Archive for month: August, 2020

Patients given a clot-busting drug within six hours of a stroke are more likely to make a better recovery than those who do not receive the treatment.
The multi-centre, randomised study of more than 3000 patients is the world

Among women with gestational diabetes mellitus, referral to a telephone-based nurse management program was associated with lower risk of high baby birth weight and increased postpartum glucose testing, according to Kaiser Permanente researchers.
Investigators for the Kaiser Permanente Northern California Division of Research examined the associations between referral to telephone-based nurse consultation and outcomes in 12 Kaiser Permanente medical centres with variation in the percent of patients referred to telephonic nurse management.
‘Compared with women from Kaiser Permanente medical centres where the annual proportions of referral to nurse management at the Kaiser Permanente Regional Perinatal Service Center was less than 30 percent, women who delivered in medical centres with an annual referral proportion of greater than 70 percent were less likely to have a high birth weight infant without increasing the risk or having a low birth weight infant,’ said Assiamira Ferrara, MD, PhD, a research scientist with the Kaiser Permanente Northern California Division of Research and the lead author of the study. ‘In addition, they were more likely to have postpartum glucose testing, which leads to earlier identification and management of postpartum glucose intolerance or diabetes.’
Investigators used data from the Kaiser Permanente Northern California GDM registry to identify women who had pregnancy complicated by GDM from 1997 through 2006. They restricted their cohort to women with GDM according to the National Diabetes Data Group criteria. During the study period, 96 percent of all pregnant women without pre-existing diabetes who delivered an infant were screened for GDM. Researchers excluded women who delivered multiple births due to their increased risk of perinatal complications. Overall, researchers identified 11,435 women with GDM at the 12 medical centres, of whom 44.5 percent were referred to the perinatal service centre.
‘The Kaiser Permanente Regional Perinatal Service Center is a nurse-based management program for women with GDM that offers supplemental care via telephone counselling to women with high-risk pregnancies, including those complicated by GDM,’ explained co-author Monique Hedderson, PhD, a research scientist with the Kaiser Permanente Northern California Division of Research.
The program includes a call center with 32 registered nurses and two registered dieticians who offer phone counselling seven days a week and address glucose monitoring and control, diet and physical activity. Nurses are available 24 hours a day, seven days a week, while dieticians are available to patients during the week from 8 a.m. to 5 p.m. In addition to care provided by obstetricians, women referred to the centre receive one to two counselling calls per week to help them manage their blood glucose levels during pregnancy. The centre also sends a laboratory slip for postpartum glucose testing and a reminder telephone call if the screening test was not performed. EurekAlert

Getting a shot at the doctor

In a significant departure from earlier models, neural engineers and neuroscientists working at Stanford University have developed a new model for the brain activity underlying arm movements. Motor neurons do not represent external-world parameters as previously thought, but rather send a few basic rhythmic patterns down the spine to drive movement. The finding has implications in prosthetics, the understanding of motor disorders and other uses yet to be discovered.
The neurons that control movement are not a predictable bunch. Scientists working to decode how such neurons convey information to muscles have been stymied when trying to establish a one-to-one relationship between a neuron