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
Researchers at the University of Southampton have completed a project that will enable surgeons to fit joint replacements with longer, optimised lifespans. The MXL project uses computational modelling to define the mechanics of an artificial joint
Encouraging interim data from the world
The ‘near-death experience’ reported by cardiac arrest survivors worldwide may be grounded in science, according to research at the University of Michigan Health System.
University of Michigan researchers George Mashour, M.D., Ph.D. and Jimo Borjigin, Ph.D., provide the first scientific framework for near-death experiences.
Whether and how the dying brain is capable of generating conscious activity has been vigorously debated.
A U-M study shows shortly after clinical death, in which the heart stops beating and blood stops flowing to the brain, rats display brain activity patterns characteristic of conscious perception.
‘This study, performed in animals, is the first dealing with what happens to the neurophysiological state of the dying brain,’ says lead study author Jimo Borjigin, Ph.D., associate professor of molecular and integrative physiology and associate professor of neurology at the University of Michigan Medical School.
‘It will form the foundation for future human studies investigating mental experiences occurring in the dying brain, including seeing light during cardiac arrest,’ she says.
Approximately 20 percent of cardiac arrest survivors report having had a near-death experience during clinical death. These visions and perceptions have been called ‘realer than real,’ according to previous research, but it remains unclear whether the brain is capable of such activity after cardiac arrest.
‘We reasoned that if near-death experience stems from brain activity, neural correlates of consciousness should be identifiable in humans or animals even after the cessation of cerebral blood flow,’ she says.
Researchers analysed the recordings of brain activity called electroencephalograms (EEGs) from nine anaesthetised rats undergoing experimentally induced cardiac arrest.
Within the first 30 seconds after cardiac arrest, all of the rats displayed a widespread, transient surge of highly synchronised brain activity that had features associated with a highly aroused brain.
Furthermore, the authors observed nearly identical patterns in the dying brains of rats undergoing asphyxiation.
‘The prediction that we would find some signs of conscious activity in the brain during cardiac arrest was confirmed with the data,’ says Borjigin, who conceived the idea for the project in 2007 with study co-author neurologist Michael M. Wang, M.D., Ph.D., associate professor of neurology and associate professor of molecular and integrative physiology at the U-M.
‘But, we were surprised by the high levels of activity,’ adds study senior author anesthesiologist George Mashour, M.D., Ph.D., assistant professor of anesthesiology and neurosurgery at the U-M. ‘ In fact, at near-death, many known electrical signatures of consciousness exceeded levels found in the waking state, suggesting that the brain is capable of well-organised electrical activity during the early stage of clinical death.
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