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Screening May Not Lessen Domestic Violence

TUESDAY, Aug. 4 (HealthDay News) — Screening for domestic violence in doctors’ offices, clinics and hospitals does little to reduce subsequent incidents of violence, Canadian researchers have found.

Their study of 6,743 women, ages 18 to 64, was conducted in 11 emergency departments, 12 family practices and three obstetrics/gynecology clinics. Of the 3,271 women who completed a domestic violence screening questionnaire before seeing their doctor, 347 were found to have been abused. Of the 3,472 other women, 360 were found to have been abused.

If a woman screened positive for abuse, the information was given to her doctor before her health-care visit. Those in the other group completed the questionnaire after their health-care visit.

During the next 18 months, 46% of the women who had been screened before their health-care visit and 53% of the others reported a recurrence of domestic violence, which the researchers called intimate partner violence, or IPV. The difference was not statistically significant, the researchers said.

Women in the screened group showed more improvement in their quality of life and less depression than those in the non-screened group, although these differences also were not statistically significant, the researchers said. They found no differences in other health outcomes.

Both groups used domestic violence services at about the same rate, the study found.

The findings appear in the Aug. 5 issue of the Journal of the American Medical Association.

“We conclude … that these results do not provide sufficient evidence to support universal IPV screening in health-care settings in the absence of an effective intervention to prevent or reduce IPV, especially in the context of the resources required to conduct screening and to deal with the number of women identified by the screening tool,” Dr. Harriet L. MacMillan, of McMaster University in Hamilton, Ontario, Canada, and her research colleagues, said in a news release.

– Robert Preidt

SOURCE: Journal of the American Medical Association, news release, Aug. 4, 2009 Copyright © 2009 ScoutNews, LLC. All rights reserved.

Blood procedure allows kidney transplants, can help minorities

By Arthur Brice CNN 
 

WASHINGTON (CNN) ~ Surgeons at two Washington hospitals have performed seven kidney transplants involving 14 recipients and donors who did not match, using a process that virtually eliminates the chances of organ rejection.

The process, called plasmapheresis, can make it easier for underserved African-American patients to receive organs for transplant. Of the 80,000 people on the kidney transplant list, 36 percent are African-Americans but only 15 percent of living donor kidneys go to African-Americans. That discrepancy is caused, in large part, by a lack of suitable matching organs, the U.S. Department of Health and Human Services says. As a rule, people are genetically more similar to others who share their ethnicity or race than to people of other races.

Donor Larry McPhatter, 59, gets a hug from the recipient of his kidney, Dachia Pinkard, 39.

 The transplants were performed at Georgetown University Hospital and Washington Hospital Center over a four-day period in July.

 All of the patients were on kidney dialysis until the transplants.

 Because of their heightened immune systems, the patients were started on immunosuppressant drugs about a week before the surgeries, Melancon said. Transplant patients typically start on immunosuppressant therapy on the day of surgery, he said.

The patients also underwent two rounds of plasmapheresis before the surgery and two rounds afterward.

 One patient remained hospitalized Wednesday but is expected to be released next week Melancon told CNN.

McPhatter is wheeled into surgery. His wife was also part of the kidney transplant chain as a recipient.

 Six of the seven kidney recipients are African-American, as are five of the seven donors. The two Caucasian donors, a 29-year-old graduate student and a 60-year-old Catholic pastoral counselor, had no connection with the recipients.

 The other five donors were a spouse, a cousin, a brother, a sister and a friend of the recipients, Melancon said. But the donors did not necessarily give their kidneys to their relatives or friend. Who received which kidney from whom was determined by who was the best match.

Although minority donors tend to match better with minority recipients because of genetic similarities, the best match for the Caucasian recipient was an African-American donor, Melancon said.

 One of the patients had undergone two previous kidney transplants and two of the patients had received one transplant each, the surgeon said. One of those two had his first transplant at 2 years of age.

 The recipients range in age from 20 to 61 and the donors from 25 to 60.

 Kidney transplant patients typically stay in the hospital for about eight days after surgery. Because of the need for heightened immunosuppressant therapy and plasmapheresis, the patients in the Washington surgeries also were hospitalized for a week before the transplants. 

The transplants were performed at two hospitals over a four-day period in July

 The use of plasmapheresis is significant, Melancon said, because it increases the chances of African-Americans to receive life-saving organs. Plasmapheresis has been used in transplant surgery for about 10 years, the doctor said.

 The Washington area, which has a large African-American population, also has the highest rate of end-stage kidney failure in the United States, hospital officials said.

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 MayoClinic.com: Kidney transplant: When your kidneys fail African-Americans also stay on dialysis longer than Caucasians — five years versus three years — and therefore become more sensitized to antibodies from prospective donors and less able to receive transplanted organs. The filters in the dialysis machine activate the blood’s immune cells to become more sensitized, Melancon said.

 Patients who have been pregnant or have had prior transplants or blood transfusions also are more sensitized.

