Today, doctors who really want to see if a wound is healing have to do a biopsy or some other invasive technique that, besides injuring an already injured patient, can really only offer information about a small area. But a technology called hyperspectral imaging offers doctors a non-invasive, painless way to discriminate between healthy and diseased tissue and reveal how well damaged tissue is healing over a wide area. The catch? A lack of calibration standards is impeding its use.

After a successful non-human trial, researchers at the National Institute of Standards and Technology (NIST) have started gathering data on how human skin looks under various wavelengths of light in order to develop these badly needed standards.

Unlike consumer digital cameras and the human eye, which only see red, green and blue light, a relatively narrow portion of the electromagnetic spectrum, each pixel of a hyperspectral image captures information for hundreds of narrow spectral bands

To the careful observer, a person

Results of a survey of more than 30,000 nurses across Europe show that nurses who work longer shifts and more overtime are more likely to rate the standard of care delivered on their ward as poor, give a negative rating of their hospitals safety and omit necessary patient care.

Led by researchers at the University of Southampton and the National Nursing Research Unit (NNRU) at King

Robot-assisted surgery to remove cancerous prostate glands is effective in controlling the disease for 10 years, according to a new study led by researchers at Henry Ford Hospital.

The study also suggested that traditional methods of measuring the severity and possible spread of the cancer together with molecular techniques might, with further research, help to create personalized, cost-effective treatment regimens for prostate cancer patients who undergo the surgical procedure.

The findings apply to men whose cancer has not spread beyond the prostate, and the results are comparable to the well-established and more invasive open surgery to remove the entire diseased prostate and some surrounding tissue.

Postsurgical cognitive side effects can have major implications for the level of care, length of hospital stay, and the patient’s perceived quality of care, especially in elderly and fragile patients. A nationwide survey of Swedish anaesthesiologists and nurse anaesthetists has found there is low awareness of the risks of cognitive side effects following surgery. Furthermore, only around half of the respondents used depth-of-anaesthesia monitors.

Patients generally expect to make a rapid recovery from anaesthesia with a minimum of side effects. The main focus by anaesthesia personnel centres around how to minimize cardiovascular and pulmonary risks and on the management of postoperative pain, nausea, and vomiting. According to the survey results, less attention is being paid to cognitive side effects following surgery, yet these complications can have major implications for the patient.

‘We found that Swedish anaesthesia personnel viewed risk assessment, prevention, and handling of postoperative delirium and postoperative cognitive dysfunction of rather low importance. Protocol and/or standardized routines were only rarely implemented,’ observes senior investigator Professor Jan G. Jakobsson, MD, PhD, of the Department of Anesthesia & Intensive Care, Institute for Physical Science, Karolinska Institute, Stockholm, Sweden.

Postoperative cognitive impairments may arise early on after surgery, such as the short-lasting, but still distressful postoperative emergence agitation (EA). Postoperative delirium (POD) usually makes its debut one or two days after surgery, sometimes giving rise to major concerns. The more subtle but longer lasting postoperative cognitive dysfunction (POCD) generally starts during the first week after surgery, but may last for a month. Although these side effects are of major concern for both hospitals and patients, they have received less attention from anaesthesia personnel.

To gain insight regarding routines and practice for risk assessment, diagnosis, and management of postoperative cognitive side effects, and the use of EEG-based depth-of-anaesthesia monitoring (DOA), investigators sent a web-based validated questionnaire to over 2,500 Swedish anaesthesiologists and nurse anaesthetists. The questionnaire consisted of three sections covering subjective preferences, routines, and practices related to the perioperative handling of EA, POD, POCD, and awareness. The response rate was 52%.

In general the respondents considered the risk for neurocognitive side effects to be the least important during the preoperative assessment, while the risk of awareness with recall (when patients are able to recall the surgery) as well as traditional cardiac and pulmonary risk was considered of high importance.

It has been suggested that the use of EEG-based DOA monitoring to fine-tune and tailor anaesthetic delivery can reduce the risk of postoperative cognitive side effects. Previous surveys of anaesthetic practice in Sweden showed a high degree of standardization and that structured protocols for the perioperative management are in place. However, the results of this survey were more diverse. EEG-based DOA monitors were used in half of all departments, but the frequency and indication for their use varied.

‘Respondents were overall quite skeptical about the value of EEG-based DOA monitors, however their use in patients at risk for awareness was more positive among the nurse anaesthetists than the anaesthesiologists,’ notes Professor Jakobsson. ‘This attitude to DOA monitoring may be due to the rather negative stance of the Swedish Council on Health Technology Assessment regarding these devices. This is in contrast to the national guidelines in the UK, which support the use of DOA monitoring in at-risk patients.’

‘The results show there is a need to improve the knowledge of anaesthesia personnel about risk factors, prevention and management of postoperative cognitive side effects,’ concludes Professor Jakobsson. EurekAlert