News Article | April 25, 2017
VIDEO: Scientists and physicians at University of California San Diego School of Medicine, working with colleagues at the U.S. Navy Medical Research Center (NMRC), Texas A&M University, a San Diego-based biotech... view more Scientists and physicians at University of California San Diego School of Medicine, working with colleagues at the U.S. Navy Medical Research Center - Biological Defense Research Directorate (NMRC-BDRD), Texas A&M University, a San Diego-based biotech and elsewhere, have successfully used an experimental therapy involving bacteriophages -- viruses that target and consume specific strains of bacteria -- to treat a patient near death from a multidrug-resistant bacterium. The therapeutic approach, which has been submitted to a peer-reviewed journal, is scheduled to be featured in an oral presentation tomorrow at the Centennial Celebration of Bacteriophage Research at the Institute Pasteur in Paris by Biswajit Biswas, MD, one of the case study's co-authors and chief of the phage division in the Department ?Genomics and Bioinformatics at NMRC-BDRD. April 27 is Human Phage Therapy Day, designated to mark 100 years of clinical research launched by Felix d'Herelle, a French-Canadian microbiologist at Institute Pasteur who is credited with co-discovering bacteriophages with British bacteriologist Frederick Twort. Authors say the case study could be another catalyst to developing new remedies to the growing global threat of antimicrobial resistance, which the World Health Organization estimates will kill at least 50 million people per year by 2050. Based on the success of this case, in collaboration with NMRC, UC San Diego is exploring options for a new center to advance research and development of bacteriophage-based therapies. "When it became clear that every antibiotic had failed, that Tom could die, we sought an emergency investigational new drug application from the FDA to try bacteriophages," said lead author Robert "Chip" Schooley, MD, professor of medicine, chief of the Division of Infectious Diseases in the UC San Diego School of Medicine and primary physician on the case. "To our knowledge, he is the first patient in the United States with an overwhelming, systemic infection to be treated with this approach using intravenous bacteriophages. From being in a coma near death, he's recovered well enough to go back to work. Of course, this is just one patient, one case. We don't yet fully understand the potential -- and limitations -- of clinical bacteriophage therapy, but it's an unprecedented and remarkable story, and given the global health threat of multidrug-resistant organisms, one that we should pursue." The story begins in late-2015. Tom Patterson, PhD, a 69-year-old professor in the Department of Psychiatry at UC San Diego School of Medicine, and his wife, Steffanie Strathdee, PhD, chief of the Division of Global Public Health in the Department of Medicine, were spending the Thanksgiving holiday in Egypt when Patterson became ill, wracked by abdominal pain, fever, nausea, vomiting and a racing heartbeat. Local doctors diagnosed pancreatitis -- inflammation of the pancreas -- but standard treatment didn't help. Patterson's condition worsened and he was medevacked to Frankfurt, Germany Dec. 3, 2015, where doctors discovered a pancreatic pseudocyst, a collection of fluid around the pancreas. The fluid was drained and the contents cultured. Patterson had become infected with a multidrug-resistant strain of Acinetobacter baumannii, an opportunistic and often deadly pathogen. The bacterium has proved particularly problematic in hospital settings and in the Middle East, with many injured veterans and soldiers returning to the U.S. with persistent infections. Initially, the only antibiotics with any effect proved to be a combination of meropenem, tigecycline and colistin, a drug of last resort because it often causes kidney damage, among other side effects. Patterson's condition stabilized sufficiently for him to be airlifted Dec. 12, 2015, from Germany to the Intensive Care Unit (ICU) at Thornton Hospital at UC San Diego Health. Upon arrival, it was discovered that his bacterial isolate had become resistant to all of these antibiotics. At Thornton Hospital, now part of Jacobs Medical Center, Patterson began to recover, moving from the ICU to a regular ward. But the day before scheduled discharge to a long-term acute care facility, an internal drain designed to localize his infection and keep it at bay slipped, spilling bacteria into his abdomen and bloodstream. Patterson immediately experienced septic shock. His heart began racing. He could not breathe. He became feverish and would subsequently fall into a coma that would last for most of the next two months. He was, in effect, dying. "That's a period of my life I don't remember," recalled Patterson. "There was so much pain that it's almost beyond your ability to cope. I'm happy not to remember." Strathdee, his wife, is no stranger to the terrors of disease. As an infectious disease epidemiologist and director of the UC San Diego Global Health Institute, she has worked around the world, from India to