#Simple alerts can cut infections from catheters University of Pennsylvania rightoriginal Studyposted by Lee-Ann Landis Donegan-Penn on August 26 2014simpler automatic alerts in electronic health
records can cut the number of urinary tract infections in patients with urinary catheters report researchers. The alerts help physicians decide
whether their patients need urinary catheters in the first place and then alert them to reassess the need for catheters that have not been removed within a recommended time period.
Approximately 75 percent of urinary tract infections acquired in the hospital are associated with a urinary catheterâ##a tube inserted into the bladder through the urethra to drain urine.
According to the Centers for Disease Control and Prevention 15 to 25 percent of hospitalized patients receive urinary catheters during their hospital stay.
As many as 70 percent of urinary tract infections in these patients may be preventable using infection control measures such as removing no longer needed catheters resulting in up to 380000 fewer infections and 9000 fewer deaths each year.##
##Our study has two crucial applicable findings##says lead author Charles A. Baillie an internal medicine specialist and fellow in the Center for Clinical Epidemiology and Biostatistics at Penn Medicine.##
##First electronic alerts do result in fewer catheter-associated urinary tract infections. Second the design of the alerts is very important.
By making the alert quicker and easier to use we saw a dramatic increase in the number of catheters removed in patients who no longer needed them.##
##Fewer catheters means fewer infections fewer days in the hospital and even fewer deaths. Not to mention the dollars saved by the health system in general.##
##In the first phase of the study two percent of urinary catheters were removed after an initial##off-the-shelf##electronic alert was triggered (the stock alert was part of the standard software package for the electronic health record.
Hoping to improve on this result in a second phase of the study the researchers developed
and used a simplified alert based on national guidelines for removing urinary catheters they had published previously with the CDC.
Following introduction of the simplified alert the proportion of catheter removals increased more than sevenfold to 15 percent.
The study also found that catheter associated urinary tract infections decreased from an initial rate of. 84 per 1000 patient days to. 70 per 1000 patient-days following implementation of the first alert and. 50 per 1000
patient days following implementation of the simplified alert. Among other improvements the simplified alert required two mouse clicks to submit a remove-urinary-catheter order compared to seven mouse clicks required by the original alert.
The study was conducted among 222475 inpatient admissions in the three hospitals of the University of Pennsylvania Health System between March 2009 and May 2012.
In patients electronic health records physicians were prompted to specify the reason (among ten options) for inserting a urinary catheter.
On the basis of the reason selected they were alerted subsequently to reassess the need for the catheter
if it had not been removed within the recommended time period based on the reason chosen. Women s health units had the highest proportion of alerts that led to a remove-urinary-catheter order
and critical care units saw the lowest proportion of alerts leading to a remove order.
The study appears in Infection Control and Hospital Epidemiology. Source: University of Pennsylvaniayou are free to share this article under the Creative Commons Attribution-Noderivs 3. 0 Unported license t
#Scan baby s fingerprints to track immunizations Michigan State university rightoriginal Studyposted by Kim Ward-Michigan State on August 20 2014more than 2 million childrenâ#die each year
because they don t receive their vaccinations on time. Researchers are developing a new system that scans a child sâ#fingerprints to track
when vaccinations are due which means parents will need no longer to keep paper documents. In developing countries keeping track of a baby s vaccine schedule on paper is largely ineffective says Anil Jain professor of computer science and engineering at Michigan State university.##
##Paper documents are lost easily or destroyed##he says.####Our initial study has shown that fingerprints of infants
and toddlers have great potential to accurately record immunizations. You can lose a paper document but not your fingerprints.##
##For a new study Jain and colleagues traveled to rural health facilities in Benin West Africa to test the new system.
They used an optical fingerprint reader to scan the thumbs and index fingers of babies and toddlers.
From this scanned data a schedule will be created and become a part of the vaccine registry system.
Once the electronic registry is in place health care workers simply re-scan the child s fingers to view the vaccination schedule.
They know who has been vaccinated for what diseases and when additional booster shots are needed. The new electronic registry system will help overcome the lack and loss of information
which is the primary problem in the vaccine delivery system in developing countries Jain says.
Collecting fingerprints from fidgety infants isn t easy. Another challenge is their small fingerprint patterns have low contrast between ridges and valleys.##
##The process can still be improved but we have shown its feasibility##Jain says.####We will continue to work on refining the fingerprint matching software
and finding the best reader to capture fingerprints of young children which will be of immense global value.
in addition to tracking vaccinations says Mark Thomas executive director of Vaxtrac a nonprofit organization supporting Jain s research.##
##Solving the puzzle of fingerprinting young children will have far-reaching implications beyond health care including the development of civil registries government benefits tracking and education recordkeeping.##
##Kai Cao postdoctoral researcher and Sunpreet Arora doctoral student are coauthors of the study. The findings will be presented at the International Joint Conference on Biometrics on Oct 2.
