Several medications can help people with alcohol use disorders maintain abstinence or reduce drinking, according to research from the University of North Carolina at Chapel Hill.
The work provides additional options for clinicians to effectively address this global concern.
Although alcohol use disorders are associated with many health problems, including cancers, stroke and depression, fewer than one-third of people with the disorders receive any treatment and less than 10 percent receive medications to help reduce alcohol consumption.
‘There are many studies that have tried to show whether certain medications can help with alcohol use disorders, but it is a lot of information to digest and many providers do not know what works or doesn

With critical care costs in the U.S. totalling roughly $80-100 billion per year, new research highlights Intensive Care Unit (ICU) telemedicine as key to enabling hospitals and health systems to improve patient care at lower cost. The study, which examined the impact of Philips’ remote Intensive Care Unit (eICU) program on 118,990 critical care patients, across 56 ICUs, 32 hospitals and 19 health systems over a five-year period, demonstrated reductions in both mortality and length of stay. The results were statistically significant on both an unadjusted and severity-adjusted basis. The key findings were that, compared to patients receiving usual ICU care, patients who received their ICU care from a hospital that utilized the eICU program were:
    

• 26% more likely to survive the ICU;
• Discharged from the ICU 20% faster;
• 16% more likely to survive hospitalisation and be discharged;
• Discharged from the hospital 15% faster.

    
“This is the first large-scale study that ties ICU telemedicine to both the improvement of patient outcomes and cost reduction through shorter length of stays in the ICU and hospital, and identifies the processes that achieved greater efficiency,” said Dr. Lilly. “These results point to a significant opportunity to better manage and treat our critical patients in this time of increasing pressure from healthcare reform to deliver high quality and cost-effective care.”  Hospitals and health systems that saw the largest reduction in length of stay and mortality rates were those that excelled in certain components of the program – involving people, technology and processes. As a result, the study revealed the following program design elements common to the most successful ICU telemedicine programs:
    

• Having an intensivist physician perform a remote review of the patient and care plan within one hour of ICU admission;
• Frequent collaborative review and use of performance data provided by the ICU telemedicine program;
• Faster response times to technology-based alerts and alarms for physiological and laboratory value instability;
• Increased rates of adherence to ICU best practices for those that are supported by the ICU telemedicine team;
• Interdisciplinary rounds;
• Institutional ICU committee effectiveness.

Philips Healthcarehttp://tinyurl.com/nbpqnez

Investigators at the Cedars-Sinai Regenerative Medicine Institute have discovered eye abnormalities that may help reveal features of early-stage Alzheimer’s disease. Using a novel laboratory rat model of Alzheimer’s disease and high-resolution imaging techniques, researchers correlated variations of the eye structure, to identify initial indicators of the disease.
Alzheimer’s disease is the leading cause of dementia, which is characterised by loss of memory and a progressive decline in cognitive function. To date, more than 26 million people are estimated to suffer from the disease and the number is expected to quadruple by 2050. Despite the disease being described over a century ago, treatment and understanding of the disease remain rather limited.
‘Detecting changes in the brain that indicate Alzheimer’s disease can be an extremely challenging task,’ said Shaomei Wang, MD, PhD, lead author of the study and an associate professor in the Regenerative Medicine Institute and Department of Biomedical Sciences. ‘By using the eye as a window to brain activity and function, we may be able to diagnose patients sooner and give them more time to prepare for the future. Options may include earlier enrolment in clinical trials, developing support networks and dealing with any financial and legal matters.’
Using both animal models and post-mortem human retinas from donors with Alzheimer’s disease, researchers found changes in the retinal pigment epithelial layer, which harbours the supportive cells located in the back of the eye, and in the thickness of the choroidal layer that has blood vessels providing nutrients to the retina. Changes in these two regions were detected using sophisticated, state-of-the-art imaging and immunological techniques.
With high-resolution, microscopic imaging and visual acuity measurements, investigators were able to monitor tissue degeneration in the cell layer and vascular layer at the back of the eye, as well as decline in visual function, that were strongly associated with Alzheimer’s disease.
‘Greater magnitude in these eye abnormalities may mean a greater chance of a patient having Alzheimer’s disease,’ said Alexander Ljubimov, PhD, director of the Eye Program within the Regenerative Medicine Institute and co-author of the study. ‘We found that a rat model showed similar signs to the human ailment in the eye. If true in a larger number of humans, these findings may be used to study Alzheimer’s disease mechanisms and test potential drugs.’
Though additional research is needed to investigate the mechanisms of these ocular changes in relation to changes in the brain, investigators hope to ultimately aid early diagnosis of Alzheimer’s disease by studying the most approachable part of the central nervous system: the eye. Cedars-Sinai has been at the cutting edge of studies on the eye and Alzheimer’s disease with a previous report showing amyloid plaques, a hallmark of Alzheimer’s disease, also build up in the eye using a similar animal model of the disease.
‘It is fascinating that the eye may provide such a window to the brain and eventually predict diseases such as Alzheimer’s, although more human studies are now needed to confirm this animal work,’ said Clive Svendsen, PhD, director of the Cedars-Sinai Regenerative Medicine Institute and a co-author on the study. Other members of the Regenerative Medicine Institute Eye Program, include Yu Chun Tsai, PhD, a post-doctoral fellow; and Bin Lu, MD, PhD, and Sergey Girman, PhD, both project scientists. Cedars-Sinai Medical Center

When stem cells are used to regenerate bone tissue, many wind up migrating away from the repair site, which disrupts the healing process. But a technique employed by a University of Rochester research team keeps the stem cells in place, resulting in faster and better tissue regeneration. The key is encasing the stem cells in polymers that attract water and disappear when their work is done.

The technique is similar to what has already been used to repair other types of tissue, including cartilage, but had never been tried on bone.

‘Our success opens the door for many