Life is hard for the children of a parent suffering from depression. Children take on an enormous amount of responsibility for the ill parent and for other family members. It is therefore important for the health services to be aware of this and have support functions in place for the whole family, and not just for the person who is ill. This is the conclusion of a thesis from the Sahlgrenska Academy, University of Gothenburg, Sweden.

Registered Nurse Britt Hedman Ahlström has examined the way in which family life is affected when a parent is suffering from depression. Nine families, including ten children and young adults between the ages of 5 and 26, and eleven parents were included in the study.

The results show how the family's daily life changes and becomes more complicated when a parent is suffering from depression. Uncertainty about what is happening has an effect on the daily life of the entire family. Depression also means that the parent becomes tired and exhausted, which then affects and weighs heavily on the children's daily life. Depression changes the relationship between a parent and his/her children, since they no longer communicate with each other as they used to. Family interplay and reciprocity decrease. The depressed parent withdraws from the family, and the children feel that they have been left to themselves.

Daily family life becomes unfamiliar to the children

The family members try their utmost, both as individuals and together, to cope with the situation, so that daily life can be restored to a more manageable level. The children take responsibility for both the depressed parent, siblings and themselves, when they notice that the parent cannot cope.

"The toughest burden of responsibility that children take on is ensuring that the depressed parent doesn't commit suicide. So children take on an extremely heavy responsibility by monitoring and keeping an eye on the depressed parent," says Britt Hedman Ahlström.

For children, the parent's depression means both a sense of responsibility and a feeling of loneliness The feelings of responsibility and loneliness include a striving and yearning for reciprocity with the parent, and for things to return to a state of normality.

"Even if the depression goes away for a time, the family is never entirely free from anxiety over it coming back. This means that there is a prolonged period of suffering associated with depression," says Britt Hedman Ahlström.

Health services must help the whole family

Involving the entire family when a parent becomes ill is important, both for the children and the parents. It is essential to have a well-defined level of guaranteed care on how, when and from whom the families will get support. Psychiatric healthcare personnel meet people suffering from depression at an early stage, and therefore have the opportunity to focus the care on the family, in order to together identify ways of helping the family get through the depression.

"We need a new approach within the health services, in which the focus is on the family's own perspective when a parent is suffering from depression. It's vital to be aware of the whole family's needs in terms of help and support, and not just those of the person who is ill. It's particularly important to be aware of the children's situation. Research can therefore focus on how to develop various ways of providing families with care and support, and introduce them into the existing organisation, as well as evaluating the consequences for the whole family, the parents and the children," says Britt Hedman Ahlström

While surviving cancer should be an occasion for rejoicing, many people who have undergone the standard or high-dose chemotherapy to defeat the disease unfortunately suffer from a physical and mental ailment known as "chemobrain." This cognitively dysfunctional symptom ranges from fatigue and memory loss to serious learning impairment due to possible brain damage. In CHEMOBRAIN: HOW CANCER THERAPIES CAN AFFECT YOUR MIND (Prometheus Books, $18.98), a clear, concise guide for cancer patients, survivors, families, friends, and caregivers, noted science journalist Ellen Clegg provides the latest information on this much-discussed but poorly understood side effect of chemotherapy treatment, while also - in an objective journalistic fashion - giving voice to those medical professionals who remain skeptical of chemobrain.

Based on extensive and candid interviews with both those suffering from chemobrain and the physicians and scientists who have treated and studied this problem, Clegg cuts through the scientific jargon and explains in understandable terms how chemotherapy works at the most basic biological level. In doing so, she provides cancer survivors with the knowledge to understand what is happening to them and practical tips for coping with the aftermath of chemotherapy treatment.

Clegg's extensive cross-analysis of chemotherapy survivors' stories with the opinions of doctors who recognize the symptoms will provide the affirmation that so many who suffer from chemobrain so desperately need. She includes tactics for dealing with cognitive problems and other lingering side effects, strategies for multitasking at home and reentering the workforce, and even ways to deal with health insurance.

In addition to personal strategies and stories, Clegg also provides the history of the patient empowerment movement that brought chemobrain to the attention of the medical establishment in the first place. She also addresses the future of cancer research and the search for treatments that do less harm, and looks at chemobrain's implications for the mental health of developing children.

Stewart B. Fleishman, MD, Director, Supportive Services, Continuum Cancer Centers of New York: Beth Israel and St. Luke's-Roosevelt Hospitals, is a doctor at the forefront of a new movement to treat cognitive dysfunction as a real symptom with real potential solutions. "We will learn more about the causes of cognitive impairment soon, asking future patient generations to invest less of their quality of life to not only survive, but also thrive after diagnosis of cancer and its treatment," he writes in the book's foreword. "Many questions have yet to be answered. Further studies are now underway to do so."

