The most common type of tumour found in the kidney is generally quite small (less than 1.5 in). These tumours are usually found by accident when CAT scans are performed for other reasons and the serendipitous finding poses a problem for doctors. Are these tumours malignant and do they need to be surgically removed because they may threaten the patient’s life? Or are they benign and can be left alone?
The decision is often made with a biopsy. By sampling the tumour, doctors are able to determine whether the cancer is benign or malignant. However, biopsies are invasive procedures and not without risks.
Investigators with the Kidney Cancer Program at UT Southwestern Harold C. Simmons Comprehensive Cancer Center have developed a Magnetic Resonance Imaging (MRI) technology that can provide information about the nature and aggressiveness of the cancer without having to perform a biopsy.
The team, led by Drs. Ivan Pedrosa and Jeffrey Cadeddu, co-authors of the study, have developed multiparametric MRI (mpMRI) protocols that tell physicians with high confidence whether the tumour is aggressive or not. These protocols allow investigators to evaluate the chemical composition of the tumour without a biopsy. This composition allows doctors to infer what type of cancer it is.
“Using mpMRI, multiple types of images can be obtained from the renal mass and each one tells us something about the tissue,” said Dr. Ivan Pedrosa, Professor of Radiology and Chief of Magnetic Resonance Imaging.
The standardized diagnostic algorithm is largely based on the appearance of the renal mass on specific MRI images, namely T2-weighted images and those immediately after intravenous (IV) dye reaches the kidney. Other images are also used that indicate whether fat is present in the tumour. Based on the algorithm, physicians can recognize clear cell carcinoma (ccRCC), the most common and aggressive form of kidney cancer, with 80% confidence.
“Using mpMRI, doctors at UT Southwestern have a four-in-five chance of identifying clear cell cancer” said Dr. Pedrosa.
The data collected from this study support the use of mpMRI to reduce the number of biopsies. “Biopsies are not entirely free of pain and discomfort,” said Dr. Cadeddu, Professor of Urology and Radiology at UT Southwestern. “Some patients, in fact, choose to observe the cancer simply to avoid the pain of the biopsy,” he says.
Investigators at UT Southwestern continue to push the technology and are hoping in the near future to be able to predict not only the type of cancer, but also to tell how aggressive it is. “If we can avoid the anxiety and the fear and the rare, but possible complication of a biopsy, I think we’re pushing medicine forward,” said Dr. Cadeddu.
UT Southwestern Medical Centerhttps://tinyurl.com/ydcyzn9b

Hospitalized patients with stable coronary artery disease (CAD) may need frequent glucose monitoring to prevent hypoglycemia and death, new research reports.
"Frequently monitoring the finger-stick blood glucose levels of heart disease patients admitted to the hospital to avoid low sugar level, even among those without diabetes, could potentially save lives and decrease length of hospital stay and healthcare costs," said lead study author Shuyang Fang, M.D., a medical resident at Mount Sinai St. Luke’s and Mount Sinai West hospitals, in New York, N.Y.
"In hospitalized patients with coronary artery disease, hypoglycemia episodes are associated with increased hospital stay, healthcare expenses and death .  In this study using national inpatient data, we found that those who had stable coronary artery disease and were admitted to the hospital for various reasons would have higher mortality if they developed low blood glucose levels during their hospital stay," he explained. "Interestingly, these effects were particular higher among patients without pre-existing diabetes."
Fang and his colleagues at Mount Sinai used the National Inpatient Sample (NIS) database to conduct a nationwide retrospective cohort study of patients admitted to acute care hospitals in the United States with stable coronary artery disease in 2014.
Of the 1,262,943 patients admitted with stable coronary artery disease that year, about 3,000 (0.24 percent) had an episode of hypoglycemia during their inpatient stay. Compared to patients without hypoglycemia, those with hypoglycemia were more likely to be female (39 percent vs 47 percent, respectively), live in poverty (29 percent vs 34 percent), and have certain features of renal failure (27percent vs 32 percent) and heart failure (20 percent vs 27 percent). But they were less likely to have diabetes (10 percent vs 32 percent).
Compared to patients without hypoglycemia, those with hypoglycemia had higher inpatient mortality (OR 4.48), longer hospital stays (mean 5.3 vs 7.0 days), and higher healthcare costs (US $57,275 vs $70,957).
After adjustments for age, sex, race, income and clinical factors including diabetes, heart failure and kidney failure, the associations for mortality, length of stay and healthcare costs remained significant.
Eurekalertwww.eurekalert.org/pub_releases/2018-03/tes-gmh031518.php

• Siemens Healthineers eHealth Solutions¹ will network healthcare facilities in Switzerland
• Electronic patient record enables secure access to patient data

