Clinical trial results published this week offer additional evidence that a new device may help relieve chronic heartburn symptoms that standard treatment cannot. The Keck Medical Center of USC was one of 14 U.S. and European medical centres to test the device prior to its March 2012 approval by the U.S. Food and Drug Administration.

John Lipham, M.D., associate professor of surgery at the Keck School of Medicine of USC, led clinical investigation of the device at USC as part of his ongoing work to find alternative ways to treat gastroesophageal reflux disease (GERD), or chronic heartburn.

‘These results show that there is another option for the millions of people suffering from chronic reflux,’ Lipham said. ‘Currently, the Keck Medical Center of USC is one of only 30 sites in the country certified to implant the device.’

The LINX Reflux Management System, manufactured by Minnesota-based Torax Medical, Inc., is like a bracelet made up of magnetic, titanium beads implanted around the end of the oesophagus, where the lower oesophageal sphincter is located. The lower oesophageal sphincter is the valve that prevents reflux, and GERD develops when this valve is weakened.

Implantation of the device is potentially an outpatient procedure that can be completed in 15 to 20 minutes, Lipham said.

Lipham and his colleagues assessed 100 patients with GERD before and after surgery, finding that acid reflux decreased, reflux symptoms improved and the use of medication to manage those symptoms decreased for most patients. Severe regurgitation was eliminated in all patients. More than 9 in 10 patients reported satisfaction with their overall condition after having the procedure, compared to 13 percent before treatment while taking medication.

Follow-up studies are still required to assess long-term safety.

Lipham says the LINX device is best for patients with mild to moderate reflux that cannot be adequately controlled by medication or for patients who do not want to take medication to manage the disease. More than 60 million Americans experience heartburn at least once a month and some studies have suggested that more than 15 million experience heartburn symptoms every day, according to the American College of Gastroenterology.

Surgical treatment of reflux disease had been limited to a procedure called a Nissen fundoplication, which involves recreating the oesophageal sphincter. While fundoplication is recommended for those with severe reflux, it is a complicated procedure that prevents the ability to belch or vomit and often leads to bloating or gas problems.

The most common adverse events experienced with the LINX included difficulty swallowing, pain when swallowing food, chest pain, vomiting, and nausea. It is important to note that patients with LINX will no longer be able to undergo magnetic resonance imaging (MRI) procedures. The magnetic beads interfere with the machine and can cause the device to be damaged and the patient to be injured. Keck Medical Center

White blood cells, or leukocytes, are the immune system’s warriors. So when an infection or disease attacks the body, the system typically responds by sending more white blood cells into the fray. This means that checking the number of these cells is a relatively easy way to detect and monitor such conditions.

Currently, most white blood cell counts are performed with large-scale equipment in central clinical laboratories. If a physician collects blood samples from a patient in the office

Most patients whose breast cancer has spread to their lymph nodes have most of the lymph nodes in their armpit area removed after chemotherapy to see if any cancer remains. A study conducted through the American College of Surgeons Oncology Group and led by Judy Boughey, M.D. a breast surgeon at Mayo Clinic shows that a less invasive procedure known as sentinel lymph node surgery successfully identified whether cancer remained in lymph nodes in 91 percent of patients with node-positive breast cancer who received chemotherapy before their surgery. In sentinel lymph node surgery, only a few lymph nodes, the ones most likely to contain cancer, are removed.

‘Since treatment with chemotherapy before surgery can eliminate cancer in the lymph nodes in some patients, we were interested in evaluating whether sentinel lymph node surgery could successfully identify whether cancer remained in the lymph nodes after chemotherapy,’ says Dr. Boughey. Removing only a few lymph nodes reduces the risk of surgical complications such as numbness and arm swelling, she says.

Researchers studied 756 women with node-positive breast cancer who received chemotherapy as an initial treatment. Of study participants, 637 patients had both sentinel lymph node and axillary lymph node surgery. Sentinel lymph node surgery correctly identified whether cancer lingered in 91 percent of patients, including 255 patients with node-negative breast cancer and 326 patients with continuing node-positive disease.

Researchers also found that 40 percent of the patients had complete eradication of the cancer from the lymph nodes. The study had a false-negative rate of 12.6 percent and the false negative rate was significantly lower with the use of dual tracers (blue dye and radiolabeled colloid) to identify the sentinel lymph nodes.

Dr. Boughey says that technical factors in surgery are important to help ensure correct staging, the process of determining how far cancer may have spread.

Global action is needed to tackle the catastrophic threat of anti-microbial resistance, which in 20 years could see any one of us dying following minor surgery, England

New research has revealed that the use of Antimicrobial Copper surfaces in hospital rooms can reduce the number of healthcare-acquired infections (HAIs) by 58% as compared to patients treated in Intensive Care Units with non-copper touch surfaces. In the United States, 1 out of every 20 hospital patients develops an HAI, resulting in an estimated 100,000 deaths per year. Although numerous strategies have been developed to decrease these infections, Antimicrobial Copper is the only strategy that works continuously, has been scientifically proven to be effective and doesn’t depend on human behaviour, according to a recently study.
‘The implications of this study are critical,’ said Dr. Harold Michels, Senior Vice President of the Copper Development Association (CDA). ‘Until now, the only attempts to reduce HAIs have required hand hygiene, increased cleaning and patient screening, which don’t necessarily stop the growth of these bacteria the way copper alloy surfaces do. We now know that copper is the game-changer: it has the potential to save lives.’
The study, funded by the U.S. Department of Defense, was conducted in the Intensive Care Units (ICUs) of three major hospitals: The Medical University of South Carolina, Memorial Sloan-Kettering Cancer Center in New York City and the Ralph H. Johnson Veterans Affairs Medical Center in Charleston, South Carolina. To determine the impact of copper alloy surfaces on the rate of HAIs, copper-surfaced objects were placed in each ICU, where patients are at higher risk due to the severity of their illnesses, invasive procedures and frequent interaction with healthcare workers. Patients were randomly placed in available rooms with or without copper alloy surfaces, and the rates of HAIs were compared. A total of 650 patients and 16 rooms (8 copper and 8 standard) were studied between July 12, 2010 and June 14, 2011.
Results of this study found that Antimicrobial Copper can continuously kill 83% of bacteria that cause HAIs within two hours, including strands resistant to antibiotics. The study compared copper to equivalent non-copper touch surfaces during active patient care between routine cleaning and sanitising.
‘Copper alloy surfaces offer an alternative way to reduce the increasing number of HAIs, without having to worry about changing healthcare worker behaviour,’ said Dr. Michael Schmidt, Vice Chairman of Microbiology and Immunology at the Medical University of South Carolina and one of the authors of the study. ‘Because the antimicrobial effect is a continuous property of copper, the regrowth of deadly bacteria is significantly less on these surfaces, making a safer environment for hospital patients.’
In study results, 46 patients developed an HAI, while 26 patients became colonised with MRSA or VRE. Overall, the proportion of patients who developed an HAI was significantly lower among those assigned to intensive care rooms with objects fabricated using copper alloys. There are currently hundreds of Antimicrobial Copper healthcare-related products available today, including IV poles, stretchers, tray tables and door hardware. EurekAlert