For patients in intensive care, knowing how much glucose, lactate and other substances are in the blood is a question of life or death. EPFL has developed a miniaturized microfluidic device that will allow medical staff to monitor these levels in real time and react more quickly.
No larger than a pack of chewing gum, the prototype developed by EPFL

RA is the commonest autoimmune arthritis affecting 1% of the   population. Despite its main articular manifestations, RA can involve extra-articular organs including the auditory system.

Environmental factors for instance smoking, alcohol and noise can deteriorate the condition. Passive smokers are also at risk of HI. Long-term exposure to alcohol affects hearing in RA, causing harmful effects on the cochlear function.

Results of pure tone audiometry revealed that RA patients have high prevalence of HI for all frequencies.Transiently Evoked Otoacoustic Emissions (TEOAEs) test has been used widely to evaluate cochlear function, and is capable of detecting various amounts of decreases in RA patients at an early stage of the disease.

Treatment of HI in RA is empirical. Oral steroids and intensifying Disease-Modifying Antirheumatic Drugs might be an option. Anti-oxidants (eg. vitamin E) may play a protective role for the inner ear. Regular audiometric test and TEOAEs should be performed. Patients will also benefit from the cessation of smoking and alcohol. Like other causes of HI in healthy individuals, HI in RA can also be managed by use of different types of hearing aids and implantable devices.

EurekAlert www.eurekalert.org/pub_releases/2016-04/bsp-iic042216.php

Idiopathic pancreatitis is often caused by small gallstones that are difficult to observe prior to surgery, shows a study from the University of Eastern Finland. Small gallstones were found in surgery from two out of three idiopathic pancreatitis patients. The study also showed that acute pancreatitis was more common in statin users than non-users.

The main causes of acute pancreatitis in Finland are alcohol and cholelithiasis. In up to 10-20 per cent of cases, the underlying cause remains unclear. These cases may be explained by small gallstones that are not found during regular examination. A gallstone can get stuck in the junction of the common bile duct and the pancreatic duct, thus causing pancreatitis.

In a multi-centre gastrointestinal surgery study, first-time idiopathic pancreatitis patients were randomized into a surgery group and a control group. 39 patients underwent gallbladder removal surgery, and 46 were controls. During an average follow-up of three years, pancreatitis recurred in 14 persons in the control group and in four persons in the surgery group, so recurrence was clearly more likely in controls. Similarly, there were 23 pancreatitis cases in controls and only eight in the surgery group. Small gallstones were found in surgery from two out of three patients, although not observed in repeated abdominal ultrasound prior to surgery.

This finding is important when charting the causes of idiopathic pancreatitis and courses of treatment. For instance, alcohol use may too often be suspected as the cause. The recurrence of idiopathic pancreatitis can in many cases be prevented by laparoscopic gallbladder removal surgery.

The study also analysed the association of pancreatitis with the use of cholesterol-lowering drugs, statins, as gallstones often contain crystallised cholesterol.  Animal studies have shown statins to dissolve gallstones. The majority of gallstones are found in the elderly, often asymptomatic. Researchers assumed that statins may also reduce the size of gallstones in humans, enabling gallstones to travel from the gallbladder to the junction of the common bile duct and the pancreatic duct, and then manifest as pancreatitis.

In a retrospective study carried out in Kuopio University Hospital, idiopathic pancreatitis was found to be more common in statin users than in non-users.  On the other hand, statin users

Postponing the start of adjuvant chemotherapy for more than 90 days following surgery may significantly increase risk of death for breast cancer patients, particularly those with triple-negative breast cancer (TNBC), according to a new study from The University of Texas MD Anderson Cancer Center. Further, the researchers found that factors such as socio-economic status, insurance coverage and ethnicity were associated with delayed treatment.
Adjuvant chemotherapy, which is given after primary surgery, has been demonstrated to benefit patients by decreasing the risk of recurrence and death, explained Mariana Chavez Mac Gregor, M.D., assistant professor, Health Services Research and Breast Medical Oncology. However, delaying the start of adjuvant chemotherapy may allow small remnants of the tumour to grow or become drug-resistant.
Currently, there are no guidelines recommending the optimal time to initiation of adjuvant chemotherapy. The Centers for Medicare & Medicaid Services (CMS) considers the administration of adjuvant chemotherapy within 120 days of diagnosis for certain patients as a quality metric. Eleven cancer hospitals, including MD Anderson, are now reporting on this metric.
Past studies have suggested that delaying the initiation of therapy could result in adverse patient outcomes, but the optimal timing for starting adjuvant therapy has not been defined. To clarify this time frame relative to modern treatments and identify factors contributing to delayed treatment, the researchers analysed data from the California Cancer Registry.
This population-based study examined data from 24,823 patients with Stage I to III invasive breast cancer diagnosed between January 1, 2005 and December 31, 2010 and treated with adjuvant chemotherapy. This is the largest study investigating the effects of delayed chemotherapy initiation with contemporary treatment regimens.