Afghanistan to Mexico, trying to lower HIV infection and mortality rates. "There came a point when he was getting weaker and weaker, and I didn't want to lose him. I wasn't ready to let him go and so I held his hand and said, 'Honey, they're doing everything they can and there's nothing that can kill this bug, so if you want to fight, you need to fight. Do you want me to find some alternative therapies? We can leave no stone unturned.'" Tom recalled the moment: "I vaguely remember you saying, 'do you want me to try or not because it's going to be a tough time and it's not certain that it will work.' I remember squeezing your hand, but it was just a flash in the whole process." Strathdee began doing research. A colleague mentioned a friend had traveled to Tblisi, Georgia to undergo "phage therapy" for a difficult condition and had been "miraculously cured." Strathdee had learned of bacteriophages while she was a student, but they were not part of mainstream medical doctrine. She turned to strangers in the phage research community and to her colleague Chip Schooley for help. Bacteriophages are ubiquitous viruses, found wherever bacteria exist. It's estimated there are more than 1031 bacteriophages on the planet. That's ten million trillion trillion, more than every other organism on Earth, including bacteria, combined. Each is evolved to infect a specific bacterial host in order to replicate -- without affecting other cells in an organism. The idea of using them therapeutically is not new. Described a century ago, phage therapy was popular in the 1920s and 1930s to treat multiple types of infections and conditions, but results were inconsistent and lacked scientific validation. The emergence of antibiotics in the 1940s pushed phage therapy aside, except in parts of Eastern Europe and the former Soviet Union, where it remained a topic of active research. With dwindling options, Strathdee, Schooley and colleagues went looking for help. They found many researchers willing to help. Three teams possessed suitable phages that were active against Patterson's particular bacterial infection: the Biological Defense Research Directorate of the NMRC in Frederick, MD; the Center for Phage Technology at Texas A&M University; and AmpliPhi, a San Diego-based biotech company specializing in bacteriophage-based therapies. A research team at San Diego State University, headed by microbial ecologist Forest Rowher, PhD, purified the phage samples for clinical use. With emergency approval from the Food and Drug Administration, each source provided phage strains to UC San Diego doctors to treat Patterson, with no guarantee that any of the strains would actually work. "That's one of the remarkable things to come out of this whole experience," said Schooley, "the incredible and rapid collaboration among folks scattered around the world. It was a desperate time and people really stepped up." Phage therapy is typically administered topically or orally. In Patterson's case, the phages were introduced through catheters into his abdominal cavity and intravenously to address a broader, systemic infection, which had not been done in the antibiotic era in the U.S. "That makes them more effective," said Schooley. "The action is at the interface of the patient and the organism." With tweaking and adjustments -- his physicians were learning on the fly -- Patterson began to improve. He emerged from his coma within three days of the start of IV phage therapy. "Tom woke up, turned to his daughter and said, 'I love you'," recalled Schooley. Patterson was soon weaned off of the respirator and blood pressure drugs. "As a treating doctor, it was a challenge," said Schooley. "Usually you know what the dosage should be, how often to treat. Improving vital signs is a good way to know that you're progressing, but when you're doing it for the first time, you don't have anything to compare it to. "A lot was really worked out as we went along, combining previous literature, our own intuition about how these phages would circulate and work and advice from people who had been thinking about this for a long time." By the time Patterson was airlifted to Thornton Hospital at UC San Diego Health, he was in dire straits. His abdomen had swelled, distended by the pseudocyst teeming with multi-drug resistant A. baumaunnii. His white blood cell count had soared -- a sign of rampant infection. Doctors tried various combinations of antibiotics. He developed respiratory failure and hypotension that required ventilation and recurrent emergency treatment. He became increasingly delirious. When he lapsed into a coma in mid-January, he was essentially being kept alive on life support. Eventually Schooley said there were no antimicrobial agents left to try. Strathdee recalled colleagues wondering aloud if she was prepared for Tom to die. She wasn't. Bacteriophage therapy began March 15, 2016, with a cocktail of four phages provided by Texas A&M and the San Diego-based biotech company AmpliPhi, pumped through catheters into the pseudocyst. If the treatment didn't kill him, Patterson's medical team planned to inject the Navy's phages intravenously, flooding his bloodstream to reach