Jan Dyer

As many as one-third of workers in some sectors of health care and social service may have hearing loss, according to the researchers at the National Institute for Occupational Safety and Health (NIOSH) who studied audiograms from hundreds of US companies. Theirs is the first known study to estimate and compare the prevalence of noise-exposed worker hearing loss by subsector within the Health Care and Social Assistance (HSA) sector.

Some subsectors had higher than expected prevalence of hearing loss for an industry that has had assumed “low exposure” to noise, NIOSH says. Most of the HSA subsector prevalence estimates ranged from 14% to 18%, but the Medical and Diagnostic Laboratories subsector had 31% prevalence, the Offices of All Other Miscellaneous Health Practitioners had 24% prevalence, and Child Day Care Services had a 52% higher risk compared with that of the reference industry.

NIOSH says successful noise reduction measures have been documented in hospital settings. Exposure to chemotherapy drugs can be better prevented and laboratories can be modified to reduce the level of noise. When noise can’t be removed or reduced to safe levels, NIOSH recommends implementing an effective hearing conservation program.

Hearing loss is the third most common chronic physical condition in the US, NIOSH says. But Elizabeth Masterson, PhD, epidemiologist and lead author of the study, says, “Occupational hearing loss is entirely preventable.”

As many as one-third of workers in some sectors of health care and social service may have hearing loss, according to the researchers at the National Institute for Occupational Safety and Health (NIOSH) who studied audiograms from hundreds of US companies. Theirs is the first known study to estimate and compare the prevalence of noise-exposed worker hearing loss by subsector within the Health Care and Social Assistance (HSA) sector.

Some subsectors had higher than expected prevalence of hearing loss for an industry that has had assumed “low exposure” to noise, NIOSH says. Most of the HSA subsector prevalence estimates ranged from 14% to 18%, but the Medical and Diagnostic Laboratories subsector had 31% prevalence, the Offices of All Other Miscellaneous Health Practitioners had 24% prevalence, and Child Day Care Services had a 52% higher risk compared with that of the reference industry.

NIOSH says successful noise reduction measures have been documented in hospital settings. Exposure to chemotherapy drugs can be better prevented and laboratories can be modified to reduce the level of noise. When noise can’t be removed or reduced to safe levels, NIOSH recommends implementing an effective hearing conservation program.

Hearing loss is the third most common chronic physical condition in the US, NIOSH says. But Elizabeth Masterson, PhD, epidemiologist and lead author of the study, says, “Occupational hearing loss is entirely preventable.”

As many as one-third of workers in some sectors of health care and social service may have hearing loss, according to the researchers at the National Institute for Occupational Safety and Health (NIOSH) who studied audiograms from hundreds of US companies. Theirs is the first known study to estimate and compare the prevalence of noise-exposed worker hearing loss by subsector within the Health Care and Social Assistance (HSA) sector.

Some subsectors had higher than expected prevalence of hearing loss for an industry that has had assumed “low exposure” to noise, NIOSH says. Most of the HSA subsector prevalence estimates ranged from 14% to 18%, but the Medical and Diagnostic Laboratories subsector had 31% prevalence, the Offices of All Other Miscellaneous Health Practitioners had 24% prevalence, and Child Day Care Services had a 52% higher risk compared with that of the reference industry.

NIOSH says successful noise reduction measures have been documented in hospital settings. Exposure to chemotherapy drugs can be better prevented and laboratories can be modified to reduce the level of noise. When noise can’t be removed or reduced to safe levels, NIOSH recommends implementing an effective hearing conservation program.

Hearing loss is the third most common chronic physical condition in the US, NIOSH says. But Elizabeth Masterson, PhD, epidemiologist and lead author of the study, says, “Occupational hearing loss is entirely preventable.”

Hyponatremia is a dangerous complication of major head trauma, and timely diagnosis and treatment can be fraught with “confounding factors” and complexity, say clinicians from the University of Newcastle and John Hunter Hospital in Australia. They reported a case of hyponatremia that required some clinical tightrope walking.

