#Sepsis sniffer generates faster sepsis care, suggests reduced mortality An automated early warning and response system for sepsis developed by Penn Medicine experts has resulted in a marked increase in sepsis identification
and care transfer to the ICU and an indication of fewer deaths due to sepsis. A study assessing the tool is published online in the Journal of Hospital Medicine.
Sepsis is a potentially life-threatening complication of an infection; it can severely impair the body's organs causing them to fail.
There are as many as three million cases of severe sepsis and 750000 resulting deaths in the United states annually.
Early detection and treatment typically with antibiotics and intravenous fluids is critical for survival. The Penn prediction tool dubbed the sepsis sniffer uses laboratory
and vital-sign data (such as body temperature heart rate and blood pressure) in the electronic health record of hospital inpatients to identify those at risk for sepsis.
When certain data thresholds are detected the system automatically sends an electronic communication to physicians nurses and other members of a rapid response team who quickly perform a bedside evaluation
and take action to stabilize or transfer the patient to the intensive care unit if warranted. The study developed the prediction tool using 4575 patients admitted to the University of Pennsylvania Health System (UPHS) in October 2011.
The study then validated the tool during a pre-implementation period from June to September 2012
two to threefold increase in orders for tests that could help identify the presence of sepsis 1. 5 to twofold increase in the administration of antibiotics
and intravenous fluids n increase of more than 50 percent in the proportion of patients quickly transferred to the ICU 50 percent increase in documentation of sepsis in the patients'electronic health recordthe study found a lower death rate from sepsis
Previous studies that have examined the impact of sepsis prediction tools at other institutions have taken only place on a limited number of inpatient wards.
and practice cultures across our health system increases the generalizability of our findings to other health care settings.
By better identifying those with sepsis requiring advanced care the tool can help screen out patients not needing the inevitably limited number of ICU beds.
or biological contaminants with far-reaching implications for public health including homeland security concerns. Applying world class research to water quality has to be viewed as a critical component for sustaining society as a whole says Clarkson University President Tony Collins. As healthy water becomes increasingly scarce establishing real-time data as the new standard for understanding water quality around the globe
The ability to mold inorganic nanoparticles out of materials such as gold and silver in precisely designed 3d shapes is a significant breakthrough that has the potential to advance laser technology microscopy solar cells electronics environmental testing disease
These coatings can also help scientists develop highly sensitive multiplex methods of detecting early-stage cancers
and genetic diseases by combining the chemical specificity of the DNA with the signal readout of the metal.
This capability should open up entirely new strategies for fields ranging from computer miniaturization to energy and pathogen detection.
and tax base needed to fund pensions health care and other benefits for the elderly it is typically families that bear the brunt of the cost of having children the study found.
#Lung cancer can stay hidden for over 20 years UK scientists have discovered that lung cancers can lie dormant for over 20 years before suddenly turning into an aggressive form of the disease according to a study published in Science*today (Thursday.
They found that after the first genetic mistakes that cause the cancer it can exist undetected for many years until new additional faults trigger rapid growth of the disease.
This research--jointly funded by Cancer Research UK and the Rosetrees Trust--highlights the need for better ways to detect the disease earlier.
Two-thirds of patients are diagnosed with advanced forms of the disease when treatments are less likely to be successful.
By revealing that lung cancers can lie dormant for many years the researchers hope this study will help improve early detection of the disease.
Study author Professor Charles Swanton at Cancer Research UK's London Research Institute and the UCL Cancer Institute said:
Survival from lung cancer remains devastatingly low with many new targeted treatments making a limited impact on the disease.
By understanding how it develops we've opened up the disease's evolutionary rule book in the hope that we can start to predict its next steps.
The study also highlighted the role of smoking in the development of lung cancer. Many of the early genetic faults are caused by smoking.
But as the disease evolved these became less important with the majority of faults now caused by a new process generating mutations within the tumour controlled by a protein called APOBEC.
The wide variety of faults found within lung cancers explains why targeted treatments have had limited success. Attacking a particular genetic mistake identified by a biopsy in lung cancer will only be effective against those parts of the tumour with that fault leaving other areas to thrive
and despite some positive steps being made against the disease it remains one of the biggest challenges in cancer research with fewer than 10 per cent surviving for at least five years after diagnosis. Building on this research will be a key priority for the recently established Cancer
The Centre--where Professor Swanton is joint centre lead--is a key part of Cancer Research UK's renewed focus to beat lung cancer;
Professor Nic Jones Cancer Research UK's chief scientist said: This fascinating research highlights the need to find better ways to detect lung cancer earlier
If we can nip the disease in the bud and treat it before it has started travelling down different evolutionary routes we could make a real difference in helping more people survive the disease.
