Sunday, January 3, 2010
Look Me in the Eye!
...Last night, I went to a well-attended New Year's party. In the crowded kitchen, I spied an old friend and his college-age daughter. Their eyes met; they seemed to be sharing a private joke, and I drank in the deep feelings of love and joy that passed between them.
From Susan Barry, PHd's Psychology Today blog:
This incident reminded me of a conversation I had had a few months ago. "What is it like to look someone in the eye?" a student (I'll call her Liz) had asked me. Liz is wall-eyed. When she looks at you, one eye turns out, giving you the impression that she is looking to the side. I told her that making eye contact could be pretty intense. It could indicate love, disapproval, or a plea for help. Sometimes, you may catch the eye of a stranger, the two of you exchanging a brief glance of mutual understanding, a shared feeling. No matter what the message, looking someone in the eye is a powerful way to connect. My student has been deprived of this way of connecting all her life.
Liz however is full of energy and optimism. In the fall, she began optometric vision therapy with a developmental optometrist in order to learn to straighten her eyes. Since her two eyes have not routinely looked at the same thing, she has been stereoblind. With vision therapy however, she is experiencing her first 3D views - a hand, for example, thrusting out toward her in space....
From Susan Barry, PHd's Psychology Today blog:
This incident reminded me of a conversation I had had a few months ago. "What is it like to look someone in the eye?" a student (I'll call her Liz) had asked me. Liz is wall-eyed. When she looks at you, one eye turns out, giving you the impression that she is looking to the side. I told her that making eye contact could be pretty intense. It could indicate love, disapproval, or a plea for help. Sometimes, you may catch the eye of a stranger, the two of you exchanging a brief glance of mutual understanding, a shared feeling. No matter what the message, looking someone in the eye is a powerful way to connect. My student has been deprived of this way of connecting all her life.
Liz however is full of energy and optimism. In the fall, she began optometric vision therapy with a developmental optometrist in order to learn to straighten her eyes. Since her two eyes have not routinely looked at the same thing, she has been stereoblind. With vision therapy however, she is experiencing her first 3D views - a hand, for example, thrusting out toward her in space....
Evidence lacking for special diets in autism
...More than 25 experts met in Boston in 2008 to write the consensus report after reviewing medical research. The Autism Society and other autism groups funded the effort but gave no input.
The report refutes the idea there's a digestive problem specific to autism called "leaky gut" or "autistic enterocolitis." The hypothesis was first mentioned in 1998 in a now-discredited study by Great Britain's Dr. Andrew Wakefield. His paper tied a particular type of autism and bowel disease to the measles vaccine....
The report refutes the idea there's a digestive problem specific to autism called "leaky gut" or "autistic enterocolitis." The hypothesis was first mentioned in 1998 in a now-discredited study by Great Britain's Dr. Andrew Wakefield. His paper tied a particular type of autism and bowel disease to the measles vaccine....
Texas Study Confirms Lower Autism Rate in Hispanics
...Hispanic kids are less likely than their non-Hispanic white counterparts to be diagnosed with autism, and socioeconomic factors don't seem to explain the difference, according to a new study in Texas schoolchildren.
"These findings raise questions: Is autism under diagnosed among Hispanics? Are there protective factors associated with Hispanic ethnicity?" ... Autism could be under diagnosed among Hispanics, ...
For every 10 percent increase in Hispanic schoolchildren in a given district, the researchers found, the prevalence of autism decreased by 11 percent, while the prevalence of kids with intellectual disabilities or learning disabilities increased by 8 percent and 2 percent, respectively....
"These findings raise questions: Is autism under diagnosed among Hispanics? Are there protective factors associated with Hispanic ethnicity?" ... Autism could be under diagnosed among Hispanics, ...
For every 10 percent increase in Hispanic schoolchildren in a given district, the researchers found, the prevalence of autism decreased by 11 percent, while the prevalence of kids with intellectual disabilities or learning disabilities increased by 8 percent and 2 percent, respectively....
