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
Pregnant women with obstructive sleep apnea are more than five times as likely to die in the hospital than those without the sleep disorder, a comprehensive national study by University of South Florida researchers found.
Among delivery-related hospital discharges, sleep apnea was also associated with an increase in severe medical conditions that are top causes of maternal death, including pre-eclampsia, eclampsia, an enlarged heart and pulmonary blood clots.
Dr. Judette Louis, assistant professor of obstetrics and gynaecology at the USF Health Morsani College of Medicine, led the large-scale national study appearing in the journal SLEEP. She specialises in maternal-foetal medicine, working out of Tampa General Hospital.
Sleep apnea causes repeated awakenings and pauses in breathing during the night. Previous smaller studies have found that the condition increases the risk for poor pregnancy outcomes, including pre-eclampsia (high blood pressure in pregnancy associated with loss of protein in the urine), restricted growth of the foetus, preterm delivery and gestational diabetes. Obesity appears to contribute to the adverse effects.
However, the USF study provided the first large-scale U.S. analysis of the association between sleep apnea and maternal deaths.
‘The astounding association with maternal death was surprising,’ said lead author Judette Louis, MD, MPH, assistant professor of obstetrics and gynaecology at the USF Health Morsani College of Medicine who works out of Tampa General Hospital. ‘I did not expect to find such a difference in mortality between pregnant women who had sleep apnea and those who did not, especially when we controlled for obesity and other complicating factors.
While more study is needed, the increased likelihood of death for those with sleep apnea may be explained in part by the physiological demands of pregnancy, she said. ‘Underlying damage or chronic disease caused by sleep apnea may be exacerbated by the stresses of pregnancy.’
Maternal death rates have increased slightly in recent years, and obesity is one suspected reason.
‘Our study indicates that sleep apnea may also play a role, whether a woman is obese or not,’ said Dr. Louis, who holds a joint appointment in the USF College of Public Health
Following ischemic stroke, the integrity of the blood-brain barrier (BBB), which prevents harmful substances such as inflammatory molecules from entering the brain, can be impaired in cerebral areas distant from initial ischemic insult. This disruptive condition, known as diaschisis, can lead to chronic post-stroke deficits, University of South Florida researchers report.
In experiments using laboratory rats modelling ischemic stroke, USF investigators studied the consequences of the compromised BBB at the chronic post-stroke stage.
‘Following ischemic stroke, the pathological changes in remote areas of the brain likely contribute to chronic deficits,’ said neuroscientist and study lead author Svitlana Garbuzova-Davis, PhD, associate professor in the USF Health Department of Neurosurgery and Brain Repair. ‘These changes are often related to the loss of integrity of the BBB, a condition that should be considered in the development of strategies for treating stroke and its long-term effects.’
Edward Haller of the USF Department of Integrative Biology, the co-author who performed electron microscopy and contributed to image analysis, emphasised that ‘major BBB damage was found in endothelial and pericyte cells, leading to capillary leakage in both brain hemispheres.’ These findings were essential in demonstrating persistence of microvascular alterations in chronic ischemic stroke.
While acute stroke is life-threatening, the authors point out that survivors often suffer insufficient blood flow to many parts of the brain that can contribute to persistent damage and disability. Their previous investigation of subacute ischemic stroke showed far-reaching microvascular damage even in areas of the brain opposite from the initial stroke injury. While most studies of stroke and the BBB explore the acute phase of stroke and its effect on the blood-brain barrier, the present study revealed the longer-term effects in various parts of the brain.
The pathologic processes of stroke-induced vascular injury tend to occur in a ‘time-dependent manner,’ and can be separated into acute (minutes to hours), subacute (hours to days), and chronic (days to months). BBB incompetence during post-stroke changes is well-documented, with some studies showing the BBB opening can last up to four to five days after stroke. This suggests that harmful substances entering the brain during this prolonged BBB leakage might increase post-ischemic brain injury.
In this study, the researchers used laboratory rats modelling ischemic stroke and observed injury not only in the primary area of the stroke, but also in remote areas, where persistent BBB damage could cause chronic loss of competence.
The primary focus for therapy development could be restoring endothelial and/or astrocytic integrity towards BBB repair, which may be ‘beneficial for many chronic stroke patients,’ senior authors Cesar V. Borlongan and Paul R. Sanberg suggest. The researchers also recommend that cell therapy might be used to replace damaged endothelial cells.
