3D printing helps surgeons plan life-saving operation

The 3D model revealed the twists and turns in the cerebral blood vessels

A 3D-printed model of the blood vessels inside a woman's brain has helped surgeons practise life-saving surgery.

The surgeons needed to operate to correct a weakness, or aneurysm, in a blood vessel inside the patient's head.

Scans of the aneurysm revealed that the usual approach surgeons would take to fix it would not have worked.

3D printing is increasingly finding a role in medicine to either help doctors prepare before carrying out procedures or to make prosthetics.

Click here to view link to the NUI, Galway Library 3D Printing Service

After suffering vision problems and recurrent headaches, New York state resident Theresa Flint was diagnosed with an aneurysm that, if left untreated, would have proved fatal.

An aneurysm is a bulging blood vessel caused by a weakness in an artery wall that risks rupturing.

The usual way to treat such problems is to implant a metallic basket that strengthens the artery wall, said Dr Adnan Siddiqui, chief medical officer atthe Jacobs Institute in Buffalo, New York, who directed the treatment.

However, scans of the weak blood vessel revealed that this approach would not work.  "It was a serious problem from the standpoint that she had an extremely irregular brain aneurysm that would be tricky to treat with micro-surgery," he said.  The scans showed that the blood vessels were severely twisted and, as a result, very difficult to reach.

"There are some commonalities between all human beings," said Dr Siddiqui, "but at the end of the day our vascular tree is as different as our fingerprints."

To help the surgeons work out the best approach, the scans taken of Ms Flint's brain were turned into a 3D model with the help of 3D-printing specialist Stratasys.

It helped make a replica built of a polymer that mimics human tissue allowing the surgeons to plan their approach and practise the operation.

"While we were doing that mock procedure we realised that we had to change some of the tools we wanted to use, given her anatomy," said Dr Siddiqui.

"The day of surgery came and we tried out exactly what we thought would work best," he said, adding that Ms Flint had "done great" since the aneurysm was corrected.

Dr Siddiqui said 3D printing was increasingly being used to help plan procedures and make models of human anatomy that give surgeons a better idea of what they will encounter during an operation. Many hospitals have now established relationships with 3D printing firms to help surgical staff.

"It may not be needed for the majority of routine cases," he said, "but here its help was immeasurable."

View more on BBC/Health

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Free screening of 'Milk - Born into this World' at NUI Galway

NUI Galway’s School of Nursing and Midwifery in partnership with Cuidiú, the Irish Childbirth Trust, are hosting a free public screening of “MILK – Born Into This World” on Thursday, 3 December, at 7pm in Áras Moyola, NUI Galway.

The director of the film, Noemí Weis will be available via Skype from Canada for a Q&A session after the screening.

Through an intimate and artistic lens, MILK brings a universal perspective on the politics, commercialisation and controversies surrounding birth and infant feeding over the canvas of stunningly beautiful visuals and poignant voices from around the globe. Inspiring, informative, provocative and sensitive, MILK celebrates bringing a new life into this World with a strong call to action and reflection. See the film’s trailer at www.milkhood.com.

Speaking ahead of the event, Tara Durkin of Cuidiú Galway said: “This special public screening of Milk, ahead of its general release in Europe, is an exciting chance for Galway’s mothers, fathers, healthcare professionals, students, friends, indeed anyone with an interest in how we birth and feed our babies, to get together to see a powerful new documentary – and discuss it with the director!”  

This is the fourth event of the School of Nursing and Midwifery Public Lecture Series, an innovative community outreach initiative which has previously focused on Suicide Prevention, Ebola Awareness and Elder Abuse. The series aims to share knowledge and expertise on health matters with our local communities.

The event is open to the public and free of charge but tickets must be pre-booked at www.eventbrite.ie/e/milk-born-into-this-world-tickets-19448984436.  

If there are any future topics you would like covered in NUI Galway’s School of Nursing and Midwifery Public Lecture Series, please contact john.quinlivan@nuigalway.ie or mary.e.gannon@nuigalway.ie.

New research centre launched to tackle dementia epidemic

A major new research centre was launched recently by Trinity College Dublin and the University of California to try to tackle the looming dementia epidemic.

The Global Brain Health Institute will be funded by a €138.4m donation from Atlantic Philanthropies - the biggest philanthropic donation in Irish history.

Affecting more than 48 million people around the world, dementia is fast becoming a major health challenge, with the numbers suffering from it expected to double every 20 years.

Experts say while no effective treatment has yet been found, public health measures tackling risk factors like high blood pressure, cholesterol and lifestyle issues could reduce the numbers developing the condition in the coming decades.

