Latest news with #LindaLee
Medscape
19-05-2025
- Health
- Medscape
Blood Detection Capsule May Help in Upper GI Bleeding
SAN DIEGO — A real-time, blood-sensing capsule (PillSense) is a safe and effective diagnostic tool for patients with suspected upper gastrointestinal (GI) bleeding that can aid patient triage, reduce unnecessary procedures, and optimize resource use, a study found. Notably, patients with negative capsule results had shorter hospital stays and lower acuity markers, and in more than one third of cases, an esophagogastroduodenoscopy (EGD) was avoided altogether without any observed adverse events or readmissions, the study team found. 'Our study shows that this novel capsule that detects blood in the upper GI tract (PillSense) was highly sensitive and specific (> 90%) for detecting recent or active upper GI blood, influenced clinical management in 80% of cases and allowed about one third of patients to be safely discharged from the emergency department, with close outpatient follow-up,' Linda Lee, MD, medical director of endoscopy, Brigham and Women's Hospital and associate professor of medicine, Harvard Medical School, Boston, told Medscape Medical News . The study was presented at Digestive Disease Week (DDW) 2025. Real-World Insights EGD is the gold standard for diagnosing suspected upper GI bleeding, but limited access to timely EGD complicates diagnosis and resource allocation. Approved by the US Food and Drug Administration, PillSense (EnteraSense) is an ingestible capsule with a reusable receiver that provides a rapid, noninvasive method for detecting upper GI bleeding. The capsule analyzes light absorption to identify blood and transmits the result within 10 minutes. Lee and colleagues evaluated the real-world impact of this point-of-care device on clinical triage and resource allocation, while assessing its safety profile. They analyzed data on 43 patients (mean age 60 years; 72% men) with clinical suspicion of upper GI bleeding in whom the device was used. The most common symptoms were symptomatic anemia (70%), melena (67%), and hematemesis (33%). Sixteen PillSense studies (37%) were positive for blood detection, and 27 (63%) were negative. Compared to patients with a positive capsule results, those without blood detected by the capsule had shorter hospital stays (mean, 3.8 vs 13.4 days, P = .02), lower GBS scores (mean, 7.93 vs 12.81; P = .005), and fewer units of blood transfused (mean, 1.19 vs 10.94; P = .01) and were less apt to be hemodynamically unstable (5 vs 8 patients; P = .03). Capsule results influenced clinical management in 80% of cases, leading to avoidance of EGD in 37% and prioritization of urgent EGD in 18% (all had active bleeding on EGD). Capsule use improved resource allocation in 51% of cases. This included 12 patients who were discharged from the ED, six who were assigned an inpatient bed early, and four who underwent expedited colonoscopy as upper GI bleeding was ruled out, they noted. Among the eight patients who did not undergo EGD, there were no readmissions within 30 days and no adverse events. There were no capsule-related adverse events. 'Clinicians should consider using this novel capsule PillSense as another data point in the management of suspected upper GI bleed,' Lee told Medscape Medical News . 'This could include in helping to triage patients for safe discharge from the ED or to more urgent endoscopy, to differentiate between upper vs lower GI bleed and to manage ICU patients with possible rebleeding,' Lee said. Important Real-World Evidence Reached for comment, Shahin Ayazi, MD, esophageal surgeon, Director, Allegheny Health Network Chevalier Jackson Esophageal Research Center, Pittsburgh, Pennsylvania, said this study is important for several reasons. 'Prior investigations have established that PillSense possesses a high negative predictive value for detecting upper GI bleeding and have speculated on its utility in triage, decision-making, and potentially avoiding unnecessary endoscopy. This study is important because it substantiates that speculation with clinical data,' Ayazi, who wasn't involved in the study, told Medscape Medical News . 'These findings support the capsule's practical application in patient stratification and clinical workflow, particularly when diagnostic uncertainty is high and endoscopic resources are limited,' Ayazi noted. In his experience, PillSense is 'highly useful as a triage adjunct in the evaluation of suspected upper GI bleeding. It provides direct and objective evidence as to whether blood is currently present in the stomach,' he said. 'In patients whose presentation is ambiguous or whose clinical scores fall into an intermediate risk zone, this binary result can provide clarity that subjective assessment alone may not achieve. This is particularly relevant in settings where the goal is to perform endoscopy within 24 hours, but the volume of consults exceeds procedural capacity,' Ayazi explained. 'In such scenarios, PillSense enables physicians to stratify patients based on objective evidence of active bleeding, helping to prioritize those who require urgent endoscopy and defer or even avoid endoscopic evaluation in those who do not. The result is a more efficient allocation of endoscopic resources without compromising patient safety,' he added. Ayazi cautioned that the PillSense capsule should not be used as a replacement for clinical evaluation or established risk stratification protocols. 'It is intended for hemodynamically stable patients and has not been validated in cases of active or massive bleeding. Its diagnostic yield depends on the presence of blood in the stomach at the time of capsule transit; intermittent or proximal bleeding that has ceased may not be detected, introducing the potential for false-negative results,' Ayazi told Medscape Medical News. 'However, in prior studies, the negative predictive value was high, and in the present study, no adverse outcomes were observed in patients who did not undergo endoscopy following a negative PillSense result,' Ayazi noted. 'It must also be understood that PillSense does not localize the source of bleeding or replace endoscopy in patients with a high likelihood of active hemorrhage. It is not designed to detect bleeding from the lower GI tract or distal small bowel. Rather, it serves as an adjunct that can provide immediate clarity when the need for endoscopy is uncertain, and should be interpreted within the broader context of clinical findings, laboratory data, and established risk stratification tools,' he added.