‘A combination of cell therapy and the inhibition of inflammatory factors crossing the blood-brain barrier may be a beneficial treatment for stroke,’ Garbuzova-Davis said.
University of South Florida
Commonly used disinfectants do not kill human papillomavirus (HPV) that makes possible non-sexual transmission of the virus, thus creating a need for hospital policy changes, according to researchers from Penn State College of Medicine and Brigham Young University.
‘Because it is difficult to produce infectious HPV particles for research, little has been known about HPV susceptibility to disinfection,’ said Craig Meyers, Distinguished Professor of Microbiology and Immunology, Penn State College of Medicine.
Use of disinfectants on HPV in health care settings has been based on what works on other viruses or what is thought should be effective.
Meyers collaborated with Richard Robison, an expert in microbial disinfectants at Brigham Young University.
HPV is estimated to be among the most common sexually transmitted diseases and is linked to cervical cancers. For this study, researchers grew HPV16, a specific strain that is responsible for up to 60 percent of all HPV-associated cancers. They then used 11 common disinfectants on the virus.
These disinfectants included ones made of ethanol and isopropanol because these are common ingredients in surface disinfectants and hand sanitises used in both public and health care settings. Study of these hand sanitises is important because other research has shown high levels of HPV DNA on fingers of patients with current genital infections. While HPV is susceptible to certain disinfectants, including hypochlorite and peracetic acid, it is resistant to alcohol-based disinfectants.
‘Chemical disinfectants in hand sanitiser are commonly used in the general population to prevent the spread of infectious diseases,’ Meyers said. ‘For flu or cold viruses they are very effective. But the data shows that they do nothing for preventing the spread of human papillomavirus.’
They also tested other common disinfectants, including glutaraldehyde, which is used for sterilisation in medical and dental facilities. Results show that glutaraldehyde is not effective at inactivating the HPV virus.
Other research has suggested that HPV could be transmitted non-sexually. The current study shows that medical instruments considered sterile could pose a risk for transmission.
‘Chemical disinfectants used in the hospitals and other healthcare settings have absolutely no effect on killing human papillomavirus,’ Meyers said. ‘So unless bleach or autoclaving is used in the hospital setting, human papillomavirus is not being killed and there is a potential spread of HPV through hospital acquired or instrument or tool infection.’
Meyers said the results suggest a need for a change in disinfectant use policies. Penn State University
Individuals who are squeamish about injections or are looking for a way to let collagen penetrate deeper into the skin may soon have a solution that is faster, more effective and painless. The key lies in a small adhesive patch topped with minuscule needles that is pioneered by researchers from the National University of Singapore (NUS).
The research team, led by Dr Kang Lifeng of the Department of Pharmacy at the NUS Faculty of Science, has successfully developed a simple technique to encapsulate lidocaine, a common painkiller, or collagen in the tiny needles attached to an adhesive patch. When applied to the skin, the microneedles deliver the drug or collagen rapidly into the skin without any discomfort to the user.
This innovation could be used clinically to administer painkiller non-invasively to patients, or in home care settings for patients suffering from conditions such as diabetes and cancer. In addition, the novel transdermal delivery system could also be used for cosmetic and skincare purposes to deliver collagen to inner skin layers.
Faster delivery of painkillers is key to effective management of acute and chronic pain conditions. Currently, such drugs are mainly administered through invasive injections, or through the use of conventional transdermal patches, which may have limited efficiency due to variability of drug absorption among individuals.
To address the clinical gap, Dr Kang, together with Dr Jaspreet Singh Kochhar, who had recently graduated from NUS with a doctorate degree in Pharmacy, and their team members, used a photolithography based process to fabricate a novel transdermal patch with polymeric microneedles. The tiny needles are encapsulated with lidocaine, a common painkiller known for its pain-relief property.
Laboratory experiments showed that the novel microneedles patch can deliver lidocaine within five minutes of application while a commercial lidocaine patch takes 45 minutes for the drug to penetrate into the skin. The shorter time for drug delivery is made possible as the miniature needles on the patch create micrometre-sized porous channels in the skin to deliver the drug rapidly. As the needle shafts are about 600 micro-meters in length, they do not cause any perceivable pain on the skin.
The patch also comprises a reservoir system to act as channels for drugs to be encapsulated in backing layers, circumventing the premature closure of miniaturised pores created by the microneedles. This facilitates continued drug permeation. In addition, the size of patch could be easily adjusted to encapsulate different drug dosages.
