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Poseida Therapeutics Announces Agreement to be Acquired by Roche Holdings, Inc.

Poseida Therapeutics, Inc. (Nasdaq: PSTX) (“Poseida”), a clinical-stage allogeneic cell therapy and genetic medicines company advancing differentiated non-viral treatments for patients with cancer, autoimmune and rare diseases, today announced that it has entered into a merger agreement to be acquired by Roche Holdings, Inc. (“Roche”) at a price of $9.00 per share in cash at closing, plus a non-tradeable CVR to receive certain contingent payments of up to an aggregate of $4.00 per share in cash upon achievement of specific milestones. This corresponds to a total equity value of approximately $1.5 billion on a fully diluted basis. The merger agreement has been unanimously approved by Poseida’s Board of Directors, and Poseida’s Board of Directors unanimously recommends that Poseida stockholders tender their shares in the tender offer.

The proposed acquisition will establish a new core capability for Roche in allogeneic cell therapy, with lead opportunities focused on CAR-T programs covered by the existing strategic collaboration between Poseida and Roche in hematologic malignancies. It will include CAR-T programs for solid tumors and autoimmune diseases, along with Poseida’s genetic engineering platform and related preclinical medicines.

Poseida has pioneered a proprietary technology platform that includes a full set of non-viral capabilities to design, develop and manufacture allogeneic, T stem cell memory cells (TSCM)-rich CAR-T therapies. TSCM cells are considered ideal for CAR-T therapy because they are long-lived, multi-potent and self-replicating, with the potential for an improved safety and efficacy profile. This may offer benefits compared to other approaches, which either use a different cell type or drive T cell differentiation (and therefore less stemness) as part of the process to manufacture the CAR-T cells.

“Poseida has demonstrated the unique ability of its proprietary non-viral technology platform to create allogeneic, TSCM-rich CAR-T therapies with the potential to improve clinical outcomes and expand access to this important class of medicines. Most recently, this was highlighted by the compelling interim clinical data for P-BCMA-ALLO1 in patients with multiple myeloma,” said Kristin Yarema, Ph.D., President and Chief Executive Officer of Poseida Therapeutics. “We have worked closely with Roche through our collaboration focused on hematologic malignancies, and we are excited to join Roche to work as colleagues together across our pipeline and future programs. Roche’s global capabilities in late-stage development and commercialization will enable patients worldwide to benefit from the transformative potential of allo CAR-T.”

Poseida and its employees will join the Roche Group as part of Roche’s Pharmaceuticals Division.

Transaction Terms

Under terms of the merger agreement, Roche will commence a tender offer to acquire all of Poseida’s outstanding shares for a price of $9.00 per share in cash at closing, plus a non-tradeable CVR to receive up to an aggregate of $4.00 per share in cash, payable upon achievement of specified milestones.

The closing of the transaction is subject to customary closing conditions, including the tender of shares representing at least a majority of Poseida’s outstanding shares (other than shares held by Poseida, Roche or any of their respective subsidiaries, and any dissenting shares), the completion of regulatory review and other customary closing conditions. Upon the successful completion of the tender offer, Roche will acquire all remaining Poseida shares that are not tendered into the tender offer through a second-step merger at the same price of $9.00 per share in cash at closing, plus a non-tradeable CVR to receive up to an aggregate of $4.00 per share in cash, payable upon achievement of specified milestones.

The closing of the transaction is currently expected to take place in the first quarter of 2025.

Advisors
Centerview Partners LLC is serving as exclusive financial advisor to Poseida and Cooley LLP is serving as legal counsel. Citi is acting as financial advisor to Roche and Sidley Austin LLP is acting as legal counsel to Roche.

Anocca Announces Submission of Clinical Trial Application for Multi-asset Trial VIDAR-1 in Advanced Pancreatic Cancer

Anocca AB, a leading T-cell receptor-engineered T-cell (TCR-T) cellular therapeutics company, announces the submission of its first Clinical Trial Application (CTA) to the European Medicines Agency (EMA) for a Phase I/II multi-asset umbrella trial, VIDAR-1. The VIDAR-1 programme will begin with ANOC-001, which targets mutant KRAS G12V, in patients with advanced pancreatic cancer. Subject to approval of the CTA, Anocca aims to initiate the study in Q2, 2025. ANOC-001 is the lead product from Anocca’s robust preclinical pipeline of TCR-T cell therapies.

Reagan Jarvis, co-founder and Chief Executive Officer, commented, “This is an important milestone for Anocca, affirming the value of our unique cell biology R&D engine. Our approach integrates the systematic generation of validated TCR-T target maps from tumour-selective genetic sequences and supports the delivery of libraries of potent and highly specific therapeutic TCRs to leverage the diverse cancer target space. With our in-house cGMP facilities and gene-edited autologous TCR-T manufacturing capability we can efficiently and cost effectively develop new investigational products at scale. Our ambition is to grow our pipeline rapidly across the immense untapped target space for TCR-T cell therapies in solid tumours.”

Hugh Salter, Chief Scientific Officer at Anocca, elaborated, “KRAS is an immensely important target in many cancer types, but has to date been challenging to address. KRAS mutations are a hallmark of PDAC, which is among the most difficult to treat cancers, and we believe TCR-T cell therapies and, in particular, our VIDAR-1 assets can be effective in addressing this target and providing a new solution in an indication with high unmet medical need.”

