Latest news with #UCSanDiegoHealth
NDTV
13-05-2025
- Health
- NDTV
Promising New Drug Could Cut Blood Pressure In Weeks, Scientists Find
Scientists have discovered a promising new drug that could cut high blood pressure by 15 points in patients within a few days of its administration. As per researchers at the University of California, San Diego, the wonder drug, named lorundrostat, could treat uncontrolled or treatment-resistant hypertension. The researchers enrolled 285 participants, including patients from UC San Diego Health, for the Phase II, multicentre clinical trial, conducted across the US. The findings showed that those who received lorundrostat experienced a 15-point reduction in systolic blood pressure, compared to a seven-point drop in those given a placebo. "At four weeks, 42 per cent of those taking lorundrostat had their blood pressure under control, compared with 19 per cent in the placebo group," the study highlighted. Luke Laffin, MD, cardiologist at Cleveland Clinic and the study's first author, said lorundrostat managed to effectively lower the blood pressure with an "acceptable side effect profile". "This drug could be another tool in our armamentarium to reduce blood pressure and, ultimately, reduce the risk from uncontrolled hypertension in terms of outcomes like strokes, heart attacks and heart failure," said Mr Laffin. Lorundrostat's success The researchers stated that the side effects experienced by patients were consistent with other drugs that work using a similar mechanism. "Some participants saw an increase in potassium in the blood and some experienced a decrease in glomerular filtration rate, a measure of kidney functioning." High blood pressure, or hypertension, is one of the leading causes of heart disease and related deaths across the globe. Lorundrostat is a new class of blood pressure medication called aldosterone synthase inhibitor (ASI) that is designed to work by disrupting the production of aldosterone -- a hormone that can contribute to hypertension. While scientists are building on the success of the study, another pivotal lorundrostat trial is currently underway with results expected later this year.
Yahoo
24-03-2025
- Health
- Yahoo
San Diego health system first in state to get top certification in spine surgery
SAN DIEGO (FOX 5/KUSI) — A local health system has earned a prestigious certification for advancements in spine surgery again after becoming the first in California to do so in 2022. UC San Diego Health was once again awarded The Joint Commission's Gold Seal of Approval for Advanced Certification in Spine Surgery (ACSS), the organization announced Monday. San Diego mulls first-of-its-kind law on digital coupons at grocery stores The announcement came three years after it became the first health organization in the Golden State to receive the designation. 'The Joint Commission's renewal of this advanced certification confirms our well-earned and sustained national prominence in spine care,' said Patty Maysent, CEO of UC San Diego Health. In order to qualify for the ACSS, health organizations must demonstrate their success in several metrics, including their adherence to evidence-based care protocols and clinical practice guidelines. They must also participate in the American Spine Registry. In addition, health systems must track and report key performance metrics such as surgical site infection rates and pre-and post-operative patient-reported outcomes. San Diego's 'hotel room tax' increases soon UC San Diego Health also underwent a rigorous review as part of its designation process. Last December, a Joint Commission reviewer came to UC San Diego Health unannounced and evaluated the organization for its compliance with several certification standards, including the ones reported above. The reviewer also conducted onsite observations and interviews. 'From minimally invasive robotic surgery to complex spinal reconstructions, our multidisciplinary team combines advanced surgical techniques and leading-edge research to ensure patients receive the best possible care, improving mobility and quality of life,' said Alexander Khalessi, chair of the Department of Neurological Surgery at UC San Diego Health. 'As one of the nation's leading centers, our teams continue to set the standard.' UC San Diego Health is the county's first Level 1 Trauma Center and the only health system in the county to have two Comprehensive Stroke Centers. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
New York Times
12-03-2025
- Health
- New York Times
Don't Underestimate the Risks of Benzodiazepines
