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International Hospital

Archive for category: E-News

E-News

Software for analysing digital pathology images proving its usefulness

, 26 August 2020/in E-News /by 3wmedia

In a new study, a program known as Spatially Invariant Vector Quantisation (SIVQ) was able to separate malignancy from background tissue in digital slides of micropapillary urothelial carcinoma, a type of bladder cancer whose features can vary widely from case to case and that presents diagnostic challenges even for experts.
‘Being able to pick out cancer from background tissue is a key test for this type of software tool,’ says U-M informatics fellow Jason Hipp, M.D., Ph.D., who shares lead authorship of the paper with resident Steven Christopher Smith, M.D., Ph.D. ‘This is the type of validation that has to happen before digital pathology tools can be widely used in a clinical setting.’
To test the software

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Radiation exposure from CT scans in childhood could triple the risk of leukaemia and brain cancer

, 26 August 2020/in E-News /by 3wmedia

Children and young adults scanned multiple times by computed tomography (CT) have a small increased risk of leukaemia and brain tumours in the decade following their first scan.
The findings from a study of more than 175,000 children and young adults was led by researchers at Newcastle University and at the National Cancer Institute, part of the National Institutes of Health, USA.
The researchers emphasise that when a child suffers a major head injury or develops a life-threatening illness, the benefits of clinically appropriate CT scans should outweigh future cancer risks.
Lead author Dr Mark Pearce, Reader in Lifecourse Epidemiology at Newcastle University said: ‘CT scans are accurate and fast so they should be used when their immediate benefits outweigh the long-term risks. However, now we have shown that CT scans increase the risk of cancer, we must ensure that when they are used they are fully justified from a clinical perspective.’
The study represents the culmination of almost two decades of research in this area at Newcastle University, and is jointly funded by the UK Department of Health and NCI/NIH.
CT imaging is a vital and commonly used diagnostic technique and it is used more frequently in countries such as the USA and Japan. However, CT scans deliver a dose of ionising radiation to the body part being scanned and to nearby tissues. Even at relatively low doses, ionising radiation can break the chemical bonds in DNA, causing damage to genes that may increase a person

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Use of dedicated pediatric imaging departments for pediatric CT reduces radiation dose

, 26 August 2020/in E-News /by 3wmedia

The use of a dedicated pediatric imaging department (with dedicated pediatric computed tomography (CT) technologists) for pediatric CT scans significantly reduces the radiation dose delivered to the patient, according to a study.
When performed and monitored properly, the benefits of CT scans outweigh the potential long-term risk of radiation. To minimise the potential adverse effects of radiation exposure to pediatric patients, it is necessary to reduce the dose of radiation delivered to these patients while preserving the diagnostic quality of the images produced.
‘There are many strategies for reducing radiation dose. The use of protocols with adjusted exposure parameters for pediatric patients on the basis of child size, organ system scanned and the size of the region scanned is most notable. However, compliance with these protocols can be challenging for technologists, particularly when scanning a combination of adult and pediatric patients,’ said Heather L. Borders, MD, lead author of the study.
A retrospective review of abdominal and pelvic CT console dose and exposure parameter data on 495 patients from a combined pediatric and adult radiology department and subsequently 244 patients from a dedicated pediatric radiology department was performed. Patients were divided into 1 of 8 weight categories for analysis.
A statistically significant decrease in the estimated effective dose for abdominal and pelvic CT studies was observed in all but one of the weight categories at the pediatric radiology department compared with the pediatric and adult radiology department.
‘Imaging pediatric patients in a dedicated pediatric imaging department with dedicated pediatric CT technologists may result in greater compliance with pediatric protocols and significantly reduced patient dose,’ said Borders.
‘Conversely, greater scrutiny of compliance with pediatric dose-adjusted CT protocols may be necessary for departments that scan both children and adults,’ she said. EurekAlert

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Researchers reveal ways to make personalised cancer therapy more cost effective

, 26 August 2020/in E-News /by 3wmedia

As scientists continue making breakthroughs in personalised cancer treatment, delivering those therapies in the most cost-effective manner has become increasingly important. Now researchers at the University of Colorado School of Medicine have identified new ways of doing just that, allowing more patients to benefit from this revolution in cancer care.

