Magnetic resonance imaging (MRI) provides an indication of a breast tumour
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,
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
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
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
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
Too often, communication barriers exist between those who can hear and those who cannot. Sign language has helped bridge such gaps, but many people are still not fluent in its motions and hand shapes.
Thanks to a group of University of Houston students, the hearing impaired may soon have an easier time communicating with those who do not understand sign language. During the past semester, students in UH
Varian Medical Systems and Siemens Healthcare announce global collaboration to advance clinical capabilities and offerings in radiotherapy and radiosurgery.
Varian Medical Systems and Siemens Healthcare have announced the signing of a strategic global partnership to provide advanced diagnostic and therapeutic solutions and services for treating cancer with image-guided radiotherapy and radiosurgery. The collaboration covers the mutual marketing and representation of products for imaging and treatment in the global radiation oncology business. This collaboration further comprises the development of software interfaces between Siemens and Varian treatment systems. The two companies will also investigate opportunities for joint development of new products for image-guided radiotherapy and radiosurgery.
Under the agreement that was signed this week, Varian will represent Siemens diagnostic imaging products such as CT, PET/CT or MRI to radiation oncology clinics around the world beginning immediately in most international markets and expanding to North America later this year. Siemens Healthcare will similarly represent Varian equipment and software for radiotherapy and radiosurgery within its offerings to its healthcare customers. This will enable the companies to offer comprehensive solutions to support the entire clinical workflow from imaging to treatment. Siemens will continue to service and support its global installed base of approximately 2,000 medical linear accelerators. The agreement will give Siemens customers more choices for therapy equipment, including smooth transition and interface to Varian equipment, as aging accelerators are due for replacement.
Furthermore, Varian and Siemens will develop interfaces that will enable connecting Varian
The founder of the French breast implant company at the heart of a global health scare has been jailed after failing to pay his bail. Jean-Claude Mas, 72, was released on 100,000 euro (
A team from the Institute of Photonic Sciences (ICFO) has developed a technique to measure internal cell temperatures without altering their metabolism. This finding could be useful when distinguishing healthy cells from cancerous ones, as well as learning more about cellular processes.
Temperature controls many of the cell’s life processes, such as splitting and metabolism. A European research team led by the Institute of Photonic Sciences (ICFO), which has the Severo Ochoa mark of excellence, has published a non-invasive method that offers quicker, more precise data from measuring intracellular heat from green fluorescent proteins (GFP).
‘A unique characteristic of our method is that it does not alter any cellular process’ Romain Quidant, ICFO researcher and study co-ordinator, explains to SINC. Unlike other techniques, this method does not stress or alter the behaviour of the cell as it does not need to be inserted into any molecules or any other synthetic nano-object that is sensitive to the internal temperature.
One of the most promising outcomes is a better understanding of cellular processes, such as those involved in metastasis. Furthermore, the possibility of obtaining information about intracellular temperature could be used to ‘differentiate normal cells from cancerous ones in a quick, non-invasive manner’ Sebastian Thompson Parga, ICFO researcher and co-author of the project.
From intracellular temperature, we can deduce how the energy used by the body in the uncontrolled spreading of cancer cells flows.
In this interdisciplinary study, biology uses physical measurements of energy transmission to study processes such as gene expression, metabolism and cell splitting.
The technique used is known by the name of ‘fluorescence polarisation anisotropy’ (FPA) as it allows the difference in polarisation between light that fluorescent molecules receive, and that which they emit later, to be measured. In the words of Quidant, ‘this difference in polarisation (anisotropy) is directly connected to the rotating of the GFP molecules and therefore with temperature’.
The authors of the study ensure that biologists will be able to implement this technique in experimental set-ups and obtain the cell temperature as another observable detail. In 2008, when Osamu Shimomura, Martin Chalfie and Roger Y. Tsien won the Nobel Chemistry Prize for discovering and developing GFP, they resolved many complications in biomedical research.
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