By delivering painkillers faster into the body through the skin, patients could potentially experience faster pain relief. In addition, enabling a larger amount of lidocaine to permeate through the skin could potentially reduce the time needed to apply the patch and this reduces the likelihood of patients developing skin irritation. National University of Singapore
By 2015, all baby boomers will be 50 or older. In an editorial for the Journal of Addictions Nursing, Savage writes that, unlike members of previous generations, many of these individuals have been using alcohol (and other drugs) for their entire adult lives. There are consequences.
Novartis announced that its eye care division Alcon has entered into an agreement with a division of Google Inc. to in-license its ‘smart lens’ technology for all ocular medical uses. The agreement with Google[x], a team within Google that is devoted to finding new solutions to big global problems, provides Alcon with the opportunity to develop and commercialize Google’s ‘smart lens’ technology with the potential to transform eye care and further enhance Alcon’s pipeline and global leadership in contact lenses and intraocular lenses. The transaction remains subject to anti-trust approvals.
The agreement between Google and Alcon represents an important step for Novartis, across all of its divisions, to leverage technology to manage human diseases and conditions. Google’s key advances in the miniaturization of electronics complement Novartis’s deep pharmaceuticals and medical device expertise. Novartis aims to enhance the ways in which diseases are mapped within the body and ultimately prevented.
‘We are looking forward to working with Google to bring together their advanced technology and our extensive knowledge of biology to meet unmet medical needs,’ said Novartis CEO Joseph Jimenez. ‘This is a key step for us to go beyond the confines of traditional disease management, starting with the eye.’
‘Our dream is to use the latest technology in the miniaturization of electronics to help improve the quality of life for millions of people,’ said Sergey Brin, Co-Founder, Google. ‘We are very excited to work with Novartis to make this dream come true.’
Under the agreement, Google[x] and Alcon will collaborate to develop a ‘smart lens’ that has the potential to address ocular conditions. The smart lens technology involves non-invasive sensors, microchips and other miniaturized electronics which are embedded within contact lenses. Novartis’ interest in this technology is currently focused in two areas:
Helping diabetic patients manage their disease by providing a continuous, minimally invasive measurement of the body’s glucose levels via a ‘smart contact lens’ which is designed to measure tear fluid in the eye and connects wirelessly with a mobile device;
For people living with presbyopia who can no longer read without glasses, the ‘smart lens’ has the potential to provide accommodative vision correction to help restore the eye’s natural autofocus on near objects in the form of an accommodative contact lens or intraocular lens as part of the refractive cataract treatment.
The agreement marries Google’s expertise in miniaturized electronics, low power chip design and micro-fabrication with Alcon’s expertise in physiology and visual performance of the eye, clinical development and evaluation, as well as commercialization of contact and intraocular lenses. Through the collaboration, Alcon seeks to accelerate product innovation based on Google’s ‘smart lens’ technology.
‘Alcon and Google have a deep and common passion for innovation,’ said Jeff George, Division Head of Alcon. ‘By combining Alcon’s leadership in eye care and expertise in contact lenses and intraocular lenses with Google’s innovative ‘smart lens’ technology and groundbreaking speed in research, we aim to unlock a new frontier to jointly address the unmet medical needs of millions of eye care patients around the world.’ Novartis
In a review, Kevin J. Tracey, MD, president of The Feinstein Institute for Medical Research, says it
A Penn Medicine team has found that targeted automated alerts in electronic health records significantly reduce urinary tract infections in hospital patients with urinary catheters. In addition, when the design of the alert was simplified, the rate of improvement dramatically increased.
The alerts help physicians decide whether their patients need urinary catheters in the first place and then alert them to reassess the need for catheters that have not been removed within a recommended time period. The electronic alert was developed by medical researchers and technology experts at the Perelman School of Medicine at the University of Pennsylvania.
Approximately 75 percent of urinary tract infections acquired in the hospital are associated with a urinary catheter, which is a tube inserted into the bladder through the urethra to drain urine. According to the Centers for Disease Control and Prevention, 15 to 25 percent of hospitalized patients receive urinary catheters during their hospital stay. As many as 70 percent of urinary tract infections in these patients may be preventable using infection control measures such as removing no longer needed catheters resulting in up to 380,000 fewer infections and 9,000 fewer deaths each year.
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
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