the infection raging throughout his body. As far as Patterson's doctors knew, such treatment had never been tried before. On March 17, the Navy phages were injected intravenously. There were fears about endotoxins naturally produced by the phages. No one knew what to expect, but Patterson tolerated the treatment well -- indeed there were no adverse side effects -- and on March 19, he suddenly awoke and recognized his daughter. "One of NMRC's goals with respect to bacteriophage science has been providing military members infected with multidrug-resistant organisms additional antimicrobial options so we were experienced and well-positioned to provide an effective phage cocktail for Dr. Patterson," said Theron Hamilton, PhD, head of Genomics and Bioinformatics at the Navy's Biological Defense Research Directorate. "Obviously, we are thrilled with the outcome and hope this case increases awareness of the possibility of applying phage therapy to tough cases like this one." Subsequent treatment, however, would not be easy. The learning curve was steep and unmarked. There were bouts of sepsis -- a life-threatening complication caused by massive infection. Despite improvement, Patterson's condition remained precarious. Doctors discovered that the bacterium eventually developed resistance to the phages, what Schooley would characterize as "the recurring Darwinian dance," but the team compensated by continually tweaking treatment with new phage strains -- some that the NMRC had derived from sewage -- and antibiotics. In early May, Patterson was taken off of antibiotics. After June 6, there was no evidence of A. baumannii in his body. He was discharged home August 12, 2016. Recovery has not been entirely smooth and steady. There have been setbacks unrelated to the phages. A formerly robust man, Patterson had been fed intravenously for months in the hospital and had lost 100 pounds, much of it muscle. He has required intense physical rehabilitation to regain strength and movement. "It's not like in the movies where you just wake up from a coma, look around and pop out of bed," Patterson said. "You discover that your body doesn't work right anymore." He said he could feel parts of his brain coming back alive. Nonetheless, Patterson described the experience as miraculous. Even comatose, when he often wrestled with imagined demons, he recalled hearing and recognizing voices and realizing that beyond his darkness, there was life and hope. And beyond him, he hopes his experience will translate into new treatments for others: "The phage therapy has really been a miracle for me, and for what it might mean that millions of people who may be cured from multidrug-resistant infections in the future. It's been sort of a privilege." Schooley said Patterson was lucky. His wife was a trained scientist and determined to find a remedy -- and they both worked at UC San Diego School of Medicine: "He was fortunate to be in a place that had all of the resources and courage necessary to support him while this innovative therapy was developed, which was essentially a home brew cocktail of viruses to be given to a desperately ill individual. I think a lot of other places would have hesitated. I think the response that he had clinically has been very gratifying and speaks to the strength of a multidimensional medical center with all of the pieces you need." Still, Schooley said any broad, future approved application of phage therapy faces fundamental challenges unlike past treatments. "What the FDA is used to saying is 'This is an antibiotic. We know what its structure is and how you can give it to multiple people.' With bacteriophage therapy, the FDA would be dealing with an approach in which doctors would have to develop phage cocktails for each patient tailored to their infecting organisms. It's the ultimate personalized medicine." The good news, Schooley said, is that new molecular tools, robotics and other advances make personalized medicine possible in a way it wasn't 10 or 15 years ago. "Then, it would have been impossible to contemplate. There's still much research to be done, but I think there are going to be a lot of clinical applications where this approach may be very beneficial to patients." Derived from the Greek words meaning "bacteria eater," bacteriophages are ancient and abundant -- found on land, in water, within any form of life harboring their target. According to Rowher at San Diego State University and colleagues in their book Life in Our Phage World, phages cause a trillion trillion successful infections per second and destroy up to 40 percent of all bacterial cells in the ocean every day. Thousands of varieties of phage exist, each evolved to infect only one type or a few types of bacteria. Like other viruses, they cannot replicate by themselves, but must commandeer the reproductive machinery of bacteria. To do so, they attach to a bacterium and insert their genetic material. Lytic phages then destroy the cell, splitting it open to release new viral particles to continue the process. As such, phages could be considered the only "drug"' capable of multiplying; when their job is done, they are excreted by the body.
