Tag Archives: patient

New technique enables increasingly accurate PET scan to detect cancer, heart conditions

In the future, the newly developed technique will enable increasingly accurate image acquisition especially during PET scans performed to detect cancers of the chest and upper abdomen, and inflammatory diseases of the heart. PET scanning, or positron emission tomography, is a modern nuclear medicine imaging method, which allows for the detection of cancer and heart conditions. Thanks to enhanced image quality, PET images provide new and increasingly accurate data, potentially improving diagnosis reliability and treatment response monitoring. High-quality image data makes the treatment more efficient both medically and financially. …

New data for engineering immune cells shows promise in solid tumors

Chimeric antigen receptor T cells (CAR T cells) are a form of personalized cell therapy that uses immune cells called T cells from patients. After T cells are harvested from a patient, they are engineered to bear a molecule that allows them to attach to a specific protein carried by the patient’s cancer cells and to be triggered to kill the cancer cells when they do so. …

Computer-controlled table could direct radiotherapy to tumors while sparing vital organs

Sophisticated computer modelling could be used to slowly move the table — known as a couch — and a radiation source in three dimensions to direct radiation precisely to the patient’s tumor, researchers have suggested. At the moment, a radiotherapy table can be angled during treatment, but there is no way to synchronise its rotation with a moving radiation beam. But with some modifications, an upgraded system could move both the patient and the beam while reducing the radiation dose of healthy tissue…

Patient communication has room to grow, study shows

There's room - and need - for improvement in the discussions between doctor and patient that go into medical decision-making, according to research out on Monday. In four studies and a commentary published in JAMA Internal Medicine, the authors look at various aspects of doctors' dialogue with patients about prognoses, options and treatment preferences and find little consistency. And though not all patients want the responsibility of making treatment decisions, medical organizations have long promoted the idea of patient-centered care through shared decision-making, and the 2010 Affordable Care and Patient Protection Act that goes into effect next year incorporates the idea into law. What's more, “When physicians reach out and communicate to patients that their views are welcome, patients really like that a lot,” said Floyd Fowler, senior scientific advisor for the Informed Medical Decisions Foundation in Boston. But research in the past decade showed that U.S. patients with common medical conditions were not being adequately informed about their treatment options, so Fowler and his colleagues wanted to see if anything had changed recently. They surveyed 2,718 U.S. adults who were over 40 years old in 2011 and had seen a doctor for any of the five most commonly treated medical conditions - high blood pressure and cholesterol, prostate and breast cancer screenings and back and knee problems - during the previous two years. They found that doctors tended to discuss the pros and cons of surgeries, but not of cancer screenings or the choice of medication to treat high blood pressure or cholesterol. “Each decision has its own dynamic, and it's intriguing that the heart risk related discussions weren't very good,” said Fowler, the study's lead author. He added that doctors may view back and knee surgeries as more complicated treatments, which is why they were discussed in more detail. In a separate study of 207 kidney patients from two dialysis centers in Boston, researchers found that doctors rarely discussed very sick patients' prognoses or their eligibility for kidney transplants. Dialysis patients tend to have one- and five-year survival rates comparable to those of many cancer patients, Dr. Melissa Wachterman, a palliative care physician with the VA Boston Healthcare system, and her colleagues point out in their report. “Talking about prognosis is tough, but there are a lot of reasons why there is a benefit for patients to have this information if they want it,” Wachterman said. In their study, Wachterman's team interviewed 60 of the sickest dialysis patients and their doctors about expectations for the patients' survival and to what degree they had been discussed. The researchers found only two patients whose doctors may have discussed their prognosis with them, and that more than half of the doctors said they would refuse to discuss prognoses - even if patients asked. “I think we do a disservice to patients if we don't give them a sense that time could be short, because they have a lot that they want to do with the time they have left,” Wachterman said. In addition, the researchers found that while patients were good judges of whether or not they'd live another year, they tended to overestimate their long-term survival without their doctors' guidance. “I think - in the long term - having this kind of information can actually give people hope and the ability to plan,” Wachterman said. But not everyone may want to play an active role in their care, according to Dr. Mack Lipkin, a professor of medicine at the New York University School of Medicine and the Bellevue Hospital Center in New York City. “There are many people who want to be active participants in their care but there are also many people who prefer not to be so active,” said Lipkin, who wrote an editorial accompanying the new research. That's supported by a study of hospitalized patients, led by Hyo Jung Tak of University of Chicago, which found the vast majority wanted information on their illness and treatment options but more than 70 percent wanted doctors to make their medical decisions. Moreover, Tak's group found that patients who preferred to participate in decision-making were more expensive. They stayed, on average, an extra quarter day in the hospital and racked up $155 to $1,576 more in costs. Still, a study led by Dr. Harlan Krumholz, of Yale University School of Medicine in New Haven, Connecticut, surveyed 7,000 heart attack patients and found more than two-thirds preferred to play an active role in decision-making. A quarter of the respondents preferred to be the sole decision-maker. At the very least, Krumholz's report concludes, doctors “who aspire to provide patient-centered care” should ask patients about their decision-making preferences directly. Lipkin also said it's best to ask patients their preferences. “We think the first thing to do is ask the patient what they'd like to know, how they'd like to learn it and then tell them,” he said. Fowler added that patients who want to be a part of the decision process shouldn't be afraid to speak up, and he hopes they get used to sharing in the process as the Affordable Care Act emphasizes shared decision-making initiatives. “We're hoping these types of changes that are in the works really happen… and that when we repeat the study three or four years from now we'll start to see a difference. That would be great,” he said.source : http://www.foxnews.com/health/2013/05/28/patient-communication-has-room-to-grow-study-shows/

