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In as many as 1 in 5 people older than 55 years, when the heart contracts to send blood around the body, some degree of backward leakage occurs across the mitral valve, a condition known as mitral regurgitation. When sufficiently severe, mitral regurgitation causes buildup of blood in the lungs, leading to difficulty in breathing and congestive heart failure. Mitral regurgitation also can cause arrhythmias such as atrial fibrillation, which can lead to stroke and other problems, and ventricular fibrillation, which can cause sudden death. A new study found that monitoring the capacity of these patients to exercise on a treadmill (exercise tolerance testing) may be useful in predicting the condition's progression and whether the patient will need surgery. Developed in its most simple form in the 1920s, exercise tolerance testing is used commonly to assess the progression of coronary artery disease and the severity of aortic stenosis. Researchers followed up 38 patients with chronic severe nonischemic mitral regurgitation for an average of 7 years. All underwent exercise tolerance testing at study entry. Patients who could continue exercising for 15 minutes or longer had a 5-fold lower annual risk of developing heart failure or other evidence of severe heart dysfunction necessitating surgery, compared with patients who were unable to exercise to that length of time. In patients with chronic severe nonischemic mitral regurgitation, progression to surgical indications generally is rapid. For more information, please call 866-NYP-NEWS.

 

The United Sates is expected to be short a half-million nurses within the next 10 years (plus 750,000 nursing assistants). Understandably, recruitment and retention are top priorities for hospitals and healthcare organizations. With increased workloads, demanding staff ratios, and challenging work conditions, many employees feel burned out. Today's healthcare workers are not signing on and staying just for the money. They are opting for employers who care about them, professionally and personally. Treatment on-the-job is a primary factor in satisfaction and retention rates. For more information concerning how employers can provide the care to their nurses that nurses show their patients, please contact Patricia F. Klier at PRguide@prpr.net.

 

One of 3 patients with asthma or chronic obstructive pulmonary disease uses his or her inhaler incorrectly, a new study shows. The study found that 31.2% of patients made at least 1 essential error while using a dry power inhaler and that the error rate increased with age and severity of airway obstruction. Dry powder inhalers rely on the force of patients' inhalation to activate, deliver, and manage the flow of medication to the lungs, compared with pressurized metered-dose inhalers that use propellants to deliver a measured dose of medication to the patient. Although metered-dose inhalers are more commonly used in the United States, the use of dry powder inhalers has grown substantially in the last 5 years. Patients younger than 60 years had a 20.0% error rate, whereas those 60 years and older had an error rate of 41.6%. Patients with normal lung function had an error rate of 25.0%, whereas patients with severe obstruction had an error rate of 63.6%. Researchers speculate that decreased cognitive and psychomotor skills, as well as an obstructive pulmonary disease-specific cognitive impairment, may make it difficult for older patients to properly use dry powder inhalers. Although the study's authors do not advise against the use of dry powder inhalers in older patients, they recommend checking older patients' inhalational technique at every healthcare encounter to ensure the efficacy of treatment. Dry power inhalers rely on the force of a person's inhalation to propel medication into the lungs; thus, they are not recommended for children younger than 5 years, people with severe asthma, or those suffering a severe attack. For more information, please contact Jennifer Stawarz at 847-498-8306.

 

Domestic violence is one of the dirty secrets that many people like to ignore. They convince themselves it happens only to strangers. But the truth is that 3 women a day are killed by the hands of their husband or boyfriend. Are you aware that nearly one-third of American women report being physically or sexually abused by a husband or boyfriend at some point in their lives according to the Family Violence Prevention Fund? They come from all walks of life and could be your daughter, sister, friend, or neighbor. Naivete is a contributing factor to the current epidemic of teen-dating violence. Often, teenage girls do not realize that their boyfriend's behavior is abusive; they believe it is normal or a part of being in love so they continue the relationship. Health experts point to the growing problem of teen domestic violence as a link in a vicious cycle. An estimated 3 million American women are abused each year. Because children are witnessing verbal or physical abuse in their homes, they begin to believe it is acceptable. Once they start dating, many of them emulate the relationships they saw as kids. For more information, please contact Rachel Friedman at http://www.newsandexperts.com.

 

New research reveals that the families of patients who died in the intensive care unit had higher satisfaction of care ratings than families of patients who survived their time in the intensive care unit (ICU). The study shows that while the families of ICU survivors and nonsurvivors were equally satisfied with the treatment that their loved ones received, the families of nonsurvivors were 2 to 3 times more likely to give higher ratings regarding family-centered aspects of care. In contrast, the families of ICU survivors were shown to be less pleased with their overall ICU experience. Results of the study showed that families of patients who died in the ICU were much more satisfied with their ICU experience than the families of ICU survivors. The largest differences were shown in the areas of inclusion in decision making, clinician communications, emotional support, respect and compassion shown to family, willingness of staff to answer questions, and consideration of family needs. Each of these items was classified as an aspect of family-centered care, and none of the items revealed higher satisfaction among family members of survivors. The findings suggest that ICU clinicians may devote extra effort toward addressing family-centered needs when a patient's death is imminent. For more information, please contact dbusche@chestnut.org.