Total annual hospital costs could be reduced by rapid candidemia identification
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A new study describes a model that estimates the economic consequences of using the T2Candida® Panel (a novel diagnostic product that provides Candida detection) as an adjunct to the current blood culture-based diagnostic strategy in a high-risk hospital patient cohort. It estimates that a typical hospital could save as much as $5,858,448 in total annual hospital costs. The study was published online ahead of print in Future Microbiology.
Candida species are a lethal form of common bloodstream infections that cause sepsis. They are associated with high patient mortality and excess inpatient costs because growth-based detection of Candida can delay treatment decisions. Improvements in outcomes are dependent on early identification of candidemia and timely administration of appropriate antifungal therapy. The T2Candida Panel is the first diagnostic test to provide species-specific Candida detection and identification directly from whole blood in 3 to 5 hours, without the need for blood culture.
“We are greatly encouraged by the benefits these data show for the early detection of Candida with our T2Candida Panel,” said John McDonough, chief executive officer of T2 Biosystems. “The findings from this study demonstrate not only significant reduction in hospital costs, but most importantly, the potential to save so many patient lives by providing faster diagnostic results - supporting our goal of changing the paradigm in sepsis diagnosis. We look forward to working closely with the medical community to help implement this important change.”
UTMB develops new online tool for nurses
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As tremendous advances are made in medicine, practitioners have new tools, but they also have more information to absorb and incorporate to provide evidence-based patient care: integrating best research evidence with clinical expertise and patient’s perspectives.
For the bedside nurse, this information can be lifesaving but time consuming. This has been a huge problem - until now.
The University of Texas Medical Branch has developed a new program that trains nurses how to pose questions that will point them to the needed information quickly. The Disciplined Clinical Inquiry - Evidence-Based Practice Literacy pathway is an online tool that helps nurses rapidly access filtered research evidence that present information in concise, easy to understand formats. An article describing this new program is available in the Journal for Nurses in Professional Development.
The EBP approach is becoming the “new normal” in patient care. UTMB’s online program offers a streamlined yet full education of the EBP skillset using online modules that take about three hours to learn. The standard DCI-EBP programs may take 50 hours to master.
Widespread agricultural contaminant impacts fish reproductive behavior
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A common growth-promoting hormone used worldwide in the cattle industry has been found to affect the sexual behaviours of fish at a very low concentration in waterways - with potentially serious ecological and evolutionary consequences.
Researchers from Monash University, Australia in collaboration with researchers from Åbo Akademi University in Finland, have found that the steroid 17β-trenbolone - used on livestock to increase muscle growth - alters male reproductive behaviour in guppy fish (Poecilia reticulata).
This androgenic growth promoter is part of a group of contaminants called endocrine disrupting chemicals (EDCs) that enter the environment through a variety of sources - from discharge of household waste to agricultural run-off and industrial effluent.
Using trenbolone in livestock farming has been banned in the EU. However, in Denmark, researchers have measured high concentrations of it in gym sewage. Trenbolone is popular among bodybuilders. Trenbolone is used for example in the United States, Argentina and Australia.
Fat grafting technique improves results of breast augmentation
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In women undergoing breast augmentation, a technique using transplantation of a small amount of the patient’s own fat cells can produce better cosmetic outcomes, reports a study in the April issue of Plastic and Reconstructive Surgery®, the official medical journal of the American Society of Plastic Surgeons (ASPS).
In particular, the fat grafting technique can achieve a more natural-appearing cleavage—avoiding the “separated breasts” appearance that can occur after breast augmentation, according to the report by Dr. Francisco G. Bravo of Clinica Gomez Bravo, Madrid.
Fat Grafting Adds to Cosmetic Results of Breast Augmentation
Dr Bravo analyzed the outcomes of breast augmentation surgery in 59 women. Thirty-eight women underwent conventional surgery using breast implants only. In the remaining 21 patients, Dr. Bravo used a combination technique using breast implants plus “selective para-sternal fat grafting.”
