LONDON (Reuters) - People who do not get enough sleep are more than twice as likely to die of heart disease, according to a large British study released on Monday.
Although the reasons are unclear, researchers said lack of sleep appeared to be linked to increased blood pressure, which is known to raise the risk of heart attacks and stroke.
A 17-year analysis of 10,000 government workers showed those who cut their sleeping from seven hours a night to five or less faced a 1.7-fold increased risk in mortality from all causes and more than double the risk of cardiovascular death.
The findings highlight a danger in busy modern lifestyles, Francesco Cappuccio, professor of cardiovascular medicine at the University of Warwick's medical school, told the annual conference of the British Sleep Society in Cambridge.
"A third of the population of the UK and over 40 percent in the U.S. regularly sleep less than five hours a night, so it is not a trivial problem," he said in a telephone interview.
"The current pressures in society to cut out sleep, in order to squeeze in more, may not be a good idea -- particularly if you go below five hours."
Previous research has highlighted the potential health risks of shift work and disrupted sleep. But the study by Cappuccio and colleagues, which was supported by British government and U.S. funding, is the first to link duration of sleep and mortality rates.
The study looked at sleep patterns of participants aged 35-55 years at two points in their lives -- 1985-88 and 1992-93 -- and then tracked their mortality rates until 2004.
The results were adjusted to take account of other possible risk factors such as initial age, sex, smoking and alcohol consumption, body mass index, blood pressure and cholesterol.
The correlation with cardiovascular risk in those who slept less in the 1990s than in the 1980s was clear but, curiously, there was also a higher mortality rate in people who increased their sleeping to more than nine hours.
In this case, however, there was no cardiovascular link and Cappuccio said it was possible that longer sleeping could be related to other health problems such as depression or cancer-related fatigue.
"In terms of prevention, our findings indicate that consistently sleeping around seven hours per night is optimal for health," he said.
Monday, September 24, 2007
Saturday, September 22, 2007
Pelvic Exams Can Help Spot Ovarian Cancer
SATURDAY, Sept. 22 (HealthDay News) -- Ovarian cancer, the "silent killer," may not always be so silent, experts say.
That's why women need to get regular pelvic exams and pay attention to possible symptoms of ovarian cancer, according to a team of University of Michigan Comprehensive Cancer Center experts who are trying to increase awareness about the disease.
September is Ovarian Cancer Awareness Month in the United States.
Until recently, it was believed that ovarian cancer did not produce any symptoms in its earliest, most curable stages. But researchers recently reported a group of symptoms that may indicate ovarian cancer.
The symptoms are: bloating; pelvic or abdominal pain; difficulty eating or feeling full quickly; and problems with urgency or frequency of urination. These symptoms are persistent and represent a change from a woman's normal health.
Women who experience these symptoms almost daily for more than a few weeks should see their gynecologist, the cancer center experts said.
"You can explain away these symptoms to yourself. But the only way to be sure it's nothing is to go get a pelvic exam," Dr. Rebecca Liu, assistant professor of obstetrics and gynecology at the U-M Medical School and a gynecologic oncologist at the U-M Comprehensive Cancer Center, said in a prepared statement.
An annual pelvic exam in a must, especially among older women, who are at increased risk for ovarian cancer.
Survival rates are much higher when ovarian cancer is diagnosed at an earlier stage. Five years after diagnosis, 95 percent of women with stage I ovarian cancer (the earliest stage) are still alive, compared with 30 percent of women with stage III or IV cancer. Currently, about 70 percent of women diagnosed with ovarian cancer are at an advanced stage of the disease.
More than 22,000 women in the United States will be diagnosed with ovarian cancer this year, and more than 15,000 will die from the disease.
More information
The American Cancer Society has more about ovarian cancer.
That's why women need to get regular pelvic exams and pay attention to possible symptoms of ovarian cancer, according to a team of University of Michigan Comprehensive Cancer Center experts who are trying to increase awareness about the disease.
September is Ovarian Cancer Awareness Month in the United States.
Until recently, it was believed that ovarian cancer did not produce any symptoms in its earliest, most curable stages. But researchers recently reported a group of symptoms that may indicate ovarian cancer.
The symptoms are: bloating; pelvic or abdominal pain; difficulty eating or feeling full quickly; and problems with urgency or frequency of urination. These symptoms are persistent and represent a change from a woman's normal health.
Women who experience these symptoms almost daily for more than a few weeks should see their gynecologist, the cancer center experts said.
"You can explain away these symptoms to yourself. But the only way to be sure it's nothing is to go get a pelvic exam," Dr. Rebecca Liu, assistant professor of obstetrics and gynecology at the U-M Medical School and a gynecologic oncologist at the U-M Comprehensive Cancer Center, said in a prepared statement.
An annual pelvic exam in a must, especially among older women, who are at increased risk for ovarian cancer.
