Day: January 28, 2022

Categories : Medical Research & TechnologyTags :

Robot Performs Surgery Without Human Assistance

On By ModernMedia
Photo by Tara Winstead from Pexels

In a significant step toward fully automated surgery on humans, a robot has performed laparoscopic surgery on the soft tissue of a pig without human guidance. 

Designed by a team of Johns Hopkins University researchers, the Smart Tissue Autonomous Robot (STAR) is described in Science Robotics.

“Our findings show that we can automate one of the most intricate and delicate tasks in surgery: the reconnection of two ends of an intestine. The STAR performed the procedure in four animals and it produced significantly better results than humans performing the same procedure,” said senior author Axel Krieger, PhD, an assistant professor at John Hopkins University.

The robot excelled at intestinal anastomosis, which connects the two ends of an intestine. It is a procedure that requires a high level of repetitive motion and precision and is arguably the most challenging step in gastrointestinal surgery, requiring a surgeon to accurately and consistently suture. A slight hand tremor or misplaced stitch can result in a leak with potentially catastrophic complications for the patient.

The team developed a vision-guided system designed specifically to suture soft tissue. Their current iteration advances a 2016 model that repaired a pig’s intestines accurately, but required a large incision to access the intestine and more guidance from humans.

The team equipped the STAR with new features for enhanced autonomy and improved surgical precision, including specialised suturing tools and state-of-the art imaging systems that provide more accurate visualisations of the surgical field.

Soft-tissue surgery is especially hard for robots because of its unpredictability, forcing them to be able to adapt quickly to handle unexpected obstacles, Dr Krieger said. STAR features a novel control system that can adjust the surgical plan in real time, just as a human surgeon would.

As the medical field moves towards more laparoscopic approaches for surgeries, it will be important to have an automated robotic system designed for such procedures to assist, Dr Krieger said.

“Robotic anastomosis is one way to ensure that surgical tasks that require high precision and repeatability can be performed with more accuracy and precision in every patient independent of surgeon skill,” Dr Krieger said.

“We hypothesise that this will result in a democratised surgical approach to patient care with more predictable and consistent patient outcomes.”

Source: John Hopkins University

Categories : Diseases, Syndromes and Conditions Mental HealthTags :

In Chronic Disease, Psychiatric Comorbidity Doubles Mortality Risk

On By ModernMedia
Photo by Sydney Sims on Unsplash

The risk of all-cause mortality among patients with chronic, non-communicable diseases is more than doubled if they also have a psychiatric comorbidity, according to a new study published in PLOS Medicine.

Non-communicable diseases such as diabetes and heart disease are a global public health challenge accounting for an estimated 40 million excess deaths annually. Researchers drew on Swedish health data for 1 million patients born between 1932 and 1995 who had diagnoses of chronic lung disease, cardiovascular disease, and diabetes. More than a quarter of the people in the analysis also had a co-occurring psychiatric disorder during their lives.

Within 5 years of diagnosis, 7% of the people included in the study had died from any cause and 0.3% had died from suicide. Comorbid psychiatric disorders were associated with higher all-cause mortality (15.4% to 21.1%) when compared to those without such conditions (5.5% to 9.1%). When compared with an unaffected sibling to account for familial risk factors, patients with psychiatric comorbidity remained consistently associated with elevated rates of premature mortality and suicide (7.2–8.9 times higher). Different psychiatric diagnoses affected mortality risks; in those with comorbid substance use disorder it was 8.3–9.9 times compared to unaffected siblings, and by 5.3–7.4 times in those with comorbid depression.

“Improving assessment, treatment, and follow-up of people with comorbid psychiatric disorders may reduce the risk of mortality in people with chronic non-communicable diseases,” the authors concluded.

Source: EurekAlert!

Categories : TransplantsTags :

Two Pig Kidneys Transplanted into Human

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Photo by Robina Weermeijer on Unsplash

In a new study published in the American Journal of Transplantation, researchers report that they successfully transplanted two kidneys from a genetically modified pig into a human recipient who had suffered brain death.

The use of pig organs, genetically modified to enable transplantation into humans, could ease the shortage of available donor organs for transplantation and prevent thousands of deaths that result each year due to a shortage of organs. Recently, a US man became the first human recipient of a genetically modified pig heart.

This study used a novel preclinical human model to answer numerous critical safety questions. No hyperacute rejection was seen for the 74 hours until termination. No chimerism or transmission of porcine retroviruses was detected. Longitudinal biopsies revealed thrombotic microangiopathy that did not progress in severity, without evidence of cellular rejection or deposition of antibody or complement proteins. Although the xenografts produced variable amounts of urine, creatinine clearance did not recover. Whether renal recovery was impacted by the milieu of brain death and/or microvascular injury remains unknown.

