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HEART FAILURE

Nurse and engineer collaborate on an app

Designed to help older adults with heart failure improve self-care and avoid hospital admissions, HeartMapp is a noninvasive smartphone application that serves as a health coach for patients. The app's six modules encourage patients to assess their heart condition daily, monitor vital signs, perform breathing and walking exercises, take their medication, read educational information on heart health, and review statistics in graphs that show their performance. It also reminds patients to check their weight and BP every morning and puts patients in green, yellow, and red zones based on their current signs and symptoms. The system is designed to receive and process data from sensors and mobile devices and save it in databases for patients and caregivers.

  
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Ponrathi Athilingam, PhD, assistant professor at the University of South Florida (USF) College of Nursing, collaborated with Miguel Labrador, PhD, professor in the Department of Computer Science and Engineering to create the app. As a cardiology nurse, Dr. Athilingam understands the challenges patients with heart failure face as they struggle to follow their medication regimen and manage self-care at home. "After patients leave the hospital, they are alone. However, they do have a phone as a companion. So, we developed this easy-to-use, patient-centered technology to help them keep their heart health on track."

 

Dr. Athilingam and Dr. Labrador have published several studies on HeartMapp and are currently collaborating on a pilot study testing HeartMapp with nine patients from the USF Health Cardiology clinic.

 

Source: Hysenlika V. Health and engineering scientists create mobile app for patients with heart failure. University of South Florida. News release. February 20, 2017.

 

ZIKA VIRUS

U.S. blood supply safe, experts say

Zika virus is potentially transmissible via transfusion of infected blood products. Although several people in Brazil were reportedly infected this way, the CDC has documented no such transmissions in the United States.

 

According to a special edition of the journal Transfusion, U.S. blood banks are currently well prepared to prevent transmission of the Zika virus in donated blood. Each blood donation is screened for Zika virus using two separate investigational tests that have been highly effective. Donated blood with any sign of possible infection is discarded. In addition, research has shown that Zika is inactivated by standard solvent/detergent treatment and pasteurization technology used in the preparation of plasma derivatives.

 

In an accompanying editorial, investigators note that Zika appears even more heat-sensitive than similar viruses. "All of these findings represent reassuring news regarding Zika virus and the safety of plasma derivatives."

 

Sources: Marks PW, Petersen LR. Decision making in the face of uncertainty: the challenge of emerging infectious diseases. Transfusion. 2017;57(3pt2):723-728. Centers for Disease Control and Prevention. Zika and blood transfusion. https://www.cdc.gov/zika/transmission/blood-transfusion.html.

 

GENETIC TESTING

FDA approves direct-to-consumer tests

Designed to test for 10 specific health disorders, the 23andMe Personal Genome Service Genetic Health Risk (GHR) tests have been approved by the FDA for marketing to consumers. These direct-to-consumer (DTC) tests provide information about a person's genetic predisposition to certain diseases, including Parkinson disease, celiac disease, and late-onset Alzheimer disease.

 

Testing involves isolating DNA from a saliva sample, which is analyzed for more than 500,000 genetic variants. Consumers may use this information to make lifestyle changes or to prepare for a more informed discussion with a healthcare professional.

 

The FDA requires manufacturers of DTC tests used for medical purposes to provide instructions and reports in easily understood language. A study showed that consumers understood over 90% of information presented in 23andMe GHR reports.

 

The FDA cautions that both false-positive and false-negative test results are possible, and that consumers and clinicians shouldn't rely on these test results alone for diagnosis or treatment decisions. Consumers should consult a healthcare professional with questions and concerns about genetic testing.

 

Source: FDA allows marketing of first direct-to-consumer tests that provide genetic risk information for certain conditions. Food & Drug Administration. News release. April 6, 2017.

 

PATIENT SAFETY

Checklist reduces post-op mortality by 22%

The Safe Surgery 2015 South Carolina program, a voluntary statewide project, was designed to encourage hospitals to implement the World Health Organization's surgical safety checklist. Fourteen hospitals representing nearly 40% of the state's inpatient surgical volume participated. Researchers compared 30-day post-op mortality for these hospitals with mortality in 44 other hospitals in the state. At the start of the study, preexisting post-op mortality and trends were similar among all hospitals. The study included a wide range of procedures, including neurologic, thoracic, cardiac, and orthopedic surgeries.

 

In the first 3 years of the program, the risk-adjusted 30-day mortality in hospitals that had adopted the checklist-based surgical quality improvement program was 22% lower than in the 44 other hospitals in the state.

 

Safe surgery checklists have been shown to reduce mortality in controlled research studies, but evidence of large-scale reductions has been lacking. This is the first study to show that a surgical checklist can have a large-scale, population-wide impact on post-op mortality.

 

Sources: Haynes AB, Edmondson L, Lipsitz SR, et al. Mortality trends after a voluntary checklist-based surgical safety collaborative. Ann Surg. [e-pub April 6, 2017]. South Carolina hospitals see major drop in post-surgical deaths with safety checklist. Harvard T.H. Chan School of Public Health. News release. April 17, 2017.

