Posts Tagged ‘medicine’

Doctors have placed humans in suspended animation for the first time, as part of a trial in the US that aims to make it possible to fix traumatic injuries that would otherwise cause death.

Samuel Tisherman, at the University of Maryland School of Medicine, told New Scientist that his team of medics had placed at least one patient in suspended animation, calling it “a little surreal” when they first did it. He wouldn’t reveal how many people had survived as a result.

The technique, officially called emergency preservation and resuscitation (EPR), is being carried out on people who arrive at the University of Maryland Medical Centre in Baltimore with an acute trauma – such as a gunshot or stab wound – and have had a cardiac arrest. Their heart will have stopped beating and they will have lost more than half their blood. There are only minutes to operate, with a less than 5 per cent chance that they would normally survive.

EPR involves rapidly cooling a person to around 10 to 15°C by replacing all of their blood with ice-cold saline. The patient’s brain activity almost completely stops. They are then disconnected from the cooling system and their body – which would otherwise be classified as dead – is moved to the operating theatre.

A surgical team then has 2 hours to fix the person’s injuries before they are warmed up and their heart restarted. Tisherman says he hopes to be able to announce the full results of the trial by the end of 2020.

At normal body temperature – about 37°C – our cells need a constant supply of oxygen to produce energy. When our heart stops beating, blood no longer carries oxygen to cells. Without oxygen, our brain can only survive for about 5 minutes before irreversible damage occurs. However, lowering the temperature of the body and brain slows or stops all the chemical reactions in our cells, which need less oxygen as a consequence.

Tisherman’s plan for the trial was that 10 people who receive EPR will be compared with 10 people who would have been eligible for the treatment but for the fact that the correct team wasn’t in the hospital at the time of admittance.

The trial was given the go-ahead by the US Food and Drug Administration. The FDA made it exempt from needing patient consent as the participants’ injuries are likely to be fatal and there is no alternative treatment. The team had discussions with the local community and placed ads in newspapers describing the trial, pointing people to a website where they can opt out.

Tisherman’s interest in trauma research was ignited by an early incident in his career in which a young man was stabbed in the heart after an altercation over bowling shoes. “He was a healthy young man just minutes before, then suddenly he was dead. We could have saved him if we’d had enough time,” he says. This led him to start investigating ways in which cooling might allow surgeons more time to do their job.

Animal studies showed that pigs with acute trauma could be cooled for 3 hours, stitched up and resuscitated. “We felt it was time to take it to our patients,” says Tisherman. “Now we are doing it and we are learning a lot as we move forward with the trial. Once we can prove it works here, we can expand the utility of this technique to help patients survive that otherwise would not.”

“I want to make clear that we’re not trying to send people off to Saturn,” he says. “We’re trying to buy ourselves more time to save lives.”

In fact, how long you can extend the time in which someone is in suspended animation isn’t clear. When a person’s cells are warmed up, they can experience reperfusion injuries, in which a series of chemical reactions damage the cell – and the longer they are without oxygen, the more damage occurs.

It may be possible to give people a cocktail of drugs to help minimise these injuries and extend the time in which they are suspended, says Tisherman, “but we haven’t identified all the causes of reperfusion injuries yet”.

Tisherman described the team’s progress on Monday at a symposium at the New York Academy of Sciences. Ariane Lewis, director of the division of neuro-critical care at NYU Langone Health, said she thought it was important work, but that it was just first steps. “We have to see whether it works and then we can start to think about how and where we can use it.”

Read more: https://www.newscientist.com/article/2224004-exclusive-humans-placed-in-suspended-animation-for-the-first-time/#ixzz65qFgVd3X

By Allie Torgan

At one point, Zach Wigal had 5,000 video games in his parents’ basement.

Yes, 5,000. But it’s not what you might think.

Wigal is the founder of Gamers Outreach, a nonprofit that makes sure that kids who can’t leave their hospital rooms during long-term medical treatment can play video games while they recuperate.

“We noticed that a lot of the video games (at the hospitals) were getting stuck in playrooms,” said Wigal, 29. “And because of that, there was a whole segment of the hospital population that was, sort of, limited to whatever it was they had access to their bedside environment.”

Those 5,000 games eventually made their way out of his parents’ basement and some were featured on simple, portable video game carts that Wigal’s foundation helped design and provide to more than a million kids a year.

