Ads By Google

Thursday, August 6, 2009

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Wondering how you calculate how much Google Adsense give you money per click? There is a simple formula for this:

Revenue = Traffic * CTR * CPC

Probably understand what traffic.

So CTR is Click Through rate, and this shows how your visitors are clicking on ads. It really depends on what your site is optimized AdSense.

CPC is cost per click. Different words have different incomes. Some may be about $ 0.01, some are over $ 10.

But how to find words that are - highly paid for your site? Well, the answer to this question depends a little of who you are and what you are willing to do to get those keywords. But the good news is that you really can not find such words if you need them.

Here is your example of these words:

S / No.

Keywords

CPC ($)

1. Purchase Structured Settlements 53.48
2. Mesothelioma Lawyers San Diego 51.47
3. Secured Loan Calculator 51.35
4. Structured Settlement Investments 50.45
5. Endowment Selling 50.35
6. Mesothelioma Patients 50.23
7. Mesothelioma attorney san diego 50.07
8. Austin Texas dwi lawyers 50.03
9. New York Mesothelioma Lawyers 50.01
10. Phoenix dui lawyers 50.01
11. Secured Loans 50.01
12. Insurance Auto 50.00
13. Phoenix dui attorney 50.00
14. car free insurance online quote 50.00
15. students debt consolidation loans 49.96
16. Pennsylvania mesothelioma lawyers 49.87
17. data recovery Denver 49.71
18. adverse credit remortgages 49.56
19. bad credit remortgages 49.47
20. data recover y service los angeles 49.37
21. Consolidating Students Loan 49.30
22. Students Loan Consolidation Rates 49.17
23. Boston dui lawyers 49.02
24. memphis car insurance 48.86
25. conference calling companies 48.64
26. dui attornes los angeles 48.60
27. georgia car accident lawyers 48.36
28. san diego dui defense 48.32
29. Phoenix arizona dui lawyers 48.28
30. Los angeles dwi attorneys 48.20
31. Student Consolidation Loans 48.15
32. free quote for car insurance 48.11
33. irs tax lawyers 48.08
34. nj auto insurance 48.08
35. dui san diego 48.01
36. Los Angeles Criminal Defense Attorney 48.00
37. Consolidating Private Student Loans 47.96
38. Personal Injury Lawyer Chicago 47.83
39. Personal Injury Attorney Pennsylvania 47.82
40. Auto Insurance 47.81

How to win more with Google AdSense

Wondering how you calculate how much Google Adsense give you money per click? There is a simple formula for this:

Revenue = Traffic * CTR * CPC

Probably understand what traffic.

So CTR is Click Through rate, and this shows how your visitors are clicking on ads. It really depends on what your site is optimized AdSense.

CPC is cost per click. Different words have different incomes. Some may be about $ 0.01, some are over $ 10.

But how to find words that are - highly paid for your site? Well, the answer to this question depends a little of who you are and what you are willing to do to get those keywords. But the good news is that you really can not find such words if you need them.

Here is your example of these words:

S / No.

Keywords

CPC ($)

1. Purchase Structured Settlements 53.48
2. Mesothelioma Lawyers San Diego 51.47
3. Secured Loan Calculator 51.35
4. Structured Settlement Investments 50.45
5. Endowment Selling 50.35
6. Mesothelioma Patients 50.23
7. Mesothelioma attorney san diego 50.07
8. Austin Texas dwi lawyers 50.03
9. New York Mesothelioma Lawyers 50.01
10. Phoenix dui lawyers 50.01
11. Secured Loans 50.01
12. Insurance Auto 50.00
13. Phoenix dui attorney 50.00
14. car free insurance online quote 50.00
15. students debt consolidation loans 49.96
16. Pennsylvania mesothelioma lawyers 49.87
17. data recovery Denver 49.71
18. adverse credit remortgages 49.56
19. bad credit remortgages 49.47
20. data recover y service los angeles 49.37
21. Consolidating Students Loan 49.30
22. Students Loan Consolidation Rates 49.17
23. Boston dui lawyers 49.02
24. memphis car insurance 48.86
25. conference calling companies 48.64
26. dui attornes los angeles 48.60
27. georgia car accident lawyers 48.36
28. san diego dui defense 48.32
29. Phoenix arizona dui lawyers 48.28
30. Los angeles dwi attorneys 48.20
31. Student Consolidation Loans 48.15
32. free quote for car insurance 48.11
33. irs tax lawyers 48.08
34. nj auto insurance 48.08
35. dui san diego 48.01
36. Los Angeles Criminal Defense Attorney 48.00
37. Consolidating Private Student Loans 47.96
38. Personal Injury Lawyer Chicago 47.83
39. Personal Injury Attorney Pennsylvania 47.82
40. Auto Insurance 47.81

How to win more with Google AdSense

Wondering how you calculate how much Google Adsense give you money per click? There is a simple formula for this:

Revenue = Traffic * CTR * CPC

Probably understand what traffic.

So CTR is Click Through rate, and this shows how your visitors are clicking on ads. It really depends on what your site is optimized AdSense.

CPC is cost per click. Different words have different incomes. Some may be about $ 0.01, some are over $ 10.

But how to find words that are - highly paid for your site? Well, the answer to this question depends a little of who you are and what you are willing to do to get those keywords. But the good news is that you really can not find such words if you need them.

Here is your example of these words:

S / No.

Keywords

CPC ($)

1. Purchase Structured Settlements 53.48
2. Mesothelioma Lawyers San Diego 51.47
3. Secured Loan Calculator 51.35
4. Structured Settlement Investments 50.45
5. Endowment Selling 50.35
6. Mesothelioma Patients 50.23
7. Mesothelioma attorney san diego 50.07
8. Austin Texas dwi lawyers 50.03
9. New York Mesothelioma Lawyers 50.01
10. Phoenix dui lawyers 50.01
11. Secured Loans 50.01
12. Insurance Auto 50.00
13. Phoenix dui attorney 50.00
14. car free insurance online quote 50.00
15. students debt consolidation loans 49.96
16. Pennsylvania mesothelioma lawyers 49.87
17. data recovery Denver 49.71
18. adverse credit remortgages 49.56
19. bad credit remortgages 49.47
20. data recover y service los angeles 49.37
21. Consolidating Students Loan 49.30
22. Students Loan Consolidation Rates 49.17
23. Boston dui lawyers 49.02
24. memphis car insurance 48.86
25. conference calling companies 48.64
26. dui attornes los angeles 48.60
27. georgia car accident lawyers 48.36
28. san diego dui defense 48.32
29. Phoenix arizona dui lawyers 48.28
30. Los angeles dwi attorneys 48.20
31. Student Consolidation Loans 48.15
32. free quote for car insurance 48.11
33. irs tax lawyers 48.08
34. nj auto insurance 48.08
35. dui san diego 48.01
36. Los Angeles Criminal Defense Attorney 48.00
37. Consolidating Private Student Loans 47.96
38. Personal Injury Lawyer Chicago 47.83
39. Personal Injury Attorney Pennsylvania 47.82
40. Auto Insurance 47.81

How To Save $1 Billion And 800 Lives In Canada

The economic burden of alcohol abuse costs each Canadian $463 per year. In fact, the direct health care costs for alcohol abuse in Canada exceed those of cancer. Released by the Centre for Addiction and Mental Health (CAMH), the Avoidable Cost of Alcohol Abuse in Canada 2002 report estimates that, even under very conservative assumptions, implementing six reviewed interventions would result in cost savings of about $1 billion per year and a savings of about 800 lives, close to 26,000 years of life lost to premature death and more than 88,000 acute care hospital days in Canada per year. This pioneering study is Canada's first systematic estimate of the avoidable costs of alcohol abuse, and the first study of its kind worldwide.

