Managing nontraditional risk factors to improve outcomes after cancer surgery

first_imgReviewed by James Ives, M.Psych. (Editor)Mar 12 2019In a study of 142 patients preparing for cancer surgery, Johns Hopkins Medicine researchers say they have evidence that psychological or social risk factors such as depression, limited resilience and lack of emergency resources along with standard medical risk factors such as high blood pressure or diabetes are linked with higher risks of surgical complications.”When it comes to cancer surgery, the conventional strategy has always been to treat the cancer as fast as you can,” says Ira Leeds, M.D., M.B.A., a research fellow in the Department of Surgery at the Johns Hopkins University School of Medicine. “But our study suggests that there are things related to their psychosocial lives that we could and should be managing ahead of time, and that would help our patients have better outcomes after their surgery.”The researchers caution that their study wasn’t designed to determine cause and effect, but to identify associations between risk factors and outcomes.In a report on the study, published Jan. 7 in Annals of Surgical Oncology, the researchers said such psychological and social factors as mood, the ability to handle stress, resources patients can pull together in a pinch, and a history of drug, alcohol or smoking addiction were tied observationally to poor surgical outcomes in their study population. Taking note of them, and perhaps taking some time to address them, may help reduce complications and improve outcomes.Leeds said his study was prompted in part by the better outcomes documented in other kinds of surgery where there may be less of a sense of immediate urgency, such as weight reduction and orthopaedic operations. In those fields, he noted, surgeons generally require that their patients have a good psychosocial safety net and plan before surgery, because such things as quitting smoking and having a plan for after-surgery care can result in fewer adverse events.To see whether that might be the case for cancer surgery patients, the researchers compiled a special questionnaire based on well-known terms and concepts used to measure psychosocial risk factors. For example, the questions ask a patient how well they bounce back from a difficult event, or how likely they could cope with and care for a minor infection from home after surgery.Related StoriesStudy: Nearly a quarter of low-risk thyroid cancer patients receive more treatment than necessaryHow cell-free DNA can be targeted to prevent spread of tumorsNew protein target for deadly ovarian cancerBetween March and October 2017, they gave the survey to 142 patients before they had abdominal cancer surgery at The Johns Hopkins Hospital or its local affiliates. Each survey took an average of 10 minutes to complete and asked patients to rank their answers to about 20 questions on a 1 to 5 scale.The patients were an average of 65 years old; 56 percent were men and 23 percent were nonwhite. More than half the patients had a liver or pancreatic tumor, and the rest had primarily colorectal tumors. The researchers assessed patient outcomes 30 days after surgery, using medical records to count such complications after surgery as infections, blood clots, bleeding from surgery, heart attack, kidney problems, stroke and spending excessive time on a ventilator.Of those who had operations, 43 percent had other medical risk factors prior to surgery, such as high blood pressure, diabetes, lung disease or heart failure, all of which may lead to post-operative complications. Almost three-quarters had at least one psychosocial risk factor, with the most frequent reported as smoking (43 percent) and limited resourcefulness (29 percent).The researchers found that one psychosocial risk factor alone did not make a person more likely to have complications after cancer surgery. However, they found that if people had medical risk factors and a single psychosocial risk factor, it made them 28 percent more likely than those without those factors to have complications after surgery, even after accounting for the extra complications tied to medical risk factors.Those patients who had a medical risk factor and two or more psychosocial risk factors were 3.4 times more likely to develop a complication after surgery than those with no risk factors.”Our results suggest that there is an opportunity to test new interventions focused on managing psychosocial risks before surgery in order to improve outcomes, and that is what we plan to do next,” says Leeds. Source:https://www.hopkinsmedicine.org/news/newsroom/news-releases/potential-way-to-improve-cancer-surgery-outcomes-by-managing-nontraditional-risk-factorslast_img read more

