A therapy that replaces the faulty gene responsible for cystic fibrosis in patients’ lungs has produced encouraging results in a major UK trial.
One hundred and thirty six patients aged 12 and over received monthly doses of either the therapy or the placebo for one year.
The clinical trial reached its primary endpoint with patients who received therapy having a significant, if modest benefit in lung function compared with those receiving a placebo.
Patients from across England and Scotland participated, and were treated in two centres, Royal Brompton Hospital in London and the Western General Hospital in Edinburgh.
The trial is the first to show that repeated doses of gene therapy can have a meaningful effect on the disease, and change the lung function of patients. However, the team say more research is needed to improve the effectiveness before the therapy will be suitable for clinical use.
Imperial College London
Cardiologists at The Mount Sinai Hospital have begun implanting tiny, state-of-the-art microchip sensors in patients with advanced heart failure to better monitor symptoms and reduce their chances of returning to the hospital.
The implantable sensor, called the CardioMEMS HF System, developed by St. Jude Medical, is a battery-less, dime-sized device placed directly inside the heart to monitor its pulmonary artery. Implanted through a minimally invasive procedure, the sensor detects increases in pulmonary artery pressure, an early sign of worsening heart failure that can be detected before symptoms arise. Among the symptoms of advanced heart failure is shortness of breath, the kind of frightening experience that sends people racing to emergency rooms.
Once implanted, the device transmits daily pressure readings to a patient’s medical team, who can then proactively provide real-time, personalised feedback before symptoms worsen. The device has been shown in clinical trials to reduce hospital readmissions for advanced heart failure patients by up to 37 percent.
The new microchip technology is designed for advanced heart failure patients who have been hospitalised within the previous 12 months. The goal of Mount Sinai’s heart failure experts is to improve the quality of life in patients with heart failure and reduce the likelihood of hospital readmissions, a growing trend for this high-risk patient population which has become a national priority for the Centers for Medicare and Medicaid Services to reduce readmissions to curb growing healthcare costs.
‘This new device will enable heart failure patients to live more comfortably, easing their worries as we closely monitor them for the earliest signs of fluid retention, a major cause of the symptoms of breathlessness and tiredness heart failure patients experience,’ says Raymond Bietry, MD, Assistant Professor of Cardiology who was the first cardiologist at Mount Sinai to implant the device.
Mount Sinai Hospital
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The first definitive summary of the best and safest treatments for kidney disease and diabetes patients has been compiled by Christchurch doctor and researcher Associate Professor Suetonia Palmer.
The University of Otago, Christchurch researcher together with a global team used innovative statistical analysis to compare hundreds of research studies on the effectiveness of blood-pressure-lowering drugs for patients with kidney disease and diabetes. The result: a one-stop-shop, evidence-based guide on which drugs are safe and effective.
Diabetes and high blood pressure are the most common causes of kidney disease around the world, and people often have both. Chronic kidney disease caused by diabetes always affects both kidneys and generally gets worse over time, often leading to kidney failure requiring dialysis treatment or a kidney transplant.
Associate Professor Palmer says this study is important because diabetes and kidney disease are at epidemic proportions in New Zealand. A common treatment for those with diabetes and kidney disease is blood-pressure-lowering drugs. The aim of these drugs is to prevent kidney damage.
However, doctors and patients face a bewildering array of treatment options as there are many drugs available to lower blood pressure, many used in combination. There are also hundreds of research studies done on the effectiveness of drugs or combinations of drugs. It is not possible for people to identify the best available treatments without scientific advances such as this study.
Associate Professor Palmer works as a nephrologist, or kidney specialist, at the Canterbury District Health Board and commonly sees first-hand how confusing the wide range of treatment options can be for patients, and those who treat them.
Her paper is the first to compare all drug options, and combinations of commonly used drugs, against each other.
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Scientists have developed the first ultra-thin, flexible device that sticks to skin like a rub-on tattoo and can detect a person
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Maquet and GE Healthcare are announcing they are developing together a new flexible angiography hybrid OR solution. The combined system for surgical procedures and catheter-based interventions will consist of the angiography system Discovery IGS 730 (GE) and the Magnus operating table system (Maquet). Besides its high-precision imaging technology, the differentiating feature of the Discovery IGS 730 is its unique mobility. With its laser-guided, mobile gantry, it can be conveniently positioned throughout the OR with high predictability to provide the medical team with full patient access. The Discovery IGS 730 enables using both left and right customizable parking locations in a single room for an excellent patient access during either left or right access procedures. Its mobile design allows more flexibility in the implantation of ceiling suspended elements such as laminar flow and booms. The Discovery IGS 730 also offers all features of a premium angiography system. It enables high-quality 2D imagery, as well as 3D rotational angiography and multimodality 3D Fusion with outstanding opportunities for minimally invasive therapy.
The Magnus operating table is a full-fledged, versatile OR table that meets all requirements of surgeons and interventional physicians. It has a
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St. Louis University scientists led by professor of pharmacological and physiological sciences Daniela Salvemini, Ph.D., discovered that drugs targeting the A3 adenosine receptor can ‘turn off’ pain signals in the spinal cord to provide relief from chronic pain.