Victoria Ratliff, the wealthy financier's wife on season 3 of HBO's 'The White Lotus,' has a problem: She keeps popping pills. And her drug of choice, the anti-anxiety medication lorazepam, has left her a little loopy. In the show, which follows guests vacationing at a fictional resort, Victoria pairs her medication with wine, which leads her to nod off at the dinner table. Sometimes she slurs her words. When she notices that her pill supply is mysteriously dwindling, she asks her children if they're stealing them. 'You don't have enough lorazepam to get through one week at a wellness spa?' her daughter, Piper, asks. 'The White Lotus' is not the only show to recently feature these drugs. The new Max series 'The Pitt,' which takes place in an emergency department, includes a story line about a benzodiazepine called Librium. This isn't a case of Hollywood taking dramatic liberties. Benzodiazepines such as lorzepam and chlordiazepoxide are notorious for having the potential to be highly addictive. They may also come with difficult — sometimes fatal — withdrawal symptoms. The characters' misuse of benzodiazepine drugs is not uncommon, said Dr. Ian C. Neel, a geriatrician at UC San Diego Health. 'We definitely see that a lot in real life as well.' And in recent years, he added, studies have shown that it's a bigger problem than doctors initially realized. A Widely Misused Collection of Drugs The drugs, which are often called benzos or downers, are commonly used to treat anxiety, panic attacks and sleep disorders like restless leg syndrome. But they can also be used for other reasons, such as to help people manage alcohol withdrawal. Other common benzodiazepines include diazepam (Valium), clonazepam (Klonopin) and alprazolam (Xanax). Unlike antidepressants, which can take weeks to start working, most benzodiazepines can provide relief within minutes — which can comfort nervous fliers and others who need quick anxiety relief for a specific situation. But if taken for longer periods, patients can develop a tolerance within weeks of starting the drug, even when using it as prescribed, said Dr. Ludmila De Faria, chair of the American Psychiatric Association's council on women's mental health. 'That's where people get into trouble,' she added, and start to take more of the medication. 'The same dose will no longer get rid of the symptoms.' In addition, drugs like clonazepam and diazepam last longer in the body than short-acting drugs such as alprazolam. 'People don't realize that,' she said. 'So they take multiple doses and it accumulates,' which can result in people 'walking around like they have a couple of drinks in them.' All of these factors combined have led to the drugs being widely misused. In 2019, the most recent data available, pharmacies dispensed an estimated 92 million benzodiazepine prescriptions, according to the U.S. Food and Drug Administration. Research suggests that the drugs are prescribed most frequently to adults between the ages of 50 and 64. Delirium, Falls and Other Risks In 2020, the F.D.A. updated the information given to prescribers and patients for all benzodiazepines to warn about the risks of physical dependence, withdrawal reactions, misuse, abuse and addiction. Ideally, these dangers are explained to a patient before they take their first pill. But that doesn't always happen. And even if a patient does receive proper counseling, 'it's one thing to say it and then another thing to experience it,' Dr. Neel said. He said he often sees patients who are already taking a cocktail of other medicines and don't understand the dangers of combining benzodiazepines, which are depressants, with other drugs that also have sedating effects, like sleep medicine or Benadryl. And if you're going to drink alcohol or use cannabis, it's best not to have any benzodiazepine in your system. When people combine substances that have a depressant effect, it can even interfere with their breathing. The geriatric population that Dr. Neel treats is especially vulnerable because benzodiazepines are metabolized differently as we age, he added, lingering in the body for a longer period of time. As a result, older people who take them may be more prone to falls or car accidents. The drugs can also cause delirium in patients who have dementia. But the medications can be risky for people of any age, which is why they are typically prescribed for a short period of time — usually four weeks or less — and they are considered a last resort to treat a chronic condition, Dr. Neel said. A Delicate Withdrawal Process A 2019 study found that nearly 20 percent of people who take benzodiazepines misuse them. If someone develops a dependence, quitting can be difficult, in part because of the intense withdrawal symptoms. Those symptoms can include sleep disturbances, irritability, sweating, heart palpitations, elevated blood pressure and stomach problems like dry heaving. Tapering off the drug needs to be done in a gentle way, ideally under the supervision of a doctor. It's 'almost like landing an airplane, where there's a gradual descent,' said Dr. John Torous, a psychiatrist at Beth Israel Deaconess Medical Center in Boston. While this is happening, he added, the patient can try different methods to get more sleep and talk to a therapist about strategies to help manage anxiety. In addition, there are other medications like clonidine, which can be used to treat the anxiety and also help with any withdrawal symptoms. In the end, it's always more effective to try to identify and address the root cause of the anxiety, Dr. Torous added. 'The benzos are giving you rapid relief in the brain but then one day wear off — that rapid relief is gone.'