These “GOKarts” — equipped with a gaming console and an array of video games — are rolled into a patient’s room and allow kids “a source of fun and relief during … stressful and difficult times,” Wigal said.

Some kids have seen health benefits as a result, and doctors are prescribing “video game time” for certain patients, according to Andrew Gabanyicz, patient technologist at C.S. Mott Children’s Hospital in Ann Arbor, Michigan.

“We’ve seen anxiety go down, prescription pain killers are being used less,” Gabanyicz said.

Wigal’s inspiration for his charity came from his love of gaming as a teen — which took an interesting turn during his junior year of high school.

He registered more than 300 fellow students to participate in a Halo 2 tournament in his high school cafeteria. He rented the space with permission from the school. He spent months organizing it.

Then BAM.

“This event got shut down a couple days before it was supposed to happen by a police officer who believed that games like Halo were, in his words, corrupting the minds of America’s youth,” Wigal said. “Everyone who had signed up for our video game tournament was a little upset.”

The cancellation sparked an idea: Wigal wanted to show authorities that gamers weren’t all bad or lazy kids — and they could do something good with their gaming skills.

So he decided to throw a new tournament. The twist: He would donate the proceeds to charity. In 2008, Wigal and his friends held an event called Gamers for Giving and raised money for the Autism Society of America.

“I thought, ‘Let’s illustrate the positive things that can happen when gamers get together around what they’re passionate about,'” said Wigal, once named to Forbes Magazine’s 30 under 30.

The event continued year after year, and as it grew in popularity, Wigal’s team branched out and started working with local hospitals. In 2009, Wigal began working with the C.S. Mott Children’s Hospital and his team designed his portable GOKarts.

“We work with kids that can’t go on the soccer field. They physically cannot participate. But I don’t feel like they should be missing out on the values that are communicated through traditional activities,” Wigal said.

CNN’s Allie Torgan spoke with Wigal about his work. Below is an edited version of their conversation.

CNN: As a teenager, your parents’ house was ground zero for charitable operations. What was the straw that broke the camel’s back, so to speak?

Zach Wigal: We had taken over my parents’ basement raising money for Gamers Outreach. It had become this holding area for gaming equipment that was being donated to our organization for use in the hospital environment. There was a period of time we had, I kid you not, more than 5,000 video games in my parents’ basement.

We actually had someone donate, like, 900 Xboxes that had just been sitting in a warehouse. Thankfully my parents just had the patience to be okay with all of this up until that semi-truck wanted to show up, and that was the day it was like, “It’s not going to go in the basement. You need to find a place for all this equipment.” That was the day we got kicked out of my parents’ house! Now we have a warehouse here in Michigan.

CNN: Your signature GOKarts are now serving more than a million kids a year at 50 hospitals. Why that model?

Wigal: By volunteering and visiting hospitals, we were noticing that it was difficult to bring technology into these environments. We noticed that a lot of the video games were getting stuck in playrooms. And because of that, there was a whole segment of the hospital population that was, sort of, limited to whatever it was they had access to their bedside environment if they couldn’t leave their rooms.

Sometimes you have families that can’t afford technology or they don’t have things that they can bring from home for their kids. It becomes important for technology and hardware to exist in the hospital environment to help provide some access to entertainment to patients who maybe can’t do things outside of their room.

CNN: What advice do you have for parents of patients who may be struggling with how much screen time is appropriate?

Wigal: Even if you’re not a fan of gaming or screen time or you feel it might be excessive, technology is a prevalent part of all our lives. I mean, even my mom has Angry Birds installed on her cell phone at this point.

What’s important is that we communicate the right values of how this technology plays a role in our life, how we balance technology with being healthy as an individual and taking care of your mental health, keeping up with schoolwork, finding a career. These are all things that can exist cohesively.

We think of the work we’re doing as an opportunity to improve a patient’s quality of life. We’re coming to provide entertainment into hospital environments. We’re helping kids to find a source of fun and relief during times where being in the hospital can be really stressful and difficult otherwise.

Want to get involved? Check out the Gamers Outreach website and see how to help.

