World’s First Drone Delivery of Kidney for Transplant

In what researchers are calling a groundbreaking achievement, an unmanned drone delivered a new kidney for a 44-year-old Baltimore woman.

On April 19, the aircraft delivered the donor kidney that was successfully transplanted by a surgical team at the University of Maryland Medical Center in Baltimore. The patient was discharged April 23. Before the operation, she had undergone eight years of dialysis because of kidney failure.

“This whole thing is amazing. Years ago, this was not something that you would think about,” the patient said in a university news release.

According to the surgeons and researchers, the flight shows how drones could improve access to organs for people on transplant waiting lists.

In many cases, drones could provide organ deliveries that are faster, safer and more widely available than traditional methods of transporting organs, the transplant team said.

“As a result of the outstanding collaboration among surgeons, engineers, the Federal Aviation Administration [FAA], organ procurement specialists, pilots, nurses, and, ultimately, the patient, we were able to make a pioneering breakthrough in transplantation,” said project leader Dr. Joseph Scalea, one of the surgeons who performed the transplant.

“There remains a woeful disparity between the number of recipients on the organ transplant waiting list and the total number of transplantable organs. This new technology has the potential to help widen the donor organ pool and access to transplantation,” Scalea said.

The researchers pointed out that transportation of organs is one of the most crucial parts of the transplant process. The amount of time an organ can remain viable while in transit is critical.

Delivering a donor organ “is a sacred duty with many moving parts. It is critical that we find ways of doing this better,” Scalea added.

While the surgeons knew the steps involved in transplantation, unmanned transportation was foreign territory.

Matthew Scassero, director of the university’s unmanned aircraft systems test site, described the task.

“We had to create a new system that was still within the regulatory structure of the FAA, but also capable of carrying the additional weight of the organ, cameras, and organ tracking, communications, and safety systems over an urban, densely populated area — for a longer distance and with more endurance.”

The custom-built drone used in this project had eight rotors and multiple powertrains to ensure reliable performance, even in the case of component failure.

Before the groundbreaking flight, the team developed and tested the drone by successfully transporting materials such as saline, blood tubes, followed by a healthy but unusable human kidney.

Current organ transportation typically uses expensive chartered flights or commercial flights, which occasionally result in an organ being left on a plane or other delays that leave the organ unusable, the researchers noted.

Current transport methods also don’t adequately cover rural or remote areas of the United States, they said.

In 2018, nearly 114,000 Americans were on waiting lists for an organ transplant, according to the United Network for Organ Sharing. But 1.5% of deceased donor organs did not make it to the intended destination; and nearly 4% of organ shipments had an unanticipated delay of two or more hours.

This work is at the proof-of-concept stage. If it’s proven successful, the team said it would then look at much greater distances of unmanned organ transport.

Source: HealthDay

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Chinese Kung Pao Chicken

Ingredients

11 oz skinned, boneless chicken breasts
3 tablespoons light soy sauce
3 tablespoons Shaoxing rice wine
2 teaspoons roasted sesame oil
1 tablespoon cornstarch
3/4 cup peeled water chestnuts
3 tablespoons oil
10 cups baby spinach leaves
1/2 teaspoon salt
3 garlic cloves, finely chopped
3/4 cup unsalted peanuts
1 scallion, finely chopped
1 tablespoon finely chopped ginger
1 teaspoon chili sauce
1 tablespoon sugar
1 teaspoon Chinese black rice vinegar
1/4 cup chicken stock

