MEDICAL RESEARCH is essential for the advancement of healthcare and the development of new treatments for diseases. It plays a crucial role in improving the lives of people around the world and saving countless lives. One of the main benefits of...

obal Health at the Harvard Global Health Institute, explained.“Despite a decade of this diarrheal disease, we have made no progress on water access,” she said, adding that only

Adults with the same type of so-called ACL injury generally showed no significant increase in such risk, investigators say.

The likely explanation, the researchers say, is that adults are more likely to dial back physical activity and comply with calls for restrictions from a doctor, while children are more likely to continue strenuous sports and other play, and experience further knee damage that may not at first be obvious.

“What we have shown with children is that the longer you wait, the more damage may be done to the knee,” says R. Jay Lee, M.D., senior author of the study and a pediatric sports medicine specialist at the Children’s Center.

In the study, described Oct. 6 in the Orthopaedic Journal of Sports Medicine, the Johns Hopkins investigators worked to establish the risk of tears to the meniscus, a C-shaped pad of cartilage in the knee, in pediatric and adult patients. They did so by comparing the presence of new meniscal tears discovered during arthroscopy-a minimally invasive surgical procedure to repair the knee tissue using a camera-and tears present during an MRI taken around the time of an initial ACL injury.

The researchers say the findings reinforce the need for timely surgical treatment in pediatric patients to prevent ongoing damage to the knee, while older patients’ surgical treatment may be safely delayed.

ACL tears, often experienced as a “popping” sensation in the knee, are especially common in children and adults who play sports that involve sudden, sharp changes in direction, such as football, soccer, lacrosse and basketball. Research estimates that between 100,000 and 200,000 people each year tear their ACL in the United States. Historically, physicians have recommended that ACL reconstruction be delayed in younger patients until the child is finished growing. However, in people of all ages, ACL tears leave the knee unstable and more prone to further injury.

For the new study, Lee and his team searched electronic medical records and identified 542 patients (173 pediatric patients and 369 adult patients) who underwent ACL reconstruction between 2013 and 2022 at Johns Hopkins Medicine.

They found that, overall, most patients (66%), both children and adults in the group studied, had a meniscal tear that was observed arthroscopically, but almost one-third of the tears, 32%, were new injuries not present on an initial MRI. In all, there were 36 new medial meniscus tears (tears on the inside of the knee joint) and 97 new lateral meniscus tears (tears on the outside of the knee). Some 17 patients developed both medial and lateral tears by the time of surgery.

Among those who showed no meniscal tears on their initial MRI, arthroscopy found new medial meniscal tears in 15% of pediatric patients and 16% of adults. But 48% of pediatric patients had new lateral meniscus tears, compared with 34% of adults.

The researchers say adults were more likely than pediatric patients overall to delay ACL reconstruction, but that among adults, the delayed reconstruction was not associated with a higher risk of meniscal tears at the time of injury or at the time of surgery. Researchers believe these findings suggest that delayed ACL reconstruction may be acceptable in adults.

The investigators say their study was limited by the potential for so-called “selection bias,” in which surgeons may have been more likely to operate soon after injury in those with more severe knee injuries. Additionally, the level of a person’s physical activity after ACL injury is likely a major contributor to the development of further knee damage, but its specific contribution is challenging to measure. Lastly, meniscal tears that were missed on the initial MRI could have led to an overestimation of the incidence of “new” meniscal tears in some cases.

However, the researchers say they hope their findings will help inform decisions when adults and caregivers of children who experience ACL injuries are deciding when to have surgery. The researchers will continue their investigation, particularly looking at whether restricting patients’ mobility has an effect on new meniscal tears.

Reference:

Arjun Gupta, Daniel Badin, and R. Jay Lee, Is Delayed Anterior Cruciate Ligament Reconstruction Associated With a Risk of New Meniscal Tears? Reevaluating a Longstanding Paradigm, https://doi.org/10.1177/23259671231203239.

A medical practitioner says the Queen Elizabeth Hospital (QEH) needs to hire additional anesthesiologists to meet the demands that can only be executed by physicians trained in that speciality area.

Speaking to members of the media at a World Anaesthesia Day Symposium in the QEH Auditorium on Monday, consultant anesthesiologist Dr Keisha Thomas-Gibson said more anesthesiologists were required to decrease the heavy workload in the Anaesthesia Department, as she noted that the duties of anesthesiologists go way beyond administering medication to put a patient to sleep before surgery and being there to wake them following the procedure.

Dr Thomas-Gibson, who is the Anesthesia Intensive Care programme coordinator for the University of the West Indies (UWI) undergraduate and postgraduate programmes, said because the anesthesiologist’s role stretches outside the operating theatre, more human resources are necessary to service all the other areas.

“Ninety-nine per cent of patients do not know that the anesthesiologist is with them throughout the surgery. They think that we give an injection and sometimes return to wake you up, or you wake up on your own, and that is absolutely not the case. We are the intraoperative, the surgeon cuts, and we do everything else. 

