New research showing that almost half of 13,000 patients with head and neck cancers had other health-related problems at the same time is one of the presentations in a special session at the 31st conference of the European Society for Radiotherapy and Oncology (ESTRO 31). The session will highlight the effect of the demographic time bomb caused by an increasingly ageing population. Dr Charlotte Rotb
Forced body cooling known as therapeutic hypothermia has reduced in-hospital deaths among sudden cardiac arrest patients nearly 12 percent between 2001 and 2009, according to a Mayo Clinic study being presented at the upcoming American Academy of Neurology 2012 Annual Meeting in New Orleans. The research is among several Mayo abstracts that will be discussed at the conference.
The goal of therapeutic cooling is slowing the body’s metabolism and preventing brain damage or death. It is believed that mild therapeutic hypothermia suppresses harmful chemical reactions in the brain and preserves cells. Two key studies published in 2002 found therapeutic hypothermia more effective for sudden cardiac arrest patients than traditional therapies. Mayo researchers analysed a database covering more than 1 million patients and found mortality rates among in-hospital sudden cardiac arrest patients dropped from 69.6 percent in 2001 — the year before the studies appeared — to 57.8 percent in 2009, the most recent data available.
‘Because we reviewed such a large number of cases, we are confident that the reduction in mortality among in-hospital sudden cardiac arrest patients is significant and sustained,’ says co-author Alejandro Rabinstein, M.D., a Mayo Clinic neurologist. ‘We continue to seek answers to the questions: Why did this trend develop, and how can we accelerate it,’ says co-author Jennifer Fugate, D.O.
These measures are important because disease accumulates in the cortex over time, and inflammation in the cortex is a sign the disease has progressed.
EurekAlertAccording to a new report* by business intelligence expert GBI Research patient care is improving at home and in remote areas, as rising rates of chronic disease, a growing elderly population, and advancements in wireless and sensor technologies continue to drive the global patient monitoring market.
The new report shows that efficient patient management through the use of wireless technology will help to reduce the rising healthcare burden which now affects many developed and developing countries, as large elderly populations who have increased life expectancy further add to the global patient pool.
Wireless technology has a wide range of applications in remote patient monitoring. Remote monitoring enables a patient to undergo hospital visits of reduced length, and have constant monitoring at home. This not only improves the quality of life for elderly and chronically ill patients, but also leads to a significant reduction in healthcare expenditure.
Wireless remote patient monitoring can also provide continuous and real time data to physicians from remote locations such as the home, hospice, ambulance, or other outpatient settings, thereby offering the advantage of convenience to both physicians and patients, while hospitalization costs are massively reduced.
Over the past few years, the number of cases of chronic diseases such as Cardiovascular Disease (CVDs), diabetes and chronic respiratory diseases has increased, due to the growing population in developing nations. According to the World Diabetes Foundation (WDF), 80% of the diabetic population is expected to come from low and middle income countries by 2025.
Emerging economies such as India and China, with huge patient bases and an under-served market, are expected to act as potentially lucrative markets for remote patient monitoring devices. The global patient monitoring devices market is expected to grow at a Compound Annual Growth Rate (CAGR) of 4% to reach $8 billion in 2017 from $6.1 billion in 2010.
*Patient Monitoring Devices Market to 2017 – Increasing Use of Wireless Remote Patient Monitoring to be the Key Technology Trend
A team of 18 researchers at Moffitt Cancer Center in Tampa have found that treating high-risk, soft tissue sarcoma patients with a combination of implanted dendritic cells (immune system cells) and fractionated external beam radiation (EBRT) provided more than 50 percent of their trial patients with tumour-specific immune responses lasting from 11 to 42 weeks.
‘Sarcomas are relatively rare forms of cancer with about 10,000 new cases in the U.S. annually,’ said study co-author Dmitry Gabrilovich, M.D., Ph.D., senior member of the Moffitt Department of Immunology.
The authors note that because 50 percent of patients with large, high-grade soft tissue sarcomas develop distant metastasis, new, effective treatments are needed.
‘Unfortunately, conventional therapy for large, high-grade tumours is frequently systematically ineffective, making this a very deadly problem,’ Gabrilovich said.
According to the researchers, administration of dendritic cells has been found to be a promising method for producing an immune response because dendritic cells process antigen material and present it to other immune cells. Dendritic cells act as immune system messengers.
‘Many studies have shown that preoperative radiotherapy and surgery is effective in treating many soft tissue sarcomas with high-risk features,’ said Gabrilovich. ‘We designed our study to investigate the effect of combining the administration of dendritic cells and EBRT for patients with soft tissue, high-risk sarcomas.’
The researchers hypothesised that if dendritic cell implants were combined with EBRT (the most common kind of radiotherapy treatment that not only can kill tumour cells but release tumour antigens) the combination therapy might be complimentary when the dendritic cells helped process tumour antigens released by the EBRT treatment.
‘The combination treatment resulted in dramatic increases in immune T cells in the tumours,’ explained Gabrilovich. ‘The presence of T cells in the tumours positively correlated with the development of tumour-specific immune responses.’
An important finding in this study was that no patient had significant tumour specific immune responses before the combined therapy. After the combination treatment, tumour specific responses were observed in 52.9 percent of trial patients.
The researchers reported that the combination treatment was ‘well tolerated’ and that 12 of the 17 patients in the clinical trial were ‘progression free’ after one year.
The authors concluded that given that the combination therapy proved effective in creating a potent anti-tumor response and was safe, producing no adverse side effects, larger trials with greater numbers of patients were warranted.
Moffitt Cancer Center
Thousands more American senior citizens with kidney disease are good candidates for transplants and could get them if physicians would get past outdated medical biases and put them on transplant waiting lists, according to a new study by Johns Hopkins researchers.