About the VIDAR-1 clinical programme
VIDAR-1 is designed as a multi-asset umbrella trial targeting oncogenic driver mutations in KRAS within pancreatic ductal adenocarcinoma (PDAC). It will investigate up to 20 patients per product, where each product is specific for a different combination of HLA and mutation, in a set of phase I/II studies. Phase I is planned for eight sites in four countries with additional countries and sites in phase II. Subject to approval of the CTA, the company plans to initiate first-in-human clinical studies in Q2, 2025. Patients will be eligible to enroll if they have a HLA and KRAS mutation matching an available product.

About KRAS and PDAC
Mutant KRAS is implicated in pancreatic, lung and colorectal cancers. G12V and G12D mutations in KRAS affect ~90% of pancreatic cancer patients. The five-year survival rate of patients with PDAC is less than 10% (1). Despite recent advances there are no definitive treatments for advanced patients at present (2).

References
1. Rawla et al (2019). Epidemiology of Pancreatic Cancer: Global Trends, Etiology and Risk Factors. World J Oncol. 10(1):10–27. doi: 10.14740/wjon1166
2. Hu & O’Reilly (2023). Therapeutic developments in pancreatic cancer. Nat Rev Gastroenterol Hepatol 21, 7–24 . doi: 10.1038/s41575-023-00840-w

Eisai Signs Research Collaboration Agreement with The National Center of Neurology and Psychiatry to Initiate Apolipoprotein E Genetic Testing in the “AD-DMT Registry” in Japan

Eisai Co., Ltd. and Biogen Japan Ltd. announced today that Eisai has entered into a research collaboration agreement with the National Center of Neurology and Psychiatry to conduct apolipoprotein E (APOE) genetic testing in the dementia research and development program, “Development and Analysis of a National Clinical Registry of Disease-Modifying Therapies for Alzheimer’s Disease” (“AD-DMT Registry”). The research will be implemented by the Japan Agency forMedical Research and Development (AMED), with NCNP as the lead research institution.

The APOE gene is known to be a risk factor for the onset of Alzheimer’s disease and is also associated with the frequency of amyloid-related imaging abnormalities (ARIA) in anti-amyloid β antibody treatments such as lecanemab (LEQEMBI®).(1)

In Japan, at present, APOE genetic testing is not available for routine clinical practice under National Health Insurance. For thisreason, by using APOE genetic information collected in the AD-DMT Registry, Eisai and NCNP can further study the relationship between the APOE genotype and the safety and efficacy of treatment with lecanemab.

Based on this research collaboration agreement with NCNP, Eisai will cover the cost of the APOE genetic testing conducted in the AD-DMT Registry. The findings, along with data collected from the lecanemab-specific post-marketing surveillance (all-casesurveillance), will be part of the reexamination of lecanemab’s application by the Japanese Pharmaceuticals and MedicalDevices Agency (PMDA) to ensure the label reflects the latest scientific understanding with the goal of improving patientoutcomes.

Eisai and Biogen Japan will continue to contribute to the advancement of Alzheimer’s disease treatment through ongoing collaboration with academia.

Eisai serves as the lead of lecanemab development and regulatory submissions globally with both Eisai and Biogen Inc. (U.S.)co-commercializing and co-promoting the product and Eisai having final decision- making authority. In Japan, Eisai and Biogen Japan will co-promote lecanemab, with Eisai distributing the product as the Marketing Authorization Holder.

(1) Foley KE and Wilcock DM (2024). Three major effects of APOEε4 on Aβ immunotherapy induced ARIA. Front. Aging Neurosci. 16:1412006. doi: 10.3389/fnagi.2024.1412006

About the “Development and Analysis of a National Clinical Registry of Disease-Modifying Therapies for Alzheimer’s Disease”

The National Center of Neurology and Psychiatry (NCNP) is the lead research institution for the dementia research and development program “Development and Analysis of a National Clinical Registry of Disease-Modifying Therapies for Alzheimer’s Disease” under the Japan Agency for Medical Research and Development (AMED). The research is being conducted with the aim of collecting clinical information and test data obtained from routine medical care using treatments including anti-amyloid β antibody drugs such as lecanemab, evaluate the efficacy and safety of these drugs, and perform blood sampling for APOE genotyping and measurement of other biomarkers in patients receiving the drugs. Some of theseresults will be reported to the participating patients, and the safety and efficacy of the drugs will be examined based on APOE genotype and other factors. Eisai plans to conduct large-scale and efficient research by sharing data of patients who have given their consent from the specific post-marketing surveillance.

For more details on AMED’s dementia research and development program, please visit the AMED website.

Philips and AWS Expand Strategic Collaboration to Advance HealthSuite Cloud Services and Power Generative AI Workflows

Philips and AWS

Royal Philips (NYSE: PHG, AEX: PHIA), a global leader in health technology, today announced the expansion of its strategic collaboration with Amazon Web Services (AWS) to offer Philips’ integrated diagnostics portfolio in the cloud, including radiology, digital pathology, cardiology [1], and AI advanced visualization [1] solutions. The collaboration aims to unify diagnostic workflows, improving access to critical insights and driving better outcomes across clinical specialties. Philips has already successfully transitioned over 150 sites across North America and Latin America to Philips HealthSuite Imaging on AWS and is building on its collaboration with AWS to accelerate the migration of health systems to the cloud, and will expand to include customer cloud migrations in Europe. 

