A plastic material already used in absorbable surgical sutures and other medical devices shows promise for continuous administration of antibiotics to patients with brain infections, scientists are reporting in a new study. Use of the material, placed directly on the brain
While the use of ultrasound to identify tumours during kidney cancer surgery is gaining acceptance, a research team at Henry Ford Hospital has successfully taken it a step further by showing an added benefit when the procedure is done robotically.
Simply put, the kidney surgeon who performs the ultrasound robotically has direct control over the painstaking procedure instead of having to rely on an assistant for part of the task.
The researchers compared the robotic ultrasound probe to the same procedure using a laparoscopic ultrasound probe, which requires an assistant to guide the ultrasound probe for the surgeon. At the end of the study, the researchers found comparable results between the two methods.
‘Besides giving the surgeon autonomy, the robotic ultrasound probe is more easily manipulated than the laparoscopic probe when measuring the tumour from certain angles,’ said Craig Rogers, M.D., a urologist at Henry Ford Hospital’s Vattikuti Urology Institute and senior author of the study. ‘This can reduce the need to move the kidney to gain better position.
‘While our study showed comparable results from both methods of mapping and measuring kidney cancers, the robotic ultrasound probe enables the precision of a robotic instrument as well as direct surgeon control.’
The surgical procedure studied used in each case studied by the researchers was robotic partial nephrectomy, or RPN, in which only the diseased part of a cancerous kidney is removed by a surgeon-controlled robot instead of traditional open surgery in which the entire kidney is removed.
They collected data from 75 consecutive RPN procedures using a laparoscopic ultrasound probe and 75 consecutive RPNs using a robotic ultrasound probe.
‘Both groups had similar tumour characteristics, operating times and other factors, and their outcomes were similar,’ Dr. Rogers says. ‘There was no statistically significant difference in measured variables between groups when controlling for tumour size and complexity. So the robotically controlled ultrasound probe performed on-par with traditional ultrasound, but with the added benefit of direct surgeon control and precision.
All patients in both study groups were found to be cancer-free during follow up examinations at a mean of 25.7 months for the laparoscopic group and 10.2 months for the robotic group.
EurekAlert
Most lung cancers are detected when patients become symptomatic and have late-stage disease. However, recently, computed tomography (CT) screening for lung cancer has been reported to reduce lung cancer mortality. Since the National Lung Screening Trial’s results showed a 20 percent reduction in lung cancer-specific deaths in those patients who had screening performed with chest CT, the use of CT screening for lung cancer has been gaining favour. However, CT is associated with the disadvantages of high radiation dosage and cost.
Digital chest tomosynthesis (DT), a tomographic technique, may offer an alternative to CT screening. A recent study concludes that digital chest tomosynthesis holds promise as a first-line lung cancer screening tool. DT uses a conventional radiograph tube, a flat-panel detector, a computer-controlled tube mover, and special reconstruction algorithms to produce section images. Compared with conventional chest radiography, chest tomosynthesis improved sensitivity in the detection of CT-proven lung nodules. Although it lacks the depth resolution of CT, tomosynthesis provides some of the benefits of CT at lower costs and radiation dosages. Furthermore, DT is less expensive than CT at approximately one-sixths of the cost of a CT.
Researchers from the Thoracic Surgery Unit and Department of Radiology at the S. Corce City Hospital in Cuneo, Italy studied assessed 1919 patients. Participants were age 45 to 75 with a smoking history of at least 20 pack years, without malignancy in the 5 years before the start of the study in December 2010. A tomosynthesis was performed at baseline and a year later.
The researchers conclude that, ‘the results on the use of DT in early detection of lung cancer are encouraging; the detection rate is comparable to the rates reported for low-dosage CT and is attained at a far lower cost and radiation dosage.’ IASLC
Radiography is widely used in diagnosing ankle injuries, with 85%
Researchers from Case Western Reserve University School of Medicine have developed an unprecedented approach to restore nitric oxide (NO) to donated blood, a breakthrough that could dramatically reduce harmful effects from transfusions.
Jonathan Stamler, MD, and colleagues from Case Western Reserve School of Medicine and from Duke University Medical Center report that restoring blood levels of NO in animals prior to transfusion improved their tissue blood flow, oxygen delivery, and kidney function.
