Monday, February 10, 2020

Novel method to spot melanoma may save lives

A new method to detect melanoma cancer cells circulating in the blood may be the key to detecting deadly cancer early and saving lives, a new study says.

A team of researchers at Edith Cowan University’s Melanoma Research Group, Western Australian hospitals, and the Harvard Medical School, and revealed that a new procedure they developed could detect circulating tumor cells (CTCs), paving the way for early diagnosis and potential therapies.
The new technique, which was described in the paper published in the British Journal of Cancer, was based on the previous work of scientists belonging to the Melanoma Research Group, who developed the world’s first blood test for melanoma, which hastened its diagnosis, providing early treatment and improving health outcomes.

Melanoma is a rare type of skin cancer, but it’s the deadliest with an expected 100,350 new melanoma cases to be diagnosed in 2020, increasing by 2 percent, with an estimated 6,850 deaths. Over the years, the rates of melanoma have been increasing rapidly, the Americana Cancer Society reports.

"These preliminary findings are the first step towards a new way to stop melanoma from spreading around the body," Associate Professor Elin Gray, study’s lead researcher, said.

"Cancer spreads around the body when CTCs shed from the primary tumor and travel through the blood to form secondary tumors (metastases) in other organs. If we can find a way to reliably detect these cells, then we have a chance to stop melanoma in its tracks with a powerful diagnostic tool and perhaps opportunities for therapies in the future,” he added.

Early detection, early treatment

Just like any other type of cancer, early detection and diagnosis are the keys to improving a patient’s health outcome or prognosis. If the cancer is detected at its early stages, it’s easier to treat. But, for cancers that have metastasized in other parts of the body, particularly vital organs, it’s harder to treat.

Melanoma CTCs have been very elusive and hard to detect. Detecting these circulating cancer cells may vary between 40 and 87 percent, making diagnosis harder than expected. The researchers believe that CTCs have many differences, especially when it comes to their bioactivity and shape. Hence, these cancer cells may respond to assays differently.

What’s more, these CTCs tend to hide among thousands of other cells, particularly in the blood. In fact, in one milliliter of blood, there are less than ten cancer cells among billions of red blood cells and white blood cells. Detecting these cancer cells is akin to finding a needle in a haystack.


New approach shows promise
Thanks to the work of scientists, they developed a new way to detect melanoma CTCs in the blood, providing a faster and more accurate way of diagnosing skin cancer. They studied the complexity of finding CTCs in the blood and decided they can’t use a one-size-fits-all approach.

The team combined three assays together, boosting the rates of detection to a staggering 72 percent. The rate is higher than using just one test.

"Our analysis revealed an extraordinary heterogeneity amongst melanoma CTCs, with multiple non-overlapping subpopulations. CTC detection using our multimarker approach was associated with shorter overall and progression-free survival. Finally, we found that CTC scores correlated with plasma ctDNA concentrations and had similar pharmacodynamic changes upon treatment initiation,” the team concluded in the study.

The team believes that the new approach will pave the way to develop reliable detection of CTCs. However, they want to further polish their diagnostic test to capture the broadest range of CTCs. Detecting these cancer cells early can improve survival rates and may lead to a better quality of life.


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Monday, November 11, 2019

Cardiac arrest on weekends has fewer chances of survival

People who experience cardiac arrests during weekends have fewer chances of survival, compared to those who undergo the same medical emergency over weekdays, claims a study. The preliminary research was presented at the American Heart Association's Resuscitation Science Symposium 2019 in Philadelphia.

UK researchers investigated "survival-to-hospital admission" for patients who suffered an out-of-hospital sudden cardiac arrest and were treated by a publicly accessible automated external defibrillator (AED).

They analysed data of nearly 3,000 patients worldwide and noted that 27 per cent survived to hospital admission, in line with other independent studies. Overall, researchers found that patients who suffered a cardiac arrest between 12 a.m. Saturday to 11:59 p.m. Sunday were about 20 per cent less likely to survive than those patients who suffered a cardiac arrest between Monday and Friday.

Survival also decreased for cardiac arrests occurring at home and as the patient's age increased. "It is often said that sudden cardiac arrest can happen to anyone, anytime, anywhere. These results suggest that there is an opportunity to address sudden cardiac arrests that occur during the weekend by improving AED awareness, availability and training and quick response by rescuers," said  the study's lead author.