Cloud Capabilities for Integrated Diagnostics

Philips offers scalable healthcare informatics solutions by leveraging industry-leading cloud availability, reliability and security from AWS. Philips’ cloud-based solutions will offer a unified view of patient data from diverse diagnostic sources, including radiology images, digital pathology slides, and other clinical records to support care team collaboration and optimize workflows. Clinicians also benefit from remote access to diagnostic, reporting, and workflow orchestration tools, which can enhance diagnostic capabilities across healthcare imaging, from diagnosis to treatment and follow-up.

“The collaboration between Philips and AWS gives healthcare providers scalable, secure-by-design cloud-enabled solutions to accelerate healthcare innovation,” said Matt Garman, CEO of AWS. “Combining Philips’ healthcare informatics portfolio with AWS generative AI capabilities gives clinicians access to imaging insights so they can deliver more effective and efficient care to patients anywhere, anytime, with best-in-class security and privacy.”

The Future of Workflows with Generative AI

As healthcare providers continue to face significant challenges, Philips works closely with clinicians to develop innovative ways to address the increasing clinical demands. By automating routine tasks and optimizing workflows, clinicians would be able to dedicate more time to image interpretation, consultations, and patient interactions. Philips aims to create robust and scalable generative AI applications that leverage state-of-the-art foundation models from Amazon Bedrock, and seamlessly integrate into clinical workflows. In the future, these AI applications may reduce administrative burdens and time-consuming repetitive tasks, helping clinicians focus their expertise where it matters most – in critical decision-making.

One example of how Philips is exploring generative AI as part of its innovation roadmap is through conversational reporting, allowing clinicians to use conversational language to convert findings into structured reports, which can then be reviewed. These capabilities can help construct and revise reports in real-time, add diagnostic impressions, and flag potential inconsistencies. Generative AI has the potential to reduce report editing time, while maintaining high quality by integrating patient histories and clinical context into the final diagnostic report. Optimized reporting could help lead to quicker diagnosis and support better overall quality of care.

“Given the tremendous increase not only in patient volumes, but also in the complexity and number of images per study, radiologists need a tool that limits the distractions of dictation while at the same time increasing accuracy,” said Edward Steiner, Chief and Medical Director, The York/WellSpan Advanced Prostate Care Center, USA. “With Philips’ concept of ambient reporting using generative AI, you simply could speak in a conversational tone and a structured report is generated within seconds. My estimate is a 15 to 20 percent increase in efficiency, and this is just the start.”

“Philips’ cloud-based healthcare informatics solutions allow us to drive better outcomes across clinical disciplines, including radiology, digital pathology and cardiology. We’re working closely with clinicians to ensure workflows become more efficient and give back valuable time to healthcare providers,” said Roy Jakobs, CEO of Royal Philips. “Collaborating with AWS helps us to innovate faster and deliver better care for more people.”

Healthcare Informatics at RSNA

Philips will showcase its latest informatics solutions in the Philips booth (#6730) at the Radiological Society of North America Annual Meeting, Dec. 1-4, 2024, in Chicago, USA. For more information, visit Philips at RSNA 2024.

Reference

[1] Available on cloud in 2025.

A Comprehensive Tax Planning Guide For Medical Professionals

Tax Planning Guide For Medical Professionals

Many people enter the medical profession because they want to help others and appreciate the paychecks these individuals receive. Doctors, in particular, typically have high incomes, leading to them entering a higher tax bracket. At the same time, they have business expenses they may write off. They need help with comprehensive tax planning to ensure every write-off is received. Doctors should use these strategies to maximize their deductions and receive the most retirement benefits possible.

Business Expenses

When it comes to tax planning for physicians, one of the most important things they can do is deduct their business expenses. They can deduct the medical supplies and equipment they use when practicing, their professional liability insurance, office rent, travel expenses, and continuing education. To do so, however, they must keep good records. They will need receipts, invoices, and other documents that outline these expenses and how they were used.

Retirement Plans

Doctors can contribute to retirement plans to give them tax advantages. They may choose a 401(k) plan, SEP IRA, a simple IRA, or health savings accounts. With each contribution to one of these accounts, they reduce their taxable income, allowing their funds to grow tax-deferred. They will only owe taxes on these funds once they withdraw the money.

 A doctor should contribute to a 401(k) plan, particularly if their employer may match their contributions. An SEP IRA is ideal for those doctors who are self-employed. They can contribute a percentage of their net earnings to this account. Positions who are small business owners should choose a simple IRA. If the company has fewer than 100 employees, this retirement plan can be offered to them. Health savings accounts are used to cover certain medical costs, and contributions are tax-deductible. The money grows tax-free.

Form a Business

Doctors may choose to form a business entity to obtain tax advantages. An LLC or S corporation is ideal because it can deduct health insurance premiums and self-employment taxes. Before establishing a business, the doctor should speak to a tax professional to learn which options will provide them with these deductions and other benefits.

