Tag: 18/11/25

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Using AI to Empower Care Physicians

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Photo by National Cancer Institute on Unsplash

By Henry Adams, Country Manager, InterSystems South Africa

When people think about artificial intelligence (AI) in healthcare, they often picture complex machines in high-tech hospitals. But some of the most exciting uses of AI are happening in primary care, right at the first point of contact between doctor and patient.

Globally, AI is helping general practitioners, nurses, and clinicians make faster, more accurate decisions by giving them access to clean, connected data. It helps detect early signs of disease, spot patterns across patient populations, and ensure the right people get the right care sooner.

South Africa is not there yet, but that is exactly why we should be paying attention.

Learning from what is working elsewhere

In countries where healthcare data is already digitised and connected, AI-assisted tools are starting to prove their worth. In parts of Europe, AI systems are helping GPs analyse symptoms, lab results and patient histories to identify possible conditions much earlier. In the US, data platforms are used to surface insights from millions of patient records, helping clinicians identify patterns that might otherwise go unnoticed.

At InterSystems, we have seen firsthand how this combination of reliable data and intelligent technology is changing the way care is delivered. In the UK, our data platform helps care providers securely connect across places of care to patient information across multiple systems, making it easier for AI tools to interpret symptoms in context. In France, AI-assisted prescriptions through partners like Posos are helping doctors reduce errors and improve treatment safety.

These examples show what is possible when data, people and technology come together in the right way.

Why data comes first

AI is only as powerful as the data it works with. If a clinician’s system lacks complete or up-to-date patient information, the AI cannot provide reliable support. That is why data quality and interoperability are so important; they form the foundation for everything else.

Many countries that are seeing success with AI in primary care started by getting their data in order, building connected health records, standardising information, and ensuring privacy and compliance at every step. Once those pieces were in place, they could start introducing AI tools that help doctors and nurses make better decisions without adding extra admin or complexity.

Again, in South Africa, we are not quite there yet, but we are heading in the right direction. There are ongoing efforts to digitise health records and bring together fragmented systems. As that process continues, it will open the door for more advanced AI-driven support tools, from diagnosis assistance to population health management.

What this could mean for South Africa

Imagine a community clinic in Limpopo or the Eastern Cape, where a doctor sees dozens of patients a day. With AI support, they could instantly access each patient’s medical history, flag high-risk symptoms, or receive early alerts about potential complications like diabetes or hypertension.

AI will not replace the doctor’s or their judgment. It simply gives them more context and better information. It is like having a quiet assistant in the background, helping spot what is easy to miss when you are under pressure.

This kind of technology could also help identify broader health trends, guiding public health decisions and making sure resources are sent where they are needed most. It is not about high-end tech for big hospitals, it is about making everyday healthcare smarter, safer and more efficient for everyone.

Building the foundations

Before we can get there, we need to focus on the basics: connected systems, reliable data, and trust. AI tools cannot function properly in silos. They need access to consistent, secure information, the kind that interoperable platforms like InterSystems IRIS for Health are designed to manage.

Once we have that in place, the rest becomes achievable. Doctors can use AI to compare patient data against proven medical knowledge bases. Clinics can share insights securely across regions. And the healthcare system becomes more proactive instead of reactive.

It is easy to look at what is happening overseas and feel that South Africa is far behind. But I see it differently. Every success story abroad gives us a roadmap, lessons we can adapt to our own realities. We do not have to reinvent the wheel; we just have to make sure it is fit for our local terrain.

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No Evidence of a Link Between Gut Microbiome and Autism

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There’s no scientific evidence that the gut microbiome causes autism, a group of scientists argue in an opinion paper published in the international Cell Press journal Neuron.

They say conclusions from past research that supported this hypothesis – including observational studies, mouse models of autism, and human clinical trials – are undermined by flawed assumptions, small sample sizes, and inappropriate statistical methods. 

“Despite what you’ve heard, read, or watched on Netflix, there is no evidence that the microbiome causally contributes to autism,” says first author and developmental neurobiologist Prof Kevin Mitchell from Trinity. 

