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Archive for category: E-News

E-News

Nearly one in five women who undergo hysterectomy may not need the procedure

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

It is estimated that one in three women in the United States will have had a hysterectomy by the age of 60. Although the numbers of hysterectomies are decreasing, a new study of more than three thousand women in Michigan who underwent hysterectomy for benign indications reveals that alternatives to hysterectomy are being underused and that treatment guidelines are often not followed. Post-surgical pathology showed that nearly one in five (18%) of hysterectomies that were done for benign indications were unnecessary, and that nearly two in five (37.8%) of women under 40 had unsupportive pathology.

Over 400,000 hysterectomies are performed in the US each year. About 68% of surgeries for benign conditions are done because of abnormal uterine bleeding, uterine fibroids, and endometriosis. The American Congress of Obstetricians and Gynecologists recommends alternatives to hysterectomy, including hormonal and other forms of medical management, operative hysteroscopy, endometrial ablation, and use of the levonorgestrel intrauterine device as primary management of these conditions in many cases.

‘Over the past decade, there has been a substantial decline in the number of hysterectomies performed annually in the United States,’ observes senior investigator Daniel M. Morgan, MD, Associate Professor of Obstetrics and Gynecology at the University of Michigan. ‘An earlier study found a 36.4% decrease in number of hysterectomies performed in the U.S. in 2010 compared to 2002. However, despite the decrease in numbers of hysterectomies in the U.S., appropriateness of hysterectomy is still an area of concern and it continues to be a target for quality improvement.’

Investigators set out to assess how often alternatives to hysterectomy are being recommended to women with benign gynaecologic disease before performing hysterectomy and how often the pathologic findings from the hysterectomy supported an indication for surgery. They examined the medical records of 3,397 women who underwent hysterectomies for benign conditions in Michigan with these goals in mind. Data were collected over a ten-month period in 2013 from 52 hospitals participating in the Michigan Surgery Quality Collaborative (MSQC). Indications for surgery included uterine fibroids, abnormal uterine bleeding, endometriosis, or pelvic pain.

Nearly 40% of women did not have documentation of alternative treatment before their hysterectomy. Fewer than 30% received medical therapy, while 24% underwent other minor surgical procedures before the hysterectomy. Alternative treatment was more likely to be considered among women under 40 years old and among women with larger uteri. About 68% of women under 40 received alternative treatment compared with 62% of those aged 40-50 and 56% of those aged 50 or above.

Nearly one in five women (18.3%) had postsurgical pathologic findings that did not support having undergone a hysterectomy. The rate of unsupportive pathology was highest among women under 40 years. Nearly two in five women under 40 (37.8%) had pathologic findings that did not support undergoing a hysterectomy versus those aged 40-50 (12%) and over 50 years (7.5%). The frequency of unsupportive pathology was highest among women with a pre-operative diagnosis of endometriosis or chronic pain.

‘This study provides evidence that alternatives to hysterectomy are underutilized in women undergoing hysterectomy for abnormal uterine bleeding, uterine fibroids, endometriosis, or pelvic pain,’ says Dr. Morgan.

‘Although quality in gynaecologic surgery has focused on care after a procedure, these findings suggest that appropriateness of surgery could serve as an important quality metric in gynaecology,’ comments noted expert Jason D. Wright, MD, Chief of the Division of Gynecologic Oncology and Sol Goldman Associate Professor of Obstetrics and Gynecology at Columbia University College of Physicians and Surgeons and New York Presbyterian Hospital, New York.

