Advances in diagnostic imaging have benefited children with otolaryngologic disease, allowing shorter hospital stays, fewer invasive procedures, more targeted surgical procedures, and earlier and more precise diagnoses. However, despite improved technology, concerns about exposure of children to ionising radiation have recently come to the forefront, according to a commentary in the July 2012 issue of Otolaryngology
Compared with historical reports, the use of stereotactic body radiation therapy in inoperable early lung cancer appears to result in longer 3-year and 5-year survival, Japanese researchers reported here. About 60% of 104 patients diagnosed with Stage IA non-small cell lung cancer achieved a 3-year overall survival and 40.8% were alive at 5 years, said Yasushi Nagata, MD, professor and chairman of radiation oncology at the University of Hiroshima, at a press briefing during the annual meeting of the American Society for Radiation Oncology.
According to Nagata, even though the patients in the study had very early stage cancer they were inoperable mainly because of their age and other comorbid conditions, as they were smokers, and their pulmonary function was compromised, so stereotactic radiotherapy was the better choice for them. He said that stereotactic body radiation therapy is less invasive, is believed to be effective against early stage lung cancer and was found to be feasible in patients with operable cancer.
Researchers have developed a new way to observe and track large numbers of rapidly moving objects under a microscope, capturing precise motion paths in three dimensions.
Over the course of the study researchers followed an unprecedented 24,000 rapidly moving cells over wide fields of view and through large sample volumes, recording each cell’s path for as long as 20 seconds.
‘We can very precisely track the motion of small things, more than a thousand of them at the same time, in parallel,’ says research lead and National Science Foundation CAREER awardee Aydogan Ozcan, an electrical engineering and bioengineering professor at UCLA. ‘We were able to achieve sub-micron accuracy over a large volume, allowing us to understand, statistically, how thousands of objects move in different ways.’
The latest study is an extension of several years of NSF-supported work by Ozcan and his colleagues to develop lens-free, holographic microscopy techniques with applications for field-based detection of blood-borne diseases and other areas of tele-medicine. Those efforts recently resulted in a Popular Mechanics Breakthrough Award and a National Geographic Emerging Explorer Award, among others. Ozcan’s research is also supported through an NIH Director’s New Innovator Award, Office of Naval Research Young Investigator Award and an Army Research Office Young Investigator Award from the Department of Defense.
For the recent work, Ozcan and his colleagues–Ting-Wei Su, also of UCLA, and Liang Xue, of both UCLA and Nanjing University of Science and Technology in China–used offset beams of red and blue light to create holographic information that, when processed using sophisticated software, accurately reveal the paths of objects moving under a microscope. The researchers tracked several cohorts of more than 1,500 human male gamete cells over a relatively wide field of view (more than 17 square millimeters) and large sample volume (up to 17 cubic millimeters) over several seconds.
The technique, along with a novel software algorithm that the team developed to process observational data, revealed previously unknown statistical pathways for the cells. The researchers found that human male gamete cells travel in a series of twists and turns along a constantly changing path that occasionally follows a tight helix–a spiral that, 90 percent of the time, is in a clockwise (right-handed) direction.
Because only four to five percent of the cells in a given sample travelled in a helical path at any given time, researchers would not have been able to observe the rare behaviour without the new high-throughput microscopy technique.
‘This latest study is an extension of truly novel and creative work,’ says Leon Esterowitz, the NSF biophotonics program officer who has supported Ozcan’s efforts. ‘The holographic technique could accelerate drug discovery and prove valuable for monitoring pharmaceutical treatments of dangerous microbial diseases.’
The paper reports observations of 24,000 cells over the duration of the experiments. Such a large number of observations provide a statistically significant dataset and a useful methodology for potentially studying a range of subjects, from the impact of pharmaceuticals and other substances on large numbers of cells–in real time–to fertility treatments and drug development.
The same approach may also enable scientists to study quick-moving, single-celled micro-organisms. Many of the dangerous protozoa found in unsanitary drinking water and rural bodies of water have only been observed in small samples moving through an area that is roughly two dimensional. The new lens-free holographic imaging technique could potentially reveal unknown elements of protozoan behaviour and allow real-time testing of novel drug treatments to combat some of the most deadly forms of those microbes.