Powys County Times
18-05-2025
- Health
- Powys County Times
Can you store eggs in the fridge? When they go out of date
Eggs are a British breakfast favourite and a healthy snack for a protein boost – but are you storing them correctly? According to the British Food Standards Agency, 2.4 million foodborne illnesses are reported annually in the UK. Storing our food products in the right place is not only key for protecting our health but it's crucial for making the most of their shelf life. We waste around four million tonnes of food each year across the food industry in the UK, according to FareShare. @ledbylinda Did you know how long Hard Boiled Eggs last in the fridge? #LedByLinda #funfact #foodtiktok #eggs #WomensHealth #Weightloss #weightlossjourney #momsoftiktok #momsover40 #momsover50 #mealprepping #weightlosstransformation #foryou ♬ original sound - Linda Lee To help Brits think smarter about their food storage, we've looked at the most searched for food storage queries - starting with the trusty egg. Should you store eggs in the fridge? Eggs left unrefrigerated or at room temperature for prolonged periods can become unsafe for consumption. The optimal place to store eggs is in the fridge, ideally maintaining a temperature around 4C, but it's crucial to avoid storing them in the fridge door. To minimise the risk of salmonella, the British Egg Industry Council (BEIC) administered egg info website advises purchasing eggs bearing the British Lion mark, which guarantees that the eggs originate from hens vaccinated against salmonella. However, we should never put them in the fridge door in the storage trays, Jason Webb, managing director of Electronic Temperature Instruments (ETI) warned. Jason explained that putting our eggs in the door - which is frequently opened and closed - can lead to a fluctuation and rise in temperature. What's the Difference Between Best Before and Use-By? As a result, this can accelerate our eggs spoiling. "With this constant temperature disruption, eggs will rise in temperature away from the optimum four degrees Celsius, and if continuous, it can pose the risk of bacteria such as salmonella,' he added. Can eggs go out of date? The egg float test is a handy trick that can help you judge the age of an egg. If it floats in water, it's become too old and dried out. But the Food Standards Agency doesn't recommend using this test to tell if an egg is still good to eat, saying it only tells you about the age of the egg and not whether it contains any dangerous bacteria. Instead, you should look at the best-before date – although the Food Standards Agency does say you can use eggs a couple of days past this date if you cook them thoroughly.
Yahoo
24-03-2025
- Health
- Yahoo
NYC Mayor Adams defends involuntary removal of mentally ill people to hospitals
Mayor Adams on Monday defended involuntary removals of mentally ill people to hospitals and said his City Council critics need to get out of their 'sterilized environment' after a Council report slammed the practice as inefficient and detracting from other long-term strategies to meet severe mental health needs. The report, released Monday, found that the data the mayor's office has released on the program is incomplete, that it disproportionately targets Black New Yorkers and that many of those who are transported don't get inpatient treatment or long-term care. It also found that involuntary removals were more than five times as likely to happen in private homes than in public spaces like the subway system — which runs against much of the mayor's argument for the program as a way to get those in need of help out of public areas. 'The Administration has continuously relied on involuntary removals as a catch-all solution without providing funding for the necessary treatment measures for people in need of long-term services,' Councilmember Linda Lee, who chairs the mental health committee, said in a statement. Adams, asked about the report at his weekly press briefing, said the administration was trying to be 'as transparent as possible' on the program and highlighted how 'challenging' the issue of severe mental illness is. 'They need to move out of the sterilized environment of the City Council chamber, and they need to go and do what we do: Go to the subway system, look at the population in need,' Adams said. 'We're going to respond to that need.' The mayor has been a major proponent of the practice of transporting people, whether they are willing or not, to hospitals if they appear to be unable to care for themselves. The directive has received harsh backlash from advocates, but has picked up some traction from other elected officials and some mayoral challengers. Data from the administration and the Council's report found that Black New Yorkers made up 54% of involuntary transports despite making up 23% of the city's population overall. 'Look at the ethnic demographics of who's homeless,' Adams said in response. 'Look at the ethnic demographics of those who are charged with some of these crimes of pushing people on the subway system, slashing, et cetera. We're going to go where the issue is, and we're not going to play race politics.' The Council suggested funding mobile help programs, establishing transitional support programs and expanding community-based clubhouse centers.