Patients in the U.S. receive approximately 15 million blood transfusions a year. The procedure is often used to replace blood lost through trauma, but also can supplement shortages in a patient
Patients at Epsom Hospital are reaping the benefits of the hospital
Researchers with Spectrum Health
A quarter of people with diabetes are not getting an annual check that is vital for picking up the early signs of kidney failure, according to a new analysis by Diabetes UK.
According to the analysis, based on National Diabetes Audit data, 25 per cent of people with diabetes in England were not recorded as having the urine check (called a urinary albumin) during 2010/11. The situation is only slightly better in Wales, where 21.6 per cent did not get a check during the same period.
Kidney failure is common in people with diabetes, but checking the urine for the presence of a protein called albumin can give an early warning of kidney damage, allowing people to be given treatment to help stop it getting worse. Unless people get this urine check, they are unlikely to find out they have kidney damage until it has already developed into an extremely serious health issue.
The urine check is one of the two checks people with diabetes should have every year to screen for kidney complications. The other part of the screening is a blood test to show how well the kidneys are working
Using MRI and blood tests can establish the cause of death in foetuses and newborn babies and is virtually as accurate as a standard autopsy (open dissection), according to a paper.
The study, led by Professor Andrew Taylor from the UCL Institute of Cardiovascular Science and Dr Sudhin Thayyil, NIHR Clinician Scientist and Consultant Neonatologist, and involving several BRC-supported researchers, found that full-body magnetic resonance imaging scans combined with non-invasive investigations were as effective as a standard autopsy in detecting any major abnormalities that led to a young child
The patient-relevant benefit of positron emission tomography (PET) in oesophageal cancer, alone or in combination with computed tomography (CT), is not proven due to a lack of comparative studies. In terms of their diagnostic and prognostic accuracy, it also remains unclear whether these diagnostic techniques can detect the spreading of tumours better than conventional diagnostics. This is the conclusion of the final report of the German Institute for Quality and Efficiency in Health Care (IQWiG).
About 4800 men and 1400 women are newly diagnosed with oesophageal cancer in Germany each year. The average age of disease onset is 65 years. The 5-year survival rate in Germany is at most 20%; this means that 5 years after diagnosis, at best 20 of 100 affected patients are still alive.
Many experts assume that an examination using PET or PET/CT, alone or in combination with other methods, is better able to evaluate how far a tumour has spread (staging) and whether it has responded to treatment (restaging). In addition, better detection of tumour recurrence ought to be possible. The desired goal: the more exactly it is known how advanced the tumour is, the more precisely and successfully patients can be treated.
IQWiG therefore searched the international literature for studies that had examined the consequences of diagnostic interventions using PET or PET/CT with regard to whether they were accompanied by perceptible improvements for patients, for example, whether they increased their chances of survival or improved their quality of life, or spared them unnecessary operations or further diagnostic interventions.
However, the search for such direct comparative intervention studies was unsuccessful, so that the question regarding the patient-relevant benefit of PET or PET/CT in oesophageal cancer still remains to be answered.
IQWiG also searched for studies in which the diagnostic accuracy and prognostic power of PET or PET/CT was compared with other examination methods.
19 studies directly compared test accuracy of PET and CT
A total of 48 studies were relevant for diagnostic and prognostic accuracy, of which most examined the accuracy of primary staging, that is, the classification of tumour stages before the start of treatment.
19 studies directly compared PET with CT. However, conclusions in favour of one or the two techniques cannot be drawn, as either no statistically significant difference was shown or the data could not be interpreted with sufficient certainty.
Too few studies are so far available that directly compared PET or PET/CT with other diagnostic techniques and investigated treatment response (restaging) or diagnosis and prognosis of tumour recurrence. A reliable conclusion on the diagnostic and prognostic accuracy of PET or PET/CT in restaging or recurrence diagnostics is therefore not possible.
In particular the potential advantage of PET and PET/CT, which visualise metabolic activity, remains unclear versus morphologic imaging techniques such as CT or magnetic resonance imaging, which display anatomical structures.
IQWiG published the preliminary results in the form of the preliminary report in May 2012 and interested parties were invited to submit comments. At the end of the commenting procedure, which included an oral scientific debate including parties who had submitted comments, the preliminary report was revised and sent as a final report to the contracting agency, the Federal Joint Committee (G-BA), in June 2013. The written comments were published in a separate document at the same time as the final report. The report was produced in collaboration with external experts.
The German-language executive summary provides an overview of the background, procedure and further results of the report.
An English-language executive summary will be available soon. If you would like to be informed when the English document is available, please send an e-mail to
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