Research: Prostrate Biopsies May Increase Risk of Hospitalization

by: continuum wellness - September 25th, 2011   Filed under: men, seniors, wellness Add Comment

Study reveals rise in prostate biopsy complications and high post-procedure hospitalization rate

In a study of complication rates following prostate biopsy among Medicare beneficiaries, Johns Hopkins researchers have found a significant rise in serious complications requiring hospitalization. The researchers found that this common outpatient procedure, used to diagnose prostate cancer, was associated with a 6.9 percent rate of hospitalization within 30 days of biopsy compared to a 2.9 percent hospitalization rate among a control group of men who did not have a prostate biopsy. The study, which will be published in the November 2011 issue of The Journal of Urology, was posted early online.

The researchers emphasize that this new data should serve as a reminder to physicians to carefully weigh the risks and benefits of biopsy for individual patients and take all precautions to prevent infections and other complications.

The Johns Hopkins team’s findings are the result of the largest analysis ever performed of Medicare records of American men age 65 and older who underwent prostate biopsies in the last two decades. They found that having a prostate biopsy makes patients more than twice as likely to need hospitalization in the immediate post-procedure period. Those hospitalized had a range of complications, such as bleeding and infection, as well as flare-ups of underlying medical conditions, such as heart failure or breathing disorders.

Overall, mortality rates in men undergoing prostate biopsies did not increase. However, men hospitalized with biopsy-related infections had a 12-fold higher risk of death compared to men who did not have a biopsy.

“Prostate biopsy is an essential procedure for detecting prostate cancers,” says Edward Schaeffer, M.D., Ph.D., a Johns Hopkins urologist and oncologist and the study’s senior investigator. “Coupled with appropriate screening, prostate biopsies save lives. However, it is important for men to be aware of the possible risks of prostate biopsies, which are often described as simple outpatient procedures,” adds Schaeffer, an associate professor at the Johns Hopkins University School of Medicine and its Brady Urological Institute.

In their study, the researchers examined the frequency of biopsy related complications that required hospitalization in more than 17,400 men age 65 and older from 1991 to 2007. They compared these rates to a cohort of 134,977 men during the same time period with similar characteristics who did not undergo a prostate biopsy. The researchers only looked at hospital admissions, not men whose complications were treated in an emergency department or outpatient setting.

While the rate of hospitalization following prostate biopsy has declined steadily since 1991, the researchers found that the rate of hospitalization during the time period was still two-fold higher among the men who had a biopsy (6.9 percent compared to 2.9 percent).

There was also a steady rise in the rate of serious infection-related complications. At the onset of the study in 1991, fewer than 0.5 percent of men were admitted to the hospital because of an infection diagnosed following a prostate biopsy. This rate remained stable until 2000, when rates of infection-related complications began to increase to more than 1.2 percent in 2007.

“Antibiotics are routinely given to men at the time of biopsy, and the fact that infections serious enough to cause hospital admissions have been on the rise makes us think that these types of complications are occurring because of a steady increase in antimicrobial resistance rates in America,” says Schaeffer.

Co-author H. Ballentine Carter, M.D., professor of urology and oncology at the Johns Hopkins University School of Medicine, says, “Based on these findings, we believe that more needs to be done to reduce potential complications. It is important for urologists to determine if a biopsy is appropriate for an individual patient and also if the patient is at increased risk for a biopsy- related complication.”

The researchers say that prostate biopsies should only be performed with strict adherence to medical guidelines, and after all potential risks and benefits have been reviewed with patients. More than 1 million prostate biopsy procedures are performed each year in the United States to diagnose and monitor prostate cancer, which is the second most common cause of cancer death among men.

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Funding for the study was provided by the Howard Hughes Medical Institute, the U.S. National Institutes of Health, an American Urological Association Astellas Research Star Award, and the Patrick C. Walsh Prostate Cancer Research Fund at Johns Hopkins.

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Reseach: Singing Lowers Patient’s Blood Pressure Prior to Surgery

by: continuum wellness - July 27th, 2011   Filed under: arthritis, music, self-healing, seniors, stress, wellness Add Comment

This research highlights the amazing power within. When we focus our intention on healing ourselves with action steps blood pressure can be reduced and many ailments can even be healed. Singing, that worked, not the drugs. Tap into the healing within you and amaze yourself.

Singing May Offer Alternative Therapy for Chronic Pain; Surgical Interventions in Osteoarthritis

Doctors report that singing reduced the blood pressure of a 76-year-old woman who had experienced severe preoperative hypertension prior to total knee replacement surgery for osteoarthritis (OA). While the patient was unresponsive to aggressive pharmacologic interventions, the woman’s blood pressure dropped dramatically when she sang several religious songs. This case-report appears in the April issue of Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).

Traditional therapy for preoperative hypertension, doctors say, involves drug-based therapies that include diuretics, beta blockers, calcium-channel blockers, and angiotensin-converting enzyme (ACE) inhibitors. These medications are used to lower blood pressure to acceptable levels for surgery, however, a number of patients do not respond to these treatments. In patients unresponsive to standard therapies, as in the current case study patient, alternative hypertension interventions are needed.

