Physicians could predict cause of hospital readmission among newborns

Physicians can easily prevent complications in context to newborns and relieve worries of parents via genetic testing, according to results of two separate studies conducted at Children's Mercy Hospitals and Clinics. This form of testing could be effectively used to make predictions in advance as to which all of their newborn patients would be requiring hospital readmission shortly after birth.

The study results are considered to assist physicians to examine which of all their young patients will be responding well or not to therapy involving steroids for treating asthma.

From Sciencedaily.com:

Up to 85 percent of hospital readmissions during the first two weeks of life are due to hyperbilirubinemia, more commonly recognized as jaundice. The condition can be concerning for new parents, and potentially devastating for the infant if not recognized and promptly treated. New research being led by Susan Abdel-Rahman, PharmD, professor of pediatrics at Children's Mercy Hospitals and Clinics is identifying specific genetic markers that will enhance the ability to predict which newborns are at risk.

"This condition can be very harmful for newborn infants and scary for new parents," said Dr. Abdel-Rahman. "Knowing in advance which babies are likely to experience symptoms can provide reassurance for parents and guidance for clinicians in determining which babies may benefit from more careful monitoring."

The goal of the research is to develop an electronic tool that can be used by clinicians in nurseries nationwide to dramatically improve prediction of risk for hyperbilirubinemia and prevent complications due to late detection. The study will be among the largest of its kind, aiming to enroll 3,500 newborns.

The research was led by Bridgette L. Jones, MD, allergy, asthma and immunology and clinical pharmacology specialist, and Carrie A. Vyhlidal, PhD, research scientist, pediatric clinical pharmacology, at Children's Mercy Hospitals and Clinics, and a separate study was conducted by researchers at Children's Mercy.

Babies in the womb benefit from second dose of steroids

According to a recent research, administering a second dose of steroids to babies, still in the womb, could be beneficial to reduce the chances of post-birth respiratory problems in the future without posing any concerns in terms of baby growth.

It was revealed by study author Dr. James Kurtzman, an associate clinical professor in the division of maternal-fetal medicine in the department of obstetrics and gynecology at the University of California, Irvine, that a reduction of 31 percent was noticed in terms of overall composite neonatal morbidity when a second steroid dose was administered to babies who are born before 34 weeks.

From Health.discovery.com:

When doctors first started giving steroids to mothers who appeared to be going into pre-term labor, they discovered that, for the babies' health, it was best if the steroid dose was given no more than seven days before delivery.
But it's not always easy to tell exactly when a woman will deliver. So, if a woman passed the seven-day mark and still had not delivered, doctors would repeat the steroid dose. However, doctors soon learned that multiple courses of steroids led to growth restriction and smaller head circumferences in the babies.
"Then the pendulum swung the other way, and doctors were holding out on giving the first dose" until they were sure the woman was going to deliver, Kurtzman explained. That resulted in some women never getting treated before delivery.
"So, we developed this study for patients that remained pregnant for more than two weeks after receiving their first course," he said.
The study included 437 women from 18 medical facilities -- both community hospitals and academic medical centers. The women were randomly assigned to receive either a second, so-called "rescue," dose of steroids closer to delivery or a placebo.
The researchers found a significant reduction in respiratory problems for babies who received the second dose of steroids. Plus, they found no evidence of growth restriction or smaller head circumferences.

The results of this study reveal that we are faring better in terms of prevention and management of premature births, as per Dr. Peter Bernstein, a maternal-fetal medicine specialist at Montefiore Medical Center in New York City.

Shoaib Akhtar banned for five years

Shoaib Akhtar, Pakistan's fast bowler and popularly known as the Rawalpindi Express, was handed over a ban of five years after repeated incidents of disciplinary breaches. This could mean an end to the maverick paceman's controversial career.

The paceman who was previously handed over a ban of two years after hitting a teammate with the bat appeared before a disciplinary committee that imposed a ban of two years after Akhtar was found publicly criticizing the country's cricket board.

From Foxsports.com.au:

Akhtar last played for Pakistan in the third and final Test against India at Bangalore in December last year. He broke down with back trouble and was blamed for Pakistan's 1-0 series defeat.

The “Rawalpindi Express” was not selected for Pakistan's five-match series against Zimbabwe in February and was omitted from next month's first two limited-overs fixtures against Bangladesh.

In 2006, Akhtar and Asif tested positive for the banned steroid nandrolone and were expelled from Pakistan's Champions Trophy team for India. Akhtar was banned for two years and Asif for one year, but the bans were lifted on appeal.

Separately spinner Danish Kaneria, who also faced a charge of criticising the PCB, was severely reprimanded, Ashraf said.