The patient, a 20-year-old university student, had fractured his skull in a skateboard fall while intoxicated. He was started on dexamethasone to reduce the risk of worsening cerebral edema. On day 3, he developed hypo-osmolar hyponatremia, which was worse on day 4, despite treatment, including IV fluid therapy, fluid restriction, and oral salt tablets. Although cognitively the patient was deteriorating, he seemed clinically euvolemic. However, the patient was in negative fluid balance, suggesting renal salt wasting (RSW). After a trial of isotonic normal saline, the patient’s serum sodium level fell further. The patient was then treated for suspected syndrome of inappropriate antidiuretic hormone (SIADH) with a hypertonic saline infusion. The rise in sodium was carefully controlled to avoid rapid overcorrection, which can lead to irreversible neurologic symptoms. Finally, the patient’s sodium level and neurologic status improved.

The clinicians say the case demonstrates the complexity of differentiating between the causes of hyponatremia after head injury. Volume status may be an indicator, they say, but current clinical and laboratory markers of volume status are often limited in accuracy. The hallmark of RSW is volume depletion, whereas diagnosis of SIADH depends on a coexisting euvolemic state (as with the patient).

As many as 10% of victims of traumatic brain injury develop hyponatremia, and it is associated with a worse prognosis, even in mild cases, the clinicians note. Making the right diagnosis is critical—the treatment chosen can easily compromise the outcome. Patients with neurosurgical conditions are often treated with considerable volumes of saline-containing fluid, with consequent dynamic changes in blood and extracellular volumes. Moreover, the patients have elevated levels of adrenergic hormones with their own confounding effects.

In the long term, the patient experienced significant neurologic sequelae, including prolonged posttraumatic amnesia. After extensive rehabilitation he was able to return to the university.

Hyponatremia is a dangerous complication of major head trauma, and timely diagnosis and treatment can be fraught with “confounding factors” and complexity, say clinicians from the University of Newcastle and John Hunter Hospital in Australia. They reported a case of hyponatremia that required some clinical tightrope walking.

The patient, a 20-year-old university student, had fractured his skull in a skateboard fall while intoxicated. He was started on dexamethasone to reduce the risk of worsening cerebral edema. On day 3, he developed hypo-osmolar hyponatremia, which was worse on day 4, despite treatment, including IV fluid therapy, fluid restriction, and oral salt tablets. Although cognitively the patient was deteriorating, he seemed clinically euvolemic. However, the patient was in negative fluid balance, suggesting renal salt wasting (RSW). After a trial of isotonic normal saline, the patient’s serum sodium level fell further. The patient was then treated for suspected syndrome of inappropriate antidiuretic hormone (SIADH) with a hypertonic saline infusion. The rise in sodium was carefully controlled to avoid rapid overcorrection, which can lead to irreversible neurologic symptoms. Finally, the patient’s sodium level and neurologic status improved.

The clinicians say the case demonstrates the complexity of differentiating between the causes of hyponatremia after head injury. Volume status may be an indicator, they say, but current clinical and laboratory markers of volume status are often limited in accuracy. The hallmark of RSW is volume depletion, whereas diagnosis of SIADH depends on a coexisting euvolemic state (as with the patient).

As many as 10% of victims of traumatic brain injury develop hyponatremia, and it is associated with a worse prognosis, even in mild cases, the clinicians note. Making the right diagnosis is critical—the treatment chosen can easily compromise the outcome. Patients with neurosurgical conditions are often treated with considerable volumes of saline-containing fluid, with consequent dynamic changes in blood and extracellular volumes. Moreover, the patients have elevated levels of adrenergic hormones with their own confounding effects.

In the long term, the patient experienced significant neurologic sequelae, including prolonged posttraumatic amnesia. After extensive rehabilitation he was able to return to the university.

Hyponatremia is a dangerous complication of major head trauma, and timely diagnosis and treatment can be fraught with “confounding factors” and complexity, say clinicians from the University of Newcastle and John Hunter Hospital in Australia. They reported a case of hyponatremia that required some clinical tightrope walking.

The patient, a 20-year-old university student, had fractured his skull in a skateboard fall while intoxicated. He was started on dexamethasone to reduce the risk of worsening cerebral edema. On day 3, he developed hypo-osmolar hyponatremia, which was worse on day 4, despite treatment, including IV fluid therapy, fluid restriction, and oral salt tablets. Although cognitively the patient was deteriorating, he seemed clinically euvolemic. However, the patient was in negative fluid balance, suggesting renal salt wasting (RSW). After a trial of isotonic normal saline, the patient’s serum sodium level fell further. The patient was then treated for suspected syndrome of inappropriate antidiuretic hormone (SIADH) with a hypertonic saline infusion. The rise in sodium was carefully controlled to avoid rapid overcorrection, which can lead to irreversible neurologic symptoms. Finally, the patient’s sodium level and neurologic status improved.

