New York Times
Afraid to get tested? Slow down and think about it
According to the Centers for Disease Control and Prevention, one in three patients infected with H.I.V. do not get tested in sufficient time to benefit from existing treatments. And other studies show low rates for colonoscopies, mammograms and an array of genetic testing. Now, new research is trying to find ways to help patients get recommended tests rather than evade testing, a phenomenon psychologists call “health information avoidance.” One of the most common barriers to being tested — or finding out the test results — is fear. According to WUSM social psychologist Dr. Amy McQueen, “if we could prime people” with approaches like contemplation, giving them the chance to slow down and think things through, they might be more willing to risk learning valuable information in a timely fashion. Other outlets: Herald-Tribune (Sarasota, FL)
Men have slim chance of breast cancer but still at risk
Surprisingly, even men can have the BRCA gene mutation that made actress Angelina Jolie susceptible to an aggressive form of breast cancer. “The issue is it’s not a sex-linked gene, so it can be in men and women,” said Dr. Michael Naughton. “Men can pass it on to their daughters women can pass it on to their sons.”
U.S. News & World Report (HealthDay)
Famous face test may spot early dementia
New research suggests that a test based on a person’s inability to verbally identify photos of well-known faces, such as Oprah Winfrey, John F. Kennedy or Albert Einstein, may help diagnose primary progressive aphasia, a form of dementia that tends to strike men and women between the ages of 40 and 65. It is principally known for disrupting language skills, making it difficult for patients to understand or find the right words when trying to articulate their thoughts. However, WUSM’s Dr. Catherine Roe took a cautious view of the findings. “To help us know how to use this test as a screening tool,” Roe said, “more research needs to be done to figure out whether this test distinguishes all people with dementia from people without dementia or whether it distinguishes only people with one particular type of early-onset dementia from people without dementia.” Other outlets: WebMD, Health24
Freezing sperm taken directly from testicles is effective option for infertile couples
A recent WUSM study published in PLOS ONE found that frozen sperm taken by biopsy from testicles in men with no sperm in their semen is as effective as fresh sperm taken by biopsy in helping couples conceive through in vitro fertilization (IVF). In these men, a biopsy in a testicle often results in enough sperm to be used in a procedure called intracytoplasmic sperm injection (ICSI) as part of the IVF process in men with severe infertility. “The convenience and ease of being able to use frozen sperm taken by biopsy in ICSI offers many advantages over fresh sperm,” Dr. Kenan Omurtag said. When frozen sperm is used, the man can have his biopsy first, and if sperm is found, it can be banked. Then, at the couple’s convenience, the woman’s eggs are retrieved and ICSI can be completed. Other outlets: Science Codex, Innovations Report(Germany), Wired (UK), MedLexicon, Australasian Science, Medical XPress, Scicasts, Medscape(free registrations required) Related news release
Washington Post (Associated Press)
Woman’s ‘Lego Leg’ video a hit
After losing her left foot in an accident, Christina Stephens, an occupational therapist and clinical researcher at WUSM, began a series of YouTube videos and a Facebook page under the name “AmputeeOT,” in which she addresses issues that many new amputees struggle with. Her video detailing the construction of a prosthetic lower leg out of hundreds of Lego pieces recently went viral. “I thought my Legos video had some viral potential but I had no idea it would explode like it did,” she said. The YouTube video has more than 1.3 million views since it was posted in early July. WUSM’s Kerri Morgan, said Stephens has always been talented in her work, but even more so now. “Since her injury, she has a different perspective to offer, making her an even stronger and more passionate occupational therapist,” Morgan said. Other outlets: ABC News, CBS News, Fox News, NBC News, BusinessWeek, News.com (Australia), KMOV-TV, Brisbane Times(Brisbane, AU), Southeast Missourian, Pioneer Press (Minneapolis-St. Paul, MN) and 66 others.
Mouth microbe turns carcinogenic
New research published in Cell Host & Microbe using mouse models shows that F. nucleatum, a microbe indigenous to the mouth, could also be found in the gut, where its abundance induces pro-inflammatory and oncogenic activities that promote the growth of colorectal cancer. Dr. Gautam Dantas, who was not involved in the research, said the new work makes “significant strides towards . . . identifying the mechanisms by which a human commensal bacterium,Fusobacterium nucleatum, promotes colorectal cancer.”
