Lab notes

Preventing strokes

A nationwide stroke prevention study shows that medication and lifestyle changes remain safer and more effective at preventing strokes than stenting in patients with narrowed brain arteries. The study analyzed long-term health outcomes from a multicenter clinical trial, which included UF Health researchers Brian Hoh, M.D., the James and Newton Eblen associate professor of neurosurgery, radiology and neuroscience, and Michael Waters, M.D., Ph.D., an assistant professor of neurology and neuroscience and UF Health Stroke Program director. The findings appeared in The Lancet. Nearly 800,000 people suffer a stroke each year, and about 10 percent of those strokes result from a narrowed artery inside the brain. The new guidelines restrict use of this stent to patients with at least a 70 percent blockage who already have had two previous strokes while on aggressive medical management. — Melissa Lutz Blouin

Saving babies

UF Health pediatric surgeons have published results from nearly 20 years of treating children with congenital diaphragmatic hernia, showing the highest published survival rate for a large-group study. The findings also present new data for determining when a baby’s hernia should be surgically repaired. Congenital diaphragmatic hernia occurs when one of the diaphragm muscles does not develop fully during gestation. Abdominal organs migrate into the chest, crowding the heart and lungs and impeding lung development. The best modern estimate of survival at U.S. centers that treat CDH patients is 67 percent. In the period from 1992 to 2011, 88 percent of CDH babies treated at UF Health who did not have lethal associated defects, often cardiac or neurological defects, lived to be released from the hospital. An article in the October issue of the Annals of Surgery describes the UF Health team’s methods and results, achieved under the leadership of David Kays, M.D. — Laura Mize

Circumcision in older boys

Circumcisions in Florida boys over the age of 1 have increased dramatically in recent years, doubling costs to the state, according to a UF Health study appearing in The American Surgeon. Saleem Islam, M.D., an associate professor in the College of Medicine department of surgery, said he and his collaborators believe the state’s decision to terminate Medicaid funding for routine circumcisions in babies under 1 month old has led to the increase in circumcisions for older boys. Because newborns require only local anesthesia for a circumcision, newborn circumcisions are safer and much less expensive. They also have a lower risk of complications. Circumcising older boys requires general anesthesia to ensure the patient remains still during the procedure. Florida was one of numerous states to stop Medicaid coverage for routine newborn circumcisions after a 1999 report from the American Academy of Pediatrics said the procedure may not be medically necessary. The AAP reversed its stance in 2012.  — Laura Mize

Parkinson’s and dementia

Rates of dementia among people with Parkinson’s disease are higher than the general population, with 25 to 40 percent of patients expected to eventually develop dementia. Now, UF has received a $2.1 million National Institutes of Health grant to use brain imaging to better understand different types of cognitive difficulties that affect patients with Parkinson’s. While Parkinson’s disease is commonly known as a movement disorder characterized by tremors and muscle rigidity, there is a growing recognition of an associated risk of cognitive problems. “Individuals with Parkinson’s disease often develop slower thinking speed. This is the cognitive hallmark of Parkinson’s disease,” said Catherine Price, Ph.D., the grant’s lead investigator and an associate professor in the UF College of Public Health and Health Professions. — Jill Pease