Tag: 5/11/25

Categories : Cardiovascular DiseaseTags : Leave a comment

Stem Cell Therapy Linked to Lower Risk of Heart Failure After a Heart Attack

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Technique may be a valuable add-on procedure for patients with weak heart function after a heart attack, say researchers

Right side heart failure. Credit: Scientific Animations CC4.0

Patients with weak heart function who receive stem cell therapy shortly after a heart attack are at lower risk of developing heart failure and related hospital stays compared with standard care, finds a clinical trial published by The BMJ.

The researchers say the findings suggest this technique may be a valuable add-on procedure for this particular group of patients after a heart attack to prevent subsequent heart failure and reduce the risk of future adverse events.

Advances in heart attack management have improved survival rates considerably, but this has also led to rising rates of subsequent heart failure. While recent studies have indicated that stem cell therapy may reduce rates of heart failure after a heart attack, clinical trials are needed to confirm these benefits.

To address this gap, the researchers set out to assess the impact of delivering stem cells directly into coronary arteries (known as intracoronary infusion) after a heart attack on the development of heart failure over three years.

Their findings are based on 396 patients (average age 57-59 years) with no previous heart conditions at three teaching hospitals in Iran. They had all experienced a first heart attack (myocardial infarction) leading to extensive heart muscle damage and weakened heart function – where the left ventricle, the heart’s main pumping chamber, is too weak to pump blood out to the body as effectively as it should.

Of these, 136 patients in the intervention group received an intracoronary infusion of allogenic Wharton’s jelly derived mesenchymal stem cells within 3-7 days of their heart attack in addition to standard care. The remaining 260 control group patients received standard care alone.

Factors such as age, sex, baseline heart function, smoking status, obesity, existing high blood pressure, diabetes, or kidney problems were taken into account, and patients were monitored for an average of 33 months.

Compared with the control group, intracoronary infusion of stem cells was associated with reduced rates of heart failure (2.77 vs 6.48 per 100 person years), readmission to hospital for heart failure (0.92 vs 4.20 per 100 person years), and a combined measure of cardiovascular death and readmission for heart attack or heart failure (2.8 vs 7.16 per 100 person years).

The intervention did not have a statistically significant effect on readmission to hospital for heart attack (1.23 vs 3.06 per 100 person years), death from any cause (1.81 vs 1.66 per 100 person years), or cardiovascular death (0.91 vs 1.33 per 100 person-years).

However, by six months heart function in the intervention group showed a significantly greater improvement from baseline at six months compared with the control group.

This was a large trial with long term follow-up and clinically meaningful outcome measures, but the researchers acknowledge several limitations to their findings. These include the inability to do a sham procedure for the control group, which would have allowed for a double blinded study design instead of a single blinded format. Nor did they assess heart failure biomarkers or investigate the physiological effects of the intervention on heart tissue.

Nevertheless, they say these results suggest that this technique “may serve as a valuable adjunctive procedure after myocardial infarction to prevent the development of heart failure and reduce the risk of future adverse events.”

Additional trials confirming this finding are needed as well as further research “to explore the underlying mechanisms of mesenchymal stem cells therapy and to optimise its application in clinical practice,” they add.

Source: BMJ Group

Categories : Neurology Surgeries & ProceduresTags : Leave a comment

New Brain Shunt Trial Restores Walking and Independence in Older Adults with iNPH

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Placebo-controlled trial shows shunt surgery improves walking, balance and safety for older adults with idiopathic normal pressure hydrocephalus

Photo by Kampus Production on Pexels

Idiopathic normal pressure hydrocephalus (iNPH) is a treatable condition caused by a buildup of cerebrospinal fluid in the brain that leads to walking and balance problems, memory decline, and bladder control issues. Researchers report the disorder affects up to 1.5% of people in their late 60s and as many as 1 in 13 over age 86. Left untreated, iNPH can cause falls, loss of independence and progressive disability.

A new international study led by Johns Hopkins University School of Medicine researchers, and published in The New England Journal of Medicine, has provided definitive proof that shunt surgery restores mobility and physical safety in older adults with iNPH. The Placebo-Controlled Effectiveness in iNPH Shunting (PENS) Trial is the first large, double-blind, placebo-controlled study to resolve decades of debate on whether shunts truly help patients.

“Although shunts have been used for 50 years, scepticism persisted because of the placebo effect and the risks of operating in frail, elderly patients,” says Mark Luciano, MD, PhD, principal investigator and director of the Johns Hopkins Hydrocephalus and Cerebral Fluid Center. “This study shows surgery is both effective and has an acceptable safety profile. We’ve proven this treatment works, definitively and safely, in the most rigorous type of study possible.” 

The National Institutes of Health–supported trial enrolled 99 patients across 17 centres in the US, Canada, and Sweden. All patients underwent shunt surgery and received a functioning shunt. However, in half, the shunt was initially adjusted to a placebo setting. Neither patients nor their doctors knew which group they were in.