To calculate the avoidable burden and avoidable costs of alcohol abuse in Canada for 2002, CAMH Senior Scientist Dr. Jurgen Rehm and his team estimated the potential economic impact of increasing alcohol taxation, lowering the blood alcohol concentration (BAC) legal limit from 0.08 per cent to 0.05 percent, zero tolerance BAC for all drivers under age 21, increasing the legal minimum drinking age from 19 to 21 years of age, a Safer Bars intervention, and brief interventions (routine screening with concise advice for problematic alcohol users by primary care physicians or other health professionals).

The data revealed that:
  • Implementing all six interventions would decrease productivity losses by more than $561 million or 58 per cent of the total avoidable cost due to alcohol, decrease health care costs (saving almost $230 million or 24 per cent), and lower criminality costs by almost $178 million or 18 per cent.

  • The most effective intervention to reduce avoidable costs in health care, criminality and productivity losses was the brief interventions (saving almost $602 million per year, 62 per cent of total savings), followed by increasing alcohol taxes (saving more than $211 million per year, 22 per cent of total savings).

  • The most effective intervention for preventing drinking and driving incidents in Canada was lowering the BAC level, which would result in a 19 per cent reduction.

  • The Safer Bars program was the most effective measure to avoid homicide and other violent crimes (more than 3 per cent reductions were estimated).

  • Brief interventions were the most effective measure to avoid other alcohol-attributable criminal activities (e.g., property crime), resulting in an almost 3 per cent reduction in these types of crimes.
"It's clear that the largest impact would come from interventions affecting the level of drinking in general such as brief interventions and increasing alcohol taxation," says Dr. Rehm. "However, the greatest overall cost avoidance would be achieved when multiple rather than single effective and cost-effective alcohol interventions are implemented as part of a comprehensive alcohol policy."

The scientists also estimated the potential impact of privatizing alcohol sales in those provinces that sell alcohol through a government monopoly. The analysis showed that substantial increases in direct and indirect costs would occur if Canadian provinces were to privatize alcohol sales. Productivity losses would increase by more than $468 million (7 per cent), health care costs would increase by more than $258 million (8 per cent), and costs related to criminality would increase by about $102 million (3 per cent).

While studies that investigate the cost of illness are a valuable indicator of the overall economic burden due to substance abuse in Canada, they do not offer potential solutions to reduce the burden. As Dr. Rehm explains, "this study shows the benefits potentially available to the community as a whole by directing public resources to specific policies, strategies and programs. It also helps identify information gaps, target problems, and identify potential solutions."

----------------------------
Article adapted by Medical News Today from original press release.
----------------------------

The Centre for Addiction and Mental Health (CAMH) is Canada's largest mental health and addiction teaching hospital, as well as one of the world's leading research centres in the area of addiction and mental health. CAMH combines clinical care, research, education, policy development and health promotion to transform the lives of people affected by mental health and addiction issues.

CAMH is fully affiliated with the University of Toronto, and is a Pan American Health Organization/World Health Organization Collaborating Centre.

Source: Michael Torres
Centre for Addiction and Mental Health

How To Stop Winter From Weathering Your Skin

All winter flakes are not made of snow. Cold weather wreaks havoc on our skin, sometimes making it dry and flaky. Skin dries out if it's deprived of water and this dryness often causes itchiness, resulting in a condition commonly referred to as "winter itch."

"Most of us experience dry and itchy skin from time to time, but you should seek medical attention if discomfort becomes severe," says Dr. Anjali Dahiya, a dermatologist at the Iris Cantor Women's Health Center at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. "The best thing you can do to relieve the itch is to moisturize your skin because, unfortunately, you can't do anything about the weather."

"Remember, dry skin is due to lack of water. Apply moisturizers immediately after bathing or showering, while your skin is still wet to trap water in the skin," notes Dr. Dahiya.

She suggests the following tips to turn your skin from alligator into suede:

-- Moisturize daily. Cream moisturizers are better than lotions for normal to dry skin. If you have sensitive skin, choose a moisturizer without fragrance or lanolin.

-- Cleanse your skin, but don't overdo it. Too much cleansing removes skin's natural moisturizers. It is enough to wash your face, hands, feet, and between the folds of your skin once a day. While you can rinse your trunk, arms, and legs daily; it is not necessary to use soap or cleanser on these areas every day.

-- Limit the use of hot water and soap. If you have "winter itch," take short lukewarm showers or baths with a non-irritating, non-detergent-based cleanser. Immediately afterward, apply a mineral oil or petroleum jelly type moisturizer. Gently pat skin dry.

-- Humidify. Humidifiers can be beneficial. However, be sure to clean the unit according to the manufacturer's instructions to reduce mold and fungi.

-- Protect yourself from the wind. Cover your face and use a petroleum-based balm for your lips.

-- Avoid extreme cold. Cold temperatures can cause skin disorders or frostbite in some people. See a doctor immediately if you develop color changes in your hands or feet accompanied by pain or ulceration. If you develop extreme pain followed by loss of sensation in a finger or toe, you may have frostbite.

-- Protect your skin from the sun. Winter sun can be as dangerous to the skin. Even in the winter months you should use a sunscreen with a sun-protection factor of 15 or greater, if you will be outdoors for prolonged periods. Overexposure to the sun's rays can lead to premature aging of the skin and skin cancer.

-- See your dermatologist. If you have persistent dry skin, scaling, itching, skin growths that concern you, or other rashes, see your dermatologist -- not only in winter but throughout the year.