Yahoo
07-03-2025
- Health
- Yahoo
The best CPAP machine for 2025, according to medical professionals
Worried about looking and sounding like Darth Vader while using a CPAP machine? Fear not — CPAP (continuous positive airway pressure) technology — has come a long way since its inception in the early 1980s. Today's best CPAP machines are much quieter, more comfortable and far less intrusive than you might imagine. "I have tons of patients who tried CPAP five or 10 years ago and failed, but they come back now and do well with it because technology has improved," says Atul Malhotra, MD, pulmonary critical care and sleep medicine specialist and professor of medicine at UC San Diego Health. If you notice signs of sleep apnea, such as loud snoring, restless sleep or feeling tired all the time, it's time to see a doctor. Sleeping well is not only crucial for your mental and physical health, but untreated sleep apnea is linked to serious health issues, including diabetes, stroke and heart problems. Yet the latest numbers show only 1 in 5 Americans with sleep apnea knows they have it. Among the 30 million affected by the condition, just 6 million have been diagnosed, according to 2022 data from the American Medical Association. "The only way to diagnose sleep apnea is through a sleep study, which can be done either at home or overnight in a sleep center," says Sam A. Kashani, MD, board-certified sleep medicine assistant clinical professor at David Geffen School of Medicine at UCLA. Once you're diagnosed, your doctor will discuss sleep apnea treatment options, including possible weight loss or positional therapy, in which a special device helps you snooze on your side. However, the gold standard of sleep apnea treatment remains CPAP. "Any sleep apnea, whether the mildest or the most severe, can be treated with a CPAP," says Kashani. Your doctor will prescribe your CPAP machine with specific settings, especially the crucial pressure level, explains Ronald Chervin, MD, professor of neurology, chief of the division of sleep medicine and director at Sleep Disorders Centers at the University of Michigan. Once your doctor selects the ideal type of machine for your needs, you can go ahead and get your equipment from a medical supplier. "The company who provides the CPAP usually will give you an orientation on how to use it and show you the different options to help you find the most appropriate and most comfortable facepiece," says Kashani. It's essential to be well-informed about your options to advocate for yourself and ensure you get the ideal equipment available, especially when navigating insurance matters. With that in mind, here's a look at some of the best CPAP machines on the market today. Your doctor can help determine which type of sleep therapy device best suits your needs and condition. The main options include: CPAP machines: These are continuous positive airway pressure machines. Standard CPAP machines release air at a fixed pressure while you sleep. Automatic CPAP (APAP): APAP machines deliver auto-adjusting positive airway pressure therapy. The machines use algorithms to adjust pressure to your needs as you sleep. "The advantage is that it may allow you to spend more of the night at a lower pressure than you would otherwise," says Chervin. Bilevel Positive Airway Pressure (BiPAP): BiPaP machines are PAP devices that deliver two different air pressure levels: one for inhaling and one for exhaling. "A BiPAP treats obstructive sleep apnea, plus, if you have issues or difficulty with ventilation, it can help with that," says Chervin. He adds that BiPAP machines may offer more comfort for patients who require very high levels of pressure. Travel CPAP machines: Travel CPAP machines are small, portable and usually not covered by insurance. Beyond size, "the biggest difference might be in the humidification system," says Chervin. "They don't have a humidifier chamber." Instead, travel CPAP machines often use filters for waterless humidification, which can be drying. To find the best CPAP machine for you, consider the following: Sleep apnea severity: "For moderate or severe cases of sleep apnea, treatment is indicated," says Husain. "Your physician will consider options like a dental appliance, nasal sprays or a CPAP machine. Surgery is an option, but typically only after more conservative options have failed, particularly attempts with an oral appliance or CPAP." Travel needs: Insurance often doesn't cover a travel CPAP machine, but if you're a frequent traveler, a smaller, lightweight machine is something to consider. While standard machines can be used for travel, they're more cumbersome. "Remember, CPAP machines are considered necessary medical equipment. In the US, they don't count toward your two-bag carry-on allowance. They're permitted as an additional medical device," says Husain. Mask selection: The options include nasal CPAP masks, which fit over the nose in a triangular or oval shape, and nasal pillow masks, which sit below the nose using silicone "pillows" to create a seal. Finding the right CPAP mask is highly personal and often requires trial and error. "You may have to try them all before you know what you like," says Malhotra. "There's no way to know by looking at a mask