Washington [US]: Researchers have found that the region of the brain called the amygdala, which is responsible for powerful emotions like fear, might also be the reason behind overeating.
Cold Spring Harbor Laboratory (CSHL) Professor Bo Li has discovered a group of neurons in the amygdala that drives mice to eat fatty or sugary foods–even when they’re not hungry. Therapeutics targeting these neurons could lead to new treatments for obesity with minimal side effects.
Like most people, mice also tend to find foods high in fat and sugar the tastiest. They may indulge in these treats for pleasure, rather than for survival. The neurons Li and his colleagues studied trigger this behaviour, called hedonic eating. Li notes:
“Even if the animal is supposed to stop eating because they are already full, if those neurons are still active, it can still drive those animals to eat more.”
Almost no one succeeds in long-term weight management when treating obesity, Li says. Metabolic processes in the body often reverse any progress that’s made. Therapeutics can help increase the odds of successful treatment, but many drugs have unwanted side effects. “The medications currently available to aid weight management can cause significant side effects. So, a more targeted approach is needed,” Li says. “Identifying the brain circuitry that controls eating is important for developing better treatment options for people who struggle to control their weight.”
When the team switched off the specific neurons, mice weren’t drawn to the fatty, sugary foods that had tempted them before. “They just happily ate and stayed healthy,” Li says. “They not only stopped gaining weight but also seemed to be much healthier overall.” Switching these neurons off reduced overeating and protected against obesity. It also boosted the animals’ physical activity, leading to weight loss and better metabolic health.
Li and his team are exploring ways to manipulate the neurons that trigger hedonic eating. The next step, he says, is to map out how these neurons respond to different types of food and see what makes them so sensitive. He hopes this collaboration will lead to new strategies for effective anti-obesity therapeutics. (ANI)
NEW DELHI: A 57-year-old Kenyan woman diagnosed with stage IV endometrial cancer received a new lease of life after undergoing “low dose” immunotherapy and chemotherapy at a leading hospital here, doctors said on Tuesday.
So far, in the medical literature across the world, such an excellent response to low-dose immunotherapy and chemotherapy has not been described in an endometrial cancer case, they claimed. Apollo hospital in a statement said, “The patient had been suffering from endometrial cancer for the past year and was operated on in her native country Kenya in November 2021.
However, after the surgery, the disease spread to other organs and the patient developed additional complications involving extensive disease in the abdomen and pelvis, fluid in both lungs, liver metastasis, a non-healing surgical wound in the abdomen, and clots in her legs,” it said.
With her condition deteriorating and disease taking a toll on her overall health, as a first step, she was given chemotherapy, it said. “Endometrial cancer is the cancer of the inner lining of the uterus. Often it is diagnosed at an early stage due to frequent abnormal vaginal bleeding, but in few cases, it can reach stage IV without being diagnosed,’ said Dr Shuaib Zaidi, senior consultant, and surgical oncologist at the hospital.
“In most cases of stage IV endometrial cancer, cancer can spread too far to be removed with surgery, and so need chemotherapy and immunotherapy for treatment,” he said. The woman from Kenya presented with “extensive peritoneal deposits” in her abdomen and pelvis, chest nodes, fluid in both lungs, extensive disease in the liver, a non-surgical wound, and clots in both legs, after surgery of stage IV endometrial cancer, the statement said.
On admission at Apollo hospital, the patient was very weak and fatigued due to multiple health complications. She was admitted on January 20 this year for initial management of disease, but with her condition deteriorating due to a large volume of disease, she was advised chemotherapy with immunotherapy, doctors said.
She underwent a “successful treatment of her stage IV endometrial cancer” with chemotherapy and immunotherapy at Apollo hospital here, it said. Dr Ajay Gupta, senior consultant, medical oncology, at the hospital said, “She needed chemotherapy to combat the widespread disease process.”
Typhoid burden is decreasing in India, although overall cases are higher than previously estimated, shows a multi-year study of nationally representative antibiotic prescription data.
The researchers found that young adult patients account for close to one-third of the typhoid cases and children less than 10 years old account for more than a million cases annually.
