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

IDTechEx Research has recently released a new market report ‘Technology for Diabetes Management, 2019-2029: Technology, Players and Forecasts’, including details of glucose test strips, continuous glucose monitoring (CGM), insulin pumps, insulin pens, digital health / digital therapeutics, side effect management and diagnosis.

The report covers the entire landscape for diabetes management devices, including mature, emerging and future options. The report has been researched via primary interviews with companies, physicians and diabetic individuals to characterize and predict the technology landscape for diabetes devices over the coming decade. In total, activities of 75 companies are covered throughout the report, ranging from the largest players to technology developers and startups developing the next generation of device options.

Historically, diabetics have monitored their blood glucose concentration by using disposable biosensors; following a finger prick, a drop of blood is placed onto a glucose test strip, which is inserted into a reader to provide the result. Whilst billions of test strips are produced each year, this sector as seen profitability shrink due to changing medical subsidies and increased competition. Alternative options have been developed to enable continuous glucose monitoring. These involve devices that are typically worn on the skin, using a sensor on a small needle to test glucose in interstitial fluid. There are now approved devices from several key players, with this industry growing each year.

However, challenges still remain with glucose monitoring devices, with the ultimate aim of providing the best experience for diabetics. CGM devices in the past have been reliant on test strips for calibration, as well as still being invasive or implantable, leading to discomfort. This has led to many players investigating glucose monitoring options which are less invasive, whilst maintaining the required accuracy and reliability. In addition, the possibility of pairing CGM devices with insulin pumps for increasingly automated "closed-loop" systems is becoming increasingly closer. These goals have been in place for decades, and the report follows all the latest news, trends and outlook in each of these technology frontiers around diabetes management devices.

However, managing diabetes is about more than just monitoring glucose levels. The report also covers other aspects of diabetes technology landscape, including insulin delivery, the role of digital health in diabetes, technology for managing side effects, technology for diagnosis and reimbursement, funding and investment examples. The report then includes detailed market forecast following two different methodologies. The first involves the collection of revenue data from companies throughout the space, with historic data back to 2010 by company and by sector. This is then projected given a series of assumptions based on IDTechEx’s primary research efforts. The second forecast scenario involves looking at data for the diabetic population, including number of diabetics, split by type, percentage diagnosis, and then adoption rates by device type for each group. The two forecasts are then discussed and compared, providing with the reader with ample content from which to base business decisions and understand the dynamics in the space.

As discussed, the report is split into 8 main chapters, discussing each aspect of diabetes management technology (not including pharmaceutical options). Following an executive summary, detailing the main conclusions and discussion of the report, the report introduces the challenges and opportunities in diabetes management, as well as going through the main patent holders and filing trends in the space. Then, topic chapters of the report are as follows:
– Sensors for diabetes management: This chapter includes coverage of glucose sensing, from test strips and glucometers, to continuous glucose monitoring (CGM), and through to a discussion of emerging options in this space. In total, 37 different companies are mentioned in this section, ranging from the largest players in tests strips and CGM (e.g. Abbott, Roche, Medtronic, Dexcom, etc.) through to many emerging players or innovators attempting new approaches to glucose monitoring.
– Insulin delivery: This chapter covers techniques from traditional vial-and-syringe and insulin pens, to insulin pumps and towards closed loop insulin delivery alongside CGM. Key trends discussed in this section include the integration of different connectivity and technology integrated alongside both insulin pump and insulin pens, the links from these devices into wider digital health ecosystems and the adoption of newer devices (particularly insulin pumps) by territory and demographic.
– Digital health: Chronic diseases are a prominent early target for those in the digital health ecosystem, and digital health options for diabetes have been prominent. This chapter discusses activities from both the small and larger players, including major acquisitions and collaborations, in areas including diabetes management systems, device companion software and digital therapeutics.
– Side effect management: The majority of the costs associated with diabetes are around managing side effects. This section focuses on new technology options emerging around areas such as diabetic neuropathy, foot ulcers and ketoacidosis. This includes various wearable, flexible and textile-based technology options.
– Diabetes diagnosis: discussing the use of emerging technologies to aid the early detection of diabetes, thereby preventing long hospital stays and other complications.
– Reimbursement options, funding and investment examples: These final elements to the report fill in details which are important for the broader space. Reimbursement, whether through insurers, national healthcare initiatives or otherwise, is still critical for the majority of diabetes devices. Funding and investment are also present, as with any large, transforming industry.

Over 75 companies are mentioned in the report, including many primary interviews, a patent analysis of the key patent-holders, and revenue data where relevant.

Nearly two decades ago, Dr. Jeffrey Cadeddu was watching TV when a lightbulb went off.  The program showed teens using magnetic studs to avoid piercings in their lips, and Dr. Cadeddu, a surgeon, realized the same principle could be applied to his work, reducing the number of incisions and resultant scars.
This summer Dr. Cadeddu performed the first of several magnet-assisted prostate cancer surgeries he has now done.
“Every hole you create in a patient has a risk associated with it. Every incision means increased pain, increased risk of hitting a blood vessel,” said Dr. Cadeddu, Professor of Urology and Surgery at UT Southwestern Medical Center and a member of the Harold C. Simmons Comprehensive Cancer Center.
Dr. Cadeddu and his colleagues spent years developing the concept of magnetic-assisted surgery. Though another company subsequently took up the mantel, when the FDA approved the first commercial magnetic-assisted laparoscopic surgery system, Dr. Cadeddu was delighted to make UT Southwestern one of the few medical centres in the country – and the first in Texas – to put the magnetic surgery device to use.
In magnetic surgery, multiple operative devices are inserted through an access point and then the magnetic device is controlled by a magnet on the skin over the abdomen. By contrast, conventional laparoscopic or robotic surgery requires an incision for each tool.
Prostate cancer surgery is typically performed with a robotic system that requires six incisions for the various surgical instruments and camera. “Going forward, five incisions or likely even less may become standard for this procedure,” Dr. Cadeddu said.

UTSouthwestern Medical Centerhttps://tinyurl.com/yb4nzvkg