Wednesday, December 13, 2017

Finally, a ‘Heart Patch’ to mend your broken heart


We are one step closer to the goal of repairing dead heart muscle in human beings, because of a research breakthrough by biomedical engineers at Duke University. The researchers have succeeded in creating a fully functioning artificial human heart muscle large enough to patch the area typically seen in patients who have suffered a heart attack.

The study was published on line in Nature Communications on November 28, 2017.

Ilia Shadrin, a biomedical engineering doctoral student at Duke University and first author on the study said in a newsletter, "Right now, virtually all existing therapies are aimed at reducing the symptoms from the damage that's already been done to the heart, but no approaches have been able to replace the muscle that's lost, because once it's dead, it does not grow back on its own. This is a way that we could replace lost muscle with tissue made outside the body."

It is estimated that around 12 million people worldwide suffer for myocardial infarction and continue living with the damaged tissue that could not contract or send electrical signals, both of which are necessary for proper heart function.

The heart patch is grown from human pluripotent stem cells and contains a myriad of different type of cells like cardiomyocytes, fibroblasts, and endothelial and smooth muscle cells, to create a tissue patch similar to functioning heart muscle. The patch can secrete enzymes and growth hormone that could help in recovering from the ischemic damage.

All these cells are put in specific combination in a jelly-like substance, where they reorganize and grow into functioning tissue. Each individual tissue patch has to be ‘custom made’ in separate container that needs a rocking and swaying motion, instead of being static.

Currently, these patches have been successfully into animal hearts. The researchers have to make many modifications to create the same tissue for human heart like increasing the thickness and vascularization.

Here is the video by Duke University showing the patch contracting on its own, a 3D visualization of the patch’s cells, and the rocking bath that proved critical to the heart patch’s record-breaking size.


Tuesday, December 12, 2017

ACOG updates its guidance on Neural Tube Defects


ACOG has recently released its updated guidance on Neural Tube Defects (NTDs) and includes guidelines about prevention, screening, antenatal management and delivery in pregnancies with  such defects. The practice bulletin No.187 is published in December issue of Journal Obstetrics and Gynecology.

NTDs is the second most common group of congenital malformation after cardiac anomalies. The prevalence differs according to race, region and environmental influences.

In contrast to other malformations, NTDs are preventable by supplementation of folic acid.  

The recommendations:


ACOG along with other professional organizations like CDC, AAFP, AAP, ACMG and AAN: Women in the reproductive age group, having the capacity to become pregnant should take at least 0.4 mg (400 µg) of folic acid daily.

USPSTF: all women who are planning or capable of pregnancy take a daily supplement containing 0.4 to 0.8 mg (400-800 µg) of folic acid.

ACOG, CDC other organization suggests a higher dose of 4 mg (4000 μg) of folic acid for women who are at high risk of having a baby with NTD. These factors are:

Previous history of pregnancy with NTD
Having a partner with NTDs or a partner who previously has had a child with NTD
Patients with a second or third degree relative with NTD
Patient herself was born with NTD
History of taking anti-epileptic medication Valproic acid
Type 1 Diabetes Mellitus
Obesity.

ACOG has also made additional recommendations in the recent 2017 updates.


With Advancements in Ultrasound techniques, Maternal Serum Alpha Feto Protein (MSAFP) has become less important in diagnosing NTDs, when high quality, second trimester ultrasound is routinely used.

MSAFP is more important for screening for other anomalies and placental complications in such cases.

If MSAFP value is ≥ 2.5 MoMs, the detection rate for anencephaly is 95% and 65-80% for other open NTDs.

2D ultrasound has a detection rate of 96% and if structural abnormalities are seen on Ultrasound, they can be considered diagnostic.

3D ultrasound is not superior to 2D in diagnosing NTDs; however, it may be more helpful in delineating the upper limit of spinal defects.

The rates of diagnosing NTDs in first trimester are lower than that of 2nd trimester sonography.
MRI is not mandatory if NTD has already been identified in sonography.

Pregnancy and delivery management:


After a pregnancy with NTD is diagnosed options should be individualized according to each pregnancy:
Pregnancy termination
In Utero fetal surgery for repair
Expectant management with neonatal surgical repair.
Studies on In-Utero repairs have demonstrated that such neonates have functional level two or more times better than expected, and reduce the neonatal mortality and morbidity.