Kaneria had hit out at his demotion from category “B” to “C” in the central contract in an online column. He later blamed a newspaper for publishing his words out of context.

“Since this was Kaneria's first offense on discipline, he has been severely reprimanded and barred from issuing any press statements,” Ashraf said.

The Pakistan cricket team is all about issues, which is evident from the incidents when and Inzamam-ul-Haq's team forfeited a Test in 2006 after being accused of ball-tampering and coach Bob Woolmer died at last year's World Cup.

Olympic coach distributed drugs

Former Olympic weightlifter Christos Konstantinidis has accused the suspended Greece Coach Christos Iacovou of giving banned substances to athletes, according to a Court official.

Konstantinidis represented Greece at the 1988 Seoul Olympics and provided evidence to a judicial investigation set up to enquire into a doping scandal in which 11 out of the 14-member national weightlifting team tested positive for the anabolic steroid, methyltrienolone.

From Foxsports.com.au:

He told prosecutor Andreas Karaflos that Iacovou, who has been suspended by the Greek Weightlifting Federation pending the outcome of the case, had pressed him to take banned substances in 1997.

"The former athlete told the prosecutor that Iacovou had urged him to take banned substances and that when he refused he found himself off the national team," the official said on condition of anonymity.

Konstantinidis made identical claims in 1997 but was then forced to sign an apology for fear of losing his job with the police.

The court official said Konstantinidis told the prosecutor that despite signing the apology 11 years ago, he had never retracted his comments.

"He stood by what he had said in 1997 and he repeated those claims today again," the official said.

Iacovou would not have given steroids to his athletes, as per Nikos Kourtidis, one of the three weightlifters who didn't test positive.

Multiple myeloma patients can live for long with steroid pills

Multiple myeloma, which is a cancer of the plasma cells in the region of bone marrow, can be effectively treated with steroid pills and help patients live for long.

It was remarked by James Berenson, M.D., lead author of the Southwest Oncology Group sponsored study and Director of the Multiple Myeloma and Bone Metastasis Program at Cedars-Sinai Medical Center that use of Prednisone in response to an upfront chemotherapy can be hailed as a safe and effective treatment option for prolonging lives.

From News.Bio-Medicine.Org:

Multiple myeloma occurs when the body makes an abnormally high number of cancerous plasma cells. When healthy, plasma cells help to protect the body from infection and disease by forming antibodies that attack foreign substances. But when the body makes too many plasma cells that all make the same type of antibody, this leads to multiple myeloma, causing damage to bones, severe bone pain, an overabundance of calcium in the blood, anemia, and a weakening of the immune system. Today, most patients with multiple myeloma receive initial treatment with chemotherapy or with high-dose chemotherapy followed by a stem cell transplant and many respond to treatment and achieve remission. However, all patients ultimately relapse with incurable disease, leading physicians to search for ways to prolong remission for as long as possible by using some type of maintenance therapy.

This finding was disclosed by researchers at the Cedars-Sinai Medical Center.

Daily Pirfenidone doses helpful for treating Idiopathic pulmonary fibrosis

According to researchers from Japan, a daily dose of Pirfenidone is effective to treat individuals afflicted with idiopathic pulmonary fibrosis.

As per the Phase III, double-blind, placebo-controlled clinical trial, daily doses of this drug can prove to be an effective option for slowing down the progression of idiopathic pulmonary fibrosis and reducing the loss of lung capacity.

From News-Medical.Net:

"The most common treatment for IPF is anti-inflammatory agents such as steroids," said lead researcher Takashi Ogura, M.D., of Kanagawa Cardiovascular and Respiratory Center in Yokohama, Japan. "However our study confirmed that pirfenidone, the main action of which is thought to be antifibrotic, achieved a therapeutic effect on IPF. I expect that our study will serve as a guide to develop a new therapy for IPF in the future."

The researchers recruited a total of 275 Japanese patients with mild to moderate IPF and randomized them to a high dose pirfenidone (1,800 mg/day) group, a low dose pirfenidone group (1,200 mg/day) and a placebo group. They measured lung capacity (vital capacity or VC) and progression-free survival, defined as a period without death or a greater than 10 percent decrease in VC, to determine the effectiveness of the regimens.

At the end of one year, they found that patients who had been randomized to the high dose regimen had significantly lower loss of VC than the placebo group. Furthermore, pirfenidone slowed the overall deterioration of IPF compared to the placebo.

"Taken altogether, our study demonstrated positive clinical effects of pirfenidone that suppresses the progress of IPF and potentially contributes to improving the outcomes of patients with IPF," said Dr. Ogura.

The trial results were presented at the American Thoracic Society's International Conference in Toronto.