Treating the pain of endometriosis



Many women suffer through years of painful menstrual periods before they are able to get an answer about what’s causing them: a common and often undiagnosed condition called endometriosis.

What is endometriosis?

Endometriosis is a condition that occurs when tissue much like the tissue that lines a woman’s uterus — called the endometrium — starts to grow in other places inside the body. Most commonly, these growths are within the pelvis, such as on the ovaries, the fallopian tubes, the outer surface of the uterus, or the bladder.

During the menstrual cycle each month, the tissue lining the uterus grows thicker, then breaks down as blood that exits through the vagina. The wayward tissue growths of endometriosis respond to the same hormones as the uterine lining. But instead of draining through the vagina as a menstrual period, blood from tissue growth elsewhere in the body has nowhere to go. It pools around nearby organs and tissues, irritating and inflaming them, and sometimes causing scarring. In addition to pain, endometriosis can cause other symptoms, such as bowel- and bladder-related problems, heavy periods, sexual discomfort, and infertility.

Diagnosing endometriosis may take time

In some cases, diagnosis of endometriosis is delayed because teenagers and adult women assume that their symptoms are a normal part of menstruation. Those who do seek help are sometimes dismissed as overreacting to normal menstrual symptoms. In other cases, the condition may be mistaken for other disorders, such as pelvic inflammatory disease or irritable bowel syndrome.

A study by the World Endometriosis Research Foundation found that among women ages 18 to 45, there was an average delay of seven years between the first symptoms and the time of diagnosis. Most cases are diagnosed when women are in their 30s or 40s. The problem of getting an accurate diagnosis and treatment is worse for some minority groups, including people of color and indigenous people, according to the Endometriosis Foundation of America.

Getting relief from endometriosis

While there is no known cure for endometriosis, the good news is that medications, surgery, and lifestyle changes can help you find relief and manage the condition.

Your doctor might recommend one or more treatments to help relieve pain and other symptoms. These include:

  • Nonsteroidal anti-inflammatory (NSAID) medications. These may be either prescription or over-the-counter formulations, including ibuprofen (Advil, Motrin) and naproxen (Aleve), which are used to relieve pain.
  • Hormone therapies. Because endometriosis is driven by hormones, adjusting the hormone levels in your body can sometimes help to reduce pain. Hormone medications are prescribed in different forms, from pills, vaginal rings, and intrauterine devices to injections and nasal sprays. The goal is to modify or halt the monthly egg-releasing cycle that generates much of the pain and other symptoms linked with endometriosis.
  • Acupuncture. This is an alternative medicine treatment, which uses small needles applied at specific sites on the body to relieve chronic pain.
  • Pelvic floor physical therapy. This practice addresses problems with the pelvic floor, a bowl-shaped group of muscles inside the pelvis that supports the bladder, bowel, rectum, and uterus. Pelvic pain sometimes occurs when muscles of the pelvic floor are too tight, causing muscle irritation and muscular pain, known as myofascial pain. To treat myofascial pain, a specially trained physical therapist uses her hands to perform external and internal manipulations of the pelvic floor muscles. Relaxing contracted and shortened muscles can help alleviate pain in the pelvic floor, just as it would in other muscles in the body.
  • Cognitive behavioral therapy. Another option to help manage pain is cognitive behavioral therapy (CBT). Although few studies have looked at the effects of CBT on endometriosis symptoms, it has been used to successfully manage other conditions that cause chronic pain. CBT is based on the idea that healthier thought patterns can help reduce pain and disability, and help people cope with pain more effectively.
  • Stress management. Experiencing chronic pain can cause stress, which may heighten sensitivity to pain, creating a vicious cycle. Because stress can make pain worse, stress management is an important component of endometriosis management.
  • Lifestyle improvements. Maintaining a regular exercise program, a healthy sleep schedule, and a healthful, balanced diet can help you better cope with and manage stress related to your endometriosis.
  • Surgery. Your doctor may recommend surgery to remove or destroy abnormal tissue growth, to help improve your quality of life or your chances of getting pregnant. Some studies have shown that removing growths of abnormal tissue and scar tissue caused by mild to moderate endometriosis can increase the likelihood of getting pregnant.

Ultimately, it may take time to find the right combination of treatments to ease pain and manage this condition. But working closely with your doctor makes it more likely that you will be able to do so.

The post Treating the pain of endometriosis appeared first on Harvard Health Blog.



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NHS is treating 22 hospitals’ worth of coronavirus patients – but ICU is no busier than normal


Sir Simon Stevens

The NHS will move back to its highest alert level from midnight tonight in anticipation of a wave of coronavirus hospital admissions in the coming weeks. 