The study, published in the BMJ Open journal, calls for including Indian’s own typhoid vaccine in its national immunisation programme.
“The key findings of the study include decline in cases from 9.9 million in 2013 to 7.9 in 2015 -- largely in the north and west regions, but children less than 10 years account for more than a million cases annually, males and boys have the highest burden,” Dr. Shaffi Koya, Research Fellow at Boston University School of Public Health, US, told PTI.
“10 different antibiotics accounted for 73 per cent of all prescriptions. Combinations and cephalosporins were the most prescribed antibiotics. Cefixime–ofloxacin combination is the preferred choice except in south India,” Koya said.
The data came from prescriptions of a panel of 4,600 private sector primary care clinicians selected through a multistage stratified random sampling.
The data had 671 million prescriptions for antibiotics extracted from the IQVIA database for the years 2013, 2014 and 2015.
The study provides the first age-specific typhoid antibiotic prescription estimates for India, using a large volume of geographically representative medical prescription audit data.
It shows a high rate of antibiotic prescription (714/100,000 population) for typhoid indicating a higher disease burden than previously estimated, especially among young adults and children, the authors said.
The team, including researchers from Public Health Foundation of India, New Delhi and Qatar University, noted that the lack of laboratory confirmation of typhoid may lead to some degree of misclassification.
Depression treatments have the ability to rewire the human brain, according to a study that calls into question the belief that the structure of the adult brain is generally rigid.
Researchers at the University of Muenster in Germany have shown that in-patient treatment for depression can lead to an increase in brain connectivity.
Those patients who respond well to this treatment show a greater increase in connectivity than those who do not, they said.
The study, presented at the European College for Neuropsychopharmacology Congress in Vienna, Austria, calls into question the belief that the structure of the adult brain is generally rigid and incapable of rapid changes.
The researchers found that patients who responded well to anti-depression treatment, showed a greater increase in connectivity than those who did not.
“We found that treatment for depression changed the infrastructure of the brain, which goes against previous expectations,” said study lead researcher Professor Jonathan Repple.
“Treated patients showed a greater number of connections than they had shown before treatment,” Repple said.
The researchers studied 109 patients with serious depression and compared them with 55 healthy controls.
Their brains were scanned using an MRI scanner which had been set up to identify which parts of the brain were communicating with other parts, determining the level of connections within the brain.
The patients were then treated for depression, some with electroconvulsive therapy (ECT), some with psychological therapy or medication, some with a combination of all therapies.
After treatment they were then rescanned and the number of connections recounted. They were also retested for symptoms of depression.
“Moreover, those who showed the most response to treatment had developed a greater the number of new connections than those who showed little response,” Repple said.
“A second scan showing that there are no time effects in healthy controls supports our findings that we see something that is related to the disease and more importantly the treatment of this disease,” said Repple.
“We don’t have an explanation as to how these changes take place, or why they should happen with such different forms of treatment,” he added.
The findings align very much with the current belief that the brain has much more flexibility in adaptation over time than was previously thought.
“This means that the brain structure of patients with serious clinical depression is not as fixed as we thought, and we can improve brain structure within a short time frame, around 6 weeks,” said Eric Ruhe, from Rabdoud Medical Center, Nijmegen, the Netherlands .
“We found that if this treatment leads to an increase in brain connectivity, it is also effective in tackling depression symptoms,” said Ruhe, who was not involved in the study.
This gives hope to patients who believe nothing can change and they have to live with a disease forever, because it is ‘set in stone’ in their brain, Ruhe added.
Following is a summary of current health news briefs.
EU regulator endorses Takeda's dengue vaccine
The European drugs regulator on Friday recommended a dengue vaccine from Japan's Takeda, paving the way for a second vaccine for the mosquito-borne disease that causes millions of infections annually. European Medicines Agency (EMA) advisors backed the use of the Takeda vaccine for those aged 4 and older to prevent any of the four so-called serotypes of dengue.
Biden takes aim at Big Pharma, Republicans in California
U.S. President Joe Biden criticized Republicans and drug companies during a stop at a California community college on Friday as he campaigned for fellow Democrats in November's midterm elections. Biden's trip includes stops in California on Friday and Oregon on Saturday as the president looks to position his party, the Democrats, as a champion of consumers and lower healthcare costs at a time that inflation ranks among voters' top concerns. The midterm elections are on Nov. 8.
