New research from McMaster University suggests that a commonly performed test during certain types of heart surgery is not helpful and possibly harmful.
The testing procedure, known as defibrillator testing (DT), is commonly used on people who require implantable cardioverter-defibrillators (ICDs) to prevent sudden cardiac death. It involves putting the patient into cardiac arrest to determine if the defibrillator can first recognise, then successfully shock the patient back into a normal heart rhythm. It requires the use of general anaesthesia and is associated with uncommon but potentially life-threatening complications.
‘As with many things in medicine, technology evolves and our knowledge grows and we have presented good evidence that the DT, which has been in use for nearly 30 years, is no longer necessary,’ says lead author Jeff Healey, associate professor of medicine, in the Michael G. DeGroote School of Medicine at McMaster University.
‘Without the testing we can save a significant amount of time, money and more importantly, avoid potentially serious complications in patients who are receiving an ICD,’ he says.
Similar to a pacemaker, an ICD is a small battery-powered electrical impulse generator meant as a permanent safeguard against sudden arrhythmias. Each year, about 300,000 worldwide receive an ICD. Of these, approximately 70 per cent undergo the routine defibrillation testing that often leads to potential complications including possible harm from ICD shocks, says Healey.
‘Over the last 10 years, there has been an important shift in practice around the world towards ICD implantation without the test. However, until now, there has been no scientific evidence to support this change in practice. Our study now provides clear and robust evidence to guide practice.’
To test the procedure, Healey initiated a randomized trial, called the ‘Shockless IMPLant Evaluation (SIMPLE)’ study. It is the largest randomised clinical trial of ICD recipients to date, involving a cohort of 2,500 patients worldwide.
The trial compared standard DT in a patient to those who do not have the testing performed and revealed that those who received ICDs without DT did as well as those who underwent the standard testing. McMaster University

Max Ortiz Catalan has developed a new method for the treatment of phantom limb pain (PLP) after an amputation. The method is based on a unique combination of several technologies, and has been initially tested on a patient who has suffered from severe phantom limb pain for 48 years. A case study shows a drastic reduction of pain.
People who lose an arm or a leg often experience phantom sensations, as if the missing limb were still there. Seventy per cent of amputees experience pain in the amputated limb despite that it no longer exists. Phantom limb pain can be a serious chronic and deteriorating condition that reduces the quality of the person

Obese people who have stomach surgery to help them lose weight will halve their risk of heart attack according to new research from a team of doctors at the University of East Anglia, University of Manchester and University of Aberdeen.

The procedures, known as bariatric surgery, involve techniques such as gastric banding, which are available on the National Health Service (NHS), UK for selected patients.

New research published today in the International Journal of Cardiology reviewed data from 14 studies involving more than 29,000 patients who underwent bariatric surgery. It reveals that death rates were reduced by 40 per cent, and that heart attacks in particular were reduced by half

‘Where does it hurt?’ is the first question asked to any person in pain.
A new UCL study defines for the first time how our ability to identify where it hurts, called ‘spatial acuity’, varies across the body, being most sensitive at the forehead and fingertips.

Using lasers to cause pain to 26 healthy volunteers without any touch, the researchers produced the first systematic map of how acuity for pain is distributed across the body.

With the exception of the hairless skin on the hands, spatial acuity improves towards the centre of the body whereas the acuity for touch is best at the extremities. This spatial pattern was highly consistent across all participants.

The experiment was also conducted on a rare patient lacking a sense of touch, but who normally feels pain. The results for this patient were consistent with those for healthy volunteers, proving that acuity for pain does not require a functioning sense of touch.

‘Acuity for touch has been known for more than a century, and tested daily in neurology to assess the state of sensory nerves on the body. It is striking that until now nobody had done the same for pain,’ says lead author Dr Flavia Mancini of the UCL Institute of Cognitive Neuroscience. ‘If you try to test pain with a physical object like a needle, you are also stimulating touch. This clouds the results, like taking an eye test wearing sunglasses. Using a specially-calibrated laser, we stimulate only the pain nerves in the upper layer of skin and not the deeper cells that sense touch.’

Volunteers were blindfolded and had specially-calibrated pairs of lasers targeted at various parts of their body. These lasers cause a brief sensation of pinprick pain. Sometimes only one laser would be activated, and sometimes both would be, unknown to participants. They were asked whether they felt one

A new study in animals shows that using a compound to block the body