Delivery:

Regarding the timing of delivery, term delivery is preferred. Elective late preterm or early term cesarean is only considered if fetal repair has been done or other obstetric indication for surgery exists.
Retrospective studies with not very long-term follow-up have demonstrated no increased risk of vaginal delivery, but each case needs to be individualized.

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Media: Univision.com





Monday, December 11, 2017

Preterm births more common after IVF/ICSI: a meta-analysis of cohort studies


Pregnancies conceived after IVF/ICSI face a greater risk of preterm delivery as compared to natural conceived cohorts reports the results of meta-analysis published recently in Journal Ultrasound in Obstetrics and Gynecology.

Earlier studies have also documented an increased risk of having a premature baby in couples who have conceived after IVF/ICSI, but whether this is a spontaneous (SPTB) phenomenon or iatrogenic has not been studied.

A research of literature identified 71 studies out of which 15 met the inclusion criteria, and resulted in total sample size of 61,677births.

Statistical analysis showed that SPTB occurred before 37 weeks in nearly 50% more pregnancies conceived by IVF/ICSI (10.1%) than natural conception (5.5%) (odds ratio 1.75; 95% CI 1.50-2.03). The corresponding rates before 34 weeks were 3.6% and 2.1% respectively.

Dr Paolo Cavoretto of IRCCS San Raffaele Hospital in Milan, Italy, is one of the study authors, and he opined that all pregnancies conceived with IVF/ICSI should undergo a mid-trimester transvaginal cervical length evaluation.

If a short cervix is diagnosed, intravaginal progesterone or cerclage should be considered as per individual patient obstetric history.

The researchers called for bigger studies in future, to explore in-depth the mechanism behind SPTB and also differentiate between iatrogenic or indicated PTB.


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Media: Flickr.com



Friday, December 8, 2017

On the go blood glucose monitoring by inbuilt Glucometer in Smartphone Case


With a wide array of features like GPS, depth perception and many health-related features like BP and ECG monitoring, Smartphones have become indispensable part of our daily lives. They are the health gadgets of future. But, so far nothing was much developed for diabetics, other than the use of  phone screen to display results of continuous glucose monitoring on the screen.

Engineers at the University of California San Diego have cleverly integrated a glucose monitor in the smartphone case and app, that will enable diabetic patients to record and track their blood glucose readings, whether they’re at home or on the go.

Currently, there is no way for people with diabetes to check the blood glucose when they are out of the house or travelling. They must pack the whole kit and carry it along with them.

Patrick Mercier, a professor of electrical and computer engineering at UC San Diego is the brain behind this new gadget. “Integrating blood glucose sensing into a smartphone would eliminate the need for patients to carry a separate device,” said Patrick Mercier, he said in a news release. “An added benefit is the ability to autonomously store, process and send blood glucose readings from the phone to a care provider or cloud service.”

The new device is named GPhone, and has two main parts. A slim, aesthetically designed, 3D printed case that fits over the smartphone with a permanent, reusable sensor at the top left corner.
The sensor has to be activated by one-time use enzyme packed pellets that magnetically attach to the sensor.

To run a test, a user has to activate the sensor by dispensing a pellet on it, followed by adding a drop of blood to the now activated sensor. The sensor measures the glucose concentration and wireless send it via a Bluetooth to a custom designed android app, that displays the results on the screen.

The user can communicate the results with his healthcare provider or store it in icloud, to track it over a long period of time.

The pellet is discarded after use and the sensor is deactivated. A 3D printed stylus with capacity of 30 pellets store them, and remains attached to the side of the case.

The pellet contains enzyme called glucose oxidase which reacts with glucose and generates an electrical signal in proportion to glucose levels that is picked by the sensor’s electrode.

The work is currently at proof of concept stage. Joseph Wang, nanoengineering professor and his other colleagues dream of integrating the monitor with the smartphone instead of case. They are also working currently to reduce the amount of blood needed for testing and bringing down the cost of the pellets, which are costlier than usual test strips.