Sir Simon Stevens – NHS England’s chief executive – said the move to level four was in response to the ‘serious situation ahead’.

He claimed the NHS is currently treating the equivalent of 22 hospitals’ worth of Covid-19 patients and believes numbers will surpass levels seen in the first wave by the end of this month.

Sir Simon said: ‘The facts are clear, we are once again facing a serious situation. This is not a situation that anybody wanted to find themselves in, the worst pandemic in a century, but the fact is that the NHS is here.’

The health service was originally put on a level four alert in January ahead of the first peak of the epidemic, but it was downgraded in August when England successfully flattened its curve through lockdown.

However, a mid-September surge in cases has resulted in thousands of coronavirus-infected patients pouring into hospitals across the country in recent weeks, particularly in hotspots in the north. There were fewer than 500 Covid-19 patients in England’s hospitals at the start of September, compared to more than 10,000 now.

A move to level four means health bosses believe there is a real threat that the influx of Covid-19 patients could start to disrupt other vital services on a national scale.

Triggering the alert means all trusts have to report to NHS England centrally so it can track capacity levels in every region and reallocate equipment, staff and capacity in the worst-affected areas.  

But Sir Simon urged people without Covid-19 not to stop using the NHS. Report after report has shown hundreds more Brits than average are dying in their houses every week, which experts believe is because they are hesitant to use the NHS for fear of catching Covid-19 or burdening the health service.

Sir Simon said: ‘The public can help us help you so our fantastic staff – our nurses, our doctors, our paramedics – can get on with looking after you and your family there when you need it.’ 

 

Leaked documents, seen by The Telegraph, revealed intensive care units are no busier than normal for this time of year for most trusts, pouring extra cold water on claims the NHS is close to being overrun

Leaked documents, seen by The Telegraph, revealed intensive care units are no busier than normal for this time of year for most trusts, pouring extra cold water on claims the NHS is close to being overrun

It comes after a leaked document showed hospital bed occupancy this year dropped to its lowest percentage for a decade when medics had to turf out thousands of inpatients to make room for a predicted surge in people with Covid-19. Now that normal care has resumed, a leaked report suggests there are still fewer than average numbers of beds in use

It comes after a leaked document showed hospital bed occupancy this year dropped to its lowest percentage for a decade when medics had to turf out thousands of inpatients to make room for a predicted surge in people with Covid-19. Now that normal care has resumed, a leaked report suggests there are still fewer than average numbers of beds in use 

Sir Simon claimed the health service had filled ‘another two hospitals full of severely ill coronavirus patients’ since Saturday, when Boris Johnson announced the second national lockdown

No10 justified the blanket draconian measures on frightening projections that the NHS could run out of beds within weeks.  

Echoing the gloomy warnings of No10’s top scientific advisers, Sir Simon told BBC Radio 4’s Today programme that by the end of November, there will be more Covid patients than there were during the first peak in April. 

Sir Simon today admitted, however, that the NHS never ran out of room during the first wave and claimed that the national lockdown will mean the health service continues to have space throughout the winter to keep up normal services and tackle backlog created from cancelling thousands of operations in the first wave. 

Thousands of beds went unused after bosses decided to scrap non-urgent operations to make way for predicted onslaught of coronavirus patients. Make-shift Nightingale units were left virtually empty.

Sir Simon’s comments come after leaked documents today revealed intensive care units are no busier than normal for this time of year for most trusts, pouring extra cold water on claims the NHS is close to being overrun. 

Eighteen per cent of critical care beds available across the health service nationally, which is normal for the autumn.

Data from the NHS Secondary Uses Services, seen by The Telegraph, claims to show that even in the worst hit region, the North West, seven per cent of critical care beds are still free.

Experts said hospitals are running ‘at normal levels’, in stark contrast to the picture which is being painted by the Government, which has honed in on the small handful of hospitals that are under more pressure than in the spring.  

It comes as MPs prepare to vote on a new four-week Covid-19 lockdown for England.

But Boris Johnson is facing a Tory revolt in a crunch Commons vote today – with fears he will have to rely on Labour to get the plan through.

The draconian measures, ordering people to stay at home and shutting non-essential retail, bars and restaurants for a month, are set to come into force from midnight.

But while Sir Keir Starmer’s backing means the PM is assured they will be rubber-stamped by MPs this afternoon, he is scrambling to contain a rising tide of anger on his own benches.  

The number of Covid-19 patients in English hospitals has soared almost five-fold from 1,995 on October 1 to 9,213 on the 31st, Department of Health data shows. 