Pain is the most common reason that people seek medical attention, but the available treatments–most commonly non-steroidal anti-inflammatory drugs (NSAIDs) and opioids–are not always successful at relieving pain in patients with chronic pain. For this reason, Salvemini and colleagues teamed up with researchers from the National Institutes of Health, the University of Arizona and two institutes in Quebec, Canada, to investigate a new target for treating chronic pain: the A3 adenosine receptor or A3AR.
In earlier studies, Salvemini’s laboratory demonstrated that two drugs which target the A3AR–IB-MECA and MRS5698–were effective in treating several models of chronic pain, including painful chemotherapy-induced neuropathy, metastatic cancer pain, and nerve injury. More recently, the group sought to uncover the mechanism of A3AR pain relief.
‘Chronic pain can result from the loss of regulatory mechanisms in the nervous system pathway that transmits pain,’ Salvemini said. ‘Adenosine acts as a regulatory signalling molecule in other areas of the nervous system, so we hypothesized that A3AR might also play a role in regulating pain signals during pain processing.’
Indeed, Salvemini and colleagues found that A3AR drugs not only relieved pain, but did so by activating an inhibitory transmitter system known as the gamma amino-butyric acid (GABA) system. In areas of the spinal cord and brain dedicated to pain processing, A3AR activation promoted GABA signalling by preventing the breakdown and removal of GABA from neuronal synapses.
‘In chronic pain, GABA signalling is often lost or diminished. Our A3AR drugs were able to restore GABA signalling in areas that process pain and ‘turn off’ the signals that maintain the pain state,’ Salvemini said.
With A3AR drugs demonstrating good safety profiles in clinical trials as anti-inflammatory and anti-cancer agents, Salvemini and colleagues are enthusiastic about the potential of these new drugs to treat chronic pain in patients.
EurekAlert
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Rheumatoid arthritis (RA) is a chronic systemic disease whose main characteristic is persistent articular inflammation. This results in joint destruction and loss of function. It is one of the major causes of disability in industrialized countries, affecting 1
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Thousands of patients die each year in hospitals across North America due to medical errors that could be prevented were doctors and nurses provided with instant access to patient records via wireless technology. Cue the catch-22: the electromagnetic radiation caused by those very devices can interfere with electronic medical equipment and thus lead to serious clinical consequences for patients.
Luckily, that could soon change thanks to new research from Concordia University that helps define a clear rule of thumb for how close health-care workers with their Wi-Fi devices can be to electronic medical equipment.
In a study researchers from the Faculty of Engineering and Computer Science assessed the risk that a medical device will malfunction when radio waves that emanate from portable devices like tablet computers are present in a hospital room.
Hospitals often specify that staff members carrying wireless transmitters not approach sensitive electronic medical devices any closer than a designated minimum separation distance (MSD).
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An existing anti-stroke drug is an effective treatment for middle-ear infections, showing the ability to suppress mucus overproduction, improve bacterial clearance and reduce hearing loss, according to researchers at Georgia State University and the University of Rochester.
The findings could result in a novel, non-antibiotic treatment for otitis media, or middle-ear infection, possibly through topical drug delivery. Vinpocetine, the drug involved in the study, has long been used to treat neurological disorders such as stroke.
The study found topical administration of Vinpocetine suppressed inflammation and the overproduction of mucus induced by Streptococcus pneumonia bacteria, improved hearing loss in the middle ear and significantly improved bacterial clearance in animal studies.
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Once daily bathing with disposable cloths with the topical antimicrobial agent chlorhexidine of critically ill patients did not reduce the incidence of health care-associated infections. Infections acquired during hospitalization (health care associated infections) are associated with increased hospital length of stay, rates of death, and increased costs. The skin of hospitalized patients is a reservoir for infectious pathogens. Subsequent invasion by skin flora is thought to be a mechanism contributing to health care-associated infections. Chlorhexidine is a broad-spectrum topical antimicrobial agent that, when used to bathe the skin, may decrease the bacterial burden, thereby reducing infections. Chlorhexidine bathing is incorporated into some expert guidelines, according to background information in the article. Michael J. Noto, M.D., Ph.D., of Vanderbilt University, Nashville, Tenn., and colleagues conducted a study in which five adult intensive care units in Nashville performed once-daily bathing of all patients (n = 9,340) with disposable cloths impregnated with 2 percent chlorhexidine or non-antimicrobial cloths as a control. Bathing treatments were performed for a 10-week period followed by a 2-week washout period (a period allowed in order to eliminate the effect of the first intervention before starting a new intervention), during which patients were bathed with non-antimicrobial disposable cloths, before switching to the alternate bathing treatment for another 10 weeks. A total of 55 infections occurred during the chlorhexidine bathing period (4 central line-associated bloodstream infections [CLABSIs], 21 catheter-associated urinary tract infections [CAUTIs], 17 ventilator-associated pneumonia [VAP], and 13 Clostridium difficile) and 60 infections during the control bathing periods (4 CLABSI, 32 CAUTI, 8 VAP, and 16 C difficile infections). After adjusting for various factors, no significant difference between groups in the rate of the primary outcome (composite of these infections) was detected. Other infection-related secondary outcomes, including health care-associated bloodstream infections, blood culture contamination, and clinical cultures positive for multi-drug resistant organisms were also not improved by chlorhexidine.
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