Building on this work Cancer Research UK is funding a study called TRACERX which is studying 100s of patient's lung cancers as they evolve over time to find out exactly how lung cancers mutate adapt
and become resistant to treatments Story Source: The above story is provided based on materials by Cancer Research UK.
Note: Materials may be edited for content and length. Journal Reference e
#Unusual skin cancer linked to chronic allergy from metal orthopedic implant In rare cases patients with allergies to metals develop persistent skin rashes after metal devices are implanted near the skin.
New research suggests these patients may be increased at risk of an unusual and aggressive form of skin cancer.
Metal alloys help make orthopedic implants stronger and more durable. But people with sensitivity to these metals which include nickel cobalt
and Barnes-Jewish Hospital in St louis. The team's findings were published online Oct 8 in the Journal of Clinical Investigation.
The researchers were alerted to the connection by a patient who had surgery at another hospital to have a metal rod implanted to repair a fractured ankle.
After the surgery the patient developed a skin rash on her ankle near the location of the implant.
The patient turned out to be allergic to nickel in the implant which led surgeons at the other hospital to remove it.
But the rash persisted and a few years later a rare form of skin cancer known as Marjolin's ulcer developed at the surgical site.
The cancer which had become painful and ulcerated was diagnosed and removed by physicians at Barnes-Jewish Hospital.
The researchers showed in mouse models that chronic skin inflammation caused by continuous skin contact with allergens contributes to tumor development.
The finding suggests that patients with metal implants near the skin may need to be monitored for this type of inflammation according to the researchers.
The results likely also will lead to debate and further research on whether physicians should test for metal sensitivity in patients preparing for surgery to get these types of implants.
Chronic inflammation from metal implants can cause joint pain and swelling and contribute to joint failure.
And when these implants are placed near the skin fewer than 5 percent of patients develop an inflammatory rash related to the implant.
The patient's diagnosis with Marjolin's ulcer an invasive and potentially deadly squamous cell cancer surprised physicians.
The patient was under 50 years old and Marjolin's ulcer is extremely rare in people who are young and otherwise healthy.
This type of cancer most often is identified in patients with a previous history of skin cancers
but this patient had had never skin cancer. To investigate whether inflammation from the implant contributed to the tumor the researchers studied mouse models of contact allergy.
A contact allergy is a different kind of reaction from allergies to pollen pet dander or food said senior author Wayne M. Yokoyama MD a Howard hughes medical institute investigator at the School of medicine.
A contact allergy usually develops when an allergen touches the skin or is close to it.
Skin rash in response to nickel and poison ivy are two common examples of contact allergies. The researchers showed that contact allergy brings inflammatory cells and molecules to the site of the allergic reaction.
If the contact allergen remains a long time--as was the case with the patient's implant--different inflammatory cells
and molecules become active at the site of the reaction. The new mix of cells and molecules promotes the development of skin tumors.
This model supported cancer development so strongly that some mice developed invasive squamous cell skin cancers similar to the patient's tumor said lead author Shadmehr Demehri MD Phd a dermatologist
and postdoctoral fellow. When the researchers examined the cells and molecules involved in chronic contact allergy in mice they identified several that already had been linked to tumor development.
Some of these cells and molecules also were present in biopsy samples from the patient's ankle.
The scientists are working to identify which inflammatory cells and molecules are most supportive of cancer formation.
If you're allergic to something the first thing to do is to avoid it but the patient couldn't said Yokoyama the Sam and Audrey Loew Levin Professor of Medicine.
Some nickel had seeped likely from it into her tissue and was still present in her skin even after the implant was removed.
It's as if a patient allergic to poison ivy kept putting poison ivy on the skin. To prevent such adverse events the researchers suggested that the potential for allergic reactions to metal implants be assessed in patients who have had the implants
and in patients preparing to receive them. Allergen-free versions of some implants are said available Demehri.
These versions may cost more or be less durable but for some patients with sensitivity to metals they may be the best option.
Similar to metal implants some dental restoration materials and tattoo inks contain substances associated with allergic reactions and cancers on the skin or in the mouth.