‘In a sense the facts speak for themselves,’ Sir Simon told BBC Radio 4’s Today programme this morning.

‘We began early September with under 500 coronavirus patients in hospitals by the beginning of October that had become 2,000 and as of today that is just under 11,000.

‘Put another way we’ve got 22 hospitals worth of coronavirus patients across England and even since Saturday when the Prime Minister gave his press conference we’ve filled another two hospitals full of severely ill coronavirus patients.’

Sir Stevens’ comments add further confusion to whether NHS hospitals are truly overwhelmed, after documents from the NHS Secondary Uses Services (SUS), a body which provides data for purposes such as healthcare planning, shows capacity in ICU was on a normal path in October.

IS THE NHS ACTUALLY QUIETER THAN USUAL?

NHS hospitals in England appear quieter than usual for this time of year even though they are treating more than 9,000 patients with coronavirus.

A leaked document claims 84 per cent of all hospital beds were occupied across the country yesterday, which is lower than the 92 per cent recorded during autumn last year. 

Bed occupancy has not averaged lower than 85 per cent in any normal three-month period for the past decade.

The only exception to this was between April and June this year, when it stood at 64 per cent because hospitals were forced to turf out thousands of non-Covid patients to make space for the epidemic. 

Regional differences in the coronavirus outbreak mean some places are feeling more strain than others – one major hospital trust in Liverpool is already be treating more Covid-19 patients than it was in the spring. 

Medics fear the numbers of people needing care for Covid-19 will become so large that they won’t be able to treat people with cancer and other serious diseases.

Doctors already face a huge backlog in cancelled or postponed non-urgent operations and procedures, on which they are now desperately trying to catch up. A resurgence in people who need saving from Covid would put this progress in jeopardy.

But the data obtained by the HSJ shows that hospitals are less full than usual despite having 70 per cent more patients than they did in the spring.

They have around twice as many non-Covid patients – more than 70,000 on wards as of yesterday – along with 9,000 coronavirus patients, and still have at least 10,000 beds available.

At the most recent measure – during the first quarter of 2020/21 – the NHS had a total of 118,451 beds available, of which 92,596 were general hospital beds. The others were on maternity, mental health and learning disabilities units.

This is not thought to include capacity in Nightingale hospitals or private wards that have been rented out. Thousands of beds were put on standby when ministers feared a catastrophic wave of patients with coronavirus, but many were never used.

Full data has not been published about daily bed occupancy and the NHS is coming under growing pressure to show the real state of pressure on its hospitals.

Figures seen by The Telegraph show there is still 15 per cent ‘spare capacity’ across the country – fairly normal for this time of year.

That’s even without the thousands of Nightingale hospital beds which will provide extra capacity if needed.  

Even in the North-West, the worst affected region in the ‘second wave’, only 92.9 per cent of critical care beds are currently occupied.

And in the peak of the Covid outbreak in April, critical care beds were never more than 80 per cent full, according to the data. 

There were around 5,900 critical care – or ICU – beds in the NHS in January 2020, according to the King’s Fund. 

It is not clear how many Covid-19 patients are on critical care wards as this data is not available. But the number of patients on a ventilator – 952 on November 3 – gives a rough idea. However, not all patients on ventilators are classed as being in ICU. 

The SUS documents show there were 9,138 Covid-19 patients in general hospital beds in England as of 8am on November 2. 

Yesterday this figure was 10,377 – the highest it has been since the beginning of May but following a drop of patients in hospital at the weekend. 

It means Covid-19 patients are accounting for around 10 per cent of general and acute beds in hospitals, which has gradually been increasing over the month of October.

However, there are still more than 13,000 beds available on general wards, considering there are almost 114,000 NHS beds in England overall. 

MailOnline revealed at the height of the first wave in April that Covid-19 patients never made up more than 30 per cent of the total beds occupied. Just under 19,000 patients out of 70,000 in hospitals at that time had Covid-19. 

An NHS source told The Telegraph: ‘As you can see, our current position in October is exactly where we have been over the last five years.’

Commenting on the new data, Professor Carl Heneghan, director of the Centre for Evidence-Based Medicine at the University of Oxford, said: ‘This is completely in line with what is normally available at this time of year. 

‘What I don’t understand is that I seem to be looking at a different data-set to what the Government is presenting.

‘Everything is looking at normal levels and free bed capacity is still significant, even in high dependency units and intensive care, even though we have a very small number across the board. We are starting to see a drop in people in hospitals.

‘Tier Three restrictions are working phenomenally well and, rather than locking down, I would be using this moment to increase capacity.’  

