Meet new free medical online database of diseases, symptoms, treatments and drugs. It’s Illnessopedia.

The quality of product is amusingly high. The design is simple, but nice.

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Search by disease is available. Example for Acne.

Search by medications is there too. Example for Abilify.

And.. Wow! Search by alternative naming of medications is available too!

In general, meet it, use it and enjoy it.

Specifically, the research team looked at a multi-drug resistant bacterium called Klebsiella pneumoniae, which is increasingly resistant to most drugs of last resort. Commonly called CRKP, which is short for carbapenem-resistant Klebsiella pneumoniae, the bacteria were found in three patients at St. Luke’s in 2010, and the team published a report about it in 2011 in the journal Diagnostic Microbiology & Infectious Disease. Endemic to the northeastern United States and recently making its way to California, reports of this particular superbug have remained uncommon throughout the majority of the country. The researchers believe these are the first confirmed cases in Texas.

“The key to effective therapy is to identify the infection quickly and accurately, so you can initiate the appropriate measures that will benefit the patient, prevent it from spreading and discourage the development of resistance,” said Vincent Tam, associate professor of clinical sciences at the UH College of Pharmacy and co-author of the report. “The current methods of detection are far from perfect, but following national and international resistance trends, we are being proactive in anticipating problems so we can deal with them when they’re in the initial, budding stage.”

Although it’s virtually impossible to pinpoint when or how this superbug arrived in Texas, researchers are working to determine its prevalence here and to develop strategies to deal with potential outbreaks. The bacteria can cause an array of infections, including pneumonia, bloodstream and urinary tract infections, and are becoming increasingly worrisome for clinicians.

Although Klebsiella pneumoniae is naturally found in the intestinal tract and relatively harmless to healthy individuals, it can lead to potentially deadly infections in people with weakened immune systems, such as patients in ICUs, long-term care facilities or nursing homes. These bacteria, for instance, are resistant to the carbapenem class of antibiotics, which are among the antimicrobials of last resort for this type of bacteria. As a result, clinicians managing the infection are left with few options but to employ more toxic drugs that pose an increased risk of damage to the kidneys or other organs.

The automated systems used in clinical microbiology laboratories can misclassify certain bacteria as being susceptible to carbapenems, potentially leading to inappropriate treatment and unfavorable patient outcomes. More accurate methods for identifying these specific bacteria require time- and labor-intensive processes and are typically only available in research laboratories outside of the clinical setting, such as at the Centers for Disease Control and academic research institutions such as UH.

With support from the Roderick D. MacDonald Research Fund at SLEH, Tam and his collaborators are working to determine the prevalence of CRKP and to employ promising techniques for rapid and accurate detection of these bacteria in the clinical setting, as well as prevent its spread within the health care system. In addition to Tam, who is also an infectious disease clinician at SLEH, the team consisted of former UH colleague Elizabeth Hirsch, who is now at Northeastern University; Kai-Tai Chang, a research associate at UH; and Todd Lasco and Juan-Pablo Caeiro of SLEH.

According to the National Institute of Neurological Disorders and Stroke (NINDS), febrile seizures, the most common type of convulsive disorder in children, affect almost 1 out of every 25 children and generally occurs between the ages of 6 months and 5 years. Earlier studies indicated that febrile seizures are caused by a combination of genetic and environmental factors, which account for an incidence rate of up to 8% depending on geographical region and culture.

Team leader Dr. Sebastian Schuchmann, at the Charité-Universitätsmedizin Berlin in Germany and the University of Helsinki in Finland wanted to examine the functional changes linked to febrile seizures. They evaluated 433 enrolled children with similar fever levels, who were hospitalized for febrile seizure (n=213) or gastroenteritis (n=220). All pediatric participants underwent blood pH and carbon dioxide level measurements upon admission.

The researchers discovered respiratory alkalosis in children with febrile seizures and metabolic acidosis in pediatric patients admitted for gastroenteritis. Apart from 15 patients in a subgroup with alkaline blood pH levels, they discovered no febrile seizures in children with gastroenteritis. Researchers discovered, that 8 patients admitted on separate occasions for febrile seizures and gastroenteritis, children admitted with febrile seizure showed elevated blood pH, but more acidotic pH was found in those admitted with gastroenteritis.

In a concluding statement Dr. Schuchmann said:

“Our findings reveal that febrile seizures are associated with respiratory alkalosis and unrelated to the severity of the underlying infection or fever level. Further investigation of methods that control the body’s acid-base status may lead to the development of novel therapies for treating febrile seizures.”