Method

1. Cut the chicken into 1-inch cubes. Place the cubes in a bowl, add 2 tablespoons of the soy sauce, 2 tablespoons of the rice wine, 1 teaspoon, of the sesame oil and 2 teaspoons of the cornstarch, and toss lightly. Marinate in the fridge for at least 20 minutes.
2. Blanch the water chestnuts in a saucepan of boiling water, then refresh in cold water. Drain, pat dry and cut into thin slices.
3. Heat a wok over high heat, add 1 teaspoon of the oil and heat until very hot. Stir-fry the spinach, salt, 2 teaspoons of the garlic and 2 teaspoons of the rice wine, turning constantly, until the spinach is just becoming limp. Remove the spinach from the wok, arrange around the edge of the serving platter, cover and keep warm.
4. Reheat the wok over high heat, add 1 tablespoon of the oil and heat until very hot. Stir-fry half the chicken pieces, turning constantly, until the meat is cooked. Remove with a wire strainer or slotted spoon and drain. Repeat with 1 tablespoon of oil and the remaining chicken. Wipe out the pan.
5. Deep-fry the peanuts in the wok or a saucepan until browned.
6. Reheat the wok over high heat, add the remaining oil and heat until very hot. Stir-fry the scallion, ginger, remaining garlic and the chili sauce for 10 seconds, or until fragrant. Add the sliced water chestnuts and stir-fry for 15 seconds, or until heated through. Combine the sugar, black vinegar, chicken stock and remaining soy sauce, rice wine, sesame oil and cornstarch, add to the sauce and simmer until thickened.
7. Add the cooked chicken and the peanuts. Toss lightly to coat with the sauce. Transfer to the center of the serving platter and serve.

Makes 6 servings.

Source: The Food of China

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Single Dose of Targeted Radiotherapy Is Safe and Effective for Prostate Cancer

A single high dose of radiation that can be delivered directly to the tumour within a few minutes is a safe and effective technique for treating men with low risk prostate cancer, according to a study presented at the ESTRO 38 conference.

Radiotherapy traditionally involves a series of lower dose treatments that take place over several days or week. The new treatment is called high dose-rate brachytherapy and it delivers radiation via a set of tiny tubes.

Researchers say this technique could offer an effective treatment that is convenient for patients and brings potential time and cost savings for hospitals.

The research was presented by Dr Hannah Tharmalingam, a Clinical Research Fellow at Mount Vernon Cancer Centre, Northwood, and The Christie NHS Foundation Trust, Manchester, UK.

She said: “Brachytherapy, where we use temporary catheters to directly treat tumours, has already proved to be a good treatment for prostate cancer, both in terms of killing the cancer cells and minimising side effects. This usually means patients make four to six visits to the hospital for a series of lower dose treatments. We wanted to see whether we could get similar results but with just one high dose treatment, saving time for the patient and the hospital.”

The research included 441 men with prostate cancer who were treated at one of seven UK hospitals between 2013 and 2018. Their cancers were classified, depending on how likely they were to spread, as either low risk (total of 44 men), medium risk (285 men) or high risk (112 men). All were treated with a single high dose (19 Gy) of radiation; 166 men also received hormone therapy but none had any surgery or chemotherapy.

Researchers monitored the men’s progress for an average of 26 months. They measured the levels of prostate specific antigen (PSA) in the men’s blood two years after the treatment and again three years after the treatment. PSA is considered to be a good indicator of how well prostate cancer treatment has worked. If levels increase, this can indicate the cancer has returned.

Overall, after two years, 94% of men showed no sign of the cancer returning, according to their PSA levels. For men with low risk cancer this figure was 100%, in men with medium risk it was 95% and in men with high risk cancer it was 92%. After three years, the overall figure was 88%, and in men with low, medium and high risk cancers, the figures were 100%, 86% and 75% respectively.

Of the 27 men with raised PSA levels, researchers were able to identify where the cancer had returned in 25. In 15, the cancer had returned in the prostate. In the rest, it had spread to other parts of the body.

At the time of the treatment, there were no serious side effects. Later on, two men developed urethral strictures that required surgery and two developed rectal fistulae that required colostomy.

Dr Tharmalingam said: “These results indicate that high dose-rate brachytherapy is a safe and effective treatment for men with low risk prostate cancer but further research is needed in medium and high risk patients to see if the results can be improved with a higher dose. This type of treatment offers an attractive alternative to surgery or other forms of radiotherapy as it has a comparatively low risk of side effects. It is also a patient-friendly option because the treatment can be given quickly at a single hospital visit.”

Dr Tharmalingam and her colleagues hope to continue studying the impact of using this type of radiotherapy, especially in patients with higher risk prostate cancer who are more likely to suffer a recurrence. She believes it would be possible, given the low risk of side effects, to modify the treatment or increase the dose even further in higher risk cases.

