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significant improvements in malnutrition-related parameters and
steatosis, according to a new study.
(Reuters Health) - An algorithm that computes hemoglobin
levels from a smart phone image of the inner eyelid may help
patients with anemia and other disorders avoid trips to
healthcare centers for blood draws, a new study suggests.
Researchers have described the warning signs – and
management approaches taken - in 35 French children who ended up
in ICUs with a SARS-CoV-2 related fever, severe multisystem
inflammation, left-ventricular dysfunction and cardiogenic
By Linda Carroll
(Reuters Health) - Patients who receive pulmonary rehabilitation
after being hospitalized for worsening of their chronic
obstructive pulmonary disease (COPD) are more likely to be alive
a year later, compared to those who don’t get rehab, a U.S.
An analysis of data from nearly 200,000 fee-for-service Medicare
beneficiaries hospitalized for COPD in 2014 showed that patients
who got pulmonary rehab within 90 days of leaving the hospital
were 37% less likely to die during the year following
hospitalization, according to the results in JAMA.
"Sixteen million individuals in the U.S. have been told they
have COPD by their doctors and there are probably millions more
who have it and are undiagnosed," said Dr. Peter Lindenauer, a
professor of medicine and director of the Institute for
Healthcare Delivery and Population Science at the University of
Massachusetts Medical School - Baystate. "It's the third leading
cause of death in the U.S. and is characterized by flare-ups, or
exacerbations, that lead to 1.5 million emergency department
visits each year and 700,000 hospitalizations."
Patients who don't receive pulmonary rehab often enter a vicious
cycle in which shortness of breath leads to less exercise, which
leads to more shortness of breath and so on, Dr. Lindenauer
Even though small randomized trials have suggested that rehab
might improve quality of life and reduce the risk of
rehospitalization, the proportion of patients receiving the
therapy hasn’t risen. Experts estimate it now stands at a mere
3% of those who could be receiving it.
Dr. Lindenauer and his colleagues decided to explore whether
pulmonary rehab could improve survival on the assumption that if
a benefit could be shown, more patients might receive the
The researchers analyzed data on 197,376 patients, mean age 76.9
years, who had been hospitalized for an exacerbation of COPD. A
mere 2,721 of those patients initiated pulmonary rehab within 90
days of discharge.
A total of 38,302 patients died within a year of discharge,
including 7.3% of patients who received rehab in the three
months following discharge and 19.6% of those who did not get
rehab. After adjustment for potential confounders, the absolute
risk difference was 6.7%.
Dr. Lindenauer allows that a retrospective study can’t prove
rehab saves lives. "The bottom line is that it's not a
randomized controlled trial and that is it's single biggest
limitation," he said, adding that it was possible the patients
who got rehab were just the healthier ones.
"We attempted to reduce the threat of this bias by adjusting for
many, many factors, including how severe their COPD was, how
many hospitalizations they had and even their level of frailty,"
Dr. Lindenauer said. "But it's impossible to adjust for
This is the first study to show there might be a survival
benefit, said Dr. Frank Sciurba, a professor of medicine and
education and director of the Emphysema/COPD Research Center at
the University of Pittsburgh.
"This is one more step in convincing the community of its
benefits," Dr. Sciurba said. "Survival carries a lot of weight
with providers and insurers."
Even if more patients and doctors opt for rehab, there is a
major barrier: not enough facilities. "If every doctor was
convinced by this to refer patients to rehab, we do not have the
capacity," Dr. Sciurba said.
That's true even in big cities like New York.
"In Manhattan, there are at most three rehab centers and most of
them are part-time," said Dr. Neil Schachter, a professor of
medicine at the Icahn School of Medicine and medical director of
the pulmonary rehabilitation program at Mount Sinai in New York
The reason for the shortage of rehab facilities is the paltry
reimbursement hospitals get for running one, Dr. Schachter said.
The result is patients missing out on a treatment that can
improve their ability to exercise, which has been shown to boost
the immune system, which is especially important in this
population, Dr. Schachter said
"People who are in these training programs have fewer
exacerbations, which is good for them overall since these are
what can continue the destructive mechanism that is COPD," Dr.
SOURCE: https://bit.ly/2Lmqvhd and https://bit.ly/2Lp11zS JAMA,
online May 12, 2020.
(Reuters Health) - In the era of COVID-19, the best way to
protect kidney failure patients may be home dialysis with
monitoring through telemedicine, a new report suggests.
NEW YORK New York-based hospital system Northwell Health said it has started to make its own nasal swabs using 3D printing, enabling it to produce thousands of swabs a day that can be used in testing for the coronavirus.
(Reuters Health) - The blood-alcohol threshold for being considered legally impaired in the U.S. may be too high, according to a study that finds a meaningful percentage of crashes happen when drivers are below that limit.
(Reuters Health) - The proportion of U.S. adults at high risk for blindness has grown over a 15-year period and so has the share who say they cannot afford eyeglasses, according to a new study.
(Reuters Health) - Patients who need to have a cancerous lesion removed from their face in a procedure known as Moh's micrographic surgery are often taken aback by the size of the resulting scar, a new study finds.
(Reuters Health) - Alcoholics Anonymous and similar 12-step programs can lead to higher rates of continuous abstinence than other addiction treatment approaches like cognitive behavioral therapy, a large new study suggests.