While survivor circles have acknowledged and debated chemobrain for years, this is the first and only book to delve into the cognitive problems many patients endure when they undergo chemotherapy. CHEMOBRAIN brings together cutting-edge science, the compelling stories of adults and children who have struggled for years with cognitive dysfunction, and the coping strategies being developed on the front lines of patient care. Clegg's investigative study of chemobrain is both a required read for today's upcoming medical professionals and a gospel for those suffering with this widespread symptom as well as for caring family members.

When Joyce Moss recently arrived at Loyola University Hospital with a life-threatening heart attack, it took just 42 minutes to perform an emergency balloon angioplasty.

The procedure opened up an artery that was 100 percent blocked. "There was no damage to the heart because of how quick they were," said Moss, 56, of Berwyn. "I feel good."

To further improve its emergency angioplasty times, Loyola will become the first hospital in Illinois to staff a Heart Attack Rapid Response Team (HARRT) at the hospital 24 hours a day, seven days a week. The HARRT program includes board-certified and highly-experienced interventional cardiologists, nurses and technicians.

Most hospitals do not have such personnel on site during nights and weekends. Thus, precious time is lost when the team has to be called in from home. This is especially true when staffers are delayed by snow storms or other bad weather.

"The HARRT program will provide the next leap of care for patients," said Loyola interventional cardiologist Dr. Fred Leya. Leya is among a team of interventional cardiologists who will rotate night and weekend shifts at the hospital. Leya is medical director of Loyola's cardiac catheterization lab.

Reducing angioplasty times is a coordinated effort that begins with paramedics who take patients to the hospital. There are 51 west suburban fire departments and ambulance companies in the Loyola Emergency Medical Services System. A growing number of ambulances are being equipped so that paramedics can administer 12-ead EKG exams while en route to the hospital. An EKG can confirm a heart attack, and results are radioed ahead to the hospital, said Dr. Mark Cichon, Loyola's director of emergency medical services.

Once a heart attack is confirmed, it takes less than five minutes to prep the patient. The interventional cardiologist then threads a catheter (thin tube) from an artery in the groin to the heart. The cardiologist inflates a balloon at the tip of the catheter to open the artery. In many cases, the cardiologist places a stent (wire mesh tube) to keep the artery open.

The doctor must be fast and accurate. "You become very focused," said interventional cardiologist Dr. Bruce Lewis. "It's like shooting a three-pointer with two seconds to go, except that you can't afford to miss." Lewis is a professor in the division of cardiology at Stritch.

Experience helps improve outcomes. Interventional cardiologists on the HARRT team each perform approximately 300 angioplasties per year. "We have seen just about every permutation," Lewis said.

A task force of the American College of Cardiology and American Heart Association recommends that a patient undergoing a heart attack receive a balloon angioplasty as soon as possible or at least within 90 minutes of arriving at the hospital -- known as the door-to-balloon time. Speed "is of central importance because the benefits of therapy diminish rapidly with delays in treatment," the task force said in a November, 2008 statement published in the heart association journal Circulation.

During a heart attack, a blockage in an artery stops blood flow. Heart muscle begins to die due to lack of blood and oxygen. An emergency angioplasty can reopen a blocked artery and restore blood flow. The procedure does the most good if done within one hour of the patient's arrival, known as the Golden Hour. After three hours, there may not be enough benefits to justify the risks of the procedure.

"Time is heart muscle," said Dr. David Wilber, director of Loyola's Cardiovascular Institute. "The sooner we can open the artery, the better."

A balloon angioplasty is the most effective way to reopen an artery, according to a review of 23 studies published in the British medical journal Lancet. In the studies, heart attack patients were randomly assigned to receive a balloon angioplasty or an intravenous clot-busting drug such as streptokinase. Among patients receiving clot-busting drugs, 14 percent died or suffered a stroke or subsequent heart attack, compared with only 8 percent in the angioplasty group.

Loyola is among a small but growing number of hospitals that are establishing around-the-clock angioplasty teams. Other hospitals include Detroit Medical Center, Vanderbilt Medical Center in Nashville, Tn. and Aurora St. Luke's Medical Center in Milwaukee. Detroit Medical Center has cut its door-to-balloon time to 47 minutes.

