Datamining Could Predict Heart Attack Risk

heart attack and coronary disease data graphBy Olivia Solon, Wired UK

A team of researchers have used datamining and machine learning techniques to find subtle changes in electrical activity in the heart that can be used to predict potentially fatal heart attacks.

Researchers from the University of Michigan, MIT, Harvard Medical School and Brigham Women’s Hospital in Boston sifted through 24-hour electrocardiograms (which measure the electrical activity in the heart) from 4,557 heart attack patients to find errant patterns that until now had been dismissed as noise or were undetectable.They discovered several of these subtle markers of heart damage that could help doctors identify which heart attack patients are at a high risk of dying soon. Electrocardiograms (ECGs) are already used to monitor heart attack patients, but doctors tend to look at the data in snapshots rather than analyze the lengthy recordings.

The team developed ways to scan huge volumes of data to find slight abnormalities — computational biomarkers — that indicate defects in the heart muscle and nervous system. These included looking for subtle variability in the shape of apparently normal-looking heartbeats over time; specific sequences of changes in heart rate; and a comparison of a patient’s long-term ECG signal with those of other patients with similar histories.

They found that looking for these particular biomarkers in addition to using the traditional assessment tools helped to predict 50 percent more deaths. The best thing is that the data is already routinely collected, so implementing the system would not be costly.

Around a million Americans have heart attacks each year, with more than a quarter of those in groups who survive the initial attack dying within a year. Current techniques miss around 70 percent of the patients that are at high risk of complications, according to Zeeshan Syed, assistant professor at the University of Michigan Department of Electrical Engineering and Computer Science.

Continue reading Datamining Could Predict Heart Attack Risk

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Athletes have used Mind Sparke and Lumosity and biofeedback tools like Heartmath for peak performance, but according to the following story, it sounds like the fighter wasusing it to counter-act a closed head injury, or even Traumatic Brain Injury.

From USA Today-
Montreal-based boxer Sylvera “Sly” Louis suffered a knockout late last year that could have ended his fighting career. But three months later he returned to the ring, a feat he credits to hard workouts on brain-training software. Louis spent countless hours on Lumosity, a brain-training program from Lumos Labs that includes more than 35 games and exercises aimed at increasing alertness, sharpening memory skills, improving concentration and thinking faster.
The boxer says he improved his reaction times. “Every little moment matters,” Louis says. Louis is part of a new club that takes exercise for the brain every bit as seriously as exercise for the body. It’s a growing movement that’s swept up 15 million users of Lumosity.
Smaller rivals such as Posit Science and MindSparke are also vying in this arena.”

Reducing CoMorbid Conditions with Obese Workers

An Interview with Doctor Alice Martinson

photo of vintage donut shop called Randy's
Just keep on driving

We hear a lot about the rising cost of workers compensation when injured workers suffer from co-morbid conditions.

What is “comorbidity?”
Co-morbidity refers to any unrelated medical condition, which nonetheless has some bearing on the primary condition under discussion, or upon an individual’s ability to return to a functional level. An example of this would be a chronic cardiac condition delaying or preventing surgery in someone who has work-related knee osteoarthritis. Another, though somewhat graphic example, is an individual with a leg amputation who sustains an injury to two of the remaining three extremities. Given the number of returning Middle East veterans who are amputees, this is not such a far-fetched possibility.

How do you define obesity?
Obesity is defined in terms of body mass index (BMI). A BMI between 25 and 30 is considered “overweight.” A BMI over 30 is considered obesity, and a BMI over 40 is considered extreme obesity. In some written material it is called “morbid obesity.” This latter term is falling out of favor because it can carry an emotionally-charged meaning getting in the way of useful discussion. BMI is calculated as the relationship between height and weight.

Rather than fooling with the math, I use a very convenient table available on the NIH website: Calculate BMI

Workers compensation will usually not cover that portion of a workplace injury related to a comorbid condition. How can the workplace injury be separated from the pre-existing condition for compensation?
For workers compensation treatment, that is not usually a hard distinction to make. A good example here would be carpal tunnel syndrome in a diabetic. Diabetes does not cause carpal tunnel syndrome, but diabetics will many times experience progression of the condition, once it occurs, at a much faster rate than non-diabetics do. Thus, surgical decisions and timing may well be affected by the diabetic state.

Where it gets harder within the workers compensation system is the question of whether a co-morbid condition interfering with the treatment of a workers compensation problem should be treated through the workers compensation system.

The most frequent instance of this I have come across is the question of whether bariatric (weight loss) surgery should be covered by workers compensation when the primary injury is knee trauma. Continued obesity in the face of a knee injury is inviting progressive osteoarthritis, so the question comes up – “Is bariatric surgery necessary to cure or relieve the effects of the work injury?” A similar example would be when a serious cardiac condition is found that interferes with necessary surgical treatment of a work injury.

Should treatment of the cardiac condition be provided under workers compensation?
There are different policies and case law in each state, so I would encourage anyone who encounters this issue to check for the rulings in their particular locale. Continue reading Reducing CoMorbid Conditions with Obese Workers

Child Proof Caps Not So Child Proof?

Number of Children Poisoned by Medication Rising Dramatically, Study Says

Child trying to open pill bottle with child proof capThe number of young children admitted to hospitals or seen in emergency departments because they unintentionally took a potentially toxic dose of medication has risen dramatically in recent years, according to a new Cincinnati Children’s Hospital Medical Center study.