Dr. Wright adds: ‘Reducing the number of procedures performed in women who may not necessarily require the procedure in the first place has the potential to have an even more meaningful impact in reducing adverse outcomes and cost than optimization of postoperative care. As reimbursement policies shift, appropriateness of surgery will likely become an even greater imperative from patients and payers.’ EurekAlert

https://interhospi.com/wp-content/uploads/sites/3/2020/06/logo-footer.png 44 200 3wmedia https://interhospi.com/wp-content/uploads/sites/3/2020/06/Component-6-–-1.png 3wmedia2020-08-26 14:39:472020-08-26 14:39:59Nearly one in five women who undergo hysterectomy may not need the procedure

Vibratory stimulation applied to the sole of the foot shows promise for fall

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

Findings show that imperceptible vibratory stimulation applied to the soles of the feet improved balance by reducing postural sway and gait variability in elderly study participants. The vibratory stimulation is delivered by a urethane foam insole with embedded piezoelectric actuators, which generates the mechanical stimulation. The study was conducted by researchers from the Institute for Aging Research (IFAR) at Hebrew SeniorLife, Beth Israel Deaconess Medical Center, the Wyss Institute for Biologically Inspired Engineering at Harvard University, and Harvard Medical School, all of Boston, Massachusetts; and Merck Sharpe and Dohme (MSD) Consumer Care, Inc., of Memphis, Tennessee.

These findings are significant because poor balance and an irregular gait are directly related to fall risk. Falls are the leading cause of death from injury among seniors. Risk increases with age and even the fear of falling can reduce quality of life.

1 in 3 seniors falls each year, and 25% of those who fall suffer moderate to severe injuries, such as hip fractures.
Only 25% of hip fracture patients make a full recovery; 40% require nursing home care; and nearly 25% die within 12 months.
By 2020, the annual direct and indirect cost of fall injuries is expected to reach nearly $55 billion.
‘Although loss of sensation in the feet is a common problem among elderly people that can impair balance and gait and result in falls, there are currently no interventions available that can reverse sensory impairments and prevent these dangerous consequences,’ said study lead author Lewis Lipsitz, M.D., Director of the Institute for Aging Research. ‘We were very excited to discover that small amounts of vibratory noise applied to the soles of the feet may be able to do just that.’

This study follows earlier research that looked at how the physical principle of stochastic resonance could be applied to mitigate deficits in the human somatosensory systems that develop due to disease, injury, or age. The somatosensory system informs us about objects in our external environment through touch. Receptors are distributed all over the body and different types of receptors respond to many different kinds of stimuli. Stochastic resonance (SR) is a phenomenon whereby the detectability of weak signals in certain types of systems can be improved through the careful addition of low

https://interhospi.com/wp-content/uploads/sites/3/2020/06/logo-footer.png 44 200 3wmedia https://interhospi.com/wp-content/uploads/sites/3/2020/06/Component-6-–-1.png 3wmedia2020-08-26 14:39:472020-08-26 14:40:07Vibratory stimulation applied to the sole of the foot shows promise for fall

Robotic surgery linked to 144 deaths in the US

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

Surgical robots allow doctors to improve recovery time and minimise scarring.  A study into the safety of surgical robots has linked the machines’ use to at least 144 deaths and more than 1,000 injuries over a 14-year period in the US.
The events included broken instruments falling into patients’ bodies, electrical sparks causing tissue burns and system errors making surgery take longer than planned. The report notes that the figures represent a small proportion of the total number of robotic procedures.

But it calls for fresh safety measures. ‘Despite widespread adoption of robotic systems for minimally invasive surgery, a non-negligible number of technical difficulties and complications are still being experienced during procedures,’ the study states. ‘Adoption of advanced techniques in design and operation of robotic surgical systems may reduce these preventable incidents in the future.’

Robotic surgery can reduce the risk of infections and help patients heal more quickly.
The work was carried out by researchers at the University of Illinois at Urbana-Champaign, the Massachusetts Institute of Technology and Chicago’s Rush University Medical Center.

Their paper says 144 deaths, 1,391 injuries and 8,061 device malfunctions were recorded out of a total of more than 1.7 million robotic procedures carried out between January 2000 and December 2013. This was based on reports submitted by hospitals, patients, device manufacturers and others to the US Food and Drug Administration, and the study notes that the true number could be higher.

Surgeons face the risk of broken parts causing injury or lengthening procedures
Its authors say the number of injuries and deaths per procedure has remained relatively constant since 2007. But due to the fact that the use of robotic systems is increasing ‘exponentially’, they add, this means that the number of accidents is increasing every year.

