Archive for month: August, 2020

Testosterone (T) therapy is routinely used in men with hypogonadism, a condition in which diminished function of the gonads occurs. Although there is no evidence that T therapy increases the risk of prostate cancer (PCa), there are still concerns and a paucity of long-term data. In a new study, investigators examined three parallel, prospective, ongoing, cumulative registry studies of over 1,000 men. Their analysis showed that long-term T therapy in hypogonadal men is safe and does not increase the risk of PCa.

Lead investigator Ahmad Haider, MD, PhD, urologist, Bremerhaven, Germany, states, ‘Although considerable evidence exists indicating no relationship between testosterone and increased risk of developing PCa, decades of physician training with the notion that testosterone is fuel for PCa made it difficult to dispel such fallacy and the myth continued to persist. Nevertheless, in the absence of long-term follow-up data demonstrating reduced risk of PCa in hypogonadal men who are receiving T therapy, considerable skepticism remains throughout the medical community and this is an expected natural and acceptable path of medical and scientific discourse. In view of the current evidence, clinicians are compelled to think this over and cannot justify withholding T therapy in hypogonadal men, also in men who have been successfully treated for PCa.’ EurekAlert

Stanford University School of Medicine researchers hunting for a better drug coating for coronary stents, the small mesh tubes used to prop open plaque-filled arteries, have pinpointed a cancer drug as a possible candidate.

In mice, crizotinib helped to prevent stent disease, the often-serious medical problem caused by stents themselves, without affecting the blood vessel lining. The medication has already been approved by the U.S. Food and Drug Administration for chemotherapy.

Predicting the beginning of influenza outbreaks is notoriously difficult, and can affect prevention and control efforts. Now, just in time for flu season, biostatistician Nicholas Reich of the University of Massachusetts Amherst and colleagues at Johns Hopkins have devised a simple yet accurate method for hospitals and public health departments to determine the onset of elevated influenza activity at the community level.

Hospital epidemiologists and others responsible for public health decisions do not declare the start of flu season lightly, Reich explains. In hospitals, a declaration that flu season has started comes with many extra precautions and procedures such as added gloves, masks and gowns, donning and doffing time, special decontamination procedures, increased surveillance and reduced visitor access, for example.

Researchers have developed a new device that may result in more comfortable mammography for women. According to a study standardizing the pressure applied in mammography would reduce pain associated with breast compression without sacrificing image quality.

Compression of the breast is necessary in mammography to optimize image quality and minimize absorbed radiation dose. However, mechanical compression of the breast in mammography often causes discomfort and pain and deters some women from mammography screening.

An additional problem associated with compression is the variation that occurs when the technologist adjusts compression force to breast size, composition, skin tautness and pain tolerance. Over-compression, or unnecessarily high pressures during compression, is common in certain European countries, especially for women with small breasts. Over-compression occurs less frequently in the United States, where under-compression, or extremely low applied pressure, is more common.

‘This means that the breast may be almost not compressed at all, which increases the risks of image quality degradation and extra radiation dose,’ said Woutjan Branderhorst, Ph.D., researcher in the Department of Biomedical Engineering and Physics at the Academic Medical Center in Amsterdam.

Overall, adjustments in force can lead to substantial variation in the amount of pressure applied to the breast, ranging from less than 3 kilopascals (kPa) to greater than 30 kPa.

Dr. Branderhorst and colleagues theorized that a compression protocol based on pressure rather than force would reduce the pain and variability associated with the current force-based compression protocol. Force is the total impact of one object on another, whereas pressure is the ratio of force to the area over which it is applied.

The researchers developed a device that displays the average pressure during compression and studied its effects in a double-blinded, randomized control trial on 433 asymptomatic women scheduled for screening mammography.

Three of the four compressions for each participant were standardized to a target force of 14 dekanewtons (daN). One randomly assigned compression was standardized to a target pressure of 10 kPa.

Participants scored pain on a numerical rating scale, and three experienced breast screening radiologists indicated which images required a retake. The 10 kPa pressure did not compromise radiation dose or image quality, and, on average, the women reported it to be less painful than the 14 daN force.

The study’s implications are potentially significant, Dr. Branderhorst said. There are an estimated 39 million mammography exams performed every year in the U.S. alone, which translates into more than 156 million compressions. Pressure standardization could help avoid a large amount of unnecessary pain and optimize radiation dose without adversely affecting image quality or the proportion of required retakes.

‘Standardizing the applied pressure would reduce both over- and under-compression and lead to a more reproducible imaging procedure with less pain,’ Dr. Branderhorst said.

The device that displays average pressure is easily added to existing mammography systems, according to Dr. Branderhorst. EurekAlert

An international team of scientists including researchers from the U. of Granada find that the speed of saccadic movements (rapid eye movements) is an excellent way to objectively measure the level of fatigue in a physician.

Results prove that after a 24-hour medical shift, the speed of saccadic movements diminishes and the subjective perception of fatigue augments. However, the execution of simulated laparoscopic tests is not affected by this type of fatigue.

An international team of scientists which includes researchers from the U. of Granada has demonstrated for the first time that it is possible to establish in an objective way the level of fatigue in physicians after long shifts through their eye movement.

This research reveals that the speed of saccadic movement (mostly voluntary rapid eye movements which we use to focus our gaze upon an object that attracts our attention) is an excellent index to measure objectively the level of fatigue in the medical profession.

Results proved that after long hours, the speed of saccadic movements effectively diminished, while their subjective perception of fatigue increased. However, in the simulated laparoscopic tests after the shift, the execution was not affected in any significant way by their fatigue.

This means that