Hire a Tax Advisor

Doctors spend their time helping patients, so they don’t have time to keep up with the latest tax law changes. For this reason, many doctors hire a tax advisor to help them devise a tax planning strategy that meets their unique needs. The advisor will ensure that the doctor claims all deductions and credits that they can and complies with all tax laws and changes.

Additional Tax Savings

Doctors need to ensure they are deducting their student loan interest. Many medical school students complete their education with hundreds of thousands of dollars in student loan debt. They can deduct up to $2,500 annually of this interest on their taxes. In addition, they can deduct continuing education expenses, as this education is required to maintain their licenses. The IRS considers these courses a business expense.

Medical malpractice insurance premiums can be deducted from a doctor’s taxes because they are necessary. Doctors may also deduct charitable donations if they donate to a qualified organization. Doctors may be eligible for other tax credits; their tax advisor will ensure they take all possible.

Every medical professional should work with an experienced tax advisor to ensure they comply with tax laws that change frequently. This advisor will ensure the professional gets every tax deduction and credit available, allowing these individuals to keep more of their hard-earned money.

Dr. Brandon Claflin’s Guide to Lumbar Spinal Stenosis Care

A diagnosis of spinal stenosis may be surprising to you, but if you’ve dealt with chronic spinal pain, this may be the first step in getting some much-needed relief. Spinal stenosis can happen to anyone at any age but is most common in older adults.

Dr. Brandon Claflin of Oklahoma shares some advice on how to manage spinal stenosis pain and how pain management can make a difference.

What Is Spinal Stenosis?

Simply put, spinal stenosis is a narrowing of the space inside the backbone. When the space inside the backbone becomes smaller, it creates pressure on the spinal cord and the nerves that surround it. Sometimes, people who have spinal stenosis don’t experience symptoms. If symptoms are present, they can range from moderate to severe.

What Causes Spinal Stenosis?

Spinal stenosis can be caused by wear and tear from arthritis, which can occur due to the normal aging process or underlying bone disease. It can also result from an accident, a genetic defect, tumors on the spine, or spinal injuries.

What Are the Symptoms of Spinal Stenosis

Some people who have spinal stenosis won’t have any symptoms or may not have symptoms until they are older. Symptoms of spinal stenosis can include:

  • Numbness, tingling, and/or pain in the back, legs, buttocks, hips, thighs, or calves, or in the upper body (arms, neck, and shoulders)
  • Cramping or muscle weakness in the areas listed above
  • Dizziness or trouble walking
  • Issues with bowel movements or urinary incontinence

Symptoms of spinal stenosis usually get worse over time, which is why it is essential to seek care as soon as possible.

Lumbar Spinal Stenosis Care

If you’ve received a diagnosis of spinal stenosis, you should know there are options for care. Getting the relief you need may involve implementing several different therapies until you and your healthcare provider find the combination that works best to help manage your symptoms. Some available treatment options include anti-inflammatory medications, physical therapy, epidural steroid injections, and surgery.

Anti-Inflammatory Medications

Most healthcare professionals agree that the use of anti-inflammatory medications can be beneficial for alleviating acute spinal stenosis pain. Ibuprofen, acetaminophen, and naproxen may be used temporarily for acute pain relief.

Check with your healthcare provider to learn how frequently to use these medications and which ones are best for you. Some patients have preexisting conditions (like kidney or liver disease), which may preclude them from using anti-inflammatories.

Physical Therapy

The use of physical therapy for spinal stenosis pain management can be very successful if a person is committed to working with a physical therapist for a few months to see improvement. Physical therapy can also ensure a person does not lose range of motion or flexibility and does not suffer further limitations to ambulation.

Physical therapy may involve gentle stretches and practicing everyday movements like walking, bending, sitting, and standing. A physical therapist guides their patients through movements that safely support the spine to help prevent further aggravation. Physical therapy may also employ the use of range-of-motion and strength training exercises to support the spine and alleviate pressure.

Epidural Steroid Injections

Lumbar spinal stenosis pain that is moderate to severe can be relieved with an epidural steroid injection or “ESI.” ESIs involve the injection of anti-inflammatory steroid medication into the space around the spine to reduce the inflammation and pain in the nerves around the affected area of spinal stenosis.

These injections are mildly invasive but can give a patient relief for several months at a time. They may be used in connection with other therapies to provide additional relief.

Surgery

In some cases, a person may need to have surgery to correct spinal stenosis. Surgery can enlarge the area inside the spine and help alleviate pain. There are different surgical options available for spinal stenosis.

Your healthcare provider can discuss which ones may work best for your particular injury. New surgical techniques are available that may make spinal surgery less invasive and offer a faster recovery.

The Relief You Need

If you’ve been diagnosed with spinal stenosis, you may feel like there is no end in sight to your pain. Working with a pain management specialist can give you hope and relief. Pain management specialists employ the use of many different therapies to help target your pain through movement, medication, and therapy.

There are many new and exciting technologies that your pain management provider can use to help find the exact cause of your pain and help you get relief. Finding relief with pain management can help you retain your quality of life and may help you avoid more invasive procedures.