The Bill & Melinda Gates Foundation funded the project. Source: Michigan State Universityyou are free to share this article under the Creative Commons Attribution-Noderivs 3. 0 Unported license m
#X-rays show live changes in cystic fibrosis New X-ray technology is allowing doctors to see almost instantly
if treatments for cystic fibrosis are working. Cystic fibrosis affects many of the body s systems but most severely the lungs and currently it can take several months to measure how effective treatment is for the early-fatal lung disease.
Lead researcher Kaye Morgan from Monash University says the imaging method allows doctors to look at soft tissue structures for example the brain airways
and lungs which are effectively invisible in conventional x-ray images. At the moment we typically need to wait for a cystic fibrosis treatment to have an effect on lung health measured by either a lung CT SCAN
or breath measurement to see how effective that treatment is Morgan says. However the new imaging method allows us for the first time to non-invasively see how the treatment is working live on the airway surface.
Morgan says this x-ray imaging method would enable doctors and researchers to measure how effective treatments are
and progress new treatments to the clinic at a much quicker rate a key goal of co-authors Martin Donnelley and David Parsons of the CF Gene therapy group at the Women s and Children s Hospital and the University
of Adelaide s Robinson Research Institute. Because we will be able to see how effectively treatments are working straight away we ll be able to develop new treatments a lot more quickly
and help better treat people with cystic fibrosis Morgan says. The new imaging method which was developed using a synchrotron x-ray source may also open up possibilities in assessing how effective treatments were for other lung heart and brain diseases.
The research appears in the American Journal of Respiratory and Critical Care Medicine. Source: Monash University You are free to share this article under the Creative Commons Attribution-Noderivs 3. 0 Unported license e
#This protein may explain why Ebola is so deadly Washington University in St louis rightoriginal Studyposted by Michael Purdy-WUSTL on August 14 2014discovery of a protein that makes the Ebola virus so effective at evading the immune systemâ
##and so deadlyâ##may lead to more effective treatments researchers say. The Ebola virus in the midst of its biggest outbreak on record has infected about 1800 people
since March in four West african nations and killed more than half of them according to the World health organization.
Researchers have developed a detailed map of how the protein VP24 binds to a host protein that takes signaling molecules in
##We ve known for a long time that infection with Ebola obstructs an important arm in our immune system that is activated by molecules called interferons##says senior author Gaya Amarasinghe assistant professor of pathology
and immunology at University of Washington in St louis.##Now that our map of the combined structure of these two proteins has revealed one critical way Ebola does this the information it provides will guide the development of new treatments.##
##Coauthor Christopher Basler professor of microbiology at Mount sinai Hospital was the first to show that VP24
##It makes a variety of responses to viral infection possible including the self-destruction of infected cells and the blockage of supplies necessary for viral reproduction.##
& Microbe Amarasinghe and Daisy Leung assistant professor of pathology and immunology show that VP24 tightly binds to a nuclear transporter a protein that takes molecules into
The group includes researchers at the Icahn School of medicine at Mount sinai Washington University the University of Texas Southwestern Medical center Howard University and Microbiotix Inc. a Massachussetts biopharmaceutical company Source:
Washington University in St. Louisyou are free to share this article under the Creative Commons Attribution-Noderivs 3. 0 Unported license
#Scientists are a step closer to making blood cells on demand Monash University rightoriginal Studyposted by Glynis Smalley-Monash on August 14 2014by watching how zebrafish embryos developâ#scientists are starting to unravel theâ#mystery
Leukemia patients have been treated successfully using HSC transplants but medical experts believe blood stem cells have the potential to be used more widely.
Lead researcher Peter Currie a professor at Monash University says that understanding how HSCS self-renew to replenish blood cells is a##Holy grail##of stem cell biology.##
##HSCS are one of the best therapeutic tools at our disposal because they can make any blood cell in the body.
Potentially we could use these cells in many more ways than current transplantation strategies to treat serious blood disorders
and diseases but only if we can figure out how they are generated in the first place. Our study brings this possibility a step closer##he says.