NewYork-Presbyterian Hospital

NewYork-Presbyterian Hospital, based in New York City, is the nation's largest not-for-profit, non-sectarian hospital, with 2,242 beds. The Hospital has nearly 2 million inpatient and outpatient visits in a year, including more than 230,000 visits to its emergency departments -- more than any other area hospital. NewYork-Presbyterian provides state-of-the-art inpatient, ambulatory and preventive care in all areas of medicine at five major centers: NewYork-Presbyterian Hospital/Weill Cornell Medical Center, NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children's Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Allen Pavilion and NewYork-Presbyterian Hospital/Westchester Division. One of the largest and most comprehensive health-care institutions in the world, the Hospital is committed to excellence in patient care, research, education and community service. It ranks sixth in U.S.News & World Report's guide to "America's Best Hospitals," ranks first on New York magazine's "Best Hospitals" survey, has the greatest number of physicians listed in New York magazine's "Best Doctors" issue, and is included among Solucient's top 15 major teaching hospitals. The Hospital's mortality rates are among the lowest for heart attack and heart failure in the country, according to a 2007 U.S. Department of Health and Human Services (HHS) report card. The Hospital has academic affiliations with two of the nation's leading medical colleges: Weill Cornell Medical College and Columbia University College of Physicians and Surgeons. For more information, visit http://www.nyp.org.

NewYork-Presbyterian Hospital
http://www.nyp.org

Scientists Decode Entire HIV Genome

A team of US scientists has for the first time unravelled the entire genetic code of HIV, the virus that causes AIDS, paving the way for a better understanding of how these types of viruses infect humans and hopefully speeding up the discovery and development of new drugs.

The work was done by Dr Kevin Weeks, a chemistry professor of the College of Arts and Sciences at the University of North Carolina (UNC) at Chapel Hill, and colleagues, and features as the cover story of the 6 August issue of Nature.

Before this work, researchers had only modelled small regions of the HIV genome, which is very large and made of two strands of nearly 10,000 building blocks or nucleotides each.

Viruses like HIV, whose genetic code is carried on RNA (rather than DNA) are harder to unravel because unlike DNA where the code is carried almost entirely in sequential building blocks or nucleotides, RNA folds into complex and intricate three-dimensional patterns that are harder to unravel. Other RNA-based viruses include the flu viruses, hepatitis C, the common cold, some cancer precursors, polio, and many others.

The replication of RNA-based viruses is controlled at many levels, including conserved "structures" of RNA genome, many of which have not been studied in much detail.

The way the HIV encodes proteins is not straightforward either: while there is a correspondence between RNA and a primary sequencing of proteins, there is another level of coding between these "structures" and "inter-domain" loops that connect different parts of HIV proteins.

For the study, the researchers used a high-throughput RNA analyser called SHAPE to examine the architecture of HIV genomes isolated from infectious cultures containing trillions of viral particles.

What they found suggests that the complex RNA structures (which they referred to as "motifs") influenced several steps in the HIV infectivity cycle, in other words they modulated "ribosome elongation to promote native protein folding".

They also found that: "Some simple genome elements previously shown to be important, including the ribosomal gag-pol frameshift stem-loop, are components of larger RNA motifs."

Weeks said in a media statement that:

"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."

The study could be the key to unlocking the secrets of other RNA genomes in other viruses.

"One approach is to change the RNA sequence and see if the virus notices," said co-author Ronald Swanstrom, from UNC's Linenberger Cancer Center.

"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," he added.

And another important insight that Weeks pointed out was:

"We are also beginning to understand tricks the genome uses to help the virus escape detection by the human host."

"Architecture and secondary structure of an entire HIV-1 RNA genome."
Joseph M. Watts, Kristen K. Dang, Robert J. Gorelick, Christopher W. Leonard, Julian W. Bess Jr, Ronald Swanstrom, Christina L. Burch and & Kevin M. Weeks.
Nature 460, 711 -716 (6 August 2009).
DOI: 10.1038/nature08237

Saturday, July 25, 2009

What Is Anemia? What Causes Anemia?

When the number of red blood cells or concentrations of hemoglobin are low a person is said to have anemia. Hemoglobin is a protein (metalloprotein) inside the red blood cells that contains iron and transports oxygen.

Anemia is the most common disorder of the blood. Approximately 3.5 million Americans are affected by it. It is much more common in developing countries, especially in very poor areas where people suffer from malnutrition. In many parts of Africa severe anemia is also caused by Malaria.

As many people who become infected with Malaria already have pre-existing anemia, most commonly due to malnutrition and helminthiasis (a disease caused by a parasitic worm), the problem is compounded.

Blood / Hematology News

For the latest news and research on blood, including articles on blood cells, plasma, anemia, platelets, dialylis, transfusions, and much more, and to sign up to newsletters or news alerts, please visit our:

Blood / Hematology News Section.
There are hundreds of types of anemia, which is divided into three groups:

Excessive blood loss anemia

Chronic bleeding (long-term bleeding) is often undetected for a long time. The patient gradually loses blood, which means a loss of red blood cells and hemoglobin. Acute bleeding (not long term), can also reduce red blood cell count. Excessive blood loss can be caused by:
  • Stomach ulcers.

  • Hemorrhoids.

  • Inflammation of the stomach (gastritis).

  • Cancer - sometimes cancer of the stomach or colon can cause bleeding.

  • Some medications - NSAIDS (nonsteroidal anti-inflammatory drugs) if used for prolonged periods, or in high doses, can occasionally cause stomach bleeding.

  • Childbirth - childbirth often involves the loss of blood.

  • Menstruation - women who have very heavy periods (menorrhagia) have a higher risk of developing anemia.

  • Surgery

  • Trauma which results in bleeding, such as a car accident.

  • Blood donations - some regular blood donors may develop anemia.

Excessive red blood cell destruction (hemolysis) anemia

A red blood cell usually lives for 110-120 days, after which it breaks down and is removed by the spleen. Some illnesses and conditions cause red blood cells to die too early. When this happens the bone marrow has to make more red blood cells than normal. If the bone marrow cannot keep up with the needed red cell production caused by their early deaths, the red blood cell count will start to fall, leading to hemolysis (anemia caused by excessive red blood cell destruction)

The following can cause hemolysis:
  • Immune reactions
  • Infections
  • Some medications
  • Toxins (poisons)
  • Some medical procedures, such as using a heart-lung bypass machine, or hemodialysis (used by patients with kidney problems)

Decreased or deficient red blood cell production anemia

In this type of anemia the body either does not produce enough red blood cells, or they may not work properly. People with this type of anemia may have:
  • Sickle cell anemia - an inherited disorder which causes the red blood cells to have a crescent shape. The red blood cells break down rapidly, before sufficient oxygen and nutrients can reach vital organs.

  • Not enough iron (iron deficiency) - lack of iron is generally caused by poor diet, blood loss, or an inability to absorb sufficient iron from food. Anemia due to iron deficiency among pregnant women who do not take an iron supplement is common.

  • Not enough vitamins (vitamin deficiency) - such as vitamin B12, often caused because the stomach cannot produce enough of a substance called intrinsic factor. This intrinsic factor is vital for vitamin B12 to be absorbed from food and drink. People with anemia for this reason have pernicious anemia. The deficiency may be caused by poor diet.

