Approximately a quarter of women with HER2 positive breast cancer, who were treated with a combination of the targeted drugs lapatinib and trastuzumab before surgery and chemotherapy, saw their tumours shrink significantly or even disappear, according to results from a clinical trial.
The University of Manchester
In an interdisciplinary collaboration between prominent academic and industry investigators, researchers have discovered a novel method for repositioning an FDA-approved anti-cancer compound so it can specifically target liver cancer tumours. A
A growing number of patients are being discharged from intensive care units, cured of the critical illness that put them there but facing a new and potentially debilitating condition — ICU-acquired weakness.
Intensive care patients are known to lose muscle mass and function for many reasons, ranging from prolonged immobilization, to the effects of ICU treatments such as mechanical ventilation to the critical illness itself.
While the mechanisms of muscle atrophy (loss) and function during an ICU stay have been studied well, little research has been conducted into the cellular and molecular mechanisms responsible for recovering muscle strength over the long-term.
A new study found that some patients who continue to suffer from weakness six months after they were discharged from the ICU, demonstrate persistent muscle wasting, even when the biologic functions that commonly cause muscles to atrophy have returned to normal such as inflammation or the breakdown of proteins in muscle tissue.
Furthermore, there is no guarantee that reconstitution of muscle size normalizes strength; patients who managed to regrow muscle remained weak. In some cases, this muscle weakness causes profound disability and reduced quality of life, and can last a lifetime, said the study
The IHF 39th World Hospital Congress was held 6-8 October 2015 at the Hyatt Regency, in Chicago, USA. The IHF Congress presents a unique and important opportunity for top healthcare leaders from around the world to share ideas and solutions for transforming care delivery. The Congress was hosted by the American Hospital Association and the American College of Healthcare Executives, the theme of which was Advancing Global Health and Healthcare. Some 700 participants representing more than 40 countries attended the event.
The keynote speaker for the event was Dr. Carissa Etienne, Director, Pan American Health Organization and Regional Director for the Americas of the World Health Organization. Other plenary speakers included Dr. Claudio Luiz Lottenberg, President, Hospital Israelita Albert Einstein (Brazil), Liisa-Maria Voipio- Pulkki, Director, Health Care Group, Ministry of Social Affairs and Health (Finland); Bernard Tyson, Chairman and CEO, Kaiser Permanente (USA) and Maureen Bisognano, President and CEO of the Institute for Healthcare Improvement (USA).
The scientific programme was further enriched with poster sessions and concurrent sessions hosted by IHF national member organizations from countries such as Hong Kong, Taiwan, Australia, Nigeria, South Africa, Spain, Norway, etc. There were also special interest sessions hosted by the international Finance Corporation, the World Health Organization and others.
The topics addressed included:
Congress attendees had the opportunity to visit four of Chicago
Specific forms of epilepsy may manifest as early as in the first weeks of life. A new laboratory study shows that a preventive therapeutic strategy can be successful if it is applied within a time window critical to brain development. The study, which was conducted by a team of German and French scientists and headed by Prof. Dirk Isbrandt of the German Center for Neurodegenerative Diseases (DZNE) and the University of Cologne. Using the substance bumetanide in new-born mice, the scientists succeeded in attenuating the disease progression, allowing the animals to develop almost normally. These research results could pave the way for the development of new therapeutic strategies in humans.
Isbrandt and his colleagues conducted experiments in mice with a genetic defect similar to a natural human variant that can cause epilepsy as early as the neonatal period. This mutation results in dysfunctional ion channels in the membranes of nerve cells, thus perturbing the communication between cells. Possible symptoms include jerking or twitching movements, but can also include more subtle behavioural impairments. Early disease symptoms can be mild, but long-term outcomes may be severe, and include pronounced cognitive impairment.