 African-Americans in general are more sensitized but scientists don’t know exactly why, Melancon said. The surgeon said he believes it’s because many African-Americans’ ancestors came from sub-Saharan Africa, where they were subjected to more infectious agents than, say, people in Europe. That could have sensitized Africans’ immune system to more antigens, he said.

In the Washington area, most minority patients wait five years or longer for a transplant, Melancon said.

   Want to see more of this amazing transplant?

 14 way Transplant - CNN’s Elizabeth Cohen explains a groundbreaking kidney transplant involving 14 people.”

© 2009 Cable News Network. Turner Broadcasting System, Inc.   All Rights Reserved.

Original Article HERE

Researchers Decode Structure of an Entire HIV Genome

Newswise — The structure of an entire HIV genome has been decoded for the first time by researchers at the University of North Carolina at Chapel Hill. The results have widespread implications for understanding the strategies that viruses, like the one that causes AIDS, use to infect humans.

The study, the cover story in the Aug. 6, 2009, issue of the journal Nature, also opens the door for further research which could accelerate the development of antiviral drugs.

HIV, like the viruses that cause influenza, hepatitis C and polio, carries its genetic information as single-stranded RNA rather than double-stranded DNA. The information encoded in DNA is almost entirely in the sequence of its building blocks, which are called nucleotides. But the information encoded in RNA is more complex; RNA is able to fold into intricate patterns and structures. These structures are created when the ribbon-like RNA genome folds back on itself to make three-dimensional objects.

Kevin Weeks, Ph.D., a professor of chemistry in UNC’s College of Arts and Sciences who led the study, said prior to this new work researchers had modeled only small regions of the HIV RNA genome. The HIV RNA genome is very large, composed of two strands of nearly 10,000 nucleotides each.

Weeks, who is also a member of the UNC Lineberger Comprehensive Cancer Center, and Joseph M. Watts, a chemistry postdoctoral fellow supported by the Lineberger Center, used technology developed by Weeks’ lab to analyze the architecture of HIV genomes isolated from infectious cultures containing trillions of viral particles that were grown by Robert Gorelick, Ph.D., and Julian Bess of the National Cancer Institute.

They then teamed up with UNC researchers in the College and the School of Medicine for further analysis: Christopher Leonard in the department of chemistry; Kristen Dang, Ph.D., from biomedical engineering; Ron Swanstrom, Ph.D., a professor of microbiology and immunology at UNC Lineberger; and Christina Burch, Ph.D., an associate professor of biology. They found that the RNA structures influence multiple steps in the HIV infectivity cycle.

“There is so much structure in the HIV RNA genome that it almost certainly plays a previously unappreciated role in the expression of the genetic code,” Weeks said.

Swanstrom and Weeks note that the study is the key to unlocking additional roles of RNA genomes that are important to the lifecycle of these viruses in future investigations.

“One approach is to change the RNA sequence and see if the virus notices,” Swanstrom said. “If it doesn’t grow as well when you disrupt the virus with mutations, then you know you’ve mutated or affected something that was important to the virus.”

Weeks added: “We are also beginning to understand tricks the genome uses to help the virus escape detection by the human host.”

The study was supported by the National Institutes of Health and the National Cancer Institute.

Abnormal Brain Circuits May Prevent Movement Disorder

Newswise — Most people who carry a genetic mutation for a movement disorder called dystonia will never develop symptoms, a phenomenon that has puzzled scientists since the first genetic mutation was identified in the 1990’s. Now, scientists at The Feinstein Institute for Medical Research have figured out why these mutation carriers are protected from symptoms of the disorder – they have an additional lesion that evens the score.

Dystonia is marked by uncontrolled movements, particularly twisting and abnormal postures. Studies have shown that muscles contract abnormally and patients can’t stop the involuntary movements. The identification of a specific abnormality in people with the genetic mutation who never develop symptoms could eventually pave the way towards new treatments for dystonia patients. There are half a million people in the United States alone. The brains of people with inherited dystonia are normal at autopsy and the exact cause of their movement abnormality is unknown.

David Eidelberg, MD, the senior author of the study published in the Journal of Neuroscience, said that they used diffusion tensor imaging – a type of magnetic resonance imaging (MRI) that measures changes in the integrity of white matter pathways in the brain – to study those with and without symptoms who carry the disease gene. There were 20 people in the study; 12 with symptoms and eight without. They also had a number of volunteers who agreed to brain scans who had no disease and no mutations in the gene for dystonia.

Dr. Eidelberg and his colleagues identified two discrete areas along the pathway that links the cerebellum to the motor cortex that together determine whether a mutation carrier will display clinical manifestations of the disease.

Their earlier work revealed that patients and non-patients with the disease gene have the same underlying functional brain abnormality, such as overactivity of motor circuits that make it hard to process sequential information. Nonetheless, mutation carriers have a characteristic circuit disorder involving a motor system that is revved up and idling at high speed, making it difficult to integrate the information needed to plan movements and to learn new motor skills. It was not suspected that these otherwise healthy individuals had such difficulties since doctors only saw those who presented with the uncontrollable movements.

