Scanxiety: why private baby scans are on the rise

Anxiety may be the scourge of our times, but it now appears we have “scanxiety”, too. According to a study of 2,000 women, the phenomenon of pregnant women paying for extra private scans is on the rise. Almost a third paid for scans during pregnancy, with 36% citing anxiety as a reason. The NHS offers routine scans at 12 and 20 weeks, although more may be given for medical reasons.

“For the last 20 years, it’s been quite common for women to access private facilities for scans,” says Dr Christoph Lees, a consultant in foetal and maternal medicine and obstetrics and a spokesman for the Royal College of Obstetricians and Gynaecologists. “Sometimes it’s simply for reassurance, or because they don’t feel they’re getting sufficient scans on the NHS. Sometimes they’re accessing a service that isn’t routinely provided, such as 3D and 4D scans. Many are what you might call souvenir scans.”

For Lauren McGlynn, who has two boys aged four and nine months, anxiety was the main reason for paying for private scans. “Before my first son, I had two miscarriages,” she says. “I just couldn’t deal with waiting until 12 weeks. I had a private scan at seven weeks, which is the earliest they will let you do it.” Did she speak to her midwife or doctor about her worries and ask for an early scan on the NHS? “I didn’t say anything,” she says. “I just assumed the NHS wouldn’t be able to give an extra scan to every woman who had a miscarriage.”

Mandy Forrester of the Royal College of Midwives believes the rise may be partly explained by the shortage of 3,500 midwives in England (Lees also points to the national shortage of sonographers). “Midwives are pressurised during antenatal appointments and continuity of care is an issue,” she says. “If a woman is seeing the same midwife, it’s more likely they will build a good relationship. It may be that women are not getting the reassurance they need.”

There is also the issue of the small, unconfirmed risk to the foetus associated with ultrasound, which is why multiple scans without sufficient medical reason are not recommended. “And it’s difficult to know the quality of the service,” Lees adds. “While there are many private providers that are extremely good, there are pop-up services where the person doing the scan doesn’t have any training in ultrasound. You don’t need to have a licence to do an ultrasound scan privately.” Does he often see women who have had private scans that have worried them? “I do see women who come back to me with a private scan report,” he replies. “Quite often we have to repeat the scan and sometimes the advice is not correct. [Private scans] can cause concerns that are not necessarily merited, which rather negates their point.”

Scanxiety: why private baby scans are on the rise

A Easy Vision Test For Alzheimer"s? Scientists Unveil Eye Scans

A straightforward eye test could soon reveal regardless of whether you have Alzheimer’s Disease – or even if the condition looms in your future. In reality, according to trial final results launched this week, the vision test detected indications of Alzheimer’s 15 to twenty many years just before the look of clinical indicators.

This potentially game-modifying information comes out of the Alzheimer’s Association International Conference, presently ongoing in Copenhagen, Denmark, where two presentations highlighted the likely of new vision screening technologies that use retinal imaging to measure amyloid plaque formation in the back of the eye.

The technological innovation is primarily based on an astoundingly basic notion: The brain-clogging amyloid plaques regarded as an indicator of Alzheimer’s can also be noticed in the back of the eye, which is considered a mirror for brain well being. ”If this test operates, then a single day screening for Alzheimer’s condition could be as straightforward as acquiring your eyes checked,” said Yogi Kanagasingam, a single of the researchers conducting clinical trials.

English: PET scan of a human brain with Alzheimer’s illness (Photograph credit score: Wikipedia)

The 1st check, from Neurovision Imaging of Sacramento, California, utilizes retinal picture fluorescence photography to scan the supranucleus region of the retina for a fluorescent signature characteristic of beta amyloid plaques. In planning for the scan, participants consider curcumin, the ingredient in turmeric that provides the spice its fluorescent yellow shade, to “light up” the amyloid plaques with a specific fluorescent signature.

Preliminary data launched on 40 trial topics showed that amounts of amyloid in the retina correlated closely with amyloid levels in the brain as revealed by PET (positron emission tomography) scans, the current test strategy of selection. The retinal imaging was also in a position to inform topics with Alzheimer’s from those with out the illness with one hundred % sensitivity and 80.six % specificity. Neurovision is functioning with Australia’s Edith Cowan University McCusker Alzheimer’s Research Basis to check their retinal imaging scan.

