A simple formula can predict at birth a baby

Abuse of the anaesthesia drug propofol is a ‘rapidly progressive form of substance dependence’ that is being more commonly seen among health care professionals, reports a study.

‘Propofol addiction is a virulent and debilitating form of substance dependence’ with a ‘rapid downhill course,’ write Drs. Paul Earley and Torin Finver of Georgia Health Professionals Program, Inc, Atlanta. Their study identifies some emerging characteristics and consequences of propofol abuse among health care professionals.

Data from an addiction centre specialising in substance abuse problems among health care professionals identified 22 patients treated for propofol abuse from 1990 to 2010. Propofol is a drug widely used to induce anaesthesia for surgery and sedation for other procedures. It is commonly used because it has a rapid onset and quick recovery time, with fewer side effects than other anaesthetics.

The number of health care professionals treated for propofol abuse increased steadily during the period studied, although increased recognition by addiction centre staff may have played a role. The patients were thirteen physicians, eight nurses, and one dentist. Most of the physicians and all of the nurses were anaesthesia providers, who had ready access to propofol.

Patients using propofol were more likely to be women, compared to health care professionals abusing alcohol or other drugs. Most propofol abusers had depression, along with a history of childhood sexual or physical abuse. In addition, most of the propofol-abusing health care professionals reported a family history of substance abuse, and a higher than expected number had family members with schizophrenia.

The patients generally started using propofol to get to sleep. However, they quickly developed characteristics of addiction, with propofol becoming a preferred drug of abuse. Most patients came for addiction treatment within a few months after starting to use propofol. Five patients came to treatment after a single propofol binge.

‘When humans abuse propofol, unintended side effects begin almost immediately,’ Drs. Earley and Finver write. About half of propofol abusers entered addiction treatment after dramatic events such as car crashes or other injuries. Some sustained facial injuries when they passed out immediately after injecting propofol.

Five patients were admitted into treatment when they were discovered unconscious. These characteristics reflect the ‘narrow window between desired effect and unconsciousness’ and the rapid loss of control over propofol use, according to the authors.

‘Propofol dependence is a rapidly progressive form of substance dependence seen in 1.6 percent of all health care addiction cases reporting to treatment,’ Drs. Earley and Finver conclude. Within the limitations of the data, the study suggests that propofol abuse by health care professionals is increasing

Severe and life-threatening complications in pregnancy can have a big impact on fathers as well as mothers.
That’s one of the key findings of work by Oxford University researchers who spoke to couples who had been through this, in compiling a new resource for the award-winning patient website www.healthtalkonline.org.
The new pages covering life-threatening conditions in childbirth and pregnancy have just been launched.
Other points that emerged from the interviews included the huge difference that little examples of thoughtful care from doctors and midwives could make to how couples coped when emergency care was needed around the time of the birth of their child.
Examples included an anaesthetist who stepped out of theatre to show the waiting father a photo of his new baby on an iPhone; staff who kept a diary of the newborn baby’s day in a neonatal unit that was in a different hospital to the mother; and a midwife who greeted a woman with major bleeding arriving in an ambulance with a monitor so she could hear her baby’s heartbeat and know nothing had happened to him.
Severe complications in labour and childbirth aren’t common. But perhaps because of this, there can be difficulties for couples in getting the support they might need or finding others that have gone through similar experiences. And for doctors and midwives who don’t see many such cases, they may not be aware of what follow-up care could help. Oxford University

Johns Hopkins biomedical engineers have teamed up with clinicians to create a new drug-delivery strategy for a type of central vision loss caused by blood vessel growth at the back of the eye, where such growth should not occur. In addition to testing a new drug that effectively stops such runaway vessel growth in mice, the team gave the drug a biodegradable coating to keep it in the eye longer. If proven effective in humans, the engineers say, it could mean only two or three needle sticks to the eye per year instead of the monthly injections that are the current standard of care.

The new drug, in its time-release coating, was tested in mice with abnormalities similar to those experienced by people with neovascular age-related macular degeneration, or ‘wet’ AMD.

‘If you lose central vision, you can’t drive a car and you can’t see your grandchildren,’ says Jordan Green, Ph.D., assistant professor of biomedical engineering and ophthalmology at The Johns Hopkins University. ‘You’re willing to do what it takes to keep your sight. We hope that our system will work in people, and make invasive treatments much less frequent, and therefore easier to comply with, and safer.’

According to Peter Campochiaro, M.D., the George S. & Dolores Dor

Forget apples