After three months, patients with functioning shunts walked significantly faster than they did before surgery, while the placebo group showed virtually no change. On average, walking speed in the shunt group improved by 0.23 metres per second — more than double the threshold considered by researchers to be a meaningful change in older adults. Eighty percent of patients with a functioning shunt achieved meaningful improvement, compared with just 24% of those in the placebo group.

“When a person walks better and doesn’t fall, everything improves: their independence, their safety and their quality of life,” says Luciano.

Patients in the treatment group also displayed improved balance and reported fewer falls. Forty-six percent of patients in the placebo group reported falling during the trial, compared with just 25% of those who received a functioning shunt. These gains are especially impactful for older adults, as poor mobility and frequent falls are directly tied to loss of independence, increased injury as well as higher mortality risk.

Despite its potential for treatment, iNPH is often overlooked. Researchers report that only about 20% of patients who could benefit from surgery are referred for evaluation because their symptoms are dismissed as normal signs of aging. That said, diagnosis can be simple.

“If there appears to be imbalance that’s increasing, or memory loss that’s increasing, it’s a diagnosis that can be explored with a routine brain scan,” says Luciano. “If the ventricles are enlarged and the symptoms are there, then patients can be referred to specialists who can further evaluate and treat.”

Looking ahead, the PENS Trial will continue to follow participants for 12 months to measure long-term outcomes, including cognition, daily functioning and quality of life. Early findings already suggest gains beyond walking.

“It has always been suspected that cognitive changes take longer to improve and need more detailed testing,” says Luciano. “At the 12-month period, we’ll have more to say not only about cognition, but how much patients are improving in their activities and independence.”

The research team is also working to develop noninvasive diagnostic methods that could replace current spinal fluid drainage trials, making it easier for clinicians to diagnose patients with iNPH and connect them to treatment.

Source: Johns Hopkins Medicine

Categories : Injury & Trauma Lab Tests and ImagingTags : Leave a comment

New Method Noninvasively Assesses Achilles Tendon in Dancers

On By ModernMedia
Photo by Nihal Demirci on Unsplash

A study in the Journal of Orthopaedic Research uses a noninvasive, nonradioactive imaging-based method to measure the structure and function of the Achilles tendon in professional ballet dancers. The method could potentially be developed to help prevent injuries and improve rehabilitation efforts in athletes, as well as in the general public.

The study involved what is called multi-echo ultrashort echo time (UTE) magnetic resonance imaging (MRI) to assess collagen and other components of the Achilles tendon. These structural UTE MRI assessments were combined with functional assessments of the Achilles tendon based on sheer wave elastography (SWE) ultrasound, which measures tendon stiffness.

Professional dancers tended to have more tendon stiffness compared with non-dancers, consistent with prior observations of a training effect from repeated loading with exercise. UTE MRI measures corresponded with the degree of stiffness from SWE ultrasound.

“These findings highlight the potential of integrating UTE and SWE imaging to investigate tendon structure‐function relationships and adaptations to mechanical loading,” the authors write. “Enhanced structure‐function assessment of tendon health and injury status could improve rehabilitation protocols or injury prevention strategies for athletes, including professional dancers.”

Source: Wiley

Categories : Dermatology New Compounds and TreatmentsTags : Leave a comment

Hydrogen Sulphide Could Be the Answer to Treating Nail Infections

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Scientists at Bath and King’s College London have discovered that a common chemical could be used to develop a new treatment for difficult-to-treat nail infections.

Paronychia. Source: Wikimedia Commons CC0

Hydrogen sulphide, the volcanic gas that smells of rotten eggs, could be used in a new treatment for tricky nail infections that acts faster but with fewer side effects, according to scientists at the University of Bath and King’s College London (KCL).

Nail infections are mostly caused by fungi and occasionally by bacteria. They are very common, affecting between 4-10% of the global population, rising to nearly half those aged 70 or over.

These infections can lead to complications, particularly in vulnerable groups such as diabetics and the elderly, but are notoriously difficult to treat.

Current treatments include oral antifungals taken in pill form, and topical treatments which are applied directly to the nail.

Oral antifungals take around 2-4 months to act and are reasonably effective, but they carry risks of side effects, especially in patients with other medical conditions.

Treatments applied directly to the nail are safer, but they often take much longer to work, sometimes taking even years to work, and they frequently relapse or fail.

This is largely because it’s very difficult to get the drug to penetrate through the nail to where the infection resides.

Even the most effective topical treatments have relatively low cure rates, so there is a clear need for new therapeutic approaches that are safe, effective, and capable of reaching microbes embedded deep within the nail.

A team from the University of Bath and King’s College London has now found that hydrogen sulphide (H₂S), a small, naturally occurring gas, could be developed into a promising new treatment.

Previous work has shown that it penetrates the nail plate far more efficiently than existing topical drugs, and now the team has demonstrated that it has strong antimicrobial activity against a wide range of nail pathogens, including fungi that are resistant to common antifungal treatments.