News Article | April 17, 2017
Owing to an increase in demand for procedures and services, St. Louis Children’s Hospital is expanding its Pediatric Epilepsy Center. The expansion will include additional surgical technology, two epileptologists, EEG technologists and an ICU EEG. St. Louis Children’s Hospital recently invested in state-of-the-art surgical technology to treat children with epilepsy. ROSA, or Robotized Surgical Assistant, has two roles in epileptic surgery: to map out the procedural route before surgery, and to assist during surgery. Children’s epilepsy surgeons have performed upwards of 20 procedures with the help of ROSA since acquiring the technology almost a year ago. “ROSA allows us to better see the onset and spread of seizures in three dimensions across the brain, while doing so in an efficient and minimally invasive fashion,” says Rejean Guerriero, DO, a Washington University Physician and neurologist at St. Louis Children’s Hospital. “It allows us to ask and answer questions about the relationship between cellular networks and their seizure susceptibility in remote parts of the brain that moves well beyond our prior abilities and technology." ROSA creates a 3-D map for the surgeons to follow during a procedure, and holds the surgical tools precisely and firmly in place. The precision and strength of ROSA has made brain surgery safer than ever before. The technology enables surgeons to perform less invasive procedures, with smaller incisions and less bleeding. It has reduced surgery time by hours, and has helped patients recover in days rather than weeks. ROSA also reduces the patient’s risk of pain and infection. In 2016, epilepsy surgery volumes at Children’s increased more than 30 percent from the previous year. To accommodate the growth in volume, the Pediatric Epilepsy Center is adding two epileptologists. Stuart Tomko, MD, who trained at Texas Children’s and Boston Children’s Hospitals, will begin working at St. Louis Children’s Hospital in July. Dr. Guerriero, who finished his residency and fellowship at Boston Children's Hospital before coming to St. Louis Children’s Hospital less than a year ago, will be spearheading the new ICU EEG program. The ICU EEG program, currently in a pilot phase, will debut at Children’s this summer. According to Bradley Schlaggar, MD, Chief of the Division of Pediatric and Developmental Neurology at St. Louis Children’s Hospital, the ICU EEG program will allow physicians to identify and treat seizures more easily using EEG machines. “This service will increase our ability to optimize outcomes for patients in our pediatric, cardiac and neonatal intensive care units,” says Dr. Schlaggar. “It has become increasingly clear that neurocritically ill children have clinically unrecognized seizures with sufficient frequency that it is important to use EEG technology to identify those seizures.” Children’s is adding several EEG technologists to identify the source of seizures in patients using EEG equipment. “We are transferring responsibility for patient observation in the epilepsy monitoring unit from our patient care techs to the EEG techs in order to improve the quality and consistency of the process,” says Susan Hibbits, OTR/L, director of Neuroscience at Children’s. With the addition of new technologists and equipment, St. Louis Children’s Hospital plans to quickly and accurately identify seizures in patients in order to provide them with proper care. As demand increases for advanced epilepsy treatment, St. Louis Children’s Hospital will continually expand the Epilepsy Center to accommodate patients from the St. Louis region, across the United States and around the world. ABOUT ST. LOUIS CHILDREN’S HOSPITAL St. Louis Children’s Hospital has provided specialized care for children for more than 130 years. US News & World Report ranks St. Louis Children’s among the best pediatric hospitals in the nation. In 2015 the hospital again received the Magnet designation from the American Nurses Credentialing Center, the nation’s highest honor for nursing excellence. St. Louis Children’s Hospital is affiliated with Washington University School of Medicine, one of the leading medical research, teaching and patient care institutions in the nation. The hospital is a member of BJC HealthCare. For more information, visit StLouisChildrens.org, or find us on Facebook and @STLChildrens on Twitter.