Sequestration ushers in a dark age for science in America
Top officials at academic and medical institutions have grown convinced that years of stagnant budgets and recent cuts have ushered in the dark ages of science in America. For the past 26 years, Dr. John Turk has been developing cultured cell lines and colonies of genetically modified mice for the purpose of advancing diabetes treatments. But Turk now finds himself in what he calls the “worst funding environment during my career,” and fears that he may be forced to close his lab before completing his research. “Research that has taken a quarter of a century to develop would be lost,” he said.
The curious case of Lars Anderson
The White Sox recently released Lars Anderson, the No. 18 prospect in the minors before the 2009 season. Senior writer David Schoenfield muses on Anderson’s poor batting performance in the major leagues and cites David Epstein’s new book, “The Sports Gene: Inside the Science of Extraordinary Athletic Performance,” where Epstein writes that when WUSM scientists tested the greatest hitter of his era, Albert Pujols, he was in the 66th percentile for simple reaction time compared with a random sample of college students. Epstein goes on to suggest that it’s not reaction time that makes Pujols or other major league hitters so good, but their experience in facing certain pitches and ability to read opponents’ body language and thus better anticipate the pitch.
St. Louis Post-Dispatch
Wash U med students see other side of St. Louis
A weeklong program allows incoming Washington University medical students to visit some of St. Louis’ most distressed neighborhoods to expose the doctors-in-training to public health needs. The tour is aimed at raising awareness of the disparities in health care based on race, income and geography. “We don’t want them to be locked in a classroom,” said Dr. Will Ross. “We want them to get out and touch the community.” Other outlets: KCTV-TV (Kansas City), Southeast Missourian (Cape Girardeau), Macon Telegraph (Macon, MO), KMOX radio
American Medical News
Buddy programs link med students, Alzheimer’s patients
Future physicians at four U.S. medical schools, including WUSM, are getting a firsthand opportunity to understand better what life is like for early-stage Alzheimer’s patients and their caregivers. Through the Buddy Program, first-year medical students are paired with patients for social activities. The program began as a way to empower Alzheimer’s patients, putting them in a position to help medical students. But a presentation at the recent 2013 Alzheimer’s Association International Conference shows that the medical students are gaining from the experience, too. It improves students’ knowledge and familiarity with Alzheimer’s, and it heightens their sensitivity and empathy toward people with the disease. Other outlets: AARP
St. Louis Post-Dispatch
Most St. Louis area hospitals improve readmissions
Most St. Louis-area hospitals have reduced their numbers of Medicare patients who are readmitted within a month of discharge. But those hospitals will still pay substantial fines over the next year for readmissions. In the last several years, Barnes-Jewish Hospital has made a “multimillion-dollar investment” to prevent readmissions, according to Dr. John Lynch. As part of the hospital’s “Stay Healthy Outpatient Program,” nurse care managers, respiratory therapists and social workers go to patients’ homes during the first 60 days after their discharge; the hospital’s mobile pharmacy program enables patients to leave the hospital with a 30-day supply of medicine; and the hospital is working with WUSM to open a clinic for patients who are unable to see their doctor soon after discharge.
Sydney Symphony’s new conductor David Robertson has music on the brain
A profile of St. Louis Symphony music director David Robertson, as he begins a five-year stint as chief conductor of the Sydney Symphony included is his experience at WUSM in October 2011. As part of an experiment, Dr. Marcus Raichle arranged for Robertson to have an fMRI brain scan while listening to music. Robertson and the scientists were surprised to see a super-tingle of neural activity when his scans were compared to two non-musicians.
St. Louis Post-Dispatch
Suggestions flow as Missouri legislators weigh options for Medicaid
Two Senate hearings were held recently as Missouri legislators grapple with whether to expand Medicaid to cover an additional 260,000 people, as envisioned by the federal Affordable Care Act. Overall, about 25 percent of health care services are used by 1 percent of the patients, said Dr. Larry Lewis. The “super-utilizers” include people with chronic conditions, mental health issues and substance abuse problems. Coordinating their care can reduce duplicative tests and unnecessary use of emergency rooms while improving patients’ health, he said. “We have the most expensive health care system in the world, with outcomes that have really fallen behind many industrialized countries,” Lewis said.