U.S. Supreme Court rebuffs Novartis, allows generic versions of MS drug
The U.S. Supreme Court on Thursday turned down Novartis' bid to block the launch of generic versions of the company's blockbuster multiple sclerosis drug Gilenya in a dispute with China's HEC Pharm Co Ltd and other generic drugmakers. Novartis had asked the justices to suspend a lower court's ruling that lifted a ban on generic versions of Gilenya, the Switzerland-based company's third highest-selling drug last year with $2.8 billion in sales.
Exclusive-NHS drafts stricter oversight of trans youth care
England's National Health Service has drafted new guidelines for treating transgender youth that would call for local authorities to be alerted in some cases where young people have obtained puberty blockers and hormone therapies on the private market, according to a copy of the guidelines reviewed by Reuters. The guidelines are part of a wide-ranging review of treatment for young transgender people seeking NHS care. The current approach, which can include medical interventions, has been criticized by some practitioners who said it rushed people onto medication, and by families who complained the service could not manage fast-growing demand.
Japan's Fujifilm stops work on Avigan as COVID drug
Fujifilm Holdings Corp has ended the development of its anti-influenza drug Avigan to treat COVID-19, the firm said on Friday, after more than two years of work on a pill once hailed as Japan's biggest contribution to the global coronavirus fight.
In March, Fujifilm had cut short enrolment in a Phase III trial, saying the emergence of the Omicron variant made it tough to measure the drug's effectiveness in preventing severe symptoms.
China says its zero-COVID policy is the best, most cost-effective, will improve
China's COVID-19 measures are the best, most cost-effective and will continue to improve, a spokesman for the ruling Communist Party said on Saturday. "We firmly believe that the light is ahead and perseverance is victory," Sun Yeli told a news conference in Beijing ahead of the party's 20th congress.
Long COVID at 12 months persists at 18 months, study shows
Most patients with COVID-19 who have lingering symptoms at 12 months are likely to still have symptoms at 18 months, new data suggest. The findings are drawn from a large study of 33,281 people in Scotland who tested positive for the coronavirus. Most of the results are in line with those from earlier, smaller studies.
Uganda introduces lockdown measures to halt spread of Ebola: President
Uganda President Yoweri Museveni said on Saturday the government was implementing an overnight curfew, closing places of worship and entertainment, and restricting movement into and out of two districts affected by Ebola for 21 days. The measures aimed at curbing the spread of the disease will be introduced immediately in Mubende and Kassanda districts in central Uganda, the epicenter of the epidemic, he said in a televised national address.
China reports 1,026 new COVID cases for Oct 15 vs 1,364 a day earlier
China reported 1,026 new COVID-19 infections for Oct. 15, of which 244 were symptomatic and 782 were asymptomatic, the National Health Commission said on Sunday. That compared with 1,364 new cases a day earlier - 361 symptomatic and 1,003 asymptomatic, which China counts separately.
Abbott recalls some liquid baby formula over bottle defect
Abbott Laboratories said on Friday it was recalling some ready-to-feed baby formula liquid products including Similac-branded items due to inadequate sealing of some bottle caps. The recall, which equates to less than one day's worth of infant formula used in the United States, is not expected to impact the overall formula supply, Abbott said in a statement.
The longevity diet is a set of eating recommendations compiled by a biochemist called Valter Longo, director of the University of Southern California’s Longevity Institute. He is known for his research on the role of fasting, the effects of nutrients on your genes and how these may impact ageing and the risk of diseases.
While the longevity diet has been targeted to older adults, it is also recommended for younger people. Longo has said he plans to live to 120 by following this diet.
So, what does the diet look like?
Foods in this diet are vegetables, including leafy greens, fruit, nuts, beans, olive oil, and seafood that’s low in mercury.
So most foods in the longevity diet are plant based. Plant-based diets are generally higher in vitamins and minerals, dietary fibre, antioxidants and lower in saturated fat and salt, which lead to health benefits.