News Article | March 14, 2017
Life is unexpected and miracles occur when one least expects it. Captain Brandon Caldwell and his family's story is one which reinstates belief. Captain Caldwell, who came back after two months of deployment in Antarctica, never expected such a warm welcome — especially from his nine-month old boy Reagan who is visually impaired. Regan received his pair of blue glasses right after his dad was deployed to Antarctica, welcomed his military father with a smile of joy. The emotional moment was captured by his wife Amanda, who shared the video on her Facebook page. The video shows Regan sitting on his father's lap, who was still in his army uniform, singing "Patty Cake" to his son. With the new pair of blue glasses, Reagan watches his dad and listens to every word he utters. As the song continues, the boy is seen resting his head on his father's chest. Being so many months away from his nine-month old son, Caldwell thought Reagan may have forgotten him, which was certainly not the scene. "You can see how hard it was for Brandon to be away from Reagan by the emotion he showed when he finally had him in his arms again," shared Amanda to Cater News. Amanda who was a school teacher by profession, like most expectant mothers underwent testing and found she was positive with Group B Strep (GBS) in the 35 to 37 weeks. According to the American Pregnancy Association, one out of every pregnant woman is tested positive with GBS, so this was nothing to be worried about. However, after being tested with GBS, she was not informed anything about the severe consequences her child was going to suffer. The initial stage with baby Reagan was not an easy one for Amanda, as the child was detected with meningitis and sepsis 20 days after his birth. As a result of which, his family members took him to the Intensive Care Unit (ICU). The child also had to go through several seizures as a result of suffering from meningitis and sepsis. Based on his MRI results, the doctors suspected that the little baby may suffer from cerebral palsy or could be even mentally handicapped. However, Reagan is now showing positive improvements, and is also taking classes for speech therapy, visual impairment, as well as special education at home. His mother, Amanda left her job as a teacher to be with Reagan and also takes him to the doctor regularly, which also includes visits to the hospitals every six weeks. One can be a part of Reagan's journey by visiting Amanda's Facebook page, where she shares his updates, details about GBS, as well the medical challenges faced by the family. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | March 12, 2017
Latest study on brain activity of dead patients has suggested that brain activity continues even after the heart stops beating. As part of the research, one of the patients' brains carried its activity for more than 10 minutes after the person was considered clinically dead. The brain activity was very similar to the one recorded from people who were engaged in deep sleep. The study, published in the Canadian Journal of Neurological Sciences, was carried out by specialists from the University of Western Ontario. The findings shed new light on how complex brain activity is in reality. Previous research carried out on decapitated rats suggested that in the minute after dying, the brain activity undergoes a surge. Before this study was published, scientist believed that the brain can remain active for up to one minute after the complete cessation of the arterial blood pressure and cardiac rhythm. However, this paper points out toward a massive difference between the brain activity of rats and that observed on people. As part of the research, the scientists analyzed four clinically ill subjects, who were just taken off life support in an ICU in Ontario. The level of brain activity differed for each of the subjects, both moments before dying and immediately after. Some of the subjects' brain activity had even stopped before they were actually dead. At the same time, there was one subject who experienced a surge of brain activity, both before and immediately after dying. According to the doctors, the brain activity continued for another mysterious 10 minutes and 38 seconds after the patient was declared dead. "In a case series of four patients, EEG inactivity preceded electrocardiogram and ABP inactivity during the dying process in three patients. Further study of the electroencephalogram during the withdrawal of life-sustaining therapies will add clarity to medical, ethical, and legal concerns for donation after circulatory determined death," noted the paper. The team of researchers is inclined to believe that the occurrence they observed was a rare phenomenon rather than a scientific reality. Also, before getting to the conclusion that the patient's brain activity continued for more than 10 minutes after having been clinically dead, the scientists were tempted to believe another hypothesis. As the delta waves of brain activity were only present in one of the four patients, the scientists thought that the EEG machine could have been faulty. However, upon checking the machine, they concluded that it was perfectly functional. This left them with the only conclusion that the brain activity did, indeed, happen as noted. Additionally, the paper provides enough information as to conclude that death is a personal experience, which can take place differently for each individual. While the phenomenon the team of scientists observed is extraordinary, the researchers avoided drawing a clear conclusion. The reason for their skepticism lies in the fact that the sample they observed is not scientifically representative for a large population. In order to have more conclusive evidence of the phenomenon, the researchers would have to carry on examining brain activity before and immediately after death. However, this issue is highly sensitive, as it is subjected to ethical implications. Should this example prove conclusive for humankind, the scientific world would have to revise some of the policies of organ donation. © 2017 Tech Times, All rights reserved. Do not reproduce without permission.
