lunes, 30 de marzo de 2020

Inside STAT: Ventilators are in high demand for Covid-19 patients. How do they work?

Morning Rounds
Shraddha Chakradhar

Debate flares over using AI to detect Covid-19 in lung scans

In the absence of readily available testing for Covid-19, a series of studies concluded that artificial intelligence could analyze chest scans of patients with suspected illness and accurately diagnose the infection. But the good news was quickly met with a healthy dose of skepticism over the use of such technology in the wake of the pandemic. Proponents of using AI to help with the outbreak argue that the technology ought to mobilized to help with the crisis, while opponents argue that flaws in study design and the limited number of chest scans from Covid-19 patients means that there aren't enough data to properly train AI algorithms. Other skeptics are also concerned about sharing imaging equipment and potentially exposing even more patients to the illness. Read more about the debate from STAT's Rebecca Robbins and Casey Ross here

Not all genetic tests convey risk in the same way, scientists warn

Research presented virtually at the World Congress of Cardiology meeting over the weekend suggests that some direct-to-consumer or lab-based genetic tests may not convey the full risk of inherited disease. Scientists analyzed de-identified data from more than 14,000 patients who were referred to genetic testing for cardiomyopathy, an inherited condition that can lead to heart failure. Patients were subject to two different kinds of genetic sequencing, and the results were compared to a simpler genetic test that only screens for nine variants in two genes known to cause cardiomyopathy. If patients had been screened using the simpler test, 96% of the patients who actually had a risk for cardiomyopathy would have been falsely reassured that they didn't have a such a risk. The scientists behind the study warn against relying on limited tests that paint an inaccurate picture.  

Inside STAT: Ventilators are in high demand for Covid-19 patients. How do they work?


(ALEX HOGAN/STAT)
As the number of Covid-19 cases in the U.S. grows, the need for ventilators is also growing. But hospitals across the country are facing a shortage of ventilators, which some Covid-19 patients need because they suffer respiratory symptoms so severe that they need these machines to continue breathing. In the absence of normal lung function, ventilators can supply oxygen through a tube and face mask. But for severe Covid-19 cases, physicians have to insert a tube into a patient's airway. Intubation in these instances forces breathing because fluid build-up in the lungs doesn't allow the organs to otherwise take in much oxygen. Learn more in a new video from STAT's Alex Hogan here

Lab Chat: ‘Research productivity’ follows dollars and disparities in two rare diseases

Sickle cell disease and cystic fibrosis are both rare, genetic diseases. While there are three times as many people in the U.S. with sickle cell disease (predominantly of African ancestry) compared to cystic fibrosis (predominantly of European ancestry), they get the same amount of research dollars. A new study found a similar number of clinical trials but more scientific papers and drugs for cystic fibrosis. Duke hematologist John Strouse talked to STAT's Elizabeth Cooney about his team's findings, published Friday in JAMA Network Open.

What does your research reveal?
We looked at research productivity. Funding supports academic careers and there is a critical shortage of sickle cell doctors. And the pipeline for cystic fibrosis drugs is more robust.

What impact do you hope your research will have?
We know that poverty affects people's ability to get high-quality health care. I would love for government and society to ask the question, how can we achieve equity in rare diseases that affect populations that are disadvantaged? 

Extreme heat associated with a greater risk of cardiovascular deaths

As global temperatures rise due to climate change, a new study finds that increasing heat could also lead to more cardiovascular-related deaths. Researchers examined more than 15,000 cardiovascular deaths in Kuwait between 2010-2016: The country has recorded the highest temperature on Earth in 76 years — 129 degrees Fahrenheit — and has consistently high average temperatures. Days with more extreme temperatures (greater than 109 degrees) were associated with three times the risk of a cardiovascular death than days when the temperature was less than 94.5 degrees. Men were more likely to be affected by the extreme temperature days as were those ages 15-64. Some caveats: The findings are based on only one country already prone to high temperatures, and researchers were unable to determine if those who died of cardiovascular reasons had other underlying conditions. 

What to read around the web today

  • In a town where meth is eclipsing opioids, everyone feels the pain. The New York Times
  • Digital disease surveillance: Tracking a pandemic. Knowable Magazine
  • Cutbacks for some doctors and nurses as they battle on the front line. The Boston Globe
  • What takes so long? A behind-the-scenes look at the steps involved in Covid-19 testing. Kaiser Health News
  • Five days of worship that set a virus time bomb in France. Reuters

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