Home

To donate to Gamers Outreach via CrowdRise, click here.
https://charity.gofundme.com/donate/project/zach-wigal-gamers-outreach/GamersOutreach

https://www.cnn.com/2019/03/08/us/cnnheroes-zach-wigal-gamers-outreach/index.html?utm_source=The+Good+Stuff&utm_campaign=2aa589d67e-EMAIL_CAMPAIGN_2019_11_14_08_33&utm_medium=email&utm_term=0_4cbecb3309-2aa589d67e-103653961

High doses of vitamin D taken one hour after sunburn significantly reduce skin redness, swelling, and inflammation, according to double-blinded, placebo-controlled clinical trial out of Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center. The trial results were recently published in the Journal of Investigative Dermatology.

In the study, 20 participants were randomized to receive a placebo pill or 50,000, 100,000, or 200,000 IU of vitamin D one hour after a small UV lamp “sunburn” on their inner arm. Researchers followed up with the participants 24, 48, 72 hours and 1 week after the experiment and collected skin biopsies for further testing. Participants who consumed the highest doses of vitamin D had long-lasting benefits — including less skin inflammation 48 hours after the burn. Participants with the highest blood levels of vitamin D also had less skin redness and a jump in gene activity related to skin barrier repair.

“We found benefits from vitamin D were dose-dependent,” said Kurt Lu, MD, senior author on the study and Assistant Professor of Dermatology at Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center. “We hypothesize that vitamin D helps promote protective barriers in the skin by rapidly reducing inflammation. What we did not expect was that at a certain dose, vitamin D not only was capable of suppressing inflammation, it was also activating skin repair genes.”

The trial is the first to describe acute anti-inflammatory benefits from taking vitamin D. According to the authors, despite widespread attention given to vitamin D deficiency, “there is a lack of evidence demonstrating that intervention with vitamin D is capable of resolving acute inflammation.” By measuring gene activity in the biopsies, the researchers also uncovered a potential mechanism behind how vitamin D aids skin repair. The results suggest vitamin D increases skin levels of an anti-inflammatory enzyme, arginase-1. The enzyme enhances tissue repair after damage and helps activate other anti-inflammatory proteins.

The study may have people flocking to vitamin supplement aisles, but Lu stresses that the trial tested very high doses of vitamin D that far exceed daily allowances. The Food and Drug Administration’s recommended adult daily allowance for vitamin D is 400 IU. Said Lu, “I would not recommend at this moment that people start taking vitamin D after sunburn based on this study alone. But, the results are promising and worthy of further study.” Lu and colleagues are planning additional studies that could inform treatment plans for burn patients.

https://www.brightsurf.com/news/article/070617433327/vitamin-d-may-improve-sunburn-according-to-new-clinical-trial.html

By Rory Sullivan

Although hiccups seem a nuisance, scientists have discovered they may play a crucial role in our development — by helping babies to regulate their breathing.

In a study led by University College London (UCL), researchers monitoring 13 newborn babies found that hiccupping triggered a large wave of brain signals which could aid their development.

Lorenzo Fabrizi, the study’s senior author, said in a statement that this brain activity might help babies “to learn how to monitor the breathing muscles,” eventually leading to an ability to control breathing voluntarily.

He added: “When we are born, the circuits which process body sensations are not fully developed, so the establishment of such networks is a crucial developmental milestone for newborns.”

Since the babies involved in the study were pre-term and full-term, ranging from 30 to 42 weeks gestational age, the scientists believe this development could be typical of the final trimester of pregnancy.

According to the researchers, fetuses and newborn infants often hiccup.

The phenomenon is seen as early as nine weeks into pregnancy, and pre-term infants — those born at least three weeks premature — spend approximately 15 minutes hiccupping every day.

The pre-term and full-term newborns involved in the study had electrodes placed on their scalps and sensors on their torsos to monitor for hiccups.

Scientists found that contractions in the babies’ diaphragms produced three brainwaves, and believe that through the third brainwave babies may be able to link the ‘hic’ sound of the hiccup to the physical contraction they feel.

Kimberley Whitehead, the study’s lead author, told CNN: “The muscle contraction of a hiccup is quite big — it’s good for the developing brain because it suddenly gives a big boost of input, which helps the brain cells to all link together for representing that particular body part.”

She added that hiccups have no known advantage for adults, and suggested they could be an example of “a hangover from early periods of our life that persists into later life.”

The same researchers have previously theorized that a baby’s kicks in the womb may help it to create a mental map of its own body.

