The father acts as an intermediary for dentist fear between both mother and children
Fear of visiting the dentist is a frequent problem in paediatric dentistry. A new study confirms the emotional transmission of dentist fear among family members and analyses the different roles that mothers and fathers might play.
A new study conducted by scientists at the Rey Juan Carlos University of Madrid highlights the important role that parents play in the transmission of dentist fear in their family.
Previous studies had already identified the association between the fear levels of parents and their children, but they never explored the different roles that the father and the mother play in this phenomenon.
Am
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Johns Hopkins scientists have created a free, Web-based tool to help patients decide whether it’s best to accept an immediately available, but less-than-ideal deceased donor kidney for transplant, or wait for a healthier one in the future.
Historically, the researchers say, it has been difficult, if not impossible, to accurately quantify the risk of accepting a deceased-donor kidney that may have been infected by hepatitis C, as compared to waiting what could be months or years for a better organ. There is a 5 to 15 percent chance of dying every year on the waiting list. Often, organs that may have been at risk of infection are thrown away and never transplanted.
In a new study the Johns Hopkins researchers showed there are some types of patients for whom survival benefit outweighs the risks of accepting a possibly infected organ. They then developed a Web-based mathematical model to help predict which patients they would be. The easy-to-use website can be found at www.transplantmodels.com/ird.
‘Because the supply of the healthiest donor organs is too small, patients need to consider all organ offers or risk dying while waiting for an organ. But this is a very hard decision, and many people turn down transplant offers that, in reality, would provide them significant benefit. Often they would have done much better taking the organ at hand than waiting for the next available one,’ says study leader Dorry L. Segev, M.D., Ph.D., an associate professor of surgery at the Johns Hopkins University School of Medicine. ‘This is the most important decision of a transplant candidate’s life, and we have developed a novel tool we believe can help patients make the best choice.’
EurekAlert
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Clinical trial results published this week offer additional evidence that a new device may help relieve chronic heartburn symptoms that standard treatment cannot. The Keck Medical Center of USC was one of 14 U.S. and European medical centres to test the device prior to its March 2012 approval by the U.S. Food and Drug Administration.
John Lipham, M.D., associate professor of surgery at the Keck School of Medicine of USC, led clinical investigation of the device at USC as part of his ongoing work to find alternative ways to treat gastroesophageal reflux disease (GERD), or chronic heartburn.
‘These results show that there is another option for the millions of people suffering from chronic reflux,’ Lipham said. ‘Currently, the Keck Medical Center of USC is one of only 30 sites in the country certified to implant the device.’
The LINX Reflux Management System, manufactured by Minnesota-based Torax Medical, Inc., is like a bracelet made up of magnetic, titanium beads implanted around the end of the oesophagus, where the lower oesophageal sphincter is located. The lower oesophageal sphincter is the valve that prevents reflux, and GERD develops when this valve is weakened.
Implantation of the device is potentially an outpatient procedure that can be completed in 15 to 20 minutes, Lipham said.
Lipham and his colleagues assessed 100 patients with GERD before and after surgery, finding that acid reflux decreased, reflux symptoms improved and the use of medication to manage those symptoms decreased for most patients. Severe regurgitation was eliminated in all patients. More than 9 in 10 patients reported satisfaction with their overall condition after having the procedure, compared to 13 percent before treatment while taking medication.
Follow-up studies are still required to assess long-term safety.
Lipham says the LINX device is best for patients with mild to moderate reflux that cannot be adequately controlled by medication or for patients who do not want to take medication to manage the disease. More than 60 million Americans experience heartburn at least once a month and some studies have suggested that more than 15 million experience heartburn symptoms every day, according to the American College of Gastroenterology.
Surgical treatment of reflux disease had been limited to a procedure called a Nissen fundoplication, which involves recreating the oesophageal sphincter. While fundoplication is recommended for those with severe reflux, it is a complicated procedure that prevents the ability to belch or vomit and often leads to bloating or gas problems.
The most common adverse events experienced with the LINX included difficulty swallowing, pain when swallowing food, chest pain, vomiting, and nausea. It is important to note that patients with LINX will no longer be able to undergo magnetic resonance imaging (MRI) procedures. The magnetic beads interfere with the machine and can cause the device to be damaged and the patient to be injured.
Keck Medical Center
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Telestroke networks that enable the remote and rapid diagnosis and treatment of stroke can improve the bottom line of patients and hospitals, researchers report.
A central hub hospital delivering rapid stroke diagnosis and treatment partnering with typically smaller spoke hospitals in need of those services means more patients recover better and the network
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White blood cells, or leukocytes, are the immune system’s warriors. So when an infection or disease attacks the body, the system typically responds by sending more white blood cells into the fray. This means that checking the number of these cells is a relatively easy way to detect and monitor such conditions.
Currently, most white blood cell counts are performed with large-scale equipment in central clinical laboratories. If a physician collects blood samples from a patient in the office
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Lung cancer is likely to overtake breast cancer as the main cause of cancer death among European women by the middle of this decade, according to new research published. In the UK and Poland it has already overtaken breast cancer as the main cause of cancer deaths in women.