“So it is a situation where, of course, we need human resources, we need persons, we need staff to be able to execute all of the different roles that we have and the speciality of anaesthesia. Because we are finding ourselves in so many other parts of the hospital, we need staff to be able to service all those areas that we are required to service,” she said.

Adding that an extensive list of highly specialised surgeries is performed in Barbados, Dr Thomas-Gibson said that, at times, anesthesiologists have to push other cases aside to be able to provide the service to that speciality case.

“So the backlogs can’t be addressed by us alone. We are here every single day, and we only do what is presented up until a particular time within here and obvious limitations,” she said.

During her presentation, Dr Thomas-Gibson stressed that the safety record at the hospital is “exceptional”.

She commended the partnership between UWI and the QEH, where doctors are receiving specialised training to become anesthesiologists. (AH)

The post More anesthesiologists needed at QEH appeared first on Barbados Today.

Perez Duran asked President Abinader to pay attention to the growing 0epidemic, about which he indicated the figures do not correspond to reality, so he asked to declare a state of emergency in the country due to increased cases.

“I am making a call to you, Mr. President (…), I understand that within 24 hours you should decree a state of emergency, where a campaign of fumigation, orientation, protocolization of the dengue fever that we have in front of us,” said the doctor.

The doctor’s daughter died on Friday last week after remaining in intensive care and being diagnosed with the disease transmitted by the Aedes Aegypti mosquito after being hospitalized since Wednesday morning.

He explained that the teenager arrived at the hospital “in a critical condition,” so she was immediately referred to the Intensive Care Unit.

“We as parents spared neither resources nor efforts to facilitate everything that was asked of us,” said the grieving father in an interview with Martina Espinal on the program Al Punto.

He indicated that, at first, they thought it was a classic dengue, but after she was intubated early Thursday morning, the infant became brain-dead at 5:00 p.m., indicating to her parents that it was too late.

The girl’s father said that the child’s platelets, which were at 266, reached 11 in just three days.

With a troubled expression, Perez narrated that they took the girl to receive medical attention since the first symptoms appeared on Sunday of that week. However, the pre-adolescent died days later.

“On Friday morning an attempt was made to connect her to a special dialysis machine, when the caveat was made that the girl was clinically dead, it was literally exploding her lungs, heart and kidneys. When she was connected to the machine, the girl died after two minutes, she went into irreversible arrest,” he said.

Saniah Spencer, marketing executive at JN Group, says the initiative has been made possible through a collaboration with member company, JN Money Services, and the Jamaica Cancer Society (JCS). The services will be offered through the JCS at its headquarters on Lady Musgrave Road in St Andrew.

"Mammograms are costly for several women and are not as readily accessible as we think. In many rural parishes there are no medical facilities that offer this service, and those which do can be expensive. Therefore, in many instances, women are forced to travel outside their parish to access the services," Spencer highlighted.

The cost to access mammograms is cheaper in public facilities, but the only public facilities which house mammography machines are the country's three Type 1 hospitals — The University Hospital of the West Indies, the Kingston Public Hospital (both in the Corporate Area), and the Cornwall Regional Hospital in St James.

The distance for women who do not live in these parishes makes access limited, while to get the procedure done at private facilities, they could pay as much as $12,000 for a mammogram.

"This is why two years ago we introduced this initiative, and last year, the offer was oversubscribed. Therefore, there is a high demand, and so we have maintained this offer to provide more women with a chance to prevent the disease by knowing their status," she pointed out.

The Power of Pink, being initiated this year under the theme 'Take the Brave Steps', will centre on encouraging women to conduct regular self-examinations and to get screened, so the disease can be detected early and treated to reduce deaths.

"Many women, and men too, fear receiving the news of a positive diagnosis, but by knowing their status early they can overcome the disease," Spencer assured.

She added that, as in past years, the campaign will be used to draw attention to and honour people battling the disease, as well as those who fought it bravely to the end.

"We will be celebrating the lives of warriors and remembering our heroes who have passed. Our campaign is targeted at educating Jamaicans about early detection and raising funds for cancer research and support for persons affected by the disease," she explained.

She noted that throughout October, the group will be supporting the cause through several of its various member companies.

"Beyond the need for early detection, we will highlight through our member companies the socio-economic challenges persons battling the disease face, and their stories of hope and survival," Spencer outlined.

She said persons may visit the JN Group website www.jngroup.com/pink/ to learn more about its activities in support of the fight against breast cancer and how they can participate.

Breast cancer is the leading cause of cancer-related deaths in Jamaican women.

Speaking at a JN Group Power Pink pop-up session held outside the JN Bank Half-Way-Tree branch in October 2022, Micheal Leslie, acting executive director of the JCS, said that "it is predicted that one out of every 21 women in Jamaica will develop breast cancer in her lifetime".

He also noted that 1,208 new breast cancer cases were diagnosed in 2020, which was an increase of more than 25 per cent when compared to 2018. Of the 1,208 cases, there was an estimated 637 breast cancer deaths, which he referred to as "alarming statistics".

Last year, the JN Group donated over $2.5 million to the JCS and its breast cancer arm, Reach to Recovery, to facilitate breast cancer research and support the fighters.