Vision of success
...Ava Rayborn has 20/20 vision, but something was hampering her ability to learn. At age 5, she was held back in kindergarten and diagnosed with dyslexia, but a school transfer and extensive tutoring uncovered a hidden diagnosis. Instead of the learning disability that hampered her brain's ability to translate written images into language, she was diagnosed with convergence insufficiency, a misalignment of the eyes when focusing on nearby objects.
As one of the 50 best careers of 2010, this should have strong growth over the next decade
...They're often referred to as "doctors of optometry," ... Optometrists are healthcare professionals who treat a wide variety of eye problems. They prescribe lenses for nearsighted and farsighted people, diagnose and treat visual problems such a scratched cornea or glaucoma, and refer patients for laser-eye surgery, among other duties. Many optometrists specialize in particular areas—eye care for infants and the elderly is in high demand, for example, and some optometrists work with athletes on sports-related visual problems....The bottom 10 percent of optometrists earned less than $46,900, while the top earners made more than $166,400. The annual median wage in 2008 was $96,320.....
Less Education, More Asthma Symptoms
..."Lower educational achievement was associated with worse asthma control, greater emergency health service use, and worse asthma self-efficacy. Patients with less than 12 years of education were 55 percent more likely to report an asthma-related emergency health service visit in the last year."...
Ginkgo Doesn't Stop Cognitive Decline
...This analysis of data from the Ginkgo Evaluation of Memory (GEM) study follows the researchers' previous analysis that found that daily use of the supplement didn't reduce the incidence of Alzheimer's disease or dementia....
New study determines H1N1 is less contagious than other pandemics.
From AOA First Look:
The CBS Evening News (12/30, story 7, 0:25, Smith) briefly reported last night that a new study has concluded that the chances of being infected with the H1N1 virus by someone in your own home "are only about one in eight."
The AP (12/31, Marchione) points out that the study, conducted by scientists at the Imperial College London and from the US Centers for Disease Control and Prevention, has determined that the H1N1 virus is significantly less contagious than many of the viruses responsible for deadly outbreaks in the past. The research, published in Thursday's New England Journal of Medicine, studied infection patterns in 216 people with swine flu from around the United States and determined that indications of the virus appeared in only 13 percent of their households. Lyn Finelli, surveillance chief for the CDC's flu division, says that children "were twice as susceptible to catching swine flu as adults were, and even more so if they were younger than four." CBC News (12/31) reports that Finelli also said the study produced the "surprising" conclusion that adults were just as likely to spread the virus as children.
BBC News (12/31) reports lead researcher Dr Simon Cauchemez said the findings may indicate that the early recommendation that employers allow extended absences to accommodate sick employees "may be unnecessary and could be detrimental to the economy."
Officials continue to recommend H1N1 vaccinations in hopes of avoiding third wave. American Medical News (12/31, Moyer) reports that federal health officials continue to urge physicians to vaccinate their patients against swine flu in hopes of preventing a third wave of the virus. "Although the virus is on the downswing now, I don't think any of us think it's going to go away," said Nicole Lurie, MD, MSPH, assistant secretary for preparedness and response at HHS. Meanwhile, Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, said that next year's seasonal flu vaccine "could include the H1N1 strain, which could eliminate the need for two separate influenza immunizations."
Health officials say second wave is finished. The Minneapolis Star Tribune (12/31, Marcotty) reports that swine flu virus appears to be on the decline in Minnesota, as "state health officials said Wednesday that only one Minnesotan was hospitalized with H1N1 flu last week and that their 50 'sentinel' clinics around the state reported no patients with flu-like illness." Kris Ehresmann, head of immunizations for the Minnesota Department of Health, said it was "safe to say that the second wave is done," but said people should continue to brace for a resurgence of the virus.
The CBS Evening News (12/30, story 7, 0:25, Smith) briefly reported last night that a new study has concluded that the chances of being infected with the H1N1 virus by someone in your own home "are only about one in eight."