#These 3 types of gut microbes flourish in preemies Washington University in St louis rightoriginal Studyposted by Elizabethe Holland Durando-WUSTL on August 12 2014scientists believe babies are born with digestive systems containing few
However in infants born prematurely researchers at Washington University School of medicine in St louis have found that the population of bacteria in babies gastrointestinal tracts may depend more on their biological makeup and gestational age at birth than on environmental factors.
but we know very little about how these microbial communities assemble##says senior author Phillip I. Tarr professor of pediatrics.##
and development immune function resistance to infection and predisposition to inflammatory and metabolic disordersâ##yet until now little has been known about how the microbes get there.
Collaborators at the Genome Institute at Washington University School of medicine used DNA sequencing to tally the bacterial populations in 922 stool samples from 58 premature infants.
The babies who were patients in the neonatal intensive care unit (NICU) at St louis Children s Hospital ranged from 23 to 33 weeks in gestational age
and weighed 1500 grams (3 pounds 5 ounces) or less. The investigators found that differing ratios of three major classes of bacteria colonized the preemies guts in sequence.
The researchers noted abrupt changes in each gut s bacterial composition along the way to 36 weeks in gestational age but found that somehow the gut ecosystems adjusted
and at other times they weren t##says Tarr who is also director of the Division of Pediatric Gastroenterology and Nutrition.##
##Armed with the knowledge of what occurs in the digestive systems of preemies in a controlled environment the researchers next aim to discern what happens in the systems of preemies who don t fare as well particularly those suffering from necrotizing enterocolitis (NEC). NEC is a devastating disorder in premature infants that causes tissue death in the lining
of the intestinal wall. The syndrome occurs in up to 10 percent of premature infants and is fatal 25 to 35 percent of the time.
Scientists believe gut microbes play a part in the disease.####Research has made not an impact in either prevention
or treatment of NEC##says co-first author Barbara Warner a professor of pediatrics who treats patients at St louis Children s Hospital.##
##The Holy grail is prevention and if so much of what happens in the gut depends on the host this research may help us identify just what increases an infant s risk for developing NEC
and help us target therapies.####Warner says she and her colleagues don t yet know the significance of the three bacterial classes that dominated the preemies gut microbiota.
and we believe that the data from this study will be immensely helpful in understanding the human gut##Tarr says.##
Washington University in St. Louisyou are free to share this article under the Creative Commons Attribution-Noderivs 3. 0 Unported license i
#Coated cells act like camo for deadly brain tumors Brain tumors are able to go undetected by the immune system
The discovery, made in mice and rats, shows the key role the protein galectin-1 plays in some of the most dangerous brain tumors, called high grade malignant gliomas.
They had actually been trying to study how the extra production of galectin-1 by tumor cells affects cancer ability to grow
the tumors were eradicated. That because the irst respondersof the body immune systemalled natural killer or NK cellspotted the tumor cells almost immediately and killed them.
But when the tumor cells made their usual amounts of galectin-1, the immune cells couldn recognize the cancerous cells as dangerous.
That meant that the immune system couldn trigger the body second line of defensealled T cellsntil the tumors had grown too large for the body to beat.
Published online in the journal, Cancer Research, the findings open the door to research on the effect of blocking galectin-1 in patients with gliomas,
says team leader Pedro Lowenstein, professor of neurosurgery at University of Michigan. his is an incredibly novel and exciting development,
and shows that in science we must always be open-minded and go where the science takes us;
no matter where we thought we wanted to go. TUMOR TENDRILS n this case, we found that over-expression of galectin-1 inhibits the innate immune system,
and this allows the tumor to grow enough to evade any possible effective T cell response.
By the time it detected, the battle is lost already. The NK-evading tealthfunction of the extra-thick coating of galectin-1 came as a surprise,
because glioma researchers everywhere had assumed the extra protein had more to do with the insidious ability of gliomas to invade the brain,
and to evade the attacks of T cells. Gliomas which make up about 80 percent of all malignant brain tumors,
include anaplastic oligodendrogliomas, anaplastic astrocytomas, and glioblastoma multiforme. More than 24,000 people in the US are diagnosed with a primary malignant brain tumor each year.
The tiny tendrils of tumor that extend into brain tissue from a glioma are what make them so dangerous.
Even when a neurosurgeon removes the bulk of the tumor, small invasive areas escape detection and keep growing, unchecked by the body.
Helping the innate immune system to recognize early stages of cancer growth, and sound the alarm for the body defense system to act
while the remaining cancer is still small enough for them to kill, could potentially help patients.
EARLY WARNING SENTINELS While the new discovery opens the door to that kind of approach, much work needs to be done before the mouse-based research could help human patients,
says Lowenstein, who also holds an appointment in the cell and developmental biology department. Galectin-1 may help other types of tumor evade the innate NK cells, too.
