Connect with us

Diseases and Conditions

The Complexities of Sepsis Care: A New Study Raises Questions About SEP-1 Compliance and Outcomes

A new study raises critical questions about the effectiveness of the Centers for Medicare and Medicaid Services’ (CMS) sepsis quality measure, known as the Severe Sepsis/Septic Shock Management Bundle (SEP-1).

Avatar photo

Published

on

The Centers for Medicare and Medicaid Services’ (CMS) Severe Sepsis/Septic Shock Management Bundle (SEP-1) has been a topic of controversy among healthcare professionals due to concerns that its rigid protocol may not account for the complexity of patient presentations. A new study led by the Center for Sepsis Epidemiology and Prevention Studies (SEPSIS) at the Harvard Pilgrim Health Care Institute sheds light on this issue, challenging assumptions about the effectiveness of SEP-1 in improving sepsis outcomes.

The study, published in JAMA Network Open, aimed to disentangle the impact of SEP-1 care from differences in patient characteristics that may influence treatment. Researchers conducted detailed medical record reviews of 590 patients with sepsis from four academic hospitals between 2019 and 2022. The investigators found that patients who received SEP-1 compliant care were systematically different from those who did not receive compliant care, with the latter having more complex medical conditions, presenting with unusual symptoms, and requiring urgent procedures.

When the study team adjusted for these patient complexities, the observed association between SEP-1 compliance and lower mortality disappeared. This raises concerns that CMS’s decision to transition SEP-1 to a pay-for-performance measure may not lead to meaningful gains in sepsis survival. The findings support growing calls from leading professional societies to rethink process-based sepsis mandates like SEP-1 and instead adopt risk-adjusted outcome measures.

As Dr. Michael Klompas, senior author of the study, emphasizes, “If we truly want to improve sepsis outcomes, we must move beyond simple admission bundles and focus on strategies that address the full spectrum of sepsis care.” The complex realities of sepsis care demand a more nuanced approach, one that takes into account the intricacies of patient presentations and competing clinical priorities.

Agriculture and Food

“Processed with Caution: Ultra-Processed Foods May Accelerate Early Signs of Parkinson’s Disease”

People who eat more ultra processed foods like cold breakfast cereal, cookies and hot dogs are more likely to have early signs of Parkinson’s disease when compared to those who eat very few ultra processed foods, according to a new study. The study does not prove that eating more ultra processed foods causes early signs of Parkinson’s disease; it only shows an association.

Avatar photo

Published

on

Eating ultra-processed foods like cold breakfast cereal, cookies, and hot dogs may speed up early signs of Parkinson’s disease, according to a recent study published in Neurology. The research found that people who consumed more of these processed foods were more likely to experience early symptoms of the disease compared to those who ate very few.

The study analyzed data from over 42,000 participants with an average age of 48, who did not have Parkinson’s disease at the start of the study. They were followed up to 26 years and completed regular medical exams and health questionnaires. Researchers also reviewed food diaries that listed what participants ate and how often.

The team looked at several types of ultra-processed foods, including sauces, spreads, or condiments; packaged sweets; snacks or desserts; artificially or sugar-sweetened beverages; animal-based products; yogurt or dairy-based desserts; and packaged savory snacks. One serving was equivalent to a single can of soda, one ounce of potato chips, one slice of packaged cake, a single hot dog, or one tablespoon of ketchup.

Researchers divided participants into five groups based on how many ultra-processed foods they ate per day on average. The highest group consumed 11 or more servings daily, while the lowest group averaged fewer than three servings daily.

After adjusting for factors like age, physical activity, and smoking, researchers found that participants who ate 11 or more servings of ultra-processed food per day had a 2.5-fold higher likelihood of having three or more early signs of Parkinson’s disease compared to those consuming fewer than three servings per day.

When looking at individual symptoms, eating more ultra-processed foods was tied to an increased risk for nearly all symptoms except constipation. The study’s author, Xiang Gao, emphasized the importance of choosing whole, nutritious foods over processed ones to maintain brain health.

While the study suggests a link between ultra-processed food consumption and early signs of Parkinson’s disease, it does not prove causation. More research is needed to confirm these findings and understand the complex relationships between diet, lifestyle, and neurodegenerative diseases.

In the meantime, individuals can take steps to reduce their exposure to ultra-processed foods by:

* Reading labels carefully
* Choosing whole grains over refined ones
* Limiting sugary drinks and snacks
* Opting for fresh fruits and vegetables instead of packaged options
* Cooking meals from scratch using fresh ingredients

By making informed food choices, individuals can contribute to a healthier brain and potentially reduce their risk of developing neurodegenerative diseases like Parkinson’s.

