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Implanted Defibrillators: New Recommendations For Drivers With ICDs
Patients with an Implantable Cardioverter Defibrillator (ICD) have an ongoing risk of sudden incapacitation that might cause harm to others while driving a car. Driving restrictions are imposed making these recommendations an important guideline for patients.

An Animal Model For Schizophrenia Identifies A Novel Approach For Treating Cognitive Impairments Associated With Schizophrenia
Researchers have been seeking a safe and effective way to treat cognitive impairments associated with schizophrenia by enhancing N-methyl-D-aspartate (NMDA) glutamate receptors. Functional deficits in NMDA receptors may contribute to the underlying neurobiology of this disorder. The first generation of studies trying to stimulate NMDA receptors administered large amounts of substances, like glycine or D-serine, which indirectly enhance NMDA receptor function. While there were some positive reports of efficacy, findings across studies were more inconsistent than was hoped.
News of the day
Easier Way To Identify A Child's High Blood Pressure Created By Pediatrician
Pediatricians now have a new and simple way to diagnose a serious problem facing our nation"s children - thanks to David Kaelber, M.D., Ph.D., M.P.H., MetroHealth System pediatrician, internist, and chief medical informatics officer and Case Western Reserve University School of Medicine researcher and faculty member. Nearly 75% of cases of hypertension and 90% of cases of prehypertension in children and adolescents go undiagnosed. These troubling statistics were documented in previously published research by Dr. Kaelber. From this research, Dr. Kaelber and fellow researchers felt that one of the main reasons for the under-diagnosis may be due to the complex chart currently used to help physicians and medical personnel identify high blood pressure in children. So Dr. Kaelber"s team simplified the chart - focusing solely on a child"s age and gender - eliminating the need for a height percentile and reducing the number of values in the blood pressure table from 476 to just 64. The revised chart and accompanying description are published in the June issue of the journal Pediatrics.
Medical Devices

Joint Replacement Patients With Diabetes Greatly Benefit From Controlled Glucose

Diabetics undergoing total joint replacement often are at a higher risk of experiencing complications after surgery due to various pre-existing health conditions. According to a new study published in the July 2009 issue of The Journal of Bone and Joint Surgery (JBJS), those complications are less likely to occur when a diabetic patient has glucose levels under control. "We found that controlled glucose levels really do make a difference for the patient," said study co-author Milford Marchant Jr., MD, an orthopaedic surgeon who conducted the study with colleagues of the Adult Reconstruction Section at Duke University Medical Center. The study found that patients with uncontrolled glucose levels were: -- More than 3 times as likely to experience a stroke or death after joint replacement surgery; and -- About twice as likely to experience post-operative bleeding and infection. Dr. Marchant and his colleagues reviewed data from a national healthcare database looking at more than one million patients who had total joint replacement surgery from 1988 to 2005. They compared surgical outcomes in patients with uncontrolled glucose levels to those who had controlled glucose levels and those patients who did not have diabetes. "It did not matter if the patient had Type I or Type II diabetes," explains Dr. Marchant. "Regardless of diabetes type, we found that patients had fewer complications after surgery if their glucose level was controlled before, during and after surgery." Diabetic patients with uncontrolled glucose were more likely to experience surgical complications, infection, blood transfusions and longer hospitals stays. "The factors necessary for diabetic patients to be considered "under control" are different for each individual patient, therefore diabetic patients should have good relationships with their medical doctors," said Dr. Marchant. Study authors say that according to the American Diabetes Association, disease control is determined for each patient based on a series of laboratory blood tests and an assessment of diabetes-related illnesses. Approximately 8 percent of patients undergoing total hip and knee replacement in the United States have diabetes. "It is crucial that patients have glucose levels well managed before, during and after surgery because it reduces the potential of having a complication," notes Dr. Marchant. "This is the responsibility of both the patient and the surgeon, and it should be a priority." Disclosure: The authors did not receive any outside funding or grants in support of their research for or preparation of this work. Neither they nor a member of their immediate families received payments or other benefits or a commitment or agreement to provide such benefits from a commercial entity. Commercial entities (Zimmer and DePuy) paid or directed in any one year, or agreed to pay or direct, benefits in excess of $10,000 to a research fund, foundation, division, center, clinical practice, or other charitable or nonprofit organization with which one or more of the authors, or a member of his or her immediate family, is affiliated or associated. American Academy of Orthopaedic Surgeons


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