  • Bone marrow problems - red blood cells are made in the bone marrow. If the bone marrow is faulty it may not be producing enough. This may be caused by a lack of vitamin B12, a serious bone marrow disorder (e.g. leukemia), long term inflammation (e.g. rheumatoid arthritis), or long term infection.

  • Some conditions/diseases - people with HIV/AIDS, rheumatoid arthritis, and Crohn's disease may have problems with adequate red blood cell production. Malaria causes anemia in millions of people worldwide. A protein produced by immune cells during malaria infection triggers severe anemia, researchers from Yale University discovered. Patients with chronic kidney disease often have low levels of erythropoietin (a hormone that stimulates the formation of red blood cells) and develop anemia. A study published by the Canadian Medical Association Journal reported that anemia may be beneficial to patients with inflammatory disease, and advocate restraint in treating mild to moderate forms of anemia.

  • Some medications - especially some cancer medications which are given in combination. A cancer drug, Avastin, given in combination with Sutent, is linked to microangiopathic hemolytic anemia, which is caused by by a build up of platelets and other organic obstructions on the inner walls of very small blood vessels. These shred healthy red blood cells as they pass through, eventually leading to a whole body shortage of them.

What are the symptoms of anemia?

People whose anemia develops gradually may have no symptoms for a long time. If it develops rapidly symptoms will usually be felt much sooner. Symptoms will vary according to the type of anemia, its underlying cause, and if there are any underlying health problems.

Below are some symptoms linked to anemia - tiredness and lethargy are the most common ones: Lethargy is a mental state while fatigue is a physical state. Lethargy may or may not be associated with physical symptoms. If somebody suffers from fatigue - is physically tired - it is not uncommon for his/her mental state to be affected as well.
  • Fatigue (tiredness)
  • Lethargy - sluggishness, apathy, a feeling of laziness
  • Malaise - a vague feeling that one is not well
  • Dyspnea - shortness of breath; difficult or labored breathing
  • Poor concentration
  • Palpitations - unpleasant irregular and/or forceful beating of the heart
  • Sensitivity to cold temperatures

  • The following symptoms are possible, but less common
  • Tinnitus (ringing in the ears)
  • Headache
  • Sense of taste is affected
  • Sore tongue
  • Dysphagia - difficulty is swallowing
  • Pallor (pale complexion)
  • Atrophic glossitis - very smooth tongue
  • Dry and flaky nails
  • Angular chelosis - ulcers in the corner of the mouth
  • Restless leg syndrome - this is more common among patients with iron deficiency anemia

  • The following symptoms are possible, but extremely rare
  • Swelling of the legs and/or arms
  • Chronic heartburn
  • Vomiting
  • Increased sweating
  • Blood in stools (feces)

How is anemia diagnosed?

A GP (general practitioner, primary care physician) will probably carry out a physical examination, order a blood test, and ask the patient some questions.
  • Blood test

    A blood test will measure the patient's red blood count and levels of hemoglobin. If the levels are low the patient has anemia. The blood test will also reveal whether the blood cells have an unusual shape, color or size. Patients with iron deficiency have smaller and paler red blood cells compared to healthy individuals. A patient with a vitamin deficiency will have fewer and larger red blood cells.

    Adults should have hematocrit values (red blood cell count) between 32% and 43%, and hemoglobin values from 11 to 15 grams per deciliter.

  • Some questions the doctor may ask

    The doctor will also try to find out what may be causing or contributing to the anemia by asking:

    • Diet - what the patient eats, and whether his/her diet includes enough vitamins and minerals, - especially iron and vitamin B12.

    • Medications - what drugs the patient has been taking, how often, for how long, and what doses.

    • Menstruation - whether periods are heavy (menorrhagia) and whether heavy periods have been happening for a long time.

    • Family history - whether any close relatives have/had anemia, blood disorders, or gastrointestinal bleedin/g. A close relative is usually limited to siblings and parents.

    • Medical history - whether the patient has a chronic disease.

    • Blood donation - whether the patient is a regular blood donor.

  • Physical examination

    • Rectal examination - a doctor may carry out a rectal examination to determine whether something in the gastrointestinal tract may be causing bleeding. GPs are used to doing this kind of examination. If an abnormality is detected the GP will refer the patient to a specialist (gastroenterologist).

    • Pelvic examination - if the GP suspects heavy menstrual bleeding may be causing the anemia he/she may carry out a pelvic examination. If the patient does not respond to iron supplement treatment and has heavy periods the GP may refer her to a gynecologist.

What is the treatment for anemia?

  • Iron deficiency - the GP will prescribe an iron supplement to restore body levels of iron. An example is ferrous sulphate, which is taken orally up to three times daily. Side effects, which are rare, may include diarrhea, constipation, stomach upset, and heartburn. Patients who find ferrous sulphate unsuitable may be given ferrous gluconate, which is less likely to have side effects but takes longer to work.

  • Diet - patient's whose diets are found to be lacking in iron will be encouraged to consume plenty of iron-rich foods, such as dark-green leafy vegetables, artichokes, apricots, beans, lentils, chick peas, soybeans, meat, nuts, prunes, and raisins.

  • Underlying causes - if there is an underlying cause for the anemia this must be treated. If non-steroidal anti-inflammatory drugs (NSAIDs) are found to be a contributory factor the doctor will prescribe an alternative medication.
The doctor will ask the patient to return a few weeks later to check that the treatment is working. If treatment has not worked the doctor will try to find out whether any undesirable side-effects may have made the patient stop taking the iron supplements.

What are the complications of anemia?

  • Pregnancy

    Pregnant women who are severely anemic have a significant risk of complications, especially when they give birth and afterwards. Giving birth often involves losing blood; being anemic already and then losing blood can result in serious complications. If a mother is severely anemic her baby is much more likely to be born prematurely and underweight. Babies born to mothers with anemia are much more likely to have problems with anemia themselves later on in infancy.

  • Fatigue

    Fatigue may have a considerable impact on the quality of life of the patient. If the anemia is severe the patient may feel too tired to work, or carry out essential daily tasks. Long-term fatigue may eventually lead to clinical depression.

    Researchers from Wake Forest University Baptist Medical Center found that elderly people with anemia have more disabilities and score lower on physical performance and strength tests than those without anemia.

  • Susceptibility to illness and infection

    People with untreated anemia are more susceptible to illness and infection, compared to healthy people.

  • Heart Problems

    The heart needs to pump more blood to make up for the lack of oxygen and nutrients if you are anemic. This can eventually lead to congestive heart failure.

    Researchers from Charles Sturt University found that the presence of anemia in patients with chronic heart failure is associated with a significantly increased risk of death.

  • Nerve damage

    Lack of vitamin B-12, one of the causes of anemia, can result in nerve damage. Good nerve function requires an adequate supply of vitamin B-12.
Written by Christian Nordqvist

Going Down?


Going Down?