The clinicians say the case demonstrates the complexity of differentiating between the causes of hyponatremia after head injury. Volume status may be an indicator, they say, but current clinical and laboratory markers of volume status are often limited in accuracy. The hallmark of RSW is volume depletion, whereas diagnosis of SIADH depends on a coexisting euvolemic state (as with the patient).

As many as 10% of victims of traumatic brain injury develop hyponatremia, and it is associated with a worse prognosis, even in mild cases, the clinicians note. Making the right diagnosis is critical—the treatment chosen can easily compromise the outcome. Patients with neurosurgical conditions are often treated with considerable volumes of saline-containing fluid, with consequent dynamic changes in blood and extracellular volumes. Moreover, the patients have elevated levels of adrenergic hormones with their own confounding effects.

In the long term, the patient experienced significant neurologic sequelae, including prolonged posttraumatic amnesia. After extensive rehabilitation he was able to return to the university.

The VA has begun publicly posting information on opioids dispensed from VA pharmacies, becoming the only health care system in the country to do so.

An interactive map is available, showing data from 2012-2017, with opioid-dispensing rates for each facility and how much those rates have changed over time. The prescribing-rate information will be updated twice a year. According to the data, opioid prescribing rates dropped 41% between 2012-2017.

Nearly all (99%) facilities reduced their prescribing rates. El Paso, Texas, and Fayetteville, North Carolina are “most improved,” cutting prescribing rates by > 60% since 2012. San Juan, Puerto Rico, and Cleveland, Ohio, have the lowest prescribing rates, at 3%.

The map is available at https://www.data.va.gov/story/department-veterans-affairs-opioid-prescribing-data.

The VA has begun publicly posting information on opioids dispensed from VA pharmacies, becoming the only health care system in the country to do so.

An interactive map is available, showing data from 2012-2017, with opioid-dispensing rates for each facility and how much those rates have changed over time. The prescribing-rate information will be updated twice a year. According to the data, opioid prescribing rates dropped 41% between 2012-2017.

Nearly all (99%) facilities reduced their prescribing rates. El Paso, Texas, and Fayetteville, North Carolina are “most improved,” cutting prescribing rates by > 60% since 2012. San Juan, Puerto Rico, and Cleveland, Ohio, have the lowest prescribing rates, at 3%.

The map is available at https://www.data.va.gov/story/department-veterans-affairs-opioid-prescribing-data.

The VA has begun publicly posting information on opioids dispensed from VA pharmacies, becoming the only health care system in the country to do so.

An interactive map is available, showing data from 2012-2017, with opioid-dispensing rates for each facility and how much those rates have changed over time. The prescribing-rate information will be updated twice a year. According to the data, opioid prescribing rates dropped 41% between 2012-2017.

Nearly all (99%) facilities reduced their prescribing rates. El Paso, Texas, and Fayetteville, North Carolina are “most improved,” cutting prescribing rates by > 60% since 2012. San Juan, Puerto Rico, and Cleveland, Ohio, have the lowest prescribing rates, at 3%.

The map is available at https://www.data.va.gov/story/department-veterans-affairs-opioid-prescribing-data.

Women, the VA wants your brains. It sounds a little disconcerting at first, but the National Center for PTSD and the nonprofit PINK Concussions are encouraging women to donate their brains for research.

In the past, says Dr. Carolyn Clancy, executive in charge of Veterans Health Administration, “the focus on TBI and PTSD brain research has primarily been based on male brains, without any active recruitment for women.” There has been almost no postmortem brain tissue available for study of injury in women. The VA also notes a lack of research on chronic traumatic encephalopathy in women. Only 2 peer-reviewed journal articles, both published in the early 1990s, have focused on women.

Women who are interested can take the “PINK Brain Pledge,” a nonbinding promise to leave their brains to science. They do not have to have a history of TBI or PTSD; brains also are needed for controls.

Women, the VA wants your brains. It sounds a little disconcerting at first, but the National Center for PTSD and the nonprofit PINK Concussions are encouraging women to donate their brains for research.