The rise in exposure to prescription products has been so striking that the U.S. Centers for Disease Control and Prevention has established the PROTECT Initiative, intended to prevent unintended medication overdoses in children.

Randall Bond, MD, an emergency medicine physician at Cincinnati Children’s, will present his study on children and pharmaceutical poisonings Sept. 20 at a PROTECT Initiative meeting in Atlanta. The study will be published online Sept. 16 in the Journal of Pediatrics.

“The problem of pediatric medication poisoning is getting worse, not better,” says Dr. Bond, who also is medical director of the Drug and Poison Information Center at Cincinnati Children’s. “More children are exposed, more are seen in emergency departments, more are admitted to hospitals, and more are harmed each year.”

Dr. Bond found that exposure to prescription products accounted for most of the emergency visits (55 percent), admissions (76 percent) and significant harm (71 percent). Levels of ingestion of opioids, most often prescribed to treat pain; sedatives-hypnotics, frequently prescribed as sleep aids; and cardiovascular medications were particularly high.

“Prevention efforts at home have been insufficient,” says Dr. Bond. “We need to improve storage devices and child-resistant closures and perhaps require mechanical barriers, such as blister packs. Our efforts can’t ignore society’s problem with opioid and sedative abuse or misuse.”

Continue reading Child Proof Caps Not So Child Proof?

Legislature Passes Healthy Families Money, Mulls More

by David Gorn

Among the raft of bills that floated through the Legislature in the final days of session were two big health-related ones:

• The Assembly, after trying and failing by one vote to pass ABX1 21 by Bob Blumenfield (D-Woodland Hills), yesterday took up the measure again and this time passed it, 61-9; and

• An Assembly bill, AB 922  by Bill Monning (D-Carmel), is designed to expand and move the Office of the Patient Advocate. It took on an amendment that also moves its parent agency, the Department of Managed Health Care. Those agencies currently reside under the Department of Business, Transportation and Housing.

ABX1 21 is designed to fund a large chunk of the Healthy Families budget by extending by a year a tax on Medi-Cal managed care organizations. Those MCOs actually support the tax extension.

“This is a bill with industry support, so we’re in the rare situation of not taxing anyone who is not wanting to be taxed,” Blumenfield said when he introduced the legislation.

ABX1 21 was approved by the Senate earlier, and now moves to the governor’s desk. It missed approval previously on the Assembly floor by one legislative vote. If the bill had not passed, the state was contemplating a massive shift of children off the Healthy Families program.

Continue reading Legislature Passes Healthy Families Money, Mulls More

MRSA: Protect your kid from a superbug

Audriana Willman with a MRSA infection.
Audriana Willman was hospitalized in 2010 with a MRSA infection.

By Sabriya Rice, CNN Medical Producer
updated 1:07 PM EST, Thu September 1, 2011

Audriana Willman was hospitalized in 2010 with a MRSA infection.

(CNN) — A few months before her second birthday, a small bump about the size of a pimple appeared on Audriana Willman’s right leg. Her parents, Andrew and Chelsea, noticed the boil in the evening, as they prepared their daughter for bed.

“We had already been through this three other times, so we weren’t too worried,” explains Chelsea, who says she had taken her daughter to a pediatrician on several occasions to treat skin infections. As they usually did when a little red circle with a white head appeared on their toddler’s body, they popped it like a pimple and cleaned the area with antibacterial soap. But this time, that small pimple would turn into a major problem.

“By the next morning, it wasn’t just a bump anymore. Her leg was red and extremely swollen, and she could hardly walk. She was in pain, and her fever had spiked to 103,” her mother recalls. “It went from minor to really, really bad overnight.”

By 10:30 that morning, they had rushed Audriana to their pediatrician in Oroville, California. She was hospitalized, and the Willmans learned their daughter had developed methicillin-resistant Staphylococcus aureus, or MRSA, which is a type of staph bacteria that does not respond to commonly used antibiotic treatments.

This type of infection has been a problem in hospital settings for many years, but starting around 2000, it began steadily making its way into the lives of otherwise healthy people, especially children, who are not typically at risk for the fast-moving bacteria. As children head back to school, epidemiologists are encouraging parents to be more aware of the drug-resistant strain of staph and how to protect their kids.

MRSA infections on the rise

“Everyone is at risk,” said Dr. Patrick Romano, lead author of a new report that found the number of children hospitalized with MRSA infections, mostly acquired from within the community, has more than doubled since 2000. “MRSA really started as a bacterium that was seen in hospitals among high-risk patients. But during the last decade, we saw it spread to the general population.”

“The problem is that MRSA began to affect people who were perfectly healthy,” adds Dr. Jaime Fergie, author of a 2005 study that concluded that infections in children had reached “epidemic proportions.” Mutations in the organism made it more virulent and easy to transmit, he says. “We continue to see more severe, life-threatening infections affecting the blood, lungs, muscles and even bones of previously healthy children.”

In 2009, 71,900 children were hospitalized because of infections under the skin, according to the Agency for Healthcare Research and Quality, and the CDC estimates there are approximately 10,800 deaths in the U.S. each year caused by staph, of which 5,500 are inked to MRSA.

The problem became so widespread that in January, the Infectious Diseases Society of America called the condition a “huge public health problem” and published its first-ever guidelines for the treatment of MRSA in pediatric patients.

Protecting your child from MRSA Continue reading MRSA: Protect your kid from a superbug