Survival rates are much higher when ovarian cancer is diagnosed at an earlier stage. Five years after diagnosis, 95 percent of women with stage I ovarian cancer (the earliest stage) are still alive, compared with 30 percent of women with stage III or IV cancer. Currently, about 70 percent of women diagnosed with ovarian cancer are at an advanced stage of the disease.
More than 22,000 women in the United States will be diagnosed with ovarian cancer this year, and more than 15,000 will die from the disease.
More information
The American Cancer Society has more about ovarian cancer.
Monday, September 17, 2007
Diabetics try new round-the-clock sensor
WASHINGTON - Diabetes care is undergoing a transformation: Thousands of patients are switching from a few finger-pricks a day to track their disease to new sensors that keep guard around the clock.
The last six months brought boosts to the technology, as federal health officials approved children's use of a sensor that works for three days in a row — and cleared the longest-lasting version yet, a seven-day model, for adults.
The ultimate goal is to create an "artificial pancreas," pairing such sensors with implanted pumps that would automatically dispense insulin to make a diabetic's blood sugar better resemble a healthy person's.
That's still years away. For now, the hope is that these under-the-skin sensors will empower the most vulnerable patients — those who require insulin injections — to make changes that better control their disease. Perhaps more important, they come with alarms that can sound in time to avoid dangerously high or low blood-sugar levels.
"It really catches problems before they're problems," says Katie Clark of Grandville, Mich. She bought a sensor for her 7-year-old daughter, and no longer has to wake up in the middle of the night to spot-check whether Ellie's OK.
But these "continuous glucose monitors" cost up to $1,000, plus at least $350 a month for supplies. Insurance coverage is hit-or-miss: Some do pay but many refuse pending proof that the sensors live up to their promise of better health.
Some short-term studies show users greatly improve control of their blood sugar, while other studies have found little impact.
Why the discrepancy? Diabetics who do the worst job fighting their disease aren't going to put in extra effort to improve just because of a sensor, says Dr. Irl Hirsch of the University of Washington.
"We learned that lesson the hard way," says Hirsch, who presented research at a recent diabetes meeting suggesting the sensors instead will most benefit patients who can't lower their blood sugar to optimal levels — a score below 7 on a test called the A1C — despite following best-care guidelines.
Hirsch finds the sensors help lower A1Cs between 7 and 8.5, but not those who start out higher.
By November, scientists should complete enrollment of 450 diabetics into a study funded by the Juvenile Diabetes Research Foundation to address insurers' questions on best use of the sensors. Preliminary results are due next year.
"People thought it would just be the silver bullet, if you got this in somebody's hand they're going to do better," says Aaron Kowalski, a JDRF research director who has used the sensors himself since 2006. "That won't just magically happen. ... They need to utilize that information."
Some 21 million Americans have diabetes, meaning their bodies cannot properly regulate blood sugar, or glucose. About 5 million inject insulin, a hormone that converts glucose into energy, to treat their diabetes — including the roughly 2 million with Type 1 diabetes who require those shots to live.
High glucose levels damage blood vessels and nerves, leading to blindness, kidney failure, amputations and heart disease. Frequent glucose testing — pricking a finger for a blood test four to eight times a day — helps patients maintain tighter glucose control, thus lowering risk of those complications.
But few diabetics test that often, and even frequent testers cannot know if glucose soars or plummets between tests or during sleep.
With the new technology, diabetics use a needle to insert a sensor just under the skin of the side or abdomen every three or seven days. The sensors wirelessly beam glucose readings to a pager-like device every 5 minutes.
Available now are Medtronic Inc.'s three-day Real-Time monitor — sold by itself, for adults or children, or together with a manually adjustable insulin pump — and DexCom Inc.'s STS-7 seven-day monitor for adults. A five-day competitor from Abbott Laboratories is in development.
Users require training. For example, it takes up to 15 minutes for a glucose change in blood to be reflected in the cell fluid that these sensors measure. Doctors warn to always double-check with a blood test when a sensor signals trouble.
But many learn to tell at a glance if they need a snack to head off a coming low, or an insulin dose to block a coming spike.
When Ellie Clark's sensor showed her morning oatmeal made her glucose soar to a level of 300, her mother started giving her entire morning insulin booster before breakfast. Now the 7-year-old's morning jump is to a moderate 200.
Ellie's average glucose dropped so much after six months of sensor use that Katie Clark, also a Type 1 diabetic, bought one for herself, even though insurance wouldn't pay for mother or daughter.
To save on monthly supply fees, Clark uses her own sensor selectively, such as to watch for dropping glucose while driving long distances. "Then, it could be a lifesaver."
_____
EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
On the Net:
Diabetes and glucose sensor information: http://www.jdrf.org
The last six months brought boosts to the technology, as federal health officials approved children's use of a sensor that works for three days in a row — and cleared the longest-lasting version yet, a seven-day model, for adults.
The ultimate goal is to create an "artificial pancreas," pairing such sensors with implanted pumps that would automatically dispense insulin to make a diabetic's blood sugar better resemble a healthy person's.