Researchers at Trinity College Dublin have formed an alliance with colleagues at the University of California, to establish the Global Brain Health Institute.

The centre aims to tackle the growing incidence of dementia by creating a generation of leaders around the world with skills to change attitudes, policy and care and carry out research.

Over the next 15 years, the institute will give multidisciplinary training to 600 fellows and scholars from around the world.

View more here on TCD/News

Supporting the Improvement and Management of Prescribing for UTIs (SIMPle)

An initiative to improve the prescribing of antibiotics for urinary tract infections resulted in better-quality prescribing of first line antibiotics, although the number of prescriptions also increased, according to new research carried out by NUI Galway and Oxford University. The study was published 16 November 2015 in the Canadian Medical Association Journal (CMAJ). 

View study here: Intervention to improve the quality of antimicrobialprescribing for urinary tract infection: a cluster randomized trial

The study involved 71 physicians, 30 general practitioners and 3,500 patients in Ireland (Galway city and county, and Roscommon). Overall, a 20% absolute increase in prescribing of antibiotics according to guidelines was observed in the intervention groups. However, general practitioners also increased overall prescribing of antibiotics for urinary tract infection.

DrAkke Vellinga, Epidemiologist in the College of Medicine, Nursing and Health Science at NUI Galway, and co-author of the study, said: “The increase in overall prescribing of antibiotics for urinary tract infection was unexpected, and it was not possible to conclude whether this was clinically appropriate or an unwanted consequence. The SIMPle study improved the quality of antibiotic prescribing through the use of audit reports and reminders. In a next step, the quantity of antibiotic prescribing for urinary tract infection will be addressed.” 

The World Health Organisation (WHO) has deemed antibiotic resistance animmediate threat to world health. Overuse and overprescribing of antibiotics are major contributors to antibiotic-resistant diseases. Urinary tract infections are one of the most common illnesses for which antibiotics are prescribed. Efforts to curb overuse must involve patients, physicians and other health care workers, pharmaceutical companies and policy makers. 

To view the SIMPle research video visit:https://www.youtube.com/watch?v=buyeYTt1uQs 

To view the CMAJ research visit:http://www.cmaj.ca/content/early/2015/11/16/cmaj.150601 

For the authors Commentary visit:http://www.cmaj.ca/content/early/2015/11/16/cmaj.151103 

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Mental Health Commission concern at rise of ECT use in psychiatric care

Commission views current legislation covering ECT as infringement of patient human rights

The Mental Health Commission has called for a change to legislation governing the use of electro-convulsive therapy for patients in psychiatric care.

MHC chairman John Saunders said there has been an increase in the use of ECT, in particular on patients who are unable to give consent or unwilling to receive the treatment.

Currently the legislation allows for two doctors, if in agreement, to prescribe the treatment even if the patient is unwilling.

Mr Saunders said the MHC views this as an infringement of the patient's human rights.

"ECT should be administered with consent and if there are situations where people are unable to give consent, that there's sufficient rules and regulations around that to protect the interests of the patient,” he said.

“What we're really concerned about is a situation where, albeit a small number of people, can in law be forced to have ECT despite their express objection to it."

View more on RTE/Health here

Fitter legs linked to a 'fitter' brain - study finds

Researchers at King’s College London have found that muscle fitness as measured by power in the legs is strongly associated with an improved rate of ageing in the brain.

The findings, published in Gerontology, suggest that simple interventions, such as increased levels of walking, targeted to improve leg power in the long term may have an impact on healthy cognitive ageing. The research was funded jointly by the NIHR and the Wellcome Trust.

Scientists studied a sample of 324 healthy female twins from the TwinsUK volunteer registry over a ten-year period from 1999, measuring various health and lifestyle predictors. Researchers were, therefore, able to control for genetic factors affecting changes in cognitive function.

Thinking, learning and memory were measured at both the beginning and end of the study and it was found that leg power was a better predictor of cognitive change than any other lifestyle factors tested. Generally, the twin who had more leg power at the start of the study sustained their cognition better and had fewer brain changes associated with ageing measured after ten years.

The study is thought to be the first that shows a specific link between power (i.e. force and speed) in the lower limbs and cognitive change in a normal, healthy population. As the legs contain the largest muscles they are of particular relevance for muscular fitness and can be exercised easily through various habitual activities such as simply standing or walking.