Sources:

Spinal stenosis – Symptoms and causes | Mayo Clinic

Spinal Stenosis: What It Is, Causes, Symptoms & Treatment | Cleveland Clinic

Epidural Corticosteroid Injections | Johns Hopkins Medicine

 

Senior Helpers on Promoting Mental and Emotional Health in Seniors: Strategies for Caregivers

Strategies for Caregivers

As people age, mental and emotional health becomes just as important as physical well-being. Seniors face a unique set of challenges, from dealing with health issues and loss of loved ones to adjusting to lifestyle changes like retirement or mobility limitations. This can lead to feelings of loneliness, anxiety, and sometimes depression. Caregivers play an essential role in supporting seniors through these changes and promoting a positive outlook on life. Here are some effective strategies for caregivers to enhance the mental and emotional well-being of their loved ones.

Encourage Social Connection

Social interaction is key to mental health at any age, but it’s especially important for seniors, who may experience feelings of isolation. Caregivers can help by arranging regular social activities. This might include family gatherings, video calls with distant relatives, or visits with friends. For seniors who are more comfortable in smaller settings, regular outings for a coffee, a walk, or even shopping can provide valuable interaction and a sense of connection.

Local community centers and senior groups often offer activities tailored to older adults, such as exercise classes, book clubs, or craft sessions. In-home caregivers, such as those from Senior Helpers, can facilitate these connections by accompanying seniors to events or arranging visits with friends, helping reduce isolation and increase social engagement.

Promote Physical Activity

Physical activity is not only good for the body but also for the mind. Studies have shown that regular exercise releases endorphins, the body’s natural mood boosters, and can help reduce anxiety and depression. Caregivers can encourage seniors to engage in gentle physical activities, such as walking, swimming, or chair exercises, which are accessible and enjoyable for many seniors.

Exercise classes specifically designed for older adults can provide both physical benefits and social interaction. Even simple stretching or balance exercises at home can make a significant difference in mood and energy levels. With consistency, seniors often feel a renewed sense of independence and vitality, which positively impacts their emotional well-being.

Foster Mental Stimulation

Keeping the mind active is crucial for cognitive health and emotional resilience. Caregivers can help seniors engage in mentally stimulating activities like puzzles, reading, or learning a new skill, which all provide mental exercise. Activities such as playing cards, board games, or even participating in brain-training apps can be enjoyable ways to keep the mind sharp and reduce feelings of boredom.

Creative pursuits, like painting or crafting, are excellent for cognitive engagement as well. Such activities not only provide mental stimulation but also a sense of accomplishment, which can boost self-esteem and emotional health. Encouraging seniors to participate in these activities can help them maintain a positive outlook and give them something to look forward to each day.

Create a Routine

A daily routine can be incredibly helpful for seniors, providing a sense of stability and control. By establishing consistent daily activities, caregivers can help their loved ones feel grounded and focused. Simple routines—such as having breakfast at the same time, going for a walk, or reading a book in the afternoon—can create structure, reducing feelings of anxiety and promoting a sense of purpose.

Additionally, routines provide reassurance and make it easier for caregivers to identify any unusual behaviors or signs of mental distress. For seniors dealing with memory issues, routines can also be helpful in supporting day-to-day memory function, making daily tasks less stressful.

Practice Active Listening and Empathy

Listening with empathy can make a big difference in the mental health of seniors. Many seniors may feel hesitant to express their feelings, fearing they might be a burden. Caregivers can create a supportive environment by being patient, nonjudgmental, and genuinely interested in their loved ones’ thoughts and experiences. Allowing seniors to express their fears, hopes, and memories without interruption can be incredibly healing.

Active listening shows respect for their perspective and can make them feel valued and heard. It also provides caregivers with insight into any emotional issues or anxieties that may need further support. Building this kind of trusting relationship can be a powerful factor in promoting emotional well-being.

Support Independence

Maintaining a sense of independence can greatly improve a senior’s self-worth and emotional health. Caregivers should encourage seniors to perform tasks they’re capable of doing on their own, even if it takes a little extra time. Whether it’s preparing a simple meal, tending to a garden, or choosing what to wear each day, these small moments of self-sufficiency foster confidence and prevent feelings of helplessness.

Home care providers, like Senior Helpers, understand the importance of respecting a senior’s independence while providing support as needed. Caregivers can work with seniors to strike a balance between assistance and autonomy, ensuring that seniors feel capable and dignified in their everyday lives.

Encourage Positivity and Purpose

Having a sense of purpose is essential for emotional well-being. Caregivers can encourage seniors to engage in activities that give them a sense of purpose, such as volunteering, helping with small household tasks, or spending time with grandchildren. Positive reinforcement can also help—acknowledging achievements, no matter how small, helps seniors feel appreciated and purposeful.

Creating opportunities for seniors to contribute to their family or community can foster a feeling of belonging and value. A few words of appreciation and encouragement can go a long way in boosting their confidence and optimism, enhancing their overall quality of life.

Conclusion

Supporting the mental and emotional well-being of seniors requires compassion, patience, and consistent effort. By fostering social connections, promoting physical activity, encouraging mental engagement, establishing routines, and listening with empathy, caregivers can greatly enhance the quality of life for their loved ones. Each of these small steps adds up, helping seniors feel valued, independent, and emotionally secure. For families looking for additional support, Senior Helpers provides experienced caregivers who can offer both companionship and care tailored to each senior’s unique needs, ensuring they enjoy their golden years with dignity and joy.