To expand its portfolio in the area of eHealth, Swiss Post will make use of the Siemens Healthineers eHealth Solutions1 in the future. The eHealth solution offered by Swiss Post, which includes the electronic patient record, will provide secure networking between patients and players in the healthcare industry. Working in partnership with Siemens Healthineers will enable Swiss Post to provide new eHealth services for its customers.
Siemens Healthineers has already put a number of major eHealth projects in place in Europe, including a large proportion of the electronic health record in Austria. In this case, eHealth Solutions assists physicians, hospitals, care facilities, and pharmacists with accessing important healthcare data relating to their patients. There are also further projects in Denmark, Spain and Germany.
The electronic patient record makes it possible to consult patient data regardless of time and place. Patients can decide for themselves who in the healthcare continuum can access their medical documents and data, e.g. discharge reports, x-rays, medication summaries, or details of allergies. In Switzerland, electronic patient records are maintained locally rather than centrally. They are made available via regional, organizational groupings of facilities, like hospitals, rest homes, medical practices, pharmacies, or rehabilitation clinics.² As a leading provider of a complete solution to network players in Switzerland’s healthcare sector, Swiss Post serves as a professional partner to the country’s Cantons (federal states).
Swiss Post’s eHealth solution is tailored to the special characteristics and peculiarities of Switzerland’s healthcare market, which includes seamlessly integrating a range of IT systems.
Siemens Healthineers eHealth Solutions contain components needed to share medical data securely between facilities. Siemens Healthineers not only provides the software but also the expertise to help with cooperative healthcare between practice-based physicians and hospitals, for example. The solution is scalable and ranges from networking different departments within a hospital to networking entire regions and countries. Siemens Healthineers eHealth Solutions can also be used with heterogeneous and changing IT infrastructure.
“Making relevant healthcare data available exactly where it is needed is the basis for a lasting improvement to healthcare,” says Arthur Kaindl, Head of Digital Products, Siemens Healthineers. “All the players involved must first be digitally networked, to enable the patient to be considered comprehensively and thus achieve a better diagnosis and reach better treatment decisions. We’re looking forward to working with Swiss Post on this project.”
Siemens Healthineers eHealth Solutions is a product of ITH Icoserve technology for healthcare GmbH, Innsbruck, Austria, a subsidiary of Siemens Healthineers.
¹ _{eHealth products from Siemens Healthineers are not commercially available in all countries. Please contact your local Siemens Healthineers sales representative for the most current information.}
² _{Source: https://www.post.ch/en/business/a-z-of-subjects/industry-solutions/industry-solution-healthcare/patient-record}

A recent study conducted at the University of Tampere, Tampere University of Technology, Pirkanmaa Hospital District and Fimlab in Finland has concluded that an electronic nose (eNose) can be used to identify the most common bacteria causing soft-tissue infections.
The eNose can be used to detect the bacteria without the prior preparation of samples, and the system was capable of differentiating methicillin-resistant Staphylococcus aureus (MRSA) from methicillin-sensitive Staphylococcus aureus (MSSA).
Skin and soft-tissue infections are common diseases that need medical treatment. Their diagnosis is usually based on bacterial cultures, but in uncomplicated cases the diagnosis may be made directly based on the clinical presentation of the disease. However, this may lead to empirical antibiotic treatments, i.e. treatments without a specific diagnosis, which may result in longer treatment times, adverse effects and increased costs.
“Our aim was to create a method for the rapid diagnosis of soft tissue infections. If we had such a method, treatment could be started in a timely manner and targeted to the relevant pathogen directly. This would reduce the need for empirical treatments and shorten diagnostic delays,” says doctoral researcher Taavi Saviauk from the faculty of medicine and life sciences at the University of Tampere.
“The portable eNose device we used does not require laboratory conditions or special training, so it is well suited for outpatient use. The results of this study are a significant step towards our goal,” Saviauk continues.
An electronic nose is a device that produces “an olfactory profile” for each molecular compound in the air. The results are analysed by a computer and the system is programmed to differentiate between different compounds.
The research group conducting the study has previously shown how an eNose can be successfully used to differentiate prostate cancer from benign prostatic hyperplasia using a urine sample and distinguish between the various bacteria that cause urinary tract infections.
Infection Controlhttps://tinyurl.com/y8bwvxmf

The amount of close and comforting contact between infants and their caregivers can affect children at the molecular level, an effect detectable four years later, according to new research from the University of British Columbia and BC Children’s Hospital Research Institute.
The study showed that children who had been more distressed as infants and had received less physical contact had a molecular profile in their cells that was underdeveloped for their age – pointing to the possibility that they were lagging biologically.
Although the implications for childhood development and adult health have yet to be understood, this finding builds on similar work in rodents. This is the first study to show that in humans the simple act of touching, early in life, has deeply-rooted and potentially lifelong consequences on the epigenome — biochemical changes that affect gene expression.
“In children, we think slower epigenetic aging could reflect less favourable developmental progress,” said Michael Kobor, a Professor in the Department of Medical Genetics who leads the “Healthy Starts” theme at BC Children’s Hospital Research Institute.
The study involved 94 healthy children in British Columbia. Researchers from UBC and BC Children’s Hospital asked parents of 5-week-old babies to keep a diary of their infants’ behaviour (such as sleeping, fussing, crying or feeding) as well as the duration of caregiving that involved bodily contact. When the children were about 4 ½ years old, their DNA was sampled by swabbing the inside of their cheeks.
The team examined a biochemical modification called DNA methylation, in which some parts of the chromosome are tagged with small molecules made of carbon and hydrogen. These molecules act as “dimmer switches” that help to control how active each gene is, and thus affect how cells function.
The extent of methylation, and where on the DNA it specifically happens, can be influenced by external conditions, especially in childhood. These epigenetic patterns also change in predictable ways as we age.
Scientists found consistent methylation differences between high-contact and low-contact children at five specific DNA sites. Two of these sites fall within genes: one plays a role in the immune system, and the other is involved in metabolism. However, the downstream effects of these epigenetic changes on child development and health aren’t known yet.
The children who experienced higher distress and received relatively little contact had an “epigenetic age” that was lower than would be expected, given their actual age. A discrepancy between epigenetic age and chronological age has been linked to poor health in some recent studies.
“We plan to follow up on whether the ‘biological immaturity’ we saw in these children carries broad implications for their health, especially their psychological development,” says lead author Sarah Moore, a postdoctoral fellow. “If further research confirms this initial finding, it will underscore the importance of providing physical contact, especially for distressed infants.”

University of British Columbiahttps://tinyurl.com/y89od57l