NEW HAVEN — Patients with implantable cardioverter defibrillators (ICDs) have significantly lower risk of death and re-hospitalization if they are followed through an automatic, wireless remote monitoring system, a Yale clinical study has found. Results of the study are being presented at the annual meeting of the Heart Rhythm Society.
ICDs are used to treat patients at high risk of sudden cardiac death. Remote patient monitoring can help physicians keep an eye on patients once they are home by wirelessly communicating with the implanted device to make sure it is functioning properly and that the patient is not in danger. But despite the nearly universal availability of wireless technology in the U.S., less than half of eligible patients are monitored in this way.
The reasons why this technology is underutilized are unknown, but one potential reason is the relative absence of evidence of the impact of remote monitoring on patient outcomes. To address this gap in knowledge, Yale researchers partnered with the American College of Cardiology and Boston Scientific, a manufacturer of ICDs, to examine the outcomes of nearly 38,000 ICD patients. The study found that patients using remote monitoring were 33 percent less likely to die and 20 percent less likely to be re-hospitalized in the three years following device implantation.
AVON — On April 17 the U.S. Food & Drug Administration released a safety notification discouraging the use of laparoscopic power morcellators for the removal of the uterus or uterine fibroids. Laparoscopic power morecellation is one of several available treatments that employs a medical device to divide the uterine tissue into smaller pieces or fragments to be removed through small incisions from the abdomen.
The FDA determined that approximately one in 350 women who are undergoing hysterectomy or myomectomy for fibroids have an unsuspected type of uterine cancer called uterine sarcoma. If laparoscopic power morcellation is performed in these women there is a risk that the procedure will spread the cancerous tissue within the abdomen and pelvis, worsening the patient’s likelihood of long-term survival.
Women’s Health Connecticut, which employs 210 OB/GYN physicians, has agreed to stop using the laparoscopic morcellator. According to Medical Director Daniel Gottschall: “There are multiple alternatives to morcellation. It is important for our patients to know their surgical options and ask about alternatives.” Women’s Health Connecticut’s gynecologists perform more than 1,500 minimally invasive hysterectomies and fibroid removals each year in 18 hospitals in Connecticut.
NEW HAVEN — Despite the benefits that physical activity can offer, a mere ten percent of cancer survivors are exercising enough to reap those benefits, according to research conducted by the Yale Cancer Center and Yale School of Public Health.
The U.S. Department of Health & Human Services (DHHS) recommends cancer survivors engage in 150 minutes of moderate-intensity physical activity, or 75 minutes of vigorous-intensity physical activity, and two sessions of strength training, every week. The Yale researchers found that among the population of cancer survivors studied in the U.S., only ten percent met these physical activity guidelines.
Yet, all survivors who said they exercised at recommended levels reported better quality of life (less fatigue, improved mental and physical health, and increased satisfaction in social activities and relationships).
The team reviewed data from the 2010 National Health Interview Survey that included information from more than 19 million cancer survivors. The large sample size of survivors and the inclusion of more than ten types of cancer were unprecedented in this type of study.
“We know that exercise not only improves multiple aspects of quality of life, but other studies have shown it also is associated with lower risk of recurrence and mortality,” said o-author Melinda Irwin, co-director of the cancer prevention and control program at Yale Cancer Center, and associate professor of epidemiology at the Yale School of Public Health. “This rate is similar to what we see in the healthy adult population, so we need to make huge efforts to increase physical activity for everyone.”
NEW HAVEN — The National Cancer Institute (NCI) has named Yale Cancer Center a lead site in a new clinical trials research network dedicated to improving treatment for the more than 1.6 million Americans diagnosed with cancer each year. The new system, called the National Clinical Trials Network (NCTN), is a consortium of 30 academic cancer centers.
“Clinical trials are the primary way advances in cancer treatment are made for cancer patients. Yale Cancer Center is gratified to join the NCTN since collaborating with other leading cancer centers will help us all deliver breakthroughs more quickly,” said Howard Hochster, MD, professor of medical oncology and associate director for clinical sciences at Yale Cancer Center. “We’re committed to bringing the best clinical and translational science from Yale to the group and using these collaborations to help lead the next generation of clinical trials to the national stage.”
One hundred clinical trials for multiple types of cancer are available to patients of Smilow Cancer Hospital and affiliated care centers. The growing portfolio of trials includes Phase I trials, which are the critical first step in testing new cancer drugs in patients.
