A new study suggests that CPAP (continuos positive air passage) therapy reduces nightmares in veterans with post-traumatic stress disorder (PTSD) and obstructive sleep apnea (OSA). Results show that the mean number of nightmares per week fell significantly with CPAP use, and reduced nightmare frequency aft er starting CPAP was best predicted by CPAP compliance.

Wake Forest Baptist Medical Center doctors have found that using stress cardiac magnetic resonance (CMR) imaging in an Emergency Department observation unit to care for patients with acute chest pain is a win-win – for the patient and the institution.
In a small, single-centre clinical trial, Chadwick Miller, M.D., M.S., and colleagues found that evaluating older, more complex patients in the observation unit with stress cardiac MRI, as opposed to usual inpatient care, reduced hospital readmissions, coronary revascularisation procedures and the need for additional cardiac testing.
The observation unit is an area of the Emergency Department designed for short stays – longer than a typical ED visit, said Miller, but shorter than a hospital admission. Cardiac MRI is a type of heart testing that uses magnetic forces to capture pictures of the heart.
‘We were looking at the optimum way to evaluate people with chest pain and focusing on those patients who are generally older, have many risk factors for coronary disease or may have had prior health problems, basically the intermediate to higher risk population,’ Miller said. ‘At most hospitals in the United States, after evaluation in the emergency department, these patients are admitted to the hospital to complete their care.’
Miller, who serves as director of clinical research and executive vice-chair of Emergency Medicine at Wake Forest Baptist, said the study built on previous research findings that more complex patients managed in an observation unit with stress CMR testing experienced a reduction in care costs of about $2,100 per patient per year. For the new study, the researchers wanted to specifically look at three care events: coronary revascularization, hospital readmissions and additional heart testing.
The researchers recruited 105 patients from Wake Forest Baptist’s Emergency Department, randomizing them to receive care either in the Observation Unit with CMR or in the hospital. The patients were followed for 90 days, after which the researchers found significant reductions in coronary revascularization procedures, fewer hospital readmissions and fewer recurrent cardiac testing episodes or the need for additional testing.
‘What’s exciting about this is not only can we reduce events that are important to patients, but we can reduce costs as well,’ Miller said. ‘What we think is happening is that the cardiac MRI is more accurately selecting patients who will benefit the most from having invasive procedures done. It’s a win-win.’ Wake Forest Baptist Medical Center

If all medical errors were counted together as a single cause, they would likely rank as the third leading cause of death in the United States. As health care personnel race to improve the quality of their care to save lives and prevent unneeded harm, a new study indicates there is more they can do to learn about what errors are occurring and why.

Researchers from the Drexel University School of Public Health demonstrated a systematic analysis of hospital administrative data for patient safety at a population level, in a recent paper in the Journal of Healthcare Risk Management. They say that health care organisations have an untapped opportunity to use their own administrative data in this way as a ‘springboard to problem identification’ at the leading edge of preventing even those medical errors that are not yet preventable.

‘For example, a patient may receive a drug in the Emergency Department and develop an allergic reaction, but did not have any known allergies at the time of treatment,’ said Dr. Jennifer Taylor, an associate professor at Drexel who led the study. ‘While such events may not be deemed to be preventable now, we need to start tracking them so our research and development colleagues know what

Johns Hopkins biomedical engineers have teamed up with clinicians to create a new drug-delivery strategy for a type of central vision loss caused by blood vessel growth at the back of the eye, where such growth should not occur. In addition to testing a new drug that effectively stops such runaway vessel growth in mice, the team gave the drug a biodegradable coating to keep it in the eye longer. If proven effective in humans, the engineers say, it could mean only two or three needle sticks to the eye per year instead of the monthly injections that are the current standard of care.

The new drug, in its time-release coating, was tested in mice with abnormalities similar to those experienced by people with neovascular age-related macular degeneration, or ‘wet’ AMD.

‘If you lose central vision, you can’t drive a car and you can’t see your grandchildren,’ says Jordan Green, Ph.D., assistant professor of biomedical engineering and ophthalmology at The Johns Hopkins University. ‘You’re willing to do what it takes to keep your sight. We hope that our system will work in people, and make invasive treatments much less frequent, and therefore easier to comply with, and safer.’

According to Peter Campochiaro, M.D., the George S. & Dolores Dor