Fuel smoke linked to cardiovascular issues
Rural households in developing countries often rely on burning biomass, such as wood, animal dung and waste from agricultural crops, to heat cooking stoves and their homes. The practice is long known to cause lung disease, but a new study in the journal Heart links the resulting smoke to cardiovascular problems including an increase in artery-clogging plaques, artery thickness and higher blood pressure. Dr. Victor Davila-Roman said the study and others like it lay the groundwork for future trials to measure effects of altering cooking stoves to direct the smoke outside the home. “The alterations can’t be too expensive,” Davila-Roman said. “And even with a reasonable cost, we have to have solid evidence to convince the people making the decisions that modifying these stoves is worthwhile.” Other outlets: Science Daily, AllVoices,Examiner Related WUSM news release
MedScape Today (free registration required)
Ancient gut microbiomes shed light on modern disease
Genetic analysis of the microbes in ancient human feces from an archaeological site in Durango, Mexico, shows that ancient cave-dwelling people of the area carried microbial communities similar to those of present-day residents of remote rural areas. “Understanding these ancient microbiomes may provide some insight into how our physiology and pathophysiology has changed,” said Dr. Indi Trehan. “These are still early days in understanding this field—and even earlier still in applying the information provided by studies of ancient humans’ microbiomes—but I am … optimistic that we have much to learn from these studies that may be useful for our present-day problems.”
Top 10 Microbiology Schools
WUSM is included in this list of leading microbiology programs. “Housed in the state-of-the-art McDonnell Pediatric Research Building, this Department of Molecular Microbiology offers a top-ranked environment for all students of biological microbes. The focus here is on the rapid transfer of scientific discovery into clinical practice.”
New initiative could help improve surgical outcomes in children, study suggests
The National Surgical Quality Improvement Program (NSQIP) is the first national database able to reliably compare outcomes among different hospitals where children’s surgery is performed. Participating institutions employ a full-time surgical clinical reviewer who collects data in nearly 100 different categories, ranging from patient demographics to specific post-surgical complications that patients experience within 30 days of surgery. Each institution submits its data, then receives a report that shows how they rank in the different categories. “Hospitals with below expected performance may use the information yielded from this analysis to improve surgical outcomes locally,” said Dr. Jacqueline M. Saito. “Eventually, best practice guidelines will be developed using processes from hospitals with better than expected outcomes.”
Wash. U, Barnes-Jewish lung transplant program
It was one of the first programs of its kind in the country. Now the WUSM and Barnes-Jewish lung transplant program is celebrating 25 years of changing lives. The program’s first successful adult lung transplant was performed on July 17, 1988. Today, the program is one of the world’s largest, with surgeons completing more than 1,280 lung transplants to date.
Cardiac arrest is less final at the gym
Your gym might be the least deadly place for your heart to stop, according to a new study in theJournal of the American College of Cardiology. Gyms show better sudden cardiac arrest survival rates compared with other public places since most are equipped with automated external defibrillators (AEDs). However, AEDs were used in only a quarter of events recorded in the study, which leaves room for improvement, said Dr. Igor R. Efimov. “The problem is when cardiac arrest happens, in this very stressful moment we don’t really know where exactly the nearest automated external defibrillator is,” he said. (Dr. Efimov video included)
Early lessons learned from key trials about glaucoma medical therapy
Despite initial skepticism, an array of multicenter, randomized clinical trials for glaucoma have played an important role in defining treatment. For example, The Ocular Hypertension Treatment Study (OHTS) offered a risk calculator, profiling those who were more or less likely to develop glaucoma based on a number of factors, Dr. Michael Kass said. “This looked at the patient’s age, intraocular pressure, cup disc ratio, corneal thickness, and pattern standard deviation from the visual field,” he said. “It said that if you look at these things as a group, you can estimate the five-year risk of someone developing glaucoma.”
Maintaining health and vitality in old age
Aging is inevitable and with a few simple lifestyle choices and attitude adjustments, people can improve the odds of aging with health and vitality. “It’s never too late to start,” emphasizes Dr. Ruth Clark. She suggests following the American Heart Association’s ‘Life’s Simple 7’ to improve quality of life, which includes controlling cholesterol, eating healthy, managing blood pressure, maintaining a healthy weight, exercising and not smoking.
Most patients returned to work after TKA, and many to the same job
According to a recently presented study, 91% of patients return to work after total knee replacement. “We can tell our patients confidently that a high percentage of young, active patients will return to work without limitations and to their usual occupations,” said Dr. Ryan M. Nunley. “Patients in more sedentary [occupations] have a high return to the same occupation. Even those of the very heavy [labor occupation] tend to return 80% of the time.” He also noted there was a gender difference. “We did find that males fared better than females in terms of their return to work,” he said.