While their brains show the same abnormal network, only approximately 30% of people who carry the mutated gene called DYT1 will develop the involuntary movements that can prevent them from living a normal life, according to Dr. Eidelberg.

The puzzle was why.

In the latest study, the new advances in diffusion imaging allowed them to see something for the first time. They saw that there were two places along the motor pathway that seemed to stop the flow of neural signals from one part of the circuit to the other. Those with only one lesion in the circuit developed the debilitating movements and those with two lesions did not. “There is something about this second lesion that is protective,” the authors concluded. “We found a consistent cerebellar pathway problem in all DYT1 carriers. When we went back and looked at those without symptoms, we saw that they had an additional lesion downstream in the portion of the pathway connecting directly to the motor cortex.” This second area of pathway disruption abrogated the effects of the first lesion.

Normally, the cerebellum (a region that controls movement) puts the breaks on the motor cortex by potentiating inhibition at the cortical level. It is likely that mutation carriers have a developmental problem in the flow of neural signals along this circuit such that the brain can’t inhibit an unwanted movement. With the second pathway lesion, Dr. Eidelberg explained, “the flow is shut off and the abnormal activity stops.”

The research was supported by the National Institutes of Health, the Bachmann-Strauss Dystonia and Parkinson Foundation, and the General Clinical Research Center, located at the Feinstein Institute.

About The Feinstein Institute for Medical Research Headquartered in Manhasset, NY, The Feinstein Institute for Medical Research is home to international scientific leaders in Parkinson’s disease, Alzheimer’s disease, psychiatric disorders, rheumatoid arthritis, lupus, sepsis, inflammatory bowel disease, diabetes, human genetics, leukemia, lymphoma, neuroimmunology, and medicinal chemistry. The Feinstein Institute, part of the North Shore-LIJ Health System, ranks in the top 6th percentile of all National Institutes of Health grants awarded to research centers. Feinstein researchers are developing new drugs and drug targets, and producing results where science meets the patient. For more information, please visit www.FeinsteinInstitute.org

© 2009 Newswise. All Rights Reserved.

Health Tip: Use Household Chemicals Safely

The Cleveland Clinic offers these safety suggestions when working with household chemicals:

• When using all-purpose cleaners in the kitchen or bathroom, always wear gloves, and open a window or turn on a fan to minimize inhalation of fumes.
• Be careful to avoid letting bleach touch your skin or splash in your eyes. Also, avoid breathing in the fumes.
• Never mix bleach with any other cleaner, especially anything that contains ammonia.
• When using an oven-cleaning product, fully protect yourself with goggles, gloves and long sleeves. Look for cleaners without lye, and make sure the area is well-ventilated.
• Antibacterial cleaning products can burn the skin, so make sure you wear gloves

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By HealthDay - Wed Mar 4, 8:47 PM PST

Alcohol-Branded Merchandise Ups Teen Drinking

SOURCE: Archives of Pediatrics & Adolescent Medicine, published online March 2, 2009

Reported March 5, 2009

Media Images of Alcohol Can Drive You to Drink

Doc-Patient Relationship May Be Key to Quality

Dog Bite Risk for Kids Greatest in Summer

It’s not clear why children are more likely to suffer dog bite injuries in the summer, but it may be because children spend more time outdoors playing with dogs in warmer months, the researchers suggested. Or it may be that dogs are generally more irritable in hot weather.

The study found that 27 percent of dog bite injuries were caused by family pets. The most common sites of bites to the head and neck were the cheeks (34 percent), lips (21 percent), and nose and ears (both 8 percent). Sixty-four percent of the children suffered dog bite wounds in more than one location, and the average wound size was 7.15 centimeters. Pit bulls were the breed most commonly involved in attacks.

The findings were published in the March issue of Otolaryngology — Head and Neck Surgery.

In the United States, dog bites account for about 1 percent of all emergency room visits, including 44,000 cases per year of facial injuries.

Implementation of more accurate and timely reporting of dog bites to local health officials can help educate medical professionals on how to identify dog bite trends and develop prevention strategies, the study authors said.

They recommended a system for uniform data collection that includes all the circumstances of the dog bite: signs of provocation; adequacy of child supervision; breed and sex of dog; spay-neuter status; history of prior aggression; dog restraint; time of event; patient’s previous history of dog bites; length of dog ownership; location where injury occurred; disposition of dog after the event; and dog’s vaccination history.

The researchers also said families need to be made aware that the risk of dog bites increases during the summer.

More information

The American Veterinary Medical Association offers advice on how to prevent dog bites.

Copyright © 2009 Yahoo! Inc. All rights reserved.

Title: Meat-Eating Dinosaurs Used Legs and Arms Like Birds
Category: Health News
Created: 3/5/2009 2:00:00 AM
Last Editorial Review: 3/5/2009