Mindfulness linked with fewer menopausal symptoms

Mindfulness may be associated with fewer menopausal symptoms for women, according to a Mayo Clinic study recently published in Climacteric: The Journal of the International Menopause Society. Researchers discovered that being mindful may be especially helpful for menopausal women struggling with irritability, anxiety and depression.

“In this study, we found that midlife women with higher mindfulness scores experienced fewer menopausal symptoms,” says Mayo Clinic general internist and women’s health specialist Richa Sood, M.D., the study’s lead author. “These findings suggest that mindfulness may be a promising tool to help women reduce menopausal symptoms and overall stress.”

Mindfulness involves focusing attention on the present moment, and observing thoughts and sensations without judgment. Prior research has shown practicing mindfulness can reduce stress and improve quality of life.

Every day, an estimated 6,000 women in the U.S. reach menopause. By 2020, the number of women age 55 and older is expected to top 46 million. A woman is considered to be in menopause if she has gone one year without a menstrual cycle. Commonly experienced symptoms of menopause can include hot flashes, night sweats, vaginal dryness and mood changes.

The study involved 1,744 women ages 40 to 65 who received care at Mayo Clinic’s Women’s Health Clinic in Rochester between Jan. 1, 2015, and Dec. 31, 2016. Participants completed questionnaires that rated their menopausal symptoms, perceived level of stress and mindfulness. Researchers found women with higher mindfulness scores had fewer menopausal symptoms. The higher a woman’s perceived level of stress, the greater the link between higher mindfulness and reduced menopausal symptoms.

One surprising outcome of the study is that higher mindfulness scores were not associated with lower hot flash and night sweat symptom scores, Dr. Sood says. One theory as to why is that the amount of distress experienced from night sweats and hot flashes may have more to do with individual personality traits rather than the symptoms themselves. An exciting finding in the study, according to Dr. Sood, was the association of higher mindfulness scores and lower symptom scores for irritability, depression and anxiety in middle-aged menopausal women.

“While more studies need to be done, doctors can consider discussing mindfulness as a potential treatment option for menopausal women,” Dr. Sood says.

Fortunately, mindfulness is a skill that can be learned.

“Essentially, the first step in being mindful is to become aware that our minds are on autopilot most of the time,” Dr. Sood says. “The goal during mindful moments is not to empty the mind, but to become an observer of the mind’s activity while being kind to oneself. The second step is to create a pause. Take a deep breath, and observe one’s own space, thoughts and emotions nonjudgmentally. The resulting calm helps lower stress.”




Researchers learn more about the impact of multiple symptoms in older adults

“Symptoms” is the medical term for any sign of a health problem, even if that sign doesn’t help your healthcare provider diagnose a specific illness. Symptoms, such as feeling tired or rundown (also called fatigue), are among the leading causes of disability for older adults.

Sometimes symptoms are directly caused by illness–for example, an aching chest can be a symptom associated with a heart attack. But often, symptoms have multiple causes. For example, fatigue can be a common symptom when you have conditions such as knee osteoarthritis, depression, and heart failure.

What’s more, older adults often experience more than one symptom at a time, which can make each symptom feel worse.

Up until now, we haven’t had much information about how symptoms that occur at the same time affect an older adult’s ability to function. To learn more, a team of researchers recently examined information from a large study of older adults, the National Health and Aging Trends Study (NHATS), which included more than 7,500 participants aged 65 and older. The study was published in the Journal of the American Geriatrics Society.

The researchers focused on answers given to several questions in the NHATS that showed whether a participant had symptoms such as:

  • Shortness of breath or difficulty breathing
  • Trouble falling or staying asleep at night
  • Depression or anxiety

The researchers also recorded measurements of the participants’ grip strength, whether they walked slowly, their balance, and their ability to rise from a chair. They were also asked whether they had fallen one or more times in the last year.

The researchers also measured whether participants had any chronic diseases, whether they had an overnight hospital stay during the last year, and whether they had trouble performing their daily activities (such as getting in or out of bed, eating, toileting, bathing, and getting dressed).

The researchers learned that 75 percent of older adults had at least one symptom and nearly half had two or more symptoms. They noted that nearly 14 percent–almost 5 million older adults in the U.S.–had four or more symptoms.

The researchers learned that:

  • Symptoms increased with older age.
  • Women were more likely to have more symptoms than men.
  • Compared to white individuals, black and Hispanic participants had more symptoms. Older adults with lower levels of education had a higher number of symptoms than those with higher education levels.
  • Current smoking, obesity, and an inactive lifestyle were also associated with a higher number of symptoms.
  • Participants who had a chronic medical condition, or multiple chronic conditions, also experienced more symptoms.

Importantly, older adults who reported more symptoms had weaker grip strength and walked more slowly. Over time, older adults with more symptoms had an increased risk of falls, hospitalizations, disability, and mortality.

The researchers believe that as we age and experience more multiple chronic conditions, the number of us living with multiple symptoms as older adults is likely to grow. While healthcare providers understand that treating symptoms is important to improving quality of life at the end-of-life (palliative care), there is less understanding about the best way to treat multiple symptoms that older adults experience.

The researchers said that their findings highlight the need for more research on symptoms in older adults to develop effective management strategies.




Researchers design new questionnaire to improve knowledge of impact of menopause on women

A new questionnaire being developed through a collaboration between the Massachusetts General Hospital (MGH) Midlife Women’s Health Center and the North American Menopause Society is designed to improve knowledge of the extent and impact on women of genitourinary symptoms of menopause. The progress of the collaboration, which has the ultimate goal of bringing effective treatments to more women, is described in a paper that will appear in the April issue of the journal Menopause and has been released online.

“The genitourinary syndrome of menopause includes symptoms of vaginal dryness and pain affecting sexual activity, urination and activities of daily life. Although it can have a significant effect on the sex lives and the overall quality of life of menopausal women, current knowledge about the syndrome is limited because we lack a simple, validated measure to assess the problem in large groups of women,” says Jan Shifren, MD, director of the MGH Midlife Women’s Health Center, corresponding author of the report. “Reliable information on its prevalence and modifying factors is needed to raise awareness and increase the numbers of women receiving effective treatment.”

The paper’s authors note that women with these symptoms often are not aware that effective treatments are available – including vaginal lubricants, moisturizers, and low-dose vaginal estrogen therapy. Women often consider their bothersome symptoms to be a normal part of aging that must be accepted. Such beliefs, along with embarrassment, may keep women from discussing symptoms with health care providers; and in turn, clinicians without expertise in the care of menopausal women may not ask about them due to lack of awareness, time constraints and uncertainty about the safety and effectiveness of treatments.

