Monitoring the heart’s mitochondria to predict cardiac arrest?

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Credit: Dr. John Kheir, Boston Children’s Hospital & Shutterstock

A new device can assess in real time whether the body’s tissues are receiving enough oxygen and, placed on the heart, can predict cardiac arrest in critically ill heart patients, report researchers at Boston Children’s Hospital and scientists from Cambridge device maker Pendar Technologies. Their study, conducted in animal models, is the cover article in today’s issue of Science Translational Medicine.

 

“With current technologies, we cannot predict when a patient’s heart will stop,” says John Kheir, MD of Boston Children’s Heart Center, who co-led the study. “We can examine heart function on the echocardiogram and measure blood pressure, but until the last second, the heart can compensate quite well for low oxygen conditions. Once cardiac arrest occurs, its consequences can be life-long, even when patients recover.”

The device uses a technology called resonance Raman spectroscopy to measure whether enough oxygen is reaching the mitochondria, the organelles that provide cells with energy. In critically ill patients with compromised circulation or breathing, oxygen delivery is often impaired, making it hard for mitochondria to do their job. This is especially a problem for the heart, which has constant high energy needs.

The current standard for measuring tissue oxygenation, known as mixed venous saturation (SvO2), requires repeated blood draws, adding extra risk in critically ill patients. More importantly, SvO2 cannot tell whether oxygen supply is sufficient to meet the dynamic demands of heart muscle.

“We wanted to create an organ-specific, continuous, reliable readout of how adequately mitochondria are being fed oxygen,” says Kheir. “This is the first demonstration of a device that can monitor mitochondria in living tissues to predict impending organ failure.”

Using light to monitor mitochondria

This technology is the product of a collaboration between the Translational Research Lab in Boston Children’s Heart Center, co-led by Kheir and Brian Polizzotti, PhD, and Pendar Technologies (Cambridge, Mass.). “At the bedside, we saw patients who had a limitation to coronary blood flow, and wanted a device that could provide an early warning sign,” Kheir says.

The team created a metric they call 3RMR that uses light readings generated by resonance Raman spectroscopy to quantify oxygenation and mitochondrial function in real time.

 

Read More: http://snip.ly/bt6o8#https://scienmag.com/monitoring-the-hearts-mitochondria-to-predict-cardiac-arrest-2/

Immune cells may heal bleeding brain after strokes

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Credit: Courtesy of Aronowski lab, University of Texas Health Science Center, Houston.

While immune cells called neutrophils are known to act as infantry in the body’s war on germs, a National Institutes of Health-funded study suggests they can act as medics as well. By studying rodents, researchers showed that instead of attacking germs, some neutrophils may help heal the brain after an intracerebral hemorrhage, a form of stroke caused by ruptured blood vessels. The study suggests that two neutrophil-related proteins may play critical roles in protecting the brain from stroke-induced damage and could be used as treatments for intracerebral hemorrhage.

“Intracerebral hemorrhage is a damaging and often fatal form of stroke for which there are no effective medicines,” said Jaroslaw Aronowski, M.D., Ph.D., professor, department of neurology, at the University of Texas Health Science Center at Houston, and senior author of the study published in Nature Communications. “Our results are a hopeful first step towards developing a treatment for this devastating form of stroke.”

Accounting for 10 to 15 percent of all strokes, intracerebral hemorrhages happen when blood vessels rupture and leak blood into the brain, often leading to death or long-term disability. Chronic high blood pressure is the leading risk factor for these types of strokes. The initial phase of damage appears to be caused by the pressure of blood leaking into the brain. Over time, further damage may be caused by the accumulation of toxic levels of blood products, infiltrating immune cells, and swelling.

 

Decades of research suggest that neutrophils are some of the earliest immune cells to respond to a hemorrhage, and that they may both harm and heal the brain. In this study, the researchers found that interleukin-27 (IL-27), a protein that controls the activity of immune cells, may shift the role of neutrophils from harming the brain to helping with recovery.

