The discovery of a certain genotype might indicate the potential for a genetic disease
and suggest that diagnostic testing be done. Also, as scientists learn more about personalized medicine, there is evidence that specific genotypes respond differently to medicationsaking this information potentially useful
when selecting the most effective therapy and appropriate dosage. The investigators are currently designing a study to correlate pharmacokineticshe time course of drug metabolismith genotype.
Additional researchers contributed to the study from Johns hopkins university University of Pennsylvania, University of Arizona, and other research institutions around the world.
For example, data analysis could detect motions associated with Parkinson disease at its onset. he application of stretchable electronics to medicine has a lot of potential,
it could be possible to catch health conditions before experiencing pain, discomfort, and illness. The National security Science and Engineering Faculty Fellowship of Energy
#Microchip could detect infection in artificial joints A tiny microchip could improve postoperative care for patients with knee replacements
and other surgical implants by detecting early signs of infection. Alexander Star, an associate professor of chemistry at the University of Pittsburgh, says the new chip,
will be able to alert doctors to encroaching bacterial infection, which causes acidosis, a drop in ph levels in nearby tissue.
and transmits the information to a radio frequency identification reader held by a doctor. The wirelessly powered chip can be attached to implants
and can stay in the body long term. One in 100 Americans has an artificial joint, Star says,
nd bacterial infections are a common complication of the implant. Infection can damage the body surrounding the implant,
and bacterial films, resistant to antibiotics, can colonize the implant itself. To catch infection early without having to resort to invasive measures could lead to faster treatment. his is a very attractive detection mechanism for monitoring the condition of the implant
Star says. t may alleviate the need for further surgical intervention. A paper on the chip appears online in Scientific Reports.
Star and his team have developed similar chip/nanotube sensors that can be affixed to a toothbrush to detect bad breath (the presence of hydrogen sulfide)
and another that can identify the beginning of an asthma attack by measuring nitric oxide. Another Star-developed chip measures acetone in breath, an indicator of diabetes.
A National Energy technology Laboratory grant supported the research
#Silly Putty component helps build carpet for stem cells The sponginess of the environment where human embryonic stem cells are growing affects the type of specialized cells they eventually become, a new study shows.
and potentially provide therapies for diseases such as amyotrophic lateral sclerosis (Lou Gehrig disease), Huntington, or Alzheimer. In the specially engineered growth systemhe arpetsfu
Fu is collaborating with doctors at the University of Michigan Medical school. Eva Feldman, professor of neurology, studies amyotrophic lateral sclerosis, or ALS.
It paralyzes patients as it kills motor neurons in the brain and spinal cord. Researchers like Feldman believe stem cell therapiesoth from embryonic and adult varietiesight help patients grow new nerve cells.
discoveries like this provide tools for modeling disease in the laboratory and for developing cell-replacement therapies.
and preventing tumor growth. Fu says his findings could also provide insights into how embryonic stem cells differentiate in the body. ur work suggests that physical signals in the cell environment are important in neural patterning,
of the H1n1 flu virus. Flu epidemics cause up to half a million deaths each year, and emerging strains continually threaten to spread to humans and cause even deadlier pandemics.
The findings, published in Immunity, pave the way for an urgently needed therapy that is highly effective against the flu virus
and potentially other viral infections. rugs that specifically target PGE2 pathways have already been developed and tested in animals,
so our results have excellent potential for clinical translation, not only for the treatment of influenza,
but other viral respiratory infections that interact with similar host immune pathways, says senior author Maziar Divangahi, an assistant professor in the Faculty of medicine at Mcgill University.
Despite the worldwide use of vaccination and other antiviral interventions, the flu virus remains a persistent threat to human health.
To investigate molecular pathways that could be targeted by new interventions, Divangahi and his team focused on drugs such as aspirin and ibuprofen,
and fever. ut since these drugs inhibit all prostanoids, each may contribute differently towards the immunity against influenza virus,
says Francois Coulombe, a Mcgill Phd student and the study first author. nderstanding their individual role is crucial in developing a new therapy.
Divangahi research team found that mice genetically engineered to lack a member of the prostanoid family,
PGE2, showed remarkably enhanced immunity to flu infection. Most importantly, the vast majority of these mice infected with a lethal dose of the H1n1 flu virus survived.
and produced better survival rates following infection with a lethal dose of the flu virus compared with untreated mice. revious studies produced conflicting results due to the inhibition of all prostanoids
and that specific inhibition of PGE2 will be an effective therapy against influenza viral infection by boosting immune responses. i
When an influenza virus infects a human cell, it uses some of the host cellular machinery to make copies of itself,
FAST-SPREADING EPIDEMICS The need for new antiviral drugs against the influenza virus is great.
Because flu vaccines are not 100 percent effective, antiviral drugs play an important role in fast-spreading epidemics.