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Saturday, January 20, 2018

Tech can be key in treating congenital heart defects’

A state which lowered child mortality significantly in the past decade, could further the trend by investing in technology to treat congenital heart defects (CHDs), said experts.
 

The head of the Department of Cardiology said India had a huge burden with around 2-2.5 lakh babies born annually suffering from congenital heart defects. Around 80,000 have serious complications but though most of them only require a single corrective surgery to live a normal life, they often have no access to them, he told media-persons here on Friday.
Hospitals also lack technical and human resources to deal with the scale of the burden. “It is only after the mortality rates fell that states began looking at CHDs. We are now operating on pre-term babies but the challenges are huge,” he said.

At the hospital, doctors operated on a 1.8 kg baby born three months before term. The baby was referred to the hospital by doctors. The baby’s father said the baby was diagnosed with a hole in the heart three days after birth, and it enlarged within a week.

Cardiovascular surgeon, who performed the surgery, said since pre-term babies’ tissues are fragile, more care is needed before and during the surgery. He used a 3D printed image of the baby’s heart from the MRI scan to help identify the exact type of lesion and cut the cardiopulmonary bypass time. This reduced the recovery time, the Dr. explained.

The institute’s expertise in paediatric cardiac surgeries led it to develop an app. A professor of Paediatric Cardiology in-charge of MRI and 3D Printing, said the study of 1,100 babies brought to the institute found that safer transport would improve their survival chances. It helped develop an app to provide real time data even as the baby is transported by ambulance. The app will be launched in soon the Dr. said.

The institute has installed a 3D printer which has helped in planning complicated surgeries in other specialities also. 


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Wednesday, April 26, 2017

US scientists develop fluid-filled artificial womb to help premature births

Scientists in the United States have developed a fluid-filled womb-like bag known as an extra-uterine support device that could transform care for extremely premature babies, significantly improving chances of survival.

In pre-clinical studies with lambs, the researchers were able to mimic the womb environment and the functions of the placenta, giving premature offspring a crucial opportunity to develop their lungs and other organs.

Around 30,000 babies in the United States alone are born critically early -- at between 23 and 26 weeks of gestation, the researchers told reporters in a telephone briefing.

At that age, a human baby weighs little more than 500 grams, its lungs are not able to cope with air and its chances of survival are low. Death rates are up to 70% and those who do survive face life-long disability.

“These infants have an urgent need for a bridge between the mother’s womb and the outside world,” said Alan Flake, a specialist surgeon at the Children’s Hospital of Philadelphia who led the development of the new device.

His team’s aim, he said, was to develop an extra-uterine system where extremely premature babies can be suspended in fluid-filled chambers for a vital few weeks to bring them over the 28-week threshold, when their life chances are dramatically improved.

It could take up to another 10 years, but by then he hopes to have a licensed device in which babies born very prematurely are given the chance to develop in fluid-filled chambers, rather than lying in incubators being artificially ventilated. “This system is potentially far superior to what hospitals can currently do for a 23-week-old baby born at the cusp of viability,” Flake said. “This could establish a new standard of care for this subset of extremely premature infants.”


The team spent three years evolving their system through a series of four prototypes -- beginning with a glass incubator tank and progressing to the current fluid-filled bag.

Six preterm lambs tested in the most recent prototype were physiologically equivalent to a 23- or 24-week-gestation human baby and were able to grow in a temperature-controlled, near-sterile environment, Flake said.

The scientists made amniotic fluid in their lab and set up the system so that this flowed into and out of the bag. Lung development in foetal lambs is very similar in humans, said foetal physiologist Marcus Davey, who worked on team.

“Foetal lungs are designed to function in fluid. We simulate that environment ... allowing the lungs and other organs to develop while supplying nutrients and growth factors,” he said.

Flake said the success of the system, details of which were published on Tuesday in the journal Nature Communications, was due to its mimicking life in the uterus as closely as possible.

It has no external pump to drive circulation, because even gentle artificial pressure can fatally overload an underdeveloped heart, and there is no ventilator, because the immature lungs are not yet ready to breathe air.

Instead, the baby’s heart pumps blood via the umbilical cord into a low-resistance oxygenator that acts as a substitute for the placenta in exchanging oxygen and carbon dioxide.

Flake’s team plans to refine the system further and then downsize it for human infants, who are around a third of the size of the lambs used in the study.

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