Nitric oxide (NO), a gas with many biological functions in healthy cells, can also help some cancer cells survive chemotherapy. A new study from MIT reveals one way in which this resistance may arise, and raises the possibility of weakening cancer cells by cutting off their supply of NO.
The findings focus on melanoma
Very low birth weight infants, those weighing less than 3.25 pounds, account for half of infant deaths in the United States each year, yet a new study released documents that these critically ill infants do not receive optimal nursing care, which can lead to hospital-acquired infections that double their death rate and may result in long-term developmental issues affecting the quality of their lives as adults.
These vulnerable infants are the highest risk pediatric patients in hospitals and account for half of all infant deaths in the country each year. These hospital-acquired infections afflicted 13.9 percent of these frail infants in 2009, the last year reported in the study.
The lead authors, based at the University of Medicine and Dentistry of New Jersey- School of Public Health and the University of Pennsylvania School of Nursing, studied very low birth weight infants cared for in 67 Neonatal Intensive Care Units (NICU).
‘One-third of NICU infants were understaffed, according to current guidelines. Understaffing varies further across acuity levels with the greatest fraction of understaffed infants (92 percent) requiring the most complex critical care, translating into a needed 25% increase in the numbers of nurses,’ wrote co-principal investigators Jeannette A. Rogowski, PhD, the University Professor in Health Economics at the UMDNJ-School of Public Health and Eileen T. Lake, PHD, RN, FAAN, associate director of the Center for Health Outcomes and Policy Research at the University of Pennsylvania School of Nursing.
The researchers noted that infection caused four to seven days of longer hospitalisation with associated increased costs, notably to Medicaid. ‘Under recent changes in Medicaid policy, hospitals will no longer be reimbursed for the costs associated with these infections,’ said Lake. ‘Sadly, because Medicaid is the largest payer for premature newborns, the additional costs may lead hospitals to further cut the nursing staff, leading to a cycle of infection and mortality that could impact even more of these fragile infants.’
‘These are the first data that demonstrate the extent of adherence to national staffing guidelines and the shortfall is dramatic,’ said Rogowski. ‘Fewer nursing hours could lead to less time devoted to cleaning and maintaining intravenous catheters used to deliver medications thus leading to the higher rates of infection.’ University of Pennsylvania School of Nursing
Researchers at UCLA report that they have refined a method they previously developed for capturing and analysing cancer cells that break away from patients’ tumours and circulate in the blood. With the improvements to their device, which uses a Velcro-like nanoscale technology, they can now detect and isolate single cancer cells from patient blood samples for analysis.
Circulating tumour cells, or CTCs, play a crucial role in cancer metastasis, spreading from tumours to other parts of the body, where they form new tumours. When these cells are isolated from the blood early on, they can provide doctors with critical information about the type of cancer a patient has, the characteristics of the individual cancer and the potential progression of the disease. Doctors can also tell from these cells how to tailor a personalised treatment to a specific patient.
In recent years, a UCLA research team led by Hsian-Rong Tseng, an associate professor of molecular and medical pharmacology at the Crump Institute for Molecular Imaging and a member of both the California NanoSystems Institute at UCLA and UCLA’s Jonsson Comprehensive Cancer Center, has developed a ‘NanoVelcro’ chip. When blood is passed through the chip, extremely small ‘hairs’
Despite receiving blood thinners and other clot prevention treatment, some patients still develop potentially lethal blood clots in the first month after their operations anyway, especially if they developed a surgical-site infection while in the hospital, according to results of a study at Johns Hopkins.
The research found that patients who experience a surgical-site infection after their abdominal surgery are four times more likely than infection-free patients to develop a deep-vein thrombosis (DVT) in the legs, or its more deadly cousin, a pulmonary embolism (PE) in the lungs. While only 4 percent of patients developed a DVT, 92 percent of those who did had received prophylaxis that previous research has shown is the best practice for prevention.
