Conditions: Postoperative Complications; Cardiovascular Diseases; Digestive System Surgical Procedures
Sponsors: Bach Mai Hospital
Recruiting
Sponsors: Bach Mai Hospital
Recruiting
Diaphragmatic Breathing Training in Chronic Spinal Pain
Conditions: Chronic Non-specific Low-Back Pain; Chronic Non-specific Neck Pain
Interventions: Behavioral: Structured Exercise program; Behavioral: Diaphragmatic Breathing Training
Sponsors: Democritus University of Thrace; University of Crete (School of Medicine); University Hospital of Heraklion (Department of Psychiatry)
Completed
Interventions: Behavioral: Structured Exercise program; Behavioral: Diaphragmatic Breathing Training
Sponsors: Democritus University of Thrace; University of Crete (School of Medicine); University Hospital of Heraklion (Department of Psychiatry)
Completed
Antibiotic Resistance Genes Established Early in Newborns
Research presented at ESCMID Global 2026 in Munich has shown that antibiotic resistance genes (ARGs) can be present in newborns within the first hours of life, with the newborn gut becoming colonized before, during, or recently after delivery.
Meconium, the first stool passed by newborns, was traditionally thought to be sterile, explained study lead Elias Iosifidis, MD, PhD, from Aristotle University of Thessaloniki in Greece. However, recent molecular studies have detected microbial genetic material in meconium samples, indicating that the neonatal gut may be exposed to bacteria during pregnancy.
It has been suggested that this early microbial exposure could contribute to the development of antibiotic resistance. Indeed, ARGs have been detected in meconium samples, and their presence at this early stage may facilitate the spread of resistance through horizonal gene transfer between bacteria.
To investigate further, Iosifidis and colleagues screened 105 meconium samples that were collected from newborns admitted to a neonatal intensive care unit within 24 hours of birth for 56 different resistance genes associated with commonly used antibiotics.
“This is the largest study of its kind exploring the effect of hospital environment on the collection of ARGs in the neonatal gut,” said lead author Argyro Ftergioti. “We analyzed meconium samples within the first 72 hours of life to capture the earliest snapshot of microbial and genetic exposure in newborns. At this stage, the collection of resistance genes is mainly shaped by maternal transmission, delivery mode, and very early hospital exposures.”
The most frequently detected ARGs were oqxA, a gene that causes resistance to fluoroquinolones (like ciprofloxacin), olaquindox, chloramphenicol, and tigecycline, and qnrS, which contributes to decreased susceptibility to quinolones. These were found in 98% and 96% of samples, respectively.
The study also identified several genes encoding beta-lactamases, enzymes that cause resistance to beta-lactam antibiotics such as penicillins and cephalosporins. Among these, the most prevalent were blaCTXM (55%), blaCMY (51%), and blaSHV (39%). Genes linked to carbapenem resistance (KPC/NDM/GES/VIM), a last-line class of antibiotics, were detected in 21% of samples.
Each sample contained a median of eight resistance genes.
“This finding suggests that a pattern of ARGs is already established at this stage. The neonatal gut harbors a diverse resistome, and the presence of clinically important ARGs so early in life is concerning,” said Ftergioti. “Although some ARGs were expected, their high prevalence across the majority of samples was striking—particularly for clinically critical genes offering carbapenem resistance.”
The team also found associations between resistance genes and several maternal and neonatal factors. The presence of the msrA (macrolide-streptogramin resistance) gene was linked with maternal hospitalization during pregnancy, while a higher number of resistance genes was associated with central venous catheter placement within the first 24 hours of life. Both findings likely reflect exposure to healthcare-associated microbes in hospital settings.
“Surprisingly, resuscitation shortly after birth was associated with fewer resistance genes,” noted Ftergioti. He cautioned, however, that “this finding should be interpreted carefully, as it may reflect differences in early microbial exposure or other clinical factors.”
Overall, the data suggest that both maternal transmissions and early exposure to the hospital environment may contribute to the establishment of ARGs in the neonatal gut.