They highlight that when problems do occur, people are several times more likely to die if the surgery involves their heart, lungs, head and/or neck rather than gynaecological and urological procedures.

They acknowledge that the data does not pinpoint why, but suggest it is because the former are more complex types of operations for which robots are less commonly used, so there is less experience and expertise available.
The researchers did not, however, compare accident rates with similar operations in which robots were not used. Their study has not been peer reviewed.

Surgical robotic devices are typically expensive – costing millions of pounds – but offer advantages.
They can allow surgeons to use smaller instruments, letting them make smaller and more nimble cuts. That can mean patients recover faster, with less risk of infection and the promise of smaller scars.
In addition, the development of remote surgery means that doctors do not always need to be in the same room as their patients, allowing specialists who are in demand to treat more people.

The report acknowledges that the ‘vast majority of procedures’ involving robots were successful BBC

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Novel portable ultrasound device for diagnosis of bacterial meningitis in babies

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

A team of biomedical engineers have developed a prototype of a low-cost portable device that can detect bacterial meningitis in babies replacing the existing painful and difficult lumbar puncture puncture test.

The innovative procedure consists of a simple, non-invasive, high-resolution ultrasound scan of part of the brain, called the fontanelle, through an opening between the cranial bones of babies under 12 months of age. The researchers created algorithms that analyse the image and can indicate, within seconds, whether cellularity, a sign of infection, exists in the cerebrospinal fluid.

The economical procedure, aims to revolutionize the detection of this illness, especially in developing countries where hospitals do not have the facilities to carry out the lumbar puncture. Without the test many children die or suffer serious complications as a result of bacterial meningitis. The procedure can be used without specialized training, and has already been tested on a small number of babies at the La Paz University Hospital (Madrid, Spain).

The research was carried out by the Madrid-MIT M+Visi

https://interhospi.com/wp-content/uploads/sites/3/2020/06/logo-footer.png 44 200 3wmedia https://interhospi.com/wp-content/uploads/sites/3/2020/06/Component-6-–-1.png 3wmedia2020-08-26 14:39:222020-08-26 14:39:29Novel portable ultrasound device for diagnosis of bacterial meningitis in babies

Sepsis screening tool spots subtle signs, saves lives

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

A simple screening tool predicts sepsis early in trauma patients and reduces mortality, according to a new study.

https://interhospi.com/wp-content/uploads/sites/3/2020/06/logo-footer.png 44 200 3wmedia https://interhospi.com/wp-content/uploads/sites/3/2020/06/Component-6-–-1.png 3wmedia2020-08-26 14:39:222020-08-26 14:39:37Sepsis screening tool spots subtle signs, saves lives

Faecal transplants in treatment of Clostridium difficile infection

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

New evidence has been gained for the success of faecal microbial transplantation in treating severe Clostridium difficile infection, a growing problem worldwide that leads to thousands of fatalities every year. The findings have important implications for a range of diseases associated with microbial imbalance, or dysbiosis, researchers say.

Research led by Michael Sadowsky, Alex Khoruts, and colleagues at the University of Minnesota in collaboration with the Rob Knight Lab at the University of Colorado, Boulder, reveals that healthy changes to a patient’s microbiome are sustained for up to 21 weeks after transplant, and has implications for the regulation of the treatment. Findings also demonstrate the dynamic nature of faecal microbiota in FMT donors and recipients.

In FMT, faecal matter is collected from a donor, purified, mixed with a saline solution and placed in a patient, usually by colonoscopy. In contrast to standard antibiotic therapies, which further disrupt intestinal microflora and may contribute to the recurrence of CDI, FMT restores the intestinal microbiome and healthy gut function.
Using DNA samples of healthy individuals from the Human Microbiome Project (HMP) as a baseline, Sadowsky and his team compared changes in faecal microbial communities of recipients over time to the changes observed within samples from the donor. Significantly, the composition of gut microbes in the both donor and recipient groups varied over the course of the study, but remained within the normal range when compared to hundreds of samples collected by the HMP.