Based on their results, the researchers suggest an application of 5% carbon dioxide in the breathing air as a possible treatment for febrile seizures.

Petra Rattue

More than 18 million Americans suffer from OSA, which is characterized by repeated episodes of upper airway collapse during sleep. Patients with OSA stop breathing frequently during sleep, often for a minute or longer. Daytime sleepiness, depression, weight gain, increase in industrial accidents and diminished quality of life are all commonly observed in people who suffer from OSA as a result of fragmented sleep patterns. Furthermore, OSA is associated with the development of systemic hypertension, cardiovascular diseases (heart failure, heart rhythm disorders), stroke, and diabetes.

Current treatment options for OSA include weight loss, CPAP, oral appliances, and surgeries. CPAP (Continuous Positive Air Pressure) applied through a nasal mask is the current standard of treatment for OSA. However several recent studies show that CPAP compliance can be as low as 50 percent because of the nasal mask constriction, discomfort and inconvenience.

The STAR trial will enroll CPAP intolerant patients. To be eligible for screening and inclusion in the STAR trial, patients must:

– Have failed or not tolerated CPAP

– Have moderate to severe obstructive sleep apnea

– Have a body mass index of less than 32

Detroit Medical Center will also be conducting a community health talk in September where interested patients can get more information and talk to the physicians involved in the clinical trial.

“Studies have shown that sleep apnea is as prevalent as adult diabetes and asthma and the consequences of OSA range from disruptive to life-threatening. While CPAP can be very effective to treat OSA, for many patients it is simply too difficult to comply with, and thus ineffective,” said M. Safwan Badr, M.D., Professor and Chief, Pulmonary Critical Care and Sleep Medicine, Department of Internal Medicine, DMC Harper University Hospital and Wayne State University School of Medicine.

“DMC was selected to participate in this study because of our extensive experience in treating patients who suffer from sleep apnea. We look forward to contributing to this important research to determine whether Inspire therapy can help the many people suffering from OSA with limited treatment options,” Dr. Badr added.

About Obstructive Sleep Apnea (OSA)

OSA is a common sleep disorder that occurs when the tongue and other soft tissues of the throat relax and obstruct the airway during sleep. Apnea events can occur multiple times per hour throughout the night, disrupting normal sleep. People suffering from OSA report significant daytime sleepiness and impaired quality of life. Depending on the degree of severity, OSA can be a potentially dangerous condition. OSA has been linked with increased risks for cardiovascular disease, weight gain and accidents resulting from daytime drowsiness. It is estimated that one in fifteen U.S. adults has moderate to severe OSA.

About Inspire™ Upper Airway Stimulation (UAS) Therapy

Inspire Upper Airway Stimulation (UAS) therapy is a dynamic, implantable therapy that works with the body’s natural physiology to prevent airway obstruction during sleep. While the OSA patient sleeps, Inspire therapy is designed to deliver physiologically timed, mild stimulation to the hypoglossal nerve on each breathing cycle. The stimulation is intended to restore tone to the muscles that control the base of the tongue, preventing the tongue from collapsing and obstructing the airway. Patients control when the therapy is turned on and off via a handheld programmer. In contrast to other surgical procedures to treat sleep apnea, Inspire therapy does not require removing or permanently altering an OSA patient’s facial or airway anatomy.

About The STAR Trial

The STAR trial is a global, multi-center clinical trial which will assess the safety and effectiveness of Inspire Upper Airway Stimulation (UAS) therapy in patients who suffer from moderate to severe obstructive sleep apnea (OSA). The trial will be conducted at leading medical centers throughout the United States and Europe.

Based on data for patients who were hospitalized with COPD in 15 states during 2008:

– About 7 percent of patients were readmitted within 30 days principally for COPD, but 21 percent were readmitted for any health condition (all-cause readmission).

– There were 190,700 initial hospital admissions specifically to treat COPD at an average cost of $7,100. The average readmission cost principally for COPD was 18 percent higher, at $8,400 per stay, but all-cause readmissions were 50 percent more expensive than the initial stay–$11,100.

– Readmissions were 22 percent higher among patients from the poorest communities than among those from the highest income areas.

– Readmissions were about 13 percent higher among male patients compared to females.

