Carestream Health has signed an agreement with Royal Philips to sell its healthcare information systems (HCIS) business to Philips.
Carestream’s HCIS business unit provides imaging IT solutions to multi-site hospitals, radiology services providers, imaging centers and specialty medical clinics around the world. The business has developed strong customer relationships in attractive, high-growth healthcare segments and is positioned for continued growth and success.
As a result of this acquisition, Philips’ expanded healthcare IT business will feature Carestream’s enterprise imaging platform—including best in class VNA, diagnostic and enterprise viewers, multimedia reporting, workflow orchestrator and clinical, operational and business analytics tools—as part of its broad portfolio.
“We have had global success in providing radiology and enterprise imaging IT systems to help medical professionals provide quality care and enhance their operations,” said Ludovic D’Aprea, Carestream’s General Manager for Healthcare Information Solutions. “By becoming part of Philips, the HCIS business will have a greater opportunity to thrive and grow. Both organizations share a commitment to meaningful innovation which is deeply embedded in each company’s culture. Customers will have access to a broader portfolio of healthcare IT solutions to simplify medical image management, enable effective collaboration and enhance patient care.”
Like Carestream, Philips has built a strong, global business based on customer focus, world-class technical excellence and continuous innovation.
“Philips partners with global healthcare providers to connect people, information and technology with the commitment to deliver on the Quadruple Aim of improved patient experiences, better health outcomes, improved staff experiences, and lower costs of care,” said Robert Cascella, Chief Business Leader Precision Diagnosis at Royal Philips. “This acquisition will enhance our ability to provide flexible solutions to hospitals and health systems. The combination of our successful innovations in imaging system platforms, workflow optimization and artificial intelligence-enabled informatics, combined with Carestream’s cloud-based enterprise imaging informatics platform and complementary geographic footprint will provide a solid foundation to deliver on the promise of precision diagnosis.”
Carestream will retain its medical imaging, dental and industrial films, non-destructive testing, and precision coating businesses which are not impacted by the sale. “These established businesses have solid financial foundations, innovative technology platforms and have earned the trust of loyal customers around the world,” said David C. Westgate, Chairman, President and CEO of Carestream. “Our focus will be on delivering innovation that is life changing—for patients, customers, channel partners, communities and other stakeholders—and we will grow the company for long-term success.”
Following receipt of all regulatory and applicable government approvals, input from works councils and unions, and meeting all pre-conditions, the two companies will work towards closing the sale in the second half of 2019 and will continue to operate independently until closing. www.carestream.com

Machine learning using real-time symptom reports can accurately detect lymphedema, a distressing side effect of breast cancer treatment that is more easily treated when identified early, finds a new study led by NYU Rory Meyers College of Nursing.
“Using a well-trained classification algorithm to detect lymphedema based on real-time symptom reports is a highly promising tool that may improve lymphedema outcomes,” said Mei R Fu, PhD, RN, FAAN, associate professor of nursing at NYU Meyers and the study’s lead author.
Lymphedema is a build-up of lymph fluid that causes swelling in the arms or legs and is commonly caused by the removal of lymph nodes as part of cancer treatment. It can occur immediately after cancer surgery or as late as 20 years after surgery; a recent study found that more than 41 percent of breast cancer patients experienced lymphedema in their arms within 10 years of their surgery.
Lymphedema is one of the most dreaded adverse effects from breast cancer treatment because of its chronic nature and debilitating symptoms, including arm swelling, heaviness, tightness, achiness, stiffness, burning, and decreased mobility. While there is no cure for lymphedema, early detection and intervention can reduce symptoms and keep it from worsening, although early detection remains a challenge.
“Clinicians often detect or diagnose lymphedema based on their observation of swelling. However, by the time swelling can be observed or measured, lymphedema has typically occurred for some time, which may lead to poor clinical outcomes,” said Fu.
“In our digital era, integrating technology into health care has led to advances in detecting and predicting various medical conditions,” said Yao Wang, PhD, professor of electrical and computer engineering at NYU Tandon School of Engineering and the study’s coauthor.
A type of artificial intelligence, machine learning is of interest to researchers due to its ability to construct algorithms that continually improve predictions and generate automated knowledge through data-driven predictions or decisions with incoming data—in this case, symptom reports. Machine learning is particularly beneficial when there are many relevant factors that are not independent, which is true for lymphedema symptoms.
In this study, the researchers used a web-based tool to collect information from 355 women who had undergone treatment for breast cancer, including surgery. In addition to sharing demographic and clinical information, including whether they had been diagnosed with lymphedema, participants were asked whether they were currently experiencing 26 different lymphedema symptoms.
Statistical and machine learning procedures were performed for data analysis. Five different classification algorithms of machine learning were compared: Decision Tree of C4.5, Decision Tree of C5.0, gradient boosting model, artificial neural network, and support vector machine. The algorithms were also compared with a conventional statistical approach that determines the optimal threshold for the symptom count based on the receiver operating curve.
The researchers found that all five machine learning approaches outperformed the standard statistical approach, and the artificial neural network achieved the best performance for detecting lymphedema. The artificial neural network was 93.75 percent accurate, correctly classifying patients to have true lymphedema cases or non-lymphedema cases based on the symptoms reported.
“Such detection accuracy is significantly higher than that achievable by current and often used clinical methods,” said Fu.
The researchers note that conducting such real-time lymphedema assessment encourages patients to monitor their lymphedema status without having to visit a healthcare professional. Based on patients’ symptoms and resulting risk for lymphedema, the assessment system could alert patients at risk to schedule in-person clinical visits for further evaluation. This may lessen the burden of unnecessary clinical visits on patients and the healthcare system.
“This has the potential to reduce healthcare costs and optimize the use of healthcare resources through early lymphedema detection and intervention, which could reduce the risk of lymphedema progressing to more severe stages,” Fu said.