Medscape Today (free registration required)
More differences found between Alzheimer’s and Parkinson’s
Although some research points to the possibility of a pathologic overlap between Alzheimer’s disease and Parkinson’s disease, two recent studies highlight the differences between these neurodegenerative diseases. One study, led by Dr. Meghan C. Campbell, found substantial differences between the patients with Parkinson’s and those with Alzheimer’s in the topography of Pittsburgh compound B (PiB) binding.
Pacific Standard Magazine
Our cyborg overlords may arrive sooner than expected
Optogenetics was invented in 2005 when a group of scientists at Stanford University showed that they could control rat neurons using a light-activated protein transplanted from green algae. Now, scientists are primarily using optogenetics in the lab, in research aimed at answering basic questions about how the brain works, and to explore possible treatments for neurological diseases like stroke, Huntington’s disease, and some forms of blindness. In the most dramatic demonstration of the potential of optogenetics, a team of scientists at WUSM and the University of Illinois created genuine mouse cyborgs. They built a micron-scale electronic device that could seamlessly interact with optogenetically modified neurons in a mouse’s brain.
St. Louis Public Radio
The battle between your body clock and the mechanical clock
University researchers Paul Gray and Erik Herzog are studying the biology behind our daily internal clock, or circadian rhythm. “It’s not really possible to defy the clock,” said Gray. “It’s as functional as your kidneys. The best you can do is try to accommodate your clock.”
Bee sting acupuncture – too good to be true?
The venom that honeybees produce has been a staple of folk medicine for generations, but its use today in an era of evidence-based medicine is controversial. While the venom might have potential, there is no definitive research showing it can be used to treat disease. Last March, researchers at WUSM published a study showing that mettilin, a potent toxin found in bee venom, is exceptionally good at destroying the HIV virus. The research is still in its early stages.
Everything you need to know about IUDs
Ariana Tobin lists facts about the oft-misunderstood IUD. IUDs can cost up to $1,000 out of pocket — a bargain compared to the pill when you consider it can last 10 years — but a prohibitive cost up front. In 2006, WUSM scientists (through the Choice Project) provided 10,000 women with contraceptive education, then gave them free access to whatever method they chose. Half of the participants ended up choosing an IUD, showing that the price was indeed prohibitive for some.
KMOV-TV (Associated Press)
One year since rare transplant in St. Louis
Doctors at WUSM and Barnes-Jewish Transplant Center are marking a milestone. On Aug. 12, 2012, 34-year-old William Drabant II of Baldwin City, Kan., became the first adult to receive a combination liver-double lung transplant at the center. Only 56 of the surgeries have been performed in the United States. Drabant returned to BJH to celebrate with his medical team. Other outlets: Enquirer Herald (York, SC) KTVI-TV FOX 2, KPLR-TV, KMOX, KTRS
St. Louis Beacon
Finding breast cancers that regular mammograms don’t catch
Many studies have shown that mammograms detect breast cancers in 98 percent of women with fatty breasts, but miss more than half of cancers in women with very dense breasts. Some physicians and professional organizations are uncomfortable with laws mandating that doctors tell women that they have dense breasts. Dr. Barbara Monsees worries that the emphasis on other screening techniques such as ultrasound or CT scans may damage women’s perception of mammograms, which she says are still the best way to detect breast cancer. Monsees favors an individualized approach to breast cancer diagnosis and screening, where a doctor and patient go over all risk factors, including family or personal cancer history, prior breast biopsies and other factors.
Viral infection and specialized lung cells linked to chronic obstructive pulmonary disease
Investigators at WUSM have described another link in the chain of events that connect acute viral infections to the development of COPD, a discovery that points to a new therapeutic target for the disease. It is well established that smoke exposure is a major risk factor for COPD, but in this new research investigators show that the cells that line the airways also can respond to viruses in a way that leads to long-term lung inflammation and mucus production that are typical of COPD. The research, featured on the cover of the September issue of the Journal of Clinical Investigation, reconciles the discrepancy between the transient nature of most viral infections and the relatively permanent nature of chronic inflammatory diseases such as COPD. Other outlets:News-Medical Related WUSM news release
Muscle cramps in hands: a symptom of rheumatoid arthritis?
Besides causing pain and inflammation in the joints of the hand, rheumatoid arthritis can also alter muscle function. “The inflammation in joints causes spasms in the muscles adjacent to the joints, which is probably why people have hand cramps,” explained Dr. Richard Brasington. “Plus, any dysfunction in joints is going to affect the adjacent muscles.” To help alleviate pain, Dr. Brasington offers a slightly off-beat version of a hot compress: Fill a plastic container with uncooked white rice and microwave until the rice is hot, but not scalding. Immerse hands in the rice and close and open hands to help ease tension and pain in the hands.
