Concerns Also Expressed About Impact of '08 Budget on Medicare Recipients in Need of Medical Rehabilitation Care CRYSTAL CITY, Va., Feb. 12 /PRNewswire-USNewswire/ -- Researchers presented findings today at the State of the Science Symposium on Post-Acute Rehabilitation in Crystal City demonstrating that the setting for rehabilitative care directly influences the outcome for patients recovering from strokes, joint replacement operations, and other conditions. The findings highlighted the need for evidence-based research to drive public-policy decisions for Medicare recipients in need of post-acute rehabilitation services. Researchers also expressed concern about the impact of the proposed 2008 budget on Medicare beneficiaries who are in need of rehabilitative care to recover from a stroke, joint replacement surgery, hip fracture, and other illnesses. The findings were discussed at a press conference today at the opening of the symposium in Crystal City, Virginia. The symposium opened with remarks from Senator Bob Dole.

SAN FRANCISCO, Feb. 8 -- Women do not always show textbook examples of stroke symptoms to emergency department physicians, researchers said here.

In a study of more than 1,700 patients with confirmed stroke, women were 33% less likely than men to have any of the five classical warning signs as the chief complaint, said Julia W. Gargano, M.S., of Michigan State University in East Lansing.

CHICAGO, Feb. 5 -- Older men and women who are lonely are twice as likely to develop Alzheimer's-type dementia as their peers with good social networks, researchers have found.

The elevated risk for dementia among the lonely was unrelated to medical causes for Alzheimer's disease or other forms of dementia, suggesting that the social isolation may lead to dementia by another route, wrote Robert S. Wilson, Ph.D., and colleagues at Rush University here and the University of Pennsylvania.
Action Points

* Explain to patients who ask that the link between loneliness and increased risk for dementia is unclear, but may be related to behavioral changes brought on by dementia, or by changes in brain function caused by reaction to social isolation.

"The basis of the association of loneliness with Alzheimer's disease and cognitive decline is uncertain," the investigators wrote in the February issue of Archives of General Psychiatry. "One possibility is that loneliness is a consequence of dementia, perhaps as a behavioral reaction to diminished cognition or as a direct result of the pathology contributing to dementia."

GLASGOW, Scotland, Feb. 5 -- About half of adults with newly diagnosed epilepsy will have good control of their seizures with the first medication tried, and a majority of responders will be seizure free at the lowest dose, reported European investigators.
Action Points

* Explain to patients who ask this study indicates that either of two drugs -- controlled-release carbamazepine (Carbatrol) or levetiracetam (Keppra) -- is effective at preventing recurring seizures in adults who are newly diagnosed with epilepsy.

In a double-blind trial comparing Keppra (levetiracetam) with Carbatrol (controlled-release carbamazepine) in such patients, nearly three-fourths of those randomized to either medication were seizure-free on the last evaluated dose for at least six months, reported Martin J. Brodie, M.D., of the Western Infirmary here, and colleagues, in the Feb. 6 issue of Neurology.

MILWAUKEE, Feb. 2 -- When patients with chest pain arrive at the emergency department, they may get profiled, before decisions are made on care, by race, female gender, and insurance coverage, found a national study by researchers here.
Action Points

* Explain to interested patients that although this study contributes to the growing literature on disparities in the provision of cardiac care, the study could not determine the clinical outcome of the disparities, or the cause or appropriateness of these differences.

A retrospective study of 7,068 patients, corresponding to more than 32 million such visits annually, found differences in who gets ECGs and x-rays as well as cardiac rhythm and oxygen saturation monitoring using pulse oximetry, said a study published in the February issue of Academic Emergency Medicine.

DES PLAINES, IL -- February 1, 2007 -- Clinical practice guidelines on supporting families whose loved ones are patients in intensive care units (ICU) will be published in the February issue of Critical Care Medicine and available on the Society of Critical Care Medicine's website www.LearnICU.org.