Their new findings may show the same process occurring internally.

https://www.cnn.com/2019/11/12/health/babies-hiccup-wellness-scli-intl-scn/index.html?utm_source=The+Good+Stuff&utm_campaign=2aa589d67e-EMAIL_CAMPAIGN_2019_11_14_08_33&utm_medium=email&utm_term=0_4cbecb3309-2aa589d67e-103653961

By Kristin Houser

Down syndrome is a cognitive disability that can affect a person’s memory or ability to learn — intellectual impairments researchers traditionally thought were untreatable and irreversible.

But now, researchers from the University of California San Francisco and Baylor College of Medicine say they’ve reversed the impairments in mouse models of Down syndrome — potentially foreshadowing an ethically-fraught future in which doctors can do the same for humans with the condition.

All people with Down syndrome share one thing in common: an extra copy of chromosome 21. For that reason, much of the research on Down syndrome has focused on genetics.

But for this new study, published Friday in the prestigious journal Science, researchers focused on the protein-producing cells in the brains of mice with Down syndrome. That led them to the discovery that the animals’ hippocampus regions produced 39 percent less protein than those of typical mice.

Further study led the researchers to conclude that the presence of an extra chromosome likely prompted the animals’ hippocampal cells to trigger the integrated stress response (ISR), which decreased protein production.

“The cell is constantly monitoring its own health,” researcher Peter Walter said in a press release. “When something goes wrong, the cell responds by making less protein, which is usually a sound response to cellular stress. But you need protein synthesis for higher cognitive functions, so when protein synthesis is reduced, you get a pathology of memory formation.”

By blocking the activity of PKR, the enzyme that prompted the ISR in the mouse model’s hippocampal cells, the researchers found they could not only reverse the decreased protein production but also improve the animals’ cognitive function.

Of course, just because something works in mice doesn’t mean it’ll work in humans.

However, when the researchers analyzed postmortem brain tissue samples of people with Down syndrome, they found evidence that the ISR had been activated. They also obtained a tissue sample from a person with Down syndrome who only had the extra copy of chromosome 21 in some of their cells — and those cells were the only ones with ISR activated.

“We started with a situation that looked hopeless,” Walter said. “Nobody thought anything could be done. But we may have struck gold.”

https://futurism.com/neoscope/scientists-reverse-cognitive-deficiets-of-down-syndrome-mice

Thanks to Kebmodee for bringing this to the It’s Interesting community.



Researchers found that a black-box algorithm predicted patient death better than humans.

They used ECG results to sort historical patient data into groups based on who would die within a year.

Although the algorithm performed better, scientists don’t understand how or why it did.

Albert Einstein’s famous expression “spooky action at a distance” refers to quantum entanglement, a phenomenon seen on the most micro of scales. But machine learning seems to grow more mysterious and powerful every day, and scientists don’t always understand how it works. The spookiest action yet is a new study of heart patients where a machine-learning algorithm decided who was most likely to die within a year based on echocardiogram (ECG) results, reported by New Scientist.

The algorithm performed better than the traditional measures used by cardiologists. The study was done by researchers in Pennsylvania’s Geisinger regional healthcare group, a low-cost and not-for-profit provider.

Much of machine learning involves feeding complex data into computers that are better able to examine it really closely. To analogize to calculus, if human reasoning is a Riemann sum, machine learning may be the integral that results as the Riemann calculation approaches infinity. Human doctors do the best they can with what they have, but whatever the ECG algorithm is finding in the data, those studying the algorithm can’t reverse engineer what it is.

The most surprising axis may be the number of people cardiologists believed were healthy based on normal ECG results: “The AI accurately predicted risk of death even in people deemed by cardiologists to have a normal ECG,” New Scientist reports.

To imitate the decision-making of individual cardiologists, the Geisinger team made a parallel algorithm out of the factors that cardiologists use to calculate risk in the accepted way. It’s not practical to record the individual impressions of 400,000 real human doctors instead of the results of the algorithm, but that level of granularity could show that cardiologists are more able to predict poor outcomes than the algorithm indicates.

It could also show they perform worse than the algorithm—we just don’t know. Head to head, having a better algorithm could add to doctors’ human skillset and lead to even better outcomes for at-risk patients.

Machine learning experts use a metric called area under the curve (AUC) to measure how well their algorithm can sort people into different groups. In this case, researchers programmed the algorithm to decide which people would survive and which would die within the year, and its success was measured in how many people it placed in the correct groups. This is why future action is so complicated: People can be misplaced in both directions, leading to false positives and false negatives that could impact treatment. The algorithm did show an improvement, scoring 85 percent versus the 65 to 80 percent success rate of the traditional calculus.