News Article | April 20, 2017
The International Nurses Association is pleased to welcome Kari Elliott, BSN, RN, AE-C, to their prestigious organization with her upcoming publication in the Worldwide Leaders in Healthcare. Kari Elliott is a Registered Nurse with more than 13 years of experience and an extensive expertise in all facets of nursing, especially pediatric, ICU, NICU, emergency, travel, postpartum, burn unit, and critical care nursing. She is currently working for a local staffing agency assisting with weekend staff needs for Grace Staffing Inc., and working in a small community hospital part-time in Missouri. Kari received her Bachelor of Science Degree in Dietetics with a minor in Chemistry in 1999 from Missouri State University. She decided to pursue nursing, and obtained her Bachelor of Science Degree in Nursing in 2004 from Truman State University. An advocate for continuing education, Kari is currently pursuing her Doctorate of Nursing with a pediatric emphasis at the University of Missouri-Columbia with a projected graduation in 2018. She holds additional certifications in Basic Life Support, Advanced Cardiac Life Support, Pediatric Advanced Life Support, Neonatal Resuscitation, Emergency Nursing Pediatric Course, Trauma Nursing Core Course, and is a Certified Asthma Educator. An inductee of the Sigma Theta Tau International Honor Society of Nursing, Kari maintains professional memberships with the American Nurses Association, the Missouri Nurses Association, the American Association of Nurse Practitioners, and the Association of Asthma Educators. She engages in asthma volunteer work, and is focusing on pediatric asthma with education for parents and patients, to ensure all asthmatic children have proper prescriptions. Kari attributes her success to her education at Truman State University, her excellent mentors, and her passion for nursing. In her free time, Kari enjoys spending time with her husband of 11 years, outdoor activities, and spending time with her dogs. Learn more about Kari here: http://inanurse.org/network/index.php?do=/4135898/info/ and be sure to read her upcoming publication in the Worldwide Leaders in Healthcare.
News Article | May 2, 2017
The International Nurses Association is pleased to welcome Terrance Scieneaux Sparks, RN, to their prestigious organization with her upcoming publication in the Worldwide Leaders in Healthcare. Terrance Scieneaux Sparks is a Registered Nurse currently serving patients within the Ochsner Medical Center in Gretna, Louisiana. With nearly three decades of experience in nursing, she is a specialist telemetry, ICU, oncology, and stroke nurse. Terrance gained her initial nursing qualification in 1987, becoming a Licensed Practical Nurse. In 1995, she completed her Nursing Degree at Nicholls State University in Thibodaux, Louisiana, and became a Registered Nurse. Throughout her career, Terrance has completed a number of advanced training courses, and holds additional certification Advanced Cardiac Life Support. Terrance has a wealth of experience in many areas of the nursing field. She attributes her success to the great mentors she has had throughout her training and her career, and when she is not assisting her patients, Terrance loves cooking, and spending time with her grandchildren. Learn more about Terrance here: http://inanurse.org/network/index.php?do=/4136126/info/ and be sure to read her upcoming publication in Worldwide Leaders in Healthcare.
News Article | April 20, 2017
On April 18, 2017, after-market hours, ICU Medical revealed that it had received a subpoena from the U.S. Department of Justice requesting "documents regarding the manufacturing, selling, pricing and shortages of intravenous solutions, including saline" that it gained when it acquired the infusion systems business of Pfizer Inc.'s Hospira unit. Following this news, ICU Medica stock dropped as much as $1.55per share, or 1.06%, during intraday trading on April 19, 2017. If you are aware of any facts relating to this investigation, or purchased shares of ICU Medical, you can assist this investigation by visiting the firm's site: www.bgandg.com/icui. You can also contact Peretz Bronstein or his Investor Relations Analyst, Yael Hurwitz of Bronstein, Gewirtz & Grossman, LLC: 212-697-6484. Bronstein, Gewirtz & Grossman, LLC is a corporate litigation boutique. Our primary expertise is the aggressive pursuit of litigation claims on behalf of our clients. In addition to representing institutions and other investor plaintiffs in class action security litigation, the firm's expertise includes general corporate and commercial litigation, as well as securities arbitration. Attorney advertising. Prior results do not guarantee similar outcomes. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/shareholder-alert-bronstein-gewirtz--grossman-llc-announces-investigation-of-icu-medical-inc-icui-300442367.html
News Article | April 28, 2017