That's still years away. For now, the hope is that these under-the-skin sensors will empower the most vulnerable patients — those who require insulin injections — to make changes that better control their disease. Perhaps more important, they come with alarms that can sound in time to avoid dangerously high or low blood-sugar levels.
"It really catches problems before they're problems," says Katie Clark of Grandville, Mich. She bought a sensor for her 7-year-old daughter, and no longer has to wake up in the middle of the night to spot-check whether Ellie's OK.
But these "continuous glucose monitors" cost up to $1,000, plus at least $350 a month for supplies. Insurance coverage is hit-or-miss: Some do pay but many refuse pending proof that the sensors live up to their promise of better health.
Some short-term studies show users greatly improve control of their blood sugar, while other studies have found little impact.
Why the discrepancy? Diabetics who do the worst job fighting their disease aren't going to put in extra effort to improve just because of a sensor, says Dr. Irl Hirsch of the University of Washington.
"We learned that lesson the hard way," says Hirsch, who presented research at a recent diabetes meeting suggesting the sensors instead will most benefit patients who can't lower their blood sugar to optimal levels — a score below 7 on a test called the A1C — despite following best-care guidelines.
Hirsch finds the sensors help lower A1Cs between 7 and 8.5, but not those who start out higher.
By November, scientists should complete enrollment of 450 diabetics into a study funded by the Juvenile Diabetes Research Foundation to address insurers' questions on best use of the sensors. Preliminary results are due next year.
"People thought it would just be the silver bullet, if you got this in somebody's hand they're going to do better," says Aaron Kowalski, a JDRF research director who has used the sensors himself since 2006. "That won't just magically happen. ... They need to utilize that information."
Some 21 million Americans have diabetes, meaning their bodies cannot properly regulate blood sugar, or glucose. About 5 million inject insulin, a hormone that converts glucose into energy, to treat their diabetes — including the roughly 2 million with Type 1 diabetes who require those shots to live.
High glucose levels damage blood vessels and nerves, leading to blindness, kidney failure, amputations and heart disease. Frequent glucose testing — pricking a finger for a blood test four to eight times a day — helps patients maintain tighter glucose control, thus lowering risk of those complications.
But few diabetics test that often, and even frequent testers cannot know if glucose soars or plummets between tests or during sleep.
With the new technology, diabetics use a needle to insert a sensor just under the skin of the side or abdomen every three or seven days. The sensors wirelessly beam glucose readings to a pager-like device every 5 minutes.
Available now are Medtronic Inc.'s three-day Real-Time monitor — sold by itself, for adults or children, or together with a manually adjustable insulin pump — and DexCom Inc.'s STS-7 seven-day monitor for adults. A five-day competitor from Abbott Laboratories is in development.
Users require training. For example, it takes up to 15 minutes for a glucose change in blood to be reflected in the cell fluid that these sensors measure. Doctors warn to always double-check with a blood test when a sensor signals trouble.
But many learn to tell at a glance if they need a snack to head off a coming low, or an insulin dose to block a coming spike.
When Ellie Clark's sensor showed her morning oatmeal made her glucose soar to a level of 300, her mother started giving her entire morning insulin booster before breakfast. Now the 7-year-old's morning jump is to a moderate 200.
Ellie's average glucose dropped so much after six months of sensor use that Katie Clark, also a Type 1 diabetic, bought one for herself, even though insurance wouldn't pay for mother or daughter.
To save on monthly supply fees, Clark uses her own sensor selectively, such as to watch for dropping glucose while driving long distances. "Then, it could be a lifesaver."
_____
EDITOR's NOTE — Lauran Neergaard covers health and medical issues for The Associated Press in Washington.
On the Net:
Diabetes and glucose sensor information: http://www.jdrf.org
Sunday, September 16, 2007
Doctor details 9/11 workers' illnesses
WASHINGTON - Doctors treating sickened ground zero workers offered Congress a detailed diagnosis Wednesday of the ailments still affecting thousands after the Sept. 11 attacks, but warned that there's no way to determine how many more may become afflicted with life-threatening illnesses.
Dr. Philip Landrigan of the Mount Sinai School of Medicine described three months of recent medical treatment to a House panel examining how many of those who toiled on the toxic debris pile are still sick — or may get sick.
Thousands of people "are still suffering," Landrigan said a day after the sixth anniversary of the Sept. 11, 2001 attacks. Their ailments range from runny noses to laryngitis to lung disease, he said.
"Respiratory illness, psychological distress and financial devastation have become a new way of life for many," he told the House Education and Labor Committee. He advocated leaving Sept. 11-related medical programs in place to try to determine how many workers might develop long-term diseases.
Patricia Clark, a regional official with the Occupational Safety and Health Administration, said workers who were exposed to ground zero toxins in the first 48 hours after the attacks were hit with an "incredible assault" on their health. Still, she defended her agency's air sampling, which found little evidence of dangerously high levels of asbestos and other contaminants.
The figures offered Wednesday further define the medical problems found by a 2006 Mount Sinai study, which said 70 percent of ground zero workers suffered new or worsened respiratory problems after their exposure to the debris of the World Trade Center.