Foods that are discouraged are an excess of meat and dairy, and those high in processed sugar and saturated fats.
For people who don’t want to go without dairy, the longevity diet recommends switching from cow’s milk to either goat’s or sheep’s milk, which have a slightly different nutrient profile. But there is little evidence sheep’s and goat’s milk provide more health benefits.
Including fermented dairy (such as cheese and yoghurt) in your diet, as recommended in the longevity diet, is beneficial as it provides a more extensive microbiome (good bacteria) than any milk.
Have you seen this diet before?
Many of you may recognise this as a familiar dietary pattern. It is similar to the Mediterranean diet, especially as both feature olive oil as the oil of choice. The Mediterranean diet is promoted and backed by a considerable body of evidence to be health promoting, reducing the risk of disease, and promoting longevity.
The longevity diet is also similar to many national, evidence-based dietary guidelines, including Australia’s.
Two-thirds of the recommended foods in the Australian dietary guidelines come from plant-based foods (cereals, grains, legumes, beans, fruits, vegetables). The guidelines also provide plant-based alternatives for protein (such as dried beans, lentils and tofu) and dairy (such as soy-based milks, yoghurts and cheeses, so long as they are supplemented with calcium).
Intermittent fasting
Another aspect of the longevity diet is the specified periods of fasting, known as intermittent fasting. The diet advocates eating in a 12-hour time-frame, and not eating for three to four hours before bed time.
Typically with intermittent fasting people fast for 16–20 hours with a four to eight hour window of eating. Another intermittent fasting option is the 5:2 diet, in which eating is restricted to about 2,000–3,000 kilojoules for two days of the week and for the other five days, eating normally.
The evidence indicates intermittent fasting may lead to improvements in insulin resistance, which leads to better blood glucose control. This can reduce your risk of type 2 diabetes and other chronic diseases, such as heart disease and obesity.
Maintain a healthy weight
The longevity diet recommends that people who are overweight eat only two meals a day – breakfast and either a midday or evening meal – plus just two low-sugar snacks. This is to try to reduce kilojoule intake for weight loss.
Another important aspect of this recommendation is to reduce snacking, particularly of foods high in saturated fat, salt or sugar. These are the foods we typically refer to as discretionary/sometimes foods, or ultra-processed foods. These offer little nutritional value, and in some cases are linked to worse health outcomes.
Eat a rainbow of colours
The longevity diet recommends eating foods rich in nutrients, which most national dietary guidelines also advocate. This means eating a diet rich in plant foods, and a variety of foods within each food group.
Each colour fruit and vegetable contains different nutrients, so eating a range of coloured fruit and vegetables is recommended. The recommendation to select a range of wholegrains over refined cereals, breads, pasta and rice also reflects the best nutritional evidence.
Restrict protein intake
This diet recommends a restricting protein intake to 0.68-0.80g per kilogram of body weight per day. This is 47-56g of protein a day for a 70kg person. For reference each of these foods contains about 10g of protein: two small eggs, 30g cheese, 40g lean chicken, 250mL dairy milk, 3/4cup lentils, 120g tofu, 60g nuts or 300mL soy milk. This is in line with government recommendations.
Most Australians easily consume this level of protein in their diet. However it is the elderly population, to whom the longevity diet is targeted, who are less likely to meet their protein requirements.
In the longevity diet it is recommended most of the protein comes from plant sources or fish. This may require special planning to ensure a complete range of all the nutrients needed if the diet is missing red meat.
Are there any problems with this diet?
This diet recommends taking a multivitamin and mineral supplements every three to four days. Longo says this prevents malnourishment and won’t cause any nutritional problems.
Supplements should only be taken on your doctor’s advice, following a blood test showing a deficiency in a specific nutrient. This is because some vitamins and minerals may be harmful in high quantities.
If you are eating a variety of foods across all food groups, you are meeting all your nutrient requirements and shouldn’t need supplements.
The verdict?
This longevity diet is a compilation of many aspects of evidence-based healthy eating patterns. We already promote these as they improve our health and reduce the risk of developing chronic diseases. All of these aspects of healthy eating could lead to increased longevity.
