Cardiac mission saves 13 children’s lives with complex surgeries
All over the globe, A&K Global Health excels in matching people who need healthcare with the right organizations to fund it and the right doctors and hospitals to provide it. A recent international surgical mission at Mater Hospital in Nairobi, Kenya delivered a powerful example of our life-saving coordination and management in action.
For two weeks last November, a team of cardiac surgeons from Kardiocentrum University Hospital in Motol, Czech Republic and Kramala Hospital in Bratislava, Slovakia, embedded with Mater’s resident surgical and support staff. In conjunction with the National Hospital Insurance Fund’s (NHIF) cardiac surgery program, the mission aimed to address the most urgent pediatric cardiac cases on the hospital’s waiting list. It conducted 13 complex surgeries in just 13 days, including one Rastelli procedure – the first to be performed at Mater Hospital. All 13 surgeries were successful, and all 13 children have since returned home to their families from the hospital.
One of these children’s remarkable stories was featured in Kenya’s The Standard shortly after the mission concluded. “Godious Kiptoo Chumba is a two-year-old patient who has benefitted from the NHIF cardiac program…at Mater Hospital,” read the testimonial. “His father…could not hide his joy and relief after his son was successfully operated on. ‘We are very happy that our son’s surgery was successful. It was a very long process before we got to where we are but we are indeed very grateful. What wonderful work NHIF has done to reach out to Kenyans!’”
Because 10 of the 13 children who received surgeries were sponsored by the NHIF and managed by A&K Global Health, Mater Hospital and the visiting surgeons organized an event at the mission’s end to acknowledge and appreciate everyone’s role. It was an emotional evening for the local and foreign doctors alike: in their presentation to our CEO, Morgan Darwin, the surgeons stressed that these patients would have died without A&K Global Health’s involvement. Several medical professionals were moved to tears as they expressed their gratitude.
There are so many beautiful stories to be told about this mission,” said Mr. Darwin. “There are the 13 children who now have the chance to live long and healthy lives. There’s also the dedication, determination, and professionalism of the Kenyan and foreign surgeons – their courage, cooperation, and teamwork, across different countries and cultures, directly enabled these life-saving procedures to be successful. It was our great privilege, as the implementer and manager of the NHIF cardiac program, to witness this surgical mission’s impact at Mater.”
A&K Global Health has more collaborative surgical initiatives on the horizon. At Mater as at every hospital involved in the NHIF’s cardiac surgery program, we are using our experience and expert knowledge to put together surgical alliances that benefit every participant, from patients and families to Kenyan as well as international surgeons and medical professionals. And we’ll continue to showcase here on the A&K Global Health blog the incredible positive returns that occur when we bring people together, united toward the common goal of expanding healthcare.
Source:http://akglobalhealth.com/cardiac-mission-saves-13-childrens-lives-complex-surgeries/
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India’s first uterine transplant, Baroda woman to get her mother’s womb.
The wonders of science never cease to amaze us. And while the rest of the first world countries are pretty used to ground-breaking medical inventions and procedures, India is slowly catching up.What seemed impossible almost a decade ago has now become the norm.
And pretty seen soon, the nation is going to have its first uterine transplant. Wondering what that is? Well, ‘it’s is the surgical procedure whereby a healthy uterus is transplanted into an organism of which the uterus is absent or diseased.’
According to a report published in the Indian Express, a 26-year-old Baroda-based woman will undergo the surgery in Pune on May 18. Prior to this, she had suffered four abortions, lost two two babies after carrying them full-term, and has a defected uterus.
“Atlu sehen karyu che, have sano dar (I have gone through a lot and am no longer worried),”she said in an interview to the leading daily. “Mara chokri ne balak thay bas etla mate operation che (I am doing this so that my daughter can have her own child),” added her 44-year-old mother.
Interestingly, Pune’s Galaxy Care Laprascopy Institute (GCLI) will witness two other similar surgeries on May 19 and one in June. “The three surgeries will be conducted for free by a 12-member team of gynaecologists, endocrinologists and IVF specialists. In all the cases, the women will be receiving wombs from their respective mothers,” reported Zee News.
Though, it’s India’s first uterine transplant, the first surgery in the world took place in Sweden in 2012. So, in order to prep up for the surgery a team of Indian doctors visited Sweden. “Before going ahead in our hospital, we followed a rigorous process while choosing the donor and the recipient of womb,” said Dr Shailesh Puntambekar, medical director, GCLI, in an interview to Hindustan Times.
There’s no doubt this new medical procedure is a blessing for women, who can’t conceive due to a scarred or non-existent womb.
Source:http://www.oddnaari.in/news/story/odd-baroda-woman-uterine-transplant-india-first-womb-surgery-125374-2017-05-12
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Focus shifts to expensive pacemakers, lenses, catheters
After the capping of cardiac stent prices, the Rajya Sabha petitions committee has turned its attention to overpricing of other medical devices. On Tuesday, the committee heard the National Pharmaceutical Pricing Authority (NPPA) and the department of pharmaceuticals (DoP) on the issue.