The leaked documents also show that no intensive care units are in Covid-19 Pandemic Critcon levels above two. 

Critcon levels – used to give an idea of how stretched a hospital is – at three and four are enacted during a ‘full stretch’ and ’emergency’, when other wards need to be used for critical care. 

COVID-19 CASES WORSE THAN ‘GLOOM MONGERS’ FEARED, ICU DR SAYS 

An intensive care consultant has said the number of coronavirus cases looks worse than ‘even gloom-mongers like me had feared’.

Dr Richard Cree works at the James Cook University Hospital in Middlesbrough and writes on his nomoresurgeons.com blog about his role.

In a post on Tuesday, he said that there were 93 Covid-19 patients in the hospital at the weekend, with ‘significant numbers’ requiring continuous positive airway pressure on the three coronavirus wards, and more ventilated patients in intensive care.

Dr Cree said when the government’s leading scientists presented the worst-case scenario in September, growth of cases was low and deaths even lower.

He wrote: ‘As a result, most people refused to believe such a prophecy. It turns out that everyone was wrong and that the situation looks much worse than even gloom-mongers like me had feared.’

He believed the second lockdown would not be as effective as the first because schools will remain open this time.

Dr Cree also said the number of coronavirus patients in the hospital was ‘having a worsening effect on the hospital’s ability to function normally’ and some surgery has had to be suspended.

He added: ‘This disruption is likely to continue for the rest of the week. However, the organisation continues to do its utmost to ensure that most surgery will continue as normal and there is to be no disruption to urgent and emergency operations.’

It comes as hospitals in Manchester have begun reorganising beds to provide more oxygen treatments for Covid patients, but is expected to fill its initial 36-bed allocation in the Nightingale by next week. 

Manchester council’s health scrutiny committee heard there are now around 300 patients with coronavirus in the city’s hospitals but that hospitals are committed t treating patients with non-Covid issues for as long as possible, the Manchester Evening News reported.  

Katie Calvin-Thomas, interim chief executive of Manchester’s Local Care Organisation – said ‘hospitals are looking at how they reorganise their beds and their staffing to create additional capacity in intensive care for people who require oxygen’. 

Mark Edwards, chief operating officer of the LCO, said there are currently nine Manchester patients in the Nightingale.

‘That will grow quite rapidly ahead of the weekend and I suspect the first ward – which is where we will need the 36 beds – is likely to be filled early next week, if not before,’ he said. 

But 146 units out of 222 (65 per cent) are still at ‘Critcon 0’, which is defined as ‘business as usual’ by the NHS.

Just 29 units (13 per cent) are at ‘Critcon 1’, defined as the usual impact of a bad winter, according to documents seen by The Telegraph. 

Only 19 (eight per cent) are at ‘Critcon 2’, described as a ‘medium surge’. Twenty-eight units have not reported their position.

The figures come after leaked documents, seen by the Health Service Journal, revealed NHS hospitals in England appear quieter than usual for this time of year. 

Some 84 per cent of all hospital beds were occupied across the country on Monday, which is lower than the 92 per cent recorded during autumn last year. 

Bed occupancy has not averaged lower than 85 per cent in any normal three-month period for the past decade, with a couple of exceptions this year when hospitals were forced to turf out thousands of non-Covid patients to make space for the epidemic.

NHS England figures show hospitals across the country were 92 per cent full last December, amid the winter months when hospital admissions increase.

Some 93,442 beds out of 101,598 were taken up by patients needing overnight care, on average. 

Regional differences in the coronavirus outbreak mean some places are feeling more strain of Covid-19 more than others – one major hospital trust in Liverpool is already be treating more Covid-19 patients than it was in the spring.

It comes after the data used by the Government to justify a second national lockdown has come under scrutiny in recent days.  

Officials are making repeated comparisons to the spring situation as a shorthand for crisis but will not explain how busy hospitals actually are. 

A chart was designed to show that some hospitals – shown in red – already had more Covid-19 patients than at the peak of the first wave in the spring.

Hospitals shown in amber have more than half as many virus patients as they had then, while green indicates hospitals with fewer than half the number of patients they had at the peak of the first wave.

The chart gave the impression that hospitals were already close to overflowing. 

However, while 29 hospitals are shown on the slide, the full dataset, published by NHS England, actually includes 482 NHS and private hospitals in England.

At least 232 of which (and probably more as some entries were left blank) had not a single Covid-19 patient on October 27. 

Mr Johnson’s top advisers also warned on Saturday that hospital admissions for Covid-19 and the numbers of beds filled by coronavirus patients are surging and the NHS could run out of room by December, unless any action was immediately taken.

