Johns Hopkins researchers have devised a computerised process that could make minimally invasive surgery more accurate and streamlined using equipment already common in the operating room.
In a report the researchers say initial testing of the algorithm shows that their image-based guidance system is potentially superior to conventional tracking systems that have been the mainstay of surgical navigation over the last decade.
‘Imaging in the operating room opens new possibilities for patient safety and high-precision surgical guidance,’ says Jeffrey Siewerdsen, Ph.D., a professor of biomedical engineering in the Johns Hopkins University School of Medicine. ‘In this work, we devised an imaging method that could overcome traditional barriers in precision and workflow. Rather than adding complicated tracking systems and special markers to the already busy surgical scene, we realised a method in which the imaging system is the tracker and the patient is the marker.’
Siewerdsen explains that current state-of-the-art surgical navigation involves an often cumbersome process in which someone
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The first UK study of the use of ketamine intravenous infusions in people with treatment-resistant depression has been carried out in an NHS clinic by researchers at Oxford Health NHS Foundation Trust and the University of Oxford.
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A new way to artificially control muscles using light, with the potential to restore function to muscles paralysed by conditions such as motor neuron disease and spinal cord injury, has been developed by scientists at UCL and King
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The use of permanent brachytherapy, a procedure where radioactive sources are placed inside the prostate, into or near to the tumour, preserves erectile function in approximately 50% of patients with prostate cancer.
Brachytherapy works by giving a high dose of radiotherapy directly to the tumour, but only a very low dose to the surrounding normal tissues. Since erectile dysfunction (ED) can occur in up to 68% of patients who receive external beam radiotherapy for the condition, this is a significant improvement and the treatment should be offered to all patients, particularly those who are sexually active, the researchers say.
Dr Ren
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Experts from the Too Fit to Fracture Initiative presented the results of an international consensus process to establish exercise recommendations for people with osteoporosis, with or without spine fractures. The results were presented at the World Congress on Osteoporosis, Osteoarthritis and Musculoskeletal Diseases in Seville, Spain.
Using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) method, the international multidisciplinary panel examined literature on exercise effects on: 1) falls, fractures, BMD, and adverse events for individuals with osteoporosis or spine fractures; and 2) pain, quality of life, and physical function after spine fracture. Evidence was rated as high, moderate, low, or very low.
In addition, a consensus process was used to established recommendations on assessment, exercise, and physical activity in the context of three cases with varying risk – one having osteoporosis based on bone density; one having osteoporosis and 1 spine fracture; and one having osteoporosis and multiple spine fractures, hyperkyphosis and pain.
The panel recommends that all individuals with osteoporosis should engage in a multicomponent exercise programme that includes resistance and balance training; they should not engage in aerobic training to the exclusion of resistance or balance training.
Other key points included:
current national physical activity guidelines are appropriate for individuals with osteoporosis in the absence of spine fracture, but not for those with spine fracture;
after spine fracture, aerobic activity of moderate intensity is preferred to vigorous; physical therapy consultation is recommended;
daily balance training and endurance training for spinal extensor muscles are recommended for all individuals with osteoporosis;
restrictions are a disincentive to activity participation, and for people with osteoporosis but no history of spine fracture, desired activities should be encouraged if they can be performed safely or modified;
health care providers should provide guidance on safe movement, rather than providing generic restrictions (e.g., lifting);
physical or occupational therapist consult is recommended for advice on exercise and physical activity among those with a history of spine fracture, particularly in the presence of balance or posture impairments, pain, comorbid conditions or that increase the risk of adverse events with exercise or activity, or unsafe movement patterns.
Lead author Dr Lora Giangregorio, University of Waterloo, Waterloo, Canada, stated, ‘People with osteoporosis and spinal fractures should be encouraged to participate in resistance training and balance training, as the strongest evidence we have supports multimodal exercise programs. We have developed evidence-based recommendations, as well as a report that addresses the ‘frequently asked questions’ of patients and health care providers around physical activity. We hope that the recommendations are helpful to health professionals worldwide as they guide their osteoporosis patients in safe, effective – and enjoyable – exercise regimens.’