The health ministry has classified 22 medical devices, including cardiac stents, as drugs under the Drugs and Cosmetics Act 1940. These include intraocular lens, knee and hip implants, syringes and catheters.
The committee is hearing a petition filed by one Sulagna Chattopadhyay on overpricing of medical devices. The petition had sought measures to regulate the price of medical devices and to investigate the role of regulatory bodies like the drug controller in preventing overpricing.
The All India Drug Action Network, a civil society group working on pricing of drugs and devices, argued before the committee that it was equally important for pacemakers, implantable cardioverter defibrillator, artificial heart valves, intraocular lenses, and hip and knee replacements to be made accessible via price control. The committee has been holding hearings since the beginning of 2016. It has visited several places including Bengaluru, Coorg, Mumbai and Bhopal to hold hearings.
“We asked for more cath labs in the public health system and for fixing procedure rates so cardiac procedures become more affordable. We also want price control of other devices such as pacemakers, cochlear implants and artificial joints,” said Dr Ravi D’Souza of Sochara, a group working on public health. D’Souza had deposed before the committee in Bhopal.
“After stents, the panel’s focus has shifted to other medical devices. However, there are still loopholes it can help fix: the cost of catheters, balloons, guidewires, which are high. Barely a dent has been made in overall angioplasty costs. Medical device firms and their associations are on a misinformation campaign to safeguard their interests by preventing price regulation of other devices. The committee should move swiftly and recommend price checks on other devices to benefit the poor,” said Malini Aisola of AIDAN. Chattopadhyay said she too has asked for the price of balloons, catheters and guide wires also to be capped to make angioplasty truly affordable.
(This article was originally published in The Times of India)
Source : http://economictimes.indiatimes.com/industry/healthcare/biotech/healthcare/focus-shifts-to-expensive-pacemakers-lenses-catheters/articleshow/58624368.cms
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Hypertension may lead to stroke or cardio-vascular diseases: Indus Health Plus report
The sample size for the study was 21,623 people who underwent preventive health check-up during January – December 2016
On the occasion of World Hypertension Day on May 17, 2017, a study by Indus Health Plus revealed that 27 per cent males and 24 per cent females from 25-35 years age group have reported of pre-hypertension. If left untreated, it would develop into hypertension eventually, leading to stroke or cardio-vascular diseases (CVDs). The sample size for the study was 21,623 people who underwent preventive health check-up during January – December 2016.
The report states that incidences of hypertension is increasing consistently in Mumbai area, with 35 per cent to 40 per cent urban people and 18 per cent to 20 per cent rural people suffering from it.
Amol Naikawadi, Preventive Healthcare Specialist, Indus Health Plus says, “90 per cent of the population are unaware about the silent symptoms of hypertension. Mumbaikars are not meeting healthy lifestyle recommendations that are important in preventing hypertension and its complications. While those from urban areas blamed work pressure and job insecurity for rising levels of stress and eventually hypertension, people from semi-rural and rural area blamed the increasing cost and increased in-house expenditure. If not treated on time, hypertension can lead to heart problems, renal and multiple organ failure. A timely and routine check-up can reduce the risk of hypertension.”
Source: http://www.expressbpd.com/healthcare/happening-now/hypertension-may-lead-to-stroke-or-cardio-vascular-diseases-indus-health-plus-report/385488/?SocialMedia
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Early MRI may lower costs for prostate cancer treatment
Study finds MRI and MRI-guided biopsy cheaper long-term than standard ultrasound.
A diagnostic MRI followed by one of three MRI-guided biopsy strategies is a cost-effective method to detect prostate cancer, according to a new study out of Case Western Reserve University School of Medicine and University Hospitals Cleveland Medical Center. Researchers compared MR-guided approaches to the current standard of transrectal ultrasound guided biopsies and found that these approaches yielded net health benefits that were well within commonly accepted threshold for costs-benefit ratios and thus are cost-effective strategies for detecting prostate cancer. The paradigm-shifting research was published in the preeminent journal Radiology.
“Many consider MRIs to be cost-prohibitive, especially when evaluating for a common entity such as prostate cancer. This was our expectation as well, prior to doing this work, but our study found the opposite. We found that performing MRI before biopsy and using that information to alter biopsy pathways would be a strategy that would add health benefits to the patient population in a cost effective manner,” said Vikas Gulani, MD, PhD, study advisor and associate professor of radiology, urology, and biomedical engineering at Case Western Reserve University School of Medicine, and member of both the Case Comprehensive Cancer Center and Case Center for Imaging Research.
The study was jointly first-authored by Shivani Pahwa, MD, department of radiology, and Nicholas Schiltz, PhD, department of biostatistics; and was developed in close collaboration with Lee Ponsky, MD, department of urology, and Mark Griswold, PhD, department of radiology.
The researchers found using MRI to help detect lesions and guide biopsies increased standardized quality-adjusted life years for patients and was cost-effective in 94.05% of simulations. The benefits were consistent across age groups, and could change how doctors identify and sample cancer lesions.