According to a new multicenter study, nearly half of previously employed adult survivors of acute respiratory distress syndrome were jobless one year after hospital discharge, and are estimated to have lost an average of $27,000 in earnings. A summary of the research was published on April 28 in the American Journal of Respiratory and Critical Care Medicine. Acute respiratory distress syndrome (ARDS) is a lung condition often caused by severe infection or trauma, and marked by fluid build up in the lungs' air sacs. The resulting damage leads to a substantial decrease in oxygen reaching the bloodstream and rapidly developing difficulty with breathing. Patients are usually hospitalized and placed on a life-supporting ventilator. ARDS affects approximately 200,000 Americans every year. ARDS survivors often have long-lasting impairments such as cognitive dysfunction, mental health issues and physical impairments, all of which may affect employment. "This study is important and novel given its comprehensive evaluation of joblessness among almost 400 previously employed ARDS survivors from multiple sites across the U.S.," says Dale Needham, F.C.P.A, M.D., Ph.D., professor of medicine and of physical medicine and rehabilitation at the Johns Hopkins University School of Medicine and senior author of the study. "Multiple studies have suggested that joblessness is common in people who survive ARDS, but to our knowledge, none have carefully tracked those who returned to work or subsequently lost their jobs, performed an in-depth analysis of risk factors for joblessness, and evaluated the impact of joblessness on lost earnings and health care coverage," adds Biren Kamdar, M.D., M.B.A., M.H.S., assistant professor of medicine at the David Geffen School of Medicine at UCLA and the study's first author. One important goal of the research, the scientists say, is to better identify specific risk factors for joblessness and to inform future interventions aimed at reducing joblessness after ARDS. The new study was conducted as part of the ARDS Network Long-Term Outcome Study (ALTOS), a national multicenter prospective study longitudinally evaluating ARDS survivors recruited from 2006 to 2014, including patients from 43 hospitals across the U.S. For the analysis, the investigators recruited 922 survivors and interviewed them by telephone at six months and 12 months after the onset of their ARDS. Each survivor was asked about employment status, hours working per week, how long before they returned to work following hospital discharge, perceived effectiveness at work and major change in occupation. The research team estimated lost earnings using age- and sex-matched wage data from the U.S. Bureau of Labor Statistics. Individual survivors' matched wages were multiplied by the number of hours worked prior to hospitalization to determine potential earnings and by current hours worked to determine estimated earnings. Estimated lost earnings were calculated as the difference between estimated and potential earnings. Of the 922 survivors, 386 (42 percent) were employed prior to ARDS. The average age of these previously employed survivors was 45 years, 56 percent were male and 4 percent were 65 years or older. Overall, previously employed survivors were younger, predominantly male and had fewer pre-existing health conditions compared with survivors not employed before ARDS. Of the 379 previously employed patients who survived to 12-month follow-up, nearly half (44 percent) were jobless a year after discharge. Some 68 percent of survivors eventually returned to work during the 12-month follow-up period, but 24 percent of these survivors subsequently lost their jobs. Throughout the 12-month follow-up, non-retired jobless survivors had an average estimated earnings loss of about $27,000 each, or 60 percent of their pre-ARDS annual earnings. The research team also saw a substantial decline in private health insurance coverage (from 44 to 30 percent) and a rise in Medicare and Medicaid enrollment (33 to 49 percent), with little change in uninsured status. For the 68 percent of ARDS survivors who returned to work by the end of the follow-up year, the median time to return was 13 weeks after discharge. Of those, 43 percent never returned to the number of previous hours worked, 27 percent self-reported reduced effectiveness at work, and 24 percent later lost their jobs. The team found that older, non-white survivors, and those experiencing a longer hospitalization for their ARDS had greater delays in returning to work. Severity of illness and sex, however, did not affect time to return to work. "These results cry out for those in our medical field to investigate occupational rehabilitation strategies and other interventions to address the problem of post-discharge joblessness," Needham says. "Health care providers need to start asking themselves, 'What can we do to help patients regain meaningful employment,' and not just concern ourselves with their survival." "We believe that ARDS survivors are often jobless due to a combination of physical, psychological and cognitive impairments that may result, in part, from a culture of deep sedation and bed rest that plagues many ICUs. Perhaps if we can start rehabilitation very early, while patients are still on life support in the intensive care unit, getting them awake, thinking and moving sooner, this may result in greater cognitive and physical stimulation and improved well-being. This change in culture can occur and is part of regular clinical practice in our medical ICU at The Johns Hopkins Hospital." Other authors on this paper include Minxuan Huang, Victor D. Dinglas and Elizabeth Colantuoni of The Johns Hopkins University, Till M. von Wachter of the University of California at Los Angeles, and Ramona O. Hopkins of Intermountain Medical Center in Utah. Funding for this study is provided by the National Heart, Lung and Blood Institute (N01HR56170, R01HL091760 and 3R01HL091760-02S1), the ARDS Network trials (contracts HHSN268200536165C to HHSN268200536176C and HHSN268200536179C) and the UCLA Clinical and Translational Science Institute (CTSI) (NIH-National Center for Advancing Translational Science (NCATS) UCLA UL1TR000124 & UL1TR001881).