whether you'll like a nasal pillow or nasal mask any more than you can decide chocolate or vanilla before you've tried it." However, Husain notes that mouth breathers will need a full face mask. Sound levels: While today's best CPAP machines are relatively quiet, "sometimes the noise, either of a poor fit or the machine itself, can bother your bed partner," says Husain. "Of course, the sound of the machine is much more appealing than the intermittent sound of loud snoring." Humidity control: A CPAP machine's airflow can dry out your nasal passages and airway, making proper humidification essential for comfort. While individual humidity needs vary, a humidifier's water capacity is crucial for users who need higher moisture levels. Most travel machines use filters rather than water chambers for humidification, which can affect moisture delivery. Comfort features: Most machines offer pressure adjustments to help you sleep better. The ramp feature starts with lower pressure and gradually increases to your prescribed level, making it easier to fall asleep. And EPR reduces pressure during exhales, creating a more natural breathing pattern. Cost and coverage: While insurance coverage varies by plan, understanding available machines and features will help you advocate for the best option for you. Standard CPAP machines are typically covered by insurance, but travel models usually require out-of-pocket payment, although you may be able to use your FSA or HSA to cover the cost. Given their price, budget becomes especially important if you're paying out of pocket. We talked with four leading sleep experts about what makes an effective CPAP. Their expertise helped us find machines that work well for various situations, ensuring our picks were top-notch all around. We only focused on trusted brands with solid reputations and paid particular attention to past recalls and quality concerns. You can rest assured; the machines we chose all show a proven track record in both safety and performance. When comparing CPAP machines, we evaluated features that matter most: ramp and AutoRamp settings, exhalation relief, humidifier types, app compatibility, wireless connectivity, power supply options, size and mask compatibility. Each feature was considered for its role in enhancing user comfort and convenience. Finally, to understand real-world experiences, we reviewed customer ratings and feedback from multiple platforms, including CPAP seller websites, YouTube, Reddit and Trustpilot. This helped us learn what works well and what doesn't for actual CPAP users. Selecting a suitable CPAP mask is a matter of personal preference. "It's really based on your breathing habits and what your comfort level is with the various types of CPAP masks," says Husain. Your doctor can help you determine which type of mask is most appropriate for your condition, but in the end, it's your choice. First and foremost, always follow your CPAP manufacturer's cleaning and maintenance instructions. Simple soap and water is typically all you need to clean your CPAP effectively. Be cautious with third-party cleaning devices. They may void your warranty and they've been linked to machine damage, safety issues and recalls. For humidifiers, Malhotra emphasizes proper water management: "Don't let water sit stagnant. Things can grow in it. Tap it out and keep it dry, then refill when you're ready to use it again." Common CPAP challenges include nasal dryness, congestion, digestive issues from swallowing air (like bloating and gas) and eye irritation from mask leaks. Some CPAP users, especially military veterans, may also feel claustrophobic. "They may have very negative connotations with them," says Husain. CPAP masks may also leave temporary marks on your face, which some may feel self-conscious about. Depending on your condition's severity and specific circumstances, you may choose to explore alternative treatment options for sleep apnea, such as: Surgery Weight loss Oral appliances, such as mandibular advancement devices Positional therapy devices, like the Zzoma Notice signs of sleep apnea? Talk to your doctor. They'll help figure out what's going on and whether a CPAP might help you sleep better. Everyone's sleep needs are different, so the best CPAP for you might not be the best for someone else. Work with your care team to find your perfect match. Understanding your options and features helps you make smart choices together — and can help when advocating for insurance coverage. Ronald Chervin, MD, professor of neurology, chief of the division of sleep medicine and director at Sleep Disorders Centers at the University of Michigan Aatif M. Husain, MD, MBA, professor in the Department of Neurology and chief of division of Epilepsy, Sleep and Clinical Neurophysiology at Duke University Sam A. Kashani, MD, board certified sleep medicine assistant clinical professor at David Geffen School of Medicine at UCLA and president-elect at California Sleep Society Atul Malhotra, MD, pulmonary critical care and sleep medicine specialist and professor of medicine at UC San Diego Health Our health content is for informational purposes only and is not intended as professional medical advice. Consult a medical professional on questions about your health.