NEWS PHOTO
EMMA BENNETT
Alyssa King, (left to right) Maralynn Sasse, Nolan Weigel, and Theo Weigel have fun on the Spring Ride at the Medicine Hat Exhibition and Stampede on Friday night.

Injection Reverses Heart-attack Damage

ScienceDaily (July 25, 2009) — Injured heart tissue normally can't regrow, but researchers at Children's Hospital Boston have now laid the groundwork for regenerating heart tissue after a heart attack, in patients with heart failure, or in children with congenital heart defects. In the July 24 issue of Cell, they show that a growth factor called neuregulin1 (NRG1), which is involved in the initial development of the heart and nervous system, can spur heart-muscle growth and recovery of cardiac function when injected systemically into animals after a heart attack.


After birth, heart-muscle cells (cardiomyocytes) normally withdraw from the cell cycle – meaning they stop dividing and proliferating. But the researchers, led by Bernhard Kühn, MD, and Kevin Bersell of the Department of Cardiology at Children's, were able to restart the cell cycle with NRG1, stimulating cardiomyocytes to divide and make copies of themselves -- even though they are not stem cells.

"Although many efforts have focused on stem-cell based strategies, our work suggests that stem cells aren't required and that stimulating differentiated cardiomyocytes to proliferate may be a viable alternative," says Kühn, the study's senior investigator and a practicing pediatric cardiologist at Children's since 2007.

When the team injected NRG1 into the peritoneal cavity of live mice after a heart attack, once daily for 12 weeks, heart regeneration was increased and pumping function (ejection fraction, assessed on echocardiograms) improved as compared with untreated controls. The NRG1-injected mice also lacked the left-ventricular dilation and cardiac hypertrophy that typify heart failure; both were seen in the controls.

When the researchers also stimulated production of a cellular receptor for NRG1, known as ErbB4, cardiomyocyte proliferation was further enhanced, demonstrating that NRG1 works by stimulating this receptor. They also identified the specific kinds of cardiomyocytes (mononucleated) that are most likely to respond to treatment.

In 2007, Kühn and colleagues first demonstrated that the heart has dormant regenerative capacities that can be reawakened. Kühn developed a sponge-like patch, soaked in a compound called periostin that is abundant in the developing fetal heart (and in injured skeletal muscle) but scarce in adult hearts. When the patch was placed over the site of cardiac injury in rats, it induced cardiomyocyte proliferation and improved heart function (Nature Medicine 2007; 13:962-9). Similar results were seen in larger animals, and periostin is now in preclinical development at Children's Hospital Boston for future application in human patients with heart failure.

The new work adds a second compound to the heart-regeneration toolbox, and reveals how both periostin and NRG-1 work at the cellular and molecular level, an essential step in predicting possible side effects. Both compounds ultimately act on the same cellular pathway, Kühn found.

"We applied periostin locally at the site of cardiac injury, but NRG1 works when given by systemic injection – a very promising result that suggests it may be feasible to use this in the clinic to treat heart failure," says Kühn, who won a first prize Young Investigator Award, from the American College of Cardiology in 2007.

The study was funded by the Department of Cardiology at Children's Hospital Boston, the Charles Hood Foundation, and the American Heart Association.

Friday, July 24, 2009

Neglecting Unilateral Neglect

Unilateral neglect (UN) is a debilitating cognitive deficit following traumatic brain injury with long-term implications to both the person affected and the health care system. In the United States, UN affects up to 200,000 stroke survivors, with the incidence and severity of UN increasing with age. However, UN is rarely recognized by the health care team and current post-stroke testing is not specific enough to provide for a definitive diagnosis of UN. As a result, people with UN are under-diagnosed and under-treated; or, when diagnosed and treated, do not receive adequate rehabilitation due to financial constraints imposed by the Medicare system.

UN is most common following damage to the right hemisphere of the brain from stroke; although illness or traumatic brain injury are also linked to the development of UN. When functioning normally, the right hemisphere of the brain is attentive to both sides of the world with a global focus and the ability for prolonged attention while the left hemisphere is attentive only to its opposite side with a centralized focus and shorter attention span.

Half BodyThe wide range and complexity of UN symptoms and the presence of other sensory or motor deficits due to stroke contributes to the high rate of missed diagnoses. A disorder of input and/or output, a person affected with UN will either completely ignore the side opposite to the brain injury or feel that side is totally unimportant; to the extent of not recognizing their own limbs. All deficits are more severe in those affected by UN following stroke and are more likely to be permanent than in people who do not have UN in conjunction with stroke.

People with UN are able to see, hear, and move but do not recognize, listen to, or understand their world. A person with input disorder, also called inattention, will ignore odors, sounds, touch, and sight on the side opposite to their brain lesion; this inattention may also include ignoring one side of hallucinations, dreams or memories. A person with output disorder will not use their limbs opposite to the lesion, despite having the ability to do so; or will only be able to move a limb within the recognized space, but not within the ignored space.

A person with UN will ignore the left side of their visual field, or will be able to see both sides but ignore the left half of each object within the visual field. They will only dress or care and protect one side of their body; will only eat food on one side of their plate; will only look to one side; will completely ignore objects or people on the affected side; or will walk into walls or furniture on the effected side. People are usually unaware of the presence of their deficits due to UN, unlike when other sensory and motor deficits are present following stroke.

Inpatient rehabilitation facilities receive a set amount of money from Medicare, based upon guidelines for each illness or disease. These prospective payment systems limit a patient’s length of stay regardless of their level of functioning upon discharge and have been found to have an impact upon the outcome of people with UN. A person affected with UN does not progress quickly during rehabilitation, requires a long time to recover, and is discharged with a low level of functioning. In addition, people with UN are less likely to return to their homes and live on their own following stroke, and have an increased risk for falls or other injuries.

People are now living longer; the incidence and severity of UN will continue to rise, straining an already overburdened health care system. UN has impacted the elderly today and will have an impact upon aging baby boomers in the very near future. Additional research is needed to ensure early and accurate diagnosis through appropriate testing methods; targeted and effective treatment modalities need to be developed; and the health care team must be educated to increase awareness of this often neglected complication of stroke. Modification of the prospective payment system within the current Medicare system is also needed that recognizes the increased rehabilitation requirements for this group of stoke and brain injury survivors.

References

Gillen R et al. The impact of the inpatient rehabilitation facility prospective payment system on stroke program outcomes. Am J Phys Med Rehabil. 2007 May; 86 (5): 356-63. doi: 10.1097/PHM.0b013e31804a7e2f

Gottesman RF et al. Unilateral neglect is more severe and common in older patients with right hemispheric stroke. Neurology. 2008 Oct 28;71(18):1439-44. doi: 10.1212/01.wnl.0000327888.48230.d2

Jepson R et al. Unilateral Neglect: Assessment in Nursing Practice. J Neurosci Nurs. 2008 Jun; 40 (3): 142-9.

