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Archive for category: E-News

E-News

Worries about dementia how hospitalisation affects the elderly

, 26 August 2020/in E-News /by 3wmedia

Older people often worry about dementia and while some risks are known, for example alcoholism or stroke, the effects of illness are less clear. New research looks at illness requiring hospitalisation and treatment in the intensive care unit (ICU) and finds that infection or severe sepsis, neurological dysfunction, such as delirium, or acute dialysis are all independently associated with an increased risk of a subsequent diagnosis of dementia.
This study was based on a random 5% of older (66 years or above) Medicare patients who were treated in intensive care in 2005 and whose health was followed for a further three years using Medicare claims data. Of the 25,368 patients included in the study 4,519 (17.8%) went on to receive a diagnosis of dementia during the three year follow up period.
Patients with previous indications of cognitive impairment for whom dementia could have been an escalation of a pre-existing condition were excluded from the study.
Increasing age was very strongly associated with diagnosis of dementia following ICU. The risk at 75 was more than double that of the 66 to 69 year olds. And this rose to more than five times the risk for those age 85 and older. Women had a marginally higher risk than men and, as other studies have shown, race was also important to risk. Length of stay in ICU was not a factor nor was the need for mechanical ventilation.
Three factors related to the critical illness were independently associated with an increased risk of a diagnosis of dementia: a critical illness with the presence of an infection which increased to a higher risk with more severe infection such as severe sepsis, having acute neurologic dysfunction during critical illness, including anoxic brain damage, encephalopathy, and transient mental disorders, and finally acute renal failure requiring dialysis. This last risk was time-dependent and only increased the risk 6 months after the patient had been discharged from hospital.
Dr Hannah Wunsch, from Columbia University Medical Center, lead author of the study commented, ‘Due to increasing life spans and better hospital care, millions of older people now survive a critical illness every year. Our study provides a greater understanding of the consequences of these hospitalisations on subsequent risk of receiving a diagnosis of dementia, and may allow for better planning and targeting future studies to high risk populations.’ EurekAlert

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DNA sequencing reveals evidence for Mycobacterium abscessus transmission between Cystic Fibrosis patients

, 26 August 2020/in E-News /by 3wmedia

Researchers at Papworth Hospital, the University of Cambridge and the Wellcome Trust Sanger Institute have discovered why a new type of dangerous bacterial infection has become more common among people with Cystic Fibrosis around the world. Through their ground-breaking research, the team has developed new measures to protect Cystic Fibrosis patients.
People with Cystic Fibrosis are prone to serious infection in part because they have sticky mucus that can clog up their lungs. In recent years doctors have seen a global increase in the number of infections caused by the antibiotic-resistant bacterial species Mycobacterium abscessus (M. abscessus). M. abscessus is distantly related to the bacterium that causes Tuberculosis and is usually found in water and soil. Until now, experts had thought it could not be passed from person to person.
‘There has been worldwide concern about the rising number of M. abscessus infections in people with Cystic Fibrosis and anxiety that spread from person to person might be responsible,’ said Dr Andres Floto, Research Director of the Cystic Fibrosis Unit at Papworth Hospital, Principal Investigator at the Cambridge Institute for Medical Research, University of Cambridge ‘Our work has allowed us to lead the world in changing hospital infection control: we used state-of-the-art DNA sequencing technology to understand how the infection is being spread, which conventional techniques would have missed.’
‘Our results will help to protect patients from this serious infection.’
The team used the latest methods to sequence the genomes of almost 170 isolates of M. abscessus from Cystic Fibrosis patients collected over a five-year period. By looking at the fine detail of the relationships between the bacterial genomes, to produce a ‘family tree’, the research team could determine where it was likely that infection had passed from one patient to another. They showed that, even with nationally recommended infection control measures in place, M. abscessus can spread between patients.
‘We are increasingly able to use DNA studies to improve patient care,’ says Professor Julian Parkhill, Head of Pathogen Genomics at the Wellcome trust Sanger Institute. ‘By sequencing the complete genomes of bacteria we can accurately describe where they have emerged from and how they pass from person to person.’
‘This knowledge means that the clinical teams can develop new health measures to safeguard their patients. Our aim is to develop the best methods to detect and control infection.’ Papworth Hospital

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In some dystonia cases, deep brain therapy benefits may linger after device turned off

, 26 August 2020/in E-News /by 3wmedia

Two patients freed from severe to disabling effects of dystonia through deep brain stimulation therapy continued to have symptom relief for months after their devices accidentally were fully or partly turned off.
‘Current thought is that symptoms will worsen within hours or days of device shut-off, but these two young men continued to have clinical benefit despite interruption of DBS therapy for several months. To our knowledge, these two cases represent the longest duration of retained benefit in primary generalised dystonia. Moreover, when these patients

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Telestroke is cost-effective for hospitals

, 26 August 2020/in E-News /by 3wmedia

Researchers have found that using telemedicine to deliver stroke care, also known as telestroke, appears to be cost-effective for rural hospitals that do not have an around-the-clock neurologist, or stroke expert, on staff. The research is intended to help hospital administrators evaluate telestroke.

