Artificial heart success
The first fully self-contained artificial heart has been successfully implanted into a man in his 50s in the US. The implantation was performed at the Jewish Hospital of the University of Louisville, Kentucky, by a team of 14. The team removed the recipient's heart and attached the synthetic heart to the aorta and pulmonary arteries. The artificial heart is powered by an internal battery which is charged transdermally through radio frequencies by an external portable battery pack. This represents a technological breakthrough and gives hope to patients awaiting heart transplant. (British Medical Journal).
Better pain relief in labour
Low-dose epidural anaesthesia via mobile epidurals have been found to reduce the likelihood of Caesarean sections and instrumental delivery and increase the likelihood of women having a normal vaginal delivery, according to a new report. The Comet study, reported in The Lancet, compared traditional epidurals with two types of mobile epidurals (which allow the women to move around while in labour) in women having their first baby. These methods offer the best chance of a spontaneous delivery with satisfactory pain control, according to the research team.
GPs and heartburn
One in four Irish GPs suffer from heartburn, according to a new survey. Of those sufferers, 53 per cent experienced heartburn at least once a week and 14 per cent suffered once a day. When asked about treatment options for their own heartburn, 58 per cent of GPs who suffered chose a prescription option. One-third used an antacid. (Irish Medical News)
Fever phobia
Parents with "fever phobia" are overreacting when their children run temperatures, according to research at Johns Hopkins University in the US. The notion that "fever is a disease rather than a symptom or sign of illness" is leading parents to overdose their children with paracetamol and give them other unnecessary treatment, researchers found. One in three parents thought that a slight fever of 100 F could cause serious harm, compared to only one in 25 parents in a similar study conducted 20 years ago. Many parents were so concerned that they didn't follow dosage guidelines on paracetamol medications and were overdosing their children. They were also doing "more harm than good" by waking children to check their temperatures on the hour, or by administering sponge baths with cool water or alcohol.
Surgeon honoured
The name Perissat is synonymous with laparoscopic surgery. The distinction of honorary fellow has been conferred by the Royal College of Surgeons in Ireland (RCSI) on the man behind the name, Prof Jacques Perissat.
Prof Perissat established a world-renowned centre in Bordeaux and became its director in 1992. There, as well as refining and developing surgical techniques and instruments, he taught both trainees and established surgeons from home and abroad. It was Prof Perissat who tutored a group from Ireland allowing Prof Bouchier-Hayes, of RCSI/Beaumont Hospital, and his team to perform the first laparoscopic cholecystectomy in Ireland.
Delivering the citation, Prof Frank Keane, said that Prof Perissat's main achievement was his early recognition of the possibilities and value of minimal laparoscopic surgery when its application became much broader with the advent of microchip video cameras. It was in his hands and those of two French compatriots, Mouret and Dubois, that laparoscopic cholecystectomy was pioneered and developed, followed closely by Reddick and Olsen in the United States, thus marking a remarkable revolution in surgical practice.
Prof Perissat's academic credentials are without dispute, having more than 300 publications to his name. In his native France, he has been honoured with the Croix de la Valeur for military duties in Algeria as well as becoming Chevalier de la LΘgion d'Honneur.
Past recipients of the RSCI's highest honour include Louis Pasteur, William and Charles Mayo, Nelson Mandela, Mother Teresa of Calcutta and President Mary McAleese.
Medicines' hidden dangers
Concerns have been raised about the safety and toxicity of supposedly inert ingredients within medicines and attention drawn to loopholes in the amount of drug information available to both doctors and patients.
A recent paper in the British Journal of General Practice highlights the risk of adverse reactions to "inert" ingredients. The presence of inert ingredients in a medication may cause an adverse reaction even if the active ingredient itself causes no such problems.
€104 - a dye that has been banned in several countries because of a recognised association with urticarial reactions (skin rashes) in some patients - has been found in some brands of erythromycin, but there was no mention of it in the patient information leaflet. Researchers found that details of inert ingredients were often omitted from the doctor information sources.
Asthma attacks and oxygen
Asthmatic patients are still dying during severe attacks, yet making oxygen available in every general practice to treat patients could save lives, concludes a study in the British Medical Journal.
A research team in London reviewed 11 studies of acute severe asthma in both children and adults. Despite some limitations, these studies show that hypoxaemia (an inadequate supply of oxygen to the tissues) is an important cause of death during a severe asthma attack. Some studies also suggest that treatment with air during severe attacks may worsen hypoxaemia.
The British Thoracic Society's guidelines advise oxygen as a first-line treatment in hospital for all patients with acute severe asthma. However, oxygen should be the first treatment for acute severe asthma wherever the patient happens to be, say the authors. Given that most asthma deaths occur in the community, oxygen should be available in every general practice. Patients with severe disease could also be provided with oxygen cylinders for emergency use at home, they conclude.
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