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Premature babies also have protective antiviral antibodies

first_imgReviewed by Alina Shrourou, B.Sc. (Editor)Mar 18 2019Even premature babies carry anti-viral antibodies transferred from the mother, researchers at Karolinska Institutet in Sweden report in a paper on maternal antibodies in newborns, published in the journal Nature Medicine. The results should change our approach to infection sensitivity in newborns, they say.Antibodies are transferred from the mother’s blood to the fetus that give the newborn passive defence against infection. Since most of this process takes place during the third trimester of the pregnancy, doctors have regarded very premature babies as being unprotected by such maternal antibodies.However, now that the total repertoire of maternal anti-viral antibodies has been analyzed in neonates by researchers at Karolinska Institutet and Karolinska University Hospital, another picture is emerging.”We saw that babies born as early as in week 24 also have maternal antibodies, which surprised us,” says corresponding author Dr Petter Brodin, physician and researcher at the Science for Life Laboratory (SciLifeLab) and the Department of Women’s and Children’s Health, Karolinska Institutet.The study comprised 78 mother-child pairs. 32 of the babies were very premature (born before week 30) and 46 were full-term. The analysis show that the repertoire of maternal antibodies was the same in both groups.”I hope that this makes us question some preconceived ideas about the neonate immune system and infection sensitivity so that we can take even better care of newborns,” says Dr Brodin. “Premature babies can be especially sensitive to infection, but that is not because they lack maternal antibodies. We should concentrate more on other possible causes, maybe like their having underdeveloped lung function or weaker skin barriers.”Related StoriesNew research offers hints to origins of systemic lupus erythematosusNovel vaccine against bee sting allergy successfully testedBio-Rad launches new isotype-specific secondary antibodiesThe study was conducted using a newly developed method for simultaneously analysing the presence of antibodies against all the viruses that can infect humans (with the exception of the Zika virus, which was identified later). The method is developed by US researchers and is based on a so-called bacteriophage display, a technique awarded with the 2018 Nobel Prize in Chemistry.Briefly, it is based on the ability to make viral particles called bacteriophages display a specific surface protein. In this case, all in all the bacteriophage library displayed over 93,000 different peptides, short-chain proteins, from over 206 species of virus and over 1 000 different strains. The library is mixed with the blood plasma to be tested. Any antibodies in the plasma sample bind with the bacteriophages and can then be detected by the researchers.The analysis was conducted on samples taken at birth and during the newborns’ first, fourth and twelfth week. The researchers found that the protection offered by the antibodies lasted different durations depending on the virus. This can suggest that their transfer during the fetal stage is regulated rather than random, a possibility the group is now examining further.The study also shows which parts of the virus proteins that antibodies target, information that is important in the development of vaccines, notes Dr Brodin.”If all maternal antibodies target a specific part of a virus protein, that is important to know because then it is that part a vaccine should be based on,” he says. “I hope that our results can be used by others to develop better vaccines, such as against the RS virus that causes so much distress for babies every winter.” Source:https://ki.se/en/research/protective-antibodies-also-found-in-premature-babieslast_img read more

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Workplace messaging startup Slack to go public

first_imgWorkplace messaging startup Slack has become the latest of the richly valued tech startups to file for an initial public offering Explore further This document is subject to copyright. Apart from any fair dealing for the purpose of private study or research, no part may be reproduced without the written permission. The content is provided for information purposes only. © 2019 AFP Citation: Workplace messaging startup Slack to go public (2019, February 4) retrieved 17 July 2019 from https://phys.org/news/2019-02-workplace-messaging-startup-slack.htmlcenter_img Workplace messaging startup Slack said Monday it had filed a confidential registration for an initial public offering, becoming the latest of a group of richly valued tech enterprises to look to Wall Street. California-based Slack’s filing comes under a special provision of securities laws enabling startups to begin the IPO process without disclosing details of their financing.The statement offered no information on the date or amount of money expected to be raised. Some reports say Slack will use the direct listing, a method used by Spotify, that allows insiders to sell existing shares without issuing new stock, streamlining the IPO process and avoiding big investment banking fees.Slack, which claims some 10 million users in 150 countries, has raised more than $1 billion from investors with the latest valuing the company at $7.1 billion, making it one of the most richly valued “unicorns”—startups with private funding worth at least $1 billion.Slack, which offers real-time messaging for the workplace, is used to help improve communication and help companies get around email overload. It offers free services for small teams and paid plans with additional options.Created in 2013, Slack has been a leader in the new segment but faces competition from the likes of Microsoft, Facebook and others offering workplace collaboration tools.Analysts say Slack has found a niche, especially among small- and medium-sized businesses.Other richly valued unicorns aiming for an IPO in 2019 include ridesharing giants Uber and Lyft, and lodging startup Airbnb. Other potential IPOs in the sector include the social platform Pinterest and coworking sector leader WeWork.Slack’s CEO and founder Stewart Butterfield was part of the team that started the photo-sharing service Flickr. Workplace messaging startup Slack eyes 2019 IPO: reportlast_img read more

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