St. Louis Post-Dispatch
Hair salon offers beauty treatments to patients, staff
Stylist Ellie Seibert shares a behind-the-scenes look at her work both in and out of the Philip Johnson Salon at Barnes-Jewish Hospital. Seibert often packs up a portable sink and styling kit to provide in-room services to patients who cannot come to the salon. From oxygen tanks to IV lines, the work comes with many complications not found in a regular salon setting – but Seibert says it’s much more rewarding. “Not your average hairstylist can do this job,” said Seibert.
St. Louis Post Dispatch
Tickets to sleep success
Children who get more sleep get better grades, exhibit better behavior and show an overall better “social intelligence,” according to pediatric hospitalist Dr. Kelly Ross. She shared some tips for parents to help children keep a healthy sleep routine, including using the Four B’s – bath, book, bottle/breastfeed, bed.
Aggression towards animals
Clinical psychologist Dr. Randi Mozenter talks with KMOX’s Fred Bodimer about the mental factors that may drive some people to become aggressive and even abusive to animals. She says the abusers could be acting out aggression, frustration, or unfairness in one’s life without having a good outlet for dealing with their problems.
Community Health Magazine
Back on schedule
Gynecologist Dr. Rosanna Gray-Swain shares some current screening recommendations for women: Pap test every three years for women between ages 21 and 30 and every five years between 30 and 65; Mammogram – every one or two years between 40 and 50, then every year after 50. Gray-Swain adds that bone density scans are “vastly overused” and most appropriate for women 65 and older.
Mehlville bus transfers
Pediatric hospitalist Dr. Kelly Ross explains the effects that long bus rides could have on students traveling to Mehlville from the Riverview Gardens School District. She adds that an extra half-hour of sleep each night is usually all it takes to help kids perform better in school and have overall better behavior. She also says the behavioral consequences of sleep deprivation can look like ADHD.
KTVI-TV Fox 2
Taking kids to public restrooms
Most cases of sexual abuse in public restrooms occur with mom or dad standing right outside the door. Pediatric hospitalist Dr. Kathleen Berchelmann recommends parents look for family restrooms or restrooms with only one exit. Also, talk to your child through the door, advise young boys to always use a private stall, and always discourage children not to talk to strangers in the bathroom.
Pedal the Cause
The anchor team at KSDK stopped by to visit and distribute chocolates to cancer patients at St. Louis Children’s Hospital and Siteman Cancer Center. KSDK is promoting the upcoming Pedal the Cause bicycle race in October, which raises money for cancer research at Siteman and St. Louis Children’s.
The inspiration for Camp Rhythm, devoted exclusively to children who have had heart surgery or have heart conditions, came after a child with a heart condition was turned away from summer camp because his medical needs were too complex. Nobody at Camp Rhythm feels different or ashamed of chest scars according to pediatric cardiologist Dr. Mark Grady. “The scars are sort of a badge of honor,” he says. Doctors, nurses, child-life specialists, pharmacists and other SLCH staff use their personal vacation time to volunteer at the camp. “Basically, we sort of have a Children’s Hospital annex out here with all the nursing staff and physicians to help supervise their care,” Grady says. This gives the kids a chance to be kids.
Umps visit sick kids
Major League Baseball umpires armed with animals from Build-a-Bear visited with children in the SLCH cancer clinic. The visit was organized by UMPS CARES, which is a charitable organization within MLB that works to enrich the lives of sick children.
Nasal vent strategies equal in tiniest preemies
A new study in the New England Journal of Medicine finds that preemies treated with intermittent positive-pressure ventilation and babies treated with continuous positive airway pressures showed no difference in outcomes. This gives bedside clinicians a choice in how they deliver ventilation. “Thanks to the ‘pragmatic’ investigative strategy of this trial — multiple international centers, considerable clinician choice — this study provides a real-world assessment that is applicable to a common problem (respiratory failure) in very premature infants,” said Dr. F. Sessions Cole.
Medical News Today
Daniel’s journey – pioneering cerebral palsy surgery
A five-year-old boy from the United Kingdom and his family are raising money to travel to St. Louis Children’s Hospital to receive spinal surgery with neurosurgeon T.S. Park to improve Daniel’s mobility. Daniel suffers from spastic cerebral palsy. The operation, called selective dorsal rhizotomy, disables the nerve rootlets that cause spasticity, improving mobility.