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guide patients through areas in which most have no training, she explains.

The research team, led by first author Anastasia B. Evanoff, sent surveys to medical school curriculum deans at 172 medical schools in North America, including 31 that specialize in osteopathic medicine, and received 101 replies. Two-thirds (66.7 percent) reported that their graduates were not prepared to prescribe medical marijuana. A quarter of deans said their trainees weren’t even equipped to answer questions about medical marijuana.

“Medical education needs to catch up to marijuana legislation…”

 

 

 

The researchers also surveyed 258 residents and fellows who earned their medical degrees from schools around the country before coming to Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis to complete their training.

Nearly 90 percent felt they weren’t prepared to prescribe medical marijuana, and 85 percent said they had not received any education about medical marijuana during their time at medical schools or in residency programs throughout the country.

Using data from the AAMC database, the researchers found that only 9 percent of medical schools had reported teaching their students about medical marijuana.

 

 

 

“As a future physician, it worries me,” says Evanoff, a third-year medical student. “We need to know how to answer questions about medical marijuana’s risks and benefits, but there is a fundamental mismatch between state laws involving marijuana and the education physicians-in-training receive at medical schools throughout the country.”

However, several states—Missouri among them—have not legalized medical marijuana, and published studies about potential risks and benefits of medical marijuana often are contradictory. So what are schools to teach?

“You address the controversy,” says co-investigator Carolyn Dufault, assistant dean for education at the unoversity and an instructor in medicine. “You say, ‘This is what we know,’ and you guide students to the points of controversy. You also point out where there may be research opportunities.”

The authors argue that as more states legalize marijuana for medical and recreational use, doctors need to have at least enough training to answer patients’ questions.

“More medical students are now getting better training about opioids, for example,” says Evanoff. “We talk about how those drugs can affect every organ system in the body, and we learn how to discuss the risks and benefits with patients. But if a patient were to ask about medical marijuana, most medical students wouldn’t know what to say.”

 

 

 

Algorithm scans medical records for higher Parkinson’s risk

 by Tamara Bhandari-Washington University

 

 

Researchers have developed an algorithm that could check patients’ medical histories to find signs of increased risk for developing Parkinson’s disease and alert doctors to evaluate patients at greater risk.

Before symptoms become pronounced, there is no reliable way to identify who is on track to develop Parkinson’s disease, a debilitating movement disorder characterized by tremors, slowness of movement, stiffness, and difficulty with balance and coordination.

“We want to be able to catch people as early as possible…”

But researchers have analyzed Medicare claims data of more than 200,000 people to develop the algorithm to predict whether a patient one day will be diagnosed with Parkinson’s. The algorithm relies on information in patients’ medical records, such as tests and diagnoses of various medical conditions.

“Using this algorithm, electronic medical records could be scanned and physicians could be alerted to the potential that their patients may need to be evaluated for Parkinson’s disease,” says Brad A. Racette, a professor of neurology at Washington University in St. Louis and the study’s senior author.

“One of the most interesting findings is that people who are going to develop Parkinson’s have medical histories that are notably different from those who don’t develop the disease. This suggests there are lifelong differences that may permit identification of those likely to develop the disease decades before onset,” Racette says.

An estimated 1 million people in the United States live with Parkinson’s disease, a chronic and progressive neurological disorder.

Recognizing that the mild but worsening symptoms in the years before diagnosis might be reflected in a signature pattern of various diagnoses and tests, Racette and colleagues analyzed de-identified medical claims data for Medicare beneficiaries nationwide, ages 66 to 90.

They found 89,790 people who had been diagnosed with Parkinson’s in 2009, and matched them with 118,095 people in the same age range who had not been diagnosed with Parkinson’s in 2009 or prior years. Then, the researchers sifted through each person’s claims history to draw up a list of all diagnoses received and medical procedures undergone from 2004 to 2009.

Racette and colleagues developed an algorithm using medical history—combined with age, sex, race or ethnicity, and history of tobacco smoking—that correctly identified 73 percent of the people who would be diagnosed with the disease in 2009, and 83 percent of the people who would not.

 

 

Specifically, many of the claims codes that helped predict the disease referred to problems already known to be associated with Parkinson’s such as tremors, posture abnormalities, psychiatric or cognitive dysfunction, gastrointestinal problems, sleep disturbances, fatigue and trauma, including falls. Other factors associated with the disease included weight loss and multiple forms of chronic kidney disease.

Factors that indicated Parkinson’s was unlikely included obesity-related conditions, history of tobacco smoking, cancer, cardiovascular disease, gout, allergy, and injuries related to physical activity such as hip replacement, osteoarthritis, and carpal tunnel syndrome.

