Hip implant for long-term use

Hip replacement is one of the most frequent operations carried out in Germany. Each year, doctors implant some 200,000 artificial hip joints. Often the artificial hips need to be replaced just ten years later. In the future, a new implant currently being developed using high technology materials could help prevent premature revision surgeries.

Thanks to artificial hips, people with irreparable damage to the joint have been able to lead active, pain-free lives for the past 50 years. Still, some hip replacements do not function completely as intended, and metal-on-metal implants in particular, demand accurate positioning in surgery and implants positioned non optimally are often susceptible to premature failure notably in small female patients. Physicians are even calling for a prohibition on the use of artificial joints made of cobalt-chromium alloys in which the joint

Expensive hospital readmissions linked to healthcare-associated infections

New research finds a strong link between healthcare-associated infections (HAIs) and patient readmission after an initial hospital stay. The finding suggest that reducing such infections could help reduce readmissions, considered to be a major driver of unnecessary healthcare spending and increased patient morbidity and mortality.
‘Although much attention has been directed toward hospital readmissions and healthcare-associated infections as potentially preventable conditions and targets to reduce healthcare spending, to our knowledge, no studies have directly assessed the association between the two,’ write the study’s authors, from the University of Maryland and Oregon State University.
The researchers, led by Jon Furuno, PhD, tracked 136,513 patients admitted to the University of Maryland Medical Center over 8 years (2001-2008). The study reviewed the number of patients readmitted within one year after discharge, as well as the number of patients with positive cultures for one of three major HAIs: methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococci (VRE), or Clostridium difficile (C. difficile) more than 48 hours after admission, considered a proxy for an HAI.
The researchers identified 4,737 patients with positive clinical cultures for MRSA, VRE or C. difficile after more than 48 hours following hospital admission. These patients were 40 percent more likely to readmitted to the hospital within a year and 60 percent more likely to be readmitted within 30 days than patients with negative or no clinical cultures. This disparity was evident even after controlling for variables, including age, sex, length of hospital stay, and severity of illness.
‘The potential to reduce readmissions along with other known benefits

First electronic retinas implanted in the UK

Surgeons in Oxford are the first in the UK to successfully implant an electronic retina into the back of an eye.
On 22 March 2012, Chris James became the first patient in the UK to receive this ground-breaking surgery as part of a clinical trial being carried out at John Radcliffe Hospital and King’s College Hospital in London.
Mr James’s operation took place at the Oxford Eye Hospital with the surgical team led by Professor Robert MacLaren.
He was assisted by Mr Tim Jackson, a consultant ophthalmic surgeon at King’s College Hospital in London.
The following week, a second patient, Robin Millar, a 60 year old music producer from London, received a retinal implant at King’s College Hospital, with Professor MacLaren assisting Mr Jackson.
Both patients were able to detect light immediately after the electronic retinas were switched on, and are now beginning to experience some restoration of useful vision. Further operations are now planned for other suitable patients.
The retinal implants have been developed by Retina Implant of Germany to restore some sight to people with retinitis pigmentosa, an inherited condition that affects around one in every 3,000 – 4,000 people in Europe.
Retinitis pigmentosa is a progressive disease that sees light-detecting cells in the retina deteriorate over time.
Retina Implant’s devices are designed to replace the lost cells in the retina. Patients have a small microchip containing 1,500 tiny electronic light detectors implanted below the retina. The optic nerve is able to pick up electronic signals from the microchip and patients can begin to regain some sight once more.
Professor MacLaren explains: ‘What makes this unique is that all functions of the retina are integrated into the chip. It has 1,500 light sensing diodes and small electrodes that stimulate the overlying nerves to create a pixellated image. Apart from a hearing aid-like device behind the ear, you would not know a patient had one implanted.’
Chris James, 54, a council worker from Wiltshire, first began to experience night blindness in his mid-20s and was diagnosed with retinitis pigmentosa following a referral to Oxford Eye Hospital.
For a number of years, Chris’ vision remained relatively stable. But in 1990, a large dip in his vision left him legally blind. In 2003, another decrease in vision rendered Chris completely blind in his left eye and only able to distinguish lights in his right.
After having the artificial retina implanted in his left eye, Chris can now recognise a plate on a table and other basic shapes. And his vision is continuing to improve as he learns to use the electronic chip in an eye that has been completely blind for over a decade.
The operation took eight hours and first required implantation of the power supply which is buried under the skin behind the ear, similar to a cochlear implant. This part of the operation was performed by Mr James Ramsden of Oxford University Hospitals assisted by Mr Markus Groppe, an academic clinical lecturer at the University of Oxford.
The electronic retina was then inserted into the back of the eye and stitched into position before being connected to the power supply.
Three weeks after the operation, Chris’ electronic retina was switched on for the first time. After some initial tuning and testing, Chris was able to distinguish light against a black background.
‘As soon as I had this flash in my eye, this confirmed that my optic nerves are functioning properly which is a really promising sign,’ Chris said. ‘It was like someone taking a photo with a flashbulb, a pulsating light, I recognised it instantly.’
Chris continues to have monthly follow-up testing of his microchip. In the meantime, he is testing the microchip at home. ‘It’s obviously early days but it’s encouraging that I am already able to detect light where previously this would have not been possible for me. I’m still getting used to the feedback the chip provides and it will take some time to make sense of this. Most of all, I’m really excited to be part of this research.’
Oxford Eye Hospital