The study provides important insights and identifies several areas where additional research is needed before xenotransplantation can be used to help address the current organ shortage.

“This study provides knowledge that could not be generated in animal models and moves us closer to a future where organ supply meets the tremendous need,” said senior author Jayme E. Locke, MD, MPH, of the University of Alabama at Birmingham.

Source: Wiley

Categories : Ageing Cardiovascular DiseaseTags :

Reduced Heart Failure Risk in Postmenopausal Women Who Walk Faster

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Photo by Teona Swift from Pexels

A study of postmenopausal women, published in the Journal of the American Geriatrics Society, found that those who reported a faster walking pace had a lower risk of developing heart failure. 

Among 25 183 women aged 50 to 79 years, there were 1455 cases of hospitalisation for heart failure during a median follow-up of 16.9 years. Compared with women who walked at a casual pace, those who walked at an average pace or fast pace had 27% and 34% lower risks of heart failure, respectively.

Fast walking for less than 1 hour per week was associated with the same risk reduction of heart failure as average or casual walking for more than 2 hours per week.

“This study confirms other studies demonstrating the importance of walking speed on mortality and other cardiovascular outcomes,” said senior author Charles B. Eaton, MD, MS, of the Warren Alpert Medical School of Brown University. “Given that limited time for exercise is frequently given as a barrier to regular physical activity, walking faster but for less time might provide similar health benefits as the recommended 150 minutes per week of moderate physical activity.”

Further study is warranted to determine whether interventions to increase the walking pace in older adults will reduce heart failure risk and whether fast pace will compensate for the short duration of walking.

Source: Wiley

Categories : Diseases, Syndromes and ConditionsTags :

Vitamin D Supplements Reduce Autoimmune Disease Risk

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A five year-long randomised, placebo-controlled study found that in older adults taking vitamin D supplements, alone or with omega-3 fatty acids, the risk of developing autoimmune disease was reduced.

Autoimmune diseases (AD) such as rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease and psoriasis, are a leading cause of morbidity and mortality as people age. Few effective treatments are available for AD, but some research has hinted that supplements, including vitamin D and omega-3 fatty acids, could have beneficial effects.

In a new study published in the BMJ, investigators from Brigham and Women’s Hospital evaluated whether taking vitamin D and/or omega fatty acid supplements could affect rates of AD. The large-scale vitamin D and Omega-3 Trial (VITAL), a randomised study which followed participants for approximately five years. Taking vitamin D, or vitamin D and omega-3 fatty acids had a significantly lower rate of AD than placebo.

“It is exciting to have these new and positive results for non-toxic vitamins and supplements preventing potentially highly morbid diseases,” said senior author Karen Costenbader, MD, MPH. “This is the first direct evidence we have that daily supplementation may reduce AD incidence, and what looks like a more pronounced effect after two years of supplementation for vitamin D.”

“Now, when my patients, colleagues, or friends ask me which vitamins or supplements I’d recommend they take to reduce risk of autoimmune disease, I have new evidence-based recommendations for women aged 55 years and older and men 50 years and older,” said Dr Costenbader. “I suggest vitamin D 2000 IU a day and marine omega-3 fatty acids (fish oil), 1000 mg a day – the doses used in VITAL.”

VITAL included 25 871 participants, with men aged 50 and older and women aged 55 and older, conducted to investigate whether taking vitamin D3 and/or omega-3 supplements could reduce the risk for developing cancer, heart disease and stroke in people who do not have a prior history of these illnesses. Prior to the launch of VITAL, investigators determined that they would also look at rates of AD among participants, as part of an ancillary study.

Participants answered questionnaires about new diagnoses of diseases, including rheumatoid arthritis, polymyalgia rheumatica, autoimmune thyroid disease, psoriasis and inflammatory bowel disease, with space to write in all other new onset ADs. Medical records were reviewed to confirm reported diagnoses.

“Autoimmune diseases are common in older adults and negatively affect health and life expectancy. Until now, we have had no proven way of preventing them, and now, for the first time, we do,” said first author Jill Hahn, ScD, post-doctoral fellow at the Brigham.

Among patients randomised to vitamin D, 123 participants in the treatment group and 155 in the placebo group were diagnosed with confirmed AD (22 percent reduction). Among those in the fatty acid arm, confirmed AD occurred in 130 participants in the treatment group and 148 in the placebo group. Omega-3 fatty acids alone did not significantly lower incidence of AD, but there was some evidence of a decrease over long periods.

Source: EurekAlert!