Wee, J., & Hopman, W. (2008). Comparing Consequences of Right and Left Unilateral Neglect in a Stroke Rehabilitation Population American Journal of Physical Medicine & Rehabilitation, 87 (11), 910-920 DOI: 10.1097/PHM.0b013e31818a58bd

Wednesday, July 22, 2009

Natural Anti-Inflammatory Power Of Tart Cherries May Help Relieve Post-Exercise Muscle Pain


Drinking cherry juice could help ease the pain for people who run, according to new research from Oregon Health & Science University presented at the American College of Sports Medicine Conference in Seattle, Wash. The study showed people who drank tart cherry juice while training for a long distance run reported significantly less pain after exercise than those who didn't. Post-exercise pain can often indicate muscle damage or debilitating injuries.

In the study of sixty healthy adults aged 18-50 years, those who drank 10.5 ounces cherry juice (CHERRish 100% Montmorency cherry juice) twice a day for seven days prior to and on the day of a long-distance relay had significantly less muscle pain following the race than those who drank another fruit juice beverage. On a scale from 0 to 10, the runners who drank cherry juice as their "sports drink" had a 2 point lower self-reported pain level at the completion of the race, a clinically significant difference.

While more research is needed to fully understand the effects of tart cherry juice, researchers say the early finding indicate cherries may work like common medications used by runners to alleviate post-exercise inflammation.

"For most runners, post-race treatment consists of RICE (rest, ice, compression and elevation) and traditional NSAIDS (non-steroidal anti-inflammatory drugs)," said Kerry Kuehl, M.D., a sports medicine physician and principal study investigator. "But NSAIDS can have adverse effects - negative effects you may be able to avoid by using a natural, whole food alternative, like cherry juice, to reduce muscle inflammation before exercise."

The researchers suggest cherries' post-exercise benefits are likely because of the fruit's natural anti-inflammation power - attributed to antioxidant compounds called anthocyanins, which also give cherries their bright red color.

Whether elite athletes or weekend warriors, this natural anti-inflammation power of cherry juice could have far-reaching benefits for the millions of active Americans currently taking over-the-counter pain medications to reduce muscle pain and beyond. A growing body of research suggests cherries could affect inflammation related to heart disease, arthritis and may even help maintain muscle strength for those suffering from fibromyalgia (a common, chronic widespread pain disorder), according to a second study presented by the same researchers at the ACSM conference.

It's Easy to Enjoy "America's Super Fruit"

Cherries are not only good for you, but they're also a homegrown "Super Fruit." According to recent data, more than 9 out of 10 Americans want to know where their food comes from, nearly 80 percent say they're purchasing "locally produced" products, and the majority are defining "local" as made in America.

This homegrown advantage, coupled with potential health benefits for athletes, make cherries "America's Super Fruit." Tart cherries come in dried, frozen and juice forms so they're readily available to enjoy all year long.

Kuehl KS, Chestnutt J, Elliot DL, Lilley C. Efficacy of tart cherry juice in reducing muscle pain after strenuous exercise. American College of Sports Medicine. 851. May, 2009.

Jones KD, Elliot DL, Kuehl KS, Dulacki K. Tart cherry juice for fibromyalgia: new testing paradigm and subgroup benefits. American College of Sports Medicine. 852. May, 2009.

Surveys conducted IRI Data and The Hartman Group, 2008

Source:
Caitlin Solway
Weber Shandwick Worldwide

Psychologists Investigate Cognitive Failings Of Eating Disorder Sufferers


Sufferers of eating disorders have problems with certain mental tasks; this is the finding of a comprehensive overview of studies examining the link between cognitive deficits and eating disorders, published online in the Journal of Neuropsychology today, 22nd July 2009.

Professor Konstantine Zakzanis from the University of Toronto carried out an analysis of 27 studies that investigated the thinking of 608 anorexia nervosa sufferers, and 14 studies of 347 bulimia nervosa patients to look for consistent patterns in cognitive deficits.

Professor Zakzanis said: "Over the last 30 years, many psychological studies have tested people with anorexia or bulimia on tasks such as decision making, verbal memory and reaction times and have found that people with eating disorders perform worse than people who don't have an eating disorder.

"In this overview we found consistent results that people with anorexia and bulimia have significant problems with some cognitive processes, and as sufferers' body mass decreased, the severity of their cognitive impairments increased."

Anorexia sufferers were found to have particular impairments in spatial perception and representation, which could explain the distorted assessment of body image in patients with anorexia nervosa. Bulimia patients had less significant impairments than anorexia sufferers overall, but a particular impairment in impulsivity was observed, with 21 per cent of patients scoring worse on measures of impulsivity when compared to people without an eating disorder.

"These results tell us that people with eating disorders have particular patterns of cognitive deficits. However, at this stage we do not know whether these deficits are a result of abnormal eating patterns, malnutrition for example, or whether these cognitive deficits result in, or affect the progression of eating disorders," Professor Zakzanis continued. "If cognitive deficits are behind eating disorders this could help us to understand why certain people are affected and could help us to develop future psychological treatments."

Source
British Psychological Society

Link Between Healthy Lifestyle And Cardiovascular Health Confirmed


Two large US studies published in a leading journal this month support the already substantial body of evidence that shows choosing to follow a healthy lifestyle helps prevent cardiovascular disease: one found it linked to lower risk of heart failure in men and the other found it linked to lower risk of high blood pressure in women.

Both studies are published in the July 22-29 issue of
JAMA, the Journal of the American Medical Association.

For the first study, first author Dr Luc Djoussé, of the Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and colleagues used data covering 20,900 men taking part in the Physicians' Health Study in the US and who were followed for an average of 22.4 years.

They found that following any one of six modifiable healthy lifestyle factors was linked to a lower lifetime risk of heart failure compared to not following any.

The six lifestyle factors were: maintaining a normal body weight, never smoking, taking regular exercise, drinking moderate amounts of alcohol, eating plenty of cereals, and eating plenty of fruits and vegetables.

The researchers also found that the more healthy lifestyle choices the men followed, the lower their lifetime risk of heart failure.

For example, the lifetime risk for heart failure was about 1 in 5 (21.2 per cent) for those men who didn't follow any of the healthy lifestyle choices (ie they smoked, they were overweight, they did not have a diet rich in cereals, fruit and vegetables, and they did not take regular exercise). But for those who followed four or more healthy lifestyle choices, the lifetime risk was 1 in 10 (10.1 per cent).

The findings have major implications for public health, especially since heart failure is now known to be a leading cause of acute hospital admission and the most prevalent chronic cardiovascular condition, according a press statement made by the European Society of Cardiology (ESC).

In the second study, first author Dr John P. Forman, also from Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, and colleagues, used data covering more than 80,000 women taking part in the Nurses' Health Study, described by the ESC as one of the "world's landmark studies in women's health epidemiology".