 

AUTISM

Warning: Avoid bogus treatments and products

The FDA has renewed its warning to the public about ineffective and potentially harmful treatments or "cures" for autism, which is considered incurable. The FDA has warned or taken action against manufacturers making fraudulent claims about products marketed as treatments for autism, including:

 

* chelation therapies, which supposedly cleanse the body of toxins and heavy metals. These products are available as sprays, suppositories, capsules, liquids, and clay baths. FDA-approved chelation agents are available by prescription only and are indicated only for a few specific disorders such as iron overload, not for autism.

 

* hyperbaric oxygen therapy, which is also not approved for autism.

 

* "detoxifying" clay baths that purport to draw out toxins, pollutants, and heavy metals from the body.

 

* other faddish treatments, such as raw camel milk and essential oils, which haven't been shown to be safe or effective as treatments for autism.

 

 

Teach patients or parents of autistic children to beware of any product or treatment that claims to cure autism or promises to produce dramatic symptom improvement. Refer them to reputable sources of information, such as the Association for Science in Autism Treatment (http://www.asatonline.org), a not-for-profit organization of parents and professionals committed to improving the education, treatment, and care of people with autism.

 

Source: Autism: beware of potentially dangerous therapies and products. Food and Drug Administration. April 12, 2017. https://www.fda.gov/ForConsumers/ConsumerUpdates/ucm394757.htm.

 

In June, celebrate

 

* Cataract Awareness Monthhttp://www.preventblindness.org

 

* Men's Health Monthhttp://www.menshealthmonth.org

 

* National Lightning Safety Awareness Week (June 18-24)http://www.lightningsafety.noaa.gov

 

* National Cancer Survivors Day (June 4)http://www.ncsd.org

 

* World Sickle Cell Day (June 19)http://www.worldsicklecellday.webs.com

 

PAIN MANAGEMENT

Music therapy relieves spinal pain

To explore the efficacy of music therapy in relieving pain after spinal surgery, researchers provided 30 patients with a 30-minute music therapy session within 72 hours after spinal surgery in addition to standard care. Another 30 patients received standard postoperative care without music therapy. Patients in the music group chose from various treatment options such as patient-preferred live music, singing, rhythmic drumming, and active visualization supported by live music. Ranging in age from 40 to 55, all 60 patients had undergone anterior, posterior, or anterior-posterior spinal fusion.

  
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Researchers collected visual analogue scale (VAS) pain ratings before and after music therapy in the experimental group and within the same time period in the control group. In the control group, post-op VAS pain levels increased slightly, from 5.20 to 5.87. In the music therapy group, VAS pain levels decreased by more than one point, from 6.20 to 5.09.

 

"This study is unique in its quest to integrate music therapy in medicine to treat post-surgical pain" said lead author John Mondanaro. "Postoperative spine patients are at major risk for pain management challenges." Read about using music therapy to relieve depressive symptoms in older adults on page 58 of this issue (Research Corner, "Do Music Therapies Reduce Depressive Symptoms and Improve QOL in Older Adults with Chronic Disease?")

 

Sources: Mondanaro JF, Homel P, Lonner B, Shepp J, Lichtensztein M, Loewy JV. Music therapy increases comfort and reduces pain in patients recovering from spine surgery. Am J Orthop. 2017;46(1):E13-E22. Music therapy reduces pain in spine surgery patients. Mount Sinai Hospital. News release. March 27, 2017.

 

COGNITIVE FUNCTION

Brain games? Not so smart after all

Age-related changes in cognitive function can impair an older adult's ability to live independently. Cognitive training with "brain games," such as crossword puzzles and other brain teasers, has been proposed as a way to preserve cognition in older adults, although evidence supporting it is weak. To test the value of this approach, researchers randomly assigned 60 older adults to "gamified" cognitive training interventions. One group played a brain-training video game and another group solved crossword or number puzzles. Using tablet computers, participants engaged in the assigned training for thirty 45-minute sessions over the course of 1 month. Participants recorded their playtime in journals.

  
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The researchers conducted testing before and after the intervention to establish participants' level of cognitive functioning, including memory, reasoning ability, processing speed, and executive control. They then analyzed the data to determine if improving working memory would translate to better performance on other tasks, known as "far transfer."

 

Consistent with previous research, this study found little evidence of transfer. "The thing that seniors in particular should be concerned about is, if I can get very good at crossword puzzles, is that going to help me remember where my keys are?" remarks study coauthor Neil Charness. "And the answer is probably no."

 

Brain training has become a booming business fueled by largely unsubstantiated claims touting its effectiveness. "More companies are beginning to be fined [by the Federal Trade Commission] for these types of inflated claims and that's a good thing," says coauthor Walter Boot. "These exaggerated claims are not consistent with the conclusions of our latest study."

 

Sources: Souders DJ, Boot WR, Blocker K, Vitale T, Roque NA, Charness N. Evidence for narrow transfer after short-term cognitive training in older adults. Front Aging Neurosci. 2017;9:41. Think brain games make you smarter? Think again, FSU researchers say. Florida State University. News release. April 17, 2017.