Home births lead to higher infant mortality than hospital births, at least for mothers living in poorer areas. This is the conclusion of a new study conducted by N. Meltem Daysal (University of Southern Denmark and IZA), Mircea Trandafir (University of Southern Denmark and IZA) and Reyn van Ewijk (VU University Amsterdam and University of Mainz) that examines 356,412 low-risk Dutch women who delivered between 2000 and 2008 and who were allowed to choose between a home and a hospital birth.

The safety of home births for low-risk women is a hotly debated topic in the Western world. In this context, the Netherlands stands out as one of the few developed countries with a health care system geared toward home births, with more than half of all low-risk deliveries taking place at home. This makes it one of the best settings to study the safety of home births.

The study shows that home births lead to higher infant mortality among the poorer half of Dutch women. The researchers suggest that the infant mortality rate may be lower in hospitals because of the availability of advanced medical treatments (such as neonatal intensive care units). In the richer half of the Dutch population, on the other hand, home births are as safe for the child as hospital births. The researchers suspect that low-income women profit from hospital births because it is more difficult to assess whether they are low-risk or high-risk, for example due to a more difficult communication with their midwife.

One of the major challenges when investigating the effect of home births is that even among low-risk women, those who give birth at home or in a hospital may have different risk factors, with riskier deliveries usually taking place in the hospital. Therefore, babies born in a hospital often have more health problems than babies born at home and simple comparisons of these two groups are misleading.

In the present study, the researchers came up with an innovative solution to circumvent this problem. They noticed that some women gave birth at home or in a hospital depending on how far they lived from the nearest obstetric ward. The researchers then compared two groups of low-risk women who were identical, except that the women in one group had a higher probability of delivering in a hospital only because they lived closer to a hospital.

This study demonstrates that home births can lead to higher infant mortality for certain women, even in a country where the health care system is geared toward home births. In the context of the Netherlands, these women are those who live in the poorer half of the country and whose decision to deliver in a hospital or at home is affected by how far they live from the nearest hospital. The authors emphasize that no conclusion can be drawn for other groups. VU University Amsterdam

Tiny gas microbubbles can enhance the delivery and absorption of cancer drugs in patients with advanced pancreatic cancer, according to a new pilot study. The study was described at the International Contrast Ultrasound Society (ICUS) annual conference in Chicago.
One year after their last treatment cycle, two of 10 patients are still alive. 74 percent of pancreatic cancer patients die within the first year of diagnosis. The average life expectancy after diagnosis with metastic pancreatic cancer is just three to six months.

SCHILLER has teamed up with medsim specialists EPICARDIO to offer a market-leading simulation-based ECG e-learning program to its customers.
Responding to requests from its customers to provide innovative training techniques to complement its medical technology solutions, SCHILLER has worked with the UK-based company to bring them a cutting-edge customized e-training package.
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Epilepsy affects more than 65 million people worldwide. One-third of these patients have seizures that are not controlled by medications. In addition, one-third have brain lesions, the hallmark of the disease, which cannot be located by conventional imaging methods. Researchers at the Perelman School of Medicine at the University of Pennsylvania have piloted a new method using advanced non-invasive neuroimaging to recognize the neurotransmitter glutamate, thought to be the culprit in the most common form of medication-resistant epilepsy.
Glutamate is an amino acid which transmits signals from neuron to neuron, telling them when to fire. Glutamate normally docks with the neuron, gives it the signal to fire and is swiftly cleared. In patients with epilepsy, stroke and possibly ALS, the glutamate is not cleared, leaving the neuron overwhelmed with messages and in a toxic state of prolonged excitation.
In localization-related epilepsy, the most common form of medication-resistant epilepsy, seizures are generated in a focused section of the brain; in 65 percent of patients, this occurs in the temporal lobe. Removal of the seizure-generating region of the temporal lobe, guided by preoperative MRI, can offer a cure. However, a third of these patients have no identified abnormality on conventional imaging studies and, therefore, more limited surgical options.
‘Identification of the brain region generating seizures in location-related epilepsy is associated with significantly increased chance of seizure freedom after surgery,’ said the new study’s lead author, Kathryn Davis, MD, MSTR, an assistant professor of Neurology at Penn. ‘The aim of the study was to investigate whether a novel imaging method, developed at Penn, could use glutamate to localize and identify the epileptic lesions and map epileptic networks in these most challenging patients.’
‘We theorized that if we could develop a technique which allows us to track the path of and make non-invasive measurements of glutamate in the brain, we would be able to better identify the brain lesions and epileptic foci that current methods miss,’ said senior author Ravinder Reddy, PhD, a professor of Radiology and director of Penn’s Center for Magnetic Resonance and Optical Imaging.
Reddy’s lab developed the glutamate chemical exchange saturation transfer (GluCEST) imaging method, a very high resolution magnetic resonance imaging contrast method not available before now, to measure how much glutamate was in different regions of the brain including the hippocampi, two structures within the left and right temporal lobes responsible for short- and long-term memory and spatial navigation and the most frequent seizure onset region in adult epilepsy patients.
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Researchers at the University of Waterloo have developed a revolutionary system for monitoring vital signs that could lead to improved detection and prevention of some cardiovascular issues, as well as greater independence for older adults.