The current standard of care for detecting prostate cancer involves 12 biopsy samples collected during an invasive transrectal ultrasound. Since most tumors are not visible on ultrasound, up to 40% of clinically significant tumors are missed via this method, and many found are clinically insignificant. The approach regularly results in patients entering treatment pathways with potential negative side effects, to treat low-risk tumors. Biopsies may also cause bleeding and complications, increasing health care costs.
MRI offers a non-invasive alternative to transrectal ultrasound which can help better steer biopsy pathways. Doctors could use MRI to evaluate patients for potentially harmful lesions, and then use that information in one of three MRI guided strategies for biopsying potential foci of cancer, and bypass biopsy if a scan is completely negative. Although scans are expensive, they can add health benefits by triaging patients into proper treatment pathways. MR tends to miss low risk cancer, the overtreatment of which is a major contributor to high health and financial costs in prostate cancer. Similarly, a negative MRI is a very good predictor of exclusion of aggressive disease. A combination of such factors is likely the reason for the cost effectiveness of the MRI guided strategies. Current estimates place prostate cancer care costs in the United States at over $10 billion annually, and the price tag is rising.
The findings may help streamline prostate cancer treatment protocols to better serve patients. Said Gulani, “Costs are escalating in part due to expensive and inefficient diagnostic pathways, and placement of patients in incorrect treatment groups. If we can maximize efficiency in how we identify clinically significant lesions and diagnose patients, we can reduce unnecessary treatments for our patients, and reduce costs to our hospitals.”
Source: Case Western Reserve University
URL: https://www.sciencedaily.com/releases/2017/05/170517154720.htm
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Cancer-cardiac connection illuminates promising new drug for heart failure
A team of researchers at the Gladstone Institutes uncovered a new strategy to treat heart failure, a leading contributor to mortality and healthcare costs in the United States. Despite widespread use of currently-approved drugs, approximately 40% of patients with heart failure die within 5 years of their initial diagnosis.
“The current standard of care is clearly not sufficient, which highlights the urgent need for new therapeutic approaches,” said Saptarsi Haldar, MD, an associate investigator at Gladstone and senior author of a new study featured on the cover of the scientific journal Science Translational Medicine. “In our previous work, we found that a drug-like small molecule called JQ1 can prevent the development of heart failure in mouse models when administered at the very onset of the disease. However, as the majority of patients requiring treatment already have longstanding cardiac dysfunction, we needed to determine if our strategy could also treat established heart failure.”
As part of an emerging treatment strategy, drugs derived from JQ1 are currently under study in early-phase human cancer trials. These drugs act by inhibiting a protein called BRD4, a member of a family of proteins called BET bromodomains, which directly influences heart failure. With this study, the scientists found that JQ1 can effectively treat severe, pre-established heart failure in both small animal and human cell models by blocking inflammation and fibrosis (scarring of the heart tissue).
“It has long been known that inflammation and fibrosis are key conspirators in the development of heart failure, but targeting these processes with drugs has remained a significant challenge,” added Haldar, who is also a practicing cardiologist and an associate professor in the Department of Medicine at the University of California, San Francisco. “By inhibiting the function of the protein BRD4, an approach that simultaneously blocks both of these processes, we are using a new and different strategy altogether to tackle the problem.”
Currently available drugs used for heart failure work at the surface of heart cells. In contrast, Haldar’s approach goes to the root of the problem and blocks destructive processes in the cell’s command center, or nucleus.
“We treated mouse models of heart failure with JQ1, similarly to how patients would be treated in a clinic,” said Qiming Duan, MD, PhD, postdoctoral scholar in Haldar’s lab and co-first author of the study. “We showed that this approach effectively treats pre-established heart failure that occurs both after a massive heart attack or in response to persistent high blood pressure (mechanical overload), suggesting it could be used to treat a wide array of patients.”
Using Gladstone’s unique expertise, the scientists then used induced pluripotent stem cells (iPSCs), generated from adult human skin cells, to create a type of beating heart cell known as cardiomyocytes.
“After testing the drug in mice, we wanted to check whether JQ1 would have the same effect in humans,” explained co-first author Sarah McMahon, a UCSF graduate student in Haldar’s lab. “We tested the drug on human cardiomyocytes, as they are cells that not only beat, but can also trigger the processes of inflammation and fibrosis, which in turn make heart failure progressively worse. Similar to our animal studies, we found that JQ1 was also effective in human heart cells, reaffirming the clinical relevance of our results.”
The study also showed that, in contrast to several cancer drugs that have been documented to cause cardiac toxicity, BRD4 inhibitors may be a class of anti-cancer therapeutics that has protective effects in the human heart.
“Our study demonstrates a new therapeutic approach to successfully target inflammation and fibrosis, representing a major advance in the field,” concluded Haldar. “We also believe our current work has important near-term translational impact in human heart failure. Given that drugs derived from JQ1 are already being tested in cancer clinical trials, their safety and efficacy in humans are already being defined. This key information could accelerate the development of a new heart failure drug and make it available to patients more quickly.”
Story Source:Materials provided by Gladstone Institutes.
URL: https://www.sciencedaily.com/releases/2017/05/170517143623.htm
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