News Article | April 24, 2017
The global patient temperature management market is anticipated to reach a value of USD 4.5 billion by 2025 Growing number of surgical procedures is expected to have a huge impact on the demand for temperature management products. For instance, open heart surgeries require maintenance of patients' temperature through blood cooling and, thereby, reducing the risk for perioperative and postoperative surgical complications. Currently, the number of cardiac surgeries being undertaken is rapidly increasing owing to the rising prevalence of cardiac arrest and other chronic cardiovascular diseases. This has resulted in increased need for patient temperature management in order to restrict adverse effects on brain. Moreover, while treatment of cancer patients, patient warming systems are used along with chemotherapy and radiation therapy for more effective results. In addition, increasing number of childbirth has also given rise to additional demand for temperature management devices in order to control temperature in neonatal care. Furthermore, technological advancements have expanded the temperature management product portfolio of companies through the introduction of warming and cooling blankets, surface pads, and cooling caps. Some of the key companies for the market include ZOLL Medical Corporation; Stryker Corporation; Medtronic, Inc.; Cincinnati Sub-Zero Products, LLC; Geratherm Medical AG; Bard Medical, Inc.; 3M Company; Smiths Medical, Inc.; Inditherm Plc; The 37Company; and Atom Medical Corporation In 2014, Medtronic acquired Covidien plc in order to enter the temperature management business Key Topics Covered: 1 Research Methodology 2 Executive Summary 3 Patient Temperature Management Market Variables, Trends & Scope 3.1 Market Segmentation & Scope 3.2 Market Driver Analysis 3.3 Market Restraint Analysis 3.4 Key Opportunities Prioritized 3.5 Patient Temperature Management- SWOT Analysis, By Factor (Political & Legal, Economic and Technological) 3.6 Industry Analysis - Porter's 3.7 Patient Temperature Management Market: Competitve Analysis, 2015 4 Patient Temperature Management Market: Product Estimates & Trend Analysis 4.1 Patient Temperature Management Market: Product Movement Analysis 4.2 Patient Warming Systems 4.2.2 Conventional warming systems 4.2.3 Surface warming systems 4.2.4 Intravascular warming systems 4.3 Patient Cooling Systems 4.3.2 Conventional cooling systems 4.3.3 Surface cooling systems 4.3.4 Intravascular cooling systems 5 Patient Temperature Management Market: Application Estimates & Trend Analysis 5.1 Patient Temperature Management Market: Application Movement Analysis 5.2 Surgery 5.3 Cardiology 5.4 Pediatrics 5.5 Neurology 5.6 Others 6 Patient Temperature Management Market: End-Use Estimates & Trend Analysis 6.1 Patient Temperature Management Market: End-Use Movement Analysis 6.2 Operating Rooms 6.3 Neonatal ICU 6.4 ICU 6.5 Emergency Rooms 6.6 Others 7 Patient Temperature Management Market: Regional Estimates & Trend Analysis, by Product, Application, End-Use 8 Competitive Landscape For more information about this report visit http://www.researchandmarkets.com/research/pvxjfp/patient Research and Markets Laura Wood, Senior Manager email@example.com For E.S.T Office Hours Call +1-917-300-0470 For U.S./CAN Toll Free Call +1-800-526-8630 For GMT Office Hours Call +353-1-416-8900 U.S. Fax: 646-607-1907 Fax (outside U.S.): +353-1-481-1716 To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/global-patient-temperature-management--patient-warming-systems-patient-cooling-systems-market-2014-2017--2025---research-and-markets-300443576.html