The Hopkins investigators estimate that between 1999 and 2006, roughly 9,000 adults over 65 would have been ‘excellent’ transplant candidates and approximately 40,000 more older adults would have been ‘good’ candidates for new kidneys. None, however, were given the chance.
‘Doctors routinely believe and tell older people they are not good candidates for kidney transplant, but many of them are if they are carefully selected and if factors that really predict outcomes are fully accounted for,’ says transplant surgeon Dorry L. Segev, M.D., Ph.D., an associate professor of surgery at the Johns Hopkins University School of Medicine and leader of the study. ‘Many older adults can enjoy excellent transplant outcomes in this day and age,’ he says, and should ‘be given consideration for this lifesaving treatment.’
Those ages 65 and older make up over one-half of people with end-stage renal disease in the United States, and appropriately selected patients in this age group will live longer if they get new kidneys as opposed to remaining on dialysis, Segev says. The trouble is, he adds, that very few older adults are even put on transplant waiting lists. In 2007, only 10.4 percent of dialysis patients between the ages of 65 and 74 were on waiting lists, compared to 33.5 percent of 18- to 44-year-old dialysis patients and 21.9 percent of 45- to 64-year-old dialysis patients.
Segev cautions that some older kidney disease patients are indeed poor transplant prospects, because they have other age-related health problems. But he says his team’s new findings, in addition to other recent research, show that new organs can greatly improve survival even in this age group.
Segev and his team constructed a statistical model for predicting how well older adults would be expected to do after kidney transplantation by taking into account age, smoking, diabetes and 16 other health-related variables. Using those data to define an ‘excellent’ candidate, the information was then applied to every person 65 and older on dialysis during the seven-year study period. The researchers also determined whether these candidates were already on the waiting list.
‘We have this regressive attitude toward transplantation in older adults,’ Segev says, ‘one based on historical poor outcomes in older patients, which no longer hold up. Anyone who can benefit from kidney transplantation should at least be given a chance. They should at least be put on the list.’
Johns Hopkins Medical Institutions
Two clinical trials led by Johns Hopkins Kimmel Cancer Center researchers in collaboration with other medical centres, testing experimental drugs aimed at restoring the immune system
A new electronic medical record tool that tallies patients’ previous radiation exposure from CT scans helps reduce potentially unnecessary use of the tests among emergency room patients with abdominal pain, according to a study from researchers at the Perelman School of Medicine at the University of Pennsylvania. The new study shows that when the tool is in use, patients are 10 percent less likely to undergo a CT scan, without increasing the number of patients who are admitted to the hospital.
Abdominal pain is the most common reason why people seek care in emergency rooms in the United States, accounting for 10 million visits each year. But the symptoms may be caused by myriad problems, from those that can be fixed with a single dose of an over-the-counter drug to those that could prove life-threatening within hours: from a bout of GI distress to an ectopic pregnancy; from constipation to an appendix about to burst; from a hernia to signs of a chronic condition like Crohn’s disease.
This complex diagnostic face-off plays a huge role in why emergency physicians tend to lean heavily on tests like CT scans, even though they expose patients to radiation and there are few clear guidelines on which patients should get them. Since the mid-1990s, the use of CT scans to diagnose ER patients has surged, increasing ten-fold. Today, 14 percent of all emergency room patients get scanned
A new Northwestern Medicine brain-machine technology delivers messages from the brain directly to the muscles — bypassing the spinal cord — to enable voluntary and complex movement of a paralysed hand. The device could eventually be tested on, and perhaps aid, paralysed patients.
‘We are eavesdropping on the natural electrical signals from the brain that tell the arm and hand how to move, and sending those signals directly to the muscles,’ said Lee E. Miller, the Edgar C. Stuntz Distinguished Professor in Neuroscience at Northwestern University Feinberg School of Medicine and the lead investigator of the study. ‘This connection from brain to muscles might someday be used to help patients paralysed due to spinal cord injury perform activities of daily living and achieve greater independence.’
The research was done in monkeys, whose electrical brain and muscle signals were recorded by implanted electrodes when they grasped a ball, lifted it and released it into a small tube. Those recordings allowed the researchers to develop an algorithm or ‘decoder’ that enabled them to process the brain signals and predict the patterns of muscle activity when the monkeys wanted to move the ball.
These experiments were performed by Christian Ethier, a post-doctoral fellow, and Emily Oby, a graduate student in neuroscience, both at the Feinberg School of Medicine. The researchers gave the monkeys a local anaesthetic to block nerve activity at the elbow, causing temporary, painless paralysis of the hand. With the help of the special devices in the brain and the arm
One in eight women in the United States will develop breast cancer. Of those, many will undergo surgery to remove the tumour and will require some kind of breast reconstruction afterward, often involving implants. Cancer is an elusive target, though, and malignant cells return for as many as one-fifth of women originally diagnosed, according to the American Cancer Society.
Would it be possible to engineer implant materials that might drive down that rate of relapse? Brown University biomedical scientists report some promising advances. The team has created an implant with a ‘bed-of-nails’ surface at the nanoscale (dimensions one-billionth of a meter, or 1/50,000th the width of a human hair) that deters cancer cells from dwelling and thriving. Made out of a common federally approved polymer, the implant is the first of its kind, based on a review of the literature, with modifications at the nanoscale that cause a reduction in the blood-vessel architecture on which breast cancer tumours depend
A powerful new imaging technique called High Definition Fibre Tracking (HDFT) will allow doctors to clearly see for the first time neural connections broken by traumatic brain injury (TBI) and other neurological disorders, much like X-rays show a fractured bone, according to researchers from the University of Pittsburgh.
In the report, the researchers describe the case of a 32-year-old man who wasn