In the past, says Dr. Carolyn Clancy, executive in charge of Veterans Health Administration, “the focus on TBI and PTSD brain research has primarily been based on male brains, without any active recruitment for women.” There has been almost no postmortem brain tissue available for study of injury in women. The VA also notes a lack of research on chronic traumatic encephalopathy in women. Only 2 peer-reviewed journal articles, both published in the early 1990s, have focused on women.

Women who are interested can take the “PINK Brain Pledge,” a nonbinding promise to leave their brains to science. They do not have to have a history of TBI or PTSD; brains also are needed for controls.

Women, the VA wants your brains. It sounds a little disconcerting at first, but the National Center for PTSD and the nonprofit PINK Concussions are encouraging women to donate their brains for research.

In the past, says Dr. Carolyn Clancy, executive in charge of Veterans Health Administration, “the focus on TBI and PTSD brain research has primarily been based on male brains, without any active recruitment for women.” There has been almost no postmortem brain tissue available for study of injury in women. The VA also notes a lack of research on chronic traumatic encephalopathy in women. Only 2 peer-reviewed journal articles, both published in the early 1990s, have focused on women.

Women who are interested can take the “PINK Brain Pledge,” a nonbinding promise to leave their brains to science. They do not have to have a history of TBI or PTSD; brains also are needed for controls.

Calling it “a major milestone,” the VA announced same-day services for urgent primary and mental health care are now available at 100% of its > 1,000 medical facilities.

Now a veteran can more conveniently have a face-to-face visit with a clinician, call a nurse, have a telehealth or video care visit, get an appointment with a specialist, or have a prescription filled in the same day, “depending upon what best meets the needs of the veteran.”

The VA also has reduced patient wait time, and implemented a new process to ensure timely follow-up appointments for time-sensitive medical needs.

Calling it “a major milestone,” the VA announced same-day services for urgent primary and mental health care are now available at 100% of its > 1,000 medical facilities.

Now a veteran can more conveniently have a face-to-face visit with a clinician, call a nurse, have a telehealth or video care visit, get an appointment with a specialist, or have a prescription filled in the same day, “depending upon what best meets the needs of the veteran.”

The VA also has reduced patient wait time, and implemented a new process to ensure timely follow-up appointments for time-sensitive medical needs.

Calling it “a major milestone,” the VA announced same-day services for urgent primary and mental health care are now available at 100% of its > 1,000 medical facilities.

Now a veteran can more conveniently have a face-to-face visit with a clinician, call a nurse, have a telehealth or video care visit, get an appointment with a specialist, or have a prescription filled in the same day, “depending upon what best meets the needs of the veteran.”

The VA also has reduced patient wait time, and implemented a new process to ensure timely follow-up appointments for time-sensitive medical needs.

An “unparalleled dataset” is providing high-quality information on the many factors that influence brain, cognitive, social, and emotional development in children.

The Adolescent Brain Cognitive Development (ABCD) study, involving > 7,500  children aged between  9 and 10 years and their families, is the largest long-term study of brain development and child health in the US. Interim results on about 30 terabytes of data (3 times the size of the Library of Congress collection) obtained from the first 4,500 participants will allow scientists to begin analyzing and publishing novel research, according to Nora Volkow, MD, director of the National Institute on Drug Abuse.

Researchers will be able to examine many aspects of growth and development, such as the impact of sports injuries on developmental outcomes, the relationship between screen time and brain and social development, and which brain pathways are associated with the onset and progression of mental health disorders.

The study aims to enroll 11,500 children by the end of 2018. Participants will be followed for 10 years, with data collected every 6 months through interviews and behavioral testing. Neuroimaging data, including high resolution MRI, are collected every 2 years.

An “unparalleled dataset” is providing high-quality information on the many factors that influence brain, cognitive, social, and emotional development in children.

The Adolescent Brain Cognitive Development (ABCD) study, involving > 7,500  children aged between  9 and 10 years and their families, is the largest long-term study of brain development and child health in the US. Interim results on about 30 terabytes of data (3 times the size of the Library of Congress collection) obtained from the first 4,500 participants will allow scientists to begin analyzing and publishing novel research, according to Nora Volkow, MD, director of the National Institute on Drug Abuse.

Researchers will be able to examine many aspects of growth and development, such as the impact of sports injuries on developmental outcomes, the relationship between screen time and brain and social development, and which brain pathways are associated with the onset and progression of mental health disorders.

The study aims to enroll 11,500 children by the end of 2018. Participants will be followed for 10 years, with data collected every 6 months through interviews and behavioral testing. Neuroimaging data, including high resolution MRI, are collected every 2 years.