The Vulvovaginal Atrophy Questionnaire (VVAQ) is being developed for clinical use and as a research tool for both epidemiologic studies and clinical trials assessing the efficacy of new therapies. The initial stages of development brought together existing knowledge about the syndrome, the input of experts in the care of menopausal women and – most importantly – the perspectives and experiences of women themselves. After developing an initial conceptual model, the team recruited 36 women in whom the genitourinary syndrome of menopause had been confirmed by both clinical examination and laboratory testing. The women participated in interviews regarding their symptoms and sensations, and the impact of symptoms on sexual function, intimate relationships, and their overall quality of life and well-being.

Among interviewed women, 86 percent indicated that symptoms impacted their sexual functioning, and 83 percent reported negative effects on their overall quality of life. The most commonly reported symptoms were pain with sexual activity, reported by 92 percent, and vaginal dryness (86 percent) and irritation (50 percent). Pain with sexual activity – described by some women as “excruciating,” and vaginal dryness were rated as particularly bothersome, with dryness affecting both sexual activity and activities of daily living.

Based on those interviews, the team developed an initial questionnaire, often incorporating terminology and expressions women used in their interviews. The initial questionnaire was then tested in nine focus groups – five with a total of 26 women with the syndrome and four with a total of 15 women without symptoms. Interviewers asked focus group participants whether the draft reflected their experiences, assessed how understandable the items and instructions were, and asked for suggestions about additional items to include. Although focus group conversations did lead to some revision of the initial version to clarify ambiguous language or reduce redundancies, most participants had a positive impression of the questionnaire, indicating that the questions were relevant and meaningful to their experiences.

“While women’s descriptions of the impact of their symptoms were not surprising to me, as a menopause specialist, we’re hopeful that their experiences will help inform clinicians who do not specialize in this area of the significance of the problem,” says Shifren, who is the Vincent Trustees Professor of Obstetrics, Gynecology and Reproductive Biology at Harvard Medical School. “Many clinicians do not realize that genitourinary symptoms of menopause are a problem even for women who are not sexually active, affecting their ability to exercise, travel, or interact with family and friends.

“Once we are able to validate the VVAQ in a larger study, it will be made freely available to clinicians and researchers,” she continues. “This will enable us and others to determine the prevalence and impact of the genitourinary syndrome of menopause in large groups of women and assess factors and conditions that may improve or worsen the problem. What we learn from those studies should help us improve treatment for all women affected by this problem.”

Source:

https://www.massgeneral.org/about/pressrelease.aspx?id=2333




Youth with obsessive and compulsive symptoms more likely to experience psychopathology

Engaging in repetitive and ritualistic behaviors is part of typical child development. However, behaviors that develop into obsessive and compulsive symptoms (OCS) may represent a red flag for serious psychiatric conditions. Researchers at the Lifespan Brain Institute (LiBI) of Children’s Hospital of Philadelphia (CHOP) and the Perelman School of Medicine at the University of Pennsylvania found children and young adults with OCS who also admitted to having bad thoughts were more likely to also experience psychopathology, including depression and suicide. This is the first and largest study examining OCS in more than 7,000 participants aged 11 to 21.

The findings were published online Nov. 23, 2018 in the Journal of the American Academy of Child and Adolescent Psychiatry.

Researchers divided OCS into four categories: bad thoughts, repeating/checking, symmetry, and cleaning/contamination. More than 20 percent of youth admitted to having bad intrusive thoughts, which included thoughts about harming oneself or others, picturing violent images, or fear that one would do something bad without intending to. These children were more likely to develop serious psychopathology beyond obsessive compulsive disorder (OCD), including depression and suicide.

“Our hope is that these results will propel both mental health professionals and non-mental health practitioners, such as pediatricians, to probe for these symptoms during their patients’ visits,” said the study’s principal investigator Raquel Gur, MD, PhD, director of the LiBI and a professor of Psychiatry, Neurology and Radiology in the Perelman School of Medicine. “These symptoms may be vital for identifying adolescents who are on a potentially debilitating psychiatric trajectory.”

“Repetitive actions are common in young children, and are in fact a healthy part of development,” says lead author of the study Ran Barzilay, MD, PhD, child and adolescent psychiatrist and research scientist at LiBI. “It’s when these symptoms continue into adolescence and start to interfere with day-to-day activities that we really need to examine the cause and treatments available.”

OCS were common in individuals who did not seek mental health treatments (38.2 percent). Only three percent met the threshold for OCD. OCS were more common in females and after puberty. The researchers suggest OCS may be a window for clinicians to probe and identify serious psychiatric conditions.

Source:

https://www.chop.edu/news/obsessive-compulsive-symptoms-youth-may-be-red-flag-other-psychological-issues




MUSC researchers uncover a new cause for laryngeal symptoms

While a sudden coughing fit is a protective reflex to clear the airway, chronic cough can be caused by multiple factors that must be investigated to determine treatment. Cough is just one of several laryngeal symptoms including hoarseness and dysphoric breathing that can become debilitating. Until recently, the cause of these severe laryngeal symptoms could not be identified in many patients, and the only treatments were to manage them with medication and rehabilitation therapy.

A team of MUSC researchers can now offer these patients some hope. Lucinda Halstead, M.D., associate professor of medicine in MUSC’s Department of Otolaryngology: Head & Neck Surgery and medical director of the Evelyn Trammell Institute for Voice and Swallowing, led her team to uncover a new cause for these symptoms and an effective treatment.

“Symptoms like hoarseness may not seem serious, but if you are a singer, teacher or a preacher, or have a job at a call center, it’s exhausting to push your voice every day,” explained Halstead. “Chronic cough is not just a little throat-clearing. We’re talking about a very forceful cough. These people can break ribs or become incontinent from the force. It’s very debilitating. They’re afraid to go out in public – to church, or a concert, or a restaurant-because it’s so disruptive.”

When a patient presents with chronic laryngeal symptoms (persisting for more than eight weeks and not improving with standard treatment), physicians follow a step-by-step protocol to look at the most common causes. For example, over 86% of chronic coughs are caused by post-nasal drainage, asthma or gastroesophageal reflux disease.

If a full history and exam do not identify the cause, an otolaryngologist evaluates the larynx. In some patients, this turns up asymmetrical movement of the vocal fold (the vocal cords) or vocal fold paralysis. The cause is usually a lesion or another structure pressing on one of the nerves that activates the vocal fold and swallowing (cranial nerves nine and ten). Because these nerves run from the brain stem through the neck and into the chest, further investigation is needed to pin-point exactly where the compression is occurring.