"There is increasing evidence that timely angioplasty not only results in better patient outcomes, but may actually reduce overall health care costs in the long run by cutting down the need for later diagnostic procedures, interventions, and hospitalizations." Wilber said. "This is achieved despite the additional effort and expense on the front end. As physicians and hospitals strive to improve the quality of care while controlling long-term costs, it is likely that more centers will adopt these programs."

In Moss' case, there was a blockage in a branch to one of her major heart arteries. After reopening the blockage, Lewis placed a stent. An echocardiogram later found there was no significant damage to her heart muscle.

Moss' heart attack occurred while she was driving to her job as a school bus driver. She said it felt like there was a 50-pound weight on her chest. Her left arm went numb and fell off the steering wheel. She was sweating and nauseous. She pulled off the road and called 911. "I knew it was a heart attack," she said.

Moss, who has six children and 11 grandchildren, said "It's good to still be here."

Loyola University Health System board member James Dowdle and his wife, Sally, have pledged $500,000 to help offset the initial costs of opening the program. The Dowdles have donated more than $2 million to LUHS and to Loyola University Chicago. James Dowdle, a retired executive vice president of the Tribune Co., is the 2001 recipient of the Sword of Loyola, the highest honor of Loyola University Chicago. Sally Dowdle has served as co-chair of the hospitality committee of the Stritch School of Medicine's annual award dinner.

Loyola is a nationally recognized center of excellence for heart and vascular care. It is the only Illinois hospital to be named to the Thomson Reuters 2008 list of the nation's top 30 teaching hospitals with cardiovascular residency programs. And U.S. News and World Report consistently ranks Loyola's heart program as one of the best in the country.

Using powder-free latex gloves rather than those with cornstarch powder greatly reduced the number of workers' compensation claims related to latex-related illness, a recent Geisinger study found.

Healthcare workers use latex gloves to reduce the spread of infection and disease when caring for patients. The gloves also protect workers from exposure to chemicals, bodily fluids and other potentially dangerous substances.

Often, a powder such as cornstarch is added to make it easier to slip on or remove the gloves. The powder provides a dry grip for contact with moist hands. The powder also makes it more difficult for gloves to tear. But, powder can aggravate latex allergies. Allergic reactions caused by latex exposure range from simple itching to anaphylactic shock.

In 2001, Geisinger Health System clinicians stopped using powdered latex gloves. A study in a recent edition of the medical journal Dermatitis examined what happened after Geisinger made the change:

-- The number of workers' compensation claims for latex illness among Geisinger employees fell from 12 per year in the five years before the transition to four-and-a-half claims per year in the four years after the transition.

-- The average workers' compensation payment to employees fell from $34,789 to $2,505.

While Geisinger's cost increased initially with the new gloves, most of that increase was offset by decreased workers' compensation claims as well as spending on water and soap to clean the powder, the study noted.

"The transition away from powdered latex gloves should decrease the chance of sensitization to the latex protein in healthcare workers," said Patricia Malerich, M.D., primary study author and Geisinger dermatologist. "Although we examined the effects on healthcare workers, we hope that this decreased exposure to latex proteins carried in powdered gloves will also lead to fewer allergic reactions in latex-sensitive patients."

Stress is a factor in the healing of wounds, whether they be in skin or mucosal tissue, but stress affects healing in these tissues differently, according to new research conducted at the University of Illinois at Chicago.

"We believe what may improve healing in one tissue type may possibly worsen healing in a different type of tissue," says Christopher Engeland, assistant professor of periodontics at UIC. Engeland will present the findings March 5 at the American Psychosomatic Society's 67th annual meeting at the Chicago Downtown Marriott Hotel, 540 N. Michigan Ave.

In the new study, 65 UIC dental students received a small circular wound and a small longitudinal wound on the hard palate of the mouth at two different times: during the high-stress week of examinations, and during their relatively relaxed summer vacation.

The circular wound was videographed daily to monitor closure.

Biopsies from the longitudinal wound were taken 6 and 24 hours after wounding to assess the early and late stages of the inflammatory process, Engeland said. The levels of expression of eight genes involved in inflammation were determined from these biopsies.

The researchers found that wound closure was delayed during high stress. The stress of examinations was associated with a state of "hyper-inflammation" in healthy tissue and higher inflammatory responses in wounded tissue, Engeland said.

Previous studies showed that stress is associated with reduced inflammation in skin wounds, an effect that appears to be reversed in the mucosal tissue of the palate. The paradox suggests that attempts to improve healing by altering inflammation should be made in a tissue-specific manner, Engeland said.

"It is also interesting to note that the degree of inflammation in unwounded tissue was indicative of healing rates following injury," Engeland said. This suggests that healing rates might be predicted from the immune status in normal tissue prior to surgery, he said.