The AP (12/31, Marchione) points out that the study, conducted by scientists at the Imperial College London and from the US Centers for Disease Control and Prevention, has determined that the H1N1 virus is significantly less contagious than many of the viruses responsible for deadly outbreaks in the past. The research, published in Thursday's New England Journal of Medicine, studied infection patterns in 216 people with swine flu from around the United States and determined that indications of the virus appeared in only 13 percent of their households. Lyn Finelli, surveillance chief for the CDC's flu division, says that children "were twice as susceptible to catching swine flu as adults were, and even more so if they were younger than four." CBC News (12/31) reports that Finelli also said the study produced the "surprising" conclusion that adults were just as likely to spread the virus as children.
BBC News (12/31) reports lead researcher Dr Simon Cauchemez said the findings may indicate that the early recommendation that employers allow extended absences to accommodate sick employees "may be unnecessary and could be detrimental to the economy."
Officials continue to recommend H1N1 vaccinations in hopes of avoiding third wave. American Medical News (12/31, Moyer) reports that federal health officials continue to urge physicians to vaccinate their patients against swine flu in hopes of preventing a third wave of the virus. "Although the virus is on the downswing now, I don't think any of us think it's going to go away," said Nicole Lurie, MD, MSPH, assistant secretary for preparedness and response at HHS. Meanwhile, Anne Schuchat, MD, director of the CDC's National Center for Immunization and Respiratory Diseases, said that next year's seasonal flu vaccine "could include the H1N1 strain, which could eliminate the need for two separate influenza immunizations."
Health officials say second wave is finished. The Minneapolis Star Tribune (12/31, Marcotty) reports that swine flu virus appears to be on the decline in Minnesota, as "state health officials said Wednesday that only one Minnesotan was hospitalized with H1N1 flu last week and that their 50 'sentinel' clinics around the state reported no patients with flu-like illness." Kris Ehresmann, head of immunizations for the Minnesota Department of Health, said it was "safe to say that the second wave is done," but said people should continue to brace for a resurgence of the virus.
Study shows steady myopic shift in patients with strabismus and proper alignment
...Study data showed that the mean spherical equivalent among all patients was 1.62 D. Mean spherical equivalent was 1.10 D in the orthophoria group, 3.22 D in the esodeviation group and 1.13 D in the exodeviation group....
Comments: Watch those post strabismic surgery patients closely....especially those with esotropia for the development of significant myopia. Could accommodation be playing a major role in the development of the myopia? DM
Comments: Watch those post strabismic surgery patients closely....especially those with esotropia for the development of significant myopia. Could accommodation be playing a major role in the development of the myopia? DM
Multiple operations and poor adduction linked to development of exotropia
.....The patient cohort had a 21% incidence of consecutive exotropia. Patients who had undergone multiple operations had a greater risk of developing consecutive exotropia than those aligned with a single operation. The difference was statistically significant (P = .00036). Postoperative restriction of adduction and convergence correlated with a high risk of consecutive exotropia (P = .0437). ..
Comments: So tell me again why we are so quick to send out for strabismus surgery? DM
Comments: So tell me again why we are so quick to send out for strabismus surgery? DM
2009-2010 Influenza Season
2009-2010 Influenza Season; influenza activity continued to decrease during wk 49 (December 6-12, 2009)
All data are preliminary and may change as more reports are received
Synopsis
During week 49 (December 6-12, 2009), influenza activity continued to decrease in the U.S.
* 391 (6.9%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
* Over 99% of all subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses.
* The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold for the eleventh consecutive week.
* Nine influenza-associated pediatric deaths were reported. Eight of these deaths were associated with 2009 influenza A (H1N1) virus infection and one was associated with an influenza A virus for which the subtype was undetermined.
* The proportion of outpatient visits for influenza-like illness (ILI) was 2.6% which is above the national baseline of 2.3%. Five of the 10 regions reported ILI at or above region-specific baseline levels. Regions 3, 6, 7, 8 and 10 reported ILI below their region specific baselines.