In this approach, a small amount of the patient’s own fat was harvested from elsewhere in the body - such as the thighs or abdomen. After processing, the fat cells were carefully placed along the inner (medial) borders of the breasts. The goal was to achieve a more natural shape, and particularly to soften the “medial transition zone” between the sternum (breastbone) and the implant edges.
Germline TP53 mutations in patients with early-onset colorectal cancer
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In a group of patients diagnosed with colorectal cancer at 40 or younger, 1.3 percent of the patients carried germline TP53 gene mutations, although none of the patients met the clinical criteria for an inherited cancer syndrome associated with higher lifetime risks of multiple cancers, according to a study published online by JAMA Oncology.
Li-Fraumeni syndrome is an inherited cancer syndrome usually characterized by germline TP53 mutations in which patients can develop early-onset cancers and have an increased risk for a wide array of other cancers including colorectal. The gene’s contribution to hereditary and early-onset colorectal cancer is needed for clinicians to counsel patients undergoing TP53 testing as part of a multigene risk assessment, according to the study background.
Sapna Syngal, M.D., M.P.H., of the Dana-Farber Cancer Institute, Boston, and coauthors estimated the proportion of patients with early-onset colorectal cancer who carry germline TP53 mutations. Participants were recruited from the Colon Cancer Family Registry from 1998 through 2007 and were those individuals who were diagnosed with colorectal cancer at 40 or younger and lacked a known hereditary cancer syndrome.
Among 457 eligible patients, six (1.3 percent) of them carried germline missense TP53 alterations and none of the patients met the clinical criteria for Li-Fraumeni syndrome, according to the results.
Repairing the cerebral cortex: It can be done
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A team led by Afsaneh Gaillard (Inserm Unit 1084, Experimental and Clinical Neurosciences Laboratory, University of Poitiers), in collaboration with the Institute of Interdisciplinary Research in Human and Molecular Biology (IRIBHM) in Brussels, has just taken an important step in the area of cell therapy: repairing the cerebral cortex of the adult mouse using a graft of cortical neurons derived from embryonic stem cells. These results have just been published in Neuron.
The cerebral cortex is one of the most complex structures in our brain. It is composed of about a hundred types of neurons organised into 6 layers and numerous distinct neuroanatomical and functional areas.
Brain injuries, whether caused by trauma or neurodegeneration, lead to cell death accompanied by considerable functional impairment. In order to overcome the limited ability of the neurons of the adult nervous system to regenerate spontaneously, cell replacement strategies employing embryonic tissue transplantation show attractive potential.
A major challenge in repairing the brain is obtaining cortical neurons from the appropriate layer and area in order to restore the damaged cortical pathways in a specific manner.
Clinical trial suggests combination therapy is best for low-grade brain tumors
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New clinical-trial findings provide further evidence that combining chemotherapy with radiation therapy is the best treatment for people with a low-grade form of brain cancer. The findings come from a phase II study co-led by a researcher at Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James) and researchers at the University of Maryland and at London Regional Cancer Program in Ontario, Canada.
The study shows that patients with low-grade gliomas and at high risk for tumor recurrence have an overall survival of 73 percent after three years when treated with radiation plus temozolomide, a chemotherapy drug. This is compared with a three-year survival of 54 percent for historical controls treated with radiation alone.
The findings are published in the International Journal of Radiation Oncology, Biology, Physics.
Two-step treatment improved function and decreased pain severity in veterans
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Although U.S. military veterans who have returned from Iraq or Afghanistan are more likely to suffer chronic pain than veterans of any other conflict in American history, little headway has been made in helping them manage the often debilitating effects of chronic pain. A new study by researchers from the Richard L. Roudebush VA Medical Center in Indianapolis, the Regenstrief Institute and the Indiana University School of Medicine reports that a stepped-care strategy improved function and decreased pain severity, producing at least a 30 percent improvement in pain-related disability.
