Tag: 31/1/22

Categories : Cardiovascular DiseaseTags :

US Sees Surge in Hypertension Hospitalisations

On By ModernMedia
Photo by Camilo Jimenez on Unsplash

The number of people hospitalised for a hypertensive crisis in the US more than doubled from 2002 to 2014, according to researchers from Cedars-Sinai Medical Center. Possible causes included socioeconomic factors such as reduced access to healthcare.

A hypertensive crisis is an acute, marked elevation in blood pressure that is associated with signs of target-organ damage. This increase in hypertensive crises happened at a time when some studies reported overall progress in blood pressure control and a decline in related cardiovascular events in the US. The findings are published in the Journal of the American Heart Association.

“Although more people have been able to manage their blood pressure over the last few years, we’re not seeing this improvement translate into fewer hospitalisations for hypertensive crisis,” said first author Joseph E. Ebinger, MD, a clinical cardiologist and director of clinical analytics at the Smidt Heart Institute

Dr Ebinger said there could be a number of explanations for the incrrease. More people may be unable to afford hypertension medications or are taking inadequate doses of these drugs. Socioeconomic factors may also make it difficult for people to avoid unhealthy behaviours that can contribute to hypertension, such as smoking, as well as having limited access to health care and other concerns.

“We need more research to understand why this is happening and how clinicians can help patients stay out of the hospital,” Dr Ebinger said.

For their study, the investigators used data from the National Inpatient Sample, which is a publicly available database. The data include a subset of all hospitalisations across the US, providing a picture of nationwide trends. They found that annual hospitalisations for hypertensive crises more than doubled over a 13-year period. Hospitalisations related to hypertensive crises accounted for 0.17% of all admissions for men in 2002 but 0.39% in 2014, and represented 0.16% of all admissions for women in 2002 but 0.34% in 2014.

The mortality risk for hypertensive crisis, however, did decrease slightly overall during the studied time period. Women died at the same rate as men, even though they had fewer health issues than men who also were hospitalised for a hypertensive crisis.

“These findings raise the question: Are there sex-specific biologic mechanisms that place women at greater risk for dying during a hypertensive crisis?” said senior study author Susan Cheng, MD, MPH, director of the Institute for Research on Healthy Aging in the Department of Cardiology at the Smidt Heart Institute. “By understanding these processes, we could prevent more deaths among women,” she added.

Source: Cedars-Sinai Medical Center

Categories : Healthcare Politics and RegulationsTags :

Mediclinic and Discovery Sound Warnings over NHI Bill

On By ModernMedia
Photo by Markus Winkler on Unsplash

Private hospital group Mediclinic has warned that the government’s proposed National Health Insurance (NHI) system will threaten public health in South Africa, and bring about the destruction of private healthcare and medical aid cover.

The NHI Bill is currently undergoing a public consultation process, with a number of healthcare, civil society and political groups presenting on why the new system should or should not be introduced.

The Bill as it stands will have a direct impact on access to healthcare services in South Africa. Mediclinic notes that there are insufficient resources to implement it; private-sector hospitals will be curtailed; and medical aids will be eroded.

The financial and human resources necessary to effectively implement the NHI scheme is a legitimate concern, Mediclinic said. It pointed out South Africa’s low doctor- and nurse-to-population ratios are low compared to peer countries.

“Everyone’s right of access to health care services would be threatened if the existing health care delivery system is uprooted and the NHI scheme envisaged in the Bill cannot be effectively implemented,” it said.

Private healthcare is an integral part of the healthcare system with everything from hospital beds to staff at risk if replaced by the NHI.

The Bill’s key components threaten the private hospital sector, with the contracting and reimbursement frameworks proposed in it unable to accommodate private hospital participation.

Additionally, the NHI Fund will create a monopoly by acting as the single purchaser of health care services in South Africa, capable of harming the competition and eroding private sector resources.

Medical scheme provider Discovery said that current private health care funding amounts to R212 billion, some 44% of the total healthcare spend. If the government were to finance this through direct taxation, this would equate to 4.1% of GDP, an unfeasible amount.

Mediclinic also warned that medical aid in South Africa would be significantly eroded under the NHI, meaning only the bare basics for South Africans needing medical care, and expensive treatments being unavailable. It gave the example of a patient with chronic renal failure receiving haemodialysis treatment currently covered by a medical scheme, and showed that the patient would be placed on a long waiting list for this life-saving treatment since it was covered (but not properly funded) by the NHI.

Source: BusinessTech

Categories : HospitalsTags :

Solar-powered Oxygen System Saves Lives in Somalia

On By ModernMedia

A newly installed solar-powered medical oxygen system at a hospital in central Somalia is proving effective in saving lives, Somali and World Health Organization doctors told Voice of America.

The innovative solar oxygen system, the first of its kind in the country, was installed at Hanaano hospital, in the central town of Dhusamareb a year ago. Doctors say the system is having an impact and helping save the lives of very young patients.

“This innovation is giving us promise and hopes,” says Dr Mamunur Rahman Malik, WHO Somalia Representative.

According to Dr Malik, 171 patients received oxygen at the hospital from the solar-powered system from February to October 2021. Of these, only three patients died, and five others were referred to other hospitals.

Every year some 15 000 to 20 000 deaths occur in Somalia among children under five years of age due to pneumonia, said Dr Malik, making it the deadliest disease among under-fives.

The director of Hanaano hospital, Dr Mohamed Abdi, said the innovation is making a difference.

“It has helped a lot, it has saved more than a hundred people who received the service,” he said to VOA Somali.

“It was a problem for the children under one year and the children who are born six months to get enough oxygen. Now we are not worried about oxygen availability if the electricity goes out because there are the oxygen concentrators.”

One patient was Abdiaziz Omar Abdi, admitted to the hospital on January 16 with severe pneumonia and was struggling to breathe normally. The oxygen rate in his body had dropped to 60%, Dr Abdi said. Doctors immediately put him on oxygen along with ampicillin and dexamethasone medications. When discharged three days later, he was breathing normally. His oxygen was up to 90%.

Dr Malik said the oxygen is being used to treat a wide range of medical conditions – asphyxia, pneumonia, injuries, trauma, and road traffic accidents.

“We have seen in other countries that use of solar-powered medical oxygen (if applied in a timely manner) can save up to 35% of deaths from childhood pneumonia,” he said, adding that it could save the lives of at least 7000 children who die “needlessly” due to pneumonia.

The initiative to install solar-powered bio-medical equipment at Hanaano hospital emerged during the height of COVID in 2020, at a time when people were dying due to respiratory problems. Hospitals were unable to keep up with case loads and the cost of a cylinder of oxygen rose to between $400 to $600, and only 20% of health facilities had any kind of access to oxygen, said Dr Malik.

“If you look at the current situation, as of today Somalia needs close to 3000 or 4000 cubic metres of oxygen per day. So, oxygen was the biggest need in all the hospitals.”

Solar power can also be used for medical refrigerators, and their use is becoming widespread in Africa.

Source: Voice of America

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!