[Vol 37] Medi-Scene: Your Weekly Health News Update


MediScene Vol 371. New device to help detect traumatic brain injury on the spot

A method for detecting traumatic brain injury at the point of care has been developed by scientists at the University of Birmingham. Researchers are able to pinpoint when patients need urgent medical attention by using chemical biomarkers released by the brain immediately after a head injury occurs. This saves time in delivering vital treatment and avoids patients undergoing unnecessary tests where no injury has occurred. The technique was developed by a multidisciplinary team of researchers in the group of Advanced Nanomaterials, Structures and Applications (ANMSA) led by Dr Goldberg Oppenheimer at the University of Birmingham. The method works using a spectroscopic technique called surface enhanced Raman scattering, in which a beam of light is ‘fired’ at the biomarker. The biomarker, taken from a pin prick blood sample, is prepared by being inserted into a special optofluidic chip, where the blood plasma is separated and flows over a highly specialised surface. The light causes the biomarker to vibrate or rotate and this movement can be measured, giving an accurate indication of the level of injury that has occurred. Dr Pola Goldberg Oppenheimer, lead researcher on the study, explains: “This is a relatively straightforward and quick technique that offers a low-cost, but highly accurate way of assessing traumatic brain injury which up until now has not been possible. The current tools we use to diagnose TBI are really quite old fashioned, and rely on the subjective judgement of the paramedic or the emergency doctors. There’s an urgent need for new technology in this area to enable us to offer the right treatment for the patient, and also to avoid expensive and time-consuming tests for patients where there is no TBI.” The next stage for this research will be to miniaturise the device technology used to analyse the samples, so that it could be easily stored on board an ambulance for use by paramedics.

2. Sleep Health Can Determine The Success Of Mindfulness

The study led by the University of South Florida found that sleeping an extra 29 minutes each night can be the key to improving mindfulness, a critical resource that has benefits for daily well-being and work performance. It  improves next-day mindfulness, which in turn, reduces sleepiness during the day. The research focused on nurses, the largest group of healthcare professionals whose need for optimal sleep and mindful attention are particularly high.Mindfulness is achieved by purposefully bringing an individual’s awareness and attention to experiences occurring in the present moment without forming an opinion. Lead author Soomi Lee, assistant professor of ageing studies at USF said, “One can be awake and alert, but not necessarily mindful. Similarly, one can be tired or in low arousal but still can be mindful. Mindful attention is beyond just being awake. It indicates attentional control and self-regulation that facilitates sensitivity and adaptive adjustment to environmental and internal cues, which are essential when providing mindful care to patients and effectively dealing with stressful situations.” The data was observed on 61 nurses for two weeks and examined multiple characteristics of sleep health. They found that nurses’ mindful attention was greater than their usual after nights with greater sleep sufficiency, better sleep quality, lower efficiency and longer sleep duration (an extra half-hour longer). Daily mindful attention contributed to less same-day sleepiness. Those with greater mindful attention were also 66% less likely to experience symptoms of insomnia during the two-week study period. Findings from this study provide insight into developing a behavioural health intervention strategy for a broader array of healthcare workers who need better sleep and mindful attention.

3. More Studies Show Coffee Intake Linked To Reduced Parkinson’s Risk

A new study has added support to the idea that coffee consumption is associated with a reduced risk of developing Parkinson’s disease and suggests that caffeine may be particularly beneficial for individuals with a genetic mutation linked to the condition. Lead author Grace Crotty, MD, Massachusetts General Hospital, Boston said in an interview, “If confirmed in other studies, these results could pave the way for trials to test caffeine-related therapies to reduce Parkinson’s disease in people carrying the LRRK2 mutation. It has already been established that increased caffeine intake is associated with a lower risk for Parkinson’s disease. This is well recognized from epidemiological studies, and it is thought that caffeine may reduce the risk of developing Parkinson’s, although it has not been proven to be a definite causal factor, as there are many other genetic and environmental factors at play.” A total of 212 of the participants also completed questionnaires about how much caffeine they consumed each day. Results showed that among individuals with a normal copy of the LRRK2 gene, for those with Parkinson’s disease, plasma concentration of caffeine was 31% lower compared with individuals without Parkinson’s. Dr Crotty further said, “Levels of these analytes were lower in both the plasma and CSF of PD patients versus unaffected controls among LRRK2 mutation carriers, whereas among non-carriers these analytes were not significantly reduced in Parkinson’s disease versus control subjects,” they add. “Direct evidence for interaction between Parkinson’s disease and LRRK2 status (P < .01) for each of the five caffeine-related analytes suggests a true gene-environment interaction.”