The Role of Endovascular Specialists in the Multidisciplinary Approach to Postpartum Hemorrhage | By Dr. Adam Power, Co-Founder and CMO, Front Line Medical Technologies

Dr. Adam Power

Postpartum hemorrhage (PPH) continues to challenge obstetric care despite ongoing medical advancements. With blood loss exceeding 500 ml in 6.3% to 13% of births and over 1000 ml in 1.9% to 2.8% of cases, PPH remains a significant concern. These figures are particularly worrying given that 500 ml is the established threshold for PPH following vaginal delivery. Cesarean sections often involve even more significant blood loss, frequently exceeding 1000 ml.

This raises critical questions about the risks we’ve come to accept in modern obstetric practice. How can understanding the significant blood loss associated with delivery reshape our management strategies? Given the advancements in minimally invasive techniques, how can we incorporate novel approaches to enhance patient safety and outcomes during deliveries? This article explores how endovascular surgery fits in the multidisciplinary approach to PPH.

The Growing Threat of Placenta Accreta Spectrum

A key contributor to PPH is the placenta accreta spectrum (PAS), where the placenta attaches too deeply to the uterine wall. This condition involves complex cellular interactions that we’re still working to fully understand. The resulting deep attachment can cause severe bleeding during delivery, posing substantial risks to maternal health.

The link between cesarean deliveries and PAS is particularly concerning. Cesarean sections disrupt the natural structure of uterine tissue, leading to scarring that can complicate future pregnancies. This microscopic change in uterine structure can lead to significant complications with potentially serious consequences. Studies consistently show that the more cesarean deliveries a woman has, the higher her risk of developing PAS.

The prevalence of PAS has increased dramatically, now affecting approximately 1 in 533 pregnancies. This rise closely mirrors the increasing rate of cesarean deliveries. Understanding this relationship is crucial to developing effective prevention and management strategies. It challenges us to balance the immediate benefits of cesarean sections with their potential long-term risks, a consideration that should inform both clinical decision-making and patient counseling.

Historical Endovascular Approaches

In the past, endovascular specialists employed various techniques to manage PPH either prophylactically or postpartum. Bilateral internal iliac artery occlusion was one of the earliest approaches, requiring balloon occlusion catheter placement in the internal iliac arteries. This technique, while pioneering, required precise catheter placement and bilateral femoral arterial access. The major disadvantage is that it fails to control the significant collateral circulation to the uterus and placenta from sources beyond the internal iliac arteries.

Uterine artery embolization (UAE) has also been proposed as an alternative. UAE is usually well-tolerated and feasible, making it suitable for hemodynamically stable patients experiencing slow, ongoing bleeding. The major disadvantage, however, is the permanence of arterial embolization, which can have implications on future fertility, with decreased blood flow to the uterus, and even the development of pelvic ischemia in rare cases.

Prophylactic Aortic Occlusion: A Preemptive Approach

Prophylactic balloon occlusion of the aorta is the newest technique for managing PPH, especially in high-risk patients, such as those with placenta accreta. This procedure involves strategically placing a balloon occlusion catheter in the abdominal aorta. It temporarily blocks blood flow to at-risk areas, significantly reducing blood loss during delivery. Recent studies show encouraging results with prophylactic aortic occlusion, suggesting it may be more effective than bilateral iliac artery occlusion or UAE for severe hemorrhage management. Research from Texas Children’s Hospital and Atrium Health suggests that prophylactic aortic occlusion can significantly reduce blood loss and transfusion requirements in high-risk patients. These hospitals exclusively use the COBRA-OS® (Front Line Medical Technologies, Canada), a 4 French aortic occlusion device, that aims for improved safety than previous aortic occlusion devices. This prophylactic approach may ultimately lead to reducing the need for unplanned surgical interventions like hysterectomy.

REBOA Technology: A Closer Look

The COBRA-OS® is part of a broader category of Resuscitative Endovascular Balloon Occlusion of the Aorta (REBOA) technology. While REBOA has shown promise in managing severe hemorrhage, its implementation has been challenging in the past, mainly due to a 7-8% access complication rate using previous 7 French devices. The 4 French COBRA-OS® aims to address these challenges, potentially making this life-saving technology safer and more accessible.

Dr. Adam Power, co-founder of Front Line Medical Technologies and a practicing vascular surgeon, explains the device’s design philosophy: “Helping mothers survive high-risk deliveries is a major focus of our company with the innovative COBRA-OS®. In female patients who are at higher risk of clotting due to pregnancy and who have smaller arteries, it is critical to use a low-profile aortic occlusion device to avoid the complications seen with larger devices.”

This focus on the unique physiological changes of pregnancy demonstrates a thoughtful approach to medical device design. By considering the specific needs of postpartum patients, the COBRA-OS® aims to provide a more tailored and potentially safer intervention option.

Conclusion

Addressing PPH, particularly in cases involving the PAS, demands a coordinated effort from a diverse team of medical professionals. Only when obstetricians, endovascular specialists, anesthesiologists, and critical care specialists work closely together can we maximize the potential of tools like the COBRA-OS®.