Yet Influenza a viruses are developing resistance to antiviral drugs currently in use. Krug and his team discovered that the viral NS1 protein is associated often,
#New clues to why RSV sends babies to the hospital Researchers have pinpointed a viral protein that plays a major role in making respiratory syncytial virus (RSV) the most common cause of hospitalization in children under one
and potential treatments for an infection that strikes nearly all children before they reach the age of three
and causes severe disease in 3 percent of infected children. RSV infection leads to the hospitalization of between 75,000 and 125,000 babies under one year of age in the United states every year.
Globally RSV is the second-leading cause of infant mortality due to infectious disease behind only malaria. ee known for a long time that RSV has increased an propensity,
compared to other respiratory viruses, for causing obstruction and inflammation in the narrowest airways of the infant lung,
leading to severe bronchiolitis, says Raymond Pickles, associate professor of microbiology and immunology. ut what wee now shown is that RSV has increased an ability to cause airway obstruction because, during an RSV infection,
the virus expresses a specific RSV-encoded nonstructural protein, or NS2, in epithelial cells, causing the cells to shed from the airway lining and into the airway lumen.
and its effect on epithelial-cell shedding that makes RSV by far the most common cause of bronchiolitis in otherwise healthy young children.
and other common respiratory viruses that might account for the increased disease caused by RSV, Pickles says. e compared the ability of RSV
which compose the lining of the lung airway. ut comparing these consequences of infection did not provide hints as to why RSV and PIV3 produced such differences in disease severity.
though, that the epithelial cells infected by RSV looked very different during infection compared to those infected by PIV3.
They found that infection of the narrowest airways of the lung by PIV3 alone caused moderate levels of inflammation,
but after infection by PIV3 expressing RSV NS2, the epithelial cells lining the narrow airways were shed rapidly into the airway lumen.
what has been found in human infants who had died because of RSV infection. Pickles says convinced that the RSV NS2 gene is a major driver for the well-recognized increased ability of RSV to cause lung disease, especially in the extremely narrow small airways of human infants.
Pickles is now on the trail of a human biomarker that would tell doctors if an RSV-infected infant is at greater risk of developing severe lung disease.
A biomarker would be key in the development of a needed diagnostic tool and would aid clinical trials that aim to develop anti-RSV therapeutics.
TOO SICK TO SEND HOME? hen young children arrive at the hospital with an RSV infection,
it challenging and frustrating to guess which children you can safely send home, versus those you should admit to the hospital
because they might require supportive care in an intensive care unit, says Michelle Hernandez, a pediatric immunologist. ny information that will help us make these decisions not only helps us ensure that we provide the best care for these kids,
but also helps us use health care resources more wisely. Using animal models, Pickles has already found candidate molecular biomarkers that indicate
if the epithelial cells in the tiniest airways are expressing the RSV NS2 protein. He is now initiating studies to look for the same biomarkers in human infants infected with RSV f we can find biomarkers informing us that the most vulnerable parts of the lung have already been infected by RSV,
then it could be possible to identify much more quickly the children at more risk for developing severe lung disease
and to get those babies in a treatment protocol at an earlier time, he says.
Thwarting this shedding effect wouldn stop infection or stifle the typical symptoms of RSV infection
which are the most likely to be obstructed by cells shed during infection. This would lead to a less severe infection and fewer hospitalizations.
Suppressing the effects of the RSV NS2 protein may also allow our immune system more time to deal with the RSV infection before the small airways become clogged with cells shedding from the lining of the airway,
Pickles says. hese are questions we are aiming to answer in studies already underway
#Gastric banding treats diabetes in overweight people Gastric banding can play a vital role in the treatment of type 2 diabetes in people who are overweightot just those who are obese.
Monash University researchers found that weight loss surgery (gastric banding) for overweight people with diabetes had a profound impact on the illness. his is randomized the first controlled trial demonstrating that treatment of type 2 diabetes
in overweight people by substantial weight loss is safe and hugely beneficial, says Professor Paul Orien from Monash University Centre for Obesity Research and Education (CORE).
this study indicates a potentially attractive path for the overweight person with diabetes and for those providing the care.
The study, published in the Lancet Diabetes and Endocrinology, looked at people who suffered diabetes
The connection between excessive body weight and diabetes is well known, but while the benefits of weight loss for obese people suffering type 2 diabetes have been well document,
it has not been clear if those who were overweight would enjoy the same benefits.
The study enrolled 50 people with diabetes who were overweight but not obese, with a body mass index between 25 and 30. e provided a comprehensive program of multidisciplinary care to all of the participants,
Orien explains. he surgery was conducted as an outpatient procedure with no significant adverse effects. We were pleased to see was that after two years into the trial,
more than half of the banded group were in remission of their diabetes while only eight percent of the non banded group were in remission.
The results showed a strong relationship between the amount of weight loss and remission of diabetes
clearly showing that successful ways of reducing weight such as gastric banding should have a high priority in the treatment of diabetes e
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