Dr Bradley Pieters, chair of ESTRO’s brachytherapy committee and a radiation oncologist at the Academic University Medical Centers, The Netherlands, who was not involved in the study, said: “This research suggests that a single treatment of high dose-rate brachytherapy could be a very good option for many men with prostate cancer. The technology and expertise needed to deliver this treatment is not yet available in all cancer centres. However, given that it may offer time and money savings for hospitals as well as benefits to patients, there is a good argument for investing in this type of radiotherapy.”

Source: EurekAlert!

Stressed at Work and Trouble Sleeping? It’s More Serious than You Think

Sophia Antipolis wrote . . . . . . . . .

Work stress and impaired sleep are linked to a threefold higher risk of cardiovascular death in employees with hypertension. That’s the finding of research published today in the European Journal of Preventive Cardiology, a journal of the European Society of Cardiology (ESC).

Study author Professor Karl-Heinz Ladwig, of the German Research Centre for Environmental Health and the Medical Faculty, Technical University of Munich, said: “Sleep should be a time for recreation, unwinding, and restoring energy levels. If you have stress at work, sleep helps you recover. Unfortunately poor sleep and job stress often go hand in hand, and when combined with hypertension the effect is even more toxic.”

One-third of the working population has hypertension (high blood pressure). Previous research has shown that psychosocial factors have a stronger detrimental effect on individuals with pre-existing cardiovascular risks than on healthy people. This was the first study to examine the combined effects of work stress and impaired sleep on death from cardiovascular disease in hypertensive workers.

The study included 1,959 hypertensive workers aged 25–65, without cardiovascular disease or diabetes. Compared to those with no work stress and good sleep, people with both risk factors had a three times greater likelihood of death from cardiovascular disease. People with work stress alone had a 1.6-fold higher risk while those with only poor sleep had a 1.8-times higher risk.

During an average follow-up of nearly 18 years, the absolute risk of cardiovascular death in hypertensive staff increased in a stepwise fashion with each additional condition. Employees with both work stress and impaired sleep had an absolute risk of 7.13 per 1,000 person-years compared to 3.05 per 1,000-person years in those with no stress and healthy sleep. Absolute risks for only work stress or only poor sleep were 4.99 and 5.95 per 1,000 person-years, respectively.

In the study, work stress was defined as jobs with high demand and low control – for example when an employer wants results but denies authority to make decisions. “If you have high demands but also high control, in other words you can make decisions, this may even be positive for health,” said Professor Ladwig. “But being entrapped in a pressured situation that you have no power to change is harmful.”

Impaired sleep was defined as difficulties falling asleep and/or maintaining sleep. “Maintaining sleep is the most common problem in people with stressful jobs,” said Professor Ladwig. “They wake up at 4 o’clock in the morning to go to the toilet and come back to bed ruminating about how to deal with work issues.”

“These are insidious problems,” noted Professor Ladwig. “The risk is not having one tough day and no sleep. It is suffering from a stressful job and poor sleep over many years, which fade energy resources and may lead to an early grave.”

The findings are a red flag for doctors to ask patients with high blood pressure about sleep and job strain, said Professor Ladwig. “Each condition is a risk factor on its own and there is cross-talk among them, meaning each one increases risk of the other. Physical activity, eating healthily and relaxation strategies are important, as well as blood pressure lowering medication if appropriate.”

Employers should provide stress management and sleep treatment in the workplace, he added, especially for staff with chronic conditions like hypertension.

Components of group stress management sessions:

• Start with 5 to 10 minutes of relaxation.
• Education about healthy lifestyle.
• Help with smoking cessation, physical exercise, weight loss.
• Techniques to cope with stress and anxiety at home and work.
• How to monitor progress with stress management.
• Improving social relationships and social support.

Sleep treatment can include:

• Stimulus control therapy: training to associate the bed/bedroom with sleep and set a consistent sleep-wake schedule.
• Relaxation training: progressive muscle relaxation, and reducing intrusive thoughts at bedtime that interfere with sleep.
• Sleep restriction therapy: curtailing the period in bed to the time spent asleep, thereby inducing mild sleep deprivation, then lengthening sleep time.
• Paradoxical intention therapy: remaining passively awake and avoiding any effort (i.e. intention) to fall asleep, thereby eliminating anxiety.

Source: European Society of Cardiology

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