Pancreatic cancer has one of the worst prognoses — with a five-year survival rate of 9 percent — in part because there are no telltale symptoms or non-invasive screening tools to catch a tumour before it spreads.
Now, University of Washington researchers have developed an app that could allow people to easily screen for pancreatic cancer and other diseases — by snapping a smartphone selfie.
BiliScreen uses a smartphone camera, computer vision algorithms and machine learning tools to detect increased bilirubin levels in a person’s sclera, or the white part of the eye.
One of the earliest symptoms of pancreatic cancer, as well as other diseases, is jaundice, a yellow discoloration of the skin and eyes caused by a buildup of bilirubin in the blood. The ability to detect signs of jaundice when bilirubin levels are minimally elevated — but before they’re visible to the naked eye — could enable an entirely new screening program for at-risk individuals.
In an initial clinical study of 70 people, the BiliScreen app — used in conjunction with a 3-D printed box that controls the eye’s exposure to light — correctly identified cases of concern 89.7 percent of the time, compared to the blood test currently used.
“The problem with pancreatic cancer is that by the time you’re symptomatic, it’s frequently too late,” said lead author Alex Mariakakis, a doctoral student at the Paul G. Allen School of Computer Science & Engineering. “The hope is that if people can do this simple test once a month — in the privacy of their own homes — some might catch the disease early enough to undergo treatment that could save their lives.”
BiliScreen builds on earlier work from the UW’s Ubiquitous Computing Lab, which previously developed BiliCam, a smartphone app that screens for newborn jaundice by taking a picture of a baby’s skin. A recent study showed BiliCam provided accurate estimates of bilirubin levels in 530 infants.
BiliScreen is designed to be an easy-to-use, non-invasive tool that could help determine whether someone ought to consult a doctor for further testing. Beyond diagnosis, BiliScreen could also potentially ease the burden on patients with pancreatic cancer who require frequent bilirubin monitoring.

University of Washington
www.washington.edu/news/2017/08/28/new-app-uses-smartphone-selfies-to-screen-for-pancreatic-cancer/

Every year millions of people around the world are diagnosed with heart failure, a chronic, progressive condition where the heart is unable to pump enough oxygenated blood throughout the body. Researchers at the University of Utah Health and Klinikum Coburg, Germany co-led a clinical trial that showed radiofrequency catheter ablation lowered hospitalization and mortality rates by 47 and 44 percent respectively in patients with atrial fibrillation (AF), a contributing factor to heart failure.
“None of the traditional drug therapies are improving the patient’s condition, a major medical dilemma when we see these patients in our clinics,” said Nassir F. Marrouche, M.D., professor in Internal Medicine and Executive Director of the Comprehensive Arrhythmia Research and Management (CARMA) Center at U of U Health.
The medical community has long debated the ideal treatment for AF, especially for patients who suffer from left ventricular dysfunction, a weakening of the left ventricle that supplies most of the heart’s pumping power. Until now, no clinical studies have been conducted that support one definitive treatment.
Marrouche and Johannes Brachmann from the Klinikum Coburg conducted the eight-year CASTLE-AF clinical trial to compare catheter ablation to conventional drug therapies recommended by the American Heart Association and European Heart Society to control the heart’s rate.
“The CASTLE-AF clinical trial represents a landmark in the history of cardiovascular medicine because of its potential impact on our patients who are suffering from heart failure,” said James Fang, M.D., Chief of Cardiovascular Medicine at the University of Utah Health. “For the first time in a randomized study, the strategy of catheter ablation for atrial fibrillation may be better than the current approach for these patients. It is also one of the many landmark contributions to cardiovascular medicine that the University of Utah has made over the past five decades.”
After evaluating more than 3,000 patients from North America, Europe and Australia, researchers selected 363 participants with temporary or persistent AF and heart failure, characterized by heart function at less than 35 percent capacity, for the clinical trial. The patients were separated into two groups, receiving either radiofrequency catheter ablation (179) or a conventional drug therapy (184).
The clinical trial’s end point was set at all-cause mortality and worsening of heart failure, resulting in an unplanned overnight hospitalization. Patients in the ablation group experienced lower overall mortality (28%; 51/179) compared to the medication group (46%; 82/184). In addition, catheter ablation resulted in lower cardiovascular mortality (13%; 24/179) compared to the medication group (25%; 46/184).
Special heart cells create electrical signals that cause the heart’s upper and lower chambers to beat in the proper sequence to pump blood through the body. Abnormal cells can cause the heart to beat faster or irregularly, resulting in AF.
“Atrial fibrillation prevents the heart from filling and pumping properly,” said Marrouche. “When the heart is not synchronized, it hastens heart failure and increases the risk of stroke.”
During the ablation process, a catheter is snaked through the patient’s body to the site of abnormal heart cells. The doctor delivers a dose of radiofrequency energy, similar to microwaves, to destroy the abnormal cells, which restores the heart’s regular rhythm.
All of the participants included in the CASTLE-AF trial had previously received an implantable cardioverter defibrillator (ICD), which allowed for continuous monitoring of heartrate. The ICD may have improved mortality, which Marrouche believes is the primary limitation in this study that may have affected death rates in both groups.
“This clinical trial is the first time we can show with hard data that ablation is saving more lives than arrhythmia medications,” said Marrouche. “It also lowers the cost of treating patients by keeping them out of hospital due to lower incidence of worsening heart failure.”
University of Utah Health http://tinyurl.com/y7fmfm2s

