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Archive for category: E-News

E-News

One-minute point-of-care anemia test shows promise in new study

, 26 August 2020/in E-News /by 3wmedia

A simple point-of-care testing device for anemia could provide more rapid diagnosis of the common blood disorder and allow inexpensive at-home self-monitoring of persons with chronic forms of the disease.
The disposable self-testing device analyses a single droplet of blood using a chemical reagent that produces visible colour changes corresponding to different levels of anemia. The basic test produces results in about 60 seconds and requires no electrical power. A companion smartphone application can automatically correlate the visual results to specific blood hemoglobin levels.
By allowing rapid diagnosis and more convenient monitoring of patients with chronic anemia, the device could help patients receive treatment before the disease becomes severe, potentially heading off emergency room visits and hospitalizations. Anemia, which affects two billion people worldwide, is now diagnosed and monitored using blood tests done with costly test equipment maintained in hospitals, clinics or commercial laboratories.
Because of its simplicity and ability to deliver results without electricity, the device could also be used in resource-poor nations.
Using a two-piece prototype device, the test works this way: a patient sticks a finger with a lance similar to those used by diabetics to produce a droplet of blood. The device

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Survey finds low awareness about risks of cognitive side effects following surgery

, 26 August 2020/in E-News /by 3wmedia

Survey of Swedish anesthesia personnel reveals the need to improve knowledge, particularly in elderly and fragile patients.
Postsurgical cognitive side effects can have major implications for the level of care, length of hospital stay, and the patient

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MRI probe technology shows brain toxins in living animals for first time

, 26 August 2020/in E-News /by 3wmedia

No methods currently exist for the early detection of Alzheimer

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Perioperative Surgical Home improves quality, reduces health care costs

, 26 August 2020/in E-News /by 3wmedia

The Perioperative Surgical Home (PSH) model consistently and significantly improves quality of care for patients and reduces health care costs, reports a first-of-its-kind, large-scale literature review of the PSH in the United States and abroad. The review provides further evidence to support the benefits, and encourage the adoption, of the PSH model.

‘There is a global push for more rigorously coordinated and integrated management of surgical patients to enhance patient satisfaction and improve quality of care and outcomes, while cutting costs,’ said Thomas R. Miller, Ph.D., M.B.A., co-author of the review and director of health policy research at the American Society of Anesthesiologists, Schaumburg, Ill. ‘Whether in the U.S. or overseas, our review found that the PSH model of care is highly effective at achieving these measures by reducing cancellations and surgical delays, lowering complication rates and readmissions, and shortening hospital stays.’

The PSH is a patient-centred, physician-led, multidisciplinary team-based model of coordinated care. In a PSH, a patient’s entire surgical experience – preoperative, intraoperative, postoperative and post-discharge – is fully coordinated and treated as one continuum of care. The PSH model emphasizes the cost-efficient use of resources as well as lead physician, multi-specialty team and patient-shared decision-making.

Interestingly, both U.S. and international studies stressed the importance of the role of physician anaesthesiologists in perioperative patient management and PSH models of care.

‘This literature review provides still more evidence that physician anaesthesiologist-led anaesthesia care teams are associated with better patient outcomes, fewer complications, less pain, earlier return to functionality and home, and lower costs,’ said J.P. Abenstein, ASA president. ‘The Perioperative Surgical Home will advance our goals of improved patient safety, quality of care and cost-effectiveness. Every patient undergoing an invasive procedure deserves the involvement of a physician anaesthesiologist in their care.’

Researchers from Texas A&M University and the ASA performed a comprehensive analysis of 152 peer-reviewed studies published between 1980 and 2013. They compared PSH models in the U.S. and other countries and summarized the findings related to clinical outcomes and efficiencies/cost of surgery in various surgical homes. All studies were categorized as preoperative, intraoperative or postoperative in scope.