“The laryngeal exam tells us that the vocal fold is not opening, lengthening or shortening correctly,” said Halstead. “For people with vocal fold paralysis, we look right away in the chest and neck. Maybe a mass in the thyroid gland is pressing on a nerve and interfering with the signal. Maybe it’s a lesion in the chest or a mass along the carotid sheath that’s causing the laryngeal weakness.”

But sometimes the cause remains elusive. “If the usual scans don’t show anything that could cause it, we usually assume that it had a viral origin-viruses do sometimes cause these problems – or we simply say that the etiology is unknown.”

Then, Halstead’s team met their index case who would inspire the study that led to their recent discovery. A medical student presented at their clinic with severe difficulty swallowing and “breathy” speech. A laryngeal exam found vocal fold paralysis, but further investigations didn’t identify a cause.

“The patient just wasn’t going to take, ‘I don’t know’ for an answer and refused to believe we couldn’t find an etiology for what was happening,” recalled Halstead. “We kept investigating but there were no masses in the neck or chest – everything looked good. So, we went back through the history and saw that the symptoms all started during a bad migraine, which is a vascular event in brain. A migraine wouldn’t cause cranial nerve compression, but many blood vessels in the brain can press on these nerves. Based on some vagal nerve symptoms that the patient reported while exercising, we hypothesized that maybe when blood vessels dilated during the migraine, it exacerbated some ongoing vascular compression at the brain stem.”

When this was confirmed by MRI, the patient chose to have surgery to move the vessel off the nerve (a procedure similar to what is done to relieve trigeminal neuralgia). It was a success. Partial motion of the paralyzed vocal fold occurred, and swallowing ability was recovered completely.

The team wondered how many of their other patients with unexplained symptoms might also have compression at the brain stem. Could this neurosurgical procedure also help them? They used retrospective chart reviews to identify 149 study candidates and, after extensive work-ups to eliminate all other causes, they found that 33% (49/149) had nerve compression at the brainstem. Their symptoms included dysphonia (51%), chronic cough (39%), dysphoric breathing (6%) and dysphagia (4%). After explaining the potential risks and benefits, 49% elected neurosurgical decompression and 51% chose non-surgical/standard-of-care treatment.

Results showed that surgical decompression significantly improved quality of life on all measures. The change in Voice-Related Quality of Life (V-RQOL) was p=0.02, Reflux Symptom Index (RSI) was p=0.02 and Glottal Closure Index (GCI) was p=0.01. Results comparing surgical and non-surgical groups showed significantly (p=0.02) greater improvement in V-RQOL in the surgical group and trends toward statistical significance on the RSI (p=0.20) and GCI (p=0.17).

42% of the surgical group reported near-complete or complete symptom resolution compared to 8% in the non-surgical group (p=0.008). Over a mean follow-up of three years, non-surgical patients (60%) experienced no significant improvement or worsening symptoms, compared to surgical patients (13%) (p=0.001). Finally, none of the non-surgical patients demonstrated improved laryngeal exam findings, while 43% of surgical patients demonstrated improvements and 29% demonstrated resolution of their laryngeal exam findings.

“Our study shows that when we can’t identify a cause for vocal fold weakness based on the standard work up, the next step may be to look at the brain stem,” Halstead said. “It’s so important that we now have one more thing to look at and one more thing we can offer as definitive treatment.”

The team hopes that their findings will benefit more patients soon and that their study might point others to investigate nerve compression at the brain stem as a possible cause for other unexplained symptoms.




Newly developed AI accurately predicts severity of cancer patients’ symptoms

Doctors could get a head start treating cancer thanks to new AI developed at the University of Surrey that is able to predict symptoms and their severity throughout the course of a patient’s treatment.

In what is believed to be the first study of its kind, published in the PLO One journal, researchers from the Centre for Vision, Speech and Signal Processing (CVSSP) at the University of Surrey detail how they created two machine learning models that are both able to accurately predict the severity of three common symptoms faced by cancer patients – depression, anxiety and sleep disturbance. All three symptoms are associated with severe reduction in cancer patients’ quality of life.

Researchers analyzed existing data of the symptoms experienced by cancer patients during the course of computed tomography x-ray treatment. The team used different time periods during this data to test whether the machine learning algorithms are able to accurately predict when and if symptoms surfaced.

The results found that the actual reported symptoms were very close to those predicted by the machine learning methods.

This work has been a collaboration between the University of Surrey and the University of California in San Francisco (UCSF). The UCSF research in this joint collaboration is led by Professor Christine Miaskowski.

Payam Barnaghi, Professor of Machine Intelligence at the University of Surrey, said: “These exciting results show that there is an opportunity for machine learning techniques to make a real difference in the lives of people living with cancer. They can help clinicians identify high-risk patients, help and support their symptom experience and pre-emptively plan a way to manage those symptoms and improve quality of life.”

Nikos Papachristou, who worked on designing the machine learning algorithms for this project, said: “I am very excited to see how machine learning and AI can be used to create solutions that have a positive impact on the quality of life and well-being of patients.”

Source:

https://www.surrey.ac.uk/




What is irritable bowel syndrome and what can i do about it?

Many people use the term irritable bowel syndrome to describe general symptoms of gut and bowel dysfunction. But diagnosis requires meeting strict, diagnostic criteria. Known as the ROME criteria, these require a person to be experiencing abdominal pain, on average, at least one day per week. The pain must be associated with two or more of the following:

  • defecation
  • a change in the frequency of stool
  • a change in the form (appearance) of stool
  • having occurred over the last three months with symptom onset at least six months before diagnosis.

Tests aren’t always needed for a diagnosis if these symptoms are present. But an accurate diagnosis of IBS is important as some symptoms, such as pelvic pain, may overlap with other diseases such as endometriosis or inflammatory bowel disease. If other symptoms are present, a doctor may need to perform blood tests, pelvic ultrasound, endoscopy or stool tests to rule out similar disorders.

Read more: I have painful periods, could it be endometriosis?

Some symptoms are considered “red flag” symptoms and should prompt further testing and specialist referral. For example, if you have rectal bleeding, weight loss and are aged over 50 when symptoms start, it is not IBS.

What causes it?

A single cause for IBS has not been identified. IBS may run in families, but we still don’t know if this is due to shared genetics or environmental factors. An episode of gastroenteritis, an infection caused by viruses or bacteria, increases the risk of developing IBS. But this is usually temporary and symptoms gradually improve.