An “unparalleled dataset” is providing high-quality information on the many factors that influence brain, cognitive, social, and emotional development in children.

The Adolescent Brain Cognitive Development (ABCD) study, involving > 7,500  children aged between  9 and 10 years and their families, is the largest long-term study of brain development and child health in the US. Interim results on about 30 terabytes of data (3 times the size of the Library of Congress collection) obtained from the first 4,500 participants will allow scientists to begin analyzing and publishing novel research, according to Nora Volkow, MD, director of the National Institute on Drug Abuse.

Researchers will be able to examine many aspects of growth and development, such as the impact of sports injuries on developmental outcomes, the relationship between screen time and brain and social development, and which brain pathways are associated with the onset and progression of mental health disorders.

The study aims to enroll 11,500 children by the end of 2018. Participants will be followed for 10 years, with data collected every 6 months through interviews and behavioral testing. Neuroimaging data, including high resolution MRI, are collected every 2 years.

A study of first graders showed that a significant number of subjects had fetal alcohol spectrum disorders (FASD)—“conservative” rates, National Institute on Alcohol Abuse and Alcoholism (NIAAA)  researchers say, ranging from 1% - 5%.

Fetal alcohol spectrum disorders cover a range of health effects that are caused by prenatal alcohol exposure, including growth deficiencies, facial abnormalities, and organ damage, as well as neurobiological deficits that contribute to challenges throughout the life of those affected.

Prenatal alcohol exposure is a “leading preventable cause of developmental disabilities worldwide,” said George Koob, PhD, director of the NIAAA. But determining the prevalence in the US is complex, he notes, because of difficulties in identifying children who have been exposed before birth and also  because previous FASD estimates were based on smaller studies.

The study conducted by the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence consortium, collected data between 2010 -2016 on 6,639 children in 4 communities located in the Midwest, Rocky Mountain, Southeast, and Pacific Southwest communities. These sites were selected to be more reflective of US community populations than in previous studies.

Their findings suggest that many children are undiagnosed or misdiagnosed, the researchers say. Of 222 children diagnosed with FASD in the study, for example, only 2 had been previously diagnosed with FASD, although many parents and guardians were aware of the children’s learning and behavioral challenges.

The study’s comprehensive approach may give a truer picture of the prevalence of FASD in the U.S. And, says Christina Chambers, PhD, a co-leader of the investigation, it further highlights the “public health burden of FASD.”

A study of first graders showed that a significant number of subjects had fetal alcohol spectrum disorders (FASD)—“conservative” rates, National Institute on Alcohol Abuse and Alcoholism (NIAAA)  researchers say, ranging from 1% - 5%.

Fetal alcohol spectrum disorders cover a range of health effects that are caused by prenatal alcohol exposure, including growth deficiencies, facial abnormalities, and organ damage, as well as neurobiological deficits that contribute to challenges throughout the life of those affected.

Prenatal alcohol exposure is a “leading preventable cause of developmental disabilities worldwide,” said George Koob, PhD, director of the NIAAA. But determining the prevalence in the US is complex, he notes, because of difficulties in identifying children who have been exposed before birth and also  because previous FASD estimates were based on smaller studies.

The study conducted by the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence consortium, collected data between 2010 -2016 on 6,639 children in 4 communities located in the Midwest, Rocky Mountain, Southeast, and Pacific Southwest communities. These sites were selected to be more reflective of US community populations than in previous studies.

Their findings suggest that many children are undiagnosed or misdiagnosed, the researchers say. Of 222 children diagnosed with FASD in the study, for example, only 2 had been previously diagnosed with FASD, although many parents and guardians were aware of the children’s learning and behavioral challenges.

The study’s comprehensive approach may give a truer picture of the prevalence of FASD in the U.S. And, says Christina Chambers, PhD, a co-leader of the investigation, it further highlights the “public health burden of FASD.”

A study of first graders showed that a significant number of subjects had fetal alcohol spectrum disorders (FASD)—“conservative” rates, National Institute on Alcohol Abuse and Alcoholism (NIAAA)  researchers say, ranging from 1% - 5%.

Fetal alcohol spectrum disorders cover a range of health effects that are caused by prenatal alcohol exposure, including growth deficiencies, facial abnormalities, and organ damage, as well as neurobiological deficits that contribute to challenges throughout the life of those affected.