Landrigan offered new specifics of the most prevalent symptoms among the police officers, firefighters, construction workers and volunteers examined.
Between April and June of this year, doctors in the 9/11 workers health program overseen by Mount Sinai saw 2,323 patients.
They found:
_Lower respiratory problems in 40 percent of patients. Asthma and asthma-like reactive airways disease were found in 30 percent. Smaller portions of patients had chronic cough — 7 percent — or chronic obstructive pulmonary disease — 5 percent.
_Upper respiratory conditions in 59 percent. The most common condition was runny nose, in 51 percent of the workers, and chronic sinusitis, in about a fifth of them.
_Mental health problems, the most common being post-traumatic stress disorder and depression, in 36 percent of patients.
Landrigan said it is still unclear how many of those patients will continue to experience such symptoms, or how many may develop new diseases like cancer many years after their exposure.
Lingering 9/11-related illnesses — and deaths of some first responders years after the attacks — have led to calls in Congress for a federal program to fund long-term health programs for those workers.
So far, the government has paid for piecemeal screening and treatment of emergency personnel, construction workers and volunteers, but advocates want such programs expanded to include lower Manhattan residents, students and tourists.
(This version CORRECTS TOPS with 5 grafs to UPDATE with testimony, OSHA official; corrects that hearing is before full committee, sted subcommittee.)
Dr. Philip Landrigan of the Mount Sinai School of Medicine described three months of recent medical treatment to a House panel examining how many of those who toiled on the toxic debris pile are still sick — or may get sick.
Thousands of people "are still suffering," Landrigan said a day after the sixth anniversary of the Sept. 11, 2001 attacks. Their ailments range from runny noses to laryngitis to lung disease, he said.
"Respiratory illness, psychological distress and financial devastation have become a new way of life for many," he told the House Education and Labor Committee. He advocated leaving Sept. 11-related medical programs in place to try to determine how many workers might develop long-term diseases.
Patricia Clark, a regional official with the Occupational Safety and Health Administration, said workers who were exposed to ground zero toxins in the first 48 hours after the attacks were hit with an "incredible assault" on their health. Still, she defended her agency's air sampling, which found little evidence of dangerously high levels of asbestos and other contaminants.
The figures offered Wednesday further define the medical problems found by a 2006 Mount Sinai study, which said 70 percent of ground zero workers suffered new or worsened respiratory problems after their exposure to the debris of the World Trade Center.
Landrigan offered new specifics of the most prevalent symptoms among the police officers, firefighters, construction workers and volunteers examined.
Between April and June of this year, doctors in the 9/11 workers health program overseen by Mount Sinai saw 2,323 patients.
They found:
_Lower respiratory problems in 40 percent of patients. Asthma and asthma-like reactive airways disease were found in 30 percent. Smaller portions of patients had chronic cough — 7 percent — or chronic obstructive pulmonary disease — 5 percent.
_Upper respiratory conditions in 59 percent. The most common condition was runny nose, in 51 percent of the workers, and chronic sinusitis, in about a fifth of them.
_Mental health problems, the most common being post-traumatic stress disorder and depression, in 36 percent of patients.
Landrigan said it is still unclear how many of those patients will continue to experience such symptoms, or how many may develop new diseases like cancer many years after their exposure.
Lingering 9/11-related illnesses — and deaths of some first responders years after the attacks — have led to calls in Congress for a federal program to fund long-term health programs for those workers.
So far, the government has paid for piecemeal screening and treatment of emergency personnel, construction workers and volunteers, but advocates want such programs expanded to include lower Manhattan residents, students and tourists.
(This version CORRECTS TOPS with 5 grafs to UPDATE with testimony, OSHA official; corrects that hearing is before full committee, sted subcommittee.)
Doctors: Protocol key to helping players
Winston Moss was still wearing his pads when he went in for the CT scan. The Seattle Seahawks linebacker suffered a neck fracture during a road game in Baltimore in 1997, and the Ravens medical staff's emergency protocol ensured that that he quickly received the proper treatment.
In the aftermath of Buffalo Bills tight end Kevin Everett's severe spinal cord injury, several neurological specialists who work with NFL teams said that the key to giving a player the best chance at recovery from a catastrophic injury is to have a well-rehearsed emergency protocol in place.
Dr. Ralph Dacey, a St. Louis Rams neurosurgeon, said that each year team physicians simulate with trainers how they would respond to a serious spinal injury.
Not all NFL teams require a neurological specialist to attend every game.
"I don't consider it an essential element," said Dr. Joseph Maroon, a neurological surgeon for one of the clubs that does insist on it, the Pittsburgh Steelers. "But I think it is essential that trainers and medical personnel be very well-versed in acute management of concussions and spinal injuries."
The Carolina Panthers' team neurosurgeon, Dr. Tim Adamson, said his presence is less important than the existence of a predetermined plan that immediately gets an injured player to the right hospital and into the necessary diagnostic tests.