“While further research is needed to understand how early carriage of resistance genes affects microbiome development and infection risk, these findings highlight the importance of surveillance, infection prevention and control in neonatal care,” Ftergioti concluded.
The post Antibiotic Resistance Genes Established Early in Newborns appeared first on Inside Precision Medicine.
STAT+: The race to catch KRAS, pancreatic cancer’s ‘greasy ball,’ and create the most promising drug in decades
Leanna Stokes had gotten into the habit of asking her oncologist what might be next for her treatment, and for good reason. Stokes, a 36-year-old gymnastics manager from New Rochelle, New York, had received one of the most difficult diagnoses in oncology: metastatic pancreatic cancer. Her oncologist kept mentioning two syllables, KAY-ras, referring to her cancer’s mutation on the KRAS gene. Mutations in this gene can make cancers more aggressive. But for Stokes, it was a possible key to extending her life.
“She always mentioned this — KRAS, KRAS, KRAS,” Stokes said of her oncologist. As Stokes proceeded to receive line after line of chemotherapy, she would remind herself, “It’s there. It’s there. It’s there. Then finally, it was my turn.”
Just a few years ago, such a refrain might have sounded odd to pancreatic cancer experts. For most of the nearly 50 years since KRAS was first discovered, scientists struggled to effectively drug the cancer protein. When Kevan Shokat, a biochemist at University of California, San Francisco, finally discovered how to drug a rare subset of KRAS mutant cancers, the first-generation drugs were a clinical disappointment. For the roughly 1% of pancreatic cancer patients who could receive them, the drugs improved outcomes only marginally, with resistance forming rapidly.
“We did not have a home run on the first effort,” said Channing Der, a pancreatic cancer researcher at the University of North Carolina, Chapel Hill. “It’s fair to say we’ve been disappointed by the durability of the responses.”
But once Shokat had shown it could be done at all, more and more companies jumped into developing drugs for KRAS, with new agents now regularly moving into clinical trials. The company leading the field has been Revolution Medicines, with the drug daraxonrasib, which targets KRAS and related proteins.
This was the drug that Stokes got on her clinical trial. It transformed her life, she said, enabling her to live far longer than most patients with her diagnosis. It’s also generating immense excitement among oncologists and drug developers, who say it heralds a new era for pancreatic cancer medicine and could bring new treatments for other cancer types with KRAS mutations including lung, colorectal, endometrial, and more. Beyond Revolution Medicines, dozens of other companies are also testing promising KRAS inhibitors in the clinic.
Triage and Recognition of Acute Aortic Dissection in Chest Pain by Electrocardiogram-Artificial Intelligence
Conditions: Aortic Dissection Type A; Chest Pain
Sponsors: Shanghai Zhongshan Hospital; Yan’an Hospital of Kunming City; Taian City Central Hospital; Mianyang Central Hospital; Guangdong Provincial People’s Hospital
Not yet recruiting
Sponsors: Shanghai Zhongshan Hospital; Yan’an Hospital of Kunming City; Taian City Central Hospital; Mianyang Central Hospital; Guangdong Provincial People’s Hospital
Not yet recruiting
Investigating Functional Changes in the Frontotemporal Cortex of Patients With Major Depressive Disorder Following Electroconvulsive Therapy or Magnetic Seizure Therapy Using Functional Near-infrared Spectroscopy (fNIRS)
Conditions: Major Depressive Disorder (MDD)
Interventions: Other: Electroconvulsive Therapy; Other: Magnetic Seizure Therapy
Sponsors: The Second Hospital of Anhui Medical University
Not yet recruiting
Interventions: Other: Electroconvulsive Therapy; Other: Magnetic Seizure Therapy
Sponsors: The Second Hospital of Anhui Medical University
Not yet recruiting
Comparison of the Efficacy and Safety of Ciprofol Versus Propofol for Sedation in ICU Patients Undergoing Non-Invasive Ventilation
Conditions: Respiratory Failure; Critical Illness
Sponsors: Nanfang Hospital, Southern Medical University
Recruiting
Sponsors: Nanfang Hospital, Southern Medical University
Recruiting
Preliminary Usability Assessment of a Rule-Based Digital Self-Monitoring Platform for Patients With Brain Tumors Toward Digital Early Warning Systems: Pilot Feasibility Study