The hypothesis that autism is caused, at least partially, by the gut microbiome stems from the fact that many people with autism suffer from gastrointestinal symptoms. 

In addition, the recent rise in autism diagnoses has led some to believe that environmental or behavioural changes are driving an increase in autism, though the authors note there is strong evidence that the rise in diagnoses reflects increased awareness and broadened diagnostic criteria rather than a biological mechanism.

Nevertheless, researchers have pursued the microbiome-autism hypothesis by comparing the gut microbiomes of people with and without autism, by studying mouse models of autism, and by conducting clinical trials involving people with autism. The authors argue that in all of these studies, the results are flawed and unconvincing.

“There’s variability in all three of those areas, and the studies just don’t form a coherent story at all,” says senior author and developmental neuropsychologist Dorothy Bishop of the University of Oxford. 

In the most highly cited studies comparing the gut microbiomes of people with and without autism, researchers used sample sizes ranging from 7 to 43 individuals per group, whereas statistical recommendations call for sample sizes in the thousands.

“Autism is not rare, so there’s no reason to be having studies with only 20, 30, or 40 participants,” says co-author and biostatistician Darren Dahly of the University College Cork.

These studies also used varying methods to characterise microbiome composition, which makes their results difficult to compare. And although some studies found differences between the microbiomes of people with autism and controls, these differences were often contradictory—for example, some studies found lower microbial diversity in the guts of people with autism, while others found the opposite.

These differences also disappeared when the studies accounted for other variables, such as diet, or when they compared the microbiomes of children with autism with their neurotypical siblings. 

“If anything, there is stronger evidence for a reverse causal effect, in that having autism can affect someone’s diet, which can affect their microbiome,” says Prof Mitchell.

Mouse models of autism that have claimed to show a link between the gut microbiome and autism are also unconvincing, the researchers say, because of behavioural, cognitive, and physiological differences between humans and mice. 

“There’s no evidence that ‘autistic-like’ behaviours in mice models have any relevance to autism, and the experiments themselves had methodological and statistical flaws that undermine their claims,” says Prof Mitchell.

Several human clinical trials have tested the microbiome-autism hypothesis by performing faecal transplants or by administering probiotic therapies to people with autism and then monitoring changes in their characteristics. Again, the researchers say that most of these studies used inadequate sample sizes and inappropriate statistical methods that undermine their findings, and many didn’t use a control group or randomisation.

 “The consensus across the studies that we surveyed is that when you do the trials properly, you don’t see anything,” says Dahly.

Based on the lack of convincing evidence, and the lack of progress in the field, the researchers argue the hypothesis that the microbiome causes autism has reached a dead end.

“If you accept our message, there’s two ways you can go. One is to just stop working on this area, which is something that we would be quite happy to see,” says Bishop. “But given that realistically, people are not going to stop, they need to at least start doing these studies in a much more rigorous way.” 

Source: Trinity College Dublin

Categories : Obstetrics & Gynaecology Pain ManagementTags : Leave a comment

New Study Challenges Fears About General Anaesthesia for C-sections

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Data analysed by Penn researchers clarifies risks associated with general anaesthesia, giving patients more control over their delivery experience.

Photo by Anna Shvets on Pexels

Regional anaesthesia has long been favoured for caesarean births due in part to concerns about the effects that general anaesthesia may have on newborns during labour and delivery. Powerful societal pressures also push the idea that mothers need to be awake during delivery to witness the first cry and capture the ‘perfect’ birth moment. But for some women who undergo a caesarean birth, the pain can become excruciating, even after they received a spinal or epidural block.

Now, new research from a team at the Perelman School of Medicine at the University of Pennsylvania, finds that general anaesthesia may be a reasonable alternative for many patients. The findings are published today in Anesthesiology, the peer-reviewed medical journal of the American Society of Anesthesiologists.

