News in brief - Oct. 20, 2003

Neurologists issue guideline for Guillain-Barré - New organ donation campaign launched - SARS virus capable of quick change - Hands-on exam key to care of hospitalized patients

Neurologists issue guideline for Guillain-Barré

Treating patients with Guillain-Barré syndrome within two to four weeks after the first symptoms appear can speed up recovery time, according to a new guideline developed by the American Academy of Neurology.

The syndrome, an autoimmune disease, causes rapid onset of weakness and often paralysis of the legs, arms and breathing muscles. It is the most common cause of rapidly acquired paralysis in the United States, affecting between one and four people in every 100,000 each year.

The guideline also determined that two treatments -- plasma exchange and intravenous immunoglobulin -- are equally effective for adults with severe, early GBS. These treatments could also be considered for treating children with severe GBS.

There was no benefit from combining the two treatments or in using one treatment after the other, according to the guideline. A third treatment, corticosteroids, or cortisone, was not found to be beneficial and was not recommended in treating GBS patients.

New organ donation campaign launched

A national year-long education campaign to promote organ donation among U.S. minority communities was recently launched as a joint venture by many of the nation's transplant and minority medical organizations.

Former NBA star and ESPN/ABC commentator Sean Elliott, the recipient of a live donor kidney, is the national spokesman for the Closing the Gap public education campaign. The campaign will emphasize the unique health needs of minorities, encourage families to discuss donations and urge the protection of health to avoid the need for a future transplant.

The National Medical Assn., one of the sponsors of the campaign, will distribute materials to family practice physicians in minority communities; health clinics and hospitals that have transplant programs; and churches.

The campaign is being led by the American Society of Minority Health and Transplant Professionals and was announced on Sept. 26 at the group's 11th annual meeting in San Antonio.

SARS virus capable of quick change

The coronavirus that causes severe acute respiratory syndrome is capable of rapid, unpredictable change, according to a paper published in Infections, Genetics and Evolution last month.

Researchers at the University of Michigan, Ann Arbor, studied several proteins from known coronaviruses and found evidence that the virus alters itself depending on its current host. Authors of the paper said that this may mean that developing drugs and vaccines to deal with SARS may be extremely challenging.

"Demonstration of recombination in the SARS-CoV lineages does indicate its potential for rapid, unpredictable evolutionary change, and this is a potentially important challenge for public health management and for drug and vaccine development," said David Mindell, PhD, an author on the paper and an associate professor in the department of ecology and evolutionary biology.

Hands-on exam key to care of hospitalized patients

A bedside physical examination by a skilled clinician can improve patient safety, accuracy of diagnosis and decisions about the course of treatment, according to a study published in The Lancet this month.

A physician at what was then known as Cook County Hospital in Chicago performed physical exams on 100 patients who had already been admitted and who had already been diagnosed by another doctor. More than a quarter of patients had their clinical management changed significantly by the hands-on exam, but less than half of those would have been discovered by subsequent diagnostic testing.

The author suggested that this demonstrates the value of the physical exam, despite significant advances in other diagnostic technology.

"Physical examination can have a substantial effect on the care of medical inpatients," wrote Brendan Reilly, MD, author of the paper and chair of the department of medicine at Cook County. "If replicated in other settings, these findings might have important implications for medical educators and quality improvement initiatives."