Approved by the state of Connecticut and the Council on Accreditation of Nurse Anesthesia Educational Programs (COA), the program will offer two options: a full-time, three-year post-baccalaureate doctor of nursing practice (DNP) for registered nurses with critical-care experience who wish to become nurse anesthetists; and a part-time, 24-month option for certified registered nurse anesthetists with a current master's degree who would like to earn the DNP.
The post-baccalaureate curriculum offers courses in advanced physiology and pathophysiology, anatomy with cadaver lab, advanced health assessment, advanced pharmacology, basic and advanced principles of anesthesia, physics and advanced chemistry for anesthetic practice, patient safety, ethics, professional aspects, biostatistics, clinical scholarship, health care leadership, epidemiology and evidence-based practice.
To learn more about the program phone 203-582-8875.
WALLINGFORD — Gaylord Hospital will be recognized on April 29 by People’s Action for Clean Energy (PACE) with the 2014 Environmental Energy Leadership Award as the first Connecticut hospital operating with a solar thermal heating system.
“We would like to tell the public about the diminished use of fuel oil and the financial savings that the hospital will enjoy,” said PACE Chair Judi Friedman. Two-thirds (66 percent) of the hospital’s hot water demand, a total of 18,000 gallons daily, is heated with rooftop solar panels, arrayed in four separate installations, each equipped a 3750-gallon water storage tank.
PACE (pace-cleanenergy.org) is the only all-volunteer Connecticut nonprofit public health organization devoted solely to clean energy education.
NEW HAVEN — Newborns whose mothers were exposed during pregnancy to any one of a variety of environmental stressors — such as trauma, illness, and alcohol or drug abuse — become susceptible to various psychiatric disorders that frequently arise later in life. However, it has been unclear how these stressors affect the cells of the developing brain prenatally and give rise to conditions such as schizophrenia, post-traumatic stress disorder, and some forms of autism and bipolar disorders.
Now, Yale University researchers have identified a single molecular mechanism in the developing brain that sheds light on how cells may go awry when exposed to a variety of different environmental insults. The findings, to be published in the May 7 issue of the journal Neuron, suggest that different types of stressors prenatally activate a single molecular trigger in brain cells that may make exposed individuals susceptible to late-onset neuropsychiatric disorders.
The researchers found that mouse embryos exposed to alcohol, methyl-mercury, or maternal seizures all activate in the developing brain cells a single gene — HSF1 or heat shock factor — which protects and enables some of the brain cells to survive prenatal insult. Mice lacking the HSF1 gene showed structural brain abnormalities and were prone to seizures after birth, even after exposure to very low levels of the toxins.
Responding to the rapid growth of nursing-home and long-term-care industries as baby-boomers begin to enter their senior years, Quinnipiac University’s Long Term Care Administration Certificate Program prepares students for careers in that fast-growing field.
In addition to teaching students the skills and prerequisite knowledge they need to become effective administrators, the program prepares them to take the national nursing home administrators exam and the state portion of licensure requirements. It likewise affords them opportunities to connect and work closely with professionals in the field.
The QU program has been approved by the state of Connecticut.
According to Angela Mattie, a QU associate professor of management who also chairs the school’s Health Care Management & Organizational Leadership program, the certificate program fills a growing need.
“There’s a requirement by the state of Connecticut that nursing-home administrators need to be licensed,” she explains. “This involves a residency component and a course component that [covers] the major factors [involved in] running a long-term care facility.”
Coursework includes “everything from how to care for an elderly patient, Medicare requirements for billing, dietary [practices] — all aspects of being a leader in a nursing-home or assisted-living situation,” she adds.
The program also involves long-term care practitioners as part of the curriculum in roles such as guest lecturers and collaborators.
Employment of medical and health-services managers, including nursing-home administrators, is projected to grow, according to the U.S. Department of Labor. "As the large baby-boom population ages and people remain active later in life, the health-care industry as a whole will see an increase in the demand for medical services,” according to the DOL’s website. “Managers will be needed to organize and manage medical information and health-care staffs in all areas of the industry.”
The program, which is under the auspices of QU’s business school, also requires two 450-hour residencies that can take place in a licensed facility.
Students entering the program range from seasoned professionals who have worked in the field by lack a license, as well as younger people entering the pipeline of nursing home administration for the first time.
The long-term-care administration course is a three-credit course, plus two four-credit residencies, for a total of 11 credits needed to attain certification. Costs are in the neighborhood of $800 per credit, according to Mattie.