Face transplant patient making good progress, doctors say

WARNING: CONTAINS GRAPHIC IMAGERY.  A surgeon who operated on Poland's first face transplant patient says the man is already practicing swallowing and making sounds. The 33-year-old man received a skin-and-bone transplant on May 15, three weeks after losing his nose, upper jaw and cheeks in a workplace accident. Doctors say it was the world's fastest time frame for such an operation. Dr. Maciej Grajek said on Monday the man is practicing to swallow liquids, has gotten out of bed a few times this weekend, communicates through writing and can make sounds when his tracheotomy tube - which helps him breathe - is closed for a moment. Grajek called that “very good progress.” The patient remains in isolation to guard against infections.source : http://www.foxnews.com/health/2013/05/28/face-transplant-patient-making-good-progress-doctors-say/

Polish man gets face transplant just 3 weeks after injury

WARSAW, Poland – & A 33-year-old Polish man received a face transplant just three weeks after being disfigured in a workplace accident, in what his doctors said Wednesday is the fastest time frame to date for such an operation. It was Poland's first face transplant. Face transplants are extraordinarily complicated and relatively rare procedures that usually require extensive preparation of the recipient over a period of months or years. But medical officials said the Polish patient's condition was deteriorating so rapidly that a transplant was seen as the only way to save his life. The patient is now being watched for any potential infections. In a photo taken Tuesday, just six days after the surgery, the patient, identified only by his first name, Grzegorz, was shown giving a thumbs-up sign from his hospital bed. Another picture, based on computer tomography, showed the extensive damage to his skull. He was injured in an April 23 accident at his job at a stone mason's workshop near the southwestern city of Wroclaw when a machine used to cut stone tore off most of his face and crushed his upper jaw. He received intensive treatment at a hospital in Wroclaw that saved his life and eyesight. But an attempt to reattach his own face failed, leaving an area close to the brain exposed to infections, doctors said. The damage was too extensive for doctors to temporarily seal the exposed areas. So he was taken to the Cancer Center and Institute of Oncology in Gliwice, the only place in Poland licensed to perform face transplants. The center has experience in facial reconstruction for patients disfigured by cancer and its experts have practiced face transplants on cadavers. Doctors at the center said the 27-hour face and bone transplant was performed May 15 soon after a matching donor was found. The surgery reconstructed the area around the eyes, the nose, jaws and palate and other parts of the man's face. Pictures show stitches running from above the patient's right eye, under the left eye and around the face to the neck. The donor, a 34-year-old man, was chosen from a national registry of potential donors after his age, gender, blood group and body features were determined to be a good match for the injured man. The head of the team of surgeons and other specialists, Dr. Adam Maciejewski, said it was the first time a face transplant was carried out so soon after the damage. Face transplants are usually a last resort after conventional reconstructive and plastic surgeries have been tried. “In such an extensive injury, where the structures close to the skull base and in contact with the brain area are exposed, any infection would be dangerous, not to mention the impossibility to function normally, including problems with breathing, with eating,” Maciejewski said. “All that led us in one direction.” “We assume the surgery will allow the patient to return to normal life. He will be able to breathe, to eat, to see.” Maciejewski said that over time, the face will mold to the man's facial bone structure and he will not look like the donor. The patient is now breathing on his own and responds to questions by nodding his head or squeezing the hands of doctors. But his condition is serious and it will be months before the procedure can be declared a full success, said Dr. Krzysztof Olejnik, head of the team of anesthesiologists. Another member of the transplant team, surgeon Dr. Maciej Grajek, told The Associated Press that the patient was receiving drugs to ward off any potential viral, bacterial or skin infections, but the face is alive and is healing. Though he is in sterile isolation, the patient has started the rehabilitation process. He will stay on special drugs for the rest of his life to prevent rejection of his new face. More than two dozen transplants of the face or parts of the face have been performed around the world. The first one was a partial face transplant in a woman maimed by her dog in France in 2005. Dr. Bohdan Pomahac, who in 2011 led a team in the United States that performed a full face and double-hand transplant on a woman mauled by a chimpanzee, said in an email he believes that in the future surgeons will decide more swiftly on a transplant, just as the Polish team did. “This is the way we likely will practice in the future,” said Pomahac, a reconstructive surgeon at Harvard-affiliated Brigham and Women's Hospital in Boston. However, he cautioned that patients should be given more time to be fully involved in a decision that will have a life-long impact on them. “I still think that a traumatized patient, even with all the psychological support, probably has a hard time making the right decision within hours/days after life-changing trauma,” Pomahac said. Dr. Zbigniew Wlodarczyk, who has performed limb transplants in Poland but was not involved in the face transplant, told the AP the surgery was groundbreaking because it was carried out on a fresh injury and on tissues that have not healed, but that leaving such an extensive wound open would have led to infection and the patient's death. “Such rare but spectacular procedures show the possibilities of medicine today and advance it,” he said.  ”This places Poland in the elite group of countries performing such transplants.  source : http://www.foxnews.com/health/2013/05/23/polish-man-gets-face-transplant-just-3-weeks-after-injury/