The work was recently published in Biosensors and Bioelectronics.
All Media: Courtesy UC San Diego Newsletter


Thursday, December 7, 2017

Yet another warning from FDA against Removal of Uterine Fibroids with Ultrasonic Aspirators


FDA issued a guidance against use of Ultrasonic Surgical Aspirators for removal of uterine fibroids because of risk of unintended spread of uterine cancer in the process of suction by the aspirators, thereby, worsening the patient’s odds for survival.

Ultrasonic aspirators are multifunctional devices that break up and emulsify both hard and soft tissues with ultrasound energy and then suck them out of the body through a small incision. They're used by a wide variety of surgeons in both open and laparoscopic procedures, including the cytoreduction of advanced malignancies that can't be removed completely.

The FDA said that the device’s oscillating tip can disperse the tissue that it breaks up with ultrasonic waves, despite the fact that it is designed to suck up the tissue, and the risk of disseminating cancer cells is outweighed by the aspirator’s benefits, which include “more extensive tumor debulking, little or no collateral thermal damage, and the ability to avoid organ resection.”

However, when it comes to removing uterine fibroids, the risk of spreading occult cancer is not outweighed by the benefits, "particularly since there are alternative treatment options available," the FDA stated. The agency noted that there is "no reliable preoperative screening procedure to detect uterine sarcoma in women with presumed benign fibroids."

Under this guidance, the FDA also requires the manufacturers to add a contraindication label to labeling of the devices, with or without 510(k) clearances, within 120 days of the Oct. 30 release of the guidance: CONTRAINDICATION: This ultrasonic surgical aspirator device is not indicated for and should not be used for the fragmentation, emulsification, and aspiration of uterine fibroids.

ACOG has however openly opposed the FDA guidance against use of ultrasonic aspirators for fibroid removal by stating it to be “too rigid and eliminates patient choice.” ACOG also disagrees with FDA regarding existence of other safer alternatives to remove the fibroids and claims that abdominal hysterectomy carries more risk.

The US FDA  has already issued a communication discouraging the use of power morcellator was issued on April 17, 2014 and have resulted in 4% decline in rate of laparoscopic hysterectomies, says the results of cross sectional study published in forthcoming issue of Journal Obstetrics and Gynecology.

FDA issued the statement because of advocacy and anti-morcellator campaign by Amy Reed, MD, PhD, an anesthesiologist who died because of uterine leiomyosarcoma on Wednesday, May 24 at age of 44.

She underwent a laparoscopic hysterectomy in October 2013 for fibroid, but her undiagnosed, occult uterine leiomyosarcoma was upstaged because of dispersion in abdominal cavity by the use of power morcellator. Since then, the power morcellator is the focal point of a four-year debate that has divided the surgical field.

Based on an analysis of currently available data, the FDA has estimated that approximately 1 in 350 women who undergo hysterectomy or myomectomy for fibroids is found to have an unsuspected uterine sarcoma. 


Related articles:






Wednesday, December 6, 2017

$10 Microchip by Duke and Stanford turns 2-D Ultrasound Machines to 3-D Imaging Devices




Researchers from Duke University and Stanford University have designed a $10 microchip to make a simple 3D ultrasound imaging device that produces 3D scans similar in quality to CT or MRI scans using your regular 2D ultrasound machine.

The researchers and physicians from Duke demonstrated their device on Oct. 31 at the American College of Emergency Physicians (ACEP) Research Forum in Washington, D.C. 

The budget microchip is roughly the size of a fingernail, and like a Nintendo Wii video game controller, the chip registers the probe’s orientation, then uses software to seamlessly stitch hundreds of individual slices of the anatomy together in three dimensions to give an instant 3-D model similar in quality to a CT scan or MRI. And the better the ultrasound machine being used, the higher the quality of the generated 3D image.

The chip can be added to your regular 2D ultrasound armament by using a 3D printed clip on attachment. 3D ultrasound machines can cost around $250,000, around five times more than their 2D counterparts.

 Joshua Broder, M.D., an emergency physician and associate professor of surgery at Duke Health and one of the creators of the technology got the idea behind the chip while playing Nintendo games with his son.

 After working on the chip for a year, he took sketches to Duke’s Pratt School of Engineering, connecting with then-undergraduate Matt Morgan, and biomedical engineering instructors and professors Carl Herickhoff and Jeremy Dahl, who have since taken positions at Stanford where they continue to develop the device.