Medics fear the numbers of people needing care for Covid-19 will become so large that they won’t be able to treat people with cancer and other serious diseases. 

Sir Stevens said today: ‘We’re adding as much capacity as we can in anticipation of not only coronavirus but the extra winter pressures that always come along at this time of year.

This chart was designed to show that some hospitals – shown in red – already had more Covid-19 patients than at the peak of the first wave in the spring

This chart was designed to show that some hospitals – shown in red – already had more Covid-19 patients than at the peak of the first wave in the spring

For while 29 hospitals are shown on the slide, the full dataset, published by NHS England, actually includes 482 NHS and private hospitals in England at least 232 of which had not a single Covid-19 patient on October 27

For while 29 hospitals are shown on the slide, the full dataset, published by NHS England, actually includes 482 NHS and private hospitals in England at least 232 of which had not a single Covid-19 patient on October 27

‘And in fact the reason we want to try and minimise the number of coronavirus infections and patients is not only because of the excess death rate that implies, but because of the knock-on consequences it has for other services, routine operations, cancer care and so if we want to preserve those other services so that the health service can continue to help the full range of patients we need to do everything we can together to keep the infection rate down for coronavirus.’ 

Officials say the ‘available capacity’ of hospitals is only around 20,000, prompting startling warnings they could run out of room by next month.  

But even during the spring, almost 40,000 beds were empty because tens of thousands of beds went unused after hospitals turfed out patients to make room for an overwhelming surge in Covid-19 patients that never fully materialised. 

GREEN LIGHT FOR NHS ROUTINE TESTING 

The head of the NHS in England has suggested that all patient-facing health service staff will soon be given routine Covid-19 tests.

Sir Simon Stevens said new tests and increased capacity mean that testing for all frontline workers – regardless of whether they have symptoms – should begin within six to eight weeks.

Routine testing of NHS staff is already taking place in the hardest-hit areas.

Sir Simon said that, so far, 70,000 staff in those regions have been tested in recent weeks.

The chief executive of NHS England told BBC Radio 4’s Today programme: ‘Routine testing of asymptomatic NHS staff has now begun in high prevalence parts of the country, areas where there are outbreaks, and more than 70,000 NHS staff have had those tests within the last several weeks.

‘And the chief medical officer, Chris Whitty, yesterday wrote to the Health Committee, to Parliament, explaining that, because the availability of testing had now increased, and we’ve got this new saliva testing that will be available for hospital and other health service staff over the next six or eight weeks, we will now be able to press on routinely testing all patient-facing NHS staff.’

On Monday, Sarah-Jane Marsh, the outgoing director of testing at NHS Test and Trace, suggested that routine staff testing would occur on a weekly basis.

The NHS has kept hold of the thousands of beds it commandeered to fight off the first wave, with nine make-shift Nightingale facilities on standby to help cope with a second surge of Covid-19.

It is not clear how many more beds could be made available if the NHS needed them.  

The NHS England chief executive admitted today the health service did not run out of critical care capacity during the first wave.

Sir Simon Stevens said: ‘We fully expect that will continue to be the case, and indeed the action Parliament is considering today will mean not only that, but should mean that we will not need to embark on a national deferral of routine operations across the country and instead will continue with targeted local decisions based on the particular pressures individual hospitals and geographies are facing.’

There is no data to show how full hospitals really are; neither the Government nor NHS bosses provide regular updates of what proportion of beds are full or how many beds are still available.

Instead, they offer a weekly report on how many Covid-19 patients are being treated at each trust and a once-a-month update on how many of the overall number of beds occupied are taken up by the infected.

At the most recent measure – during the first quarter of 2020/21 – the NHS had a total of 118,451 beds available, of which 92,596 were general hospital beds. Only around 10,000 are currently occupied by coronavirus patients. 

The total number of inpatient beds that could be called upon – including those rented from private hospitals and those in make-shift Nightingales – is unknown.  

Mr Johnson and his advisers warned in Saturday’s briefing that admissions are on track to exceed levels seen in the spring crisis within weeks, heading for more than 30,000 inpatients by the end of November and more than 4,000 new admissions per day in the first week of December. 

However, coronavirus data for all of England now shows that the number of people in hospital with the disease dropped on Sunday for the first time in a month, falling from 9,213 to 9,077.

Daily admissions also fell on Saturday – the most recent data – from 1,345 new patients on Friday to 1,109 on October 30. 

Oxford University’s Professor Carl Heneghan, a vocal critic of lockdown policies, today said the outbreak is ‘flatlining’. 