People with IBS often also have anxiety and depression. Research suggests early childhood trauma can predispose some people to IBS in later life. This is because the gut and brain talk to each other through nerve signals, the release of gut or stress hormones, and other pathways.

We have long known that emotions can directly alter gut function. But studies now show that gut function also affects emotions. One Australian study indicated that for some people gut symptoms occur first and the psychological symptoms occur as a result. But this is not true for all people with IBS.

What do I do?

Non-drug treatments should be considered initially, and more than one treatment strategy may be needed to help improve symptoms.

Good-quality evidence shows a low-FODMAP diet reduces IBS symptoms. FODMAPs are carbohydrates that produce excess gas when digested. They can be found in roots such as onions and garlic, and fruits (or seeds) like legumes, apples, pears and mangoes. For the best result, a person should start a low-FODMAP diet under the guidance of an experienced dietitian.

It’s a common misconception that people should keep to a low-FODMAP diet for life. Foods like onions, which are high in FODMAPs, are also good prebiotics and promote the growth of friendly gut bacteria. Restricting these can result in low gut bacterial diversity, which is linked to autoimmune diseases and obesity. That’s another reason a dietician should guide people through the diet over a few weeks and avoid unnecessary dietary restriction.

Simple dietary measures include adding more soluble fibre to the diet. This can include psyllium, which can be bought as a powder from chemists and health food shops. Insoluble fibres like bran are generally unhelpful.

A trial of probiotics might help. These could be trialled for one month and then re-evaluated by the GP, but are unlikely to be useful if used indefinitely. Exercise has been shown in randomised trials to improve gut symptoms in people with IBS.

Managing stress and anxiety are key to improving symptoms for many people. Psychological therapies have been shown in trials to help symptoms more than placebo or other interventions. This is particularly so when the psychologist is interested in IBS.

Clinical trials have also shown that, for some people, hypnotherapy that is directed at the gut is just as effective as a low-FODMAP diet. The benefits are still seen at six months. Hypnotherapy is not for everyone, however, and multiple sessions are needed for symptoms to improve.

What about medications?

IBS affects quality of life but it doesn’t change a person’s risk of early death or cancer. So, treatments should have few side effects to be acceptable. Clinical trials have shown that medications such as peppermint oil (usually given in capsules) can reduce troublesome abdominal cramps with minimal side effects.

Melatonin can improve symptoms through better sleep quality where sleep is disturbed.

The choice of drug should be tailored to each person’s symptoms. For instance, low-dose antidepressants can be helpful for some people, especially where significant depression or anxiety symptoms exist together with IBS. Medications that reduce inflammation are generally unhelpful, as consistent and clinically apparent inflammation is not part of the syndrome.

A few new approaches are being trialled for IBS, including faecal transplants and new medications. But all of these need better long-term data before they appear on the market.


Explore further:
Modified rye bread helps patients with irritable bowel syndrome

Provided by:
The Conversation




Study suggests biological basis for depression, anxiety, sleep disturbances in older adults

Neurofibrillary tangle in brainstem. Credit: Grinberg Lab / UCSF.

UC San Francisco researchers, in collaboration with the unique Brazilian Biobank for Aging Studies (BBAS) at the University of São Paulo, have shown that the earliest stages of the brain degeneration associated with Alzheimer’s disease (AD) are linked to neuropsychiatric symptoms including anxiety, depression, loss of appetite, and sleep disturbances.

The findings – published in their final version Oct. 15, 2018, in the print edition of the Journal of Alzheimer’s Disease following preliminary online publication in September – could lead to earlier diagnosis of AD and prove a valuable biomarker in the development of therapies to slow the course of the disease, the authors say, but may also have broader implications for understanding the biological basis of psychiatric symptoms in older adults.

Though commonly associated with memory loss and dementia, Alzheimer’s disease is actually a progressive neurodegenerative condition that can be detected in a brain autopsy decades before these classic cognitive symptoms occur. A “Holy Grail” of Alzheimer’s research is to develop treatments that could be given in the disease’s earliest stages to protect brain tissue from further loss and to slow or prevent the eventual development of dementia. However, the development of such drugs will require a better understanding of the biology that drives the first stages of the disease and the ability to diagnose patients early enough to prevent extensive loss of neural tissue.

Correlations, But Murky Relationship

Many studies have identified correlations between neuropsychiatric symptoms such as depression, anxiety, and sleep disturbances and an eventual Alzheimer’s diagnosis, and some have even proposed that these symptoms could be used as biomarkers for the disease in its earliest stages. But the relationship between the two has remained murky. In fact, some researchers have proposed that depression and other psychiatric conditions, or even the drugs used to treat these conditions, could themselves be triggers that lead to the onset of dementia decades later, much like occasional seizures can contribute to the development of chronic epilepsy.

Now members of the lab of Lea Grinberg, MD, Ph.D. in the UCSF Weill Institute for Neurosciences’ Memory and Aging Center, working with Brazilian colleagues, have shown that psychiatric symptoms are tightly linked to the earliest stages of Alzheimer’s brain pathology. These results strongly suggest that neuropsychiatric conditions or treatments do not cause Alzheimer’s, but could be the earliest warning signs of the disease.

“The discovery that the biological basis for these symptoms is the early Alzheimer’s pathology itself was quite surprising,” Grinberg said. “It suggests these people with neuropsychiatric symptoms are not at risk of developing Alzheimer’s disease – they already have it.”

World’s Largest Resource of Samples

The research took advantage of São Paulo’s unique century-old autopsy service, which is mandated in all deaths and conducts approximately 15,000 autopsies per year. In 2003, as part of her doctoral research, Grinberg co-founded the BBAS to collect brain tissue samples from these autopsies, and BBAS has since grown to become the largest such resource in the world.

Most postmortem brain studies of AD use relatively small “convenience samples” from older individuals who already show signs of memory loss or dementia. Because multiple brain pathologies can accumulate with age, it can be difficult to tightly link specific AD-related symptoms to brain abnormalities detected in these samples. Thanks to the BBAS collaboration, however, Grinberg’s team was able to avoid these potential pitfalls by drawing from a much larger population, selecting brains from younger and healthier individuals, and excluding tissue samples with multiple competing pathologies.