National Science Foundation
Medical staff struggle to spot problem drinking in their patients unless they are already intoxicated, according to research by the University of Leicester.
The work led by Dr Alex J Mitchell, consultant at Leicestershire Partnership NHS Trust and honorary senior lecturer at the University, reveals that clinical staff often overlook alcohol problems in their patients when they do not present intoxicated.
In a new study involving 20,000 patients assessed for alcohol problems by medical staff, all clinicians struggled to detect alcohol problems whether or not patients volunteered information regarding their drinking.
1 in 4 of the adult population in England (33% of men and 16% of women) consumes alcohol in a way that is potentially harmful to their health and 6% of men are alcohol dependent (Pilling et al, 2011). 1 in 6 primary care patients have an alcohol use disorder or are alcohol dependent.
General practitioners (GPs) identified 40% of problem drinkers, hospital doctors identified 50% of problem drinkers and mental health specialists recognised 55% of problem drinkers. Clinicians correctly recorded a diagnosis in the case-notes for only 1 in 3 people who had an alcohol problem. Only alcohol intoxication was accurately identified. A&E clinicians were able to correctly detect patients with alcohol intoxication in 9 out of 10 patients. In research studies where patients admitted to a drinking problem by self report, the same rates of under-detection occurred.
Assessing for alcohol problems in patients using a short questionnaire is recommended by the UK Primary Care Service Framework and NICE but not widely implemented by clinicians.
Dr Alex Mitchell said: ‘This study highlights that clinical identification of alcohol problems is challenging in busy clinical environments. When clinicians try and spot alcohol problems they often miss patients who have serious alcohol problems but who are not currently intoxicated. Further they can misidentify about 5% of
An injection of banked sperm-producing stem cells can restore fertility to male primates who become sterile due to cancer drug side effects, according to researchers at the University of Pittsburgh School of Medicine and Magee-Womens Research Institute. In their animal study previously frozen stem cells restored production of sperm that successfully fertilised eggs to produce early embryos.
Some cancer drugs work by destroying rapidly dividing cells. As it is not possible to discriminate between cancer cells and other rapidly dividing cells in the body, the precursor cells involved in making sperm can be inadvertently wiped out leaving the patient infertile, said senior investigator Kyle Orwig, Ph.D., associate professor, Department of Obstetrics, Gynecology and Reproductive Medicine, Pitt School of Medicine, and an investigator at Magee-Womens Research Institute.
‘Men can bank sperm before they have cancer treatment if they hope to have biological children later in their lives,’ he said. ‘But that is not an option for young boys who haven
The study explains why certain patients develop severe infections after chemotherapy and points to ways of averting this side-effect
Cancer chemotherapy can be a life-saver, but it is fraught with severe side effects, among them an increased risk of infection. Until now, the major criterion for assessing this risk has been the blood cell count: if the number of white blood cells falls below a critical threshold, the risk of infection is thought to be high. A new model built by Weizmann Institute mathematicians in collaboration with physicians from the Meir Medical Center in Kfar Saba and from the Hoffmann-La Roche research center in Basel, Switzerland, suggests that for proper risk assessment, it is essential to evaluate not only the quantity of these blood cells, but also their quality, which varies from one person to another.
This research may represent an important step in the emerging field of personalised medicine, leading to a more individualised approach to chemotherapy. In particular, better precautions might need to be taken to prevent infection in high-risk patients whereas those at a low risk could be spared unnecessary preventive treatments.
The study brought together the expertise of researchers from such diverse disciplines as applied mathematics, electrical engineering, oncology, immunology and paediatrics.
The new model reveals how the immune system functions under conditions of neutropenia
A new study has determined how often people should get screened for gastric or stomach cancer in high-risk regions of the world. The findings could help reduce deaths from gastric cancer, which is the second most common cause of cancer-related mortality.
Although the incidence of gastric cancer has decreased substantially in the western part of the world, the disease is still common in areas such as Eastern Asia, including Korea, Japan, and China.
Gastric cancer patients’ prognosis strongly depends on the stage of the disease, or how advanced it is, at the time of diagnosis. In other words, early detection and treatment can save lives.
