Defective blood coagulation is one of the leading causes of preventable death in patients who have suffered trauma or undergone surgery. The body
Measuring variability of heart rate may identify premature infants at risk of developing narcotising enterocolitis, a serious inflammatory condition that can lead to death, according to Penn State College of Medicine researchers.
Narcotising enterocolitis, or NEC, may lead to destruction of the intestinal wall and vital organ failure. It affects 6 to 10 percent of premature infants within the first two weeks of life.
‘NEC is currently diagnosed by a combination of laboratory and radiology tests, usually done when the disease is already significant,’ said Kim Doheny, director of clinical research in newborn medicine and assistant professor of pediatrics. ‘Since NEC progresses so rapidly and the symptoms develop suddenly, a non-invasive biomarker that allows early detection of patients at risk is required as a matter of urgency.’
Heart rate fluctuates in the intervals between beats, and contributors to this fluctuation are measured through mathematical analysis. One of these contributors is the parasympathetic nervous system — the system that controls digestive responses and regulates the organs during rest — represented through measurement of high-frequency energy distribution. The researchers studied 70 infants born at 28 to 35 weeks within the first five to eight days of life. The babies were stable with no sign of illness.
The researchers then measured heart rate variability in the infants to test whether measuring the high-frequency component of heart rate variability may be used as a way to predict an infant’s NEC risk before disease onset.
Of the 70 infants studied, nine who later developed NEC had decreased high frequency in the heart rate variability, suggesting reduced parasympathetic nervous system activity. Of all the infants with a decreased high-frequency heart rate variability, 50 percent developed the disease. In contrast, 98 percent of those with a higher high-frequency value did not get the disease.
‘This shows that measuring high-frequency variability during this early critical window of postnatal development has value for identifying NEC risk at a time when symptoms are not evident and interventions to improve the parasympathetic nervous system activity can be given,’ said researcher R. Alberto Travagli, professor of neural and behavioral sciences. ‘This relatively simple, economical, and non-invasive method offers the opportunity to monitor at-risk infants more closely and to test the efficacy of emerging treatments.’
The researchers say future investigations should include a larger sample that also includes measurement of inflammation at the time heart rate variability is measured. Penn State College of Medicine
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
The pink plastic box that Cynthia Kim, MD, EdD, opens at the bedside of a young patient at UCSF Benioff Children
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
For the millions of people forced to rely on a plastic tube to eliminate their urine, developing an infection is nearly a 100 percent guarantee after just four weeks. But with the help of a little bubble-blowing, biomedical engineers hope to bring relief to urethras everywhere.
About half of the time, the interior of long-term urinary catheters become plagued by biofilms
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
Surgical implants are widely used in modern medicine but their effectiveness is often compromised by how our bodies react to them. Now, scientists at the University of Cambridge have discovered that implant stiffness is a major cause of this so-called foreign body reaction. An obvious difference between electrodes and brain tissue is stiffness. Brain tissue is as soft as cream cheese, it is one of the softest tissues in the body, and electrodes are orders of magnitude stiffer Dr Kristian Franze This is the first time that stiffness of implant materials has been shown to be involved in foreign body reactions.
The findings could lead to major improvements in surgical implants and the quality of life of patients whose lives depend on them. Foreign bodies often trigger a process that begins with inflammation and ends with the foreign body being encapsulated with scar tissue. When this happens after an accident or injury, the process is usually vital to healing, but when the same occurs around, for example, electrodes implanted in the brain to alleviate tremor in Parkinson
Researchers have determined that a copper compound known for decades may form the basis for a therapy for amyotrophic lateral sclerosis (ALS), or Lou Gehrig
A shortened version of a questionnaire used by psychologists to assess risk factors for obsessive-compulsive disorder also may help determine the risk of depression and anxiety, according to a Baylor University study.
The revision may be a good fit for assessing the risk of mental health issues stemming from certain beliefs
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