New, More Accessible Staging System Developed to Predict Survival for Patients with Light Chain AmyloidosisDecember 31, 1969
(Boston) – A new staging system developed with a more accessible test to predict the chance of survival in patients living with light chain (AL) amyloidosis. Led by researchers from the Amyloidosis Center at Boston Medical Center (BMC) and Boston University School of Medicine, the test incorporates cardiac biomarkers to accurately identify the involvement of the heart in the disease, allowing doctors to predict outcomes of patients with AL amyloidosis.
AL Amyloidosis is a rare condition caused when bone marrow produces abnormal antibodies that can’t be broken down and are deposited in tissues, interfering with organ function. Survival for patients with AL amyloidosis is related to cardiac involvement, making cardiac biomarkers an accurate measure for staging for risk stratification.
BMC researchers created the new brain natriuretic peptide (BNP)-based staging to align with current staging systems that use another test, called N-terminal pro-brain natriuretic peptide (NT-proBNP). The NT-proBNP testing method is not available at all medical centers; however, BNP testing is available at these academic facilities, making the new Boston University (BU) biomarker score a viable option for hospitals seeing patients with AL Amyloidosis.
The researchers analyzed data from 250 participants who had received both tests during their evaluation at the Amyloidosis Center between April 2016 and September 2016. The study, published in Blood, Journal of the American Society of Hematology, found that the BU biomarker system accurately identified cardiac involvement and separated patients into survival stages equivalent with current systems.
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“Our goal in creating the BU biomarker score and staging system was to increase access to appropriate staging systems at hospitals that are not able to perform NT-proBNP testing,” said Vaishali Sanchorawala, MD, senior author and director of the Amyloidosis Center at BMC and BUSM. “Despite being a rare disease, it is vital that all patients with AL amyloidosis are given the best chance at effective treatment and ultimately, survival.”
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Boston Medical Center Receives an ‘A’ for Patient Safety in Fall 2018 Leapfrog Hospital Safety GradeDecember 31, 1969
(Boston) – Boston Medical Center (BMC) has earned an ‘A’ for patient safety from The Leapfrog Group’s Fall 2018 Hospital Safety Grade. The designation recognizes BMC’s efforts in protecting patients from harm and meeting the highest safety standards in the United States.
“Boston Medical Center providers and employees are dedicated to delivering exceptional care without exception and this grade reflects our mission to be a high value, high quality provider for our patients.” says James Moses, MD, Chief Quality Officer at BMC. “Patient safety is at the heart of our work, and we are proud to be recognized as a leader in the field.”
“Leapfrog’s Hospital Safety Grades recognize hospitals like Boston Medical Center that focus on advancing patient safety. This ranking provides an important resource for patients, and a benchmark for hospitals, to determine how care at one hospital compares to others in a region,” said Leah Binder, president and CEO of The Leapfrog Group. “Hospitals that earn an A Hospital Safety Grade deserve to be recognized for their efforts in preventing medical harm and errors.”
Developed under the guidance of a National Expert Panel, the Leapfrog Hospital Safety Grade uses 28 measures of publicly available hospital safety data to assign grades to more than 2,600 U.S. hospitals twice per year. The Safety Grade assigns an A, B, C, D or F grade to hospitals across the country based on their performance in preventing medical errors, infections and other harms among patients in their care. The Hospital Safety Grade’s methodology is peer-reviewed and fully transparent, and the results are free to the public.
BMC was one of 855 across the United States awarded an A in the Fall 2018 update of grades. To see BMC’s full grade details visit www.hospitalsafetygrade.org.
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Multidisciplinary Lung Care at Boston Medical Center
Often, people with early-stage lung cancer have no symptoms. A lung cancer screening is a chest scan to look for signs of lung cancer. Former and current smokers who are most at risk for developing lung cancer should be screened in order to have a better chance of being diagnosed at an early and more curable stage. To find out if you are a candidate for a lung screening, call 617.414.9729 or visit https://www.bmc.org/lung-screening. Watch this video to learn more.
If your child needs help with substance use, support is available
The Grayken Center for Addiction at Boston Medical Center and the Partnership for Drug-Free Kids have teamed up to provide Massachusetts families with the support and information they need to help address a child’s substance use, whether your son or daughter is a teenager living at home or a young adult living independently.