Gastric cancer screening is often done by upper endoscopy
On World Mental Health Day (10 October), WHO has called for an end to the stigmatisation of depression and other mental disorders and for better access to treatment for all people who need it.
Globally, more than 350 million people have depression, a mental disorder that prevents people from functioning well. But because of the stigma that is often still attached to depression, many fail to acknowledge that they are ill and do not seek treatment.
Depression is different from usual mood fluctuations. Depression induces a sustained feeling of sadness for two weeks or more and interferes with the ability to function at work, school or home. Effective treatments include psychosocial treatment and medication. The active involvement of depressed people and those who are close to them in addressing depression is key. The first step is to recognise the depression and reach out for support. The earlier the treatment begins, the more effective it is.
‘We have some highly effective treatments for depression. Unfortunately, fewer than half of the people who have depression receive the care they need. In fact in many countries this is less than 10%,’ says Dr Shekhar Saxena, Director of the Department for Mental Health and Substance Abuse. ‘This is why WHO is supporting countries in fighting stigma as a key activity to increasing access to treatment.’
Cultural attitudes and lack of proper understanding of the condition contribute to a reluctance to seek help for depression.
WHO estimates suggest that depression is common in all regions of the world. A recent study supported by WHO revealed that around 5% of people in the community had depression during the last year.
Depression results from a complex interaction of social, psychological and biological factors. There is a relationship between depression and physical health, for example cardiovascular disease can lead to depression and vice versa. Up to one in five women who give birth experience post-partum depression.
In addition, circumstances such as economic pressures, unemployment, disasters, and conflict can also increase the risk of the disorder. At its worst, depression can lead to suicide. Tragically almost one million people commit suicide every year and a large proportion of them had experienced depression.
WHO assists governments in including treatment of depression in their basic health care packages. Through WHO
Mobile health (mHealth) solutions that allow patient consultation and monitoring, among other benefits, are surging in popularity as the spread of smartphones and tablets expands according to a new report.
The latest research states that the global mHealth market was worth $1.2 billion in 2011, but will jump in value to reach $11.8 billion by 2018, climbing at an impressive Compound Annual Growth Rate (CAGR) of 39%.
mHealth involves the use of mobile applications and devices to monitor a patient
Five million ‘test tube babies’ have now been born around the world, according to research presented at a conference of fertility experts. Delegates hailed it as a ‘remarkable milestone’ for fertility treatments.
The first test tube baby, Louise Brown, was born in the UK in July 1978. Her mother Leslie Brown died last month.
However, delegates at the conference in Turkey warned couples not to use fertility treatment as an ‘insurance policy’ if they delayed parenthood.
The International Committee for Monitoring Assisted Reproductive Technologies (Icmart) presented its latest data on children born to infertile parents at the European Society of Human Reproduction and Embryology conference.
It said official figures up to 2008, plus three years of estimates, put the total number of test tube babies born at five million.
Icmart chairman Dr David Adamson said: ‘This technology has been highly successful in treating infertile patients. Millions of families with children have been created, thereby reducing the burden of infertility.
IVF success rates (based on figures for 2008)
33.1% for women under 35
27.2% for women aged 35-37
19.3% for women aged 38-39
12.5% for women aged 40-42
‘The technology has improved greatly over the years to increase pregnancy rates.’
About 1.5 million cycles of IVF, and similar techniques, are performed every year, resulting in 350,000 babies, Icmart said.
Stuart Lavery, a consultant gynaecologist and director of IVF at Hammersmith Hospital, said: ‘IVF is now part of the mainstream, it is no longer something couples are ashamed of.’
However, he cautioned that the great success of assisted reproduction techniques should not lull people into thinking they could wait to have children.
‘The subtext is that if people delay childbirth they may view IVF as an insurance policy that they can access at any stage.
‘Unfortunately the facts still suggest that IVF success rates in women as they get older are not fantastic.’
Dr Allan Pacey, senior lecturer in andrology at the University of Sheffield, said: ‘I think it’s significant that we’ve got to five million. It’s far more socially acceptable than it has been over the last 10 or 20 years.
‘One word of warning, we should make sure that couples understand that IVF isn’t a guaranteed solution and if they’re in a position to have their children earlier in life then they should try and do that.
‘IVF really is something that should be preserved for those people who really need it.’
BBC
April 2024
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