Whenever cardiac insufficiency or serious heart defects worsen, such deterioration is often associated with a loss of muscular mass and muscular strength. Scientists at the Charit
Millions of people are dying from potentially treatable cancers like breast and prostate because of a chronic underinvestment in radiotherapy resources, according to a major new Commission on access to radiotherapy.
New estimates produced for the Commission reveal that 204 million fractions of radiotherapy will be needed to treat the 12 million cancer patients worldwide who could benefit from treatment in 2035. Despite the enormity of the problem, say the authors, the cost per fraction is highly cost-effective and very low compared to the high price of many new cancer drugs.
The Commission estimates that full access to radiotherapy could be achieved for all patients in need in low-and middle income countries (LMIC) by 2035 for as little as US$ 97 billion, with potential health benefits of 27 million life years saved, and economic benefits ranging from US$ 278 billion to US$ 365 billion over the next 20 years.
‘There is a widespread misconception that the costs of providing radiotherapy put it beyond the reach of all but the richest countries. Nothing could be further from the truth’, says Commission author Professor Rifat Atun from Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA. ‘Our work for this Commission clearly shows that not only can this essential service be deployed safely and high quality treatment delivered in low- and middle-income countries, but that scale-up of radiotherapy capacity is a feasible and highly cost-effective investment.’
The Commission exposes the reality of radiotherapy services on a country-by-country basis across the world and, for the first time, calculates the costs and benefits of meeting the worldwide shortfall in resources and bridging the gap in access to effective treatment.
Radiotherapy treatment is essential for the cure and palliation of most cancers including breast, lung, prostate, head and neck, and cervical cancers. Up to 60% of all cancer patients will require radiotherapy at some point. New estimates produced for the Commission find that in 2035 over 12 million new cancer patients could benefit from radiotherapy treatment. Yet, worldwide access to radiotherapy is unacceptably low, with only 40-60% of cancer patients having access to this vital treatment.
Even in high-income countries like Canada, Australia, and the UK, numbers of radiotherapy facilities, equipment, and trained staff are inadequate.
Access is worst in low-income countries where as many as nine out of 10 people cannot access radiotherapy treatment. The problem of access is especially acute in Africa, where in most countries radiotherapy treatment is virtually non-existent, and where 40 countries have no radiotherapy facilities at all.
Radiotherapy has, until now, been overlooked as a critical need for the health of the world’s population and is often the last resource to be considered when planning cancer control systems. Persistent underinvestment in radiotherapy resources has already resulted in millions of unnecessary deaths. News-Medical
Using apheresis to remove a serum protein called soluble Fms-like tyrosine kinase-1 (Sflt-1) may help pregnant women with severe preeclampsia safely delay delivery, according to a pilot study.
‘Based on recent advances in the understanding of this condition, we and others are developing treatments for preeclampsia to allow women to safely prolong their pregnancy if they are suffering from very preterm preeclampsia,’ first author Ravi Thadhani, MD, MPH, from Massachusetts General Hospital in Boston, said in a press release.
Symptoms of preeclampsia include high blood pressure and proteinuria. The condition affects between 3% and 8% of pregnancies worldwide and can be harmful or even fatal to both the mother and newborn. Because of limited understanding about its underlying mechanisms, no cure exists other than delivery, which can be problematic if preeclampsia develops very early in pregnancy, the authors note.
In the open pilot study, Dr Thadhani and colleagues tested the safety and efficacy of removing sFlt-1 from the blood of pregnant women with very preterm preeclampsia. The serum protein sFLT-1 acts as a receptor for vascular endothelial growth factor. By inhibiting vascular endothelial growth factor activity, sFTL-1 modifies blood vessel growth. Women with preeclampsia often have elevated sFTL-1 levels.
Using apheresis, researchers removed the blood from 11 pregnant women and passed it through a negatively charged dextran sulfate column to bind and remove the positively charged sFLT-1. Participants were aged 20 to 38 years and were between 23 to 32 weeks of gestation. Inclusion criteria included systolic blood pressure of 140 mm Hg or higher or diastolic blood pressure of 90 mm Hg or higher, new-onset protein/creatinine ratio higher than 0.30 g/g, and sFLT-1/placental growth factor ratio higher than 85.
Apheresis resulted in an 18% (range, 7% – 28%) reduction in mean sFLT-1 levels, as well as reductions of 44% in protein/creatinine ratios.
Pregnancy continued 8 days after admission (range, 2 – 11 days) in six women treated once with apheresis, and 12 days (range, 7 – 19 days) in five women treated multiple times. In comparison, delivery occurred after 3 days (range, 0 – 14 days) in untreated women with preeclampsia (n = 22) and women who delivered preterm for other reasons (n = 22); the control participants, who had been treated contemporaneously, were matched to the treated women for several factors, including gestational age at delivery.
Although antihypertensive treatments were withheld the morning of the apheresis treatment, the most common adverse effect of apheresis was transient hypotension, which was treated with saline hydration and decreasing blood flow through the column. Hypotension was not severe enough to cause any of the women to stop treatments. No significant changes in foetal heart monitoring occurred during apheresis.
Babies born to apheresis-treated women needed fewer days of supplemental oxygen than babies born to untreated women. However, neonatal test results, total days in the neonatal ICU, and days spent in the hospital did not differ between the groups.
