People who have to sit at work often have back pain. People permanently confined to bed are even worse off they frequently develop bed sores. New smart cushioning is intended to eliminate the discomforts of lying and sitting. An integrated sensor system equalizes pressure selectively. Anyone confined to a wheelchair or a bed has to deal with numerous complications. Frequently, they suffer from bedsores or decubitus ulcers as physicians call them. Bony prominences, such as the sacrum, coccyx and ischium, are especially endangered spots. Unrelieved pressure can lead to tissue necrosis. Damage can extend into the periosteum and, at the worst, into bones themselves. The ulcers are entryways for germs, which can trigger sepsis. While hitherto available passive aids such as air, gel or vacuum cushions relieve pressure, they do not relieve the affected area optimally.
According to an investigation published Online First by the Archives of Internal Medicine, one of the JAMA/Archives journals, magnetic resonance imaging (MRI) prior to administration of epidural steroid injections (ESI), does not seem to improve outcomes for individuals with chronic lower back pain or for those with conditions like sciatica, and only has a small effect on the physician's decision making. In the report the researchers explain: "Lower back pain is the number one cause of disability in the world, and one of the top three reasons people seek medical attention. Despite several studies demonstrating that advanced radiologic testing does not improve outcomes in patients with lower back pain, with or without radicular symptoms [nerve irritation, characterized, for example, by pain radiating down the back of the leg], the use of MRI in this context continues to soar.
A draft guidance to help artificial pancreas researchers and makers as they create and submit their devices for FDA approval has been issued by the Agency. Artificial pancreases are currently being designed and created for the treatment of diabetes type 1. The draft guidance provides flexible recommendations for the design and testing of devices so that they can still meet regulatory requirements for efficacy and safety. An example is a flexible choice of study endpoints, how many patients can be involved in the study, and how long the clinical trial can be. Jeffrey Shuren, M.D., director of the FDA's Center for Devices and Radiological Health, said: "The FDA is focused on improving the process for the study and approval of artificial pancreas systems, and developed this guidance to provide maximum flexibility to manufacturers seeking to bring this device to U.
Researchers at Royal Holloway, University of London are calling for more unified guidelines about returning back pain patients to work as currently the advice can be contradictory and confusing. A study by researchers from the Department of Psychology at Royal Holloway reveals that the advice clinicians give out can vary greatly and despite NICE (the National Institute for Health and Clinical Excellence) guidelines encouraging health care practitioners to advise patients to stay active and return to work, most practitioners believe work factors can cause or exacerbate lower back pain, and a recommendation for a "short break from work" to allow healing is common. The Health and Safety Executive guidelines includes advice for employers and workers but nothing for clinicians. Lead author Professor Tamar Pincus, from Royal Holloway, explains: "Lower back pain is consistently among the top most costly health problems.
Johns Hopkins-led research suggests that routine MRI imaging does nothing to improve the treatment of patients who need injections of steroids into their spinal columns to relieve pain. Moreover, MRI plays only a small role in a doctor's decision to give these epidural steroid injections (ESIs), the most common procedure performed at pain clinics in the United States. With greater focus on runaway health care costs, the study's findings, appearing online in the Archives of Internal Medicine, highlight one element of the problem: the indiscriminate use of an expensive imaging tool that shows little clinical benefit. "Our results suggest that MRI is unlikely to avert a procedure, diminish complications or improve outcomes, " says study leader Steven P. Cohen, M.D., an associate professor of anesthesiology and critical care medicine at the Johns Hopkins University School of Medicine.