NUMBER OF COVID-19 PATIENTS IN CRITICAL CARE BEDS HALF OF WHAT IT WAS IN THE SPRING IN WALES 

The number of coronavirus patients in Wales needing critical care is less than half of what it was during the peak of the virus despite rising hospital admissions, the chief executive of NHS Wales said.

Dr Andrew Goodall said early intervention by doctors, aided by increased testing, and improvements with oxygen therapies meant that both demand on intensive care units and mortality rates were lower compared with April.

Demand for critical care capacity in Wales is 60 per cent lower than at the peak, with 57 people currently receiving treatment, while 1,275 people currently occupy hospital beds because of Covid-19 in non-critical care areas.

The number of Covid patients occupying non-critical hospital beds is just nine per cent lower than it was in April and is the highest amount since that time, with numbers expected to rise further in the coming days.

But Dr Goodall said increasing admissions were not resulting in greater demand for critical care beds, saying the numbers were ‘lower than expected’ and represented ‘a good sign’.

He told the Welsh Government’s Covid-19 briefing on Tuesday: ‘By now I would have expected, if it was the first wave’s experience, to have seen more coronavirus patients in our critical care areas.

‘I think that’s a good sign, of course, because we don’t want patients to be in critical care with coronavirus. We want them to be supported and to be able to be discharged home safely and back to their family arrangements.’

Dr Goodall said using oxygen treatments instead of putting patients on ventilators was proving a ‘more effective’ way of treating patients compared with the first wave of the virus.

That, added to early interventions, was also leading to lower death rates compared with the peak not just in Wales but across the UK.

‘With the high level of testing that is going on across Wales at the moment, it does mean we’re identifying people with coronavirus earlier,’ Dr Goodall said. 

Dr Goodall said the next ‘two or three weeks’ would be important for the NHS in anticipation of Wales’s 17-day firebreak lockdown having an effect on the number of hospital admissions.

But he warned that if transmission rates and admissions continued to increase, it could lead to the health service becoming ‘overwhelmed’.



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Apollo group to adopt AI for treating stroke patients


Hospital partners with Medtronic; software expected to provide analysis in two minutes

“When we talk of stroke, time is brain,” said Sathishchandra P., neurologist, Apollo Speciality Hospitals. In an effort to diagnose stroke faster and reduce treatment time, doctors are adopting artificial intelligence (AI) for stroke management.

Apollo Hospitals and India Medtronic Pvt. Ltd have partnered for integrating AI for advanced stroke management across 10 hospitals in the network. The AI software would provide automated analysis in less than two minutes as against currently accepted imaging practices for diagnosis of stroke that takes up one hour to complete, enabling faster decision-making in stroke, according to a release.

The platform uses AI to create high quality, advanced images from non-contrast CT, CT angiography, CT perfusion and MRI diffusion and perfusion scans. The stroke team will be able to remotely access the brain scans of stroke patients with AI analysis on mobile app or email, the release said.

Silent killer

Stroke was one of the leading causes of death and disability in the country. It was the fourth leading cause of death and fifth leading cause of disability, according to Dr. Sathishchandra.

“We need to spot stroke to stop stroke,” he said, listing the signs of stroke — face looking uneven, arm or leg weak/hanging down, slurred speech, sudden loss of balance and loss of vision in one or both eyes.

The door to treatment time should be less than 60 minutes as management of acute stroke requires re-establishing blood flow to the brain by injecting a thrombolytic agent. “If treated early, we can reduce disability and mortality,” he added.

He said the advantages of AI-based technology were shortest treatment time, tailored approach for each patient, accurate assessment in shortest possible time and faster decision-making in stroke.

Madan Krishnan, vice-president (Indian sub-continent), Medtronic, said their research showed that every day, more than 4,500 persons were affected by stroke in India, and only about 2 or 3% received right care at the right time. “We want to reduce the door-to-needle time. With this technology, we can do scans faster and accurate diagnosis,” he said.

Prathap C. Reddy, chairman, Apollo Hospitals, said according to the World Economic Forum, non-communicable diseases (NCD) — diabetes, heart attacks, strokes, cancers and infections — were of serious concern during 2020-2030. At least 70% of deaths were due to NCDs, and this would be 80% by the end of the decade. “Healthcare will have greater inputs in terms of AI, automation, robotics and 3D printing,” he said.

“Sharing of knowledge and technology has to work hand-in-hand. Speed is the key and intervention at the right time will benefit patients. By focussing on AI, we will be able to work on research, take data and collate it and better the outcomes,” Preetha Reddy, vice-chairperson of the group, said.