Prenatal alcohol exposure is a “leading preventable cause of developmental disabilities worldwide,” said George Koob, PhD, director of the NIAAA. But determining the prevalence in the US is complex, he notes, because of difficulties in identifying children who have been exposed before birth and also  because previous FASD estimates were based on smaller studies.

The study conducted by the Collaboration on Fetal Alcohol Spectrum Disorders Prevalence consortium, collected data between 2010 -2016 on 6,639 children in 4 communities located in the Midwest, Rocky Mountain, Southeast, and Pacific Southwest communities. These sites were selected to be more reflective of US community populations than in previous studies.

Their findings suggest that many children are undiagnosed or misdiagnosed, the researchers say. Of 222 children diagnosed with FASD in the study, for example, only 2 had been previously diagnosed with FASD, although many parents and guardians were aware of the children’s learning and behavioral challenges.

The study’s comprehensive approach may give a truer picture of the prevalence of FASD in the U.S. And, says Christina Chambers, PhD, a co-leader of the investigation, it further highlights the “public health burden of FASD.”

Thrombectomy is currently approved for use up to 6 hours after symptom onset; the researchers from the Endovascular Therapy Following Imaging Evaluation for the Ischemic Stroke (DEFUSE 3) trial discovered that even 16 hours after symptom onset, the procedure could improve outcomes compared with those of standard medical therapy.

Using automated software to analyze perfusion magnetic resonance imaging or computer tomography scans, the researchers identified patients thought to have salvageable tissue. The patients were randomly assigned to receive endovascular thrombectomy plus standard medical therapy or medical therapy alone.

In the thrombectomy group, 45% of patients achieved functional independence compared with 17% of the control group. Thrombectomy also was associated with improved survival: 14% of the treated group died within 90 days of the study compared with 26% of the control group.

The DEFUSE 3 trial is a large study supported by StrokeNet, a network of hospitals providing research infrastructure for multisite clinical trials, in this case, at 38 centers. The study was ended early because of “overwhelming” evidence of benefit from the clot removal procedure.

“These striking results will have an immediate impact and save people from lifelong disability or death,” said Walter Korshetz, MD, director of the National Institute of Neurological Disorders and Stroke. “I really cannot overstate the size of this effect.” He adds that 1 of 3 stroke patients with at-risk brain tissue improves, and some may walk out of the hospital “saved from what would otherwise have been a devastating brain injury.”

Thrombectomy is currently approved for use up to 6 hours after symptom onset; the researchers from the Endovascular Therapy Following Imaging Evaluation for the Ischemic Stroke (DEFUSE 3) trial discovered that even 16 hours after symptom onset, the procedure could improve outcomes compared with those of standard medical therapy.

Using automated software to analyze perfusion magnetic resonance imaging or computer tomography scans, the researchers identified patients thought to have salvageable tissue. The patients were randomly assigned to receive endovascular thrombectomy plus standard medical therapy or medical therapy alone.

In the thrombectomy group, 45% of patients achieved functional independence compared with 17% of the control group. Thrombectomy also was associated with improved survival: 14% of the treated group died within 90 days of the study compared with 26% of the control group.

The DEFUSE 3 trial is a large study supported by StrokeNet, a network of hospitals providing research infrastructure for multisite clinical trials, in this case, at 38 centers. The study was ended early because of “overwhelming” evidence of benefit from the clot removal procedure.

“These striking results will have an immediate impact and save people from lifelong disability or death,” said Walter Korshetz, MD, director of the National Institute of Neurological Disorders and Stroke. “I really cannot overstate the size of this effect.” He adds that 1 of 3 stroke patients with at-risk brain tissue improves, and some may walk out of the hospital “saved from what would otherwise have been a devastating brain injury.”

Thrombectomy is currently approved for use up to 6 hours after symptom onset; the researchers from the Endovascular Therapy Following Imaging Evaluation for the Ischemic Stroke (DEFUSE 3) trial discovered that even 16 hours after symptom onset, the procedure could improve outcomes compared with those of standard medical therapy.

Using automated software to analyze perfusion magnetic resonance imaging or computer tomography scans, the researchers identified patients thought to have salvageable tissue. The patients were randomly assigned to receive endovascular thrombectomy plus standard medical therapy or medical therapy alone.

