Daily ReCAP April 21, 2017


The latest news on chronic, acute, and preventive care across the health care landscape.

Chronic: Pre-Drive Checklists May Reduce Accidents in Patients with Type 1 Diabetes

Individuals with type 1 diabetes (T1D) have a higher than average risk of getting in a car accident. To help prevent diabetes-related accidents, scientists created an 11-question test called the Risk Assessment of Diabetic Drivers (RADD). In a new study published inDiabetes Care, investigators administered the test to more than 500 drivers with T1D from Boston, central Virginia, and Minneapolis. The study participants were asked about their “driving mishaps,” defined in the study as a dangerous driving situation that could have/did result in an accident. The assessment was able to accurately identify 61% of individuals who were at a high risk for driving issues, and 75% who were at low risk of driving problems. In the second half of the study, nearly 500 drivers with T1D from across the nation took the RADD test online. The investigators found that 372 individuals were identified as high-risk, and 118 were considered low-risk. Next, half of the participants were given routine care, whereas the rest were asked to participate in an online intervention that aimed to anticipate, prevent, detect, and treat hypoglycemia. All of the participants in the intervention arm were given a toolkit that contained a blood sugar meter, a pre-drive checklist, fast-acting glucose products, and a key chain with a stoplight symbol to remind drivers to stop and treat low blood sugar if their reading was below 70 mg/dL, or to be cautious and eat foods containing carbohydrates before driving if between 70 and 90 mg/dL. Over 90 mg/DL is considered a green light, according to the authors. The results of the study showed that the intervention tool helped drivers avoid hypoglycemia while driving.

Acute: “Connshing Syndrome” Dubbed New Cause of Hypertension

Scientists have identified a new cause of high blood pressure, according to a study published inJCI Insight. Although an estimated 1 of 4 adults have hypertension, most patients have no identifiable cause for the condition. However, in up to 10% of patients with hypertension the cause of the disease is Conn syndrome: the overproduction of the adrenal hormone aldosterone. But in a new study, investigators found that in addition to the overproduction of aldosterone in patients with Conn syndrome, they also produce too much cortisol. The investigators dubbed this new cause of hypertension Connshing syndrome. “These findings are very likely to change clinical practice,” said second author Katharine Lang. “Patients will now need to undergo more detailed assessment to clarify whether they suffer from Conn or Connshing syndrome. Previously, patients with Conn syndrome were never assessed for the overproduction of other hormones but this will now change thanks to the results of this study.”

Preventive: Fungi Shows Potential in Producing New Antibiotics to Combat Resistance

As scientists work to combat antibiotic resistance, a new study found that fungi have huge potential in the development of new antibiotics. Penicillin, derived fromPenicilliumfungi, was the first antibiotic to be mass produced. In a study published inNature Microbiology, investigators sequenced the genomes of 9 different types ofPenicilliumspecies. “We found that the fungi have enormous, previously untapped, potential for the production of new antibiotics and other bioactive compounds, such as cancer medicines,” said investigator Jens Christian Nielsen. For the study, investigators scanned the genomes of 24 different types of fungi to identify genes responsible for producing various bioactive compounds, such as antibiotics. More than 1000 pathways were identified, indicating the immense potential for fungi to produce natural and bioactive chemicals that could be used in pharmaceuticals. The investigators could predict the chemical products of the pathways in approximately 90 cases. Overall, the findings revealed the potential for fungi to produce new antibiotics as well as improving the efficacy of existing ones.

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