The new research suggests that in the brain unique environment, galectin-1 creates an immunosuppressive effect immediately around tumor cells.
The brain cancer cells seem to have evolved the ability to express their galectin-1 genes far more than normal
to allow the tumor to keep growing. Most brain tumor immune research has focused on triggering the action of the adaptive immune systemhose cells control the process that allows the body to kill invaders from outside or within.
But that system take days or even weeks to reach full forcenough time for incipient tumors to grow too large for immune cells to eliminate solid tumor growth.
The new research suggests the importance of enhancing the ability of the innate immune system arly warningsentinels to spot glioma cells as early as possible.
Maria Castro is a co-team leader of the study. Graduate student Gregory J. Baker is the first author.
The National Institute of Neurological disorders & Stroke supported the research e
#Glucose control switch links both types of diabetes Scientists have linked a mechanism in the brain that senses glucose levels in the blood
and kick starts the body insulin response to both type 1 and type 2 diabetes. ee discovered that the prolyl endopeptidase enzymeocated in a part of the hypothalamus known as the ventromedial nucleusets a series of steps
in motion that control glucose levels in the blood, says Yale School of medicine professor and lead author Sabrina Diano. ur findings could eventually lead to new treatments for diabetes.
The ventromedial nucleus contains cells that are glucose sensors. To understand the role of prolyl endopeptidase in this part of the brain
the team used mice that were engineered genetically with low levels of this enzyme. They found that in absence of this enzyme,
mice had high levels of glucose in the blood and became diabetic. Diano, a professor in the departments of obstetrics, gynecology,
and reproductive sciences, and her team discovered that this enzyme is important because it makes the neurons in this part of the brain sensitive to glucose.
The neurons sense the increase in glucose levels and then tell the pancreas to release insulin,
which is the hormone that maintains a steady level of glucose in the blood, preventing diabetes.
The findings are published in the Proceedings of the National Academies of Sciences. ecause of the low levels of endopeptidase,
the neurons were no longer sensitive to increased glucose levels and could not control the release of insulin from the pancreas,
and the mice developed diabetes. says Diano, who is also a member of the Yale Program in Integrative Cell Signaling and Neurobiology of Metabolism.
Diano says the next step in this research is to identify the targets of this enzyme by understanding how the enzyme makes the neurons sense changes in glucose levels. f we succeed in doing this
and treat type 2 diabetes, she says. The National institutes of health, and the American Diabetes Association supported the research
#See into living brain with lasers and nanotubes By injecting carbon nanotubes into the bloodstream, scientists can use near-infrared lasers to see blood flow in a living animal brain.
The new technique, which is almost completely noninvasive, was developed for mice, but could offer insight into human ailments, such as strokes, migraines,
and possibly Alzheimer and Parkinson diseases.""The continuity field smoothes what would otherwise be a jittery perception of object features over time,
Some of the most damaging brain diseases can be traced to irregular blood delivery in the brain.
noninvasive techniques such as CT SCANS or MRI visualize function best at the whole-organ level, but can visualize individual vessels or groups of neurons.
or NIR-IIA, involves injecting water-soluble carbon nanotubes into a live mouse bloodstream. The researchers then shine a near-infrared laser over the rodent skull.
The light causes the specially designed nanotubes to fluoresce at wavelengths of 1, 300-1, 400 nanometers;
The fluorescing nanotubes can then be detected to visualize the blood vesselsstructure. Amazingly, the technique allows scientists to view about three millimeters underneath the scalp
says senior author Hongjie Dai, professor of chemistry at Stanford university. Furthermore, it does not appear to have any adverse affect on innate brain functions. he NIR-IIA light can pass through intact scalp skin
who conducted the research as a graduate student in Dai lab and is now a postdoctoral fellow at Harvard university. ll we have to remove is some hair.
Second, injecting carbon nanotubes needs approval for clinical application; the scientists are currently investigating alternative fluorescent agents.
though, the technique provides a new technique for studying human cerebral-vascular diseases, such as stroke and migraines, in animal models.
and Parkinson diseases might elicitr be caused in part byhanges in blood flow to certain parts of the brain.
NIR-IIA imaging might offer a means of better understanding the role of healthy vasculature in those diseases,
Hong says. e could also label different neuron types in the brain with biomarkers and use this to monitor how each neuron performs.
Other coauthors of the study are from Stanford, Massachusetts General Hospital, and Harvard Medical school a
#Mutated gene causes heart defect in Newfoundland dogs Researchers have discovered a gene mutation that causes a deadly heart defect in Newfoundland dogs.