In the new study, lead author Alex Ehrenberg, a neuropathology research associate in the Grinberg lab, worked closely with Claudia Suemoto MD, Ph.D., and other colleagues from the University of São Paulo to study the brains of 1,092 seemingly healthy adults over the age of 50 who closely represented the general population of São Paulo. The researchers excluded 637 brains that showed neurological signs of brain abnormalities not related to AD, leaving 455 brains with either no signs of degeneration or a range of AD-related pathology.

Progression of the Disease

AD pathology is characterized by buildup of telltale neurofibrillary (NF) tangles and amyloid-beta (Aß) plaques, paralleled by the atrophy of brain tissue in associated regions. The disease nearly always progresses in the same fashion, with NF tangles first appearing in brainstem regions associated with sleep, appetite and emotional processing, while Aβ plaques first appear in cortical regions and then spread to deeper parts of the brain.

Ehrenberg and colleagues classified each of the 455 brains using standard scales of AD progression based on NF tangle and Aβ plaque accumulation. They then used statistical algorithms to test for a relationship between AD stage and reported changes in the brain donor’s cognitive and emotional status prior to their death, based on interviews with informants – typically relatives and caretakers – who had been in at least weekly contact with the deceased in the six months before their deaths, a gold-standard approach for neuropathological studies of degenerative brain diseases such as AD.

Ehrenberg’s computational analysis of the results found that in individuals whose brainstems showed the very earliest stages of NF tangles but lacked memory changes, family members and caretakers reported increased rates of one or more neuropsychiatric symptoms including agitation, anxiety, appetite changes, depression, and sleep disturbances, but lacked any noticeable memory problems. The next stage of the disease, as NF buildup increased in the brainstem and began to spread to other brain regions, was associated with increased odds of agitation, while only in later stages, as NF buildup began to reach the brain’s outer cortex, did the individuals begin showing signs of the dementia-like delusions and the cognitive and memory decline typically associated with AD.

Tellingly, the researchers found no link between buildup of Aβ plaques and these neuropsychiatric symptoms. Alzheimer’s researchers have long debated whether Aβ plaques or NF tangles – made up of clumps of a protein called “tau” – play an earlier or more central role in driving neurodegeneration in AD, and the authors believe the new findings add additional support for focusing on developing tau-targeted treatments, particularly given disappointing results from many recent trials of Aβ-targeted AD therapies.

“These results could have major implications for Alzheimer’s drug trials focused on early degenerative changes, where people have been seeking tractable clinical outcomes to target in addition to early cognitive decline,” Ehrenberg said. He added that the findings will also be valuable as new technologies become available for detecting early stages of AD pathology in living patients—such as blood biopsies or PET brain imaging of tau—to aid the implementation of such novel biomarkers into clinical practice.

To Grinberg, the discovery that psychiatric symptoms such as depression or sleep disturbance in older adults may be linked to a specific biological phenomenon – namely accumulation of tau protein into NF tangles in the brainstem – is as exciting as the implications for Alzheimer’s disease itself.

“Because we generally don’t know the biological basis for most psychiatric conditions, we can’t do what we do for other diseases like diabetes or cancer – we can’t say, ‘You are having depression or sleep problems because of this disease in your brain, so let’s see if we can treat that disease,'” Grinberg said. “If we could use this new knowledge to find a way to reduce the burden of these conditions in aging adults it would be absolutely huge.”


Explore further:
Scientists discover why some people with brain markers of Alzheimer’s have no dementia

More information:
Alexander J. Ehrenberg et al. Neuropathologic Correlates of Psychiatric Symptoms in Alzheimer’s Disease, Journal of Alzheimer’s Disease (2018). DOI: 10.3233/JAD-180688

Journal reference:
Journal of Alzheimer’s Disease

Provided by:
University of California, San Francisco




Intellectually active lifestyle confers protection against neurodegeneration in Huntington’s patients

Researchers from the Cognition and Brain Plasticity research group of the Bellvitge Biomedical Research Institute (IDIBELL) and the University of Barcelona (UB), in collaboration with several hospitals, have discovered that an intellectually active lifestyle confers protection against neurodegeneration in people with Huntington’s disease, delaying the onset of symptoms and loss of grey matter in the brain. The research, led by Dr. Estela Càmara and doctoral researcher Clara García Gorro, helps to understand the factors related to the differences in symptoms among patients with this disease and to decipher the cerebral mechanisms responsible for such differences.

The study, published in Neuropsychologia, shows how patients with Huntington’s disease with greater cognitive activity throughout life obtain better scores in neuropsychological tests. “These patients showed a delay in the appearance of the first symptoms of the disease and a lower level of atrophy in an area of the brain especially affected in this disease, which is called the caudate nucleus”, explains Clara García Gorro.

In order to assess intellectual activity throughout life, the educational level, the type of professional occupation, the number of languages, the reading activity and the frequency with which participants played games such as chess were taken into account, among other factors.

These results suggest that greater mental activity somehow protects the brain from neurodegenerative processes, keeping it in good condition for an extended period of time. “Therefore, this discovery emphasizes the importance of cognitive interventions in neurodegenerative diseases, as well as leading a cognitively stimulating life to maintain a healthy brain”, adds Dr Càmara.

Huntington’s disease is a neurodegenerative disease of genetic origin for which there is currently no cure. Its main symptoms include motor, cognitive and psychiatric problems. The average age of onset of the first symptoms is around 40 years, being a progressive disease in which the symptoms gradually worsen.

Source:

http://www.idibell.cat/en/whats-on/noticies/intellectually-active-lifestyle-protects-against-neurodegeneration-people




Study explores how patients want to discuss symptoms with doctors

Sleep, pain, anxiety, depression, and low energy/fatigue (known collectively as SPADE for short) symptoms are extremely common, but often unrecognized and undertreated by primary care physicians. A new Regenstrief Institute study has found that patients want to tell their doctors about their symptoms and would be willing to do so via a formal reporting system, but patients are reluctant to report symptoms if they perceive busy clinicians will not use that information to improve care.

“Patients see both personal and clinical benefits in routinely completing questionnaires about symptoms they are experiencing,” said Regenstrief Institute Research Manager Tasneem (Nina) Talib, Ph.D., lead author of the study. “While they understand that their doctors see a lot of patients, they don’t want to feel like a number. They want their doctors to actually review and use the information they are providing.”

“A Qualitative Study of Patients’ Perceptions of the Utility of Patient-reported Outcome Measures of Symptoms in Primary Care Clinics” is published in the December issue of the peer reviewed journal Quality of Life Research.