Those clinical observations also could be explained by the new findings. The researchers suggested that the potential for these other allergens to promote skin cancer needs to be examined further.
Story Source: The above story is provided based on materials by Washington University in St louis. Note: Materials may be edited for content and length.
Journal Reference e
#Plasmonic paper for detecting trace amounts of chemicals, pollutants and more Using a common laboratory filter paper decorated with gold nanoparticles,
researchers at Washington University in St louis have created a unique platform, known as"plasmonic paper, "for detecting and characterizing even trace amounts of chemicals and biologically important molecules-from explosives, chemical warfare agents and environmental pollutants to disease markers.
The work will be described by Srikanth Singamaneni, assistant professor in the department of mechanical engineering and materials science at Washington University in St louis,
and medical diagnostic applications.""For example, Tian noted, the plasmonic paper can be used to detect target molecules that serve as indicators for diseases such as kidney cancer."
"We believe that we have a platform technology that nicely lends itself for such applications,
including the disambiguation of electroencephalograph patterns from epileptic seizure patients; detection of anomalous cardiac activity from heart recordings;
#Giant leap for diabetes: From human embryonic stem cells to billions of human insulin producing cells Harvard stem cell researchers announced that they have made a giant leap forward in the quest to find a truly effective treatment for type 1 diabetes,
a condition that affects an estimated three million Americans at a cost of about $15 billion annually:
when his then infant son Sam was diagnosed with type 1 diabetes, dedicated his career to finding a cure for the disease,
said he hopes to have human transplantation trials using the cells to be underway within a few years."
"We are now just one preclinical step away from the finish line, "said Melton, whose daughter Emma also has type 1 diabetes.
A report on the new work has been published by the journal Cell. Felicia W. Pagliuca, Jeff Millman,
and opened the door for drug discovery and transplantation therapy in diabetes, "Fuchs said. And Jose Oberholtzer, M d.,Associate professor of Surgery, Endocrinology and Diabetes,
and Bioengineering at the University of Illinois at Chicago, and its Director of the Islet and Pancreas Transplant Program and the Chief of the Division of Transplantation, said work described in today's Cell"will leave a dent in the history of diabetes.
Doug Melton has put in a life-time of hard work in finding a way of generating human islet cells in vitro He made it.
Type 1 diabetes is an autoimmune metabolic condition in which the body kills off all the pancreatic beta cells that produce the insulin needed for glucose regulation in the body.
Thus the final preclinical step in the development of a treatment involves protecting from immune system attack the approximately 150 million cells that would have to be transplanted into each patient being treated.
the Samuel A. Goldblith Professor of Applied Biology, Associate professor in the Department of Chemical engineering, the Institute of Medical Engineering and Science,
Cell transplantation as a treatment for diabetes is still essentially experimental, uses cells from cadavers, requires the use of powerful immunosuppressive drugs,
MIT's Anderson said the new work by Melton's lab is"an incredibly important advance for diabetes.
human beta cells through controlled differentiation of stem cells will accelerate the development of new therapeutics.
In particular, this advance opens to doors to an essentially limitless supply of tissue for diabetic patients awaiting cell therapy."
This significant accomplishment has the potential to serve as a cell source for islet replacement in people with type 1 diabetes
and may provide a resource for discovery of beta cell therapies that promote survival or regeneration of beta cells and development of screening biomarkers to monitor beta cell health and survival to guide therapeutic
strategies for all stages of the disease.""Melton expressed gratitude to both the Juvenile diabetes Research Foundation and the Helmsley Trust, saying"their support has been,
"While diabetics can keep their glucose metabolism under general control by injecting insulin multiple times a day,
and that lack of control leads to devastating complications from blindness to loss of limbs.
About 10 percent of the more than 26 million Americans living with type 2 diabetes are also dependent upon insulin injections,
and would presumably be candidates for beta cell transplants, Melton said.""There have been previous reports of other labs deriving beta cell types from stem cells,
#Multiple neurodevelopmental disorders have a common molecular cause Neurodevelopmental disorders such as Down syndrome and autism-spectrum disorder can have profound lifelong effects on learning
and memory but relatively little is known about the molecular pathways affected by these diseases. A study published by Cell Press October 9th in the American Journal of Human genetics shows that neurodevelopmental disorders caused by distinct genetic mutations produce similar molecular effects in cells suggesting that a one-size-fits-all therapeutic approach could be effective
for conditions ranging from seizures to attention-deficit hyperactivity disorder. Neurodevelopmental disorders are rare meaning trying to treat them is not efficient says senior study author Carl Ernst of Mcgill University.
