Archive for month: August, 2020

A group of oncologists have revealed in a new study by Ben-Gurion University of the Negev (BGU) researchers that communicating about death and dying with their patients is one of the most difficult and stressful parts of their work.
In the United States, 577,190 deaths from cancer occurred in 2012, according to the American Cancer Society.
The paper reported that despite this important element of their work, oncologists receive little training in this area, and many do not communicate well with patients. The research included interviews with doctors about what they found difficult and what they believed they did well.
‘To our knowledge, this is the first qualitative exploration of communication about the end of life from an oncologist

An avatar system that enables people with schizophrenia to control the voice of their hallucinations is being developed by researchers at UCL with support from the Wellcome Trust.

The computer-based system could provide quick and effective therapy that is far more successful than current pharmaceutical treatments, helping to reduce the frequency and severity of episodes of schizophrenia.

In an early pilot of this approach involving 16 patients and up to seven, 30 minute sessions of therapy, almost all of the patients reported an improvement in the frequency and severity of the voices that they hear. Three of the patients stopped hearing voices completely after experiencing 16, 13 and 3.5 years of auditory hallucinations, respectively. The avatar does not address the patients’ delusions directly, but the study found that they do improve as an overall effect of the therapy.
Even though patients interact with the avatar as though it was a real person, they know that it cannot harm them… As a result the therapy helps patients gain the confidence and courage to confront the avatar, and their persecutor.
The first stage in the therapy is for the patient to create a computer-based avatar, by choosing the face and voice of the entity they believe is talking to them. The system then synchronises the avatar

A new device could improve how blood pressure is measured, according to NHS researchers.
A team at University College London showed a sensor worn on the wrist could measure the pressure of blood leaving the heart throughout the day. Normally blood pressure is measured in the arteries in the arm, but the pressure at the heart might be a better predictor of future health problems. If blood pressure is too high it can lead to heart attacks and stroke.
About a third of people in the UK have hypertension, dangerously high blood pressure, but most are unaware of the condition.
A team at the NHS National Institute of Health Research (NIHR) trialled the sensor, which contains a mini-plunger that moves up and down as blood pulses past with every heartbeat. A computer programme in the wrist strap used this ‘pulse wave’ to work out the pressure in the heart. This was compared with measures taken from sensors in patients’ hearts.
‘It was remarkably accurate,’ said Prof Bryan Williams, the director of the NIHR University College London Hospitals Biomedical Research Centre.
Guidelines in the UK recommend that blood pressure is measured at home over the course of 24 hours before drugs for hypertension are prescribed.
Their study showed that the measurements in the arm did not reflect the true changes in blood pressure at night.
Prof Williams said: ‘What we have shown is that pressures by the heart do not dip as much during sleep as we previously thought. ‘We know the pressure when someone is asleep is a strong predictor of heart disease. This [the device] almost certainly gives a better measure than blood pressure in the arm.
‘This is not mainstream, but in the future you could see people having their central blood pressure measured instead of in the arm.’ BBC

Wake Forest Baptist Medical Center doctors have found that using stress cardiac magnetic resonance (CMR) imaging in an Emergency Department observation unit to care for patients with acute chest pain is a win-win – for the patient and the institution.
In a small, single-centre clinical trial, Chadwick Miller, M.D., M.S., and colleagues found that evaluating older, more complex patients in the observation unit with stress cardiac MRI, as opposed to usual inpatient care, reduced hospital readmissions, coronary revascularisation procedures and the need for additional cardiac testing.
The observation unit is an area of the Emergency Department designed for short stays – longer than a typical ED visit, said Miller, but shorter than a hospital admission. Cardiac MRI is a type of heart testing that uses magnetic forces to capture pictures of the heart.
‘We were looking at the optimum way to evaluate people with chest pain and focusing on those patients who are generally older, have many risk factors for coronary disease or may have had prior health problems, basically the intermediate to higher risk population,’ Miller said. ‘At most hospitals in the United States, after evaluation in the emergency department, these patients are admitted to the hospital to complete their care.’
Miller, who serves as director of clinical research and executive vice-chair of Emergency Medicine at Wake Forest Baptist, said the study built on previous research findings that more complex patients managed in an observation unit with stress CMR testing experienced a reduction in care costs of about $2,100 per patient per year. For the new study, the researchers wanted to specifically look at three care events: coronary revascularization, hospital readmissions and additional heart testing.
The researchers recruited 105 patients from Wake Forest Baptist’s Emergency Department, randomizing them to receive care either in the Observation Unit with CMR or in the hospital. The patients were followed for 90 days, after which the researchers found significant reductions in coronary revascularization procedures, fewer hospital readmissions and fewer recurrent cardiac testing episodes or the need for additional testing.
‘What’s exciting about this is not only can we reduce events that are important to patients, but we can reduce costs as well,’ Miller said. ‘What we think is happening is that the cardiac MRI is more accurately selecting patients who will benefit the most from having invasive procedures done. It’s a win-win.’ Wake Forest Baptist Medical Center