* Eleven states reported geographically widespread influenza activity, 20 states reported regional influenza activity, the District of Columbia, Puerto Rico, and 11 states reported local influenza activity, the U.S. Virgin Islands and eight states reported sporadic influenza activity, and Guam reported no influenza activity.
All data are preliminary and may change as more reports are received
Synopsis
During week 49 (December 6-12, 2009), influenza activity continued to decrease in the U.S.
* 391 (6.9%) specimens tested by U.S. World Health Organization (WHO) and National Respiratory and Enteric Virus Surveillance System (NREVSS) collaborating laboratories and reported to CDC/Influenza Division were positive for influenza.
* Over 99% of all subtyped influenza A viruses being reported to CDC were 2009 influenza A (H1N1) viruses.
* The proportion of deaths attributed to pneumonia and influenza (P&I) was above the epidemic threshold for the eleventh consecutive week.
* Nine influenza-associated pediatric deaths were reported. Eight of these deaths were associated with 2009 influenza A (H1N1) virus infection and one was associated with an influenza A virus for which the subtype was undetermined.
* The proportion of outpatient visits for influenza-like illness (ILI) was 2.6% which is above the national baseline of 2.3%. Five of the 10 regions reported ILI at or above region-specific baseline levels. Regions 3, 6, 7, 8 and 10 reported ILI below their region specific baselines.
* Eleven states reported geographically widespread influenza activity, 20 states reported regional influenza activity, the District of Columbia, Puerto Rico, and 11 states reported local influenza activity, the U.S. Virgin Islands and eight states reported sporadic influenza activity, and Guam reported no influenza activity.
Lack of patient knowledge regarding hospital medications
...Inpatient medication errors represent an important patient safety issue. The magnitude of the problem is staggering, with 1 review finding almost 1 in every 5 medication doses in error, with 7% having potential for adverse drug events.[1] While mistakes made at the ordering stage are frequently intercepted by pharmacist or nursing review, administration errors are particularly difficult to prevent.[2] The patient, as the last link in the medication administration chain, represents the final individual capable of preventing an incorrect medication administration. It is perhaps surprising then that patients generally lack a formal role in detecting and preventing adverse medication administration events.[3]
There have been some ambitious attempts to improve patient education regarding hospital medications and involve selected patients in the medication administration process. Such initiatives may result in increased patient participation and satisfaction.[4-7] There is also potential that increased patient knowledge of their hospital medications could promote the goal of medication safety, as the actively involved patient may be able to catch medication errors in the hospital.
Knowledge of prescribed medications is a prerequisite to patient involvement in prevention of inpatient medication errors and yet there is little research on patient knowledge of their hospital medications. Furthermore, as the experience of hospitalization may be disorienting and disempowering for patients, it remains to be seen if patient attitudes toward participation in inpatient medication safety are favorable. To that end, we conducted a pilot study in which we assessed current patient awareness of their in-hospital medications and surveyed attitudes toward increased patient knowledge of hospital medications....
Comments: Read the whole article online by clicking the title. If patients do not know about the meds they are taking in a hospital....how much do they know about the meds you give them in your office? DM
There have been some ambitious attempts to improve patient education regarding hospital medications and involve selected patients in the medication administration process. Such initiatives may result in increased patient participation and satisfaction.[4-7] There is also potential that increased patient knowledge of their hospital medications could promote the goal of medication safety, as the actively involved patient may be able to catch medication errors in the hospital.
Knowledge of prescribed medications is a prerequisite to patient involvement in prevention of inpatient medication errors and yet there is little research on patient knowledge of their hospital medications. Furthermore, as the experience of hospitalization may be disorienting and disempowering for patients, it remains to be seen if patient attitudes toward participation in inpatient medication safety are favorable. To that end, we conducted a pilot study in which we assessed current patient awareness of their in-hospital medications and surveyed attitudes toward increased patient knowledge of hospital medications....
