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Study of 17 million confirms factors that make COVID-19 more likely to kill

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Risk factors associated with COVID-19 death, based on analyses of full pseudonymized health records of 17 million adults in England, are reported in Nature. The study provides detailed information on the size of the risk associated with various pre-existing medical conditions, such as diabetes and obesity. Consistent with previous work, it also indicates higher risk of death from COVID-19 for men, older people and people with greater deprivation. Black and Asian people were also found to be at a higher risk of death; however, contrary to prior speculation, this increased risk was only partially attributable to pre-existing clinical risk factors and deprivation.

Ben Goldacre, Liam Smeeth and colleagues developed OpenSAFELY, a secure analytics platform that incorporates pseudonymized data for 40% of all National Health Service (NHS) patients in England. Among the electronic health records of 17,278,392 adults, there were 10,926 deaths in and out of hospital that were linked to COVID-19. This is a substantial expansion of the authors’ initial findings on factors associated with 5,707 deaths in hospital, which were released to a preprint in May.

In line with previous studies, men had a greater (1.59-fold-higher) risk of COVID-19-related than women, and age was also found to be a risk factor—people aged 80 or above had a 20-fold-increased risk compared to 50–59-year-old people, for example. Black and South Asian people, and those of mixed background, were 1.62–1.88 times more likely to die with COVID-19 than white people, after taking into account their prior . The most deprived people in the cohort were 1.8 times more likely than the least deprived to die with COVID-19; clinical factors made only a small contribution to this risk, suggesting that social factors have a role.

Pre-existing medical conditions—including obesity (especially a BMI of over 40),

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Sjögren’s research explores genetic link to dry mouth, other saliva issues

Blake Warner, D.D.S., Ph.D., M.P.H., studies disorders that affect our salivary glands, including Sjögren’s syndrome. Sjögren’s syndrome is an autoimmune disease, which means that it causes your immune system to attack healthy cells in your body by mistake.

The condition can damage glands that make saliva, or spit. It can also cause dry mouth, loss of taste, swollen glands, and more.  

Dr. Warner works at the National Institute of Dental and Craniofacial Research (NIDCR), where he helps oversee research on Sjögren’s syndrome. He and his research team at NIDCR want to better understand what causes this disease so they can improve the quality of life of people who have it.

Why did you decide to study Sjögren’s syndrome?

During my residency, I worked in a clinic with patients with Sjögren’s syndrome and other complications. Despite helping patients understand their condition, I felt compelled to find ways to better treat or prevent this condition. By pursuing clinical research, I could play a more active role in improving the lives of people with Sjögren’s syndrome.

What led to your current research on the topic?

“Living with Sjögren’s syndrome can be easier if you maintain good health habits.”

– Blake Warner, D.D.S., Ph.D., M.P.H.

Years of development and testing of therapies have led to few successes in the management of the main symptoms of Sjögren’s syndrome. These setbacks may be due in part to the variability of Sjögren’s syndrome.

At NIDCR, we have a more than 35-year history of Sjögren’s syndrome research in patients. Studying patients both at baseline and over long periods of follow-up can help us better understand distinct groups of patients with the disease and understand the underlying cause of the disease, with the goal of discovering better treatments.

Could you talk about the research you’re conducting?

Our research team

Health Life

Electronic health records fail to detect many medication errors

(HealthDay)—There is wide variation in the safety performance of electronic health record (EHR) systems used in U.S. hospitals, according to a study recently published in JAMA Network Open.

David C. Classen, M.D., from the University of Utah in Salt Lake City, and colleagues used data from the National Quality Forum Health IT Safety Measure EHR computerized physician order entry test administered by the Leapfrog Group (2009 to 2018) to assess EHR safety performance in U.S. adult hospitals. The Health IT Safety Measure test used simulated medication orders known to have either injured or killed patients to assess how well hospital EHR systems can identify medication errors associated with potential harm.

The researchers found that during the 10-year study period, mean overall test scores increased from 53.9 to 65.6 percent. For the categories representing basic clinical decision support, the mean score increased from 69.8 to 85.6 percent. The mean score also increased for advanced clinical decision support categories (29.6 to 46.1 percent). Test performance varied by EHR vendor.

“These systems meet the most basic safety standards less than 70 percent of the time,” the researchers conclude. “These systems have only modestly increased their safety performance during a 10-year period, leaving critical deficiencies in these systems to detect and prevent critical safety issues.”

Electronic health records fail to detect up to 33% of medication errors

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A personal approach to stroke treatment

Gregory Symko, D.C., is a chiropractor who specializes in helping people with brain issues related to stroke. He helps them improve their hand-eye coordination and balance issues, working with their arms, legs, or hands.

Dr. Symko also brings a unique perspective to his work: He is a stroke survivor.

Firsthand experience

When he was 40 years old, Dr. Symko had a stroke, which he later learned had been a series of five mini-strokes.

“I realized that if I could do brain-based therapy for myself, I could help other stroke victims recover.”

– Gregory Symko, D.C.

Dr. Symko’s stroke left him unable to see, eat, or walk. Something as simple as raindrops or wind on his hand would cause severe pain, and he had to wear gloves to help prevent it.

“It was terrible,” he recalls. “I had extreme burning in my arm, leg, and face.”

His symptoms became worse over time. In addition to pain and numbness, he also had vertigo, which makes you feel like you are spinning. This caused severe balance issues. He also couldn’t focus his eyes on anything.

“When you have a stroke, your brain gets confused,” he says. “Parts of your brain that deal with your sense of touch can get messed up.” For example, his left arm was numb, but he experienced extreme pain in his right arm.

Hard work pays off

For a few years, Dr. Symko couldn’t do anything on his own and had to get help from his wife, family, and health care professionals.

But after three years of hard work with physical therapists and occupational therapists, and on his own, Dr. Symko was able to go back to work—just not as a chiropractor. He worked at a pharmaceutical company and continued to take care of himself by eating well, exercising