For patients at low-to-intermediate risk, transfemoral TAVR is a safe alternative to surgery, with comparable survival at 1 year, according to a large registry study. For the OBSERVANT trial, Marco Barbanti, MD, of Ferrarotto Hospital (Catania, Italy), and colleagues looked at 7,618 Italian patients with aortic stenosis and low-to-intermediate surgical risk who underwent either surgery (n = 5,707) or TAVR (n = 1,911) between 2010 and 2012. Patients were propensity-matched into 650 pairs, although surgically-treated patients still had slightly higher levels of albumin and hemoglobin and the TAVR group
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Although non adherence to medication is common in patients with newly diagnosed hypertension, those with greater compliance may have a lower risk of early heart failure, according to a new study from Italy.
Specifically, in 6.6 years of follow-up, compared with patients who filled their prescriptions less than a quarter of the time those who filled their prescriptions more than three-quarters of the time had a 34% lower risk of being hospitalized for heart failure.
The inverse relationship between drug adherence and hospitalization for heart failure was similar in 71- to 80-years-olds vs 40- to 70-year-olds. ACE inhibitors, angiotensinreceptor blockers (ARBs), and diuretics protected patients against heart failure, but calcium-channel blockers did not.
This research shows that
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A minimally invasive implant procedure is highly effective in reducing pain and disability for patients with sacroiliac joint (SIJ) dysfunction, reports a clinical trial.
The randomized controlled trial shows superior outcomes in patients undergoing minimally invasive sacroiliac joint (SIJ) fusion using triangular titanium implants, compared to nonsurgical management, according to the new research overseen by Dr. Daniel J. Cher of SI-BONE, Inc., in San Jose, Calif.
The study included 148 patients with low back pain caused by confirmed SIJ dysfunction, treated at 19 US spine surgery clinics. The SIJ connects the central (sacrum) and lateral (ilium) bones of the pelvis. SIJ disruption or osteoarthritis is a common pain condition, estimated to cause 15 to 23 percent of cases of chronic low back pain.
Trial subjects had severe SIJ pain, with an average pain score of 82 on a 0-to-100-point scale. Average pain duration was longer than six years, and about two-thirds of subjects were taking opioid (narcotic) medications. Many had previously received many non-surgical SIJ treatments, and many had a history of prior spinal surgery.
Two-thirds of subjects were randomly assigned to undergo minimally invasive SIJ fusion. In this procedure, triangular titanium implants were placed through a small incision to stabilize and fuse the SIJ. Procedures were unilateral in most cases, but some subjects underwent bilateral treatment. The remaining subjects received nonsurgical treatments, such as physical therapy, steroid injections and/or radiofrequency ablation of sacral nerve root lateral branches.
Pain and other outcomes were compared at baseline and at 1, 3, 6 and 12 months. At 6 months, subjects in the nonsurgical group had the option to ‘cross over’ to the implant procedure.
Based on reduction in pain and absence of complications at 6 months, treatment was rated successful in 81 percent of subjects assigned to the SIJ implant procedure, compared to 26 percent with nonsurgical treatment. Average pain score decreased to 30 in the surgical group versus 72 in the nonsurgical group. Seventy-three percent of subjects undergoing the implant procedure had ‘clinically significant’ reduction in disability scores, compared to just 14 percent in the nonsurgical group.
After one year, subjects assigned to SIJ fusion still had significant reductions in pain and disability, as well as improved quality of life. Thirty-five subjects from the nonsurgical group opted to undergo the implant procedure, with similarly good results. There were only a few complications related to the SIJ implant procedure.
EurekAlert
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Advances in 3-D printing have led to new ways to make bone and some other relatively simple body parts that can be implanted in patients. But finding an ideal bio-ink has stalled progress toward printing more complex tissues with versatile functions
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An early snapshot of study outcomes suggests that the use of a processed amniotic fluid allograft may be safe and effective for the treatment of knee osteoarthritis (OA) as an alternative to hyaluronic acid (HA). Longer-lasting
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It is important to use the right embolic agent for the job
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Vygon, the specialist single-use medical devices group, has acquired Perouse Medical, a French company which designs, manufactures and markets cardiovascular medical devices (stents, vascular grafts and patches, radial compression and inflation systems, hemostasic valves, angiographic syringes as well as consumables for contrast media injectors for CT scanners and MRI, etc.) and long-term vascular access devices (implantable ports, PICCs, Huber needles, catheter maintenance dressings, etc.). Established in 1984, Perouse Medical generated a turnover of
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Health care organizations have been implementing health information technology at increasing rates in an effort to engage patients and caregivers improve patient satisfaction, and favourably impact outcomes. A new study led by researchers at Brigham and Women’s Hospital (BWH) finds that a novel web-based, patient-centred toolkit (PCTK) used by patients and/or their healthcare proxys in the hospital setting helped them to engage in understanding and developing their plan of care, and has the potential to improve communication with providers.
The research study, Promoting Respect and Ongoing Safety through Patient-centeredness, Engagement, Communication, and Technology (PROSPECT), provided patients and their caregiver’s iPads on which they could access novel tools to participate in their plan of care during hospitalization. The study was conducted in the medical intensive care and oncology units at BWH. The PCTK provided access to educational content specific to a patient’s condition and facilitated patient-provider communication using a novel messaging platform integrated into providers’ workflow. In this study, researchers evaluated their enrollment strategy, use and usability of patient tools, and the content of patient-generated messages.
‘Doctors and nurses oversee the plan of care, but the patients’ goals, priorities, and preferences may not always be effectively conveyed to the clinical care team. Decision-making should be shared among patients, families and healthcare providers. We found that this tool widened communication, helping patients and family members partner with healthcare providers to improve the quality and safety of their care,’ says lead author Anuj Dalal, MD, and a hospitalist in BWH’s Division of General Medicine and Primary Care.’
Specifically, researchers report that non-critically ill oncology patients were more likely to engage with the PCTK compared with critically-ill MICU patients. However, caregivers of critically-ill MICU patients often used the PCTK on the patient’s behalf. They learned that patients and caregivers most often used the PCTK to establish goals, view test results and medications, and identify care team members. Additionally, patients and caregivers used the messaging functionality primarily to report health concerns, needs, or preferences, but did not overwhelm providers with too many messages or demand immediate responses.
‘Our findings indicate that even with critically-ill patients, technology can serve as a helpful mediator to get the provider, patient and/or caregiver on the same page, working towards a shared goal.’
Researchers indicate that more investigation is needed to better understand how to effectively implement this tool within complex hospital settings, including trouble shooting technological issues, and making the PCTK more user-friendly and accessible for patients and caregivers.
Brigham and Woman
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Building on wireless technology that has the potential to interfere with pain, scientists have developed flexible, implantable devices that can activate
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What happens in the moments just before death is widely believed to be a slowdown of the body
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