“Patient reported symptoms are not routinely put into a patient’s electronic medical record, and most EMR systems are not designed to include symptoms,” said Regenstrief Institute Investigator Kurt Kroenke, M.D., senior author of the study. “The healthcare system spends a lot of money on lab and imaging test results, which we put into the patient’s EMR; shouldn’t we be valuing patient-reported symptoms enough to put them into that same record? Pain and other symptoms have scales assigned to them similar to measurements obtained from blood pressure cuffs which alert us to an increase or decrease.

“We — health care systems and the doctors who work in these systems — haven’t figured out how to deal efficiently with symptoms. Some doctors want to know about symptoms but others don’t see how they can work discussion and follow-up on symptoms into an already busy primary care visit,” he said.

Dr. Kroenke is an internationally respected expert in symptoms. Over the past three decades, his research has focused on the management of pain and other symptoms by primary care physicians, initially examining unexplained medical symptoms. This focus has expanded to include underlying mental disorders, including depression and anxiety, that affect patient experience with symptoms. Faced with the difficulty of diagnosing these problems in primary care, he co-developed easy, valid and reliable measurement tools for depression and anxiety. These instruments, which have been translated into more than 100 languages, are used today in daily practice in most internists’ offices and are the annual screening tool implemented by major healthcare institutions throughout the U.S. and Europe.

In the new study, 23 male and female patients (age 24 to 77 years) with one or more SPADE symptoms were interviewed about the use, implementation and visual display of formal, computerized patient reporting of symptoms.

Among the interview responses:

“I think they [formal surveys in which patients note their symptoms] are beneficial if they’re being utilized. Every doctor should do this as a force of habit with every single patient on every single visit. But, if it’s just a person checking some boxes and throwing it in my medical folder, and it’s not being looked at or reviewed…sometimes I feel like a number, not an actual patient.”

“I wouldn’t necessarily recognize that I’m anxious, unless somebody asked me: Are you nervous? If I stop and think about it, well maybe I am. But if I don’t, you know…most people are too busy to recognize what they’re feeling. By looking at that [symptoms questionnaire] it does help me to stop and think. And if I did have that, then maybe I better mention this.”

“In order to get them [patients] to understand the value of it, of filling out the information, the doctor needs to use it…I mean, why am I gonna fill it out if they’re not gonna look at it?…I fill out the information, the doctor actually asked me a question about it. Wow! I see that as a motivating factor for filling out the information.”

“Barriers exist and doctors shouldn’t be blamed for not focusing on pain, depression and anxiety. They need efficient clinical strategies to deal with symptoms and reimbursement to pay for these strategies,” said Dr. Kroenke, whose recent work focuses on what these optimal strategies might be and how they would function. “Extra time during the patient visit, getting nurses and other non-physicians involved, telecare, online and other self-management tools have the potential to help physicians help their patients deal with symptoms.”

Source:

https://www.regenstrief.org/article/how-do-patients-want-to-discuss-symptoms/




How do patients want to discuss symptoms with clinicians?

Sleep, pain, anxiety, depression, and low energy/fatigue (known collectively as SPADE for short) symptoms are extremely common, but often unrecognized and undertreated by primary care physicians. A new Regenstrief Institute study has found that patients want to tell their doctors about their symptoms and would be willing to do so via a formal reporting system, but patients are reluctant to report symptoms if they perceive busy clinicians will not use that information to improve care.

“Patients see both personal and clinical benefits in routinely completing questionnaires about symptoms they are experiencing,” said Regenstrief Institute Research Manager Tasneem (Nina) Talib, Ph.D., lead author of the study. “While they understand that their doctors see a lot of patients, they don’t want to feel like a number. They want their doctors to actually review and use the information they are providing.”

“A Qualitative Study of Patients’ Perceptions of the Utility of Patient-reported Outcome Measures of Symptoms in Primary Care Clinics” is published in the December issue of the peer reviewed journal Quality of Life Research.

“Patient reported symptoms are not routinely put into a patient’s electronic medical record, and most EMR systems are not designed to include symptoms,” said Regenstrief Institute Investigator Kurt Kroenke, M.D., senior author of the study. “The healthcare system spends a lot of money on lab and imaging test results, which we put into the patient’s EMR; shouldn’t we be valuing patient-reported symptoms enough to put them into that same record? Pain and other symptoms have scales assigned to them similar to measurements obtained from blood pressure cuffs which alert us to an increase or decrease.

“We—health care systems and the doctors who work in these systems—haven’t figured out how to deal efficiently with symptoms. Some doctors want to know about symptoms but others don’t see how they can work discussion and follow-up on symptoms into an already busy primary care visit,” he said.

Dr. Kroenke is an internationally respected expert in symptoms. Over the past three decades, his research has focused on the management of pain and other symptoms by primary care physicians, initially examining unexplained medical symptoms. This focus has expanded to include underlying mental disorders, including depression and anxiety, that affect patient experience with symptoms. Faced with the difficulty of diagnosing these problems in primary care, he co-developed easy, valid and reliable measurement tools for depression and anxiety. These instruments, which have been translated into more than 100 languages, are used today in daily practice in most internists’ offices and are the annual screening tool implemented by major healthcare institutions throughout the U.S. and Europe.

In the new study, 23 male and female patients (age 24 to 77 years) with one or more SPADE symptoms were interviewed about the use, implementation and visual display of formal, computerized patient reporting of symptoms.

Among the interview responses:

“I think they [formal surveys in which patients note their symptoms] are beneficial if they’re being utilized. Every doctor should do this as a force of habit with every single patient on every single visit. But, if it’s just a person checking some boxes and throwing it in my medical folder, and it’s not being looked at or reviewed…sometimes I feel like a number, not an actual patient.”

“I wouldn’t necessarily recognize that I’m anxious, unless somebody asked me: Are you nervous? If I stop and think about it, well maybe I am. But if I don’t, you know…most people are too busy to recognize what they’re feeling. By looking at that [symptoms questionnaire] it does help me to stop and think. And if I did have that, then maybe I better mention this.”

“In order to get them [patients] to understand the value of it, of filling out the information, the doctor needs to use it… I mean, why am I gonna fill it out if they’re not gonna look at it?… I fill out the information, the doctor actually asked me a question about it. Wow! I see that as a motivating factor for filling out the information.”

“Barriers exist and doctors shouldn’t be blamed for not focusing on pain, depression and anxiety. They need efficient clinical strategies to deal with symptoms and reimbursement to pay for these strategies,” said Dr. Kroenke, whose recent work focuses on what these optimal strategies might be and how they would function. “Extra time during the patient visit, getting nurses and other non-physicians involved, telecare, online and other self-management tools have the potential to help physicians help their patients deal with symptoms.”