In telestroke care, the use of a telestroke robot allows a patient with stroke to be examined in real time by a neurology specialist elsewhere who consults via computer with an emergency room physician in the rural site.

‘Previous studies have demonstrated that a hub-and-spoke telestroke network is cost-effective from the societal perspective

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Nearly half of older women diagnosed with urinary tract infections in an emergency department did not have findings confirmed in urine culture

, 26 August 2020/in E-News /by 3wmedia

Older adults represent an important and growing demographic in emergency departments (ED) across the country, with urinary tract infections (UTIs) being one of the leading causes for ED visits. In fact, UTIs, which can progress to serious health concerns, are the fourth most common diagnosis in women over age 65. But a new study at Rhode Island Hospital has found that many such women receive treatment for a UTI, but have no firm evidence of such an infection, resulting in the prescribing of unnecessary antibiotics.

The study, conducted by Leonard Mermel, DO, medical director of the department of epidemiology and infection control at Rhode Island Hospital, and his colleagues found that collection of urine to rule in, or rule out, a UTI in this patient population is best done by inserting a temporary catheter into the bladder to collect the specimen rather than collecting urine by the so-called

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Deep Brain Stimulation shows promise for patients with chronic, treatment resistant anorexia nervosa

, 26 August 2020/in E-News /by 3wmedia

In a world first, a team of researchers at the Krembil Neuroscience Centre and the University Health Network have shown that Deep Brain Stimulation (DBS) in patients with chronic, severe and treatment-resistant Anorexia Nervosa (anorexia) helps some patients achieve and maintain improvements in body weight, mood, and anxiety.
The study is a collaboration between lead author Dr. Nir Lipsman a neurosurgery resident at the University of Toronto and PhD student at the Krembil Neuroscience Centre; Dr. Andres Lozano, a neurosurgeon, at the Krembil Neuroscience Centre of Toronto Western Hospital and a professor and chairman of neurosurgery at the University of Toronto, whose research lab was instrumental in conducting the DBS research; and Dr. Blake Woodside, medical director of Canada

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Pill-sized device rivals endoscopy

, 26 August 2020/in E-News /by 3wmedia

Physicians may soon have a new way to screen patients for Barrett

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Technique finds software bugs in surgical robots

, 26 August 2020/in E-News /by 3wmedia

Surgical robots could make some types of surgery safer and more effective, but proving that the software controlling these machines works as intended is problematic. Researchers at Carnegie Mellon University and the Johns Hopkins University Applied Physics Laboratory have demonstrated that methods for reliably detecting software bugs and ultimately verifying software safety can be applied successfully to this breed of robot.
They used theorem-proving techniques to analyse a control algorithm for a research robot that would help a surgeon perform surgery at the base of the skull. Their method identified a safety flaw that could enable a scalpel or other surgical tool to go dangerously astray in this area, where the eye orbits, ear canals and major arteries and nerves are closely spaced and vulnerable to injury. It also guided development of a new algorithm and verified that the new controller was safe and reliable.

‘These techniques are going to change how people build robotic surgery systems,’ predicted APL’s Yanni Kouskoulas, who led the research study with Andr

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Cancer researchers and astronomers team up to beat cancer

, 26 August 2020/in E-News /by 3wmedia

Cambridge scientists have honed techniques originally developed to spot distant galaxies and used them to identify biomarkers that signal a cancer

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Brain imaging identifies bipolar risk

, 26 August 2020/in E-News /by 3wmedia

Researchers from the Black Dog Institute and University of NSW have used brain imaging technology to show that young people with a known genetic risk of bipolar but no clinical signs of the condition have clear and quantifiable differences in brain activity when compared to controls.
‘We found that the young people who had a parent or sibling with bipolar disorder had reduced brain responses to emotive faces, particularly a fearful face. This is an extremely promising breakthrough,’ says study leader Professor Philip Mitchell.
Affecting around 1 in 75 Australians, bipolar disorder involves extreme and often unpredictable fluctuations in mood. The mood swings and associated behaviours such as disinhibited behaviour, aggression and severe depression, have a significant impact on day-to-day life, careers and relationships. Bipolar has the highest suicide rate of all psychiatric disorders.
‘We know that bipolar is primarily a biological illness with a strong genetic influence but triggers are yet to be understood. Being able to identify young people at risk will enable implementation of early intervention programs, giving them the best chance for a long and happy life,’ says Prof Mitchell.
Researchers used functional MRI to visualise brain activity when participants were shown pictures of happy, fearful or calm (neutral) human faces. Results showed that those with a genetic risk of bipolar displayed significantly reduced brain activity in a specific part of the brain known to regulate emotional responses.
‘Our results show that bipolar disorder may be linked to a dysfunction in emotional regulation and this is something we will continue to explore,’ Professor Mitchell said.
‘And we now have an extremely promising method of identifying children and young people at risk of bipolar disorder.’
‘We expect that early identification will significantly improve outcomes for people that go on to develop bipolar disorder, and possibly even prevent onset in some people.’ University of New South Wales

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