<strong>Background:</strong> Postoperative follow-up after brain tumor surgery is typically limited to intermittent clinic visits, leaving subtle neurological or general deterioration between visits underrecognized. Digital self-monitoring platforms may help fill this gap, but evidence in neuro-oncology is scarce, particularly regarding how patient-reported symptom trajectories can feed into future data-driven early warning systems. <strong>Objective:</strong> This study aimed to evaluate the feasibility, use patterns, and preliminary usability of a smartphone or web-based self-monitoring system for patients after brain tumor surgery and to explore simple rule-based digital alerts as a first step toward an advanced digital early warning framework. <strong>Methods:</strong> We conducted a single-center prospective pilot study including adults discharged after brain tumor surgery who had access to a smartphone and could use a web app. Participants completed brief symptom surveys consisting of 51 binary items across 7 symptom domains, with an automatically calculated daily total score and score history visualization. Feasibility was assessed by enrollment, retention, submission counts, and submission rates. A total of 4 interpretable alert rules based on current score, short-term worsening, new-onset symptom combinations, and persistence across domains were evaluated using each patient’s last 3 submissions as the analytic unit. Clinical deterioration was defined a priori as objective decline in performance status, new neurological deficit, radiologic progression, or clinically significant laboratory changes. Rule performance metrics and bootstrap CIs were computed. Usability and acceptability were evaluated using the System Usability Scale and additional adherence-related items. <strong>Results:</strong> Of 64 enrolled patients, 30 (47%) with ≥3 submissions formed the analysis cohort (median age 57, IQR 47.2–64.5 years; n=12.9, 43% malignant tumors); 6 (20%) experienced clinical deterioration during follow-up. Patients contributed a median of 8.5 submissions (mean 19.03, SD 30.12) at 1.7 surveys per week on average, indicating sustained but heterogeneous engagement. The best-performing rule, based on net short-term score increase, achieved an area under the receiver operating characteristic of 0.88, with sensitivity 0.83, specificity 0.92, and accuracy 0.90 on the last-window dataset, outperforming rules based solely on current score or multidomain persistence. Among 23 app users who completed the System Usability Scale, the mean score was 84.0, reflecting high perceived usability; higher-frequency users reported stronger perceived usefulness and habit-driven use. <strong>Conclusions:</strong> This pilot study demonstrates that a smartphone or web-based self-monitoring platform for patients with brain tumor is feasible and well accepted and that simple, transparent rules applied to longitudinal symptom scores show potential to capture early signals of clinical deterioration. However, given the small sample size, these predictive metrics are preliminary and require rigorous validation in larger, independent cohorts. These findings support further development of integrated digital early warning systems that combine patient-reported trajectories with clinical and physiological data to enhance postoperative neurosurgical care.
Palantir’s NHS contract could end if others ‘can do the job better’
Health minister Zubir Ahmed said that Palantir’s NHS data contract could be reconsidered if other firms “can do the job better”.
Opinion: Health care is not ready for the new era of AI-enabled cyberattacks
On April 6, cancer patients at Brockton Hospital in Massachusetts showed up for chemotherapy infusions and were told to go home. The hospital’s information systems had been hit by a cyberattack. The ER closed. Ambulances were diverted. Staff switched to paper records. Patients were told to call back later to reschedule their treatment.
This wasn’t the first time that this kind of incident has happened. In May 2024, the Ascension ransomware attack took down systems across 136 hospitals for six weeks. That same year, the Change Healthcare breach compromised the personal health information of 100 million Americans, roughly one in three people in the country, and disrupted billing and authorization systems so severely that physician practices warned they might have to close their doors. After the Change breach, an AHA survey of nearly 1,000 hospitals found that 74% reported direct impact on patient care.