According to Sadowsky, the findings have important implications for a range of diseases associated with microbial imbalance, or dysbiosis, and could influence the regulatory regime surrounding FMT, currently treated as a drug by the U.S. Food and Drug Administration (USFDA).

‘The dynamic nature of fecal microbiota in both the donor and recipients suggests that the current framework of regulation, requiring consistent composition, may need to be re-examined for faecal transplantations,’ says Michael Sadowsky. ‘Change in faecal microbial composition is consistent with normal responsiveness to shifts in the diet and other environment factors. Variability should be taken into account when comparing microbial composition in normal individuals to those with dysbiosis characteristic of disease states, especially when assessing clinical interventions and outcomes.

Also discovered in the research, the performance of frozen and fresh preparations of faecal material was indistinguishable. Though the sample was limited and warrants further study with a larger cohort, it has several implications for the widespread adoption of FMT. The frozen preparation greatly simplifies the standardization and distribution of the faecal material. It also facilitates long-term storage of donor material for future study and makes FMT accessible to a greater number of physicians and patients. Finally, it offers advantages over fresh material in the testing of faecal samples for pathogens, which in some cases can take several weeks to complete. ScienceDaily

https://interhospi.com/wp-content/uploads/sites/3/2020/06/logo-footer.png 44 200 3wmedia https://interhospi.com/wp-content/uploads/sites/3/2020/06/Component-6-–-1.png 3wmedia2020-08-26 14:39:222020-08-26 14:39:45Faecal transplants in treatment of Clostridium difficile infection

Stem cells might heal damaged lungs

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

Collectively, such diseases of the airways as emphysema, bronchitis, asthma and cystic fibrosis are the second leading cause of death worldwide. More than 35 million Americans alone suffer from chronic respiratory disease. Weizmann Institute scientists have now proposed a new direction that could, in the future, lead to the development of a method for alleviating some of their suffering. The study

https://interhospi.com/wp-content/uploads/sites/3/2020/06/logo-footer.png 44 200 3wmedia https://interhospi.com/wp-content/uploads/sites/3/2020/06/Component-6-–-1.png 3wmedia2020-08-26 14:39:222020-08-26 14:39:24Stem cells might heal damaged lungs

Controlling a robotic arm with a patient’s intentions

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

Neural prosthetic devices implanted in the brain’s movement centre, the motor cortex, can allow patients with amputations or paralysis to control the movement of a robotic limb

https://interhospi.com/wp-content/uploads/sites/3/2020/06/logo-footer.png 44 200 3wmedia https://interhospi.com/wp-content/uploads/sites/3/2020/06/Component-6-–-1.png 3wmedia2020-08-26 14:39:222020-08-26 14:39:32Controlling a robotic arm with a patient’s intentions

Potential new painkiller provides longer lasting effects

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

Medications have long been used to treat pain caused by injury or chronic conditions. Unfortunately, most are short-term fixes or cause side effects that limit their use. Researchers at the University of Missouri have discovered a new compound that offers longer lasting painkilling effects, and shows promise as an alternative to current anaesthetics.

https://interhospi.com/wp-content/uploads/sites/3/2020/06/logo-footer.png 44 200 3wmedia https://interhospi.com/wp-content/uploads/sites/3/2020/06/Component-6-–-1.png 3wmedia2020-08-26 14:39:222020-08-26 14:39:39Potential new painkiller provides longer lasting effects

A person?s diet, acidity of urine may affect susceptibility to UTIs

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

The acidity of urine

https://interhospi.com/wp-content/uploads/sites/3/2020/06/logo-footer.png 44 200 3wmedia https://interhospi.com/wp-content/uploads/sites/3/2020/06/Component-6-–-1.png 3wmedia2020-08-26 14:39:222020-08-26 14:39:27A person?s diet, acidity of urine may affect susceptibility to UTIs
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Latest issue of International Hospital

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