4. Cell therapy is safe for anthracycline-induced cardiomyopathy

In yet another trial of cell therapy for heart failure, this time in cancer survivors with anthracycline-induced cardiomyopathy (AIC), administration of allogeneic bone marrow-derived mesenchymal stromal cells (allo-MSCs) was shown to be safe. First author Roberto Bolli, MD, professor of medicine and director of the University of Louisville’s Institute of Molecular Cardiology in Louisville, Kentucky said, “This is the first in-human clinical trial of cell therapy for patients with anthracycline-induced cardiomyopathy, a very serious disease with a very grim prognosis which is actually worse than ischemic cardiomyopathy, and for which treatment options are very limited at the moment. The study was successful in showing that the treatment is safe, we did not have any serious adverse events, and that it is feasible in all patients. We also wanted to see if there was a signal for efficacy, but I want to stress that this was a small study and was not powered or designed to establish efficacy.” After an open-label lead-in phase done in 6 volunteer patients established that the procedure was safe, the 31 patients were randomly assigned to receive either allo-MSCs (n = 14) or cell-free placebo (n = 17) administered via 20 transendocardial, electromechanically-guided injections. The patients were followed up for 12 months. A total of 93 adverse events were reported in 27 study participants. Forty-two of these met the definition of serious adverse events; however, none of the 93 events were deemed to be related to treatment with allo-MSCs. Dr Bolli further added, “That’s why we tried it in AIC. Cardiac injection of MSCs has given some encouraging results in both ischemic and non-ischemic cardiomyopathy in phase 2 trials and right now there is a phase 3 trial going on using these cells in heart failure patients,” he added. “Our study was a very rigorous study and it was done, I believe, according to the highest levels of rigor that you can possibly do. For a phase 1 trial, it is unusual to have this level of rigor. The improvement in the Minnesota Living with Heart Failure Quality of Life and 6-minute walking scores are very flaky measures; someone just maybe walked 2 or 3 seconds faster than before, so I would not put any stock in these secondary measures. What this paper shows is that the therapy is safe and it’s doable, at least in this small number of patients. But beyond that, there is truly nothing else that we can conclude.”

5. Fetal Estrogen shows positive results for safer therapy of menopause

Hormone therapy for menopausal symptoms has come a long way in the past decade, but some low risks remain, particularly for certain groups of women. But new naturally occurring estrogens are on the horizon and may provide safer options with similar efficacy. Hugh S. Taylor, MD, in an annual meeting said, “Unfortunately, there is no such thing as the perfect estrogen that has all the things that makes it favorable and none of the negative. It probably doesn’t exist. But there’s an opportunity for us to design better estrogens or take advantage of other naturally occurring estrogens that come closer to that goal of the ideal estrogen. If there’s a better cardiovascular effect without the breast cancer risk, this could be something everyone would want to take. It’s the first new estrogen we’ve had in many years, and it makes so much sense that we go back to a naturally occurring estrogen. We’ve never really been able to get a synthetic estrogen [that works].”

6. Breast Cancer Recurrence Risk Linked To Textured Implants

According to new findings in JAMA Surgery, using textured implants for reconstruction after mastectomy is associated with greater risk of breast cancer recurrence compared to smooth implants. Dr. Sa Ik Bang of Samsung Medical Center at Sungkyunkwan University School of Medicine in Seoul, South Korea said, “We initiated this study for the purpose of obtaining evidence that implant surface type is not significantly associated with breast cancer prognosis in an effort to relieve the vague anxiety of patients with breast cancer. Contrary to expectations, we found that the textured implant group had a significantly worse DFS than the smooth group, and this difference remained significant after adjusting for tumor stage and ER status. Textured implants are intended to reduce capsular contracture and implant malrotation. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) was first reported in the late 1990s.” They looked at 650 patients, representing 687 cases, who underwent total mastectomy and immediate reconstruction at their hospital in 2011-2016. All were followed for at least two years after implant insertion. About 40% of cases received smooth implants and 60% textured implants. The smooth and textured groups had similar distribution of tumor stage and similar rates of adjuvant radiotherapy and chemotherapy. Five-year local and regional recurrence-free survival and disease-free survival (DFS) were 96.7% and 95.2%, respectively. Dr. Michael R. Cassidy and Dr. Daniel S. Roh of Boston University wrote, “Given the association of textured implants with ALCL, and now the suggestion that they are associated with increased risk for breast cancer recurrence, surgeons who choose textured implants should counsel their patients with breast cancer about their possible consequences. Many reconstructive surgeons across the world have already abandoned the use of textured implants altogether.”

7. Poor Air Quality Harmful For Those Vulnerable To Covid-19

Northern India, including the National Capital Region (NCR), is in the grip of worsening air pollution amid the Covid-19 pandemic as farmers in nearby states, especially Punjab, are clearing their fields by burning crop residue. The worst offenders among the districts contributing to the smog are Amritsar, with 1,158 fire counts between September 22 and October 12, compared with 345 a year ago; Tarn Taran, with 750 counts this year, up from 167 in 2019; and Patiala, with 266 counts versus 85, as per the data. Prof. Sagnik Dey, coordinator of the Centre of Excellence for Research on Clean Air at IIT Delhi said, “The number of (fire) events this year is much higher than in the last few years. The reason for the early surge in burning needs to be understood. Also, whatever measures are adopted are not working at the ground level.” Dr Naresh Trehan, chairman, Medanta said, “In the past one week, Medanta multi-super speciality hospital in Gurgaon has seen a rise in patients who were discharged and had recovered from Covid-19 coming back complaining of respiratory problems. Among other things, bad air quality could also be contributing to patients who have recently recovered from Covid infection and are now facing complications like trouble in breathing. Year after year, the problem of smog due to crop burning has not been resolved. This is cruel for those suffering from respiratory ailments, young children and old with weak lungs, especially in the year of pandemic when all are fighting the virus.”

Reference Link:

  1. https://health.economictimes.indiatimes.com/news/industry/new-device-for-detecting-traumatic-brain-injury-on-the-spot/78625530
  2. https://health.economictimes.indiatimes.com/news/diagnostics/sleep-health-dictates-success-of-practicing-mindfulness/78658516
  3. https://www.medscape.com/viewarticle/939148
  4. https://www.medscape.com/viewarticle/938518
  5. https://www.medscape.com/viewarticle/939095
  6. https://www.medscape.com/viewarticle/939069
  7. https://health.economictimes.indiatimes.com/news/industry/worsening-air-quality-harmful-for-those-vulnerable-to-covid-19-attack/78672337


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