The team has used Duke’s own 3-D printing labs to create a prototype, in the form of a streamlined plastic holster that slips onto the ultrasound probe. A physician can use the probe as a regular 2D probe or add the 3-D capability by simply snapping on a plastic attachment containing the location-sensing microchip. To get the best 3-D images, the team also devised a plastic stand to help steady the probe as the user hones in on one part of the anatomy.

The microchip and the ultrasound probe connect via computer cables to a laptop programmed for the device. As the user scans, the computer program whips up a 3-D model in seconds.

Both Duke and Stanford are testing the technology in clinical trials to determine how it fits in the flow of patient care. The creators believe some of the most promising uses could be when CT scans or MRIs are not available, in rural or developing areas, or when they are too risky.
“Instead of looking through a keyhole to understand what’s in the room, we can open a door and see everything in front of us.”

This upgrade is especially important for babies and trauma patients who cannot be moved. The team has already received a grant from Emergency Medicine Foundation and General Electric to conduct clinical trials for application of the device to located bleeding vessels in trauma patients.

The quality of resulting 3D model is comparable to images produced by a 3D sonography machine, CT scan or MRI scan.”

Clinical trials are already on the way to test the technology in real life applications and emergency scenarios.

Here is a video in which Dr.Broder demonstrate the device.






3D printed fetus to hold and love: Brazilian obstetrician prints ultrasound fetal model for visually impaired couple

Ana Paula and Alvaro with the baby's model

A team of doctors from Brazil printed a 3D life like model of  baby in utero from images obtained from 
GE Voluson10 ultrasound  for a legally blind couple, so that they can feel their baby, because they were unable to see the ultrasound images.

Ana Paula Silveira and her husband, Alvaro Zermiani, live in São Paulo, Brazil, and are legally blind. Like other normal couples they also wanted to enjoy the grainy glimpses of their son, Davi Lucas and see him growing and developing well inside the uterus.

They consulted Dr. Heron Werner, a gynecologist and obstetrician working atthe DASA clinic in Rio de Janeiro, who is well into 3D printing and is known for printing 3D fetus models through high-quality ultrasound exams.

So, they printed the first fetus model for the couple at 12 weeks of pregnancy. Ana and Alvaro were thrilled. “Holding the small fetus at 12 weeks is an indescribable feeling,” she says. “Following up on our son’s evolution allowed us to have this feeling of being whole, because we feel with our hands.”

Ana Paula and Alvaro with Dr. Werner (left) in his office in Rio. 
Images credit: Ana Paula and Alvaro Zermiani.

Dr. Werner got the idea of 3D printing babies during a visit to Rio’s National Museum, which was using a tomography machine to digitize its ancient Egyptian exhibits.

“From the moment we got to the high-quality ultrasound exam, through the possibility of 3D printing it, I realized that it could also serve to enhance the prenatal experience of visually impaired pregnant women,” Dr. Werner said.

A second model has also been printed, in which they could feel Davi’s face and appreciate the close resemblance he shared with them. “Thanks to the exams and printing, we were able to not only know that our baby was growing healthy but also to have a very real contact and establish a very strong involvement with our son,” she says.

The ultrasound machine, Voluson E10 is GE’s newest and most advanced Voluson system to date. The Voluson E10’s Radiance System Architecture sets a new standard in imaging technology and gives the more clarity because of 4X ultrasound pathways for spectacular 2D and 3D/4D images with increased penetration, transfer the data at 10x speed providing higher resolution and very fast frame rates and it processes the information 4X times faster to streamline the workflow.

A real-time ultrasound GIF of a baby’s face taken by the GE’s Voluson 10 machine.
 Image credit: GE Healthcare

All images: Courtesy GE

Monday, December 4, 2017

Intra-amniotic debris linked to Preterm Birth independent of Cervical Funnel

Amniotic fluid ‘‘sludge’’ (A) with normal cervix (B) with short cervix
courtesy:https://www.researchgate.net/figure

Presence of Intra-amniotic debris or sludge identified by sonography is linked to increased risk of Preterm Birth(PTB) before 34 weeks of pregnancy in nulliparous women with a cervical length less than 30 mm, reports the results of a secondary cohort study accepted for publication in Journal Ultrasound in Obstetrics and Gynecology.