‘Our pilot study suggested we can safely prolong pregnancy when we target removal of sFlt-1 in women with severe preterm preeclampsia, and we hope this is confirmed in randomized trials,’ Dr Thadhani. MedScape
As the Ebola virus disease pandemic unfolded in 2014, it may have seemed like a sudden and unprecedented event. But the disease has a long history, the epidemic is ongoing, and new outbreaks are certain to occur in the future, reports. Especially with recent news of persisting and recurrent Ebola outbreaks in some West African countries, anaesthesia providers and other healthcare professionals need to know about the ‘past and present’ of Ebola virus disease, according to a review by Dr. Michael J. Murray of Grand Canyon Anesthesia Consultants, Scottsdale, Ariz. He writes, ‘We as anesthesiologists should take the necessary steps now to better prepare and educate ourselves so that we can protect our families from the sequelae of such events, and provide effective treatment for those to whom we will provide care during this and subsequent epidemics.’
The first cases of viral haemorrhagic disease caused by Marburg virus were recognized nearly 50 years ago, when European laboratory workers were infected by monkeys imported from Uganda.
Two epidemics caused by a virus that proved to be Ebola occurred in Sudan and Zaire during 1976. The disease spread readily, especially with close contact. Stringent infection control and isolation measures were necessary to bring the outbreaks under control. Over the years, more than 20 outbreaks have occurred in Africa, with mortality rates sometimes reaching 100 percent.
After extensive research, fruit bats were identified as the natural reservoir of Ebola virus. The current epidemic likely began with a child in Guinea who had contact with a bat. The disease rapidly spread to other West African countries
The results of a study indicate that Magnetic Resonance Imaging (MRI) Diffusion-Tensor Imaging (DTI) could be used for the prognosis and treatment of sports injuries in athletes. The researchers obtained DTI Three-dimensional (3-D) measurements of the upper leg from the hip to the knee, including the hamstring and other susceptible muscles, in a single imaging session. The technique revealed changes that qualitative T2-weighted MR imaging with fat suppression was not able to show, and could be used to help clinicians detect long-term changes in the upper leg from sports-related muscle injuries.
The researchers evaluated five male amateur long-distance runners using a 3-T MR examination of both upper legs at three points in time. The exams took place one week before, two days after, and three weeks aft er the runners took part in a marathon. A musculoskeletal radiologist used three grades to evaluate the level of muscle injury using T2-weighted images with fat suppression. The radiologist noted the specific muscle and its location, the craniocaudal, and axial length of the hemorrhage and/or edema, and manually segmented six muscles in both upper legs based on T1- and T2-weighted images.
Lead author of the study, Martijn Froeling, PhD, at the University Medical Centre Utrecht (Utrecht, Netherlands), said,
Hydrocephalus is a nightmarish medical condition. Accumulating fluid in the skull ratchets up pressure on the brain and can cause lifelong mental disabilities. Current treatment requires physicians to cut through the skull and implant pressure-relieving shunts.
The necessary surgery is effective but invasive. For surgeries like these, science fiction authors have long dreamt of shrinking surgeons to mere millimeters to allow them to navigate interior passageways of the body instead of cutting large access holes. Arriving at problem sites, the fictional physicians might provide targeted drug delivery or surgical intervention.
Aaron T. Becker, electrical and computer engineering professor at the UH Cullen College of Engineering, is working collaboratively to deliver a robotic version of this micro-surgeon. His submission to ICRA, the flagship conference of the IEEE Robotics and Automation Society in Seattle, Wash., was nominated for best conference paper and best medical robotics paper.
A collaboration between biologists and engineers at Monash University has led to the development of a new noninvasive image processing technique to visualize embryo formation. Researchers were able to see, for the first time, the movement of all of the cells in living mammalian embryos as they develop under the microscope. This breakthrough has important implications for IVF (in vitro fertilization) treatments and pre-implantation genetic diagnosis (PGD). In the future, this approach could help with embryo selection before the embryo is implanted back into the uterus to improve IVF success rates.
This latest research provides new insights into embryo formation and challenges the prevailing model of cell placement through division.
Mammalian embryos start out as a small group of identical cells. Then at an early stage, some of these cells take up an internal position within the embryo. These internal cells are the ones that will go on to form all of the cells of the body while the remaining outer cells go on to form other tissues such as the placenta.
For many years, researchers theorized that the internal cells adopt their position through a special process of cell division, but due to technological limitations, this had never actually been shown. Using their newly developed imaging methods, the Monash University researchers were able to demonstrate that this model of embryo formation was incorrect.
The researchers then applied cutting-edge laser techniques to the mammalian embryo (previously used in fly and plant embryos or cultured cells only) to determine what forces were acting on the cells to make them move inside the embryo.
Using these new imaging techniques, researchers were able to see how the cells moved and changed shape over time as they were
It is important to use the right embolic agent for the job
German charity Help in Motion has equipped its two new mobile hospital vehicles with robust and portable NanoMaxx
Award-winning actress and singer Kristin Chenoweth joined Steve MacMillan, the company’s Chairman, President and Chief Executive Officer, to ring the Nasdaq Opening Bell on October 1, the first day of Breast Cancer Awareness Month. This is the 10th year in a row that Nasdaq has invited Hologic to preside over its Opening Bell ceremony to kick off Breast Cancer Awareness Month.
‘Hologic’s Genius
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