All articles by Amit Thadani
Amit Thadani
The OR of tomorrow
Hybrid operating rooms enable surgeons to use minimally invasive techniques that save patients’ lives and reduce risk – but the ongoing financial costs are still high. Will every OR eventually be hybrid, or are there times when an old-fashioned surgical theatre would do the job just as well? Kim Thomas asks Lars Kock, head of the department for vascular and endovascular surgery at Albertinen Hospital; Mark Slack, chief medical officer and co-founder of CMR Surgical; and Anthony Fernando, president and CEO of Asensus Surgical.
Helping hands
While the pandemic has brought hand hygiene front of mind for healthcare professionals and the public alike, it’s not yet clear if it will prompt any lasting changes in attitudes and behaviours. Monica Karpinski talks to Rachel Ben Salem, deputy director for infection prevention control and head of nursing at King’s College Hospital; Dr Mamdooh Alzyood, infection prevention specialist and public health lecturer at Oxford Brookes University; and Dr Manjula Meda, consultant clinical microbiologist and infection control doctor at Frimley Park Hospital in Surrey, about what can be done to encourage hand hygiene compliance among healthcare workers.
Keep your finger on the pulse
With a respiratory pandemic raging, pulse oximeters have become more important than ever. But alongside the benefits, previously underplayed weaknesses in their design have become more apparent. Tim Gunn speaks to Michael Sjoding, assistant professor of pulmonary and critical care and hospital medicine at the University of Michigan, and Olamide Dada, founder of UK charity Melanin Medics, about how pulse oximetry fails people of colour, and what doctors can do to make up for it.
New blood
The almost total shutdown in invasive cancer diagnostics during the first wave of Covid-19 focused attention on the need for alternatives. Now, all eyes are turning to liquid biopsies. Tim Gunn talks to Naureen Starling, consultant medical oncologist at The Royal Marsden NHS Trust in London and a clinical senior lecturer at the Institute for Cancer Research, about how simple blood tests could save lives.
High intensity
The equipment is the easy part. Beds are an important measure, but ICUs wouldn’t be needed at all if frames and mattresses alone saved lives. Unlike the people working around them, they don’t keep the system from toppling, nor will their shelter count for much if it does. Unfortunately, minds can’t be laundered like sheets. Sarah Graham asks Tim Cook, consultant in anaesthesia and intensive care medicine at Royal United Hospitals in Bath, UK, and Greg Martin, president of the US Society of Critical Care Medicine, about the impact of the pandemic on ICU doctors and nurses.
Personal touch
Given the heterogeneity of patients and the broad definition of conditions like acute respiratory distress syndrome and sepsis, precision medicine is as applicable in the ICU as anywhere else. Radhika Holmström speaks to Kiran Reddy of Beaumont Hospital, Dublin, Cecilia O’Kane, clinical professor at Queen’s University Belfast, and Imperial College London’s Anthony Gordon – authors of a recent review article on the topic – about how biomarkers can be used to identify subphenotypes of each condition and tailor treatment to improve patient outcomes.
True positives
When they work, Covid-19 tests are good for one yes or no question. If only deciding how to use them were so simple. Repeatedly, mass testing programmes using lateral flow tests have foundered on the risks of false negatives, but the more reliable PCR tests remain too costly to implement on a wide enough scale. Abi Millar speaks to Niraj Jha, co-founder of AI company NeuTigers, Timothy Plante from the University of Vermont and Melanie Ott, director of the Gladstone Institute of Virology, about using machine learning, wearables and even CRISPR to find a middle path out of the pandemic.
Time management
It’s been decades since developers realised workflows dominated by hours of repetitive pipetting were market opportunities for pipetting robots, but automation has not impacted all clinical laboratories equally. Now, as even complex, heterogeneous microbiology begins to reap the benefits, Isabel Ellis asks Felix Lenk, head of the SmartLab systems research group at TU Dresden, and Nate Ledeboer, medical director for clinical microbiology and molecular diagnostics at the Medical College of Wisconsin, how ‘total’ automation might reinvent laboratory medicine.
War on drugs resistance
When a novel pandemic fills hospitals and stretches resources to breaking point, it’s hard to avoid overusing antibiotics – even if doing so might create even bigger problems for tomorrow. Allie Anderson speaks to Gemma Buckland-Merrett, the science and research lead of the drug-resistant infections priority programme at the Wellcome Trust, to find out how the pandemic has impacted antimicrobial resistance, and asks Jeremy Barr, senior lecturer at the school of biological sciences at Melbourne’s Monash University, whether the answer might be to turn viruses on the bacteria.
The invisible enemy
Where there’s a chronic wound, there’s probably a biofilm. Where there’s wound care, however, there isn’t necessarily a strategy for addressing it. Natalie Healey talks to Karen Ousey, professor of skin integrity at the University of Huddersfield, about the role of biofilms in interrupting wound healing, new diagnostic tools for detecting them, and the measures that practitioners can implement today.