In a paper health economist Adam Atherly, PhD, of the Colorado School of Public Health (CSPH) and medical oncologist D. Ross Camidge, MD, PhD, of the University of Colorado Cancer Center, argue the cost of profiling patients

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Breast MRI helps predict chemotherapy’s effectiveness

, 26 August 2020/in E-News /by 3wmedia

Magnetic resonance imaging (MRI) provides an indication of a breast tumour

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Implantable medical device is designed to warn patients of impending heart attack

, 26 August 2020/in E-News /by 3wmedia

More than 30% of the one million heart attack victims in the United States each year die before seeking medical attention. Although widespread education campaigns describe the warning signs of a heart attack, the average time from the onset of symptoms to arrival at the hospital has remained at 3 hours for more than 10 years. In their upcoming article,’This is your heart speaking. Call 911,

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Duration of RBC storage does not affect short-term pulmonary, immunologic, or coagulation status

, 26 August 2020/in E-News /by 3wmedia

There is no difference in early measures of pulmonary function, immunologic status or coagulation status after fresh versus standard issue single-unit red blood cell (RBC) transfusion, according to a new study from the Mayo Clinic.

‘Longer duration of RBC storage is thought to increase the risk of transfusion-related pulmonary complications,’ said Daryl J. Kor, assistant professor of anaesthesiology at the Mayo Clinic College of Medicine. ‘In our study of 100 intubated, mechanically ventilated patients, we did not see evidence for an increased risk associated with RBC storage duration, at least not in the early post-transfusion period.’

In the double-blind trial, 50 patients were randomised to receive fresh (median storage duration = 4.0 days) RBC and 50 were randomised to receive standard issue RBC (median storage duration = 26.5 days). The primary outcome measure was change in pulmonary gas exchange, as measured by the partial pressure of arterial oxygen to fraction of inspired oxygen concentration ratio (ΔPaO2/FiO2). Post-transfusion measurements were performed upon completion of the transfusion and within two hours of the transfusion (median 1.9 hours in the fresh RBC group and 1.8 hours in the standard issue RBC group).

No significant differences between groups were seen in the primary outcome measure of change in PaO2/FiO2 ratio (2.5 +/- 49.3 vs. -9.0 +/- 69.8; fresh RBC vs. standard issue RBC; p = 0.22). Similarly, no significant differences were seen for any of the other outcome measures of pulmonary function (fraction of dead space ventilation, dynamic and static pulmonary compliance), immunologic status (tumor necrosis factor-alpha, interleukin-8, C-reactive protein) or coagulation status (fibrinogen, anti-thrombin consumption).

‘Our data do not support a significant effect of RBC storage duration on respiratory, immunologic or coagulation parameters in the immediate post-transfusion period,’ said Dr. Kor. ‘Previous observational studies linking RBC storage duration and respiratory complications may have suffered from bias and unmeasured confounding, which were more effectively addressed in our double-blind, randomised trial study design.’

The study did have some limitations, including the short duration of follow-up, the study’s limited sample size and the single centre, tertiary-care setting, which may limit the generalisability of the results.

‘Given the lack of an association between RBC storage duration and evidence of transfusion-related pulmonary complications in our study, randomization to fresh versus longer storage duration RBC in clinical trials would clearly seem ethical,’ said Dr. Kor. ‘Further study will need to clarify the impact of RBC storage duration on other patient-centered outcomes.’