Continue Reading

Brain Tumor

“Revolutionizing Lymphoma Treatment: Enhanced CAR T Cell Therapy Shows Promise in Small Study”

A phase I study of a next-generation CAR T cell therapy showed a 52 percent complete remission rate for patients with relapsed/refractory lymphoma.

Avatar photo

Published

on

The article describes a groundbreaking study that has shown promising results in treating lymphoma patients who have resisted multiple rounds of other cancer treatments, including commercially available CAR T cell therapies. The new enhanced CAR T cell therapy, dubbed huCART19-IL18, was found to be highly effective in 81% of patients and resulted in complete remission in 52%. This is a significant improvement over traditional CAR T cell therapies, which have been shown to result in long-term remission in only around 50% of patients.

The study, led by researchers at the University of Pennsylvania, used a new process that shortens the manufacturing time for the CAR T cells to just three days. This means that patients with aggressive, fast-growing cancers can begin CAR T cell therapy quicker than is currently possible with standard manufacturing times of nine to 14 days.

The addition of interleukin 18 (IL18) to the CAR T cells enhanced their ability to attack cancer cells and protected them from immune suppression and T cell exhaustion. The researchers also found that the type of CAR T cell therapy patients previously received may impact the efficacy of huCART19-IL18.

This study represents a significant development in the ongoing evolution of CAR T cell therapy, as it is the first time a cytokine-enhanced CAR T has been tested in patients with blood cancer. The researchers believe that incorporating cytokine secretion into CAR T cell design will have broad implications for enhancing cellular therapies, even beyond blood cancers.

The study has already led to several other clinical trials being planned, including studies for acute lymphocytic leukemia (ALL) and chronic lymphocytic leukemia (CLL). Another trial for non-Hodgkin’s lymphoma using a similar IL18-armored CAR T cell product is currently enrolling patients. On the manufacturing side, the team is partnering with a Penn spinout company to improve the process for how these CAR T cells are created and expanded in the laboratory before being reinfused into the patient.

Overall, this study has shown promise in treating lymphoma patients who have resisted multiple rounds of other cancer treatments, and further research is needed to fully understand its potential.

Continue Reading

Diabetes

A Double-Edged Approach: Targeting Inflammation for a Potential Type 1 Diabetes Treatment

A new strategy may help prevent or slow the progression of Type 1 diabetes.

Avatar photo

Published

on

The article presents a promising strategy to prevent or slow the progression of Type 1 diabetes by targeting an inflammation-related protein known to drive the disease. Researchers have found that applying a molecular method to block inflammation signaling through the tyrosine kinase 2 (TYK2) protein reduces harmful inflammation in the pancreas, protecting insulin-producing beta cells and calming the immune system’s attack on those cells.

Type 1 diabetes is a lifelong condition where the immune system mistakenly attacks and destroys insulin-producing beta cells in the pancreas. This leads to high blood sugar levels, requiring ongoing insulin therapy and careful monitoring to avoid severe health complications.

The study, co-led by Indiana University School of Medicine researchers, presents a potential new strategy using a medication that inhibits TYK2, which is already approved for the treatment of psoriasis, an autoimmune condition causing skin inflammation. This finding is exciting because there is already a drug on the market that can do this for psoriasis, which could help move toward testing it for Type 1 diabetes more quickly.

Past genetic studies have shown that people with naturally lower TYK2 activity are less likely to develop Type 1 diabetes, further supporting the group’s approach for future treatments using this TYK2 inhibitor approach.

The researchers hope their findings will support future clinical trials to safely assess the efficacy of a new drug or drug combination in humans. They emphasize the importance of initiating translational studies to evaluate the impact of TYK2 inhibition alone or in combination with other already approved drugs in individuals at-risk or with recent onset Type 1 diabetes.

The study’s lead author, Farooq Syed, PhD, notes that their preclinical models suggest that the treatment might work in people as well. The next step is to initiate translational studies to evaluate the impact of TYK2 inhibition alone or in combination with other already approved drugs in individuals at-risk or with recent onset Type 1 diabetes.

The research team hopes to support future clinical trials to safely assess the efficacy of a new drug or drug combination in humans, offering hope for a potential treatment approach for Type 1 diabetes.

Continue Reading

Trending