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Study Links Recurrence Of Abnormal Cervical Cells To Age, Treatment Type
Older women, women with a higher grade of precancerous cells and women who undergo a freezing procedure known as cryotherapy to remove abnormal cervical cells are at a higher risk than other groups that the problem cells will return or develop into cervical cancer, according to a study published in the Journal of the National Cancer Institute, Reuters reports. For the study, Joy Melnikow of the University of California-Davis and colleagues compared 37,000 women who were treated for cervical intraepithelial neoplasia -- abnormal cervical cells -- from 1986 through 2000 with 71,000 women who had no history of abnormal cervical cells.The researchers found that the risk of cervical cancer and recurrence of medium to severe degrees of CIN was highest for women who were older than age 40, who had been previously treated for severe CIN or whose abnormal cells were treated using cryotherapy. The women underwent cone biopsies a surgical procedure to remove abnormal cells were least likely to have a recurrence of CIN. According to Melnikow, recurrence was most likely to occur within the first six years after treatment. Melnikow said that women who have been treated surgically have higher risks of bleeding and preterm labor. Therefore, younger women who are planning to become pregnant might prefer cryotherapy, she said, adding that younger women"s "risk of recurrence is lower, and a recurrence can be treated again" (Steenhuysen, Reuters, 5/12).

Early Screening Reduces Disparities For Prostate Cancer
Men who have a regular, ongoing relationship with a health care provider are more likely to receive prostate cancer screening and less likely to be diagnosed with advanced prostate cancer, regardless of their race, according to a University of North Carolina study published in the current issue of the journal Cancer.
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Complaints Of Fatigue And Tiredness In People With OSA Improve With CPAP Treatment
A study in the June 15 issue of the Journal of Clinical Sleep Medicine shows that the complaints of fatigue and tiredness in patients with obstructive sleep apnea (OSA) improved significantly with good adherence to continuous positive airway pressure (CPAP) therapy, suggesting that - like the symptom of excessive daytime sleepiness - these complaints are important symptoms of OSA.
Mental Health

New Medicare Nursing Home Guidance To Include Quality Of Life And Environment Requirements

The Centers for Medicare & Medicaid Services (CMS) issued new guidance for nursing home surveyors, further defining and clarifying several important dimensions of care to help improve nursing home residents" quality of life and environment. Beginning June12, 2009, nursing home surveys will be conducted with a sharpened focus on resident rights in key areas such as: - Ensuring they live with dignity; - Offering choices in care and services; - Accommodating the environment to each of their needs and preferences; and - Creating a more homelike environment - including access for visitors. Currently, nearly 1.5 million individuals live in approximately 15,800 nursing homes on any given day, and about 3 million people will spend some time in a nursing home each year. "These groundbreaking revisions matter in the daily lives of people who live in the nation"s long-term care facilities," said CMS Acting Administrator Charlene Frizzera. "The improvements in the guidance are intended to support efforts underway to transform nursing homes into environments that are more like their homes through both environmental changes and resident-centered caregiving." The new guidance also calls on nursing homes to de-institutionalize their physical environments. The guidance highlights institutional practices that facilities should strive to eliminate including meals served on institutional trays and noise from overhead paging systems, alarms and large nursing stations. A homelike environment is not achieved simply through enhancements to the physical environment, according to the new guidance. It concerns striving for person-centered care that emphasizes individualization, relationships, and a psychological environment that welcomes each resident and offers comfort. The guidance also makes clear that residents have the right to choices concerning their schedules -consistent with their interests, assessments, and plans of care. Choice over schedules includes, but is not limited to, those matters that are important to the resident, such as daily waking, eating, bathing, and going to bed at night. The facility should gather this information in order to be proactive in assisting residents to fulfill their choices. CMS inspects nursing homes periodically to ensure they meet the federal regulations requiring that each resident receive good quality care in a home that also provides good quality of life. CMS provides guidance, such as today"s release, to help surveyors interpret those regulations. The new guidance provides a substantial roadmap for environmental and culture change in nursing homes, while noting that some facilities are further along than others. As noted in the guidance: "many facilities cannot immediately make these types of changes, but it should be a goal for all facilities that have not yet made these types of changes to work toward them." The guidance can be found here. Centers for Medicare & Medicaid Services


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