This secondary analysis of multicentric trial was funded by Eunice Kennedy Shriver National Institute of Child Health and Human Development Maternal-Fetal Medicine Units (MFMU) Network.

The exact composition of amniotic fluid debris is not known. They may be formed of hemorrhage, meconium or a mixture of bacteria and inflammatory cells, that is encased in a biofilm that is resistant to antibiotics. They are probably a sign of placental senescence, and preterm delivery seems to be a protective phenomenon to shuttle the fetus out of the already compromised environment.

The initial trial was conducted to study the effect of progesterone injections to prevent preterm birth in nulliparous women with a short cervix.

A total of 657 women between 16 and 22 weeks of gestation were randomized to progesterone or placebo. All of them had a transvaginal ultrasound by a certified sonologist, 78 were found to have intra-amniotic debris, 112 women had cervical funnel on ultrasound.

A significant number of women with debris had a preterm labor (35% vs. 23%), as also women who cervical funnel (37% vs.21%).

After multivariate analysis, only amniotic fluid debris was found to be significantly associated with preterm birth prior to 34 or 32 weeks (aOR 1.85, 95% CI 1.00-3.44; aOR 2.78, 95% CI 1.42-5.45) respectively.

Earlier study have also shown that Amniotic fluid debris or ‘‘sludge’’ (AFS) is an independent risk factor for preterm delivery in women with CL< 25 mm. During Ultrasound it is recognized as a hyperechogenic matter in the amniotic fluid close to the uterine cervix and its prevalence is 22.3% in patients with preterm labor.




Sunday, December 3, 2017

SMFM issues guidelines for managing patients with third trimester bleeding between 34 0/7-36 6/7 weeks.


Third trimester bleeding is not so uncommon and nearly 1 in 10 women will experience vaginal bleeding during this period. It may present as just spotting or may be heavier. It could be just due to softening and opening of cervix or a sign of more serious obstetric nightmare like placenta previa or abruption.

Optimal management of third trimester bleeding depends on accurate identification of the cause and the gestational age window.

The earlier Society for Maternal-Fetal Medicine (SMFM) recommendations were not specific to the gestational age. The recommendations were published electronically in October in American Journal of Obstetrics and Gynecology.



Recommendations: 

If a patient with placenta previa is stable and have no other obstetric complications, deliver her at 36–37 6/7 weeks of gestation. If this episode is mild and self-limiting, but there is history of previous bleeding episodes < 34 weeks, deliver her to avoid risk of major bleeding episode in future. (Grade 1B)

Routine cervical length screening for women with placenta previa is not indicated in the late preterm period because of a lack of data on an appropriate management strategy (Grade 2C)

A stable woman with placenta accreta, schedule a planned delivery between 34 and 37 weeks of gestation.  (Grade 1C)

A stable woman with vasa previa, schedule a planned delivery between 34 and 37 weeks of gestation.  (Grade 1C)

Recommendations are less clear about ideal time of delivery in placental abruption for women who are hemodynamically stable along with the fetus. Delivery may be prolonged with close monitoring of mother and fetus. If the women with abruptio is hemorrhaging profusely, she should undergo delivery.

If a woman is bleeding profusely, do not defer delivering her for the purpose of administering corticosteroids.  (Grade 1B)

Fetal lung maturity testing is not indicated in late preterm period, when a indication for delivery is already present.  (Grade 1B)

Administer antenatal corticosteroids to women who are eligible, stable and are being managed expectantly and delivery is expected within 7 days, the gestational age is between 34 and 36 6/7 weeks of gestation, and antenatal corticosteroids has not previously been given (Grade 1A).

Clinical Considerations:


For placenta previa, vasa previa or accreta, cesarean section should be performed. For other clinical situation, in absence of contraindications to vaginal delivery and fetus in stable condition, a vaginal delivery might be attempted.

Very small amount of vaginal bleeding, that resolves by the time the patient presents in the hospital, can be managed expectantly provided the patient and fetus are stable and patient has access to emergency care 24/7.

Perform an ultrasound for evaluation of cause of bleeding and location of placenta before doing a digital examination. For suspected placenta previa vaginal ultrasound is a better choice and pulsed-wave doppler may help identify a fetal arterial vessel (with FH rate) or fetal vessels with venous flow in vasa previa.