Once we fully define the major common pathways involved targeting these pathways for treatment becomes a viable option that can affect the largest number of people.
but the genetic factors responsible for these diseases are very complex. For example whereas common variants in the same gene have been associated with two
or more different disorders mutations in many different genes can lead to similar diseases. As a result it has not been clear
and his team used human fetal brain cells to study the molecular effects of reducing the activity of genes that are mutated in two distinct autism-spectrum disorders.
Changes in transcription factor 4 (TCF4) cause 18q21 deletion syndrome which is characterized by intellectual disability and psychiatric problems and mutations in euchromatic histone methyltransferase 1 (EHMT1) cause similar symptoms in a disease known as 9q34 deletion syndrome.
Interfering with the activity of TCF4 or EHMT1 produced similar molecular effects in the cells.
Our study suggests that one fundamental cause of disease is that neural stem cells choose to become full brain cells too early Ernst says.
This could affect how they incorporate into cellular networks for example leading to the clinical symptoms that we see in kids with these diseases s
#Gene that drives aggressive brain cancer found by new computational approach Using an innovative algorithm that analyzes gene regulatory and signaling networks,
Columbia University Medical center (CUMC) researchers have found that loss of a gene called KLHL9 is the driving force behind the most aggressive form of glioblastoma, the most common form of brain cancer.
The CUMC team demonstrated in mice transplants that these tumors can be suppressed by reintroducing KLHL9 protein,
offering a possible strategy for treating this lethal disease. The study was published today in the online issue of Cell.
and heritable variants that have been linked to breast cancer and Alzheimer's disease, suggesting that the algorithm, combined with the researchers'sophisticated computer models of cellular regulation, is a powerful method for identifying genetic drivers of a wide range of diseases."
"This algorithm adds a new dimension to our ability to identify the genetic causes of complex disease.
When combined with other tools that our lab has developed, it will help identify many more genes that hold potential as genetic biomarkers of disease progression
and targets for treatment,"said study leader Andrea Califano, Phd, the Clyde and Helen Wu Professor of Chemical Biology (in Biomedical Informatics and the Institute for Cancer Genetics), chair of the Department of Systems Biology,
and director of the JP Sulzberger Columbia Genome Center, at Columbia's College of Physicians and Surgeons.
In previous studies Dr. Califano and his colleagues used high-power computer models to demonstrate that certain types of cancer have conserved highly"master regulators"--genes
whose individual or synergistic activity is necessary for disease to develop and persist. However, these models provided no information on the key genetic mutations that presumably drive the abnormal activity of these master regulators.
In the current study, the team combined its existing computational tools with a new algorithm called DIGGIT (for Driver-Gene Inference by Genetical-Genomic Information theory),
which"walks"backward from the master regulators to find the genetic events that drive cancer."
"Conventional techniques, like genome-wide association studies, must test all possible genetic mutations and variants in a disease cell, compared with a normal cell,
"The new approach was tested on mesenchymal glioblastoma, the most aggressive subtype of the disease, by jointly analyzing the gene expression
and mutational profile data of more than 250 patients collected by the Cancer Genome Atlas consortium.
C/EBPD, had already been identified by the labs of Dr. Califano and of Antonio Iavarone, MD, professor of neurology and of pathology & cell biology (in the Institute for Cancer Genetics),
as a master regulator of the disease, so the researchers focused on KLHL9, which had never been tied to this or any other form of cancer.
In subsequent laboratory studies, the researchers reactivated the defective KLHL9 gene in aggressive glioblastoma cells,
When KLHL9 protein was reintroduced into mice receiving direct transplants from patients with mesenchymal glioblastoma, their tumors regressed, providing further evidence that KLHL9 mutations
(which were found in 50 percent of the mesenchymal glioblastoma patients), are directly responsible for driving this cancer subtype.
DIGGIT may be applicable to other complex diseases. In further studies by the Califano team, the algorithm identified 35 genes as drivers of breast cancer.
Of the 25 genes previously identified in the literature 19 (76 percent) were identified by DIGGIT,
confirming that the algorithm is capable of capturing driver mutations in other types of cancer.