“No patient should have to experience pain during caesarean section; as an anaesthesiologist, I never want someone to feel forced to choose between their baby’s health and not having to experience the pain of surgery,” said Mark Neuman, MD, MSc, Professor of Anesthesiology and senior author of the study. “Since regional anaesthesia is so widely used, it’s common for patients to feel that a spinal or epidural block is the only safe option for caesarean section. But as our study shows, anaesthesia type during pregnancy does not need to be one-size-fits-all.”

Reducing pain during C-section delivery

The research analysed 30 years’ worth of data from multiple clinical trials, comparing outcomes between general anaesthesia versus spinal or epidural anaesthesia for C-sections. The Penn study found that, while babies born under spinal or epidural anaesthesia had slightly higher Apgar scores than those born under general anaesthesia, the differences were small and not likely to be clinically meaningful.

While the majority of patients experience good outcomes with spinal or epidural block for caesarean delivery, recent studies show that up to one in six patients who receive an epidural or spinal may feel pain during their C-section. These experiences can be traumatic and have lasting emotional impacts.

The findings come amid growing public discourse on caesarean experiences. Recent podcasts and published news stories have featured candid patient accounts of pain under spinal or epidural anaesthesia. “This study equips women with evidence-based context about the use of general anaesthesia during c-section.” said Sarah Langer, MD, a resident in anaesthesiology at the Perelman School of Medicine and lead author the study. “Childbirth is a physically and emotionally demanding process, but we do not want patients to feel like there aren’t options when it comes to their anaesthesia for c-section,”

Broadening evidence-based choices

The study found that babies born under general anaesthesia were slightly more likely to need breathing support immediately after birth, but there was no increase in NICU admissions. The research does not suggest that general anaesthesia should replace regional techniques, but it can be a reasonable option in certain cases.

“For patients who are open to regional anaesthesia, spinal or epidural block remain great first choice options,” Neuman emphasised. “But having conversations with patients about general anaesthesia doesn’t need to be taboo. Patients deserve to know they have options, and our study helps provide the evidence to support those discussions.”

The authors note that most of the trials included in the analysis were conducted outside North America, highlighting the need for more US-based research in this area. They also point to historical barriers in studying women during pregnancy, which have limited the availability of robust data.

Source: Perelman School of Medicine at the University of Pennsylvania

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Single-dose Radiation Before Surgery Can Eradicate Breast Cancer

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These two magnetic resonance imaging (MRI) scans were taken 10 months apart. On the left, the blue arrow points to the edge of a breast tumour, and the red arrow locates a biopsy clip, which appears as a black dot. The MRI on the right, which includes the biopsy clip, shows the tumour is gone after a single, targeted dose of radiation and antihormone therapy.

A single, targeted high dose of radiation delivered before other treatments could completely eradicate tumours in most women with early-stage, operable hormone-positive breast cancer, according to a study led by UT Southwestern Medical Center researchers. The findings, published in JAMA Network Open, could shift the paradigm for patients with the most common form of breast cancer, who typically undergo surgery before a regimen of radiation therapy.

“This is a major advance in the field,” said study leader Asal Rahimi, MD, Professor of Radiation Oncology. “This treatment protocol provides patients a significant time savings, spares a lot of their tissue from irradiation, and allows them to still undergo any type of oncoplastic surgery they may choose, all while very effectively treating their disease.”

Like patients with other forms of cancer, those with breast cancer are typically treated with a combination of surgery to remove tumours, medications such as hormone blockers, chemotherapy, and radiation, often in that order. In addition, many patients choose to have breast reconstructive surgeries before radiation treatment.

Having targeted radiation prior to surgery has several benefits, including a more than 100-fold smaller volume of tissue being irradiated compared with whole breast radiation; one day of radiation compared with up to 6.5 weeks of radiation, creating a huge time savings for patients; and more options for patients seeking reconstructive surgery, explained Dr Rahimi.