Medical innovations provide new ways to address PPH, a condition that remains one of the leading causes of maternal mortality worldwide. Although the road from breakthrough technology to becoming a standard of care can be lengthy and complex, devices like the COBRA-OS® give us a glance at how targeted solutions can make a real difference.

The reality is that these advancements present a critical opportunity to save lives and improve maternal care. Ultimately, the goal is to reduce the risks women face during childbirth, but also to make childbirth safer and less stressful for mothers and their families.

References:

Lambrecht S, Van De Velde M. Interventional radiology for the obstetric patient. Curr Opin Anaesthesiol. 2020;33(4):566-570. doi:10.1097/ACO.0000000000000884 https://pubmed.ncbi.nlm.nih.gov/32628404/

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  2. Biffl WL, et al. The role of REBOA in the control of exsanguinating torso hemorrhage. J Trauma Acute Care Surg. 2018;84(6S Suppl 1):S92-S103. https://pubmed.ncbi.nlm.nih.gov/25909430/
  3. Ganguli S, et al. Uterine artery embolization in the treatment of postpartum uterine hemorrhage. J Vasc Interv Radiol. 2011;22(2):169-176. https://www.sciencedirect.com/science/article/abs/pii/S1051044310010109
  4. Say L, et al. Global causes of maternal death: a WHO systematic analysis. Lancet Glob Health. 2014;2(6):e323-e333. https://pubmed.ncbi.nlm.nih.gov/25103301/
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How to Deal with the Loss of a Loved One: Coping Strategies

How to Deal with the Loss of a Loved One: Coping Strategies

Losing someone you deeply care about is one of the most challenging things you can face in life. It’s a difficult time that brings overwhelming sadness and shakes the very foundation of your life. The grief process can feel insurmountable, with a whirlwind of different feelings, making it hard to know where to start or how to cope.

Understanding healthy coping strategies and recognizing that seeking help is part of the journey can make this difficult time more manageable and pave the way for eventual healing. This article shares some coping strategies for dealing with a loved one’s passing. Continue reading to learn more.

Understanding the Grieving Process

It’s natural to feel sorrowful after a loved one passes, and everyone experiences it in their own way. While some may feel numb and detached, others might be overwhelmed by waves of sadness, anger, or guilt. The emotions tied to a significant loss can be intense and unpredictable, and it’s crucial to acknowledge that there is no right or wrong way to grieve.

These different feelings are all part of the process, and understanding them can help you manage their intensity without feeling lost or overwhelmed. Permit yourself to feel these emotions without judgment or pressure to move on too quickly.

Getting Practical Support

Here are some examples of practical support that can significantly ease the burden of those grieving after the death of a loved one:

1. Home Cleaning and Organization

Practical support from local after death cleanup experts can help a grieving person by handling the cleanup and organization of the home. This not only eases emotional stress but also allows you to focus on your grief without dealing with physical reminders.

2. Assistance with Funeral Arrangements

Dealing with the loss of a loved one makes planning a funeral or memorial service feel truly daunting. Help from friends, family members, or professionals to arrange the service, choose a venue, and handle logistical details can lift a significant burden.

3. Help with Daily Tasks

Small gestures of kindness, like cooking meals, doing errands, or looking after kids or pets, can make a big difference. This support ensures that the grieving person can focus on their emotions without worrying about routine responsibilities.

4. Financial and Legal Assistance

Loss often brings financial and legal tasks that can be difficult to manage, such as handling insurance claims, managing the deceased’s estate, or sorting through legal documents. Professional help from financial advisors or estate lawyers can provide necessary guidance and support.

Meanwhile, guidance with budgeting or accessing any available financial assistance can be critical, especially if the deceased was a primary income earner. Getting support from financial advisors or community programs can help you manage this transitional period.

5. Helping with Documentation

Filling out paperwork related to death certificates and benefits or notifying necessary institutions can be time-consuming and difficult for someone in mourning. Assistance in completing and organizing these tasks can lighten their load and reduce stress.

6. Transportation Assistance

Loss Of A Loved

Providing rides to appointments, counseling sessions, or support groups can be valuable, especially if you’re too emotionally drained to drive yourself.

Each type of practical support can contribute to creating a supportive environment, helping you manage loss and focus on emotional healing.

Healthy Ways to Cope

Ignoring grief or handling it the wrong way can lead to health problems and impact your mental health. Here are some examples of how to cope with difficult emotions involved in the grieving process:

1. Express Your Emotions

Finding ways to express your emotions is essential to the grief process. This can include talking with friends, journaling, or joining a support group where you can share memories and experiences. Opening up about your feelings in a supportive space can help ease emotional stress and promote healing.

2. Maintain a Self-Care Routine

Caring for yourself through healthy habits must be a top priority during this difficult time. Try doing some light workouts, meditating, or practicing deep breathing to help lower stress and boost your mental well-being. Proper nutrition, hydration, and sleep are fundamental for maintaining physical and emotional resilience during a difficult time.

3. Join a Support Group

Connecting with others who have similar experiences related to loss can be highly beneficial. Joining a therapy group gives you a safe space to share your grief without feeling isolated and provides insight into different ways to handle overwhelming sadness. Knowing others understand your pain can make the journey feel less lonely.