The study will be presented at the European Respiratory Society’s (ERS) Annual Congress in Amsterdam on 25 September 2011. All the abstracts for the ERS Congress are publicly available online.

The study aimed to assess whether fatty acids found in dairy products could protect against the development of allergic diseases in children.

The researchers assessed milk and dairy intake during pregnancy and monitored the prevalence of asthma and allergic rhinitis using registries and questionnaires in the Danish National Birth Cohort.

The results showed that milk intake during pregnancy was not associated with increased risk of developing asthma and it actually protected against asthma development. However, women who ate low-fat yoghurt with fruit once a day were 1.6-times more likely to have children who developed asthma by age 7, compared with children of women who reported no intake. They were also more likely to have allergic rhinitis and to display current asthma symptoms.

The researchers suggest that non-fat related nutrient components in the yoghurt may play a part in increasing this risk. They are also looking at the possibility that low-fat yoghurt intake may serve as a marker for other dietary and lifestyle factors.

Ekaterina Maslova, lead author from the Harvard School of Public Health, who has been working with data at the Centre for Fetal Programming at Statens Serum Institut, said: “This is the first study of its kind to link low-fat yoghurt intake during pregnancy with an increased risk of asthma and hay fever in children. This could be due to a number of reasons and we will further investigate whether this is linked to certain nutrients or whether people who ate yoghurt regularly had similar lifestyle and dietary patterns which could explain the increased risk of asthma.”

The authors used data from Statistical Brief #121: Readmissions for Chronic Obstructive Pulmonary Disease, 2008, from State Inpatient databases, including Virginia, Louisiana, Utah, Arkansas, California, Tennessee, Florida, Hawaii, , Massachusetts, Missouri, Nebraska, New Hampshire, New York, South Carolina, and Washington.

The findings revealed that of all patients readmitted within 30 days, 7% were readmitted mainly for COPD with 21% being readmitted for any health condition (all-cause readmission).

In total, hospitals admitted 190,700 initial COPD patients at an average cost of $7,100. The average readmission cost of $8,400 per stay for patients diagnosed principally for COPD was 18% higher, with all-cause readmissions being 50% more expensive than the initial stay, i.e. $11,100.

Patients from the poorest communities showed 22% higher readmission rates compared with those from the highest income areas.

Results also showed that male patients had a 13% higher readmission rate compared with females.

Petra Rattue

Because the technique uses off-the-shelf wireless transceivers similar to those used in home computer networks, “the cost of this system will be cheaper than existing methods of monitoring breathing,” says Neal Patwari, senior author of a study of the new method and an assistant professor of electrical engineering.

While he estimates it will be five years until such a product is on the market, Patwari says a network of wireless transceivers around a bed can measure breathing rates and alert someone if breathing stops without any tubes or wires connected to the patient.

“We can use this to increase the safety of people who are under sedation after surgery by knowing if they stop breathing,” he says. “We also envision a product that parents put around their baby’s crib to alert them if the baby stops breathing. It might be useful for babies at risk of SIDS.”

The American Academy of Pediatrics says there is “no evidence that home monitors are effective” for preventing SIDS. Since 2005, the group has opposed the use of breathing monitors to prevent SIDS, but has said they “may be useful in some infants who have had an apparent life-threatening event,” including some combination of apnea [abnormal interruptions in breathing], color change, limpness and choking or gagging.

“The AAP recognizes that monitors may be helpful to allow rapid recognition of apnea, airway obstruction, respiratory failure, interruption of supplemental oxygen supply, or failure of mechanical respiratory support,” the group states.

In addition to other possible uses, Patwari wants to conduct research with doctors to test his method as an infant-breathing monitor, and, if it proves useful, develop it as a medical device that would need federal approval. He also says it may be useful for adults with sleep apnea, which causes daytime fatigue and impairs a person’s performance.

SIDS monitors now on the market include FDA-approved medical devices that measure heart rate and respiration and are connected to babies with wires, electrodes and-or belts. Other monitors, which are non-medical and over-the-counter versions, detect a lack of sound, or use mattress sensors to detect a lack of movement.

Patwari says that with the new method, “the patient or the baby doesn’t have to be connected to tubes or wired to other sensors, so they can be more comfortable while sleeping. If you’re wired up, you’re going to have more trouble sleeping, which is going to make your recovery in the hospital worse.”

Some opposition to SIDS monitors is based on a fear that parents will depend on monitors instead of following other, more effective medical measures, including always placing babies on their backs to sleep, keeping redundant bedding and soft objects out of the crib, and not having babies share a bed with adults.