"The difference I make is knowing how to quickly get them through the process of treatment and evaluation," Adamson said. "There's nothing magical to do with my presence at the stadium other than to be available to get started quickly with them."
Having a neurological specialist on call near the stadium would serve equally well, he said.
On that day 10 years ago, Moss' CT scan showed no neurological damage. Dr. Kevin Auld, the Seahawks' former team physician who recalled the treatment the player received, said he wasn't completely confident that Moss would've have gotten that needed test as promptly and efficiently in every NFL city.
Before Seattle's road games, the home team's medical staff would often share information about the emergency protocol with Seahawks doctors, but not always. Auld hoped every club had the proper procedures in place but wasn't sure.
The NFL requires that the home team have on hand a physician trained in rapid sequence intubation (for players who need help breathing) as part of the on-field emergency crew. There must also be a medevac helicopter, ambulance, stretchers and carts, X-ray service, oxygen and emergency medical information for that city.
Dr. Andrew Cappuccino, a Bills team physician who oversaw Everett's initial treatment, specializes in spinal surgery. He's a "real star" in his field, Auld said, but what most helped Everett was Buffalo's excellent emergency protocol system. Auld observed the Bills doctors' care in formulating the plan during conversations between the Buffalo and Seattle staffs at the annual NFL pre-draft combines.
While the Everett saga has focused attention on spinal injuries, the doctors agreed that the greatest need for the input of neurological specialists is with concussions, which are far more common in football.
In the aftermath of Buffalo Bills tight end Kevin Everett's severe spinal cord injury, several neurological specialists who work with NFL teams said that the key to giving a player the best chance at recovery from a catastrophic injury is to have a well-rehearsed emergency protocol in place.
Dr. Ralph Dacey, a St. Louis Rams neurosurgeon, said that each year team physicians simulate with trainers how they would respond to a serious spinal injury.
Not all NFL teams require a neurological specialist to attend every game.
"I don't consider it an essential element," said Dr. Joseph Maroon, a neurological surgeon for one of the clubs that does insist on it, the Pittsburgh Steelers. "But I think it is essential that trainers and medical personnel be very well-versed in acute management of concussions and spinal injuries."
The Carolina Panthers' team neurosurgeon, Dr. Tim Adamson, said his presence is less important than the existence of a predetermined plan that immediately gets an injured player to the right hospital and into the necessary diagnostic tests.
"The difference I make is knowing how to quickly get them through the process of treatment and evaluation," Adamson said. "There's nothing magical to do with my presence at the stadium other than to be available to get started quickly with them."
Having a neurological specialist on call near the stadium would serve equally well, he said.
On that day 10 years ago, Moss' CT scan showed no neurological damage. Dr. Kevin Auld, the Seahawks' former team physician who recalled the treatment the player received, said he wasn't completely confident that Moss would've have gotten that needed test as promptly and efficiently in every NFL city.
Before Seattle's road games, the home team's medical staff would often share information about the emergency protocol with Seahawks doctors, but not always. Auld hoped every club had the proper procedures in place but wasn't sure.
The NFL requires that the home team have on hand a physician trained in rapid sequence intubation (for players who need help breathing) as part of the on-field emergency crew. There must also be a medevac helicopter, ambulance, stretchers and carts, X-ray service, oxygen and emergency medical information for that city.
Dr. Andrew Cappuccino, a Bills team physician who oversaw Everett's initial treatment, specializes in spinal surgery. He's a "real star" in his field, Auld said, but what most helped Everett was Buffalo's excellent emergency protocol system. Auld observed the Bills doctors' care in formulating the plan during conversations between the Buffalo and Seattle staffs at the annual NFL pre-draft combines.
While the Everett saga has focused attention on spinal injuries, the doctors agreed that the greatest need for the input of neurological specialists is with concussions, which are far more common in football.
Thursday, September 13, 2007
ER kiosks let patients avoid long lines
DALLAS - An emergency room might be the last place you'd think would have do-it-yourself check-in. But Parkland Memorial Hospital has three self-service computer kiosks, similar to those used by airport passengers and hotel guests. And so do a handful of other hospital ERs, where the long wait in line to register and explain symptoms can be grueling.
True emergency cases — gunshot or car crash victims with serious injuries — are still rushed in for treatment. But patients like Rickey Washington, a diabetic concerned about numbness in his hands and feet, find it fairly simple to sign in by computer.
"Once you look and see, it's kind of easy," said Washington, 44.
Besides offering patients more privacy, the kiosks should help nurses identify the most urgent cases. Newark Beth Israel Medical Center in New Jersey plans to install check-in kiosks in its ER within the next couple months.
"Patients don't always know if their symptom is potentially bad or serious," said Dr. Marc Borenstein, chairman and residency program director for the department of emergency medicine at Beth Israel.
Parkland's administrators say patients have been spared the long check-in lines since the kiosks arrived. The hospital's ER handles about 300 cases a day.