4. Engage in Therapeutic Activities

Activities like journaling, art, or even taking nature walks can offer solace and a creative outlet for grief. These healthy ways of coping allow you to express emotions without words and bring moments of peace amidst the storm of mourning.

5. Seek Professional Help

If your grief becomes too difficult to manage alone, reaching out to a therapist or counselor is a vital step. Professional help can offer tailored coping strategies, guidance, and a safe space to express and process emotions. Therapy can support your journey toward acceptance and healing, helping you move forward at your own pace.

6. Create Rituals or Traditions

Honoring the memory of your loved one through personal rituals or traditions can bring comfort. This could be as simple as lighting a candle on particular dates, planting a tree in their memory, or creating a scrapbook of cherished moments. These acts can help you maintain a connection and find meaning amidst the grief.

Coping strategies take time and patience, so be gentle with yourself as you explore what works best for you. Remember, finding healthy ways to cope with grief can lead to gradual healing and a sense of peace as you move forward.

Staying Connected with Family and Friends

Family plays an integral role during bereavement. Spend more time with people who can provide comfort and understanding. Share stories, reminisce about memories, and allow yourself to feel supported. Family members often experience grief in different ways, so accepting that everyone may not cope in the same manner is critical. Whether it’s a hug from a friend or a moment of shared silence, these connections can bring moments of healing during a difficult time.

Conclusion

Grief and loss are inevitable, and while the journey is filled with emotions, healing is possible. By accepting support, taking care of your mental and physical health, and allowing yourself to grieve in your own time, you can navigate this difficult path. Remember, there’s no wrong way to grieve; there are only ways that either help you heal or hinder your progress. Choose compassion, support, and understanding—both from yourself and those around you—to build a future that honors your loved one’s memory and allows you to find your way forward.

Climate Change Exposure Associated with Increased Emergency Imaging

Using data collected over a 10-year period from four emergency departments, researchers at the University of Toronto found that short-term exposure to ambient heat and air pollution levels was associated with increased utilization of X-rays and computed tomography (CT). Results of the study were published today in Radiology, a journal of the Radiological Society of North America (RSNA).

“Extreme climate exposures are associated with higher demand for health care including emergency department visits,” said Kate Hanneman, M.D., M.P.H., vice chair and associate professor at the University of Toronto, Department of Medical Imaging, and deputy lead of sustainability at the Joint Department of Medical Imaging at Toronto General Hospital. “However, the impact of climate-related environmental exposure on medical imaging utilization is currently unknown.”

In the retrospective study, the research team analyzed the association between daily imaging utilization counts at four emergency departments in academic hospitals in Toronto, Canada, and local daily ambient environmental data between 2013 and 2022. A time-stratified, case-crossover design was used to control for seasonality, time trends, influence by day of the week, and covariates including age, sex, race and behavioral risk factors.

For the purposes of the study, high heat was defined as a mean ambient temperature greater than 68 degrees Fahrenheit. A high level of air pollution was defined as the presence of fine particulate matter (PM2.5) at levels greater than 12 μg/m3.

Over the study period, 1,666,420 medical imaging exams were performed in the four emergency departments with a mean of 428 exams daily. The mean for daily emergency department visits was 659. The average mean daily ambient temperature was 48.2 degrees (range, -7°F to 85°F), and the mean daily ambient particulate matter was 7.9 μg/m3.

The researchers found that short-term (fewer than seven days) exposures to higher ambient (outdoor) heat and higher PM2.5 air pollution were associated with overall increases in imaging utilization (5.1% and 4.0%, respectively). High heat exposure days and high air pollution exposure days were associated with excess absolute risk of 5.5 and 6.4 imaging studies per 1 million people at risk per day, respectively.

“While the individual daily effects we observed are modest, the cumulative increase in total imaging volumes is substantial,” Dr. Hanneman said.

Over the study period, there were 602 high-heat exposure days and 552 unhealthy high air pollution days. High heat exposure increased by 0.6% (2.2 days) per year while high PM2.5 days decreased by 0.4% (1.3 days) per year over the study period.

“This is consistent with overall improved air quality in Canada and the U.S. over the last two decades attributed to policies aimed at regulating air pollution and the phasing out of coal plants in Ontario,” Dr. Hanneman said. “Despite the decrease in high air pollution days, PM2.5 remains a health threat.”

Heat and air pollution were associated with increased utilization of X-rays and CT, but not ultrasound or MR. High temperatures had a greater effect on X-ray utilization, while high PM2.5 levels were associated with higher CT utilization. Both environmental exposures were associated with increased utilization of chest, neuro and musculoskeletal imaging.

Increased imaging utilization associated with ambient heat was a function of higher emergency department visits, whereas increased utilization related to high PM2.5 levels was a function of both increased patient volumes and increased per-patient imaging.

Dr. Hanneman said data from the study may help radiology departments prepare for and build resiliency to the current and future impacts of climate change.

“As global temperatures continue to rise, the frequency and severity of heat waves and extreme weather events are expected to increase,” she said. “Knowing the impact on our departments will allow us to plan proactively.”

The research was supported by an RSNA Research & Education Foundation Emerging Issues Grant.

 

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