A pioneering surgical blood salvage technology developed at the University of Strathclyde, Glasgow, is set to transform the way major surgery is carried out by reducing blood loss in patients.
HemoSep is set to revolutionise the health care sector after gaining the CE mark and receiving Canadian national approval, following highly successful clinical trials in the world leading University of Kirikkale University Hospital in Ankara, Turkey.
The device is designed to recover blood spilled during open-heart and major trauma surgery and concentrate the blood cells for transfusion back to the patient. This process, known as autotransfusion, reduces the volume of donor blood required and the problems associated with transfusion reaction.
Professor Terry Gourlay, who led the development of the technology at the University
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A multicenter trial showed that nearly half of young patients with early-stage Hodgkin lymphoma can be cured without undergoing either irradiation or intensive chemotherapy that would leave them at risk for second cancers, infertility, heart and other problems later.
St. Jude Children
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The World Health Organization has launched the first global strategy on health policy and systems research (HPSR) at the Second Global Symposium on Health Systems Research. This document represents a unique milestone in the evolution of health policy and systems research and has three broad aims. First, it seeks to unify the worlds of research and decision-making and connect the various disciplines of research that generate knowledge to inform and strengthen health systems. Second, the strategy contributes to a broader understanding of this field by clarifying the scope and role of HPSR. It provides insight into the dynamic processes through which HPSR evidence is generated and used in decision-making. Finally, it is hoped that this strategy will serve as an agent for change and calls for a more prominent role for HPSR at a time when the health systems mandate is evolving towards broader goals of universal health coverage and equity. This strategy on health policy and systems research is intended to augment and amplify WHO
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In 2010 breast reconstruction entered the Top Five list of reconstructive procedures in the US, with 93,000 procedures performed, up 8% from 2009, and 18% from 2000. This is among the most common skin flap procedure performed.
Skin flaps are typically used to cover areas of tissue loss or defects that arise as a result of traumatic injury, reconstruction after cancer excision and repair of congenital defects. In the case of a mastectomy
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A major study of Medicare beneficiaries shows that the risk of hip fractures was significantly reduced in patients who had had cataract surgery, compared to patients who did not undergo the procedure. The researchers believe their study is the first to demonstrate that cataract surgery reduces the rate of fractures in older patients with vision loss. This suggests that cataract surgery could be an effective intervention to help prevent fractures and reduce associated morbidity and costs. The American Academy of Ophthalmology and the Jules Stein Eye Institute at the University of California, Los Angeles, collaborated on the study.
The study tracked hip fracture incidence in a cohort of Medicare patients with cataracts from 2002-09. Anne L. Coleman, M.D., Ph.D., the Fran and Ray Stark professor of ophthalmology at the Jules Stein Eye Institute at UCLA and director of the Academy’s Hoskins Center for Quality Eye Care, led the research. The medical records of about 400,000 patients who had cataract surgery were analysed for hip fractures that occurred within one year of cataract surgery. This data was then compared to hip fracture incidence in a matched group of patients who had cataracts, but did not have cataract surgery. Cataract surgery was associated with a 16 percent decrease in patients’ adjusted odds of suffering a hip fracture within one year of the procedure.
This is particularly significant because older people’s higher risk of falling makes them especially vulnerable to fractures of the hip and other bones. Previous studies have found that vision loss is a major factor in seniors’ risk of falling. When visual sharpness and depth perception decline, people also lose their ability to maintain balance, stability and mobility.
‘Our study suggests that people should never be regarded as ‘too old’ to have their cataracts removed,’ said Dr. Coleman, who also serves as the Academy’s secretary for quality of care. ‘In fact, the greatest reduction in hip fracture risk was in patients who had cataract surgery when they were in their 80s.’
Overall, the greatest decrease in hip fracture risk was seen in patients aged 80 to 84 who had cataract surgery. Another notable group was patients with severe cataracts, for whom risk was reduced by 23 percent. Although U.S. health statistics show that women are more susceptible to hip fractures than men, this study found no significant gender-linked differences in fracture risk.
‘When older people’s vision improves following cataract surgery, they, their families, and society gain from the resulting reductions in suffering and medical costs,’ said William L. Rich, M.D., a cataract specialist and the Academy’s medical director for health policy. ‘Ophthalmic research continues to demonstrate that cataract surgery is highly successful in terms of patient-reported outcomes such as improved vision and quality of life. The new study provides data on an important ancillary health benefit.’
EurekAlert
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Transplant patients are among those at highest risk of adverse outcomes when receiving a stent to address a blockage in an artery. Compared with the general public, these patients have a much higher rate of restenosis, a side effect of stenting in which the artery becomes re-blocked because of an exaggerated scarring process at the stenting site.
New research by UCLA researchers and colleagues has found that heart transplant patients who develop restenosis after receiving a stent have poor long-term survival.
‘The findings point to the need for improvements in prevention and treatment of transplant coronary artery disease that may help reduce restenosis for patients who require later cardiac procedures like stenting,’ said Dr. Michael Lee, an assistant professor of cardiology at the David Geffen School of Medicine at UCLA.
A stenting procedure begins with an angioplasty, in which a catheter is placed in an artery of the groin and a tiny wire is snaked up through the artery to the blocked area of the heart. The clogged artery is cleaned out, and then a stent
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Currently repeated operations are needed to replace batteries in pacemakers, but according to US researchers a device which could harness energy from a beating heart can produce enough electricity to keep a pacemaker running.