This is the first set of guidelines that defines standards for incorporating families into decision-making and care for ICU patients. "The guidelines attempt to define evidence-based best practices for support of families in the delivery of patient-centered care in the ICU," says Judy E. Davidson, RN, FCCM, chairperson of the American College of Critical Care Medicine task force and the lead author of the guidelines. "It is now known that up to 80% of family members of ICU patients develop anxiety, depression and/or post-traumatic stress response related to their experience."

TAMPA, Fla.--(BUSINESS WIRE)--Jan 31, 2007 - Nanobac Pharmaceuticals Inc. (OTCBB:NNBP) ("Nanobac" or "the Company") announces new evidence that may help solve one of the great puzzles of 21st century medicine was published today in a special section of the Journal of Investigative Medicine. It features leading scientists in the field brought together by The American Federation for Medical Research and the American Physiological Society.

Is chronic disease triggered by an infection? New evidence comes from scientists at NASA, Mayo Clinic, and Nanobac Pharmaceuticals who pioneered investigations into infectious calcifying particles.

A condition known as calcification occurs in most diseases on the leading cause of death list and in illnesses such as kidney, gallbladder and prostate stones. Calcification is also linked to chronic inflammation in atherosclerosis and end-stage renal disease, but it is unclear how this occurs.

KANSAS CITY, Jan 29 -- New clinical-practice guidelines for the diagnosis and management of venous thromboembolism in primary care were released jointly by the American Academy of Family Physicians here and the American College of Physicians.

Key elements of the diagnostic guidelines include the use of clinical-prediction rules to establish the probability of deep venous thrombosis or pulmonary embolism prior to further testing.

The management guidelines support the use of low-molecular-weight heparin for patients with lower-extremity deep vein thrombosis in an outpatient setting, provided appropriate support services are in place.
Action Points

* Explain to interested patients that the newly released diagnostic guidelines for diagnosis of venous thromboembolism recommend the use of pretesting (with the Wells prediction rules) to determine the probability of DVT or pulmonary embolism before starting further testing.

* Be aware that the management guidelines support the use of low-molecular-weight heparin for patients with lower-extremity deep vein thrombosis in an outpatient setting, provided appropriate support services are available.

The guidelines, as well as a companion diagnostic-evidence review, were published online and in the January-February issue of the Annals of Family Medicine. They will also be published in the Feb. 6, 2007, issue of the Annals of Internal Medicine.

The United Nations Food and Agriculture Organisation (FAO) has reported resurgence of the dreaded avian influenza in at least eight countries in Asia and Africa, and has urged all nations to remain vigilant and fully cooperate with international organisations in keeping this menace under check.

In a statement issued simultaneously in Rome and Bangkok, the FAO has said 2007, new flare-ups of the bird flu have been reported this year, from China, Egypt, Indonesia, Japan, Nigeria, South Korea, Thailand and Vietnam.

The FAO has cautioned that cold weather enhances virus survival. Wild bird migration as well as the movement of animals can play a role in its spread. However, it also pointed out that the number of outbreaks in the first few weeks of this year has been significantly lower than the epidemic waves of last year.

Even while observing that the inter-continental flow of the H5N1 bird flu virus by wild birds migrating from Asia to Europe and Africa had not taken place during this autumn/winter season at the same level as it had in 2005, the FAO has stressed that the virus persists in several Asian countries as well as in Egypt and Nigeria. Other countries may also have it but have yet to declare.

With the start of the first epidemic wave in Asia in late 2003 and early 2004, eight countries became infected. During 2004/05, the situation improved in some countries but remained largely unchanged. In 2005/06, the virus spread from East Asia to Siberia, Eastern Europe, the West Asia and Africa, affecting over 40 countries, including India.

STOCKHOLM, Jan. 26 -- Activase (alteplase), the thrombolytic agent, appears as safe in real-world use for acute stroke as it was in the clinical trials that led regulators to okay it, according to a large European study.
Action Points

* Explain to interested patients that thrombolytic drugs like Activase break up clots that block blood flow to the brain during a stroke but must be given within 180 minutes after symptom onset to be effective.