According to the review, 82 percent of preoperative studies analysed found that the PSH model had a significant positive impact on preoperative clinical outcomes (32 studies) and reduced costs (23 studies). Studies cited preoperative patient education as a component of the PSH model that significantly reduced length of stays and readmission rates. Additionally, studies cited that minimizing the number of unnecessary preoperative tests was found to reduce costs. In fact, one study found eliminating unneeded tests reduced costs by as much $112 per patient, for a total of $1.01 million over the course of the study.

Eighty-two percent of intraoperative studies analysed found that the PSH model had a significant positive impact on intraoperative clinical outcomes (29 studies) and reduced costs (17 studies). Studies cited design and process flow initiatives such as real-time patient-routing systems (real-time electronic dashboards that ensure access to medical records) as one of the intraoperative components of the PSH model that led to a reduction in O.R. delays, surgical cancellations and improved efficiencies.

Last, 90 percent of postoperative studies analysed found that the PSH model had a significant positive impact on clinical outcomes (71 studies) and reduced costs (23 studies). Studies cited enhanced recovery after surgery programs as a component of the PSH model that significantly helped reduce complications, length of stays and costs by encouraging quicker recovery and earlier discharges.

‘We would like to see the PSH model of care be adopted nationwide,’ said Miller. ‘Large reviews such as this show just how successful this model of care can be at raising the quality of care for patients, while meeting the increasing demands of health care reform.’ EurekAlert

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Proton therapy shown to be less costly than some alternatives

, 26 August 2020/in E-News /by 3wmedia

In terms of duration of treatment and cost, patients with early stage breast cancer may benefit from accelerated partial breast irradiation (APBI) with proton therapy versus whole breast irradiation (WBI), according to new research from The University of Texas MD Anderson Proton Therapy Center. 

In a cost analysis study based on typical patient characteristics, researchers used Medicare reimbursement codes to analyse allowable charges for eight different types of partial and whole breast irradiation therapies and treatment schedules available to early stage breast cancer patients. Taken together, these represent roughly 98% of the treatment options available to these patients. The cost of proton therapy when used for APBI, introduced to decrease overall treatment time and toxicity, was estimated at $13,833. Comparatively, WBI using IMRT (x-ray) therapy resulted in the highest Medicare charges at $19,599. The average charges across the eight treatment regimens were $12,784; thus, proton costs were similar to that of other types of radiation.

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Phone counselling reduces pain, disability after back surgery

, 26 August 2020/in E-News /by 3wmedia

Research by Johns Hopkins scientists suggests that having a short series of phone conversations with trained counsellors can substantially boost recovery and reduce pain in patients after spinal surgery.

The phone calls, designed to enrich standard pre- and post-operative care by reinforcing the value of sticking with physical therapy and back-strengthening exercise regimens, are a relatively inexpensive and simple intervention that can maximize surgical outcomes for the hundreds of thousands of patients who undergo spinal surgeries every year, the investigators say.

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Using portable ultrasound to identify possible heart attacks and strokes before symptoms arise

, 26 August 2020/in E-News /by 3wmedia

A study of portable ultrasound performed in the United States, Canada, and India has revealed the potential of this technology for identifying plaques in peripheral arteries that can lead to heart attacks and stroke before symptoms occur, in both developed and developing country environments, allowing preventive treatment in those affected.

The study was conducted by Dr. Ram Bedi, affiliate assistant professor, department of bioengineering, University of Washington (Seattle, WA, USA), and Prof. Jagat Narula, editor-in-chief of Global Heart and Icahn School of Medicine at Mount Sinai (New York, NY, USA), and colleagues.

Many research studies have shown that it is possible to evaluate subclinical atherosclerotic cardiovascular disease (ASCVD) using ultrasound imaging. Because more portable and lower cost ultrasound devices are now available, combined with increased automation and enhancements, it may be possible in the near future to typically examine people with ultrasound to establish any ASCVD present before symptoms arise, so that future disease can be prevented, for example using medication. In this study, ASCVD was determined using ultrasound of both the carotid arteries and the ileofemoral arteries. The findings were summarized in an easy to understand index called the Fuster-Narula (FUN) Score.