Early-stage, hormone-positive breast cancer accounts for 60–75% of all breast cancers. Seeking a more time-efficient way to treat these patients, Dr Rahimi and her colleagues tested a strategy in which 44 patients started treatment with a single dose of targeted radiation. While typical radiation therapy protocols call for 1.8–2.67Gy per day for 16 to 33 days, the researchers divided the study participants into three groups and gave each patient a single dose of 30, 34, or 38Gy. The volunteers then went on hormone-blocking drugs and waited a median of 9.8 months until they underwent surgery to remove any residual tumour tissue.

In 72% of study participants, the surgeons found no residual tumor left, indicating that patients had a “pathological complete response.” An additional 21% of patients had a “near complete response,” meaning that their cancer was more than 90% eliminated.

Further analysis showed that time to surgery was the best predictor of response. The longer patients waited to undergo surgery, the more likely their tumours were to disappear, regardless of the radiation dose or tumour size. These results were probably due to the time it takes cells to die or be removed by the immune system after radiation therapy, Dr Rahimi explained.

This new treatment protocol could hold significant advantages over the current gold standard, said Marilyn Leitch, MD, Professor of Surgery. For example, being able to wait to schedule surgery will allow patients to plan for the disruption it brings to their lives. The radiation course lasts a single day rather than weeks. Plus, in the future, this new approach may eliminate the need for surgery in some patients.

“Much of the current research in breast cancer is looking at ways to reduce the extent of surgery, radiation, and/or medical therapy that is required to completely treat early-stage breast cancer. It is very exciting to be part of innovative research that can improve the quality of life of our cancer patients and minimize the extent of treatment they require,” Dr Leitch said.

The research team is currently enrolling patients in a phase two clinical trial. “If the results mirror the ones from this study, an initial targeted dose of radiation could become a new treatment option for patients with small, early-stage, hormone-positive breast cancer,” Dr Leitch said.

Source: UT Southwestern Medical Center

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Investing in Nurses Reduces Physician Burnout, International Study Finds

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A landmark international study finds that hospitals with better nurse staffing and work environments not only benefits nurses but is significantly associated with less physician burnout and job dissatisfaction. The research, published in JAMA Network Open, provides a clear solution to the global crisis of physician burnout.

A research team, led by Penn Nursing’s Center for Health Outcomes and Policy Research (CHOPR), surveyed more than 6400 physicians and 15 000 nurses across the United States and six European countries (Belgium, England, Germany, Ireland, Norway, and Sweden). The findings show that hospitals with better nurse staffing, supportive work environments, and effective interdisciplinary teamwork had substantially lower rates of physician burnout, job dissatisfaction, and intent to leave.

“Physician burnout is a global crisis, but few actionable solutions have been identified,” said Linda H. Aiken, PhD, RN, FAAN, FRCN, Professor of Nursing and Sociology and Founding Director, CHOPR. “Our study provides evidence that investing in nurses is a ‘two-for-one’ solution – improving both nurse and physician wellbeing while also strengthening patient care.”

Key findings include:

  • In US hospitals, a modest 10% improvement in the nurse work environment including staffing adequacy was associated with a 22% reduction in physician intent to leave, a 25% reduction in physicians unwilling to recommend their hospital as a place to work, a 19% reduction in physician job dissatisfaction, and a 10% reduction in physicians experiencing high burnout.
  • In European hospitals, a 10% increase in nurse staffing adequacy was linked to 20% lower physician intent to leave, 27% lower odds of not recommending their hospital, 15% lower physician job dissatisfaction, and 12% lower odds of high burnout.
  • Hospitals with stronger physician-nurse teamwork consistently reported better physician outcomes.

The results come at a critical time, as both physicians and nurses face unprecedented levels of stress, burnout, and turnover. According to the study, 20–44% of physicians surveyed reported intentions to leave their hospital positions due to dissatisfaction, and up to 45% reported high burnout.

“These findings highlight a path forward that hospital leaders can act on immediately,” said Karen B. Lasater, PhD, RN, Chair in Nursing and Health Policy, Associate Professor, and Associate Director, CHOPR. “Improving nurse staffing and creating supportive work environments are organisational reforms that are feasible, evidence-based, and capable of retaining both nurses and physicians.”

Source: University of Pennsylvania School of Nursing