‘This genetic defect has an impact on a specific ion channel in the cell membrane, the so-called Kv7 or M channel. The defect disturbs the ionic balance, which has a direct effect on the excitability of neurons
Royal Philips and a consortium of leading European healthcare regions, companies, universities and hospitals* have announced the start of the first large scale care coordination and telehealth programme in the European Union to support tens of thousands of people living with chronic conditions. The three-year ACT@Scale programme will collect and analyse the health outcome and economic impact data for large populations of chronic patients and elderly people to develop, test and consolidate best practice’ care coordination and telehealth programmes that can be replicable and successfully rolled out across the European Union. The programme aims to reach more than 75,000 patients in the United Kingdom, the Netherlands, Spain and Denmark by 2019.
‘Today, 70 percent of Europe’s healthcare budget is spent on patients living with chronic conditions, largely a result of Europe’s aging population and rapidly changing care needs,’ said Jeroen Tas, CEO Connected Care and Health Informatics, Philips. ‘The ACT@Scale programme will provide the evidence needed to successfully deliver a seamless patient experience with better outcomes at lower cost.’
The five participating healthcare regions are all in the process of rolling out innovative care coordination and telehealth services. Within the ACT@Scale programme, they will share an agreed and standardized data set including programme outcomes such as the number of patients included, (re)hospitalizations, duration of hospitalizations and mortality rates. They will also assess economic impact factors such as cost per patient and the impact on hospitals income models. This data is to support the development of new and sustainable business models. Next to this, patient satisfaction scores are measured and the degree to which connected technology empowers people and affects health outcomes.
The regions involved comprise Catalonia (Spain), which has developed programmes to support nursing homes, reduce hospital re-admissions, manage complex cases and promote physical activity; Southern Denmark (Denmark), which is rolling out a telehealth programme to deliver psychiatric treatment; Northern Ireland (UK), which has remote telemonitoring programmes to support COPD and diabetes patients, and manage maternal obesity; Northern Netherlands (The Netherlands), with programmes to provide specialist support for COPD, asthma and heart failure patients, and connect healthcare and community services for chronic disease patients; and the Basque Country (Spain), which is rolling out programmes to support older people with complex health and social care needs, plus telehealth services for chronic heart failure patients.
‘Telehealth and coordinated care services may offer the elderly and otherwise frail individuals the ability to maintain their independence for longer and enjoy a significantly better quality of life, but they also involve significant changes to the healthcare system and the recipients’ ability to self-manage,’ said Professor Erik Buskens, Professor of Medical Technology Assessment at University Medical Center Groningen (UMCG). ‘ACT@Scale will allow us to determine the most cost-effective ways of implementing those changes while also maximizing the benefits for Europe’s ageing population.’
The ACT@Scale scientific consortium members comprise of University Medical Center Groningen (The Netherlands), Aristotle University of Thessaloniki (Greece), City University London (UK), Universitatsklinikum Wurzburg/Klinikum der Bayerischen Julius-Maximilians-Universitat (Germany), University of Hull (UK), Kronikgune-Centre for Research Excellence in Chronicity (Basque Country, Spain), Hospital Clinic of Barcelona (Spain) and Philips. It is anticipated that the first preliminary findings will be available from the end of Q4, 2016.
ACT@Scale builds on the successful ACT programme, a two-and-a-half year study (2013 – 2016) that looked into the results of European integrated care programmes. Thousands of interviews were conducted with participating patients and care providers. These learnings on success factors are applied to significantly grow the ACT@Scale healthcare regions’ coordination and telehealth programmes. The programme is part of the European Innovation Partnership on Active and Healthy Ageing (EIP-AHA), an initiative from the European Commission under its Innovation Union strategy, and aims to increase the average healthy lifespan by two years by 2020.
Wireless brain sensors developed by researchers at Washington University School of Medicine in St. Louis and the University of Illinois at Urbana-Champaign are smaller than a pencil tip and can monitor intracranial pressure and temperature before being absorbed by the body, negating the need for surgery to remove the devices.