EurekAlert
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First electronic retinas implanted in the UK

, 26 August 2020/in E-News /by 3wmedia

Surgeons in Oxford are the first in the UK to successfully implant an electronic retina into the back of an eye.
On 22 March 2012, Chris James became the first patient in the UK to receive this ground-breaking surgery as part of a clinical trial being carried out at John Radcliffe Hospital and King’s College Hospital in London.
Mr James’s operation took place at the Oxford Eye Hospital with the surgical team led by Professor Robert MacLaren.
He was assisted by Mr Tim Jackson, a consultant ophthalmic surgeon at King’s College Hospital in London.
The following week, a second patient, Robin Millar, a 60 year old music producer from London, received a retinal implant at King’s College Hospital, with Professor MacLaren assisting Mr Jackson.
Both patients were able to detect light immediately after the electronic retinas were switched on, and are now beginning to experience some restoration of useful vision. Further operations are now planned for other suitable patients.
The retinal implants have been developed by Retina Implant of Germany to restore some sight to people with retinitis pigmentosa, an inherited condition that affects around one in every 3,000 – 4,000 people in Europe.
Retinitis pigmentosa is a progressive disease that sees light-detecting cells in the retina deteriorate over time.
Retina Implant’s devices are designed to replace the lost cells in the retina. Patients have a small microchip containing 1,500 tiny electronic light detectors implanted below the retina. The optic nerve is able to pick up electronic signals from the microchip and patients can begin to regain some sight once more.
Professor MacLaren explains: ‘What makes this unique is that all functions of the retina are integrated into the chip. It has 1,500 light sensing diodes and small electrodes that stimulate the overlying nerves to create a pixellated image. Apart from a hearing aid-like device behind the ear, you would not know a patient had one implanted.’
Chris James, 54, a council worker from Wiltshire, first began to experience night blindness in his mid-20s and was diagnosed with retinitis pigmentosa following a referral to Oxford Eye Hospital.
For a number of years, Chris’ vision remained relatively stable. But in 1990, a large dip in his vision left him legally blind. In 2003, another decrease in vision rendered Chris completely blind in his left eye and only able to distinguish lights in his right.
After having the artificial retina implanted in his left eye, Chris can now recognise a plate on a table and other basic shapes. And his vision is continuing to improve as he learns to use the electronic chip in an eye that has been completely blind for over a decade.
The operation took eight hours and first required implantation of the power supply which is buried under the skin behind the ear, similar to a cochlear implant. This part of the operation was performed by Mr James Ramsden of Oxford University Hospitals assisted by Mr Markus Groppe, an academic clinical lecturer at the University of Oxford.
The electronic retina was then inserted into the back of the eye and stitched into position before being connected to the power supply.
Three weeks after the operation, Chris’ electronic retina was switched on for the first time. After some initial tuning and testing, Chris was able to distinguish light against a black background.
‘As soon as I had this flash in my eye, this confirmed that my optic nerves are functioning properly which is a really promising sign,’ Chris said. ‘It was like someone taking a photo with a flashbulb, a pulsating light, I recognised it instantly.’
Chris continues to have monthly follow-up testing of his microchip. In the meantime, he is testing the microchip at home. ‘It’s obviously early days but it’s encouraging that I am already able to detect light where previously this would have not been possible for me. I’m still getting used to the feedback the chip provides and it will take some time to make sense of this. Most of all, I’m really excited to be part of this research.’
Oxford Eye Hospital

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Second study investigates two-arm blood pressure difference

, 26 August 2020/in E-News /by 3wmedia

44 per cent of patients being treated for high blood pressure and who took part in the study either suffered vascular disease or died over a 10-year period
In January a research team from the Peninsula College of Medicine and Dentistry reported the first systematic review of findings related to the risk factors associated with a difference in blood pressure between arms.
The first study, which was published in The Lancet, suggested that a difference of more than 10mmHg or 15mmHg in systolic blood pressure (the

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Drug side-effects are so bad women end treatment and risk return of cancer

, 26 August 2020/in E-News /by 3wmedia

Why do so many postmenopausal women who are treated for oestrogen-sensitive breast cancer stop using aromatase inhibitors that help prevent the disease from recurring? The first study to actually ask the women themselves, as well as the largest, most scientifically rigorous study to examine the question, carried out at Northwestern University, USA reports that 36 percent of women stop treatment early because of the medications

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