What’s not mentioned in the longevity diet is the importance of exercise for good health and a long life.
New Delhi: Researchers at theIndian Institute of Technology (IIT), Delhi have developed SARS-CoV-2 Virus-Like Particles (VLPs), which are a possible vaccine candidate against COVID-19, according to officials.
The VLPs tricked the immune system into launching a counter-attack in mice, just as it does against SARS-CoV-2, they said.
“The majority of the VLPs developed worldwide have utilised only the spike protein of SARS-CoV-2 as the primary antigen. However, our VLPs are as native virus-like as possible, which means they contain all four structural proteins from SARS-CoV-2 (s – spike, n – nucleocapsid, m – membrane, e – envelope),” said Manidipa Banerjee, lead researcher and professor at IIT-Delhi’s Kusuma School of Biological Sciences.
“Vaccines based on an inactivated virus naturally have this advantage. However, VLPs are safer as they are non-infectious due to a lack of genome. This could be an advantage in case there are several mutations in ‘spike’ in any variant, which preclude the binding of neutralising antibodies. Animal experiments carried out at THSTI indicate that our VLPs trigger a strong adaptive immune response against multiple antigens,” she added.
The researchers have worked in collaboration with a team from the Translational Health Science and Technology Institute (THSTI), Faridabad, Haryana.
The study, titled “Virus-Like Particles of SARS-CoV-2 as Virus Surrogates: Morphology, Immunogenicity and Internalisation in Neuronal Cells”, was recently published in the “ACS Infectious Diseases” journal.
According to the officials, since the outbreak of the Covid pandemic, researchers are trying to get a better understanding of the SARS-CoV-2 virus and developing vaccines against it.
“Vaccines offer a great deal of protection against the virus, but some people who have received the shots still catch COVID-19. To develop even better vaccines and treatments, ideally, experiments need to be conducted with the real virus, which can only be handled in very specialised laboratories.
“Working with live viruses can put personnel at risk and the requirement for specially-designed settings can limit the scope of research that some teams can perform. Instead, a safer and easier strategy is to use VLPs which are molecular mimics that look and act like a certain virus without being infectious. The particles can even serve as a vaccine themselves, as is the case with two that are currently available against the human papillomavirus,” Banerjee said.
The researchers and their collaborators have also utilised these VLPs to understand how SARS-CoV-2 could be invading cells in the central nervous system (CNS).
“COVID-19, while well-known as a respiratory illness, can also affect the nervous system, bringing on headaches and fatigue and wiping out the sense of smell, but it is unclear how these symptoms are caused. The research showed that the VLPs could get into brain cells in petri dishes and the process depended on both cholesterol in the cell membrane and an enzyme called dynamin,” Banerjee said.
Women who used chemical hair straightening products were at higher risk for uterine cancer compared to women who did not report using these products, according to a new study. The researchers found no associations with uterine cancer for other hair products that the women reported using, including hair dyes, bleach, highlights, or perms.
The study data includes 33,497 U.S. women ages 35-74 participating in the Sister Study, a study led by the National Institute of Environmental Health Sciences (NIEHS), part of NIH, that seeks to identify risk factors for breast cancer and other health conditions. The women were followed for almost 11 years and during that time 378 uterine cancer cases were diagnosed.
The researchers found that women who reported frequent use of hair straightening products, defined as more than four times in the previous year, were more than twice as likely to go on to develop uterine cancer compared to those who did not use the products.
"We estimated that 1.64% of women who never used hair straighteners would go on to develop uterine cancer by the age of 70; but for frequent users, that risk goes up to 4.05%," said Alexandra White, Ph.D., head of the NIEHS Environment and Cancer Epidemiology group and lead author on the new study. "This doubling rate is concerning. However, it is important to put this information into context -- uterine cancer is a relatively rare type of cancer."
Uterine cancer accounts for about 3% of all new cancer cases but is the most common cancer of the female reproductive system, with 65,950 estimated new cases in 2022. Studies show that incidence rates of uterine cancer have been rising in the United States, particularly among Black women.