Such implants potentially could be used to monitor patients with traumatic brain injuries, but the researchers believe they can build similar absorbable sensors to monitor activity in organ systems throughout the body.
‘Electronic devices and their biomedical applications are advancing rapidly,’ said co-first author Rory K. J. Murphy, MD, a neurosurgery resident at Washington University School of Medicine and Barnes-Jewish Hospital in St. Louis. ‘But a major hurdle has been that implants placed in the body often trigger an immune response, which can be problematic for patients. The benefit of these new devices is that they dissolve over time, so you don’t have something in the body for a long time period, increasing the risk of infection, chronic inflammation and even erosion through the skin or the organ in which it’s placed. Plus, using resorbable devices negates the need for surgery to retrieve them, which further lessens the risk of infection and further complications.’
Murphy is most interested in monitoring pressure and temperature in the brains of patients with traumatic brain injury.
About 50,000 people die of such injuries annually in the United States. When patients with such injuries arrive in the hospital, doctors must be able to accurately measure intracranial pressure in the brain and inside the skull because an increase in pressure can lead to further brain injury, and there is no way to reliably estimate pressure levels from brain scans or clinical features in patients.
‘However, the devices commonly used today are based on technology from the 1980s,’ Murphy explained. ‘They’re large, they’re unwieldy, and they have wires that connect to monitors in the intensive care unit. They give accurate readings, and they help, but there are ways to make them better.’
Murphy collaborated with engineers in the laboratory of John A. Rogers, PhD, a professor of materials science and engineering at the University of Illinois, to build new sensors. The devices are made mainly of polylactic-co-glycolic acid (PLGA) and silicone, and they can transmit accurate pressure and temperature readings, as well as other information.
Washington University School of Medicine at St Louis http://tinyurl.com/hoqcm6w
Scientists of Tomsk State University have changed the physical and chemical properties of zeolites (aluminosilicates of calcium and sodium) by mechanical and thermal influence. After these studies, scientists will be able to create a portable device for haemodialysis – blood filtration from toxic products of metabolism in the case of renal insufficiency.
Of course now there are analogues of traditional devices for haemodialysis, but with all of them, the procedure must be performed in a hospital setting, so people are tied to their place of residence. And with the new device, they will be able to go even on long trips. Haemodialysis can be done at home and in an emergency situation, – said Alexander Buzimov, co-author of the study.
Zeolite gives out and absorbs moisture well. To increase this capacity, we had to find a way to increase the specific surface area.
The natural zeolite is a solid mineral, so it is important to find the technology of chopping in order to increase its surface area – said Alexander Buzimov. Its changing under the influence of mechanical processing allows control of varying the properties of zeolites.
TSU scientists compared the synthetic zeolite SAPO-34 to natural zeolite from the Tokay deposits in Hungary. They exposed the minerals to thermal and mechanical treatment in a ball mill and found that the specific surface area of the synthetic zeolite had decreased and area of the natural had increased. There had been a change in the mineral composition of natural zeolite.
Now scientists want to combine zeolites with nano-ceramic material developed by the Institute of Strength Physics and Materials Science of RAS and create a composite sieve, which will be the basis for the future haemodialysis device. The device will connect to a shunt, which is implanted under the skin of the patient. The blood will circulate through the composite sieve and will be cleaned. The scientists plan to get the new material from zeolite and nanoceramics in a year, and in two years to create the first device.
Tomsk State University en.tsu.ru/news/tsu-has-changed-the-properties-of-a-mineral-needed-for-hemodialysis/
Market opportunities in the women’s healthcare imaging and nutrition segment are ripe, especially in developing nations where awareness of preventive medicine is rising. Issues afflicting women include breast cancer, urinary tract infections, anemia, cardiovascular diseases and osteoporosis. In response, the healthcare industry is progressively employing early diagnosis through screening and prescribing preventive solutions in the form of nutrients supplemented through diet.
