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Hopkins News For You
This is a service for our friends around the world from Johns Hopkins International. To receive reports, please contact us at patientnewsletter@jhmi.edu.
November 2004
Weekend Use As Good as Daily Drops for Lazy Eye
John McDonald, Christopher Reeve physician, Joins Hopkins Faculty
An Alternative to Angiography?
New Program Channel Creates Healing Environment
Is it Heartburn or a Heart Attack?
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Weekend Use As Good as Daily Drops for Lazy Eye
Adults who give eye drops daily to correct a child's "lazy eye" or amblyopia, should take note: A new study from Johns Hopkins and 29 other centers across North America finds that giving the drops just twice during the weekend is as effective as administering them every day of the week. The investigators concluded "there is no obvious advantage to the daily administration of atropine eye drops in either the speed or magnitude of improvement after four months of treatment," says pediatric ophthalmologist Michael Repka, M.D., lead author of the study.
"The daily burden of administering drops usually falls on the parent, and if weekend eye drops are a good option, the regimen not only relieves some of this burden but may also encourage compliance with the treatment," Repka adds. "Compliance is very important, since timely and successful treatment for amblyopia in childhood can prevent lifelong visual impairment."
John McDonald, Christopher Reeve physician, Joins Hopkins Faculty
For years, Hopkins has been on the cutting-edge of spinal cord and paralysis research and clinical treatment. Now, with the addition of John McDonald III, M.D., Ph.D., the pace of that research and treatment will increase dramatically. McDonald, who treated the late actor Christopher Reeve, is leading an exciting initiative on spinal cord and paralysis recovery headquartered at the Kennedy Krieger Institute, an affiliate of Johns Hopkins specializing in children's developmental disabilities. He also holds appointments in Neurology, Neuroscience and Physical Medicine and Rehabilitation at Johns Hopkins School of Medicine.
Dr. Mcdonald will see children, adolescents and young adults with acute and chronic injuries-from trauma, birth defects or disease. McDonald uses what he calls “activity-based restoration therapies” to treat patients with spinal cord injury. He has discovered that the central nervous system often holds the keys to recovery, and that progress can be made many years after injury.
An Alternative to Angiography?
Each year, millions of people go to emergency rooms with chest pain. To find out if the patient has a heart problem, doctors order several tests including angiograms, in which dyes are injected in the arteries. Even after the tests, “we often still don’t know whether the patient has coronary artery disease,” says Hopkins cardiologist Joao Lima.
To get clearer pictures of the heart vessels, Lima and his colleagues are now using a new 32-slice CT scanner--the only 32-slice machine currently in use in the U.S.--to get high-resolution, three-dimensional images. The CT gives transparent views through different layers of vessels, allowing doctors to detect obstructions and evaluate the density of the plaque, and whether a vessel may rupture. To find out if the multislice CT can replace angiography, the standard tool to diagnose coronary artery disease, future studies will compare the scanner with angiograms done on the same patients.
New TV Channel Creates Healing Environment
The Johns Hopkins Hospital is adding a new channel to the hospital's inpatient television system that administrators and doctors believe will create a more healing environment for patients, families, and staff. The programming provides uninterrupted music as an environmental tool to enhance and promote healing. Paced for time of day and night, the programming provides a special midnight star field for overnight broadcast. Many hospitals using this system have reported reductions in the use of pain medication, restraints, and better quality of rest for patients. They have also noted lower noise levels on the nursing units and an increase in patient and staff satisfaction due to lower stress levels.
Is It Heartburn or a Heart Attack?
Digestive disorders were once believed to stem from heart problems. This explains why the misnomer "heartburn" is used to describe a burning sensation in the chest caused by gastroesophageal reflux. In fact, because heartburn and a heart attack can both cause chest pain, these two conditions can often be confused. Even more confusing is the fact that people over 40 are at higher risk of suffering from both conditions, and both conditions can be induced by physical exertion. Furthermore, some medications used to treat heart problems -- particularly calcium channel blockers -- can relax the lower esophageal sphincter and make heartburn more severe. Always seek medical help if you believe you may be having a heart attack. In general, heartburn and a heart attack can be differentiated by the following symptoms:
Heart Attack
• Feeling of pain, squeezing, fullness, or pressure in center of chest lasting longer than a few minutes.
• Pain radiating into the shoulder, arm, or jaw, particularly on left side of body.
• Chest pain accompanied by shortness of breath, cold sweat, nausea, fainting, dizziness or paleness.
• Palpitations or an increase in heart rate.
• Fatigue, weakness or anxiety of unknown cause.
Heartburn
• Burning feeling behind breastbone or ribs that may travel into neck and throat.
• Bitter or acidic taste in mouth associated with acid regurgitation.
• Pain typically occurs 1 to 4 hours after a meal and subsides after a few minutes of antacid treatment.
• Belching or difficulty swallowing.
• Symptoms can be brought on or exacerbated by lying down or bending over.
• Symptoms are rarely accompanied by a cold sweat.
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