In cases of placenta accreta, ultrasound can be performed but the sensitivity and specificity is less than for placenta previa and vasa previa.

In cases of placental abruption, always rely on clinical acumen as sonography can miss the diagnosis in 20-50% of cases.

MRI is contraindicated in women with active bleeding in third trimester.






Saturday, December 2, 2017

First US baby born after uterine transplant delivered in Texas

Dr showing the baby to mother. Courtesy Baylor University Medical Center at Dallas

The first birth as a result of a uterine transplant in the United States took place on Friday in Texas at the Baylor University Medical Center in Dallas. The women had undergone a live donor transplant and have received her uterus from Taylor Siler, 36, a registered nurse in the Dallas area.

The boy delivered by elective cesarean section is just named “baby number 9, as he is the 9th person in the world to be born out of transplanted uterus. 

“We’ve been preparing for this moment for a very long time,” says Dr. Liza Johannesson, an ob-gyn and uterus transplant surgeon at Baylor. “I think everyone had tears in their eyes when the baby came out. I did for sure.” The woman and her husband asked that their identity not be revealed in order to protect their privacy.

This is the first baby born as a part of hospital’s ongoing uterus transplant clinical trial, being conducted by Baylor Scott & White Research Institute. Uterine transplant is offered to patients with absolute uterine factor infertility (AUI). Most of the women in the trial have a condition called Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome.

The trial is expected to enroll 10 patients and will end in January 2026. So far, there are 8 women enrolled in the study who have received a uterine transplant. Out of which 3 have failed and there is an additional ongoing pregnancy in a woman who received a live donor transplant.  

A similar trial was conducted in Sweden for women with uterine factor infertility, which resulted in seven uterine transplants and four live births. In September 2014, Mats Brännström and colleagues report the first successful birth of a child following uterus transplantation. The recipient, a 35-year-old woman lacking a uterus (Rokitansky syndrome), received a cryopreserved embryo 1 year after transplantation, leading to a livebirth by caesarean section.

Giuliano Testa, MD, principal investigator of the uterine transplant clinical trial at Baylor University Medical Center at Dallas said, “This first live birth to a uterus transplant recipient in the United States was a milestone in our work to solve absolute uterine factor infertility; but, more importantly, a beautiful moment of love and hope for a mother who had been told she would never be able to carry her own child.”



Thursday, November 30, 2017

In case you missed it: Here are the top 5 posts this month


The American Heart Association updates BP guidelines in 14 years: now 130 is the new 140
The American Heart Association (AHA)  and The American College of Cardiology (ACC) has changed the definition of hypertension for the first time in 14 years, moving the number from the old standard of 140/90 to the newly revised 130/80.
According to the new definition, 130 to 139 mm Hg systolic and or 80 to 89 mm Hg will be labelled as stage 1 hypertension.

WHO updates its guidance on Tranexamic Acid for the Treatment of Postpartum Hemorrhage
WHO has recently updated their guidelines for use of Tranexamic acid for treatment of Postpartum Hemorrhage: TXA should now be included in the treatment regimen for PPH along with other drugs, irrespective of the cause of hemorrhage.  
In 2012, WHO recommended Use of TXA  for the treatment of PPH if oxytocin and other uterotonics fail to stop the bleeding or if it is thought that the bleeding may be partly due to trauma.

ACOG recommends against vaginal seeding in Cesarean births
ACOG today issued a policy statement against the practice of vaginal seeding in cesarean deliveries, in absence of sufficient data on potential benefits associated with the procedure.

Just wait a minute, and you save thousands of preterm babies a year
November 17 is celebrated as World Prematurity Day and theme for this year is ‘let them thrive.’
According to WHO An estimated 15 million babies are born preterm every year – more than 1 in 10 babies around the world and this number is rising. Preterm birth complications are the leading cause of death for children under 5.

ACOG updates the practice advisory for influenza vaccination during pregnancy
The American congress of obstetrics and gynecologists(ACOG) has issued a recent practice advisory for influenza vaccination during pregnancy.