With the effects of Congenital Zika syndrome manifesting in infants as more than microcephaly, rather a pattern of congenital anomalies, including intracranial and other brain or eye anomalies, the Centers for Disease Control (CDC) recently updated guidelines for physicians monitoring the development of infants born to mothers with a possible Zika virus infection during pregnancy.
Included within this document are instructions for laboratory testing and follow-up evaluation and care based on each patient’s lab results and observed conditions. The guidelines can be found in their entirety here on the CDC site.
Children’s National Congenital Zika Virus Program is poised to assist physicians with care for infants and children affected by Congenital Zika syndrome during infancy and throughout their childhood. The multidisciplinary team includes representatives from the Children’s National Complex Care Program available to provide comprehensive care coordination and help families with children affected by the syndrome—who may be medically complex, see multiple specialists, or are technology-dependent—navigate through the healthcare system.
In addition to complex care specialists, Children’s National has over 40 subspecialties under the same roof with top physicians available to work with healthcare professionals through the Congenital Zika Virus Program to provide their patients the best care for their specific conditions, including: ENT, Infectious Disease, Neonatology, Neurology (including Developmental Pediatrics), Ophthalmology, Orthopedics, Physical Medicine and Rehabilitation and Radiology.
Childrens National Health Systemhttps://tinyurl.com/y7vkv6y7

Ultrasonography findings seem to correlate well with the disease activity of idiopathic inflammatory myopathies (IIMs), and may be a useful tool for patient evaluation, according to a study.
Joana Sousa Neves, M.D., from the Hospital Conde de Bertiandos in Ponte de Lima, Portugal, and colleagues evaluated 15 IIM patients (from 2005 to 2015). Patients had a mean age of 52.2 ± 22.09 years and mean disease duration of 4.6 ± 3.20 years. Assessments included a physical examination, muscle strength tests, laboratory analysis, and a selective muscle ultrasonography assessment.
The researchers found that nine of the 15 patients were in clinical remission, and ultrasonography revealed a preserved muscle pattern. In one patient with longstanding polymyositis with proximal weakness, symmetrical proximal muscle atrophy was found. In the remaining five patients, inflammation and focal or generalized muscle edema were present with muscular weakness, suggesting active disease. One of these patients in acute flare presented with atrophy changes plus edema. An additional patient had early untreated myositis with moderate power Doppler signal.
“As far as muscle ultrasonography assessment is concerned, a single specific pattern was not observed in our study. A mixture of muscle edema and atrophy was detected depending on disease activity and duration,” the authors write. “Ultrasonography findings seem to correlate well with disease activity, suggested by clinical data, and may be a useful tool to complement patient evaluation.”

Physician’s Weekly http://tinyurl.com/yaoy7u9u

Although the problem of whether foetuses are able to feel pain or not is still controversial, experts at the University Hospital Virgen del Rocío in Seville have recently published a study in which they confirm that from the second trimester of pregnancy, the future baby already shows signs of pain when given a harmful stimulus or as a response to stress. In response to this confirmation, the researchers indicate the need to anaesthetise the foetus during open foetal surgery, OFS.
There is a school of thought that believes that in the case of foetal interventions, it is sufficient to administer anaesthesia to the mother as this passes through the foetus through the umbilical cord. Now, the experts have shown that this might not be sufficient and that from 21 weeks, the foetus can feel pain, so it also needs to be anaesthetised.
"At the Hospital Virgen del Rocío, we have spent a decade doing open foetal surgery. In 2007, we did the first intrauterine spina bifida operation in Europe, and in only one case was the foetus unable to receive intravenously administered anaesthesia from the start of the operation. It was at that moment that our monitoring teams detected anomalies in the behaviour of the foetus, which led us to believe that this was effectively a reaction to the stress caused by the pain. We quickly put in place the anaesthesia protocol and the spinal reconstruction was possible and the post-op period passed without any problems", explains Doctor Javier Márquez Rivas, Heat of the Infant Neurosurgery Unit and the Neurosurgery Service at the hospital.
For her part, Doctor María J. Mayorga Buiza, paediatric anaesthetist and first signatory of the article, adds that one of the key aspects of anaesthesia in open foetal surgery is to help uterine relaxation, to keep foetal circulation stable and, once surgery is complete, to offer adequate management of the patient to avoid contractions among other complications, which helps to reduce the incidence of premature birth in these cases.
Open foetal surgery (OFS) is still a serious procedure for the mother and the foetus. In such cases, anaesthesia given directly to the foetus can be provided by different means, but in the opinion of these experts, direct administration is "obligatory" for reduce foetal stress and also release the incidence of foetal mortality.
Even though current models do not prove the perception of foetal pain before the third trimester and there is little evidence of the effectiveness of direct foetal analgesic and anaesthetic techniques, it is a confirmed fact that foetal mortality is higher than 20% in the case of non-anaesthetised foetuses. This rate drops to 0% in operations carried out until now at the University Hospital Virgen del Rocío in Seville.
"The response of foetal stress to harmful stimulation that our monitoring teams observed in this case, does not completely prove that the foetus can feel pain. However, it is very improbable that there can be a perception of pain without a response to stress, and so these signals are often used as a substitute pain indicator", explains the University of Seville researcher and co-author of this study, The Applied Physics professor Emilio Gómez González.
University of Seville (in Spanish)comunicacion.us.es/centro-de-prensa/personal-docente-e-investigador/la-anestesia-disminuye-el-indice-de-mortalidad