Comments: Read the whole article online by clicking the title. If patients do not know about the meds they are taking in a hospital....how much do they know about the meds you give them in your office? DM
Increased Prevalence of Myopia in the United States Between 1971-1972 and 1999-2004
Comment: I uploaded info on this paper previously....but now you can read the whole article by clicking on the title above. Is this substantial increase in myopia do to genetics or environment or both? We don't know. Type in "myopia" in the search box above to see more articles on this topic. DM
When using similar methods for each period,the prevalence of myopia in the United States appears to be substantially higher in 1999-2004 than 30 years earlier.Identifying modifiable risk factors for myopia could lead to the development of cost-effective interventional strategies.
When using similar methods for each period,the prevalence of myopia in the United States appears to be substantially higher in 1999-2004 than 30 years earlier.Identifying modifiable risk factors for myopia could lead to the development of cost-effective interventional strategies.
Psychotropic Medications Linked to Pregnancy Outcomes
Pregnant women who use benzodiazepines have an increased risk of preterm delivery
THURSDAY, Dec. 31 (HealthDay News) -- In pregnant women, the use of psychotropic medications, especially benzodiazepines, is associated with adverse perinatal outcomes, according to a study in the December issue of the American Journal of Obstetrics & Gynecology.
Ronit Calderon-Margalit, M.D., of the University of Washington School of Public Health and Community Medicine in Seattle, and colleagues interviewed 2,793 pregnant women in Washington State and abstracted their medical files.
The researchers found that pregnant women who used benzodiazepines had a dramatically increased risk of preterm delivery (adjusted odds ratio, 6.79), as well as increased risks of low birth weight, low Apgar score, neonatal intensive care unit admission, and respiratory distress syndrome. They also found an association between initiation of selective serotonin receptor inhibitor (SSRI) use after the first trimester and preterm delivery.
"In view of the strong association between benzodiazepine and adverse outcomes of pregnancy and the suggested associations of venlafaxine and SSRI therapy, there is a pressing need to pursue this association with large well-conducted cohort studies to confirm our results," the authors write. "Findings from additional studies are needed to provide data for decision making about treatment during pregnancies and to promote knowledge about the possible mechanisms in which psychotropic drugs affect perinatal outcomes."
THURSDAY, Dec. 31 (HealthDay News) -- In pregnant women, the use of psychotropic medications, especially benzodiazepines, is associated with adverse perinatal outcomes, according to a study in the December issue of the American Journal of Obstetrics & Gynecology.
Ronit Calderon-Margalit, M.D., of the University of Washington School of Public Health and Community Medicine in Seattle, and colleagues interviewed 2,793 pregnant women in Washington State and abstracted their medical files.
The researchers found that pregnant women who used benzodiazepines had a dramatically increased risk of preterm delivery (adjusted odds ratio, 6.79), as well as increased risks of low birth weight, low Apgar score, neonatal intensive care unit admission, and respiratory distress syndrome. They also found an association between initiation of selective serotonin receptor inhibitor (SSRI) use after the first trimester and preterm delivery.
"In view of the strong association between benzodiazepine and adverse outcomes of pregnancy and the suggested associations of venlafaxine and SSRI therapy, there is a pressing need to pursue this association with large well-conducted cohort studies to confirm our results," the authors write. "Findings from additional studies are needed to provide data for decision making about treatment during pregnancies and to promote knowledge about the possible mechanisms in which psychotropic drugs affect perinatal outcomes."
Autism Spectrum Disorder Prevalence Increases
About 1 percent of 8-year-olds in study sites identified as having an ASD in 2006
-- Improved documentation and identification of children with Autism Spectrum Disorders (ASDs) may have contributed to a rise in prevalence from 2002 to 2006, but an increased risk of developing an ASD should not be discounted, according to a surveillance summary published Dec. 18 in the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
-- Improved documentation and identification of children with Autism Spectrum Disorders (ASDs) may have contributed to a rise in prevalence from 2002 to 2006, but an increased risk of developing an ASD should not be discounted, according to a surveillance summary published Dec. 18 in the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.
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