"It's helping us find the people that we need to see right now," said Jennifer Hay, unit manager for the ER department.
Patients spend about eight minutes at the kiosks, using touchscreens to enter their name, age, and other personal information. The computer shows the patient a list of ailments to choose from, like "pain" or "fever and/or chills" and a list of body parts to indicate where it hurts.
Previously, a nurse checked in patients and took their vital signs as lines at the ER got longer and frustration mounted.
"If it's getting people to be able to sit down and not be in a long line, then it's good," said Dr. Brian Keaton, president of the American College of Emergency Physicians.
Once the patient's problem is entered into the system, it pops up on a screen accessible to the nurses. Those with chest pains, stroke symptoms or other worrisome complaints take priority. But for patients with lesser complaints, even computer kiosks can't eliminate the "wait" from ER waiting rooms. It still often takes a couple of hours for a nurse to check their vital signs, and several more to see a doctor.
John Lovelock, research director for industry research firm Gartner Inc., said patients may initially hesitate to use the kiosks, but repeat customers realize they're saving time.
"I think the public is absolutely ready for this," he said.
One family practice and urgent care center in Cookeville, Tenn., has used computer kiosks and hand-held electronic devices to get patient information since opening just over a year ago, said Kara Hufstedler, a systems manager for Satellite Med.
"We had some people who loved it. We had some people who didn't. The staff helps anyone who needs it," she said.
Brandie Glover, 27, of Dallas, said she first thought the kiosks at Parkland were "weird."
"I thought it was kind of impersonal, but at the same time, it's a quicker process," said Glover, who came to the ER with neck and ear pain. But after waiting for more than three hours without seeing a doctor, Glover decided to leave without getting treated.
Hays said that shortening the check-in time only addresses part of the problem. Like other hospitals, she said, Parkland is also trying to find ways to improve the overall wait time in its emergency room.
True emergency cases — gunshot or car crash victims with serious injuries — are still rushed in for treatment. But patients like Rickey Washington, a diabetic concerned about numbness in his hands and feet, find it fairly simple to sign in by computer.
"Once you look and see, it's kind of easy," said Washington, 44.
Besides offering patients more privacy, the kiosks should help nurses identify the most urgent cases. Newark Beth Israel Medical Center in New Jersey plans to install check-in kiosks in its ER within the next couple months.
"Patients don't always know if their symptom is potentially bad or serious," said Dr. Marc Borenstein, chairman and residency program director for the department of emergency medicine at Beth Israel.
Parkland's administrators say patients have been spared the long check-in lines since the kiosks arrived. The hospital's ER handles about 300 cases a day.
"It's helping us find the people that we need to see right now," said Jennifer Hay, unit manager for the ER department.
Patients spend about eight minutes at the kiosks, using touchscreens to enter their name, age, and other personal information. The computer shows the patient a list of ailments to choose from, like "pain" or "fever and/or chills" and a list of body parts to indicate where it hurts.
Previously, a nurse checked in patients and took their vital signs as lines at the ER got longer and frustration mounted.
"If it's getting people to be able to sit down and not be in a long line, then it's good," said Dr. Brian Keaton, president of the American College of Emergency Physicians.
Once the patient's problem is entered into the system, it pops up on a screen accessible to the nurses. Those with chest pains, stroke symptoms or other worrisome complaints take priority. But for patients with lesser complaints, even computer kiosks can't eliminate the "wait" from ER waiting rooms. It still often takes a couple of hours for a nurse to check their vital signs, and several more to see a doctor.
John Lovelock, research director for industry research firm Gartner Inc., said patients may initially hesitate to use the kiosks, but repeat customers realize they're saving time.
"I think the public is absolutely ready for this," he said.
One family practice and urgent care center in Cookeville, Tenn., has used computer kiosks and hand-held electronic devices to get patient information since opening just over a year ago, said Kara Hufstedler, a systems manager for Satellite Med.
"We had some people who loved it. We had some people who didn't. The staff helps anyone who needs it," she said.
Brandie Glover, 27, of Dallas, said she first thought the kiosks at Parkland were "weird."
"I thought it was kind of impersonal, but at the same time, it's a quicker process," said Glover, who came to the ER with neck and ear pain. But after waiting for more than three hours without seeing a doctor, Glover decided to leave without getting treated.
Hays said that shortening the check-in time only addresses part of the problem. Like other hospitals, she said, Parkland is also trying to find ways to improve the overall wait time in its emergency room.
Wednesday, September 12, 2007
Life expectancy in U.S. rises to all-time high of 78
WASHINGTON (Reuters) - Life expectancy in the United States has increased to almost 78 years, the country's highest on record, amid a downturn in deaths from heart disease, cancer and stroke, according to new federal estimates published on Wednesday.
The U.S. Centers for Disease Control and Prevention also said preliminary figures for 2005 showed an increase in the U.S. infant mortality rate from the previous year, although it called the rise statistically insignificant. Black babies under age 1 remained far more likely to die than white babies.