International Osteoporosis Foundation
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Wearing a fitness tracker on your wrist or clipped to your belt is so 2013.
Engineers at the University of Illinois at Urbana-Champaign and Northwestern University have demonstrated thin, soft stick-on patches that stretch and move with the skin and incorporate commercial, off-the-shelf chip-based electronics for sophisticated wireless health monitoring.
The patches stick to the skin like a temporary tattoo and incorporate a unique microfluidic construction with wires folded like origami to allow the patch to bend and flex without being constrained by the rigid electronics components. The patches could be used for everyday health tracking
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Scientists reported today the first human recipients of laboratory-grown vaginal organs. A research team led by Anthony Atala, M.D., director of Wake Forest Baptist Medical Center
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When it comes to the cost and quality of hospital care, nurse tenure and teamwork matters. Patients get the best care when they are treated in units that are staffed by nurses who have extensive experience in their current job, according to a study from researchers at Columbia University School of Nursing and Columbia Business School.
The review of more than 900,000 patient admissions over four years at hospitals in the Veterans Administration Healthcare System is the largest study of its kind to link nurse staffing to patient outcomes. The researchers analysed payroll records for each nurse and medical records for each patient to see how changes in nurse staffing impacted the length of stay for patients. Because length of stay is increased by delays in delivery of appropriate care and errors in care delivery, a shorter length of stay indicates that the hospital provided better treatment. At the same time, a shorter length of stay also makes care more cost-effective. The study found that a one-year increase in the average tenure of RNs on a hospital unit was associated with a 1.3 percent decrease in length of stay.
‘Reducing length of stay is the holy grail of hospital management because it means patients are getting higher quality, more cost-effective care,’ says senior study author Patricia Stone, PhD, RN, FAAN, Centennial Professor of Health Policy at Columbia Nursing. ‘When the same team of nurses works together over the years, the nurses develop a rhythm and routines that lead to more efficient care. Hospitals need to keep this in mind when making staffing decisions
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The new interferon-free, all-oral, three direct-acting-antiviral (3D) treatment regimen in development by AbbVie has achieved very high rates of virological response in patients chronically infected with hepatitis C virus (HCV) genotype 1 (GT1); according to the results of three studies presented at the International Liver CongressTM 2014.
The 3D regimen consists of the HCV NS3/4A protease inhibitor ABT-450 dosed with ritonavir, the NS5A inhibitor ABT-267, and the NS5B RNA polymerase inhibitor ABT-333.
‘Using this investigational 3D regimen, with or without ribavirin, these studies have demonstrated consistently high cure rates across a number of patient types, including the more difficult-to-treat subtype GT1a, and HCV patients with compensated cirrhosis,’ said EASL’s Scientific Committee Member Dr. Alessio Aghemo, Gastroenterology and Hepatology Unit, Ospedale Maggiore Policlinico, University of Milan. ‘The impressive SVR12 results seen are consistent with the results from AbbVie’s phase II studies,’ he added.
In the SAPPHIRE-I study, treatment na
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Surgical decision making for sick, elderly patients should be orchestrated by a multidisciplinary team, including the patient, his or her family, the surgeon, primary care physician, nurses and non-clinicians, such as social workers, advocates Laurent G. Glance, M.D., in a perspective piece published.
For this group of patients, surgery can be very risky. Glance, professor and vice-chair for research in the Department of Anesthesiology at the University of Rochester School of Medicine and Dentistry believes a more patient-centred, team-based treatment approach would lead to higher quality care that matches the values and preferences of the sickest patients.
Usually, patients undergo a one-on-one consultation with their surgeon, who is frequently solely responsible for most of the decision making and management surrounding a possible surgical procedure. However, this traditional approach has potential pitfalls. For example, patients may not always be presented the full range of treatment options, such as medical treatment, less invasive surgical options, or watchful waiting.
‘Evaluating treatment options, formulating recommendations and articulating the benefits and risks to patients comprehensively require more than a well-informed or experienced surgeon,’ noted Glance, who is also a professor of Public Health Sciences and a cardiac anaesthesiologist at UR Medicine
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