Approximately 60% of the participants who reported using straighteners in the previous year were self-identified Black women, according to the study published in the Journal of the National Cancer Institute. Although, the study did not find that the relationship between straightener use and uterine cancer incidence was different by race, the adverse health effects may be greater for Black women due to higher prevalence of use.
"Because Black women use hair straightening or relaxer products more frequently and tend to initiate use at earlier ages than other races and ethnicities, these findings may be even more relevant for them," said Che-Jung Chang, Ph.D., an author on the new study and a research fellow in the NIEHS Epidemiology Branch.
The findings are consistent with prior studies showing straighteners can increase the risk of hormone-related cancers in women.
The researchers did not collect information on brands or ingredients in the hair products the women used. However, in the paper they note that several chemicals that have been found in straighteners (such as parabens, bisphenol A, metals, and formaldehyde) could be contributing to the increased uterine cancer risk observed. Chemical exposure from hair product use, especially straighteners, could be more concerning than other personal care products due to increased absorption through the scalp which may be exacerbated by burns and lesions caused by straighteners.
"To our knowledge this is the first epidemiologic study that examined the relationship between straightener use and uterine cancer," said White. "More research is needed to confirm these findings in different populations, to determine if hair products contribute to health disparities in uterine cancer, and to identify the specific chemicals that may be increasing the risk of cancers in women." This team previously found that permanent hair dye and straighteners may increase breast and ovarian cancer risk.
After 30, without proper maintenance, bones, muscles and joints weaken and deteriorate. The age of 50 acts as a cutoff. After that, 50 per cent of men and women experience pain. It may be present occasionally or be constant and nagging, interfering with their daily activities. Incapacitating, long-lasting, daily pain is more likely if other lifestyle diseases, worries or depression are also present.
While doctors may be consulted for other diseases such as diabetes or hypertension, people often do not mention the pain they are suffering to their doctor and instead self-medicate. Some take simple anti-inflammatory agents. Others take stronger, habit-forming medications like opioids. Sometimes, as the pain interferes with sleep, they take unprescribed “sleeping pills”. Sometimes, they mix prescribed hypertension or heart failure medication with herbal, ayurvedic or Siddha pain medications. Many believe they can handle pain on their own without professional medical help.
Unless the underlying condition causing the pain is correctly diagnosed, medicines will only suppress the symptom. Eventually, more frequent and larger doses may be needed. All drugs have some side-effects and interactions. As the patient’s “doctor shop”, different doctors may inadvertently prescribe the same medicine or supplement under various trade names, resulting in side-effects and overdoses.
Sometimes the location of the pain is vague. It may be in the muscles and not in the joint itself. It may be in the bones. This can occur because of deficiencies of Vitamin D3 (lack of activity and exposure to sunlight) and low calcium, phosphorous or magnesium levels. Elevated uric acid levels and gout can cause excruciating joint pain in men. All these conditions have to be evaluated before self-diagnosing and self-medication.
Osteoarthritis — causing age-related wear and tear in the muscles, ligaments and joints — is the most common form of arthritis. It tends to run in families and can damage any of the joints. However, usually, the weight-bearing hips, knees and spine are affected. There may be pain, warmth, swelling or even a grating sensation. Once the damage has occurred, it cannot be reversed. However, it is possible to slow the progression of the disease and continue an active life.
Weight tends to creep up as we get older. As the gain is gradual, initially it is often imperceptible. Weigh yourself every month on the same day, wearing the same clothes. A deficit of 7,700 calories is needed to lose a kilo. A combination of exercise (aerobic) and weights works best. With a combination of today’s apps and smartwatches, it is possible to do this efficiently.
Bones, joints and ligaments have to be properly aligned. Damage and changes to bones and joints start around the age of 30. Prevention, with yoga sessions at least three times a week, has to start before this. Once the pain has set in, it is essential to get a medical evaluation and establish the diagnosis. Pain relief can often be obtained and sustained with external applications of painkilling ointments, heat and cold therapy, acupressure and physiotherapy. Invasive procedures, intra-articular injections of hyaluronic acid or steroids should be delayed as long as possible.