Data were gathered from four cohorts, two Indian and two North American. In India, a medical camp setting was used, and screening with automated ultrasound imaging was conducted over eight days in 941 comparatively young (mean age 44 years, 34% female) asymptomatic volunteers recruited from the semi-urban town of Sirsa (Haryana) and urban city of Jaipur (Rajasthan) in northern India. The cohort from Sirsa was specifically recruited because all participants had already undergone aggressive lifestyle changes (smoking cessation, no alcohol, vegetarian diet, physically active lifestyles, daily meditation), radiology resident physicians who had no earlier training in vascular ultrasound were trained right on the spot to perform the ultrasound examinations.

To compare the imaging findings with traditional risk factors, two cohorts (481 persons) were recruited from primary care clinics in North America (one in Richmond, TX, USA, the other in Toronto, Canada). As well as the same ultrasound examinations given in the Indian cohort, comprehensive ASCVD risk factor information collected from these participants, all of whom were self-referred asymptomatic individuals (mean age 60 years, 39% female). Data collected included cholesterol levels, blood pressure, glucose level, weight, height, smoking and family history. These people were attending clinics for routine health examinations in most cases. Effectiveness of established ASCVD prevention guidelines was then compared to findings from direct imaging; ultrasound was performed by trained experts at each center.

In India, ultrasound revealed plaques in at least one artery in almost a quarter (24%) of those examined; 107 (11%) had plaques in only the carotids, 70 (7%) in both the carotids and iliofemoral arteries, and 47 (5%) had plaques in only the iliofemoral arteries. If just the carotids had been examined, 177 (19%) of the asymptomatic individuals would have been identified with plaques; by adding the iliofemoral examination, 47 additional individuals (5% of the total) were identified with plaque. Older age and male sex were associated with the presence of plaque both in urban and semi-urban populations (the much higher levels of smoking in men could account for their higher risk).

Data from the American and Canadian clinics showed that 203 subjects (42%) had carotid plaque; 166 of these (82% of those with plaque) would not have qualified for lipid-lowering therapy such as statins under the most widely used guidelines known as ATP III (Third Report of the Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults [Adult Treatment Panel]) guidelines. Using the recently published, more rigid ATP IV guidelines, 67 people (one-third of those with plaque and 14% of the total US/Canadian cohort) individuals with carotid plaque would also have failed to qualify for treatment.

Furthermore, the study revealed 34 individuals in the United States and Canada who qualified for treatment under ATP III but did not have any plaques, and this number increased to 81 under ATP IV (if receiving treatment such as statins, these people could be said to be overtreated, since no plaques were seen).

The investigators reported,

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New device reduces scarring in damaged blood vessels

, 26 August 2020/in E-News /by 3wmedia

When blood vessels are damaged through surgery, it can trigger an endless cycle of scarring and repair.

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Temple Study Suggests a Novel Approach for Treating Non-Cardiac Chest Pain

, 26 August 2020/in E-News /by 3wmedia

Chest pain doesn’t necessarily come from the heart. An estimated 200,000 Americans each year experience non-cardiac chest pain, which in addition to pain can involve painful swallowing, discomfort and anxiety. Non-cardiac chest pain can be frightening for patients and result in visits to the emergency room because the painful symptoms, while often originating in the esophagus, can mimic a heart attack. Current treatment

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Clever application of magnetic force enhances laparoscopic surgery

, 26 August 2020/in E-News /by 3wmedia

Pietro Valdastri is convinced that the clever application of magnetic force can make minimally invasive surgery easier and more effective.

‘In 2007, a team of University of Texas researchers did some basic experiments using magnets in laparoscopic surgery,’ said Valdastri, assistant professor of mechanical engineering and director of Vanderbilt University’s Science and Technology of Robotics in Medicine (STORM) Lab.

‘Although their designs were very simple, mechanically speaking, they made me realize that small surgical devices guided and powered by external magnets have a number of potential advantages over placing tools on the end of a stick, which is the current approach. All that was required is a little sophisticated engineering!’

This realization led Valdastri and his graduate students – particularly Christian Di Natali and Nicol

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