* Point out to interested patients that this study appears to counter European concerns that more brain bleeding complications would ensue with Activase in clinical practice than in trials.

The adverse event of most concern -- symptomatic intercranial hemorrhage -- occurred at a similar rate in the post-marketing study as it did the pooled randomized trials (7.3% versus 8.6%), reported Nils Wahlgren, M.D., of the Karolinska Institutet here, and colleagues, in the Jan. 27 issue of The Lancet.

BETHESDA, Md., Jan. 25 -- MRI is better than CT for detecting acute strokes of any kind, and should be the diagnostic imager of choice in the ER, according to NIH researchers.

Comparing the two modalities in patients with suspected acute stroke, the investigators found that the sensitivity of MRI for diagnosing acute strokes was 83%, compared with just 26% for CT performed on the same patients.
Action Points

* Explain to patients who ask that early diagnosis of acute stroke and differentiation between ischemic and hemorrhagic strokes is essential for preventing or reducing subsequently disability. This study suggests that MRI should be the imager of choice when emergency doctors suspect acute stroke.

MRI was also superior to CT at diagnosing acute hemorrhagic stroke and chronic stroke, and was comparable at detecting intracranial hemorrhage, reported Steven Warach, M.D., Ph.D., of the National Institute for Neurological Disorders and Stroke, and colleagues, in the Jan. 27 issue of The Lancet.

SAN FRANCISCO, Jan. 26 -- A new prognostic tool called ABCD2 for predicting the early risk of stroke after transient ischemic attack (TIA) may help physicians determine which patients need emergency care, according to researchers here.
Action Points

* Explain to interested patients that after a TIA most strokes occur within the first days or weeks.

* Point out to patients that risk prediction tools help physicians determine which patients may need hospitalization and emergency care due to their high risk for a stroke after TIA.

The ABCD2 scoring system tended to predict short-term stroke risk better than the two existing longer-term risk prediction scales, reported S. Claiborne Johnston, M.D., of the University of California San Francisco, and colleagues, in the Jan. 27 issue of The Lancet.

How is influenza vaccine effectiveness measured?

Vaccine efficacy and effectiveness studies use various endpoints or outcomes, which influence how we interpret the results. These endpoints may include the prevention of medically attended acute respiratory illness (MAARI), prevention of laboratory-confirmed influenza virus illness or hospitalization, prevention of influenza-like illness (ILI, such as illness with fever and cough or sore throat), or influenza-associated hospitalizations or deaths. Studies that use outcomes such as an influenza laboratory-confirmed outcome provide the most specific estimates of the impact of the vaccine in preventing influenza. The more non-specific the outcome being measured (e.g., all pneumonia hospitalizations or influenza-like illness that include many illnesses not caused by the influenza virus), the lower the estimates of vaccine effectiveness. For example, a study by Bridges et al. (JAMA 2000) among healthy adults found that the inactivated influenza was 86% effective against laboratory-confirmed influenza, but only 10% effectiveness against all respiratory illnesses in the same population and year.

Background Rapid influenza testing decreases antibiotic and ancillary test use in febrile children, yet its effect on the care of hospitalized adults is unexplored. We compared the clinical management of patients with influenza whose rapid antigen test result was positive (Ag ) with the management of those whose rapid antigen test result was negative or the test was not performed (Ag0).

GAITHERSBURG, Md., Jan. 11 -- The issues surrounding the safety of drug-eluting coronary stents remain white hot, with extremes views on the future of the little mesh devices.

The core question is whether drug-eluting stents will emerge, in the end, as a great boon to coronary-disease patients or as an out-of-control lethal insult of major magnitude.

The two approved devices, Cypher (sirolimus-eluting) and Taxus (paclitaxel-eluting), dodged several bullets late last year when an FDA advisory safety panel agreed that the stents are safe when used according to label directions Yet that use represents a minority of the millions of drug-eluting stents implanted in Americans.