Analysis from Frost & Sullivan, Technology Trends in Women’s Health, explores developments in the fields of health nutrients and health imaging for women. Manufacturers are trying to customize nutrients according to a woman’s lifecycle since the needs of prenatal, postnatal and menopausal women are different. The main health nutrients women consume are calcium, iron and vitamin D.
In imaging, technological advancements will focus on platforms that:
‘Customized innovation is essential in the women’s health sector,’ said Technical Insights Industry Analyst Darshana De. ‘In addition to age-related nutritional requirements, a woman’s health needs vary according to geographic and consumer preferences. Demand is high for natural supplements, strong scientific evidence of health claims and minimal side effects. For instance, the constipation and gastrointestinal symptoms caused by available calcium tablets are driving innovations within the industry to provide a more natural form of calcium.’
In the women’s imaging segment, digitization is a sweeping trend. Hospitals and screening centres worldwide are digitizing systems to optimize workflows and enhance image clarity. Government initiatives are pushing several advances. A U.S. federal bill (HR 3102) mandates breast density reporting on a national level to generate interest in newer technologies improving image screening accuracy.
‘Tomosynthesis will become the primary screening modality; it offers the ability to view slices of the breast to better differentiate actual lesions from areas of overlapping dense tissue,’ noted De.
Similarly, government-initiated screening programs, designed to diagnose osteoporosis in developed countries, are encouraging bone density scans and boosting the sales of densitometry systems. However, the high initial investment for scanning systems and reimbursement issues can bring challenges to the market.
Frost & Sullivanhttp://tinyurl.com/jkgj7xz
Twice as many patients with non-serious injuries, such as fractures or neck strain, are undergoing CT scans in emergency departments at California hospitals, according to a UCSF-led study, which tracked the use of the imaging from 2005 to 2013.
While CT scans enable clinicians to swiftly pinpoint life-threatening conditions, exposure to its ionizing radiation is associated with an increased risk of cancer. According to a 2009 report by the FDA, a single CT scan may be associated with a fatal cancer in one in 2,000 patients.
In the study, researchers at UCSF and Stanford studied more than 8 million adult patient visits at 348 state hospitals, using data from the California Office of Statewide Health Planning and Development. These patients had been discharged after being seen in emergency departments for injuries such as minor falls or low-impact vehicle accidents. The study found that 3.51 percent of patients underwent at least one CT scan in 2005, versus 7.17 percent in 2013.
‘The reasons for this increase are multifactorial,’ said senior author Renee Hsia, MD, professor of emergency medicine and health policy at UCSF. ‘They range from defensive medicine practices, the superior diagnostic accuracy of CT scans compared with X-rays, to their increased availability and convenience in emergency departments, and the demand to expedite discharge of patients.’
The authors noted that CTs were more likely to be ordered in hospitals that were designated high-level trauma centres. Some 39 percent of those in the study were ordered at level I and II trauma centres, compared with 3 percent at low-level centres.
‘This may reflect an underlying work culture largely centred around the management of severely injured patients, guided by standard trauma CT protocols, and also the fact that level I and II trauma centres see sicker patients,’ the authors wrote in their paper.
Also disproportionately visible were patients between the ages of 18 and 24, ‘those at greatest risk for radiation,’ wrote the authors, as well as those over 45. ‘With the aging of the U.S. population, physicians may be influenced toward greater advanced imaging even in the case of low-mechanism injuries, given the atypical presentations and more serious pathology that older adults may have,’ said Hsia.
The authors reported an upswing in the use of CTs from 2005 to 2009, followed by a gradual decline to 2011 – reflecting awareness of overuse – which was preceded by a resurgence from 2011 to 2013 that almost reached the zenith of 2009.
‘The message for both patients and physicians is that there are long-term risks associated with radiation exposure and there may be situations where imaging is not definitively warranted or beneficial,’ said Hsia.
University of California – San Francisco http://tinyurl.com/hp4525h
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