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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).

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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.

Disability

A Spark of Hope: Electric Implant Helps Paralyzed Rats Walk Again, Could Humans Be Next?

A groundbreaking study from the University of Auckland and Chalmers University of Technology is offering new hope for spinal cord injury patients. Researchers have developed an ultra-thin implant that delivers gentle electric currents directly to the injured spinal cord. This device mimics natural developmental signals to stimulate nerve healing, and in animal trials, it restored movement and touch sensation in rats—without causing inflammation or damage.

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The devastating effects of spinal cord injuries have left millions without hope for recovery. However, groundbreaking research at Waipapa Taumata Rau, University of Auckland, has sparked new possibilities. Scientists have successfully used an implantable electronic device to restore movement in rats with spinal cord injuries, offering a glimmer of hope for humans and their pets.

Spinal cord injuries disrupt the communication between the brain and body, resulting in a loss of function. Unlike cuts on the skin, which typically heal on their own, the spinal cord does not regenerate effectively, making these injuries currently incurable. However, researchers have harnessed the same electrical guidance system that naturally occurs before birth to encourage nerve tissue growth along the spinal cord.

Lead researcher Dr. Bruce Harland explains, “We developed an ultra-thin implant designed to sit directly on the spinal cord, precisely positioned over the injury site in rats.” The device delivers a carefully controlled electrical current across the injury site, aiming to stimulate healing and restore lost functions.

In a 12-week study, rats that received daily electric field treatment showed improved movement and responded more quickly to gentle touch compared to those who did not. This indicates that the treatment supported recovery of both movement and sensation, with no signs of inflammation or damage to the spinal cord.

The new study, published in Nature Communications, is a result of a partnership between the University of Auckland and Chalmers University of Technology in Sweden. Long-term, the goal is to transform this technology into a medical device that could benefit people living with life-changing spinal-cord injuries.

“This study offers an exciting proof of concept showing that electric field treatment can support recovery after spinal cord injury,” says doctoral student Lukas Matter from Chalmers University. The next step is to explore how different doses and treatment regimens affect recovery, to discover the most effective recipe for spinal-cord repair.

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Diabetes

The Ancient Longevity Switch: How Morning Coffee Could Be Slowing Down Your Ageing Process

Caffeine appears to do more than perk you up—it activates AMPK, a key cellular fuel sensor that helps cells cope with stress and energy shortages. This could explain why coffee is linked to better health and longer life.

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The scientific community has made another groundbreaking discovery that reveals how our beloved morning coffee might be doing more than just waking us up. A recent study conducted by researchers at Queen Mary University of London’s Cenfre for Molecular Cell Biology sheds light on the potential anti-ageing properties of caffeine, the world’s most popular neuroactive compound.

The research, published in the journal Microbial Cell, delves into the intricate mechanisms within our cells and how they respond to stress and nutrient availability. The scientists used a single-celled organism called fission yeast as a model to understand how caffeine affects ageing at a cellular level.

One of the key findings was that caffeine doesn’t act directly on the growth regulator called TOR (Target of Rapamycin), which is responsible for controlling energy and stress responses in living things for over 500 million years. Instead, it works by activating another crucial system called AMPK, a cellular fuel gauge that is evolutionarily conserved in yeast and humans.

“When your cells are low on energy, AMPK kicks in to help them cope,” explains Dr Charalampos (Babis) Rallis, Reader in Genetics, Genomics, and Fundamental Cell Biology at Queen Mary University of London, the study’s senior author. “And our results show that caffeine helps flip that switch.”

The implications of this discovery are significant, as AMPK is also the target of metformin, a common diabetes drug being studied for its potential to extend human lifespan together with rapamycin. The researchers demonstrated using their yeast model that caffeine’s effect on AMPK influences how cells grow, repair their DNA, and respond to stress – all of which are tied to ageing and disease.

These findings open up exciting possibilities for future research into how we might trigger these effects more directly – with diet, lifestyle, or new medicines. So, the next time you reach for your coffee, remember that it might be doing more than just boosting your focus – it could also be giving your cells a helping hand in slowing down your ageing process.

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Diseases and Conditions

“The Pleasure Prescription: Unlocking the Secret to Less Menopause Pain”

Keeping sex on the schedule may be its own menopause medicine: among 900 women aged 40-79, those active in the last three months reported far less dryness, pain, and irritation, while orgasm and overall satisfaction stayed rock-solid despite dips in desire and lubrication. The results hint that intimacy itself can curb genitourinary syndrome of menopause, a cluster of estrogen-related symptoms that erode quality of life.

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The Pleasure Prescription: Unlocking the Secret to Less Menopause Pain

For many women, the transition into menopause is not only marked by hormonal changes but also accompanied by a decline in interest in sex. However, research suggests that regular sexual activity may be the key to alleviating some of the uncomfortable symptoms associated with this life stage.

A recent study published in the journal Menopause found that engaging in regular sexual activity can limit vulvar pain, irritation, and dryness – common reasons women have less sex as they get older. The researchers examined the association between sexual regularity and vulvovaginal-related problematic menopause symptoms among over 900 women aged 40 to 79 years.

The study revealed that while the frequency of sexual activity decreases with age, scores for orgasm and satisfaction remain relatively unchanged. Notably, women who engaged in more regular sexual activity showed a lower prevalence of genitourinary syndrome of menopause (GSM)-related symptoms – a condition characterized by genital, sexual, and urinary symptoms associated with decreased estrogen levels.

The findings highlight the importance of diagnosing and treating GSM, which can impair quality of life and even reduce life expectancy in women. Dr. Monica Christmas, associate medical director for The Menopause Society, emphasizes that local low-dose vaginal estrogen therapy is a safe and effective treatment option for alleviating bothersome vulvovaginal symptoms.

The study’s results suggest that treating GSM should not be limited to women who are sexually active but rather offered to anyone experiencing symptoms. By normalizing the use of local low-dose estrogen therapy, we can empower women to take control of their menopause experience and prioritize their overall well-being – including their sexual health.

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