Monthly Archives: October 2014

Mild traumatic brain injury can have lasting effects for families, reports the American Journal of Nursing

Nurses

Families of patients with mild traumatic brain injury (TBI) may expect them to return to normal quickly – after all, it’s “just a concussion.” But mild TBI can have a lasting impact on families as well as patients, according to a review in the November issue of American Journal of Nursing. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

“With the increasing numbers of people with mild TBI in the community, it’s crucial for nurses to make this a part of assessment for early recognition and intervention,” comments Maureen Shawn Kennedy, MA, RN, Editor-in-Chief of American Journal of Nursing. “Nurses may often be the first health professionals who, hearing the complaints of the patient or family member, might recognize that they’re having difficulty adjusting to the family impact of head injury.”

Mild TBI Affects Families, Not Just Patients

The article by Kyong S. Hyatt, PhD, RN, FNP, of Walter Reed National Military Medical Center discusses the ways mild TBI can affect patients and families. Important causes of mild TBI include sports injuries, motor vehicle accidents, and falls. In addition, many veterans are dealing with TBI sustained while serving in Iraq or Afghanistan. Yet so far, patient and family adjustment after mild TBI has received “scant” attention in the medical literature.

Patients with mild TBI may have a range of cognitive, physical, and psychological symptoms. In most patients, these symptoms resolve promptly – but “a subset experience persistent symptoms that create unique treatment challenges,” Hyatt writes. The injured patient may express stress in the form of anger, depression, and anxiety – sometimes perceived by family members as a “personality change.” Without prompt recognition and intervention, mild TBI can have a major impact in terms of reintegration into to the family, changes in family functioning, and disrupted family relationships.

Family members may not understand that the person may have difficulty doing everyday tasks – for example, balancing a checkbook or helping children with homework. The impact may be especially great for families that weren’t functioning well before the injury.

Nurses have a critical role to play in recognizing and responding to the impact of mild TBI on family functioning. Hyatt writes, “Finding ways to help the patient and family manage emotional distress and accept enduring changes may be the key to postinjury reintegration.”

Click here to read “Mild Traumatic Brain Injury.”

http://www.medicalnewstoday.com/releases/284054.php

 

 

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An ingestible pill with needles could be the new form of injection

Nurses_Immunology

Imagine swallowing a pill with tiny needles instead of getting an injection. Then again, imagine swallowing a pill with tiny needles. It may sound painful, but according to the researchers who developed the novel capsule – which could replace painful injections – there are no harmful side effects.

The researchers, from the Massachusetts Institute of Technology (MIT) and Massachusetts General Hospital (MGH), have published the results of their study – which tested the microneedle pill in the gastrointestinal (GI) tracts of pigs – in the Journal of Pharmaceutical Sciences.

Though most of us would probably prefer swallowing a pill over having an injection, many drugs cannot be given in pill form because they are broken down in the stomach before being absorbed.

Biopharmaceuticals made from large proteins, such as antibodies – known as “biologics” – are used to treatcancer, arthritis and Crohn’s disease, and also include vaccines, recombinant DNA and RNA.

“The large size of these biologic drugs makes them nonabsorbable,” explains lead author MIT graduate student Carl Schoellhammer. “And before they even would be absorbed, they’re degraded in your GI tract by acids and enzymes that just eat up the molecules and make them inactive.”

In an effort to design a capsule that is capable of delivering a wide range of drugs – while preventing degradation and effectively injecting the medicine into the GI tract – Schoellhammer and colleagues constructed the capsule from acrylic, including a reservoir for the drug that is coated with hollow, 5 mm long needles made of stainless steel.

The capsule measures 2 cm long and 1 cm in diameter.

Needle capsule worked safely and effectively in pigs

The team notes that previous studies involving humans who have accidentally swallowed sharp objects have suggested swallowing a capsule coated with short needles could be safe. They explain that there are no pain receptors in the GI tract and that, as a result, patients would not feel any pain.

But to assess whether their capsule could safely and effectively deliver the drugs, the researchers tested the pill in pigs, using insulin in the drug reservoir.

The capsules took more than a week to move through the whole digestive tract, and there were no traces of tissue damage, the researchers say. Additionally, the microneedles effectively injected insulin into the lining of the pigs’ stomachs, small intestines and colons, which resulted in their blood glucose levels dropping.

The video below explains in more detail how the capsule works:

Co-lead author Giovanni Traverso, a research fellow at MIT’s Koch Institute for Integrative Cancer Research and gastroenterologist at MGH, notes that the pigs’ reduction in blood glucose was faster and larger than the drop observed from insulin injection.

“The kinetics are much better and much faster-onset than those seen with traditional under-the-skin administration,” he says. “For molecules that are particularly difficult to absorb, this would be a way of actually administering them at much higher efficiency.”

‘Oral delivery of drugs is a major challenge’

Though they used insulin for their tests in pigs, the researchers say they envision their capsule being used to deliver biologics to humans.

“This could be a way that the patient can circumvent the need to have an infusion or subcutaneous administration of a drug,” says Traverso.

Prof. Samir Mitragotri, a professor at the University of California-Santa Barbara – who was not involved in the research – says:

“This is a very interesting approach. Oral delivery of drugs is a major challenge, especially for protein drugs. There is tremendous motivation on various fronts for finding other ways to deliver drugs without using the standard needle and syringe.”

In terms of future modifications, the team plans to alter the capsule so that contractions of the digestive tract slowly squeeze the drug out of the capsule as it travels through the body, and they also want to make the needles out of degradable polymers and sugar that break off, becoming embedded in the gut lining and slowly disintegrating.

Written by Marie Ellis

Copyright: Medical News Today

http://www.medicalnewstoday.com/articles/283459.php

 

 

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