Yet many parents want monitors too. The AAP acknowledges “distribution of home monitors continues to be a substantial industry in the United States.”

New Uses for Wireless Technology

Wireless technology has become pervasive, from wireless phones to wireless networks linking home computers. In 2009, Patwari and then-graduate student Joey Wilson showed how a couple dozen wireless transceivers – devices that transmit and receive radio signals – could be used to literally see through walls to detect the location of a burglar, people trapped by a fire or hostages held captive inside a building.

They formed a University of Utah spinoff company, Xandem Technology LLC, which is commercializing the wireless networks for use as motion detectors for burglar alarm systems, to help police locate hostages and even to alert out-of-town, vacationing parents if a crowd of teenagers is partying at their home during their absence.

Patwari’s new study points out pros and cons of adding wireless detection of breathing to the motion-detecting capability.

“A search and rescue team may arrive at a collapsed building and throw transceivers into the rubble, hoping to detect the breathing of anyone still alive inside,” Patwari and colleagues write. “Police or SWAT teams may deploy a network around a building to determine if people are inside.”

“On the other hand, the ability to measure breathing from a wireless network has privacy implications,” they add. “We have shown previously that a network deployed around external walls of a building can detect and track a person who is moving or changing position. If this system can also detect and monitor a sleeping person’s breathing, it would have additional utility for eavesdroppers or thieves.”

The Study: Using Wireless Transceivers to Detect Breathing

Because of efforts to patent the new use of the wireless breathing-detection technology – which has been named BreathTaking – Patwari is posting his study on the online scientific preprint website ArXiv this week before submitting it to a journal for formal publication.

Patwari conducted the study with Wilson; Sai Ananthanarayanan, a postdoctoral electrical engineer; Sneha Kasera, an associate professor of computer science; and Dwayne Westenskow, a professor of anesthesiology and research professor of bioengineering. The research was funded by the National Science Foundation.

In a new study, Patwari showed a network of 20 wireless transceivers placed around a hospital bed could reliably detect breathing and estimate breathing rate to within two-fifths of a breath per minute based on 30 seconds of data.

This is different than using wireless transmitters to relay measurements from conventional breathing monitors. The motion of the chest and abdomen during breathing impedes the wireless radio signals crisscrossing a bedridden patient, who in the study was Patwari himself. Each of the 20 transceivers or “nodes” can transmit and receive to the other 19, meaning there can be up to 380 measurements (20 times 19) of radio signal strength within a short period of time (the transceivers transmit one after the other).

The study was conducted in a clinical room used for research at the University of Utah School of Medicine’s Department of Anesthesiology. Patwari reclined on a hospital bed and listened to a metronome to time his breathing so he inhaled and exhaled 15 times per minute – about the average breathing rate for a resting adult.

His breathing was measured two ways: by the experimental wireless network, and by a carbon dioxide monitor connected to his nostrils by tubes. It calculated breathing rate by measuring the amount of carbon dioxide exhaled with each breath. Patwari also tested the wireless network with no one in the hospital bed.

The study found the wireless network could measure breathing within 0.4 to 0.2 breaths per minute, an insignificant error rate given that most breathing monitors round to the nearest breath per minute, he says. If a bedridden person or baby moves, the wireless system detects the movement but cannot measure their breathing at the same time.

To decide if someone is breathing or not, the wireless system uses a computer algorithm – basically, a set of formulas. Patwari says his algorithm squares the amplitude or loudness of the signal on each link between nodes, then averages it over all 380 links. A number larger than 1.5 indicates breathing has been detected.

Patwari also measured how many nodes were required to measure breathing accurately. The minimum was 13 nodes or transceivers, while the rate of incorrect breathing measurements fell to zero when 19 nodes were used. The study also showed the height of the nodes around the hospital bed didn’t significantly affect breathing measurements.

Patwari plans more research on whether different or multiple radio frequencies might detect breathing better than the one 2.4 gigahertz frequency used in the study.

He also wants to test whether the system can detect two people breathing at the same rate but not in sync – something that might make it possible to design a system that could detect not only the location of hostages in a building, but the number held together.

Back in 2009, autopsies of 34 of the victims of the H1N1 pandemic influenza virus revealed that about half showed signs of bacterial co-infection in their lungs. This was a telling sign that the two pathogens are playing off one another, but until now little was known about the biological interactions between them or why influenza was so lethal when accompanied by pneumonia.