Injections of IL-27 after a hemorrhage helped mice recover. Days after the strokes, the treated mice had better mobility, including walking, limb stretching and navigating holes in a floor. In contrast, injections of an antibody that blocked natural IL-27 activity slowed recovery. The brains of the mice treated with IL-27 also showed less damage. They had less swelling around the hemorrhages and lower levels of iron and the blood protein hemoglobin, both of which are toxic at high

Read More: http://snip.ly/5llk8#https://scienmag.com/immune-cells-may-heal-bleeding-brain-after-strokes/

Brain Activity and Good Diet May Prevent Insomnia-Related Depression

Brain Activity and Good Diet May Prevent Insomnia-Related Depression
While lack of sleep is a major risk factor for depression, not everyone who tosses and turns at night becomes depressed. According to a study, individuals whose brains are more attuned to rewards may be protected from the negative mental health effects of poor sleep. The findings revealed that students with poor quality sleep were less likely to have symptoms of depression if they also had higher activity in a reward-sensitive region of the brain.”This helps us begin to understand why some people are more likely to experience depression when they have problems with sleep,” said Ahmad Hariri, Professor at the Duke University in North Carolina, US. “This finding may one day help us identify individuals for whom sleep hygiene may be more effective or more important,” Hariri added.

For the study, appearing in The Journal of Neuroscience, the team examined a region deep within the brain called the ventral striatum in 1,129 college students. Ventral striatum helps regulate behaviour in response to an external feedback as well as reinforce behaviours that are rewarded, while reducing behaviours that are not. The results showed that those who were less susceptible to the effects of poor sleep showed significantly higher brain activity in response to positive feedback or reward compared to negative feedback.

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The effects of poor sleep showed significantly higher brain activity

“Poor sleep is not good, but you may have other experiences during your life that are positive. And the more responsive you are to those positive experiences, the less vulnerable you may be to the depressive effects of poor sleep,” Hariri said.

 

Read More: http://snip.ly/ttax2#http://food.ndtv.com/health/brain-activity-and-good-diet-may-prevent-insomnia-related-depression-1753267

Shipley Center Website Offers Prostate Cancer Facts for Patients

One in every seven men in the United States will get prostate cancer, making it the second most common type, after skin cancer, for American men. It tends to be a slow-growing disease, but can sprint to life-threatening severity if detected too late. Screening for prostate cancer can yield false-positive findings, but those most at risk for the disease—men whose father or a brother had prostate cancer, African American men, overweight men, and those in their 60s and 70s who are in good health and could expect years more of life—still should ask their doctors whether screening makes sense for them.

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The website for the Shipley Prostate Cancer Research Center provides basic information about the prostate gland and how disease affects it.

That information comes from the just-launched website of the Shipley Prostate Cancer Research Center at the School of Medicine. Created with a $10.5 million gift from BU trustee Richard Shipley (Questrom’68,’72), the center’s labs will be in the Conte Building on the Medical Campus when it opens. The center’s research will be focused on finding genomic approaches to determine which prostate cancers are aggressive and need treatment, and which can simply be monitored.

The center’s website and its Facebook page and Twitter account are up and running now, offering easy-to-follow, impartial information on practically everything anyone needs to know about prostate cancer. There’s “Prostate 101,” an overview about the prostate, information about prostate cancer and getting a second opinion, and a checklist of symptoms; information on screening; treatment options; and the state of research.

This knowledge is available to patients everywhere, “irrespective of where they choose to get their medical care or where they are in terms of testing, diagnosis, or treatment,” says site editor Gretchen Gignac, a School of Medicine associate professor of hematology and medical oncology.

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Most cases of prostate cancer are slow-growing tumors that have a very high cure rate, but some cases are fast-growing.

For its founding donor, the center is as much a beacon of information to patients as an incubator for medical research. Shipley was diagnosed with prostate cancer in 2014 and chose focal laser ablation, a new and less invasive treatment than surgery and other therapies.

“The website will be unique in that it will provide up-to-date information, both on diagnostic and treatment options, in a form the layman can easily understand,” Shipley says.

Read More: http://snip.ly/olj5q#http://www.bu.edu/today/2017/shipley-center-website-offers-prostate-cancer-facts-for-patients/

Hermetic Packaging, Connectors for Medical Implant Industry

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Hermetic Implantable Packaging and Connectors for Medical Components

PA&E works with leading medical implant designers to advance integration and performance for hermetic implantable packaging and connectors in one of the most unique and critical environments known: the human body.

PA&E has created proprietary materials and encapsulations with hermetic seals that enable implantable medical devices to bypass the human body’s natural defenses and perform with greater reliability.