Explore further:
Over half of former ICU patients in the UK report symptoms of psychological disorders

Provided by:
Regenstrief Institute




History of Partner Violence Tied to Menopause Symptoms

WEDNESDAY, Dec. 5, 2018 — A history of intimate partner violence (IPV) or sexual assault and current symptoms of posttraumatic stress disorder (PTSD) are associated with an increased risk for menopause symptoms, according to a study published online Nov. 19 in JAMA Internal Medicine.

Carolyn J. Gibson, Ph.D., M.P.H., from the San Francisco Veterans Affairs Health Care System, and colleagues studied a multiethnic cohort of 2,016 women (mean age, 60.5 years) in the Kaiser Permanente Northern California health care system between Nov. 15, 2008, and March 30, 2012. Questionnaires were used to assess lifetime physical or emotional IPV, sexual assault, and current symptoms of PTSD.

The researchers found that 21 percent of women reported lifetime emotional IPV, 15.7 percent reported lifetime physical IPV, 18.9 percent reported sexual assault, and 22.5 percent had current clinically significant symptoms of PTSD. After adjustment for age, race/ethnicity, educational level, body mass index, menopause status, hormone therapy, and parity, symptoms of PTSD were associated with difficulty sleeping (odds ratio [OR], 3.02), vasomotor symptoms (hot flashes, OR, 1.69; night sweats, OR, 1.72), and vaginal symptoms (vaginal dryness, OR, 1.73; vaginal irritation, OR, 2.2; pain with intercourse, OR, 2.16). An association was seen between emotional IPV and difficulty sleeping (OR, 1.36), night sweats (OR, 1.5), and pain with intercourse (OR, 1.6), while physical IPV was associated with night sweats (OR, 1.33). Sexual assault was associated with vaginal symptoms, including vaginal dryness (OR, 1.41), vaginal irritation (OR, 1.42), and pain with intercourse (OR, 1.44).

“These findings highlight the need for greater recognition of these exposures by clinicians caring for midlife and older women,” the authors write.

One author disclosed financial ties to pharmaceutical companies.

Abstract/Full Text (subscription or payment may be required)
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© 2018 HealthDay. All rights reserved.

Posted: December 2018




FDA Warns About Rare But Serious Risks of Stroke and Blood Vessel Wall Tears with Multiple Sclerosis Drug Lemtrada (alemtuzumab)

November 29, 2018

Audience: Consumer, Health Professional, Pharmacy

The U.S. Food and Drug Administration (FDA) is warning that rare but serious cases of stroke and tears in the lining of arteries in the head and neck have occurred in patients with multiple sclerosis (MS) shortly after they received Lemtrada (alemtuzumab). These problems can lead to permanent disability and even death. As a result, we have added a new warning about these risks to the prescribing information in the drug label and to the patient Medication Guide. We have also added the risk of stroke to the existing Boxed Warning, FDA’s most prominent warning.

Alemtuzumab is also approved under the brand name Campath, which was approved in May 2001 to treat a type of cancer called B-cell chronic lymphocytic leukemia (B-CLL). The Campath drug label will also be updated to include these risks in the Adverse Reactions section under Postmarketing Experience.

Patients or their caregivers should seek emergency treatment as soon as possible if the patient experiences signs or symptoms of a stroke or tears in the lining of the head and neck arteries, called arterial dissection, which can include:

  • Sudden numbness or weakness in the face, arms, or legs, especially if it occurs on only one side of the body
  • Sudden confusion, trouble speaking, or difficulty understanding speech
  • Sudden trouble seeing in one or both eyes
  • Sudden trouble with walking, dizziness, or loss of balance or coordination
  • Sudden severe headache or neck pain

Most patients taking Lemtrada who developed stroke or tears in the artery linings, developed symptoms within 1 day of receiving Lemtrada. One patient reported symptoms that occurred 3 days after treatment.

Health care professionals should advise patients at every Lemtrada infusion to seek immediate emergency medical attention if they experience symptoms of ischemic or hemorrhagic stroke or cervicocephalic arterial dissection. The diagnosis is often complicated because early symptoms such as headache and neck pain are not specific. Promptly evaluate patients who complain of symptoms consistent with these conditions.

In the nearly five years since FDA approved Lemtrada in 2014 to treat relapsing forms of MS, we identified 13 worldwide cases of ischemic and hemorrhagic stroke or arterial dissection that occurred shortly after the patient received Lemtrada (see Data Summary). This number includes only reports submitted to FDA,* so additional cases we are unaware of may have occurred. Twelve of these cases reported symptoms within 1 day of receiving Lemtrada. As a result, we have added a new warning about this risk in the Warnings and Precautions section of the prescribing information in the drug label. We have also added the risk of stroke to the existing Boxed Warning, FDA’s most prominent warning.

To help FDA track safety issues with medicines, we urge health care professionals to report side effects from Lemtrada or other medicines to the FDA MedWatch program, using the information in the “Contact FDA” box at the bottom of this page.

*The cases were reported to the FDA Adverse Event Reporting System (FAERS).


Source: FDA




Scientists alleviate schizophrenic symptoms in mice

Despite extensive research efforts, schizophrenia remains one of the least understood brain disorders. One promising area of research is in receptors on the surfaces of brain cells that help sense growth factors. But there’s been a problem: in previous schizophrenia studies, researchers have genetically manipulated brain cell receptors in very young mice. Schizophrenia usually affects adults.

In a recent issue of the Proceedings of the National Academy of Sciences, Lin Mei, MD, PhD, asked, does all the tinkering in young mice hamper their brain development, causing schizophrenia-like symptoms? Or, do their brain cells develop normally, but in adulthood struggle to communicate? Researchers need to know whether to focus their efforts on brain cell development or communication, or both, because the answer to these questions implies different therapeutic approaches.

In the new study, Mei, professor and chair of neurosciences at Case Western Reserve University School of Medicine, led an international team of neuroscientists. The team included Mei’s long-time collaborator, Wen-Cheng Xiong, PhD, professor of neurosciences, and first authors Hongsheng Wang and Wenbing Chen, graduate students, all of CWRU. Additional collaborators included researchers at Nanchang University and Guangzhou Medical University in China, and neuroscientists from the Medical College of Georgia at Augusta University.