‘We need heightened awareness about the potential for venous thromboembolism (VTE) in patients with surgical-site infections,’ says study leader Susan L. Gearhart, M.D., an associate professor of surgery at the Johns Hopkins University School of Medicine. ‘We need to think beyond the prophylaxis we are already giving these patients. We need to think smarter.’
Nearly all surgical patients at The Johns Hopkins Hospital are routinely given proven treatments to prevent VTEs, usually the regular administration of low-dose blood thinners and the use of compression devices to keep blood flowing in the legs. Typically the treatments cease when people are discharged from the hospital.
Gearhart notes that much work in hospitals has gone into ensuring compliance with prophylaxis measures, including automated checklists to remind health care workers of their importance. VTEs are considered a form of preventable harm, and the Centers for Medicare & Medicaid Services may penalise hospitals where patients develop clots after some orthopedic procedures. But this new study shows that even when hospitals comply with prevention guidelines, VTEs can still occur.
For their study, Gearhart and her colleagues reviewed the records of 615 adults who underwent colorectal surgery at The Johns Hopkins Hospital between July 2009 and July 2011. Twenty-five (4.1 percent) developed VTE. Among patients who experienced a VTE, 92 percent had been given risk-appropriate VTE prophylaxis.
What was even more interesting to Gearhart, she says, was that 14 of the 25 patients with VTE (56 percent) also developed postoperative infections compared with 168 patients (28.5 percent) without VTE. The infectious complications in nine of the 14 patients (64.3 percent) occurred prior to or on the same day as the VTE. She says she had never before seen a link between infections and VTE in surgical patients.
One theory for the apparent link is that an increase of inflammatory protein molecules that accompanies an infection affects the functioning of platelets in the blood, which could increase the risk of thrombosis. Platelets are the sticky cells that facilitate clot formation in the blood.
Gearhart says it may be time to conduct more intense monitoring of colorectal surgery patients who develop surgical-site infections, and consider frequent screening for clots in those with infections. Such screening can be done with ultrasound equipment. She also suggests such patients be kept on blood thinners for 30 days after surgery regardless of when they are discharged.
Johns Hopkins Medicine
Reaching out to ‘high five’ someone, grasping and moving objects of different shapes and sizes, feeding herself dark chocolate. For Jan Scheuermann and a team of researchers from the University of Pittsburgh School of Medicine and UPMC, accomplishing these seemingly ordinary tasks demonstrated for the first time that a person with longstanding quadriplegia can manoeuvre a mind-controlled, human-like robot arm in seven dimensions (7D) to consistently perform many of the natural and complex motions of everyday life.
The researchers described the brain-computer interface (BCI) technology and training programs that allowed Ms. Scheuermann, 53, of Whitehall Borough in Pittsburgh, Pa. to intentionally move an arm, turn and bend a wrist, and close a hand for the first time in nine years.
Less than a year after she told the research team, ‘I
Immobile patients are in constant danger of developing pressure ulcers on the skin. Empa, Schoeller Medical and the Swiss Paraplegic Centre have worked together to develop a special sheet that is gentle on the skin and helps to make patients more comfortable.
The skin is the most versatile of our organs: It protects the body from environmental effects, contributes to the body
Researchers at Imperial College London have begun the first UK clinical trials of a gene therapy for heart failure.
Heart failure, when the heart is unable to pump blood adequately, affects more than 750,000 people in the UK, causing breathlessness and hindering day-to-day activities. The therapy is designed to increase the levels of SERCA2a protein in heart muscle cells by using a harmless virus to insert extra genes into the cells.
The two clinical trials announced mark the culmination of more than 20 years of research funded by the British Heart Foundation (BHF) at Imperial and the Royal Brompton Hospital, which have identified SERCA2a as an important factor affecting how well heart muscle cells can contract in people with heart failure.
The trials will be led in the UK by cardiologists and scientists at Brompton and Imperial, in collaboration with doctors at several UK hospitals including Harefield in London, Papworth in Cambridge and the Golden Jubilee National Hospital in Scotland. The announcement coincides with Fight For Every Heartbeat, a new hard-hitting campaign from the BHF that hails research as the weapon needed to win the battle against heart disease.