Suneeta Reddy, managing director of the group, emphasised on the need for patients to get timely care.



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Adelaide physio banned from treating women after allegations of inappropriate behaviour


An Adelaide physiotherapist accused of inappropriate behaviour will be banned from treating women, after his appeal against the decision was dismissed.

The South Australian Civil and Administrative Tribunal (SACAT) had taken the action earlier this year after female patients made complaints about physiotherapist Ashley Smith’s treatment as his practice in Prospect.

The tribunal implemented a ban, but Mr Smith tried to appeal against the gender-based restrictions, arguing they were “unnecessary and disproportionate,” describing his own actions as, “clinically justified”.

His behaviour was described as “displaying a lack of respect for the patient’s dignity and privacy,” with the SACAT upholding its previous decision.

He said allegations of improper or sexually motivated conduct could be explained by deficiencies in communication and the procurement of consent.

The board rejected that, deciding there was a “serious risk” he may act with a sexual motivation in consultation with female patients, as it does not trust he can adequately regulate his behaviour.

It also rejected his submission that mentoring would be enough to ensure his behaviour was regulated.

‘Completely violated, harassed, humiliated and stressed’

The complaints include one woman who said Mr Smith put his hand under her breasts, and while at first, she thought it was an accident, he did not apologise or say anything.

“It made me feel nervous that he might do something else. At the time I thought that maybe he just was not thinking and was trying to guide my breasts into the gap between the pillow and bed, but it was unnecessary,” the woman said.

Another said Mr Smith reached in from behind her without warning, undoing the buttons of her shorts, lowering the zip, rolling down her shorts at the rear to expose her buttocks.

She said he then took a photo without notice or consent, which left her feeling “completely violated, harassed, humiliated and stressed”.

Mr Smith previously worked at this practise in Prospect but the tribunal heard he has now been banned from working there.(Supplied: Facebook)

The board said they were “particularly concerned” by one female patient’s description of a massage in April this year.

She said Mr Smith unclipped her bra during the massage without seeking consent, describing the massage as “flirty or over-friendly”.

In his defence, Mr Smith provided the board with a video demonstrating his technique and the placement of his hands, but the board said it did not find the explanation convincing.

In its decision, SACAT also considered the financial impact on Mr Smith and his wife, who is an administration manager at the practice.

It ruled while the impact was significant, it was not because of the gender-based restrictions, but rather from the franchisor of his practice effectively banning him from practising in the franchise.



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Is the ‘Love Hormone’ Key to Treating COVID-19?


FRIDAY, Oct. 9, 2020

The so-called love hormone, oxytocin, may be worth investigating as a treatment for COVID-19, a new study suggests.

One of the most serious complications of infection with the new coronavirus is a “cytokine storm,” in which the body attacks its own tissues.

There are currently no U.S. Food and Drug Administration-approved treatments for COVID-19, which means that “repurposing existing drugs that can act on the adaptive immune response and prevent the cytokine storm in early phases of the disease is a priority,” according to the researchers.

Previous research suggests that oxytocin — a hormone that’s produced in the brain and is involved in reproduction and childbirth — reduces inflammation.

In this new study, researcher Ali Imami, a graduate research assistant at the University of Toledo in Ohio, and colleagues used a U.S. National Institutes of Health database to analyze characteristics of genes treated with drugs closely related to oxytocin.

The investigators found that one drug in particular, carbetocin, has similar characteristics (called a signature) to genes with reduced expression of the inflammatory markers that trigger cytokine storm in COVID-19 patients.

Carbetocin’s signature suggests that the drug may trigger activation of immune cells called T-cells that play an important role in immune response. In addition, carbetocin’s signature is also similar to that of lopinavir, an antiretroviral medication under study as a treatment for COVID-19.

All of these factors indicate that oxytocin may have potential as a targeted treatment for cytokine storms in COVID-19 patients, the researchers said in a news release from the American Physiological Society.

“Understanding the mechanisms by which oxytocin or the oxytocin system can be a new immune target is crucial,” the authors concluded in their report, which was published online recently in the journal Physiological Genomics.

However, they added that “safety and efficacy of intravenous oxytocin in hospitalized patients with COVID-19 remains to be assessed.”

— Robert Preidt

MedicalNews
Copyright © 2020 HealthDay. All rights reserved.

References


SOURCE: American Physiological Society, news release, Oct. 6, 2020



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Sydney Swans treating home stretch as ‘measuring stick’ for fledgling team


There were 11 players aged 23 and under in the side which upset Melbourne, including Nick Blakey, Tom McCartin and Justin McInerney who were all important in victory.