Using mice, Kash et al., from the National Institute of Allergy and Infectious Diseases (NIAID) and the Institute for Systems Biology (ISB), teased the problem apart. They infected some mice with the seasonal flu virus and others with the 2009 pandemic strain and waited 48 hours for the influenza to take hold. Next, they exposed some of the mice to the bacterium Streptococcus pneumoniae, one of the leading causes of pneumonia.

In mice that were only given either of the flu viruses, influenza had the same effects it has in humans, including weight loss, but all the mice infected with influenza alone survived. The mice infected with seasonal influenza and S. pneumoniae had slightly enhanced lung tissue damage, but they all survived the dual infections.

In contrast, all the mice co-infected with both the 2009 pandemic flu and S. pneumoniae showed severe weight loss and 100% mortality. The lung tissues of the dead mice revealed that the alveoli were severely inflamed and the surfaces of the bronchioles were wiped clean of the protective layer of cells called the epithelium. There was also increased bacterial replication in the lungs of the co-infected mice, a sign that the bacteria were thriving there.

Looking at the mouse genes that were expressed during infection revealed more details about how the pandemic influenza virus sets the stage for lethal bacterial infections. Mice infected with the pandemic flu virus and S. pneumoniae had a similar inflammatory response as the other mice, but they lack responses that would repair and regenerate their damaged epithelial cells, those protective tissues that would otherwise keep bacteria from penetrating to deeper layers of tissue.

All these factors add up to big problems in the lung: as compared with seasonal flu, infection with the pandemic strain of flu was associated with more extensive damage to the epithelium that requires more extensive tissue repair. This opens the body up to attack from bacterial invaders, including Streptococcus pneumoniae.

Keith Klugman, who studies pneumonia and pneumococcal disease at Emory University, edited the paper. He says the study has a number of implications for treatment of pandemic flu.

“One implication is that if you can prevent the bacterial infection, you may be able to prevent a significant fraction of the pneumonia that leads to death. There may be a role for antibiotics in the severe pneumonias that follow influenza,” says Klugman.

Klugman points out that a vaccine for S. pneumoniae exists and that it is effective at interrupting transmission of pneumonia in the community. Now that we know pandemic flu causes increased susceptibility to pneumonia, says Klugman, we might head off deadly influenza-S. pneumoniae co-infections with more proactive vaccination programs.

Many end-stage lung disease patients, particularly those with idiopathic pulmonary fibrosis or cystic fibrosis have GERD, and the reflux problem is very common after lung transplantation, said Blair Jobe, M.D., professor of surgery, Department of Cardiothoracic Surgery, Pitt School of Medicine. Also, GERD has been associated with bronchiolotis obliterans syndrome (BOS), which is a progressive impairment of air flow that is a leading cause of death after lung transplantation. Its cause is not yet known.

“It’s possible that reflux, which is due to a weak sphincter between the stomach and esophagus, allows acid and other gastric juices to leak back not only into the esophagus, but also to get aspirated in small amounts into the lungs,” Dr. Jobe said. “That micro-aspiration could be setting the stage for the development of BOS.”

Lead author Toshitaka Hoppo, M.D., Ph.D., research assistant professor, Department of Cardiothoracic Surgery, Pitt School of Medicine, stressed the importance of esophageal testing for reflux in patients with end-stage pulmonary disease. He noted that “almost one-half of the patients in our series did not have symptoms but were having clinically silent exposure to gastric fluid. Based on this finding, there should be a very low threshold for esophageal testing in this patient population.”

For the study, Dr. Jobe’s team reviewed medical charts of 43 end-stage lung-disease patients with documented GERD, 19 of whom were being evaluated for lung transplant and 24 who had already undergone transplantation. All the patients were on GERD medications at the time they were evaluated for antireflux surgery (ARS), which prevents fluid from leaking back into the esophagus. Prior to ARS, nearly half of the patients had either no or mild symptoms of GERD and only a fifth had the typical symptoms of heartburn and regurgitation.

The researchers found that nearly all measures of lung function improved after ARS in both the pre- and post-transplant groups. There also were fewer episodes of acute rejection and pneumonia after ARS in the post-transplant group.

“The surgery appeared to benefit even those who hadn’t yet had a transplant,” Dr. Jobe noted. “Given the shortage of donor organs, ARS might help preserve the patient’s own function and buy some more time.”