NeuroVision isn’t alone in the retinal imaging discipline  a second information presentation, this time from Massachusetts-based Cognoptix, also showed promising final results from another pioneering technology. Cognoptix’s SAPPHIRE II technologies utilizes a fluorescent ligand eye scanning (FLES) method in which a topical ointment applied to the lens of the eye binds to beta-amyloid. The plaques are then detected with a laser scanner.

The Cognoptix clinical trial data, published in February in the Journal of Alzheimer’s Condition and Other Dementias, involved forty participants and predicted Alzheimer’s with 85 percent sensitivity. It differentiated participants with Alzheimer’s from people with out the illness with 95% accuracy.

A retinal imaging check for Alzheimer’s, if it proved accurate, could dramatically modify the way Alzheimer’s is diagnosed. “Presently the exams that are used in clinical trials are PET scan of the brain and CSF by way of lumbar puncture to measure amounts of amyloid and tau,” says CEO NeuroVision CEO Steven Verdooner. ”Our retinal imaging check is anticipated to be meaningfully less pricey than a PET scan, is noninvasive, and possibly much more sensitive.”

What’s far more, due to the fact a retinal imaging test is reasonably straightforward to get and without major longterm overall health effects, it could be re-administered often to keep track of the progress of the illness.  “We feel the potential to measure progression is really effective and are engaging in partnerships for therapeutic trials to demonstrate that out,” says Verdooner.

Proper now, simply because PET scans are radioactive, medical doctors don’t like to repeat them multiple instances and typically wait at least 18 months ahead of administering a 2nd PET scan. In accordance to Verdooner, Neurovision’s test can be repeated after an interval as brief as three months.

Whilst a vision test for Alzheimer’s is not going to be commercially accessible anytime soon, the wait isn’t going to be as prolonged as you may believe, either. The present trial winds up in the fall, at which stage Neurovision will get started doing work with academic institutions to carry on validating the retinal imaging procedure.

Commercialization is expected to be in the 2nd half of 2015, Verdooner says. “Once commercialized, we assume it to be accessible in doctors’ offices and can be administered by request from the patient or a referring medical professional.”

The retinal imaging check will be administered as element of a bundle, along with blood-primarily based biomarkers and cognitive screening, Verdooner says. “The paradigm we’re aiming at is a battery of tests that is price-effective, rapidly, and non-invasive.”

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A Easy Vision Test For Alzheimer"s? Scientists Unveil Eye Scans

PET scans could predict extent of recovery from brain damage, trials exhibits

Medical doctors feel they might have found a reliable way to assess whether individuals in a vegetative state soon after a significant brain damage are most likely to wake up, raising ethical inquiries about the best treatment method for individuals in an unresponsive state.

In a hospital trial, brain scans making use of PET engineering – positron emission tomography – recognized hidden ranges of consciousness in a third of patients who had been unresponsive and diagnosed as in a vegetative state for far more than a year. Most of these “woke up” or moved to a more responsive state within 12 months.

The outcomes of the 4-year trial – which took area in a professional hospital in Belgium, on patients from all above Europe, which includes the United kingdom – increase ethical queries and could adjust clinical practice.

If the testing proves to be as correct as it appears, there may be an argument for such sufferers to be treated differently – medical doctors might want to reconsider their want for painkillers, for instance. But there could also be a strengthened case for switching off existence help for those in whom no consciousness is detected.

The physicians at the University of Liège carried out the trial to set up whether PET scans or another form of brain scan using functional magnetic resonance imaging (fMRI) had been more reputable predictors of recovery than the assessments by medical doctors using standardised bedside exams. People end result in up to 40% of patients currently being misdiagnosed.

In the most current trial, involving 126 individuals, the final results of which have been published in the Lancet healthcare journal, 41 had been in a persistent vegetative state, 81 were in a minimally aware state and four had locked-in syndrome. PET appropriately predicted the extent of recovery in the following yr in 74% of patients and fMRI in 56%.

Prof Steven Laureys from the University of Liège, who led the research, explained a third of the patients referred to them by medical professionals elsewhere had been misdiagnosed. Of 41 sufferers whose doctors had diagnosed a vegetative state, 13 have been discovered by a PET scan to have some degree of consciousness. Of the 13, nine had regained consciousness inside of the year, three had died of other causes such as pneumonia and just one particular was still in a vegetative state.