In a study of Alzheimer's disease, DIGGIT found 14 genetic variants that appear to drive the condition,
that had not been connected previously with the disease and that are currently being investigated.""It's important to stress that this constitutes an important improvement over traditional gene-association studies.
The latter can identify statistical associations between mutations and disease, but cannot explain how the mutation drives that effect,
"Because DIGGIT identifies disease-causing genes by tracing their aberrant activity through the regulatory network of the cell,
it provides direct information on the specific molecular interactions through which a genetic mutation causes disease--the'mechanism.'
""Even in our studies of breast cancer and Alzheimer's disease, where the goal was simply to show that DIGGIT could identify mutations
which these mutations likely work to drive disease, adding significant new knowledge that can be tested rapidly in the lab"Dr. Chen said a
whether defects in these mechanisms might even contribute to human disease. tory Source: The above story is provided based on materials by Whitehead Institute for Biomedical Research.
The original article was written by Nicole Giese Rura. Note: Materials may be edited for content and length.
what type of chemotherapy you attack a tumor with, many cancer cells resort to the same survival tactic:
"This gives us a therapeutic avenue to target autophagy in tumors, "said Josh Andersen, a BYU chemistry professor."
"The idea would be to make tumors more chemo-sensitive. You could target these proteins and the mechanism of this switch to block autophagy,
they forced tumor cells to undergo autophagy by depriving them of oxygen and glucose. A comparison with a control group let them see that the two proteins hook up only when under attack.
That's because stress makes Atg9 undergo a modification that enables 14-3-3 zeta to bind with it
Andersen notes that several medicines already exist that could block autophagy and make chemotherapy more effective.
#Minimally invasive surgery with hydraulic assistance Endoscopic surgery requires great manual dexterity on the part of the operating surgeon.
Their outstanding sensitivity simplifies the biopsy procedure. Minimally invasive techniques, also known as"keyhole surgery,"enable surgeons to operate on patients without requiring major incisions.
This method causes much less trauma for the patient, and is used commonly when performing lung, esophageal and joint biopsies,
and most especially when operating inside the abdominal cavity. An endoscope is inserted through one or two small incisions in the abdominal wall
allowing the internal organs to be visualized for surgery. Surgical techniques have advanced by leaps and bounds in recent years.
The same cannot be said for surgical instruments. In certain types of endoscope, the tip can be oriented at different angles."
and even physical strength on the part of the surgeon, has changed barely since the earliest days of endoscopy,"says Timo Cuntz, a member of the Project Group for Automation in Medicine and Biotechnology PAMB in Mannheim, a part of the Fraunhofer Institute for Manufacturing Engineering and Automation IPA.
The force required to deflect the tip is transmitted by a wire mechanism known as a Bowden cable (similar to a bicycle brake cable.
The cable mechanism transmits the surgeon's hand movements at one end to the tiny instruments at the other extremity of the endoscope.
making it difficult for the surgeon to manipulate the tissue precisely.""The surgeon's work would be made much easier
if it were possible to reduce the friction and increase the power density. Hydraulic instruments are one of the alternatives being considered as a substitute for mechanical transmission based on Bowden cable."
They allow the surgeon to carry out much finer movements, "says the engineer. A plastic tube filled with a sterile,
biocompatible fluid based on medicinal white oil is used in place of the wire cable. To control the attached instruments and orient the tip of the endoscope,
the surgeon manipulates a hydraulic cylinder or robotic muscle that exerts the required pressure to compress the fluid and push it through the hydraulic tube onto a second, spring-mounted cylinder.
Such hydraulically actuated instruments are suited ideally for use in connection with a technique known as natural orifice transluminal endoscopic surgery (NOTES),
in which the surgeon operates through natural body orifices in order to access internal organs; going through the stomach, for instance,
#Mining big data yields Alzheimers discovery Scientists at The University of Manchester have used a new way of working to identify a new gene linked to neurodegenerative diseases such as Alzheimer's.
which is linked to a group of neurodegenerative diseases. The study has just been published in the journal BMC Genomics.
"Ultimately this could provide another biomarker in the toolkit for identifying those at greatest risk of developing diseases such as Alzheimer's."
but also the networks it uses to influence a disease like Alzheimer's. We believe this information will be incredibly useful for future studies looking at treatments and preventative measures."
advancing our knowledge of diseases and ultimately improving detection and treatment
Overtext Web Module V3.0 Alpha
Copyright Semantic-Knowledge, 1994-2011