The CDC's National Center for Health Statistics said in a report that a child born in the United States in 2005 can expect to live 77.9 years, up from 77.8 in 2004 and continuing a rise dating back decades. U.S. life expectancy was 75.8 years in 1995 and 69.6 years in 1955.
The United States, a country of 300 million people, ranks 42nd in the world in life expectancy, according to previously released data.
U.S. whites will live longer than blacks, and women longer than men, the CDC said, reflecting enduring disparities.
The 2005 report estimated that white women will live 80.8 years, compared to 76.5 years for black women. However, black women will outlive white men (75.7 years) and black men (69.6 years), the CDC said. The CDC said the figures for both black men and women were the highest ever recorded.
"If death rates from certain leading causes of death continue to decline, we should continue to see improvements in life expectancy," CDC statistician Hsiang-Ching Kung, who worked on the report, said in a statement.
The death rates from heart disease, cancer and stroke, the three leading causes of death in the United States, fell in 2005 compared to 2004. The report showed rises in 2005 in death rates from Alzheimer's disease, the seventh-leading killer, and Parkinson's disease, the 14th-leading cause of death.
The U.S. infant mortality rate is higher than many other rich nations. The CDC said 2005 figures showed an infant mortality rate of 6.89 per 1,000 live births up to age 1, a rise from 6.79 in 2004. Infant mortality for black babies in 2005 was 13.69 per 1,000 live births, compared to 5.76 for white babies, the CDC said.
The agency said birth defects were the leading cause of infant mortality in 2005, followed by problems related to premature birth and low birth weight.
The U.S. Centers for Disease Control and Prevention also said preliminary figures for 2005 showed an increase in the U.S. infant mortality rate from the previous year, although it called the rise statistically insignificant. Black babies under age 1 remained far more likely to die than white babies.
The CDC's National Center for Health Statistics said in a report that a child born in the United States in 2005 can expect to live 77.9 years, up from 77.8 in 2004 and continuing a rise dating back decades. U.S. life expectancy was 75.8 years in 1995 and 69.6 years in 1955.
The United States, a country of 300 million people, ranks 42nd in the world in life expectancy, according to previously released data.
U.S. whites will live longer than blacks, and women longer than men, the CDC said, reflecting enduring disparities.
The 2005 report estimated that white women will live 80.8 years, compared to 76.5 years for black women. However, black women will outlive white men (75.7 years) and black men (69.6 years), the CDC said. The CDC said the figures for both black men and women were the highest ever recorded.
"If death rates from certain leading causes of death continue to decline, we should continue to see improvements in life expectancy," CDC statistician Hsiang-Ching Kung, who worked on the report, said in a statement.
The death rates from heart disease, cancer and stroke, the three leading causes of death in the United States, fell in 2005 compared to 2004. The report showed rises in 2005 in death rates from Alzheimer's disease, the seventh-leading killer, and Parkinson's disease, the 14th-leading cause of death.
The U.S. infant mortality rate is higher than many other rich nations. The CDC said 2005 figures showed an infant mortality rate of 6.89 per 1,000 live births up to age 1, a rise from 6.79 in 2004. Infant mortality for black babies in 2005 was 13.69 per 1,000 live births, compared to 5.76 for white babies, the CDC said.
The agency said birth defects were the leading cause of infant mortality in 2005, followed by problems related to premature birth and low birth weight.
Thursday, September 6, 2007
Breast cancer more deadly in black women
A new study gives a possible explanation for why breast cancer is more deadly in black women: they are more likely to have tumors that do not respond to the hormone-based treatments that help many others with the disease.
The study is the largest yet to link a biological factor to the racial disparity, which also has been blamed on black women getting fewer mammograms and less aggressive treatment.
"This puts biology more to the forefront," said Dr. Julie Gralow, a cancer specialist at the University of Washington School of Medicine familiar with the work. "It's not just access to care, access to treatment and other factors that have been implicated in the past."
The study was led by Dr. M. Catherine Lee of the University of Michigan Comprehensive Cancer Center and is to be presented at a conference starting Friday in San Francisco, organized by the American Society of Clinical Oncology and other cancer groups.
Breast cancer is the most common cancer in American women. An estimated 178,480 new cases and 40,460 deaths from it are expected in the United States this year.
Blacks are less likely than whites to develop breast cancer but are more likely to die from it, doctors have long known. Blacks also are diagnosed at younger ages and at later stages of disease.
Researchers for the first time used the National Cancer Data Base, a tumor registry maintained by the American College of Surgeons, to explore these issues, using more than 170,000 cases diagnosed in 1998. Ten percent were in black women.
The study focused on the 95,500 women whose cancers were invasive rather than still confined to a milk duct. About 39 percent of such tumors in black women were estrogen receptor-negative, or ER-negative, compared with 22 percent of those in white women.
Estrogen helps tumors grow. Drugs that block this hormone, like tamoxifen and a newer class of medications called aromatase inhibitors, work against these cancers.