“Pain is disabling and interferes with daily living as well as the ability to work,” said Matthew Bair, M.D., the VA and Regenstrief Institute investigator and IU associate professor of medicine who led the randomized controlled ESCAPE trial - short for Evaluation of Stepped Care for Chronic Pain. “It is a critical health issue among veterans, many of whom had multiple, often lengthy deployments.
“Many have significant long-term pain. We know that medications alone are only modestly successful in helping them; current pain treatments haven’t made much of a dent. The decrease in pain severity and 30 percent improvement in pain-related disability we achieved in the ESCAPE study are clinically significant, and we found that improvement lasted for at least nine months.”
Online health information - keep it simple!
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Australian health websites are too difficult for many people to read.
This is the finding from a study published in Australian and New Zealand Journal of Public Health.
Matthew Dunn and Christina Cheng from Deakin University evaluated Australian online health information to see if it matched the reading level of Australians.
“Limited availability of ‘easy-to-read’ health materials suggests that many Australians may not be benefiting from the convenience of the internet,” Dr Dunn said.
Quitting smoking has favorable metabolic effects
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People who quit smoking have improved metabolic effects, a new study finds. The results will be presented in a poster Thursday, March 5, at ENDO 2015, the annual meeting of the Endocrine Society in San Diego.
“In general, people think that when they stop smoking, they are going to gain weight and their diabetes and insulin resistance are going to get worse, but we didn’t find that,” said principal investigator Theodore C. Friedman, MS, MD, PhD, chair of the Department of Internal Medicine of Charles R. Drew University of Medicine and Science in Los Angeles, California. “Our study showed that insulin resistance was basically the same and some of the fat redistribution seemed to be better. Initially fat might have gone into the abdomen, but later, it went back to the thigh, which is more benign.”
In this study, researchers enrolled healthy, ½-to-2 pack-per-day smokers into an 8-week smoking cessation program of behavioral counseling plus oral bupropion (Phase I), followed by a 16-week maintenance period without counseling or bupropion wherein subjects either remained abstinent or naturally resumed/increased smoking (Phase II).
Before and after Phase 1, the researchers measured the subjects’ number of cigarettes per day, breath carbon monoxide, urine nicotine metabolites, weight, body composition, fat distribution, free fatty acids, and rate of glucose release from the liver and overall glucose utilization.
Garlic extract could help cystic fibrosis patients fight infection
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A chemical found in garlic can kill bacteria that cause life-threatening lung infections in people with cystic fibrosis, research suggests.
The study is the first to show that the chemical - known as allicin - could be an effective treatment against a group of infectious bacteria that is highly resistant to most antibiotics.
Allicin is produced naturally by garlic bulbs to ward off a closely-related group of plant pathogens found in soil and water habitats. In the 1980s, the bacteria - known as the Burkholderia cepacia complex (Bcc) - emerged as a cause of serious and transmissible lung infections in people with cystic fibrosis.
Measures to limit the spread of Bcc infections among people with cystic fibrosis have brought the number of cases down considerably. However, current therapies available to treat infections - that are potentially fatal - are limited and require the use of combinations of three to four antibiotics at a time.
Your privacy online: Health information at serious risk of abuse
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There is a significant risk to your privacy whenever you visit a health-related web page. An analysis of over 80,000 such web pages shows that nine out of ten visits result in personal health information being leaked to third parties, including online advertisers and data brokers.
This puts users are risk for two significant reasons: first, people’s health interests may be publicly identified along with their names. This could happen because criminals get ahold of the information, it is accidentally leaked, or data brokers collect and sell the information. Second, many online marketers use algorithmic tools which automatically cluster people into groups with names like “target” and “waste”. Predictably, those in the “target” category are extended favorable discounts at retailers and advance notice of sales. Given that 62 percent of bankruptcies are the result of medical expenses, it is possible anyone visiting medical websites may be grouped into the “waste” category and denied favorable offers.
