Sometimes the journey toward better health must begin at the beginning—with an actual acknowledgement that there’s a problem, and a sense of self-worth strong enough to allow a person reach out for help. Just ask “Greg,” a transgender man who endured pelvic pain for years.
“My body was, for me, this thing that I fed, and got it in a car, and drove places, and it did the work I wanted it to do,” Greg said. “Because I spent so much of my life feeling betrayed by it, it was just this thing I didn’t want to pay attention to.”
Now available on Move Forward Radio: a conversation with Greg and Schoonover, the physical therapist (PT) who helped Greg see his body—and his connection to it—in a new way. The podcast is a must-listen for anyone seeking a better understanding of not just the challenges faced by the transgender population, but the importance of providers honoring the individual stories every patient brings to the clinic.
Sheri Lewis, 59, of Seattle, needed a hip transplant. Bradley Fuller, 63, of nearby Kirkland, needed chemotherapy and radiation when the pain in his jaw turned out to be throat cancer. And Kim Bruzas, 55, of Waitsburg, hundreds of miles away, needed emergency care to stop sudden —and severe — rectal bleeding.
Each of these Washington state residents required medical treatment during the past few years, and each thought they had purchased health insurance through an online site.
But when it was time to pay the bills, they learned that the products they bought through Aliera Healthcare Inc. weren’t insurance at all — and that the cost of their care wasn’t covered.
Lewis and the others had enrolled in what Aliera officials claimed was a health care sharing ministry (HCSM) — faith-based co-ops in which members agree to pay one another’s medical bills.
The use of cardiac rehabilitation (CR) has grown over time, but with that growth comes changes to patient demographics that present new challenges to providers, say researchers who studied the CR patient population in 1 health system over 2 decades. They describe today’s CR patients as older, more overweight, and having a higher prevalence of coronary risk factors than CR patients in the past, with an expanded range of reasons for receiving CR that makes the population more diverse than ever.
The study analyzed data from 5,396 patients who received CR at the University of Vermont Medical Center over a 20-year period between 1996 and 2015, taking in a host of variables, including the reason for participation in CR, the presence of comorbidities, BMI, age, sex, and medications taken. Results were published in the Journal of Cardiopulmonary Rehabilitation and Prevention.
Some risk factors for osteoporosis such as being older and female or having a family history of the condition cannot be avoided. But others can, like smoking cigarettes, consuming alcohol, taking certain medications, or being exposed to environmental pollutants. But until now researchers haven’t gained a firm picture of how these exposures link up with bone loss.
A new study led by researchers from Penn’s School of Veterinary Medicine reveals a mechanism by which these factors and osteoporosis may be linked. Damage to mitochondria—key cellular organelles and energy generators—leads to a surge in the creation of cells called osteoclasts, which are responsible for breaking down bone, the researchers report in FASEB Journal. They uncovered these effects in cells in culture as well as in an animal model.
“In a normal individual, the process of bone degradation and rebuilding proceeds in a very balanced way, but in some people they somehow produce a lot more osteoclasts, and this leads to bone loss and osteoporosis,” said Narayan Avadhani, a biochemist at Penn Vet and senior author on the work. “We show in this paper that, when mitochondrial function is affected, it not only affects energy production but also triggers a type of stress signaling that induces the overproduction of osteoclasts.”
A large study of more than 21,000 people finds that training emergency medical services (EMS) agencies to implement prehospital guidelines for traumatic brain injury (TBI) may help improve survival in patients with severe head trauma. The findings were published in JAMA Surgery, and the study was supported by the National Institute of Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health.
“This demonstrates the significance of conducting studies in real-world settings and brings a strong evidence base to the guidelines,” said Patrick Bellgowan, Ph.D., program director at NINDS. “It suggests we can systematically increase the chances of saving lives of thousands of people who suffer severe traumatic brain injuries.”
Based on scores of observational studies, guidelines for prehospital management of TBI that were developed in 2000, and updated in 2007, focused on preventing low oxygen, low blood pressure, and hyperventilation in people with head injury. Collectively, the studies suggested that controlling those factors before patients arrived at the hospital could improve survival, but actual adherence to the guidelines had not been examined.
An international team of researchers, including a psychologist at Oregon State University, has developed a standardized measurement for pediatric facial palsy that will improve the care for current and future patients with the condition.
The team, which includes researchers from nine countries, published its findings Thursday in JAMA Facial Plastic Surgery.
Each year, more than a million children worldwide are diagnosed with pediatric facial palsy, a condition where there is a weakness of facial muscles on one or both sides of the face. There are a number of causes, including abnormalities in nerves at birth, trauma to the head or infections. For some children, the condition resolves with time, but others may have permanent facial palsy.
On Sunday, April 28, a team of researchers received the 2019 Human Growth Award at the Pediatric Endocrine Society’s Annual Meeting for their abstract, entitled “Clinical Characterization and Trial of Growth Hormone in Patients with Aggrecan Deficiency: 6 Month Data,” and presented this at the PES Presidential Poster Session.
Eirene Alexadrou, M.D., a fellow at Cincinnati Children’s Hospital Medical Center, accepted the award and honorarium, while ongoing research is underway. This study started in 2017, with the objective of characterizing the phenotypic spectrum and response to a standardized regimen of growth hormone in a small cohort of 10 patients and their families.
In 2017, Andrew Dauber, M.D., MMSc., the division chief of endocrinology at Children’s National Health System, led an international consortium of researchers in publishing a manuscript describing the phenotypic spectrum of 103 individuals – 70 adults and 33 children, including 57 females and 46 males – from 20 families with aggrecan gene (ACAN) mutations.
Bundled care models for total joint arthroplasty (TJA) may be popular with payers and policy makers, but do they work for patients? A new study says yes.
Researchers arrived at their conclusion after tracking TJA episodes in the University of Utah health care system during its switch from a more traditional approach to Medicare’s Bundled Payment Care Improvement (BCPI) model 2. Similar to other bundled care models, the BPCI reimburses providers a set amount for an entire episode of care, from admission to 90 days after the patient is discharged, rather than for specific services provided during care.
The before-and-after pictures focus on functional recovery, based on data from 680 prebundle and 1,216 postbundle patients gathered between 2014 and 2016 (the health system launched the BCPI in July 2015). Researchers used the Activity Measure for Post Acute Care (AMPAC) mobility assessment and the PROMIS Physical Function Computer Adaptive Test (PF-CAT) to track function outcomes. The AMPAC was used at various points during the hospital stay, and the PF-CAT tracked function presurgery and then 2 weeks, 6 weeks, and 12 months afterwards. Results were published in Arthroplasty Today.