Quality in colorectal surgery and viral infection effects neuronal development
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Also this week MedZine brings you the latest medical news on various medical specialisms. In this editorial two striking studies are highlighted. The first describes a tool to measure quality and outcomes in colorectal surgery. The second describes how viral infections in the mother can affect the neuronal development in the baby.
Quality and outcomes in colon and rectal surgery patients
To reduce preventable medical errors measurements of health care outcomes are important. In a publication in Annals of Surgery, Keller and colleagues describe a novel tool to measure quality and outcomes in patients undergoing colon and rectal surgery, the HARM score. HARM stands for HospitAl stay, Readmission rate, and Mortality, the data sources used to calculate the score. The researchers find a strong correlation between the HARM score and the quality of clinical outcomes achieved by surgeons and hospitals for patients having major abdominal surgery. Previous research has shown that most utilized process measures have no relationship to outcomes. The researchers now find that outcome measures, including length-of-stay (LOS), readmission rates, and mortality, are the most important measurements for quality. The HARM score was validated by retrospective review of 81,600 colectomy discharge records from 324 hospitals between January 2010 and January 2011. The HARM score can be determined used routinely collected data, making it easy to use without extra costs for personnel or software.
Maternal immune activation alters prenatal brain development
In a publication in Journal of Neuroscience, Elmer and colleagues describe how viral infection of the mother affects the capacity of the developing brain of the offspring to produce synapses. In mice and rats, the researchers show that the pups of animals that were exposed to viral infection had much higher brain levels of major histocompatibility complex I (MHCI) molecules. The high MHCI levels impaired the ability of the neurons from the newborn mice’s brains to form synapses. Previously, changes in the development of synapses in the brain, especially in the cerebral cortex, have been suggested to cause autism spectrum disorder and schizophrenia-like pathophysiology. According to the researchers, this is the first evidence that neurons in the developing brain of newborn offspring are altered by maternal immune activation.
Sources: Eurekalert, Annals of Surgery and Journal of Neuroscience