Please go to https://graykenaddictionsupport.org for more information.
Movement disorders don’t have to slow your children down
Movement disorders don’t have to slow your child down. If your child is experiencing movement symptoms that you don’t think are normal it’s important to talk to your child’s pediatrician. The pediatrician will listen to your concerns and examine your child. Then, you might need to take your child to a pediatric neurologist.
A pediatric neurologist is a doctor who specializes in children’s nervous systems. Issues with movement can be related to the nervous system and can mean the child is moving too much or too little in a way that interferes with the normal flow of movements and postures. Movement disorders can be common in babies and school-aged children.
There are many causes of movement disorders including structural damage to the brain, medications, infections, autoimmune conditions, and disorders that are inherited. Some movement disorders are caused by a disease or condition while others are not.
Given that movement disorders in children are so common, it is a surprise that this area of specialization has been slow to develop and has attracted so few pediatric neurologists with the commitment and expertise needed to advance care. At BMC, our Pediatric Movement Disorder Clinic is led by Patrick Mabray, MD, who diagnoses and treats these disorders. Dr. Mabray brings both his passion and innate sensitivity to the table when addressing the needs of BMC’s children and their families.
Though tics and Tourette’s are perhaps some of the most common movement disorders, Dr. Mabray and his team also treats tremors, dystonia, and ataxia, among others. Beyond this, our pediatric movement disorders care unites with the equivalent adult programs to create the ability to offer continuous care across life’s stages.
If you believe your child could benefit from seeing a movement disorder specialist, talk with your child’s pediatrician. With a referral, your child can be seen in 1-2 weeks. Or, to book an appointment for your child, please call 617.414.4841 or visit www.bmc.org/pedineurology.
Back Pain Shows Significant Association with Mortality among Older WomenDecember 31, 1969
(Boston) - Researchers at Boston Medical Center found that frequent, persistent back pain is associated with earlier death in a study of more than 8,000 older women who were followed for an average of 14 years. After controlling for important sociodemographic and health factors, women who reported frequent, persistent back pain had a 24 percent increased risk of death compared to women with no back pain. Published in The Journal of General Internal Medicine, the study is the first to measure the impact of back pain persisting over time on mortality. The researchers also found that disability measured after back pain helped explain the association.
Back pain is the leading cause of disability worldwide, and women aged 40-80 years have the highest prevalence of back pain. Also, women report more frequent and debilitating back pain compared to men. The proportion of adults over the age of 65 is increasing rapidly in the United States, and optimizing physical health in order to extend life for older adults is a well-documented public health goal.
“To our knowledge, our study is the first to measure disability after measurement of back pain. This allowed for a prospective analysis of back pain that persisted over time and later rates of disability, which may help explain the association between back pain and mortality,” said Eric Roseen, DC, MSc, a research fellow at Boston Medical Center and leading author of the study. “Our findings raise the question of whether better management of back pain across the lifespan could prevent disability, improve quality of life, and ultimately extend life.”
After taking baseline measurements of back pain, researchers followed up with participants two years later and measured back pain again. In year four, participants were asked about and observed doing common activities of daily living. The study found that disability following the measurements of back pain explained much of the association with mortality.
Specifically, difficulty performing one or more basic daily activities, like walking short distances or meal preparation, explained nearly half (47 percent) of the effect of frequent persistent back pain on mortality. Slow performance on more objective measures, like observed walking speed or repetitive standing up from a chair, each explained about a fourth of this association (27 percent and 24 percent, respectively). Of 8,321 women in the study, 56 percent died over a median follow up of 14.1 years. A higher proportion of women with frequent persistent back pain died (65.8 percent) than those with no back pain (53.5 percent).
While the study’s findings are consistent with prior studies that found older women with daily or disabling back pain had elevated mortality risk, why this association occurs remains unclear.
“Back pain may directly impair daily activities, but older adults could inappropriately avoid them due to fear of re-injury or worsening of symptoms. Being unable to perform, or avoiding, daily activities could lead to weight gain, development or progression of other chronic health conditions, and ultimately earlier death,” said Roseen.
These results lay the foundation for future studies to assess the long-term impact of back pain treatments and self-care strategies. Clinicians should assess physical function in older adults with back pain and recommend guideline-based management, which encourages use of less invasive treatments.
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