A recent case -control study published in September issue of journal Vaccines linked spontaneous abortion and receipt of influenza vaccine in first trimester of pregnancy. In this case control study women had nearly twice the odds of experiencing a miscarriage if they were vaccinated in the preceding 28 days period. (OR 2.0; 95% CI 1.1–3.6)


CDC links overweight and obesity to increased risk of 13 different cancers


CDC recently released ‘vital signs’ have reported that being obese or overweight puts you at increased risk of 13 different cancers. These cancers constitute about 40% of all burden of cancer incidence in US. In 2014, approximately 631,000 persons in the United States received a diagnosis of a cancer associated with overweight and obesity.

Endometrial, ovarian, and postmenopausal female breast cancers accounted for 42% of new cases of overweight-and obesity-related cancers in 2014.

A review of data from 2005-2014 revealed that incidence of many of these cancers have increased by 7% in last 10 years, except colorectal cancers. Nearly 30% of US adult weigh more than what’s recommended and 50% do not have any idea that being overweight puts them at risk for these cancers.

CDC fact sheet
The obesity related cancers are adenocarcinoma of the esophagus, cancers of the breast [in postmenopausal women], colon and rectum, endometrium, gallbladder, gastric cardia, kidney, liver, ovary, pancreas, and thyroid; meningioma; and multiple myeloma.

On the other hand, non-obesity related cancers are down by 13%.

These obesity related cancers constitute nearly half of all the cancers in women and quarter of all cancers in men.

This finding has important public health implications as the burden can be considerably reduced by making a change in lifestyle and behaviors.

Multiple level interventions into policy, systems, and environmental changes that promote physical activity and healthy food options in communities

The CDC’s National Comprehensive Cancer Control Program supports comprehensive cancer control efforts, including environmental approaches that promote physical activity and healthy food options in communities.

To start with everyone can:
Eat a healthy diet by following the 2015-2020 Dietary Guidelines for Americans.
Do at least 150 minutes of moderate intensity physical activity, such as brisk walking, every week.
Talk to your primary healthcare provider about losing weight.


Wednesday, November 29, 2017

FDA clears Hologic’s Quantra 2.2 Breast Density Assessment Software during routine screening mammography


Hologic Inc. announced it has received 510(k) clearance from the U.S. Food and Drug Administration (FDA) for its Quantra 2.2 Breast Density Assessment Software. The software helps radiologists and clinicians to provide information about breast density to women during routine breast cancer screenings.

Quantra standardizes breast density reporting and helps eliminates the visual subjectivity by radiologists, through a proprietary algorithm powered by machine learning. The software classifies the breast tissue into four density categories based on  ACR Breast Imaging Reporting and Data System( ACRBI-RADS®) Atlas 5th Edition, based on the distribution of fibroglandular tissue  and texture of breast tissue.

The BI-RADS® Atlas provides standardized breast imaging findings terminology, report organization, assessment structure and a classification system for mammography, ultrasound and MRI of the breast.

The Quantra software is compatible with Hologic's 3D Mammography systems, including the new 3Dimensions mammography system, which is designed to be the fastest, highest resolution breast tomosynthesis system ever, with the 'Intelligent 2D imaging technology'.

Nearly 40% of women between the age of 40 and 74 have dense breasts, which can make it difficult to detect breast cancer during annual screenings and necessitates additional imaging, resulting in increased patient anxiety and unnecessary facility costs. Perhaps most importantly, women with very dense breasts are four to five times more likely to develop breast cancer than women with less dense breasts.

The software is one of several groundbreaking products that is available for demonstration in Hologic's booth (#4705) at the ongoing 103rd ScientificAssembly and Annual Meeting of the Radiological Society of North America (RSNA) at McCormick Place in Chicago from Nov. 26 to 30.

Pete Valenti, Hologic's Division President, Breast and Skeletal Health Solutions said, "As the global leader in breast cancer screening technology, we relentlessly pursue the development of clinically superior products that address the unmet and changing needs of our customers and their patients, especially when it comes to breast density. Quantra software is yet another example of our dedication and we are proud to feature it – along with a number of other new, breakthrough products – for the world's leading radiologists at RSNA this week."

Earlier this year, FDA approved its Genius 3D Tomosynthesis Mammography as the only test superior to 2D mammography for routine breast cancer screening for women with dense breasts. 

Hologic also commercially launched its SmartcCurve breast stabilization system at the same time, that makes mammography experience less painful for women without compromising on image quality and diagnostic accuracy.

Hologic Worldwide Quantra Volumetric Breast Density Assessment