They hope the findings will lead to better breeding practices. Newfoundlandshose massive, furry, black dogsre all too often afflicted with a potentially lethal congenital disease called subvalvular aortic stenosis,
or SAS, which also affects other dog breeds, including the golden retriever. Although rare, SAS sometimes affects children,
surgical removal of the ridge or ring below the aortic valve is one option for improving the child health.
And open-heart surgery for dogs is only available at a few centers around the world. ur hope now is that breeders will be able to make informed breeding decisions
and avoid breeding dogs that harbor this mutation, thus gradually eliminating the disease from the Newfoundland breed,
says Joshua Stern, a veterinary cardiologist at the University of California, Davis, who led the study. n addition,
now that we know one gene responsible for SAS and more about which proteins are involved, we can move forward to consider novel therapies that may help treat this devastating condition.
The researchers conducted a hole genomeanalysis scanning thousands of genes, which revealed that the mutation associated with SAS resides in a gene called PICALM.
This same gene mutation has been associated with the formation of plaque-like lesions in the brains of people with Alzheimer disease,
Stern says. The researchers also conducted a pedigree analysis in a family of 45 Newfoundland dogs to examine the inheritance pattern of the SAS mutation.
This analysis confirmed that the inheritance follows a certain pattern, by which only one parent needs to be carrying the gene mutation in order for the offspring to inherit the disease,
and that not all dogs carrying the mutation will develop the disease. SAS shows up in the dog heart as abnormal tissue growthften forming a ridge or ring below the aortic valve,
which restricts blood flow from the heart into the aorta. Diagnosing and treating SAS, however, is particularly challenging
because the disease may appear in mild to severe forms. The first sign that a dog has SAS may be a collapse,
Veterinarians sometimes discover the disease when they detect a heart murmur and conduct further diagnostic tests such as chest X-rays,
an echocardiogram, or an electrocardiogram. Dogs with the mild form of SAS may have a normal lifespan.
Those with the severe form, however, often die by the time they turn four years old, even with therapeutic drugs.
Researchers are now beginning to study why SAS is less severe in some dogs while causing severe symptoms in others.
They also are examining the genetic basis of SAS in the golden retriever, Rottweiler, and other dog breeds.
whether a dog carries the PICALM mutation are now available through North carolina State university College of Veterinary medicine
and will soon be available through the Veterinary Genetics Laboratory at the UC Davis School of veterinary medicine.
Pfizer Animal health training grant, and the Newfoundland Club of America supported the research, which appears online in the journal Human genetics r
#Wearable vapor sensor can smell diabetes A wearable vapor sensor could monitor diseases such as diabetes
and hypertension by picking up airborne biomarkers exhaled or released through the skin. ach of these diseases has its own biomarkers that the device would be able to sense,
says Sherman Fan, professor of biomedical engineering at University of Michigan. or diabetes, acetone is a marker, for example.
Other biomarkers it could detect include nitric oxide and oxygen, abnormal levels of which can point to conditions such as high blood pressure, anemia,
or lung disease. Fan is developing the sensor with Zhaohui Zhong an associate professor of electrical and computer engineering,
and Girish Kulkarni, a doctoral candidate in electrical engineering. The device is faster, smaller, and more reliable than its counterparts,
which today are too big to wear. Other applications Beyond disease monitoring, the sensor has other applications.
It would be able to register the presence of hazardous chemical leaks in a lab,
or elsewhere, or provide data about air quality. ith our platform technology, we can measure a variety of chemicals at the same time,
or modify the device to target specific chemicals. There are limitless possibilities, Zhong says. To create their technology
the researchers took a unique approach to detecting molecules. anoelectronic sensors typically depend on detecting charge transfer between the sensor and a molecule in air or in solution,
Kulkarni says. However, these previous techniques typically led to strong bonds between the molecules being detected and the sensor itself.
That binding leads to slow detection rates. Response time: Tenths of a second nstead of detecting molecular charge, we use a technique called heterodyne mixing, in
which we look at the interaction between the dipoles associated with these molecules and the nanosensor at high frequencies,
Kulkarni says. This technique, made possible through the use of graphene, results in extremely fast response times of tenths of a second,
as opposed to the tens or hundreds of seconds typical in existing technology. It also dramatically increases the device sensitivity.
The sensor can detect molecules in sample sizes at a ratio of several parts per billion.
These nanoelectronic graphene vapor sensors can be embedded completely in a microgas chromatography system which is the gold standard for vapor analysis,
The entire microgas chromatography system can be integrated on a single chip with low power operation, and embedded in a badge-sized device that can be worn on the body to provide noninvasive and continuous monitoring of specific health conditions. e believe this device can be extremely beneficial to society,
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