A new study suggests a pioneering testing technology could reduce hospital stays by up to eight days and lower annual health care costs for people with serious infections by approximately $2.2 million (
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For patients experiencing non-ST-segment elevation acute coronary syndromes (NSTE-ACS), a rapid invasive strategy (within 24 hours) using coronary angiography and other interventions is beneficial for high-risk as well as low-risk patients. However, this treatment may be constrained on weekends by the need to mobilize on-call catheterization teams. A new study evaluated costs associated with an early versus delayed invasive intervention strategy for patients presenting on weekdays and weekends. Investigators determined that early invasive strategy for Canadian NTSE-ACS patients significantly reduced costs, even on weekends, because of resulting shorter length of hospital stays (LOS).
According to lead investigator Andre Lamy, MD, MHSc, Population Health Research Institute, and Professor in the Department of Surgery and Department of Clinical Epidemiology, McMaster University, ‘Hospitals that currently tend to delay stable patients in favour of weekday catheterization instead of mobilizing the on-call team for an earlier invasive management of NSTE-ACS patients should consider the latter as the savings from adhering to the timing of an early intervention approach would outweigh additional costs.’
The research team analysed data from 479 Canadian patients from the Timing of Intervention in Acute Coronary Syndromes (TIMACS) multinational trial, which included 238 in the early strategy group and 241 in the delayed strategy group in order to assess the impact from the perspective of the Canadian healthcare system.
By the end of the trial patients who had received a strategy of early coronary angiography and intervention saved CAN $2,938 per patient compared to those who underwent a delayed strategy. These significant savings were driven by lower costs associated with LOS ($9,761 for those who underwent an early strategy compared to $12,569 for delayed; a savings of $2,808), especially in ICU/CCU and ward units. There was no significant difference in cost for study percutaneous coronary interventions, drugs, procedures or diagnostic procedures.
‘The results of our Canadian-led multinational trial shows that early intervention is a cost saving strategy for all patients with acute coronary syndromes. In higher risk patients, early intervention also appears to improve clinical outcomes,’ added TIMACS lead investigator Shamir R. Mehta, MD, MSc, Professor of Medicine, McMaster University, and Director, Interventional Cardiology, Hamilton Health Sciences.
EurekAlert
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Researchers at Tufts University, in collaboration with a team at the University of Illinois at Champaign-Urbana, have demonstrated a resorbable electronic implant that eliminated bacterial infection in mice by delivering heat to infected tissue when triggered by a remote wireless signal. The silk and magnesium devices then harmlessly dissolved in the test animals. The technique had previously been demonstrated only in vitro.
‘This is an important demonstration step forward for the development of on-demand medical devices that can be turned on remotely to perform a therapeutic function in a patient and then safely disappear after their use, requiring no retrieval,’ said senior author Fiorenzo Omenetto, professor of biomedical engineering and Frank C. Doble professor at Tufts School of Engineering. ‘These wireless strategies could help manage post-surgical infection, for example, or pave the way for eventual ‘wi-fi’ drug delivery.’
Implantable medical devices typically use non-degradable materials that have limited operational lifetimes and must eventually be removed or replaced. The new wireless therapy devices are robust enough to survive mechanical handling during surgery but designed to harmlessly dissolve within minutes or weeks depending on how the silk protein was processed, noted the paper’s first author, Hu Tao, Ph.D., a former Tufts post-doctoral associate who is now on the faculty of the Shanghai Institute of Microsystem and Information Technology, Chinese Academy of Sciences.
Each fully dissolvable wireless heating device consisted of a serpentine resistor and a power-receiving coil made of magnesium deposited onto a silk protein layer. The magnesium heater was encapsulated in a silk ‘pocket’ that protected the electronics and controlled its dissolution time.
Devices were implanted in vivo in S. aureus infected tissue and activated by a wireless transmitter for two sets of 10-minute heat treatments. Tissue collected from the mice 24 hours after treatment showed no sign of infection, and surrounding tissues were found to be normal. Devices completely dissolved after 15 days, and magnesium levels at the implant site and surrounding areas were comparable to levels typically found in the body.
The researchers also conducted in vitro experiments in which similar remotely controlled devices released the antibiotic ampicillin to kill E. coli and S. aureus bacteria. The wireless activation of the devices was found to enhance antibiotic release without reducing antibiotic activity.
Tufts University
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A multi-centre study of 169 men and women with a common form of neck pain suggests that both spinal steroid injections and conservative treatment with physical therapy and painkillers work equally well to relieve pain in the short term. But over time, a combination of the two appears to offer the most relief.
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As the rate of children with autism in the U.S. continues to grow, a new study shows that medical professionals can
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Needles almost too small to be seen with the unaided eye could be the basis for new treatment options for two of the world’s leading eye diseases: glaucoma and corneal neovascularization.
The microneedles, ranging in length from 400 to 700 microns, could provide a new way to deliver drugs to specific areas within the eye relevant to these diseases. By targeting the drugs only to specific parts of the eye instead of the entire eye, researchers hope to increase effectiveness, limit side effects, and reduce the amount of drug needed.
For glaucoma, which affects about 2.2 million people in the United States and is the second leading cause of blindness worldwide, the goal is to develop time-release drugs that could replace daily administration of eye drops. A painless microneedle injection made once every three to six months – potentially during regular office visits – could improve treatment outcomes by providing consistent dosages, overcoming patient compliance issues.
In the second disease, corneal neovascularization, corneal injury results in the growth of unwanted blood vessels that impair vision. To treat it, the researchers developed solid microneedles for delivering a dry drug compound that stops the vessel growth.
‘The power of microneedles for treating eye conditions is the ability to target delivery of the drug within the eye,’ said Mark Prausnitz, a Regents’ professor in the School of Chemical and Biomolecular Engineering at the Georgia Institute of Technology. ‘We are developing different microneedle-based systems that can put the drug precisely into the part of the eye where it’s needed. In many cases, we hope to couple that delivery with a controlled-release formulation that would allow one application to treat a condition for weeks or months.’
EurekAlert
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A research consortium headed by Professor Hossam Haick of the Technion-Israel Institute of Technology is developing a product that, when coupled with a smartphone, will be able to screen the user
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Oxford University doctors and scientists are starting the first safety trial of an experimental preventative Ebola vaccine regimen being developed by the Janssen Pharmaceutical Companies of Johnson & Johnson (Janssen).
The Oxford Vaccine Group, part of the University of Oxford Department of Paediatrics, aims to have vaccinated all 72 healthy adult volunteers by the end of January.
The development of this prime-boost vaccine regimen has been accelerated in response to the current outbreak of Ebola virus disease in West Africa, which has claimed over 6,000 lives. An effective vaccine would be an important step in controlling the spread of disease.
Volunteers for the trial, aged 18
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A collaborative effort by scientists has led to the development of an innovative strategy that can considerably improve the capabilities of medical imaging with safer procedures for the patient. Medical imaging is a significant part of healthcare today, with imaging techniques such as magnetic resonance imaging (MRI), computed tomography (CT) scanning, and nuclear magnetic resonance (NMR) increasing greatly over the last 20 years. However, continuing problems of image resolution and quality still hinder these techniques because of the nature of living tissue. A solution is hyperpolarization, which involves injecting the patient with substances that can enhance imaging quality by following the distribution and fate of specific molecules in the body but that can be harmful or potentially toxic to the patient. A team of scientists from Ecole Polytechnique F
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