Piezoelectric materials generate an electric charge when their shape is changed. They are used in some microphones to convert vibrations into an electrical signal. Researchers at the University of Michigan are trying to use the movement of the heart as a source of electricity.
In tests designed to simulate a range of heartbeats, enough electricity was generated to power a pacemaker. Tests suggested the device could produce 10 times the amount of energy needed. The designers now want to test the device on a real heart and build it into a commercial pacemaker.
The British Heart Foundation said clinical trials were needed to show it would be safe for patients.
Dr Amin Karami told a meeting of the American Heart Association that pacemaker batteries needed to be replaced approximately every seven years. ‘Many of the patients are children who live with pacemakers for many years. You can imagine how many operations they are spared if this new technology is implemented.’
Prof Peter Weissberg, the medical director at the British Heart Foundation, said: ‘Advancing technology over recent years has meant people with pacemakers need to change their battery less often. This device could be another step forward along this path. ‘If researchers can refine the technology and it proves robust in clinical trials, it would further reduce the need for battery changes.’
BBC
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Sitting still is tough for children, which makes MRI scans a challenge. The scans require that patients remain motionless for extended periods. Findings from St. Jude Children
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Cancers are notorious for secreting chemicals that confuse the immune system and thwart biological defences.
To counter that effect, some cancer treatments try to neutralise the cancer’s chemical arsenal and boost a patient’s immune response–though attempts to do both at the same time are rarely successful.
Now, researchers have developed a novel system to simultaneously deliver a sustained dose of both an immune-system booster and a chemical to counter the cancer’s secretions, resulting in a powerful therapy that, in mice, delayed tumour growth, sent tumours into remission and dramatically increased survival rates.
The new immunotherapy incorporates well-studied drugs, but delivers them using nanolipogels (NLGs), a new drug transport technology the researchers designed. The NLGs are nanoscale, hollow, biodegradable spheres, each one capable of accommodating large quantities of chemically diverse molecules.
The spheres appear to accumulate in the leaky vasculature, or blood vessels, of tumours, releasing their cargo in a controlled, sustained fashion as the spherule walls and scaffolding break down in the bloodstream.
For the recent experiments, the NLGs contained two components: an inhibitor drug that counters a particularly potent cancer defence called transforming growth factor-β (TGF-β), and interleukin-2 (IL-2), a protein that rallies immune systems to respond to localised threats.
‘You can think of the tumour and its microenvironment as a castle and a moat,’ says Tarek Fahmy, the Yale University engineering professor and NSF
CAREER grantee who led the research. "The ‘castles’ are cancerous tumours, which have evolved a highly intelligent structure–the tumour cells and vasculature. The ‘moat’ is the cancer’s defence system, which includes TGF-β. Our strategy is to ‘dry-up’ that moat by neutralising the TGF-β. We do that using the inhibitor that is released from the nanolipogels. The inhibitor effectively stops the tumour
Researchers at Boston Medical Center (BMC) have shown that patient navigation services help decrease the time to diagnosis for female patients who have received an abnormal result from a breast or cervical cancer screening. The study demonstrates the importance of patient navigation in helping vulnerable populations get the care that they need in a timely manner and supports the recent standard recommendations for all cancer care centres to provide patient navigation services.
Tracy Battaglia, MD, MPH, director of the Women’s Health Unit at BMC and associate professor of medicine at Boston University School of Medicine (BUSM), is the study’s lead author.
The Boston Patient Navigation Research Program, which was conducted at six federally qualified inner-city community health centres affiliated with BMC between 2004 and 2008, is part of a five-year national study designed to reduce delays in completing recommended care after an abnormal cancer screening. During the intervention, 1,497 female subjects received patient navigation services and 1,544 were in the control group. All subjects were followed for one year to document whether all recommended tests were completed and women received a final diagnosis of cancer or no cancer.
The subjects who received navigation services were diagnosed in significantly less time and were more likely to ever complete their care compared to the control subjects. The decrease in time was shown among all women who received abnormal cervical screening results and among the subset of women with abnormal breast cancer screening results who took longer than 60 days to complete their care.
Data shows that low-income racial/ethnic minority patients often do not access timely, quality cancer treatment and services. ‘The goal of patient navigation is to facilitate timely care for these vulnerable patients by addressing barriers to care,’ said Battaglia. Patient navigation services include identifying patients at risk for delays in treatment and facilitating appointment scheduling by identifying and addressing barriers that may interfere with this care, such as: child care and transportation services; co-ordinating care among numerous providers; organising interpreter services; and providing guidance and support so patients can advocate for themselves.
According to the Centers for Disease Control and Prevention (CDC), breast cancer is the most common cancer among women in the United States aside from non-melanoma skin cancer and is one of the leading causes of cancer death among women of all races and Hispanic origin populations. The CDC also notes that more black and Hispanic women get HPV-associated cervical cancer than women of other races or ethnicities, which is possibly due to a decreased access to Pap testing or follow-up treatment.
‘This study confirms the long presumed benefit of navigation for vulnerable populations and supports recent standard recommendations for all cancer centres to provide patient navigation services to their patients, especially those whose patients are at risk for delays in care,’ said Battaglia.
EurekAlert
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