It follows the progress made by midfield tyros Oliver Florent and James Rowbottom, who have been earmarked for long careers in the Swans’ engine room.

Justin McInerney (second from right) is among a band of promising young Swans.Credit:Getty

The Swans need just one more win in this abbreviated season to match the seven from 22 they secured last year when veterans Lance Franklin and retired duo Jarrad McVeigh and Kieren Jack were available.

Franklin, captains Josh Kennedy and Dane Rampe, young star Isaac Heeney headline a long list of first-choice Swans who have missed large chunks of the season.

As coach John Longmire noted, the Swans have only once fielded an older team than their opposition this year.

The Swans tackle Carlton next week then round out 2020 with stern tests against Brisbane and Geelong, both of whom are considered leading contenders for the premiership.

“That’s a really good measuring stick for them to go into the pre-season to try and learn as much as they possibly can,” Swans assistant coach Dean Cox said. “You want players to realise what the best teams do and how far you are off them. We learned that last week when we went to Adelaide and played Port, who are top of the ladder and have a really good home record.

“Barring a bit of the first and second quarter we performed quite well against them. It’s just a matter of trying to make sure we can test them as much as we possibly can.

“We’ve got to do it again next week. We’ve had some good wins the last few weeks and we need to back it up. It’s a five-day break, we’ve got a pretty tough schedule, we’ve still got to come with that mindset next week.

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The downside of youth, however, is the lack of consistency in performance. The Swans have not strung together consecutive wins this season. Their two previous wins, over Hawthorn and Greater Western Sydney, were followed by substandard displays.

“Certainly, we have developed,” Cox said. “Having said that, we hate being where we are on the ladder. We really pride ourselves on being a really consistent team and playing finals year in, year out.

“As much as you like to develop, you still want to make sure your main objective is still to win games of footy and play finals. There’s still a lot of work to do but some of these kids are still heading in the right direction.”

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New reliable method for treating male sterility



Infertility affects one in seven men of reproductive age worldwide. One idea for treating male sterility is spermatogonial stem cell (SSC) therapy. In this approach, sperm stem cells in the testis are transferred to a test tube, cultured, and nudged into becoming fully-fledged sperm.

However, a key bottleneck has been identifying just the right conditions to get human SSCs to grow in the lab. There have been many attempts, but in most reported cases it was not clear whether the cells being cultured were actually SSCs, and no previously published method is routinely used.

Researchers at the University of California San Diego School of Medicine have now developed a reliable method for culturing cells with the characteristics of human SSCs. Their work is published in the July 13, 2020 issue of Proceedings of the National Academy of Sciences.

We think our approach -; which is backed up by several techniques, including single-cell RNA-sequencing analysis -; is a significant step toward bringing SSC therapy into the clinic.”


Miles Wilkinson, PhD, Study Senior Author and Distinguished Professor, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California San Diego

SSCs are what make it possible for men to father children beyond the age of 65. These specialized cells continually self-renew, making more SSCs, and develop into sperm so prolifically that men (and some transgender, non-binary and gender-fluid people) produce more than 1,000 new sperm every few seconds.

Progress in the field has been hindered by the fact that it’s extremely difficult to distinguish SSCs from other cells in the testes. It was a major step forward when several laboratories, including the Wilkinson team, recently used a technique called single-cell RNA sequencing to define the likely molecular characteristics specific to human SSCs.

In their latest effort, the Wilkinson team used its single-cell RNA sequencing information to purify what it thought might be human SSCs. Using a method called germ-cell transplantation, it showed that the cells it purified were indeed highly enriched in human SSCs.

The team then gathered the profile of genes expressed in these human SSCs to make guesses as to the conditions that might best support their growth in the lab. Using more than 30 human testis biopsies, the researchers determined just the right conditions needed to culture immature germ cells with the characteristics of SSCs.

The key ingredient was an inhibitor of the AKT pathway, a cellular system that controls cell division and survival. The Wilkinson team determined that AKT inhibition maintains human SSCs by inhibiting the development of later-stage sperm precursors. Several AKT inhibitors are currently used to treat cancer.

With that approach, the researchers were able to favor the culture of human cells with the molecular characteristics of SSCs for two-to-four weeks.

“Next, our main goal is to learn how to maintain and expand human SSCs longer so they might be clinically useful,” Wilkinson said.

Source:

Journal reference:

Tan, K., et al. (2020) Transcriptome profiling reveals signaling conditions dictating human spermatogonia fate in vitro. Proceedings of the National Academy of Sciences. doi.org/10.1073/pnas.2000362117





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