A technique which cools the human body, inducing a kind of hibernation, is to be used to see if it will help the recovery of stroke victims. The technique, which recuduces body temperature from 36.8C to between 34C and 35C has already been used to treat brain injury after cardiac arrest or birth defects.
Inducing hypothermia by use of cooling pads and intravenous fluids, the procedure has been successful in small-scale trials, but the process by which it helps is not yet fully known. Theories suggest that when cooled, the brain requires less oxygen, so giving doctors more time to help prevent damage.
The clinical trials are being run by Friedrich-Alexander-University in Germany in collaberation the University of Edinburgh and are likely to last until 2016 or 2017 . They will involve around 1500 people across Europe, with 200 from the UK.
It is hoped that if these trials are successful, the chances of a complete recovery from a stroke will be increased from 1 in 13 to 1 in 10. Currently there are few treatments available for stroke victims.
Dr Malcolm Macleod, head of experimental neuroscience at the Centre for Clinical Brain Sciences at the University of Edinburgh commented that “every day 1,000 Europeans die from stroke – that’s one every 90 seconds – and about twice that number survive but are disabled. Our estimates are that hypothermia might improve the outcome for more than 40,000 Europeans every year.”
Currently in Scotland a third of all strokes are fatal and although survival rates have improved over the last decade they are the third highest killer after cancer and coronary heart disease.
James Cameron’s film Avatar may fall into the science fiction category but the idea of virtual bodies existing for people may not be as unrealistic as some might think. Technological advances in the medical world have brought forward the idea of “medical avatars” being used in the treatment of patients in the future. In 2006, the Virtual Physiological Human (VPH) initiative was set up across Europe to investigate the use of ICT in the development of treatment of patients. The project will span over ten years and is currently costing the European Commission about 350 million euro to fund. There are over 20 active VPH projects across Europe, each improving on the recent innovations in the research of biotechnology and medical advances.
The aim of the project is to make diagnosis of varying diseases more all-encompassing. Rather than seeing the human body as a collection of individual organs, the virtual body would allow it to be seen as a single multi-organ system. This “medical avatar” would contain both medical data of the person in question and detailed knowledge about how their bodily systems work. This combining of information would make it easier to diagnose current symptoms, to anticipate any future illness, and to predict the side- effects of any drugs used for treatment. The response of the virtual body to any treatment drugs could be tested before any prescriptions given to the actual patient. This is being researched in the preDICT programme, one of several projects being run by the VPH initiative. The advantages of this particular aspect of the project include a reduced need for animal experimentation when testing new drugs. It also allows for the elimination of any drug-related allergies without incurring risk to the patient themselves.
Other perceived benefits of the VPH initiative include the preventative approach it takes to the treatment of diseases, particularly various forms of cancer and Alzheimer’s Disease. NeoMARK is a project for an ICT enabled prediction of cancer reoccurrence. IMMPACT looks at the use of images in Ablation cancer treatment. PredictAD aims to use patient data to make healthcare in Alzheimer’s Disease more personalised. These are just a few of the innovations being put forward by the VPH initiative and it is yet to be seen what the results will yield.
For now, the pseudo-bodies are still in the test stages but it may not be too long before members of the public will have their own avatar. Scientists and medical experts working on the project are satisfied with the progress of the initiative and it could only be a matter of years before the real world merges with the virtual. One director’s dream is close to realisation.
The European Centre of Disease prevention and Control (ECDC), which is focused on controlling infectious diseases like swine flu in Europe, is to write this week to all practicing GPs, warning them of the dangers of routinely prescribing antibiotics for coughs and colds because their overuse is contributing to the spread of hospital bugs and putting vital treatments under threat.
This is not a new problem, the prescription of the drugs, which are not necessary in most cases, has long fuelled the rising number of antibiotic resistant infections. But experts at the ECDC centre say that modern medicine is reaching a point when it will no longer be able to function because antibiotics are fast becoming powerless to fight life-threatening hospital infections.
The process of producing new antibiotics is too slow-paced to allow for the current growth in resistance; an ECDC spokesman said that “If we continue to consume antibiotics at the current rate, Europe may face a return to the pre-antibiotic era where a common bacterial infection could be a death sentence”
Dominic Monnet, from the ECDC’s Scientific Advice unit warned that this would mean a halt to treatments with a high-infection risk like organ transplants, intensive care and chemotherapy.
“It is the whole span of modern medicine as we know it, that we will not be able to do if we lose antibiotics.”
These concerns echo conclusions drawn from the findings of a recent European Medicines Agency study into the rising number of multi-drug resistant bacteria.
Dr Bo Aronsson who led the study said, “Industry’s pipeline contains few new antibiotics active against multidrug-resistant bacteria. Without stimulating research and development into new antibiotics, an increasing number of infected patients will be without effective treatment”.
80% of antibiotics prescriptions in the UK are from GPs and community pharmacists, as opposed to hospitals where there is more legitimate need for them. Dr A. Adams, an Edinburgh medical practitioner commented, “The simple fact of the matter is that antibiotics do nothing to help viral illnesses like your cold, sore throat or flu. Antibiotics kill bacteria, not the viruses that cause flu. But GPs are often under pressure from patients, parents or pharmaceutical interests to prescribe antibiotics for these conditions,” adding that this situation will only be “exacerbated by the approaching flu season and predictions of a second wave of swine flu.” A 2002 survey found that 60% of people surveyed did not know that antibiotics do not work against viruses, so perhaps this pressure is understandable considering the lack of public understanding on the subject.
These warnings from the ECDC are only one of many attempts to steer GPs away from this path of least resistance, and to raise public awareness of just what antibiotics can and cannot do. For instance, this Wednesday will see the first annual European Antibiotic Awareness Day, a Europe-wide campaign aiming to inform and educate the public about the danger of antibiotic resistance and the importance of prudence in antibiotic use – emphasising the need to take antibiotics only as prescribed in order to maximise their effects and prevent the emergence of resistant bacteria.
According to the Department of Health, the government’s progress on this matter is “well ahead” of other European nations, but says that the Department of Health “recognises that this work must be sustained, with joint working across disciplinary boundaries, and that action must be maintained at local, national and international levels” to be effective.
As for those of us who are unfortunate enough to catch the flu this winter, the Chief Medical Officer of England, Sir Liam Donaldson simply advises that “you should rest, take plenty of fluids and speak to your pharmacist who will advise you on over the counter remedies that are available.”