In the thrombectomy group, 45% of patients achieved functional independence compared with 17% of the control group. Thrombectomy also was associated with improved survival: 14% of the treated group died within 90 days of the study compared with 26% of the control group.

The DEFUSE 3 trial is a large study supported by StrokeNet, a network of hospitals providing research infrastructure for multisite clinical trials, in this case, at 38 centers. The study was ended early because of “overwhelming” evidence of benefit from the clot removal procedure.

“These striking results will have an immediate impact and save people from lifelong disability or death,” said Walter Korshetz, MD, director of the National Institute of Neurological Disorders and Stroke. “I really cannot overstate the size of this effect.” He adds that 1 of 3 stroke patients with at-risk brain tissue improves, and some may walk out of the hospital “saved from what would otherwise have been a devastating brain injury.”

Living in a neighborhood with poor access to food and poor walkability puts people at risk for cardiovascular disease (CVD)—and according to researchers from Morehouse School of Medicine in Atlanta, Georgia, African Americans seemed to have the highest risk.

In a CDC-funded study, the researchers examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates in Atlanta, using census tracts to map neighborhoods. Atlanta is in Fulton County, which has a food insecurity rating of nearly 20%. Food access was defined as the percentage of no-vehicle households living beyond a 0.9-mile radius of a food outlet in 2012. Walkability was measured in relationship to amenities, population density, and road metrics.

The researchers found no significant difference in walkability scores between high-poverty and low-poverty census tracts. However, they found significant racial differences: Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality.

Of 124 census tracts, 87 contained 73% of the city’s population aged 35 to 64 years and accounted for 1,225 deaths between 2010-2014, with a premature CVD mortality rate of 11 per 1,000. Black premature CVD deaths accounted for nearly 85% of the premature CVD deaths in all census tracts—a “disproportionate number,” the researchers say, because blacks make up only 52% of the city’s total population aged 35 to 64 years.

The  findings can be used to “calibrate” neighborhood interventions, based on racial/ethnic or other demographic characteristics, the researchers suggest. They add that the results highlight the need to examine racially stratified health outcomes.

Living in a neighborhood with poor access to food and poor walkability puts people at risk for cardiovascular disease (CVD)—and according to researchers from Morehouse School of Medicine in Atlanta, Georgia, African Americans seemed to have the highest risk.

In a CDC-funded study, the researchers examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates in Atlanta, using census tracts to map neighborhoods. Atlanta is in Fulton County, which has a food insecurity rating of nearly 20%. Food access was defined as the percentage of no-vehicle households living beyond a 0.9-mile radius of a food outlet in 2012. Walkability was measured in relationship to amenities, population density, and road metrics.

The researchers found no significant difference in walkability scores between high-poverty and low-poverty census tracts. However, they found significant racial differences: Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality.

Of 124 census tracts, 87 contained 73% of the city’s population aged 35 to 64 years and accounted for 1,225 deaths between 2010-2014, with a premature CVD mortality rate of 11 per 1,000. Black premature CVD deaths accounted for nearly 85% of the premature CVD deaths in all census tracts—a “disproportionate number,” the researchers say, because blacks make up only 52% of the city’s total population aged 35 to 64 years.

The  findings can be used to “calibrate” neighborhood interventions, based on racial/ethnic or other demographic characteristics, the researchers suggest. They add that the results highlight the need to examine racially stratified health outcomes.

Living in a neighborhood with poor access to food and poor walkability puts people at risk for cardiovascular disease (CVD)—and according to researchers from Morehouse School of Medicine in Atlanta, Georgia, African Americans seemed to have the highest risk.

In a CDC-funded study, the researchers examined the relationship between neighborhood-level food access and walkability on premature CVD mortality rates in Atlanta, using census tracts to map neighborhoods. Atlanta is in Fulton County, which has a food insecurity rating of nearly 20%. Food access was defined as the percentage of no-vehicle households living beyond a 0.9-mile radius of a food outlet in 2012. Walkability was measured in relationship to amenities, population density, and road metrics.

The researchers found no significant difference in walkability scores between high-poverty and low-poverty census tracts. However, they found significant racial differences: Census tracts with high concentrations of minority populations had higher levels of poor food access, poor walkability, and premature CVD mortality.