Dr Claire Steves, lead author and Senior Lecturer in Twin Research at King’s College London and King’s College Hospital said: ‘Everyone wants to know how best to keep their brain fit as they age. Identical twins are a useful comparison, as they share many factors, such as genetics and early life, which we can’t change in adulthood.

View Study: Kicking back Cognitive Ageing: Leg power predicts cognitive ageing after ten years in older females.

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Chronic pain sufferers invited to join free online treatment programme

A recent online treatment programme, set up by expert psychologists and physiotherapists, aimed at helping those who suffer from chronic pain, has been extended due to the number of inquiries received in recent weeks.

The Centre for Pain Research at NUI Galway, with the support of the Health Research Board, is currently recruiting people with chronic pain (pain which has lasted for three months or more). The Acceptance and Commitment Therapy (ACT) trial will provide eight online sessions to people in the comfort of their own home. At the moment, such supports are mainly available through specialised hospital-based pain management teams.

Chronic pain affects up to 35% of the Irish population and is increasingly recognised as a disease in its own right. Chronic pain is sometimes associated with psychological effects, which may include anxiety and changes in mood, as well as forgetfulness, and difficulties in focusing attention, planning tasks and making decisions. The ACT trial is based on emerging clinical science that demonstrates the usefulness of managing chronic pain through mindfulness and psychological wellbeing.

The study is open to people all over Ireland and will take place over the coming months. GPs and physiotherapists around the country are being encouraged to refer suitable people with pain to the study.

To find out if you are eligible, visit http://centreforpainresearch.com/actstudy.html and complete the online survey.

For further information contact Dr Christopher Dwyer at the Centre for Pain Research, NUI Galway or emailpainresearch@nuigalway.ie, or see the website http://www.nuigalway.ie/centre-for-pain-research/. Alternatively, phone 091 495391. GP’s or physiotherapists who are interested in referring suitable patients to the trial can also use these contact details.

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Research into best models of palliative care

The project is one of two new projects that will look at how to best organise and deliver healthcare services in palliative care and epilepsy.

‘Each of these projects aims to provide solid evidence that will support the development of the best models of care in their respective areas’, says Graham Love, the Chief Executive of the HRB.  ‘Over the past few years, the HRB, HSE and Royal College of Physicians in Ireland have made a focussed, coordinated effort to increase the level of funding available for quality and patient safety research that addresses knowledge gaps of national priority. These two projects are the latest ones to come through that process’.  

According to Professor Charles Normand, Trinity College Dublin, who will be conducting detailed research into what are the best models of palliative care in an Irish context; 

‘We do not know enough about the extent to which better provision of palliative care takes pressure off other health and social care. Nor do we know enough about the effects of different models of palliative care on the burden on families and informal care givers.  There are a lot of important and as yet unanswered questions regarding the strengths and weaknesses of different models of care, the extent to which those that cost more achieve more, and the differences in experiences and outcomes.'

 Dr Mary Fitzsimons, from Beaumont Hospital will lead the project on patient-centred epilepsy care.

These latest awards will join two ongoing projects in Emergency medicine and Rheumatology care that have been funded under this partnership scheme, the RCQPS (the Research Collaboration on Quality andPatient Safety). To date over €1.5 million has been committed to research under this specific scheme.  

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Masters Degree in Medical Physics at NUI Galway receives Accreditaion

Dr. Jim Browne, President of NUI Galway and Prof. Wil van der Putten, Medical Physics at NUI, Galway and Galway University Hospitals

The MSc Degree in Medical Physics at NUI Galway, in conjunction with the Department of Medical Physics and Bioengineering (MPBE) at Galway University Hospitals, was recently awarded accreditation from the North American Commission on Accreditation of Medical Physics Education Programs (CAMPEP). This is the first medical physics programme in Europe to receive this accreditation and only the second outside North America.

The first year students enrolled on the MSc in Medical Physics in 2002 and over 130 students have graduated since. Of these graduates, over 70% are currently employed as medical physicists in the healthcare environment in Ireland, UK and beyond.

Commenting on this accreditation, Wil van der Putten, Adjunct Professor of Medical Physics, NUI Galway and Head of MPBE at Galway University Hospital, said: “Accreditation by CAMPEP is an important validation of the quality of this course. The Galway MSc is a unique collaboration between University and Hospital staff. The ability of the students to learn and conduct projects in the clinical environment accounts for the success of our graduates in finding employment. It is a tribute to both the staff in the Department of Medical Physics and Bioengineering and University staff in the Schools of Anatomy, Physiology, Medicine, Engineering and Physics. I would also like to pay tribute to colleagues in other hospitals who have accommodated our students for their dissertation work.”

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