“Several studies suggest that listening to music can be effective in reducing blood pressure by calming or diverting patients prior to surgery, which lessens stress and anxiety,” explains lead author Nina Niu, a researcher from Harvard Medical School in Boston. “Our case study expands on medical evidence by showing that producing music or singing also has potential therapeutic effects in the preoperative setting.”

The current case subject was a 76-year-old woman from the Dominican Republic who had hypertension and a 15-year history of bilateral knee OA. The patient was treated with ACE inhibitors and calcium-channel blockers for high blood pressure and diclofenac, a non-steroidal anti-inflammatory drug (NSAID), for knee pain. She was accepted into Operation Walk Boston, a philanthropic program providing total join replacement to poor Dominican patients with advanced OA of the hip or knee. The case study authors served as members of her medical team.

Upon admission to the hospital for surgery the patient’s blood pressure was 160/90 mm Hg, controlled by her normal regimen of nifedipine and lisinopril. In the preoperative area, the woman’s blood pressure increased to 240/120 mm Hg and persisted, requiring doctors to postpone surgery. The Operation Walk medical team was onsite site at the Dominican hospital for a limited time; therefore it was imperative that the patient’s blood pressure be reduced so surgery could proceed.

The patient asked doctors if she could sing, which the patient reported doing frequently to calm herself down and to help with sleeping. The medical team encouraged her to so, and after two songs checked her blood pressure which had lowered to 180/90 mm Hg. With continued singing for 20 minutes, the patient’s blood pressure remained lower and persisted for several hours after. As instructed by doctors, the patient sang periodically through the night which kept her blood pressure at acceptable levels. The following morning, the woman was cleared for knee replacement surgery, which was successful and without complications.

Niu commented, “Singing is simple, safe, and free. Patients should be encouraged to sing if they wish.” This single case study showed the positive effective of singing in reducing blood pressure and controlling pain. “To be formally considered as an alternative therapy for the OA patient population, larger studies are needed to explore the effects of signing on hypertension and chronic pain relief,” said Niu.

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Recognize a Stroke in 4 simple steps

by: continuum wellness - January 19th, 2009   Filed under: Health, men, seniors, stroke, symptoms, women, women's health Add Comment

Blood Clots/Stroke – They Now Have a Fourth Indicator, the Tongue

STROKE:Remember the 1st Three Letters….S.T.R..

STROKE IDENTIFICATION:

During a BBQ, a friend stumbled and took a little fall – she assured everyone that she was fine (they offered to call paramedics); she said she had just tripped over a brick because of her new shoes.

They got her cleaned up and got her a new plate of food. While she appeared a bit shaken up, Ingrid went about enjoying herself the rest of the evening

Ingrid’s husband called later telling everyone that his wife had been taken to the hospital – (at 6:00pm Ingrid passed away.) She had suffered a stroke at the BBQ. Had they known how to identify the signs of a stroke, perhaps Ingrid would be with us today. Some don’t die; they end up in a helpless, hopeless condition instead.

It only takes a minute to read this…

A neurologist says that if he can get to a stroke victim within 3 hours he can totally reverse the effects of a stroke…totally. He said the trick was getting a stroke recognized, diagnosed, and then getting the patient medically cared for within 3 hours, which is tough.

RECOGNIZING A STROKE

Remember the ’3′ steps, STR

Sometimes symptoms of a stroke are difficult to identify. Unfortunately, the lack of awareness spells disaster. The stroke victim may suffer severe brain damage when people nearby fail to recognize the symptoms of a stroke.

Now doctors say a bystander can recognize a stroke by asking three simple questions:

S *Ask the individual to SMILE.

T *Ask the person to TALK and SPEAK A SIMPLE SENTENCE (Coherently)

(i.e. It is sunny out today)

R *Ask him or her to RAISE BOTH ARMS.

If he or she has trouble with ANY ONE of these tasks, call emergency number immediately and describe the symptoms to the dispatcher.

New Sign of a Stroke ——– Stick out Your Tongue

NOTE: Another ‘sign’ of a stroke is this: Ask the person to ‘stick’ out his tongue… If the tongue is ‘crooked’, if it goes to one side or the other, that is also an indication of a stroke.

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Antidrepressants May Lead to Bone Loss

by: continuum wellness - July 15th, 2008   Filed under: adolescents, adverse events, healing, seniors, side effects, symptoms, teens, Uncategorized Add Comment

As if it is not hard enough in itself going through a deep sadness, for those who take anti-depressant medication another risk is surfacing, brittle bones. This is a rather serious problem. In the model of Traditional Chinese Medicine (TCM) the kidneys are the rulers of the bones. The kidneys are involved in water metabolism, relate to bone problems (knees, teeth, low back); urinary and sexual issues, growth, mental development and from an emotional perspective relate to fear and insecurity.