Badly damaged joints can be replaced surgically. Although prosthetic joints and the techniques employed have improved vastly, this should only be used as a last resort. Prior to as well as post surgery, strengthening physiotherapy needs to be rigorously done; otherwise, the area around the replaced joints may soon become just as incapacitating and painful.
Washington [US], October 17 (ANI): The findings of recent research suggest that certain hospital room features, such as having a window view and distance from a nursing station, may influence clinical outcomes after undergoing high-risk operations.
The findings were presented at the Scientific Forum of the American College of Surgeons (ACS) Clinical Congress 2022.
Each year, about USD 50 billion is spent on the construction of healthcare facilities in the United States. Architecture and interior design can enhance patient care and outcomes. A seminal comparative study published in Science in 1984 revealed that having a window view may influence recovery from surgery, and additional research has found that severely ill patients who are assigned to ICU rooms that are not well visualized by the medical staff may experience worse outcomes.
However, little research has investigated how room features such as single versus double occupancy, distance from a nursing station, and a window view may impact clinical outcomes. Researchers at the University of Michigan sought to understand whether certain hospital room features impact mortality and length of stay after surgery.
“We were fascinated to see from a previous study that mortality was different in rooms that were in the line of sight of a nurse’s station. Nurses could more readily assess the patient’s condition and intervene more quickly in severe events. We wanted to see how this finding would play out at our institution, specifically in a surgical population,” said study coauthor Mitchell J. Mead, a health and design scholar at the University of Michigan.
He added, “One of the next big steps for health care design is to understand these pathways of causation that can lead to different clinical outcomes in patients staying in hospital rooms with different features.”
The analysis for this single-site study involved 3,964 patients who underwent 13 high-risk surgical procedures (including colectomy, pancreatectomy, and kidney transplant) at the University of Michigan Hospital between 2016 and 2019. The patients were admitted to rooms on two hospital floors.
Patient rooms were coded based on their features–window or no window, single occupancy, double occupancy, distance to the nursing station, and line of sight to clinicians. Patient encounters were linked by room number to identify clinical outcomes, including mortality and length of stay, related to room design.
Key findings
Mortality rates for high-risk procedures varied across room design features and room types.
Room features that influenced clinical outcomes after surgery included distance from a nursing station, single room occupancy, and having a direct line of sight where clinicians can see into the room.
After adjusting for patient comorbidities and the complexity of the operation, mortality rates were 20 per cent higher (odds ratio 1.2) if patients were admitted to a hospital room without a window than if they were put in a room with a window.
For patients staying in a room without a window, 30-day mortality rates were 10 per cent higher (odds ratio 1.1).
Though mortality rates varied across room design, mortality rates did not vary by room type after accounting for the length of stay, suggesting that length of stay does not account for differences in mortality.
“This investigation provided evidence that patients had differential outcomes across room design features, when accounting for clinical risk, and warrants further investigation for how hospital design may be influencing outcomes,” Mr Mead said.
When the authors looked at different rooms based on the favourable design features, it became clear that the sicker patients were more likely to get single rooms, closer to a nursing station and within direct line of sight, and a window view, added study coauthor Andrew M. Ibrahim, MD, MSc, assistant professor of surgery, architecture, and urban planning at the University of Michigan and co-director of the Center for Outcomes and Policy.
Dr Ibrahim noted that this study is just one example illustrating the often-overlooked relationship between hospital design and patient care. Investing in research to figure out what design features work best may be one key factor in improving patient outcomes. “I think we can get a much better return on what we build and hopefully design safer healthier hospitals,” he said.
Future studies should investigate these outcomes at multiple hospitals to find out if the results are generalizable, the authors suggest. They are in the process of replicating a similar study across Michigan Medicine and hope to recruit collaborators across other hospital systems.
In addition, the researchers hope to expand their study to include other metrics like the use of pain medication and patient satisfaction across these room types.
“The common question we get asked is, do you want us to rebuild our hospitals? Of course, that is not practical. But we do recognize clear patterns where certain room types have better outcomes after surgery,” Dr Ibrahim said. “We can start to prioritize the sickest patients there. Just the way we have developed precision health models for getting the right care to the patient, there may be a corollary for the right room for the right patient and procedure to optimize outcomes collectively.” (ANI)