Dr Alexander Lyon, BHF Senior Lecturer at Imperial College London and Consultant Cardiologist at the Royal Brompton Hospital, who is the UK lead investigator for both studies, said: ‘Heart failure affects more than three quarters of a million people across the UK. Once heart failure starts, it progresses into a vicious cycle where the pumping becomes weaker and weaker, as each heart cell simply cannot respond to the increased demand.
‘Our goal is to fight back against heart failure by targeting and reversing some of the critical molecular changes arising in the heart when it fails.’
The trials are the next step in the research after laboratory studies found that the gene therapy can be used to effectively restore function to the failing heart, in collaboration with colleagues from the United States.
Doctors plan to study the gene therapy in two separate clinical trials. The first, called CUPID2, will begin treating people with heart failure in the next few weeks in the Cardiovascular Biomedical Research Unit at the Royal Brompton Hospital.
CUPID2 will assess whether cardiac gene therapy to increase SERCA2a is safe and can improve both quality and length of life, and reduce emergency hospital admissions, for heart failure patients. The trial will involve 200 patients with heart failure from the Royal Brompton Hospital and other centres across the world, and is funded by US biotech company Celladon.
The second trial, called SERCA-LVAD, is due to start recruitment in the summer of 2013. Co-funded by the BHF, this trial will test the SERCA2a gene therapy in 24 UK heart failure patients already fitted with mechanical heart pumps, known as left ventricular assist devices (LVADs). It will give vital information about the effectiveness of the therapy by measuring the amount of the SERCA2a gene and protein that has been introduced into heart muscle.
Professor Sian Harding, Professor of Cardiac Pharmacology and Head of the BHF Centre for Regenerative Medicine at Imperial College London, who developed the treatment, said: ‘It
Researchers at the University of Warwick and The Royal Marsden NHS Foundation Trust have completed a study that may lead to clinicians being able to more accurately predict which patients will suffer from the side effects of radiotherapy.
Gastrointestinal side effects are commonplace in radiotherapy patients and occasionally severe, yet there is no existing means of predicting which patients will suffer from them. The results of the pilot study outline how the use of an electronic nose and a newer technology, FAIMS (Field Asymmetric Ion Mobility Spectrometry) might help identify those at higher risk.
Warwick Medical School, working in collaboration with the School of Engineering and The Royal Marsden NHS Foundation Trust (led by Dr J Andreyev), carried out a pilot study to look into the relationship between levels of toxicity in the gut and the likelihood of experiencing side effects.
Dr Ramesh Arasaradnam, of Warwick Medical School and Gastroenterologist at University Hospitals Coventry & Warwickshire, outlines the results of the study. ‘In the simplest terms, we believe that patterns in toxicity levels arise from differences in a patient
The Centers for Disease Control and Prevention (CDC) and Maryland Department of Health and Mental Hygiene have confirmed that a patient who recently died of rabies in Maryland contracted the infection through organ transplantation done more than a year ago. The patient was one of four people who had received an organ from the same donor. This week, CDC laboratories tested tissue samples from the donor and from the recipient who died to confirm transmission of rabies through organ transplantation.
In early March, the Maryland Department of Health and Mental Hygiene initiated an investigation after the organ recipient died, which led to the rabies diagnosis. The investigation revealed that the organ recipient had no reported animal exposures, the usual source of rabies transmission to humans, and identified the possibility of transplant-related transmission of rabies, which is extremely rare.
The organ transplantation occurred more than a year before the recipient developed symptoms and died of rabies; this period is much longer than the typical rabies incubation period of 1 to 3 months, but is consistent with prior case reports of long incubation periods. CDC
A new therapy for Parkinson’s cancels out brain signals causing the characteristic tremors.
A new therapy could help suppress tremors in people with Parkinson’s disease, an Oxford University study suggests.
The technique
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