New York Universitywww.nyu.edu/about/news-publications/news/2018/june/machine-learning-helps-detect-lymphedema-among-breast-cancer-sur.html

A study, which has recently been published in NDT [1] shows that caffeine consumption is associated with a lower mortality rate in CKD patients. This relationship has already been observed in the general population. Although this study shows that this association may persist if caffeine is consumed through caffeine-containing soft drinks, the president of the European Renal Nutrition Working Group, Professor Denis Fouque, recommends CKD patients not to consume these soft drinks, but to drink coffee or tea instead.
In the general population an inverse relationship between coffee consumption and life expectancy has been shown.  A high coffee consumption can actually help people to live longer. Numerous possible reasons for this effect have been observed: coffee decreases uric acid levels and increases adiponectin, a protein hormone regulating glucose levels and the fat metabolism, as well as magnesium, which is known to benefit heart and vessel health. It stimulates the production of nitric oxide and, thus, promotes vasodilation, the relaxation of the vessels, which results in lower blood pressure. In addition, a cup of coffee contains antioxidants that are known to have beneficial effects on health.
The study examined whether or not caffeine consumption has the same beneficial effects in CKD patients. 4863 adults from the “National Health and Nutrition Examination Survey” (NHANES) with a GFR of between 15 and 60 ml/min/1,73 m2  were analyzed and underwent a median follow-up of 60 months. The patients were divided into four groups according to their caffeine consumption: Very low (<28.2 mg/day), medium low (28.2 – 103 mg/day), medium high (103 – 213.5 mg/day) and high (>213,5 mg/day). A 26% lower mortality rate was observed in the low and medium group compared to the very low caffeine consumption group. However, this beneficial effect on life expectancy did not increase in the high group (there it was only 22%). Therefore, the relationship between caffeine consumption and life expectancy may not be linear, but present a U-shaped pattern.
The authors of this study made another observation: the protective effect of caffeine consumption was also detected when the analysis was performed according to caffeine consumption from soft drinks. Study author Miguel Bigotte Vieira points out that this might be due to a confounder: “Sicker patients may avoid soft drinks with caffeine, while the `healthier ones´ may consume more cola and energy drinks.” Professor Denis Fouque, editor-in-chief of NDT and president of the European Renal Nutrition Working Group adds: “Physical activity may also correlate with caffeine-containing soft drinks, which might have falsified the results. We doubt this finding because we know that these soft drinks do not only contain caffeine, but also high amounts of sugar and phosphate. Phosphate is known to be a `vessel toxin´ for CKD patients. Therefore, this observational study cannot give the `green light´ for CKD patients to consume caffeine-containing soft drinks. We advise that they strictly limit their consumption”.
The expert points out however that caffeine itself is not harmful. Caffeine consumption from coffee or tea appears to be safe at certain stages of kidney disease and probably has the same beneficial effects in CKD patients as in the general population. The authors of the study conclude: “ If these results are to be confirmed in future studies, advising patients with CKD to drink more caffeine may reduce their mortality.”
[1]  https://academic.oup.com/ndt/advance-article/doi/10.1093/ndt/gfy234/5063554?searchresult=1 www.era-edta.org

A team of doctors led by Karen L. Kotloff, M.D., University of Maryland School of Medicine (UMSOM), Center for Vaccine Development and Global Health (CVD), has performed a clinical trial involving multiple hospitals that tested the effectiveness of applying a topical antibiotic known as mupirocin for prevention of Staphylococcus aureus (SA) infection in babies in the neonatal intensive care unit (NICU).
In this study, between 10 and 45 percent of infants became colonized with SA in the eight NICUs across the country that participated in this study. A 5-day course of mupirocin was applied to the skin and nasal passages of the infants in the NICU who tested positive for SA. The results indicate mupirocin is safe and highly effective in eliminating SA from the skin and nasal passages of these infants. More than 90 percent of the treated infants tested negative for SA after treatment, indicating effective “decolonization” in response to mupirocin. This is the first randomized multicentre clinical trial to demonstrate the effectiveness and safety of mupirocin in infants, including those born prematurely, and to show that this treatment reduced colonization by both SA that are susceptible to commonly used antibiotics (MSSA) and those that are not (MRSA).
SA are bacteria that are commonly present on the skin and mucous membranes without causing disease. When bacteria live in the body without causing disease, this is referred to as colonization. Infants who become colonized with SA while hospitalized are at increased risk of developing life-threatening infections. Therefore, this treatment is likely to reduce clinical infection in infants. The effect of a course of mupirocin lasted for at least two to three weeks.
“Staph aureus is a leading cause of sepsis in young children admitted to the NICU. Sepsis, which is systemic infection, can be fatal in infants. Thus, preventing these infections is very important in managing risk for babies in the NICU who are fragile and struggling with multiple medical problems,” said Dr. Kotloff. This is the first study to test the safety and efficacy of mupirocin use in the NICU using a randomized controlled trial.
University of Maryland School of Medicine https://tinyurl.com/yatqk822