Precision Machining of Implantable Devices

PA&E’s unique precision machining techniques for materials and components are used to create implantable packaging and connectors for applications such as: cochlear implants, pacemakers, and other cardiac-function implants.

Here’s what PA&E can offer to medical implant designers:

Implantable Packaging and Connectors Example
PA&E’s unique brazing technologies allows materials like titanium and zirconia to be hermetically joined for applications that require an RF transparent package.

Medical Implantable Packaging — Devices implanted in the human body are at the leading edge of medical science. Advancing that technology and making more implantable medical components and devices possible requires overcoming several complex challenges. For example, medical implants must be as small as possible. However, the performance of new devices is often constrained by material selection and thickness. External communication with the implant is critical. Current communication technology relies on case material and size. Reliability and implantable viability are always issues because it is important that the body does not reject a newly-implanted device.

Read More: http://snip.ly/14fsc#http://pacaero.com/industries/medical/

Gauteng Health head office: Sheriff attaches furniture due to non-payment of negligence claim

Gauteng Health head office

Staff at the Gauteng Department of Health provincial head office are without equipment to do their work after the Sheriff of the Court attached two truckloads of furniture on Thursday following a failure by the department to pay court-ordered damages related to a hospital negligence case. By ORATENG LEPODISE.

If you walk into several offices at the provincial health department’s head office at the Bank of Lisbon building in downtown Johannesburg, you are likely to find administrative staff sitting on the floor.

On Thursday the sheriff arrived at the offices and removed two truckloads of furniture from four floors in the building in a bid to force the department to settle payment of a R6.2-million negligence claim awarded against it.

The negligence claim relates to a protracted legal battle between the department and the parents of a child who suffered brain damage during birth at the Pholosong Hospital in December 2009. The seven-year legal battle drew to a close on March 8 with a cost order being awarded against the department.

But it is yet to settle.

“It is a terrible injustice that this case has dragged on for more than seven years, with further suffering for the child and her family, and now the department delays further,” said Jack Bloom, the DA’s Gauteng Shadow MEC for Health.

On Thursday, according to the writ of attachment, the sheriff removed:

• 400 desks;

• 600 chairs
;

• 400 computers;

• 200 filing cabinets
;

• 50 printers
;

• 10 fridges;

• 10 microwaves; and

• three lounge suites

Asked by Daily Maverick to comment on the attachment of its furniture, its impact on the health department staff to do their work and on the department’s failure to pay the negligence claim, department spokesman Prince Hamnca said: “All I am willing to say is that we are concerned that the furniture has been taken from the offices, but that was a court order from the Sheriff.”

“I am appalled that the department has yet again disregarded a court-ordered payment,” said Bloom, while accusing the Gauteng Health MEC, Gwen Ramokgopa, of downplaying the effect of the removal of truckloads of furniture.

An employee at the department and branch secretary of the National Health, Education and Allied Workers Union, Charles Phasa, said the working conditions were “very bad” as everything with any value was taken.

“This is not something new. Every year the sheriff comes in and the department waits until the 11th hour to negotiate some sort of way to cover their payments, but this time around it is just too much,” Phasa said.

According to Phasa the department has urged its workers to be patient while it attempted to address the issue.

The health department finds itself in a pool of debt which includes outstanding payments to suppliers and medical negligence cases and in May this year faced a R10.9-billion funding gap as budgeted funds were all taken up by salaries, accumulated debt and payments for negligence.

Medical negligence claims have increased significantly in recent years. From just over R8-million paid out by the Gauteng Department of Health in 2010/11, almost R154-million was paid out by the same department in 2013/14. Contingent liabilities for medical malpractice (money that the department would have to pay should all medical negligence claimants be successful in their claims) in 2016 in Gauteng sat at over R13-billion.

Bloom said the Gauteng Provincial Government was being destabilised by the endless financial woes of the Health Department, which faces a potential medico-legal liability of more than R13-billion and owes large sums to suppliers as well.

“Delays in payment also add to the costs as a 10.5% penalty interest is charged – in this case, this amounts to more than R300,000,” Bloom said. DM

Photo: Gauteng premier David Makhura speaks at a Gauteng township economy revitalisation summit in Soweto, Tuesday, 7 October 2014. Picture: Werner Beukes/SAPA

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