Of 124 census tracts, 87 contained 73% of the city’s population aged 35 to 64 years and accounted for 1,225 deaths between 2010-2014, with a premature CVD mortality rate of 11 per 1,000. Black premature CVD deaths accounted for nearly 85% of the premature CVD deaths in all census tracts—a “disproportionate number,” the researchers say, because blacks make up only 52% of the city’s total population aged 35 to 64 years.

The  findings can be used to “calibrate” neighborhood interventions, based on racial/ethnic or other demographic characteristics, the researchers suggest. They add that the results highlight the need to examine racially stratified health outcomes.

As many as 1 in 5 asthma-related deaths in the US is due to occupational exposure—and many could be prevented, according to CDC researchers.

The researchers analyzed reports from 1999-2016 of asthma-related mortality and occupations of the people involved. Of 3,396 deaths (3,396 in 2015 alone), between 11% and 21% were due to occupational exposures. Health care workers and construction workers were at highest risk.

By industry, the highest number of deaths were among men working in construction (13%) and women in health care (14%). By occupation, the most deaths were among men construction trades workers (11%) and women office and administrative support workers (9%).

The researchers note that ongoing exposure to cleaners, disinfectants, and antibiotics, all can trigger asthma. But they also point out that steps can be successfully taken to limit the type of exposure that exacerbates asthma symptoms, such as replacing powdered latex gloves with powder-free natural rubber latex or nonlatex gloves.

In an interview with MD Magazine, principle investigator Jacek Mazurek, MD, PhD, said there’s also an opportunity for health care providers to intervene more effectively. “Inadequate screening of workers for occupational exposures by health providers and lack of recognition of associations between workplace exposures and asthma symptoms remain the main reasons for underrecognition and underdiagnosis of work-related asthma.”

The Occupational Safety and Health Administration offers guidance for diagnosing work-related asthma at https://www.osha.gov/SLTC/occupationalasthma/.

As many as 1 in 5 asthma-related deaths in the US is due to occupational exposure—and many could be prevented, according to CDC researchers.

The researchers analyzed reports from 1999-2016 of asthma-related mortality and occupations of the people involved. Of 3,396 deaths (3,396 in 2015 alone), between 11% and 21% were due to occupational exposures. Health care workers and construction workers were at highest risk.

By industry, the highest number of deaths were among men working in construction (13%) and women in health care (14%). By occupation, the most deaths were among men construction trades workers (11%) and women office and administrative support workers (9%).

The researchers note that ongoing exposure to cleaners, disinfectants, and antibiotics, all can trigger asthma. But they also point out that steps can be successfully taken to limit the type of exposure that exacerbates asthma symptoms, such as replacing powdered latex gloves with powder-free natural rubber latex or nonlatex gloves.

In an interview with MD Magazine, principle investigator Jacek Mazurek, MD, PhD, said there’s also an opportunity for health care providers to intervene more effectively. “Inadequate screening of workers for occupational exposures by health providers and lack of recognition of associations between workplace exposures and asthma symptoms remain the main reasons for underrecognition and underdiagnosis of work-related asthma.”

The Occupational Safety and Health Administration offers guidance for diagnosing work-related asthma at https://www.osha.gov/SLTC/occupationalasthma/.

As many as 1 in 5 asthma-related deaths in the US is due to occupational exposure—and many could be prevented, according to CDC researchers.

The researchers analyzed reports from 1999-2016 of asthma-related mortality and occupations of the people involved. Of 3,396 deaths (3,396 in 2015 alone), between 11% and 21% were due to occupational exposures. Health care workers and construction workers were at highest risk.

By industry, the highest number of deaths were among men working in construction (13%) and women in health care (14%). By occupation, the most deaths were among men construction trades workers (11%) and women office and administrative support workers (9%).

The researchers note that ongoing exposure to cleaners, disinfectants, and antibiotics, all can trigger asthma. But they also point out that steps can be successfully taken to limit the type of exposure that exacerbates asthma symptoms, such as replacing powdered latex gloves with powder-free natural rubber latex or nonlatex gloves.

In an interview with MD Magazine, principle investigator Jacek Mazurek, MD, PhD, said there’s also an opportunity for health care providers to intervene more effectively. “Inadequate screening of workers for occupational exposures by health providers and lack of recognition of associations between workplace exposures and asthma symptoms remain the main reasons for underrecognition and underdiagnosis of work-related asthma.”

The Occupational Safety and Health Administration offers guidance for diagnosing work-related asthma at https://www.osha.gov/SLTC/occupationalasthma/.