The study by researchers in Italy and Switzerland predicts that just over 1.3 million people will die from cancer (737,747 men and 576,489 women) in the 27 countries of the European Union in 2013. Although the actual numbers have increased when compared with 2009 (the year for which there are World Health Organisation mortality data for most EU countries), the rate (age-standardised per 100,000 population) of people who die from the disease has declined. Since 2009 there has been 6% fall among men and 4% fall among women.
However, despite the decline in cancer deaths overall, lung cancer death rates continue to rise among women in all countries, while breast cancer rates fall. In 2013 there will be an estimated 88,886 deaths (14.6 per 100,000 women) from breast cancer and 82,640 deaths (14 per 100,000 women) from lung cancer. Lung cancer deaths have risen by 7% among women since 2009.
One of the study
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Most patients whose breast cancer has spread to their lymph nodes have most of the lymph nodes in their armpit area removed after chemotherapy to see if any cancer remains. A study conducted through the American College of Surgeons Oncology Group and led by Judy Boughey, M.D. a breast surgeon at Mayo Clinic shows that a less invasive procedure known as sentinel lymph node surgery successfully identified whether cancer remained in lymph nodes in 91 percent of patients with node-positive breast cancer who received chemotherapy before their surgery. In sentinel lymph node surgery, only a few lymph nodes, the ones most likely to contain cancer, are removed.
‘Since treatment with chemotherapy before surgery can eliminate cancer in the lymph nodes in some patients, we were interested in evaluating whether sentinel lymph node surgery could successfully identify whether cancer remained in the lymph nodes after chemotherapy,’ says Dr. Boughey. Removing only a few lymph nodes reduces the risk of surgical complications such as numbness and arm swelling, she says.
Researchers studied 756 women with node-positive breast cancer who received chemotherapy as an initial treatment. Of study participants, 637 patients had both sentinel lymph node and axillary lymph node surgery. Sentinel lymph node surgery correctly identified whether cancer lingered in 91 percent of patients, including 255 patients with node-negative breast cancer and 326 patients with continuing node-positive disease.
Researchers also found that 40 percent of the patients had complete eradication of the cancer from the lymph nodes. The study had a false-negative rate of 12.6 percent and the false negative rate was significantly lower with the use of dual tracers (blue dye and radiolabeled colloid) to identify the sentinel lymph nodes.
Dr. Boughey says that technical factors in surgery are important to help ensure correct staging, the process of determining how far cancer may have spread.
Mayo Clinic Cancer Center
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Fragility fractures due to osteoporosis are a major cause of disability or premature death in older adults. Those at highest risk are patients who have already suffered one fragility fracture; they are at twice the risk of suffering a future fracture compared to others who have not fractured.
Nevertheless health care systems around the world are failing to identify and treat these patients, leaving them exposed to debilitating and life-threatening secondary fractures.
Based on evidence from numerous global studies, a new report, ‘Capture the Fracture: A Best Practice Framework and Global Campaign to Break the Fragility Fracture Cycle’ (1), sets 13 achievable standards for best practice in implementing fracture liaison services (FLS) worldwide, in a broad range of health-economic environments.
The report has been published in the peer-reviewed journal ‘Osteoporosis International’ and is endorsed by the International Osteoporosis Foundation (IOF) Committee of Scientific Advisors. It is available at link.springer.com/article/10.1007/s00198-013-2348-z
Fracture Liaison Systems help reduce the burden of fragility fractures:
Professor Cyrus Cooper, Chair of the IOF Committee of Scientific Advisors (CSA) emphasized the importance of systematic and coordinated secondary prevention care: ‘Coordinator-based FLS have been shown to close the gap in secondary fracture prevention care, ensuring that fragility fracture sufferers receive appropriate assessment and intervention to reduce future fracture risk.’
The best practice framework sets the foundation for ‘Capture the Fracture’, a multi-stakeholder initiative led by the International Osteoporosis Foundation. The initiative hopes to drive change so that secondary fracture prevention becomes a reality around the world.
The new initiative aims to:
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Global action is needed to tackle the catastrophic threat of anti-microbial resistance, which in 20 years could see any one of us dying following minor surgery, England
The hormone-releasing Mirena coil intrauterine device (IUD) is a better treatment for heavy menstrual periods than other conventional medical approaches, according to results of a major clinical trial led by scientists from the Universities of Nottingham and Birmingham.
The findings of the ECLIPSE study, funded by the National Institute for Health Research (NIHR) are widely expected to change standard clinical practice.
Heavy periods, or menorrhagia, affect the lives of large numbers of women aged 25-50 years, accounting for many GP consultations and 20 per cent of gynaecological referrals in the UK. Yet to date there has been limited evidence to help women and doctors make informed choices about treatments.
The ECLIPSE trial compared the clinical effectiveness of the levonorgestrel-releasing intrauterine system (also known as LNG-IUS or the Mirena contraceptive coil) with other medical treatments on offer in primary care.
A total of 571 women, consulting their GPs for heavy menstrual bleeding, agreed to be randomly assigned to LNG-IUS or to another standard medical treatment, such as tranexamic acid, mefanamic acid, combined estrogen and progestogen or progestogen only.
Over two years, patient reported outcomes improved more with LNG-IUS than with other treatments, including women
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