The makers of Prozac list osteoporosis as a rare event (1 in 10,000). Are those who have smaller, nagging symptoms ignored? Researchers are also concerned about growing teens that there later health may be affected by taking SSRI medication.

Antidepressant medication should not be stopped suddenly. Following are a few measures to build bone and fight the blues.

  1. Take a daily walk. If you just can’t find the motivation, find a friend, a relative, a neighbor or a coach to help you.
  2. Increase your vit D by spending time in the sun. Find 30 minutes to relax and sunbathe.
  3. Increase your green vegetable intake.
  4. Increase whole grains in your diet.
  5. Make a soup of sprouted barley and kale. Cook the sprouted barley for 10 minutes and add the kale towards the end.
  6. Practice T’ai Chi the gentle exercise strengthen the bones.
  7. Reduce meat intake. Meat in excess interferes with calcium absorption.


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Yoga Poses can prevent falls in the Elderly

by: continuum wellness - April 27th, 2008   Filed under: aging, baby boomers, elderly, exercise, seniors, Uncategorized, wellness, women 2 Comments

Research out of Temple’s Gait Study Center suggests basic yoga exercises could help prevent falls in elderly women

A specific type of yoga can help improve stability and balance in women over age 65, which could help to prevent falls, finds a preliminary study out of Temple University’s Gait Study Center.

Dr. Jinsup Song and researchers at the School of Podiatric Medicine and the College of Health Professions examined the gait and postural stability of 24 elderly females who were enrolled in an Iyengar yoga program specifically designed for those over 65. They found that at the end of the nine-week program, participants had a faster stride, an increased flexibility in the lower extremities, an improved single-leg stance and increased confidence in walking and balance.

Song will present these findings at the Gait and Clinical Movement Analysis Society’s Annual Meeting on April 4.

The Centers for Disease Control and Prevention reports that among people 65 years and older, falls are the leading cause of nonfatal injuries and hospital admissions for trauma, and nearly one-third of older adults suffer from some type of fall each year.

Song and his researchers suggest that improving balance and stability through yoga could help reduce the risk of falling, as these are two areas that are often deficient when a fall occurs.

“We were very impressed at the progress our participants made by the end of the program,” said Song. “Subjects demonstrated improved muscle strength in lower extremities, which helps with stability. There was also a pronounced difference in how pressure was distributed on the bottom of the foot, which helps to maintain balance.”

Song and study coauthor Marian Garfinkel, Ed.D., a certified senior Iyengar Yoga instructor, consulted her mentor, renowned yoga master B.K.S. Iyengar, to craft a specific yoga program of poses tailored to the elderly who have had little to no yoga experience. The use of props in the Iyengar program allows participants to gradually master the poses while building their confidence level.

“In the past, similar studies have been done that look at gait and balance improvement in elderly females using a more aggressive form of yoga,” said Song, principal investigator and director of the Gait Study Center. “For this study, we worked to create a very basic regimen that taught participants proper ways to breathe, stand and pose.”

Before she started the program, Maryanne Brown wasn’t sure she’d even want to stick with it.

“I’ve never been one for exercise,” said the West Philadelphia native. “But I started attending the classes, and I thought, ‘Why not?’ I really did want to make an effort to get healthy, so I kept at it.”

Now, even after the program, Brown continues her regimen at the B.K.S. Iyengar Yoga Studio of Philadelphia, under the direction of Garfinkel, an adjunct associate professor at the School of Medicine.

“I feel more centered now. I have more confidence when I walk, and I’m able to walk further for longer periods of time,” Brown said.

Researchers also found that some participants, like Brown, who had unrelated back and knee pain at baseline, were pain-free by the end of the study.

“I’ve had that pain for years,” Brown said. “And during one session, I heard a ‘pop’ and was sure I wouldn’t be able to get up. But I did, and I felt better than I had in years.”

In addition to improving balance and stability, Song notes that participation in a group setting, such as an Iyengar yoga class, could have positive psychological effects for the elderly, as well.

“Throughout the program, participants consistently noted that they had a better outlook on their day-to-day lives,” he said. “The class gave them something to look forward to; they found it engaging, and said that if they couldn’t attend a class, they definitely missed it.”

“This program has been amazing,” said Brown, who now spends up to six hours a week practicing Iyengar yoga. “They’re really onto something with it. It’s made a tremendous difference in my quality of life.”

“The bottom line is, people want to stay active as long as possible,” Song said. “This can help elderly women maintain their mobility and independence, in several ways.”

Song noted that this preliminary information will pave the way for a larger study on how Iyengar yoga affects the function of the foot to improve balance and stability and prevent falls.

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Other researchers on this study are Roberta Newton, P.T., Ph.D., of Temple University’s College of Health Professions; and Ji Su Yun, B.A., Benjamin Heilman, M.S., and Emilie Zoltick, B.A., of the Gait Study Center at Tempe University. Funding was provided by the Office of the Vice President for Research and Development at Temple University.

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