Scientists Are Developing New Ways to Treat Disease With Cells, Not Drugs
When Nichelle Obar learned she was pregnant with her second child last year, she never expected that her pregnancy, or her baby, would make history. But when the 40-year-old food-and-beverage coordinator from Hawaii and her fiancé Christopher Constantino went to their 18-week ultrasound, they learned something was wrong. The heart was larger than it should have been, and there was evidence that fluid was starting to build up around the organ as well. Both were signs that the fetus was working extra hard to pump blood to its fast-growing body and that its heart was starting to fail. Obar’s doctor knew what could be causing it. Obar and Constantino are both carriers of a genetic blood disorder called alpha thalassemia, which can lead to dangerously low levels of red blood cells. Red blood cells carry hemoglobin, which binds to oxygen and transports it from the lungs to feed other cells–so fewer red blood cells means low levels of oxygen in cells throughout the body. Neither parent is affected by the condition, but depending on how their genes combined, their children could be. When Obar was pregnant with their first child, Gabriel, the couple was told that if he had the disease, his prognosis would be grim. “The information we got was that most babies don’t survive, and if they do survive to birth, they might not live for too long,” Obar says. Gabriel was lucky. The DNA he inherited from his mom and dad did not endow his cells with enough o...
Parkinson ’s Disease is a condition characterized by degeneration of the nigrostriatal pathways resulting in marked bradykinesia. Studies have reported that nearly 25% of Medicare beneficiaries with Parkinson’s Disease reside in long-term care facilities (LTCFs). Residents of LTCFs are older and may also have other age-related mobility disorders. It is important for providers to know that Parkinsonism symptoms can also occur as a result of natural aging and will not respond to standard therapy for Parkinson’s Disease.
Antipsychotic medications are a vital part of controlling psychosis in schizophrenic patients. However, when those patients live in nursing facilities, we are obligated by CMS to undertake gradual dose reductions of antipsychotic medication if possible. Sometimes, these efforts are successful and sometimes they fail. Antipsychotic medications have many side effects, including sedation, diabetes, hyperlipidemia, weight gain, motor rigidity, impaired gait, and falls. Monitoring of blood glucose, lipids, and extrapyramidal symptoms is mandatory.
Nutrition plays a vital role in the older adult, as weight in older adults is used as a marker of health and wellness. Individualization of meals is very limited; therefore, it is essential to offer a well-balanced diet options. In this regard, the national guidelines for the older adult can offer guidance to direct the meal options. There are national guidelines from the US Departments of Health and Human Services and Agriculture with dietary recommendations for community-dwelling healthy older adults.
Pneumonia is the most common cause of hospitalization for nursing home residents. When deciding whether to treat a resident in the nursing home or transfer to a hospital, it is important to consider risks of hospitalization, including significant functional decline. Little is known about the functional status outcomes of nursing home residents hospitalized for pneumonia.
Management of diabetes in post-acute settings needs special considerations. Hypoglycemia in the skilled nursing and rehabilitation facilities can lead to readmissions and complications including falls. Current EHR care-sets may not make a distinction between hospital and post-acute settings regarding diabetes management. The current diabetes management care-set in the EHR of our large healthcare system includes checking the blood sugar QID/AC/HS (before breakfast, lunch and dinner, and bedtime).
The geriatric population is at high risk of severe low blood glucose (LBG) events due to diminished homeostatic mechanisms, especially on hypoglycemic medications. Moderate to severe LBG events in these patients can contribute to behavior changes such as agitation, change in level of consciousness, disruption of sleep, instability and increased risk of myocardial infarction, stroke and falls. Rapid recognition and appropriate treatment and prevention of LBG and recurrences can reduce risk for hospitalization in the geriatric population.
Parkinson ’s disease (PD) is a multifaceted condition that impacts a wide range of functions, including speech. The effect of loss of communication ability creates a cascade of effects which includes decreased participation in social events, social isolation, and potentially depression. If improvements in v oice occur, the cascade can be diverted. A physiological basis, as well as research evidence, supports use of singing to improve voice of those with PD. The implementation of a choir for those with PD has the potential to provide a socially engaging intervention, which is cost effective.
Chronic pain is among the most common reasons for seeking medical attention. In the United States, 1 in 5 adults had chronic pain in 2016 and it is estimated to cost over $500 billion annually in direct medical costs and disability. It is a prevalent problem among residents in the nursing home. Non-pharmacologic therapies are the most preferred treatment for chronic pain as pharmacological therapies, such as opioids, have proven to be less effective and associated with numerous side effects among older adults.
Publication date: Available online 25 February 2020Source: Mutation Research/Genetic Toxicology and Environmental MutagenesisAuthor(s): Yu Gao, Ping Wang, Yinping Su, Zhaonan Wang, Lin Han, Jie Li, Yinghua Fu, Fengling Zhao, Quanfu Sun, Yumin Lyu
The objectives of this study are: (i) to assess the frequency of self-stigma in a multicentric nonselected psychiatric rehabilitation SMI and ASD sample; and (ii) to investigate the correlates of elevated self-stigma in different SMI conditions and in ASD. METHODS.: A total of 738 SMI or ASD outpatients were recruited from the French National Centers of Reference for Psychiatric Rehabilitation cohort (REHABase). Evaluations included sociodemographic data, illness characteristics, and standardized scales for clinical severity, quality of life, satisfaction with life, wellbeing, personal recovery, a large cognitive batte...
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