For individuals, this means profiles are built based on web page visits, potentially resulting in someone being labeled a commercial risk due to the fact that they have used a site like WebMD.com or CDC.gov to look up health information for themselves, a family member, or a friend. Given that data brokers are free to sell any information they collect regarding visits to health websites, those visiting such sites are potentially at risk of being discriminated against by potential employers, retailers, or anybody else with the money to buy the data.
UW research shows sensor technology may help improve accuracy of clinical breast exams
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Sensor technology has the potential to significantly improve the teaching of proper technique for clinical breast exams (CBE), according to a new study by researchers at the University of Wisconsin School of Medicine and Public Health.
The results of the study were published in a correspondence today in the New England Journal of Medicine.
Carla Pugh, director of patient safety and education at the University of Wisconsin Hospital and Clinics and principal investigator of the study, says the use of sensors allows a level of critical analysis unavailable to clinicians until recently.
“Variations in palpable force used during a CBE cannot be reliably measured by human observation alone,” Pugh says. “Our findings revealed that 15 percent of the physicians we tested were using a technique that put them at significant risk of missing deep tissue lesions near the chest wall. This research underscores the potential for sensor technology to be used not only to improve clinical performance, but to also allow for objective evidence-based training, assessment and credentialing.”
Joslin researchers find drugs are effective for diabetic macular edema in new trial
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In the first clinical trial directly comparing three drugs most commonly used to treat diabetic macular edema, researchers found all were effective in improving vision and preventing vision loss. However, one drug, aflibercept, provided greater improvement for people with more severe vision loss when treatment was initiated. The trial was conducted by the National Eye Institute Diabetic Retinopathy Clinical Research Network (DRCR.net) including researchers from Joslin Diabetes Center. The results appeared in the February online edition of the New England Journal of Medicine.
Diabetes is a significant risk factor for developing eye diseases. The most common diabetic eye disease and a leading cause of blindness is diabetic retinopathy, which is caused by elevated blood sugar levels damaging the blood vessels of the retina and affects approximately 7.7 million Americans. About 750,000 Americans with diabetic retinopathy have diabetic macular edema (DME) in which fluid leaks into the macula, the area of the retina used when looking straight ahead. The fluid causes the macula to swell, blurring vision. “DME is the leading cause of moderate vision loss in working-age adults with diabetes. With the rate of diabetes increasing dramatically worldwide, many individuals will be at risk for vision loss from diabetic eye complications and DME is a major global health concern,” says Jennifer K. Sun, M.D., M.P.H., a member of the study research team and writing committee, and an Investigator in the Section on Vascular Biology, an ophthalmologist in Beetham Eye Institute at Joslin and an Assistant Professor at Harvard Medical School.
In an earlier study, Joslin researchers reported that VEGF, a major growth factor for blood vessels, is elevated in the eye fluids of patients with proliferative diabetic retinopathy and DME, causing leakage and the growth of abnormal blood vessels.
Drug improves measures of genetic disease that affects liver, spleen
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Among previously untreated adults with Gaucher disease type 1, a genetic disease in which there is improper metabolism due to a defect in an enzyme, treatment with the drug eliglustat resulted in significant improvements in liver and spleen size hemoglobin level, and platelet count, according to a study in the February 17 issue of JAMA.
Gaucher disease type 1 is characterized by enlargement of the spleen and liver, anemia, low blood platelets, chronic bone pain, and the failure to grow properly. Untreated Gaucher disease type 1 is a chronic and progressive disorder associated with disability, reduced life expectancy, and, in some patients, life-threatening complications. The current standard of care is enzyme replacement therapy, which requires lifelong intravenous infusions every other week. A safe, effective oral therapy is needed, according to background information in the article.
Pramod K. Mistry, M.D., Ph.D., F.R.C.P., of the Yale University School of Medicine, New Haven, Conn., and colleagues randomly assigned 40 untreated adults with Gaucher disease type 1 to receive eliglustat (twice daily; n = 20) or placebo (n = 20) for 9 months. Eliglustat is a novel oral medication, which showed favorable results for patients with this disease in a phase 2 trial. This phase 3 trial was conducted at 18 sites in 12 countries.