“We want to be able to catch people as early as possible,” Racette says. “If I know someone may be in the beginning stages of Parkinson’s disease, I would evaluate their gait and balance to determine if they have unrecognized impairments that could lead to falls, or whether they have difficulty performing activities of daily living. Either of these scenarios may benefit from treatment.”

In the 18 months before diagnosis, people eventually diagnosed with Parkinson’s endured a flurry of doctor’s visits and medical tests. Most likely, their symptoms were worsening, and their doctors were running test after test, looking for the cause, says Racette. Using this algorithm potentially could help reduce unnecessary tests and speed the process of diagnosis, he says.

How to prevent sudden cardiac arrest

 

 

 

Sudden cardiac arrest (SCA) is a condition in which the heart suddenly and unexpectedly stops beating. If this happens, blood stops flowing to the brain and other vital organs.

Ways to prevent death due to SCA differ depending on whether:

You’ve already had SCA You’ve never had SCA but are at high risk for the condition You’ve never had SCA and have no known risk factors for the condition

For People Who Have Survived Sudden Cardiac Arrest

If you’ve already had SCA, you’re at high risk of having it again. Research shows that an implantable cardioverter defibrillator (ICD) reduces the chances of dying from a second SCA.

An ICD is surgically placed under the skin in your chest or abdomen. The device has wires with electrodes on the ends that connect to your heart’s chambers. The ICD monitors your heartbeat.

If the ICD detects a dangerous heart rhythm, it gives an electric shock to restore the heart’s normal rhythm. Your doctor may give you medicine to limit irregular heartbeats that can trigger the ICD.

Implantable Cardioverter Defibrillator

The location of an implantable cardioverter defibrillator in the upper chest. The electrodes are inserted into the heart through a vein.

The illustration shows the location of an implantable cardioverter defibrillator in the upper chest. The electrodes are inserted into the heart through a vein.

An ICD isn’t the same as a pacemaker. The devices are similar, but they have some differences. Pacemakers give off low-energy electrical pulses.

They’re often used to treat less dangerous heart rhythms, such as those that occur in the upper chambers of the heart. Most new ICDs work as both pacemakers and ICDs.

For People at High Risk for a First Sudden Cardiac Arrest

If you have severe coronary heart disease (CHD), you’re at increased risk for SCA. This is especially true if you’ve recently had a heart attack.

Your doctor may prescribe a type of medicine called a beta blocker to help lower your risk for SCA.

Your doctor also may discuss beginning statin treatment if you have an elevated risk for developing heart disease or having a stroke. Doctors usually prescribe statins for people who have:

Diabetes Heart disease or had a prior stroke High LDL cholesterol levels

Your doctor also may prescribe other medications to:

Decrease your chance of having a heart attack or dying suddenly. Lower blood pressure. Prevent blood clots, which can lead to heart attack or stroke. Prevent or delay the need for a procedure or surgery, such as angioplasty or coronary artery bypass grafting. Reduce your heart’s workload and relieve coronary heart disease symptoms.

Take all medicines regularly, as your doctor prescribes. Don’t change the amount of your medicine or skip a dose unless your doctor tells you to.

You should still follow a heart-healthy lifestyle, even if you take medicines to treat your coronary heart disease.

Other treatments for coronary heart disease—such as percutaneous coronary intervention, also known as coronary angioplasty, or coronary artery bypass grafting—also may lower your risk for SCA. Your doctor also may recommend an ICD if you’re at high risk for SCA.

For People Who Have No Known Risk Factors for Sudden Cardiac Arrest

CHD seems to be the cause of most SCAs in adults. CHD also is a major risk factor for angina (chest pain or discomfort) and heart attack, and it contributes to other heart problems.

Following a heart-healthy lifestyle can help you lower your risk for CHD, SCA, and other heart problems. A heart-healthy lifestyle includes:

Heart-healthy eating Aiming for a healthy weight Managing stress Physical activity Quitting smoking How Islamophobia overlaps with racism

 by Amy McCaig-Rice University

 

 

 

A new paper argues that Islamophobia represents a form of racism mixed with cultural intolerance, rather than just an issue of religious intolerance.

“We often hear that because Muslims are not a race, people cannot be racist for attacking Muslims. This argument does not stack up.”

Author Craig Considine, a lecturer in sociology at Rice University, reviewed more than 40 news articles and referenced dozens of academic studies relating to the experiences of American Muslims and the stereotypical depictions