Simulation training improves critical decision-making skills of ER residents

A Henry Ford Hospital study found that simulation training improved the critical decision-making skills of medical residents performing actual resuscitations in the Emergency Department.
Researchers say the residents performed better in four key skill areas after receiving the simulation training: leadership, problem solving, situational awareness and communication. Their overall performance also sharpened.
While many studies have shown the benefits of simulation training for honing the skill level of medical professionals, Henry Ford

Breathing during radiotherapy ? how to hit the treatment target without causing collateral damage

Respiratory movement during radiotherapy makes it difficult to hit the right treatment target and this in turn can lead to an under-dose of radiation to the tumour, or a potentially toxic over-dose to the surrounding healthy tissue. Getting this right is a real challenge for the radiotherapist, but new techniques are helping to deliver the correct dose to the right place.
Dr. Amira Ziou

Electronic medical record tool cuts down on unnecessary CT scans in emergency room

A new electronic medical record tool that tallies patients’ previous radiation exposure from CT scans helps reduce potentially unnecessary use of the tests among emergency room patients with abdominal pain, according to a study from researchers at the Perelman School of Medicine at the University of Pennsylvania. The new study shows that when the tool is in use, patients are 10 percent less likely to undergo a CT scan, without increasing the number of patients who are admitted to the hospital.
Abdominal pain is the most common reason why people seek care in emergency rooms in the United States, accounting for 10 million visits each year. But the symptoms may be caused by myriad problems, from those that can be fixed with a single dose of an over-the-counter drug to those that could prove life-threatening within hours: from a bout of GI distress to an ectopic pregnancy; from constipation to an appendix about to burst; from a hernia to signs of a chronic condition like Crohn’s disease.
This complex diagnostic face-off plays a huge role in why emergency physicians tend to lean heavily on tests like CT scans, even though they expose patients to radiation and there are few clear guidelines on which patients should get them. Since the mid-1990s, the use of CT scans to diagnose ER patients has surged, increasing ten-fold. Today, 14 percent of all emergency room patients get scanned

Cancer in the elderly: research fails to keep up with demographic change

New research showing that almost half of 13,000 patients with head and neck cancers had other health-related problems at the same time is one of the presentations in a special session at the 31st conference of the European Society for Radiotherapy and Oncology (ESTRO 31). The session will highlight the effect of the demographic time bomb caused by an increasingly ageing population. Dr Charlotte Rotb

Highly targeted irradiation as good as whole breast radiotherapy in early stage cancer

Using a concentrated, highly targeted dose of radiation to the breast has equally good results as irradiating the whole area, with no adverse effects on survival and a much better cosmetic outcome, Hungarian researchers have found. Reporting the ten-year results of a randomised trial, Professor Csaba Polg

New device to diagnose irregular heart beat

A study conducted at Scripps Health has found that a novel new heart monitoring device helped emergency room patients avoid unnecessary follow-up care. Scripps Health electrophysiologist Steven Higgins, MD, presented findings of the study, titled ‘Prevalence of Arrhythmias in Emergency Department Patients Discharged Using a Novel Ambulatory Cardiac Monitor,’ at the Heart Rhythm Society

ESC Heart Failure Guidelines feature new recommendations on devices, drugs and diagnosis (HF)

The full ‘ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012’ will be available is online as of 14:30 hrs on Saturday 19 May 2012.
New recommendations on devices, drugs and diagnosis in heart failure were launched at the Heart Failure Congress 2012, 19-22 May, in Belgrade, Serbia.
The ESC Guidelines for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 were developed by the European Society of Cardiology (ESC) in collaboration with the Heart Failure Association (HFA) of the ESC. The Congress is the HFA