Doctors did not always carry out the bedside diagnostic check that they ought to, said Laureys. “We are doing work very hard to make all centres seeing these individuals use that inexpensive behavioural test,” he mentioned. “If not, you miss about a third of the patients with indicators of consciousness. Then, in addition, there is about a third of the sufferers who will present indicators using functional imaging.”

It was surprising that the basic assessments have been not effectively carried out, he explained. “Unfortunately these individuals are sort of neglected by medicine and society as a entire. He [the patient] frequently has not witnessed a medical medical doctor or professional for years.”

PET scans had been utilized for cancer individuals but had not been employed to detect consciousness in brain-injured sufferers due to the fact of the cost, stated Laureys. But he hoped, if other study supported their findings, that PET and other tests which includes fMRI would turn out to be the norm.

In a commentary in the journal, two professionals, Jamie Sleigh from the University of Auckland and Catherine Warnaby from the University of Oxford, mentioned much more correct diagnosis and prognosis were essential – “for example, intensive care doctors caring for former racing driver Michael Schumacher following his latest serious brain damage refused to offer you any firm prognosis to the world’s media,” they wrote.

The work by the team at Liège is a signpost for potential studies, they mentioned. “Practical brain imaging is costly and technically difficult, but it will virtually undoubtedly grow to be less costly and less difficult. In the long term, we will almost certainly search back in amazement at how we were ever ready to practice with no it.”

Other scientists were enthusiastic about the results. “This actually interesting research suggests for the initial time that a brain scanning strategy called PET could be utilised in the long term to predict the probability that a patient may wake-up a long time following a extreme brain injury,” explained Dr Michael Bloomfield, clinical research fellow at the Health care Research Council Clinical Sciences Centre in London.

“If the benefits of this examine are confirmed in future study, this could have far-reaching clinical, ethical and legal implications, including whether or not to provide an apparently unconscious patient soreness relief and, in the long run, regardless of whether treatments that may be trying to keep a person alive should be continued or not.”

Prof Martin Monti from the departments of psychology and neurosurgery at the University of California, Los Angeles, stated: “This new report marks a lengthy-awaited very first stage in the direction of translating cutting-edge science into clinical practice.”

A Belgian guy, Rom Houben, who was presumed in a vegetative state for 23 many years following a near-fatal visitors accident, was in truth misdiagnosed and had been paralysed. A neurologist spotted this in 2009 making use of state-of-the-artwork technological innovation and Houben was given intensive physiotherapy. He can now communicate utilizing 1 finger with a touchscreen, and utilizes a wheelchair.

Terry Wallis of the US was severely injured right after his pickup truck went off the road in 1984. He was declared to be in a persistent vegetative state, but in the years following the accident his situation enhanced and he was deemed to be in a minimally conscious state. In 2003 he spoke to his mom right after currently being mute for 19 years, and study identified that his brain had managed to grow new connections to restore itself.

Amy Pickard, 17, was declared in a vegetative state after taking heroin in Hastings and collapsing in 2001. Her baby was delivered by doctors but did not survive. She was offered a sleeping pill in 2007 and this allowed her to breathe unaided, start to formulate phrases and even stand. Regardless of this progress she died in 2009.

British guy Mark Newton resurfaced too rapidly while diving and fell into a coma in 1996. Medical doctors declared him brain dead and recommended switching off his daily life assistance, but six months later he woke up, saying that he had been conscious of what was going on around him but could not communicate.

Andrew Devine, who suffered severe injuries at the 1989 Hillsborough disaster right after his chest being crushed and his brain deprived of oxygen, was diagnosed as being in a persistent vegetative state and his loved ones were told he would almost certainly be dead inside of six months. eight years later he began to communicate with his family members and can now eat pureed foods, though he is confined to a wheelchair. He attended his 1st Hillsborough memorial support yesterday this week.

New Yorker Carrie Coons was declared to be in an irreversible vegetative state following a stroke in 1989. 6 months soon after falling into the coma a judge gave permission for her feeding tube to be eliminated, but just a couple of days later on she started talking and eating on her personal.

- Right after an accident at function in 1988, Polish man Jan Grzebski fell into a persistent vegetative state. He appeared to wake up 19 many years later on but told newspapers that he was only in a coma for the very first four years. He was paralysed afterwards and this was not detected by physicians.

PET scans could predict extent of recovery from brain damage, trials exhibits