All of the women's blood pressure was normal (120/80 or less) and they were free of heart disease,
diabetes, and cancer at the start of the study which followed them for 14 years.

The researchers found that following any one of six modifiable healthy lifestyle factors was linked to lower blood pressure.

The six modifiable lifestyle factors were: keeping to a normal BMI (under 25), exercising vigorously every day, following a heart-healthy diet, consuming a modest amount of alcohol, using non-narcotic pain relievers no more than once a week, and taking a folic acid supplement.

A heart-healthy diet was described as eating lots of fruits, nuts, legumes and other vegetables, whole grains, low fat dairy products, low sodium intake, and not consuming much red or processed meat or sugary drinks.

In this study too the researchers found a cluster effect: following all six lifestyle choices was linked to an 80 per cent lower risk of developing high blood pressure. Only 0.3 per cent of the women in the study followed all 6 lifestyle choices.

The ESC said this study also had important implications for public health.

ESC spokesman Professor Joep Perk from Oskarshamn District Hospital in Sweden, told the press that there wasn't enough research on preventing poor health in women and called this study "an important piece of evidence".

"The Nurses' Health Study is an observational study, but because of the numbers involved I'm sure the results will be valid in broader female populations," he added.

Talking about the 80 per cent reduction in risk of high blood pressure found in the women who followed all 6 lifestyle choices, Perk said this was like the findings of the Interheart study, the 2004 global study led by McMaster University in Canada.

That study found that 90 per cent of first heart attacks were linked to 9 lifestyle factors.

"So there's a consistent pattern here," said Perk, it suggests, he said, that:

"Four out of five cases of hypertension or heart attack are amenable to lifestyle intervention. So, most of us can do something about prevention."

"It's a public health issue, and we need to put our heads together," he urged.

Perk said the two studies affirmed the ESC message on cardiovascular disease prevention:
  • Don't smoke.
  • Exercise for at least 30 minutes every day.
  • Use calorie control and exercise to keep your BMI in the normal range.
BMI stands for Body Mass Index: it is the ratio of your weight in kilos to the square of your height in metres. A normal BMI is between 20 and 25. Thus a person who weighs 80 kilos (176 pounds) and stands 183 cm tall (6 feet) has a BMI of 23.9 which is in the normal range.

"These two studies yet again confirm the wisdom of this advice, and provide even more evidence to translate our knowledge into action" said Perk.

"Relation between modifiable lifestyle factors and lifetime risk of heart failure."
Luc Djousse; Jane A. Driver; J. Michael Gaziano.
JAMA. 2009;302(4):394-400.

"Diet and Lifestyle Risk Factors Associated With Incident Hypertension in Women."
John P. Forman; Meir J. Stampfer; Gary C. Curhan
JAMA . 2009;302(4):401-411.

Additional source: European Society of Cardiology.

Monday, July 20, 2009

Oldest New Mom Dies, Leaves Twins

MADRID (July 15) -- A Spanish woman who deceived a U.S. fertility clinic about her age and become the oldest woman to give birth has died at 69, leaving behind 2-year-old twins, newspapers reported Wednesday.
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Maria del Carmen Bousada
News International / ZUMA Press

Maria del Carmen Bousada, the oldest woman to give birth, died at age 69, leaving behind 2-year-old twins.

Maria del Carmen Bousada gave birth in December 2006 after telling a clinic in Los Angeles that she was 55, the facility's maximum age for single women receiving in-vitro fertilization. Guinness World Records said the 66-year-old was the oldest on record to give birth and the case ignited fierce debate over how much responsibility fertility clinics have over their patients.
Bousada told an interviewer at the time that the Pacific Fertility Center did not ask her for identification, and maintained that because her mother had died at 101, she stood a good chance of living long enough to raise her children.
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Dr. Vicken Sahakian, director and owner of the clinic, said Bousada falsified her birth date on documents from Spain.
When he learned of the deception, "I figured something might happen and wind up being a disaster for these kids, and unfortunately I was right," he said.
It's easy for women to lie to their doctors, he said.
"We don't ask for passports, obviously," Sahakian said. "When is the last time you went to a doctor and he asked you for a birth certificate? We're not detectives here."
Bousada's brother told the local newspaper Diario de Cadiz that she had died but he did not disclose the cause. The newspaper said, without citing a source, that Bousada had been diagnosed with a tumor shortly after giving birth.
Sahakian said he implanted the Spanish woman with a younger woman's eggs and donated sperm, using hormones to "rejuvenate" her uterus with hormone therapy after she had been in menopause for 18 years.
The hormone treatment lasted three weeks. Sahakian said he did not believe that increased the woman's cancer risk.
"Nothing she did (to get pregnant) caused her illness," he said.
The brother, Ricardo Bousada, told the Barcelona-based newspaper El Periodico de Catalunya that he had exclusively sold details of his sister's death to an unidentified television program and that the proceeds would go to looking after his sister's twin boys, Pau and Christian.
Repeated calls by The Associated Press to Ricardo Bousada's residence in the southern province of Cadiz went unanswered. A woman who answered the phone at a number listed for another brother, Jose Luis Bousada, declined to comment. Her death was also reported by the national newspapers El Mundo
There was no word on who would raise the twins. Bousada had once said she would look for a younger man to help her raise them.

¨
Bousada lived with her mother most of her life in Cadiz and worked in a department store before retiring. She decided to have children after her mother died in 2005 and initially kept her plan secret from her family, she told reporters.
She told the British tabloid News of the World that she sold her house to raise $59,000 to pay for the in-vitro fertilization.
"I think everyone should become a mother at the right time for them," Bousada told the paper. "Often circumstances put you between a rock and a hard place, and maybe things shouldn't have been done in the way they were done, but that was the only way to achieve the thing I had always dreamed of, and I did it," she said.
Spanish law on assisted reproduction sets no age limit, but state-funded and private clinics that offer the procedure set the ceiling at age 50 in an informal agreement based on recommendations from the scientific community, according to the Health Ministry.
There is no U.S. law limiting the age at which women can receive in vitro fertilization but Sahakian said he generally limits it to 55 or 56 because "I would like the mother ... to basically survive until the kids reach 18."
When Bousada finally told her relatives she was two months pregnant, they thought she was joking, she said.
"Yes, I am old of course, but if I live as long as my mom did, imagine, I could even have grandchildren," she told the News of the World.
Allan Pacey, secretary of the British Fertility Society, said the organization recommends that assisted conception generally not be provided to women beyond the natural age of menopause at about 50.
"The rationale for all that is that nature didn't design women to have assisted conception beyond the age of the natural menopause...once you get into the mid-50s, I think nature is trying to tell us something," Pacey told The AP.
He added: "I think many people would worry about providing fertility treatment to women in their 60s. I think as a general rule, to embark on pregnancy when you may not see your child go to university is potentially a very difficult situation."
Adriana Iliescu, a Romanian who in 2005 also gave birth at 66, although she was 130 days younger than Bousada, said she was pained to hear of her death and what it meant for her sons.
"It is a great sadness when kids are orphans but civil society will help these children," she told The AP.
She described her little daughter Eliza as "very energetic and spoiled. We dance and sing together."
"I don't feel I am getting old. My pregnancy kept me young," Iliescu said.
AP correspondents Maria Cheng in London, Alison Mutler in Bucharest, and Jorge Sainz and Paul Haven in Madrid contributed to this report.