Together, the researchers studied a brain cell receptor–ErbB4–whose level is altered in adults with schizophrenia. ErbB4 helps maintain an inhibitory neurotransmitter in the brain–GABA–that prevents brain cells from overreacting and keeps fear and anxiety in check. The researchers have shown previously that ErbB4 mutations change signals inside brain cells that lead to schizophrenic symptoms in mice.

“When ErbB4 is mutated early on in mice, it impairs brain circuit wiring. It also impairs GABA transmission in adult animals, causing schizophrenic symptoms,” said Mei. “But previous models are unable to distinguish whether deficits are from abnormal development in young mice brains, or abnormal transmission developed later on.” Mei’s new study shows schizophrenic symptoms come from deficits in how brain cells communicate during adulthood, regardless of whether or not they fully developed.

To find their answers, Mei’s team genetically engineered two new mouse models of schizophrenia. In the first, the researchers treated mice with a chemical that switches “off” the gene encoding ErbB4. “Using inducible knock-out mice, we depleted ErbB4 only in adult animals, and showed that this impairs behavior,” said Mei. In mice missing ErbB4 only in adulthood, brain cell development and appearance were normal, but symptoms persisted. The experiment suggested schizophrenic symptoms in adult mice were unrelated to abnormal brain cell development.

In the second mouse model, the receptor was missing in mice from the beginning, hampering brain cell development. The researchers used the same genetic switch to turn ErbB4 “on” in adulthood–in essence, recovering it. “In recovery knock-out mice, ErbB4 is missing during development and thus the mice have crippled brain circuits. Yet, when ErbB4 is restored on a malformed circuit, mice scored better in behavioral tests,” said Mei. Even with underdeveloped brain cells, schizophrenic symptoms could be alleviated simply by adding ErbB4.

Mei’s team found restoring ErbB4 receptors reduced hyperactivity, and normalized fear responses in adult mice. “ErbB4 is a risk factor for schizophrenia,” said Mei. “This study shows correcting ErbB4 signaling could be therapeutic in relevant patients.”

The results in the two mouse models confirm that ErbB4 is critical to how brain cells communicate during adulthood. The nuanced distinction could lead to new therapeutics designed to improve brain cell signaling associated with the ErbB4 receptor. In particular, therapeutics that improve how GABA neurotransmitters regulate brain cell activity.

“Restoring ErbB4 could be beneficial to patients–even those with malformed brain circuitry,” said Mei. “We are now looking into how restoring ErbB4 improves neurotransmitter signaling inside brain cells, including those relevant to other psychiatric disorders, such as attention deficit hyperactivity disorder and major depression.”

Source:

http://casemed.case.edu/cwrumed360/news-releases/release.cfm?news_id=1575&news_category=8




Researchers identify sepsis symptoms that contribute to patient mortality

Using patient records from 210,289 hospital visits between 2013 and 2016, Drexel University researchers have identified the specific symptoms that put patients at the greatest risk of dying from sepsis – and they’re not what many clinicians might think.

Sepsis, a life-threatening condition caused by the body’s response to an infection, is one of the most frequent causes of death in the hospital and one of the most expensive conditions to treat. Early recognition can save lives, but patients require close, consistent monitoring, and providers can easily miss the insidious, gradual signs of the disease. Complicating matters, the definition of sepsis is in dispute amongst experts. This can lead to muddied treatment guidelines and a lack of care for patients whose symptoms do not fit the standard checklist for a sepsis diagnosis, but who, in fact, may be at high risk for death.

The new study by Drexel researchers, published this month in Critical Care, shows that impaired kidney function is one of the leading predictors of sepsis patient mortality. The data offers an advanced analytical model for detecting early warning signs of sepsis and for differentiating between different organ dysfunctions’ contribution to in-hospital morality.

“We now have large-scale evidence that many of these organ system failures that are typically underappreciated – particularly the renal and respiratory systems – actually have the highest association with death,” said study co-principal investigator Ryan Arnold, MD, an emergency medicine doctor and faculty member at Drexel College of Medicine. “That means that symptoms related to these systems need to be raising a red flag for doctors. We’re saying, ‘Hey, this is the type of patient you need to be paying more attention to.'”

The researchers found that the more well-known symptoms of sepsis, such as low blood pressure, were linked to lower mortality rates in the population they studied.

“That likely speaks more to the health care providers’ response to the symptom, than the low blood pressure itself actually being a protective factor,” Arnold added. “With sepsis, patients generally don’t fall off of a cliff. Instead, it’s a day by day, gradual deterioration. Maybe someone has a small increase in creatinine today, and tomorrow it’s a little worse. Those subtle changes that don’t get detected, we found, lead to death.”

To quantify the association between organ dysfunctions and health outcomes, the research team used retrospective Electronic Health Record data for adult patients hospitalized within Delaware’s Christiana Care Health System from July 2013 to April 2016. They analyzed the relationship between in-hospital mortality and symptoms with seven organ systems: cardiovascular, metabolic, hematopoietic, nervous, gastrointestinal, renal and respiratory.

Of the 210,289 visits during the study period, 62,057 patients (30 percent) were treated for an infection, and 48,680 (78 percent) experienced organ dysfunction. Of the patients treated for an infection, 1,955 (3 percent) died during this period. Patients with worsening kidney function (increase in creatinine levels by 50 percent from baseline) had the highest mortality rate (17 percent), followed by mechanical ventilation requirement (13 percent). Patients with hypotension had the lowest incidents of death. The researchers also found that treating patients for an infection within 24 hours of being admitted to the hospital significantly lowered their risk of dying.

The study paves the way for the creation of a clinical decision support system that can give providers real-time alerts about patients that might be high-risk for dying from sepsis, according to study co-principal investigator Muge Capan, PhD, an associate clinical professor at Drexel’s LeBow College of Business.

“The integration of analytics and clinical, translational research provides insight into developing smart and connected systems that support data-driven and personalized management of sepsis,” Capan said.

The research team is now building a model that assigns different “weighted risk” to individual organ system dysfunctions that are observed simultaneously, allowing clinicians to plug in combinations of symptoms and create an individualized picture for each sepsis patient. For instance, a patient with dysfunction of both kidney and respiratory systems, would require more close monitoring than a patient suffering from kidney dysfunction and low blood pressure.

“Now, when a new patient walks into the hospital, we can use our math and analytic skills to match that patient’s fingerprint and really see: ‘What is that person’s individualized risk of in-hospital death?’ and ‘What is that person’s individual risk of developing septic shock?’ That is very useful, and very exciting,” Capan said.

Source:

https://drexel.edu/now/archive/2018/November/Sepsis-Symptoms-Lead-to-Death/