Combining optical coherence tomography (OCT) with another advanced imaging technology may more accurately identify coronary artery plaques that are most likely to rupture and cause a heart attack. In a report, investigators from the Wellman Center for Photomedicine at Massachusetts General Hospital (MGH) describe the first use in patients of a catheter-based device utilizing both OCT and near-infrared autofluorescence (NIRAF) imaging.

Two simple interventions — sterile tubing change in combination with hub scrub compliance — can significantly reduce the rates of central line-associated bloodstream infection (CLABSI) in children’s hospital neonatal intensive care units (NICUs), according to a multi-centre improvement collaborative.
“The practices we identified that are associated with lower central line infections should be considered by clinicians in efforts to decrease central line infection rates,” said Dr. Anthony J. Piazza, from Emory School of Medicine, Atlanta, Georgia. “These central line care practices can be incorporated into daily patient care. Lowering central line infections can decrease health care costs and may be associated with fewer deaths, shorter hospital stays, and improved developmental outcomes.”
Dr. Piazza and colleagues from 17 centres participating in the Standardizing Line Care Under Guideline (SLUG Bug) collaborative used orchestrated testing to identify infection practices that contribute to reductions in infection rates.
The collaborative CLABSI rate decreased from a baseline rate of 1.333 to 1.076 per 1000 line-days, a 19.28% reduction, according to the study.
Among the 14 centres that had decreased CLABSI rates during the study period, sterile tubing changes decreased rates by an average of 0.51 and the addition of hub scrub compliance monitoring decreased rates by an average of 1.25 per 1000 line-days.
“We are excited to have identified specific infection prevention practices that helped achieve very low rates of infection,” Dr. Piazza said. “We are hopeful these findings can spread to other areas of the hospital that are still working on lowering infection rates.”

Medscapehttp://tinyurl.com/hpbnysc

Head and neck cancer patients may no longer have to undergo invasive post-treatment surgery to remove remaining cancer cells, as research shows that innovative scanning-led surveillance can help identify the need for, and guidance of, neck dissection.

The study from the Universities of Birmingham and Warwick and University Hospitals Coventry and Warwickshire used advanced imaging to identify cancer cells still present after treatment of head and neck cancer with primary chemoradiotherapy.

Previous guidelines meant that all head and neck cancer patients have to undergo neck dissection surgery, a three-hour operation with considerable morbidity and up to a one week hospital stay, because there was no reliable way to identify which patients still had remaining cancer cells.

The use of positron emission tomography

Since up to 90% of patients develop hospital- acquired anemia by their third day in the ICU (Intensive Care Unit) with many requiring subsequent transfusions, blood conservation strategies can be of significant benefit to patients and will help reduce costs of care. The new paper observes that within the ICU setting, the total amount of diagnostic (iatrogenic) blood loss is a significant predicator of anemia and subsequent allogeneic transfusion. Notably, iatrogenic blood loss is the factor most easily controlled by the intensivist – the paper discusses the main methods of reducing the contribution of blood tests to the incidence of iatrogenic anemia. Entitled

Researchers at University of California, San Diego School of Medicine and Shiley Eye Institute, with colleagues in China, have developed a new, regenerative medicine approach to remove congenital cataracts in infants, permitting remaining stem cells to regrow functional lenses.
The treatment, which has been tested in animals and in a small, human clinical trial, produced much fewer surgical complications than the current standard-of-care and resulted in regenerated lenses with superior visual function in all 12 of the paediatric cataract patients who received the new surgery.
In subsequent tests in animals with cataracts and in a small human trial, they found the new surgical technique allowed pre-existing LECs to regenerate functional lenses. In particular, the human trial involved 12 infants under the age of 2 treated with the new method and 25 similar infants receiving current standard surgical care. The latter control group experienced a higher incidence of post-surgery inflammation, early-onset ocular hypertension and increased lens clouding.