As in other studies, one flaw in this research is that the scientists used past data where the one-year window had finished. The data set is closed and scientists can directly compare their results to a certain outcome. There’s a difference—and in medicine it’s an ethical one—between studying closed data and using a mysterious, unstudied mechanism to change how we treat patients today.

Medical research faces the same ethical hurdles across the board. What if intervening based on machine learning changes outcomes and saves lives? Is it ever right to treat one group of patients better than a control group that receives less effective care? These obstacles make a big difference in how future studies will pursue the results of this study. If the phenomenon of better prediction holds up, it may be decades before patients are treated differently.

https://www.popularmechanics.com/science/health/a29762613/ai-predict-death-health/

By Steven Reinberg

Loneliness can take a heavy toll on heart patients — including a higher risk of death in the year after hospitalization, researchers found.

“This study confirms what has also been indicated in previous research regarding the serious health consequences of loneliness,” said lead researcher Anne Vinggaard Christensen, of Copenhagen University Hospital in Denmark.

“Loneliness should be considered a serious risk factor in patients with cardiac disease and should be included in risk evaluation of patients,” added Christensen, who is with the hospital’s heart center.

The Danish researchers cautioned, however, that their findings can’t prove that loneliness caused people to die, only that loneliness and the risk of death appear to be connected. But the differences in mortality between those who felt lonely and those who didn’t can’t be explained by their medical condition alone, they said.

Loneliness is a subjective experience, one that is distressing and unpleasant, the researchers noted.

The connection between loneliness and health is complex, Christensen said.

People who are lonely or socially isolated tend to have more unhealthy lifestyles. They smoke more, are less likely to be physically active and don’t take their medication, she said.

“Having a social network helps motivate people to make healthier choices,” Christensen said. “A social network can act as a buffer for stress.”

Also, lonely people have been found to have higher levels of stress hormones and lower immune function, she added.

“These different pathways are interconnected and help us understand why people feeling lonely or socially isolated experience worse health,” Christensen said.

James Maddux is a professor emeritus in the department of psychology at George Mason University in Fairfax, Va. Reviewing the findings, he took issue with the study’s methodology.

“My major concern about the methodology is that their measure of loneliness is rather weak and is not consistent with most studies about loneliness that I am familiar with,” Maddux said. He explained that the question used to measure loneliness failed to capture loneliness “as a profound sense of isolation and disconnected from others, accompanied by sadness and a longing to be with others. In other words, loneliness is painful.”

Still, even in its flawed state, the new study “adds to the growing research on the perils of social isolation among people in general and among older adults over 60 in particular,” said Maddux. “These results help reaffirm what we’ve learned so far about how unhealthy social isolation can be.”

For the study, Christensen and her colleagues collected data on more than 13,400 heart patients after they left the hospital from 2013 to 2014. Their average age was in the mid-60s.

Participants completed questionnaires on their health, psychological well-being, quality of life and levels of anxiety and depression.

Compared to people who didn’t feel lonely, those who said they were lonely were nearly three times more likely to be anxious and depressed and have a lower quality of life, the researchers found.

A year later, Christensen’s team found that feeling lonely had a significant impact on participants’ health.

Regardless of other factors, lonely women were nearly three times more likely to die than women who weren’t lonely, and lonely men were more than twice as likely to die, the researchers found.

Living alone, however, is not necessarily equal to feeling lonely, and it was linked to a lower risk of depression and anxiety than living with others.

But among men, living alone was tied with a 39% greater risk for poor heart health. This may be because men tend not to have an extensive support network after divorce or death of a spouse, compared with women, the researchers noted.

“Loneliness can have many causes and can occur even if you have people around you,” Christensen said.

For some, it would help to have a family member who remembers to ask how they are doing and is ready to listen, she said.

“For others, help with practical things might be what they need, and for some, the opportunity to talk to other patients who have gone through the same thing is helpful,” Christensen said.

She also stressed that the effects of loneliness are not confined to heart disease. “It’s also [detrimental] for individuals who do not suffer from an illness. Loneliness seems to be damaging to your health no matter what,” Christensen said.

The report was published online Nov. 4 in the journal Heart.

https://consumer.healthday.com/cardiovascular-health-information-20/misc-stroke-related-heart-news-360/risks-mount-for-lonely-hearts-after-cardiac-surgery-751879.html