In laboratory tests, the team used a chemical that breaks down to release the H₂S gas and found that it acts in a unique way, disrupting microbial energy production and triggering irreversible damage, ultimately killing the fungi.

The research is published in Scientific Reports.

Dr Albert Bolhuis, from the University of Bath’s Department of Life Sciences, said: “Thanks to its ability to efficiently reach the site of infection and its novel mode of action, we believe that a topically applied medicine containing hydrogen sulphide could become a highly effective new treatment for nail infections, which avoids the limitations of current therapies.

“Our research lays the foundation for a compelling alternative to existing treatments, with the potential to improve outcomes for patients suffering from persistent and drug-resistant fungal nail infections.”

Hydrogen sulphide is known for its pungent smell of rotten eggs, and has some toxicity, however researchers believe the amounts required are well below toxicity levels and the correct formulation will limit any unpleasant odours.

The research has so far only been done in vitro, but the team hopes to develop a treatment that could be used in patients in the next five years.

Professor Stuart Jones, Director of the Centre for Pharmaceutical Medicine Research at KCL said: “We are looking forward to translating these findings into an innovative topical product that can treat nail infection.”

Source: University of Bath

Categories : Ethics and Law IT in HealthcareTags : Leave a comment

POPIA Compliance for Health Data: Navigating Special Personal Information Requirements in Healthcare

On By ModernMedia

By Wendy Tembedza, Partner at Webber Wentzel


Health data is one of the most valuable assets in modern healthcare, and the Protection of Personal Information Act, 2013 (POPIA) places strict requirements on its use.

Stakeholders in the healthcare sector understand the value of data in ensuring appropriate treatment for patients. With the proliferation of technologies such as artificial intelligence, which enable healthcare practitioners to derive valuable insights from the data they hold, the importance of managing data in a manner that ensures compliance with data protection laws must remain front of mind in all data processing activities.

This obligation is particularly acute given the volumes of data that evolving technologies allow healthcare institutions to collect and utilise. Importantly, when these larger datasets include special personal information, the obligation to process such information lawfully becomes even more significant. This is because POPIA regulates the processing of special personal information (which includes health and sex life information) more closely than it does other forms of personal information.

The implications of POPIA’s strict regulation of processing health and sex life information means that, where a responsible party is considering collecting such data, an assessment must be made before collection to ensure that the intended processing activities will be lawful under POPIA. Conducting such an assessment prior to collection is integral to establishing a lawful basis for processing from the outset, as all handling of health and sex life information must remain lawful throughout the processing lifecycle, from collection and use to deletion and destruction.

POPIA establishes, as a starting point, a prohibition on processing health and sex life information unless a justification exists. One general exception is where the data subject has granted consent for such processing. It is important to note that consent is specifically defined under POPIA as an informed, voluntary expression of will. Importantly, consent must be specific and cannot be overly generalised. Any reliance on consent must therefore meet these definitional requirements. Ensuring compliance with these requirements is increasingly pertinent where data is used for purposes that differ from the reason for which it was initially collected.

POPIA provides additional exemptions for processing special personal information. For health information, POPIA permits processing by medical professionals, healthcare institutions or facilities, or social services, where such role players are providing healthcare services. POPIA also provides an exemption that applies to insurance companies, medical schemes, medical scheme administrators, and managed healthcare organisations in certain circumstances.

While POPIA creates these categories of exemptions, it is important to note that even where a role player falls within an exemption, this does not eliminate the obligation on a responsible party to comply with POPIA’s eight conditions for lawful processing. Any responsible party relying on an exemption must still ensure that processing activities are ultimately lawful and consistent with the standards of care contemplated under POPIA.

The use of automated means to make decisions about data subjects using their health and sex life information must also be carried out lawfully and in compliance with POPIA. A data subject cannot be subject to a decision that has legal consequences for them, or that otherwise affects them to a substantial degree, where such a decision is based solely on automated decision-making using their personal information, except in limited instances.

Notably, POPIA specifically identifies health as an example of a decision that could have legal consequences or otherwise affect a data subject substantially. This highlights the importance of assessing all data processing activities, especially in sectors like healthcare, where there is growing reliance on technology to make diagnostic or treatment-related decisions.

The Information Regulator has recognised the importance of properly regulating the processing of health and sex life information in recently published Draft Regulations relating to the processing of such data by certain responsible parties. The Information Regulator notes that the primary purpose of these Draft Regulations is to assist responsible parties in implementing POPIA correctly and to provide better transparency to data subjects regarding their information.

The scope of application of the Draft Regulations includes insurance companies, medical schemes, medical scheme administrators, managed healthcare organisations and pension funds.

The Information Regulator’s move to regulate the processing of health and sex life information more closely underscores the importance of ensuring that all such processing activities are undertaken with an increased measure of care. Organisations must therefore assess their processing activities routinely to ensure ongoing compliance with POPIA. This is particularly important as healthcare-related technologies continue to advance, creating new and innovative ways to use data in patient treatment.

Healthcare stakeholders must ensure that use of such technologies comply with POPIA’s requirements and meet the standards established under the Act.