ER-negative tumors are resistant to such therapies and harder to treat. Other tools like chemotherapy, radiation and targeted biological drugs then become more important for such women, and doctors should consider this when they evaluate black women with the disease, Lee said.
In the study, ER-negative tumors were more common in black women at every stage of disease and at all ages.
For example, only 17 percent of early stage tumors in white women were ER-negative, but 31 percent in black women were. Of the most advanced cancers, 31 percent in whites and 46 percent in blacks were ER-negative.
Echoing previous research, the new study found that black women were diagnosed at younger ages — an average of 57 years old versus 62 for white women — and with more advanced disease: only 29 percent had early stage tumors versus 42 percent of white women. They also had larger tumors and more cell traits that are signs of a poor prognosis.
Smaller studies have suggested biological differences between breast cancer in blacks and whites. Earlier this year, the Carolina Breast Cancer Study found that young black women were more likely to have an aggressive form called the basal-like subtype.
Last fall, two studies by researchers from the University of Texas M. D. Anderson Cancer Center found that black women were more likely to have larger, later-stage tumors and lower survival rates than Hispanic and white women given similar treatments.
But these findings do not mean that differences in screening and health care are not contributing to the trend, especially in certain parts of the country, said Dr. Wendy Woodward, a breast cancer specialist at M.D. Anderson.
"You really have to kind of go at the problem from all angles. If you solve the access problem and women come in and you don't have an adequate therapy for them, you haven't taken a step forward," she said.
Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, agreed. Racial disparity in breast cancer survival did not appear until the mid-1980s, suggesting that much of it is due to lack of screening mammograms and access to care, he said.
___
On the Net:
Cancer treatment information: http://www.plwc.org
American Cancer Society: http://www.cancer.org
National Cancer Institute: http://www.cancer.gov
The study is the largest yet to link a biological factor to the racial disparity, which also has been blamed on black women getting fewer mammograms and less aggressive treatment.
"This puts biology more to the forefront," said Dr. Julie Gralow, a cancer specialist at the University of Washington School of Medicine familiar with the work. "It's not just access to care, access to treatment and other factors that have been implicated in the past."
The study was led by Dr. M. Catherine Lee of the University of Michigan Comprehensive Cancer Center and is to be presented at a conference starting Friday in San Francisco, organized by the American Society of Clinical Oncology and other cancer groups.
Breast cancer is the most common cancer in American women. An estimated 178,480 new cases and 40,460 deaths from it are expected in the United States this year.
Blacks are less likely than whites to develop breast cancer but are more likely to die from it, doctors have long known. Blacks also are diagnosed at younger ages and at later stages of disease.
Researchers for the first time used the National Cancer Data Base, a tumor registry maintained by the American College of Surgeons, to explore these issues, using more than 170,000 cases diagnosed in 1998. Ten percent were in black women.
The study focused on the 95,500 women whose cancers were invasive rather than still confined to a milk duct. About 39 percent of such tumors in black women were estrogen receptor-negative, or ER-negative, compared with 22 percent of those in white women.
Estrogen helps tumors grow. Drugs that block this hormone, like tamoxifen and a newer class of medications called aromatase inhibitors, work against these cancers.
ER-negative tumors are resistant to such therapies and harder to treat. Other tools like chemotherapy, radiation and targeted biological drugs then become more important for such women, and doctors should consider this when they evaluate black women with the disease, Lee said.
In the study, ER-negative tumors were more common in black women at every stage of disease and at all ages.
For example, only 17 percent of early stage tumors in white women were ER-negative, but 31 percent in black women were. Of the most advanced cancers, 31 percent in whites and 46 percent in blacks were ER-negative.
Echoing previous research, the new study found that black women were diagnosed at younger ages — an average of 57 years old versus 62 for white women — and with more advanced disease: only 29 percent had early stage tumors versus 42 percent of white women. They also had larger tumors and more cell traits that are signs of a poor prognosis.
Smaller studies have suggested biological differences between breast cancer in blacks and whites. Earlier this year, the Carolina Breast Cancer Study found that young black women were more likely to have an aggressive form called the basal-like subtype.
Last fall, two studies by researchers from the University of Texas M. D. Anderson Cancer Center found that black women were more likely to have larger, later-stage tumors and lower survival rates than Hispanic and white women given similar treatments.
But these findings do not mean that differences in screening and health care are not contributing to the trend, especially in certain parts of the country, said Dr. Wendy Woodward, a breast cancer specialist at M.D. Anderson.
"You really have to kind of go at the problem from all angles. If you solve the access problem and women come in and you don't have an adequate therapy for them, you haven't taken a step forward," she said.
Dr. Len Lichtenfeld, deputy chief medical officer of the American Cancer Society, agreed. Racial disparity in breast cancer survival did not appear until the mid-1980s, suggesting that much of it is due to lack of screening mammograms and access to care, he said.
___
On the Net:
Cancer treatment information: http://www.plwc.org
American Cancer Society: http://www.cancer.org
National Cancer Institute: http://www.cancer.gov
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