Cancer Patient Dedicates Life to Research


(July 16) - The diagnosis could not have been more devastating. At 23, medical student PJ Lukac learned he had a rare, often fast-growing brain tumor.
But it's what Lukac did after the diagnosis that has made headlines in the Chicago Tribune.

According to the newspaper, Lukac, a second-year medical student at Columbia University, sought out Dr. Markus Bredel, the director of the Northwestern Brain Tumor Institute's research program, and said he wanted to study his cancer -- and try to save his own life.
Bredel hired the student as an assistant researcher.
This week, the newspaper reported, Bredel's lab announced it had identified genes that are key to forming the type of tumor Lukac has, glioblastoma. The research suggests that certain genes in the tumor could determine how it will grow, which in turn could help doctors better treat the cancer. It is the same type of brain cancer Sen. Edward Kennedy has.
"The last two or three months, being here and doing what I've been able to do, it just feels great," Lukac, now 24, told the Tribune. "It sounds really weird, but it has been two or three of the best months of my life."
Said Bedel: "Having PJ around us as a co-worker and friend is something that motivates our whole team in trying to be as quick and good as possible in finding that needle in a haystack, or needles in the haystack, to make progress in the treatment ... from which, hopefully, PJ will be able to benefit."
Read the full story from the Chicago Tribune.

Prenatal Pollution May Lower IQ Scores

CHICAGO, Ill. (July 20) - Researchers for the first time have linked air pollution exposure before birth with lower IQ scores in childhood, bolstering evidence that smog may harm the developing brain.
The results are in a study of 249 children of New York City women who wore backpack air monitors for 48 hours during the last few months of pregnancy. They lived in mostly low-income neighborhoods in northern Manhattan and the South Bronx. They had varying levels of exposure to typical kinds of urban air pollution, mostly from car, bus and truck exhaust.
At age 5, before starting school, the children were given IQ tests. Those exposed to the most pollution before birth scored on average four to five points lower than children with less exposure.
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Also See: Fetuses Have Memories, Study Says
That's a big enough difference that it could affect children's performance in school, said Frederica Perera, the study's lead author and director of the Columbia Center for Children's Environmental Health.
Dr. Michael Msall, a University of Chicago pediatrician not involved in the research, said the study doesn't mean that children living in congested cities "aren't going to learn to read and write and spell."
But it does suggest that you don't have to live right next door to a belching factory to face pollution health risks, and that there may be more dangers from typical urban air pollution than previously thought, he said.
"We are learning more and more about low-dose exposure and how things we take for granted may not be a free ride," he said.
While future research is needed to confirm the new results, the findings suggest exposure to air pollution before birth could have the same harmful effects on the developing brain as exposure to lead, said Patrick Breysse, an environmental health specialist at Johns Hopkins' school of public health.
And along with other environmental harms and disadvantages low-income children are exposed to, it could help explain why they often do worse academically than children from wealthier families, Breysse said.
"It's a profound observation," he said. "This paper is going to open a lot of eyes."
The study in the August edition of Pediatrics was released Monday.
In earlier research, involving some of the same children and others, Perera linked prenatal exposure to air pollution with genetic abnormalities at birth that could increase risks for cancer; smaller newborn head size and reduced birth weight. Her research team also has linked it with developmental delays at age 3 and with children's asthma.
The researchers studied pollutants that can cross the placenta and are known scientifically as polycyclic aromatic hydrocarbons. Main sources include vehicle exhaust and factory emissions. Tobacco smoke is another source, but mothers in the study were nonsmokers.
A total of 140 study children, 56 percent, were in the high exposure group. That means their mothers likely lived close to heavily congested streets, bus depots and other typical sources of city air pollution; the researchers are still examining data to confirm that, Perera said. The mothers were black or Dominican-American; the results likely apply to other groups, researchers said.
The researchers took into account other factors that could influence IQ, including secondhand smoke exposure, the home learning environment and air pollution exposure after birth, and still found a strong influence from prenatal exposure, Perera said.
Dr. Robert Geller, an Emory University pediatrician and toxicologist, said the study can't completely rule out that pollution exposure during early childhood might have contributed. He also noted fewer mothers in the high exposure group had graduated from high school. While that might also have contributed to the high-dose children's lower IQ scores, the study still provides compelling evidence implicating prenatal pollution exposure that should prompt additional studies, Geller said.
The researchers said they plan to continuing monitoring and testing the children to learn whether school performance is affected and if there are any additional long-term effects.

Interactive Patient Care Technology Improves Outcomes in Heart Failure Care

A hospital bedside technology solution offers significant improvements in heart failure readmission rates, average length of stay, and patient satisfaction.

The Heart Failure Interactive Care Plan is powered by a proprietary workflow engine called Patient Pathways that helps automate patient care processes, and guides patients through critical aspects of their stay, inviting them to learn more about their care, condition, and safety. The system can interface with existing hospital systems, enhancing workflow without requiring the staff to use additional software or take additional steps. Tasks such as education ordering and medication dispensation can be carried out as usual, from within the hospital’s clinical system. The system can then automatically trigger a customized pathway to engage the patient in the care process, sending information back to the hospital’s clinical system for documentation in the patient’s electronic medical record (EMR).

The system comprises a head-end unit with high performance servers designed to support application and database services, private networking, firewall protection, remote access monitoring, and system maintenance services. The system also provides support for redundant power supply and surge protection, and is housed in one full height, high-density rack unit. Each patient-room display device (usually a television monitor) is equipped with a digital set-top box that acts as a controller and conduit between the head-end hardware and the display device. Patients and other end users access the system through a pillow-speaker and accompanying keyboard for text input, or via an optional remote control. Thus, the system transforms the television in the patient room into an interactive resource during the hospital stay. Patients can access an education library, entertainment options, surveys, service request menus, and more, directly at the bedside. The Heart Failure Interactive Care is a product of GetWellNetwork (Bethesda, MD, USA).

“With so much attention in health care today being devoted to improving heart failure outcomes, especially reducing hospital readmission rates, we are excited to be able to report these results,” said David Wright, chief outcomes officer of GetWellNetwork. “This study is a clear example of the impact patient engagement has on advancing quality, cost and even service outcomes in hospitals today. When patients have the resources to be a more active participant in their care, the overall care experience is exceptional.”