Since the initial publication of primary stroke center recommendations in 2000, there have been significant advancements in the standard of care for stroke patients in terms of diagnosis and treatment. To that end, the Brain Attack Coalition (BAC) has recently issued revised recommendations for primary stroke centers.
The updated guidelines take into account the efficacy and importance of stroke teams, stroke units, the use of intravenous tissue plasminogen activator (tPA), and imaging advances. Primary stroke centers (PSCs), proficient in providing acute care for stroke patients and administering the clot busting drug IV-tPA, can be distinguished from their counterpart comprehensive stroke centers (CSCs), which cater to more complex stroke cases and offer advanced interventional treatments.
The revised recommendations, based on extensive literature review and experience of PSCs, encompass numerous aspects of stroke care, with the key points summarized below.
Brain Attack Coalition updates recommendations for primary stroke centers
Carly Anderson, Technology Insights
Heart failure management throughout the care continuum has become an increasing focus for hospitals lately given health care reform’s upcoming readmission penalties for these patients. Yet, managing individuals with HF is fraught with challenges. For one, HF patients are of advanced age and highly comorbid, with complicating conditions ranging from chronic obstructive pulmonary disease (COPD), severe renal dysfunction, and diabetes, all of which can make treatment more difficult and increase the likelihood of hospital readmission. Second, patients with HF may be located throughout the hospital as they are likely to be admitted for reasons outside of heart failure alone. This challenge may be contributing to the estimated 40 to 50 percent of HF patients with relatively preserved systolic function who do not receive specific guideline-recommended therapies. Furthermore, there is a general lack of evidence-based interventions and medications showing consistent positive outcomes for HF patients in the acute care setting; for instance, in the ASCEND-HF trial, the FDA-approved drug nesiritide (Johnson & Johnson) was recently found to have no benefit in HF patients, even leading to hypotension for some.
With looming readmission penalties, hospitals turn attention to managing heart failure care continuum
A new robot, the Amadeus system, may give Intuitive Surgical a run for its money in the near future. The Amadeus system, which is manufactured by Titan Medical Inc. (Toronto, Canada), would make an interesting addition to the robotics market, which has and continues to be dominated by Intuitive Surgical, the maker of the da Vinci robot.
Titan Medical recently posted on its website the first batch of concept designs for the Amadeus (see below).
Concept Design for the Amadeus surgical robot (Titan Medical Inc., Canada)
According to announcements made by the company at the end of Q1, initial testing of the robot's beta console were recently completed and its makers are happy with the testing's "encouraging results." The company has also disclosed that the Amadeus system will be using arms made by Kuka Robot Group, an international company based in Germany. Among the features of this lightweight arm (pictured below), which will weigh only 14 kg, is that it includes seven degrees of freedom (DOF). This is the same number of DOF as Intuitive's da Vinci.
Lightweight robotic arm (KUKA Robotic Group, Germany)
Despite all this progress, Titan Medical's Amadeus appears to be still several years away from complete development. Still, as far as competition for Intuitive's da Vinci is concerned, the Amadeus seems to be one of the more developed systems out there and may be the closest competitor da Vinci has for now.