Newsdesk

Nose controlled wheelchair helps severely paralysed patients get mobile

2010-07-30T07:51:00Z

Researchers from the Weizmann Institute’s Neurobiology department have created a device that could let severely disabled patients control wheelchairs or communicate by inhaling and exhaling through the nose. The new system detects changes in air pressure in the nostrils, and translates these into electrical signals. Essentially, the nose becomes an input mechanism, where devices can be controlled by sniffing.

The researchers, Prof. Noam Sobel, Dr. Anton Plotkin and Aharon Weissbrod and Lee Sela, tested the technology on both healthy volunteers and patients with severely limited movement skills. The discovered that people were quick to master the control method. In one test, the participants were told to navigate a wheelchair around a complex path. Two successive sniffs in made the chair go forward, two out made it reverse. To turn left, volunteers sniff out then in, and to turn right they sniff in then out. After around 15 minutes, a patient paralysed below the neck was able to navigate the course, including making sharp turns.

Participants also used the system to play video games, achieving a level of control that compared favourably to a joystick or a mouse.

The research team also tested the technology’s potential as a communication device. Paralysed patients were able communicate with family members, and initiate communication themselves. Professor Sobel says: “Some wrote poignant messages to their loved ones, sharing with them, for the first time in a very long time, their thoughts and feelings.” The technology has many other applications, which could help medical professionals. For example Sobel believes sniff-control could be used in surgery, giving surgeons a ‘third arm’.

FDA approves blood test for newborns

2010-07-30T07:46:00Z

The first few days of a baby’s life are crucial for its development. They are also dangerous. As foetal red blood cells are broken down, infants produce increased amounts of the toxin bilirubin. In many cases, more of this toxin is created than the liver can remove, so it remains in the blood. This commonly leads to jaundice, but in some cases the jaundice progresses – first to severe hyperbilirubinemia, and then to kernicterus, an irreversible brain injury.

The American Academy of Pediatrics recommends that a risk-assessment for bilirubin be performed on every newborn. Traditionally, it can take hours for the results of these tests to come back, but a new test from Instrumentation Laboratory, a manufacturer of in vitro diagnostic instruments, could get things moving faster.

This week, the company announced that it has received clearance from the U.S. Food and Drugs Administration to market the first ever rapid blood test to measure bilirubin in newborns. The total bilirubin assay is performed on the company’s GEM Premier 4000 critical care analyzer, and gives doctors test results in 90 seconds from whole blood, while still in the Neonatal Intensive Care Unit.

"Over the past decade, kernicterus has re-emerged, due to a variety of factors," said Anthony Napolitano, M.D., Neonatal/Pediatric Transport Program at All Children's Hospital, St. Petersburg. “The ability to assess bilirubin in the NICU with accuracy and precision is a tremendous advantage and has the potential to prevent this absolutely devastating outcome and reduce hospital readmissions.”

Google Wave Makes Pitch for Health Records

2010-07-29T10:18:00Z

It was only a matter of time before Google positioned Wave for electronic healthcare record management, and now two of its engineers, Shirley Gaw and Umesh Shankar, have done just that. In a recent paper, to be presented at USENIX HealthSec '10, part of the 19th USENIX Security Symposium, which runs from August 11-13, 2010, they argue that many of the features built into Wave could support existing protocols.

The authors admit that their document is meant to be 'thought-provoking', but it does appear to answer some of the issues that currently slow down take up or deployment of digital records. Here's a quick summary of their main points about how Wave could help:

However many times the record is updated, the most recent version is always well defined, irrespective of the number of authors and how often they communicate. This "fits well with the distributed electronic health record model."
"The merging of health records maps to the collaborative document editing problem". So Wave's framework for aggregating and managing the actions of many writers makes "data provenance much easier to document and implement in real systems."
The play back feature, which enables an end user to review amends and additions in the order in which they appeared, is also useful according to the authors. This means that you can always check who contributed to the record at every step - vital with so many parties contributing to the same document.
"Federation allows different authoritative providers, so both tech companies and HMOs can start offering this right away, while preserving integrity by deciding who else to trust."
It is aligned with existing protocols including CCR and CCD. "Wave understands XML tags, so existing formats---at a fine enough granularity---can be largely reused. You can continue to source from any underlying data store, but Wave changes the model for the 'system view' of a record and offers the opportunity to review snapshots of the record along a timeline and monitor the evolution of the record.

The authors also admit that this approach would require patients and other stakeholders to be more relaxed about data privacy. One of the fundamental features of Wave is that all contributing providers can see the record history. Healthcare providers can also edit data sent from other providers although the authors argue that this enables a doctor offering a second opinion, for example, to update earlier diagnoses.

iPAD frog dissection app is a leap forward for students

2010-07-29T09:01:00Z

Here's a neat and simple way to introduce children or younger students to medicine. Frog Dissection for iPAD introduces the basics of medical dissection taking full advantage of the iPAD's large colour screen and touchpad. Using the app, which was developed by Emantras, students can choose from dissection instruments including pins, scalpel, marker, and forceps. Following simple instructions, the end-users learns the basics of dissection. They can also 'remove' organs for a 3D view and further information on the role of the liver, for example.

Here's a video with an overview of the application in use.

(Please visit the site to view this media)

Frog Dissection is available for U.S.$4.99 from iTunes

Samsung and Verizon launch mobile phone for seniors

2010-07-27T16:19:00Z

In 1902, a farmer in Murray, Kentucky patented a design for a wireless telephone. Nathan Stubblefield’s device was the size of a dustbin lid and had a range of just half a mile, but it was nevertheless the first of a kind. Faster, smaller and multi-functional, today’s models are far removed from their prototype, but for the older population, the benefits of the modern mobile are not always accessible.

Recognising this, Verizon Wireless and Samsung have partnered to produce the Samsung Haven – a handset designed for senior citizens. The Haven has a traditional keypad, rather than a touchscreen, making it easier to operate. Number keys are large, and the 2.2 inch (5.5 cm) display can be customized to a range of font sizes. End users can also prompt the device using voice commands. It also has one-touch access to emergency services, so that users do not have to navigate a series of menus when they need help quickly. Meanwhile, an ‘In Case of Emergency’ (ICE) button ensures rapid access to emergency contacts in event of an emergency.

The Haven also includes a number of lifestyle features that may appeal to older users, including:

· A fitness trainer that offers 15 unique stretching techniques

· Music selections aimed at stress relief

· A medical information application for making medical notes and storing information such as allergies and medications

The phone will be available from July 29th 2010, and will cost U.S.$39.99 with a two year customer agreement.

Vertigo sufferers tip their hats to new treatment

2010-07-27T14:27:00Z

A new treatment is now available for sufferers of benign paroxysmal positional vertigo (BPPV), also known as spinning dizziness. DizzyFIX from Clearwater Clinical enables people to treat BPPV - the most common cause of vertigo - at home.

BPPV develops when calcium carbonate crystals, known as otoconia, pass into and become trapped within the semicircular canals of the inner ear. As the person’s head position changes, the otoconia roll around, stimulating the tiny hairs in the ear and causing vertigo.

The DizzyFIX device is a special fluid-filled tube which attaches to the tip of a baseball hat. The device contains a small particle which the user guides through the tube by tilting his or her head, thus performing the particle repositioning exercise known as the Epley manoeuvre. The particle passing through the tube represents the path of the otoconia in the ear, so by moving the head in this motion, the user shifts the otoconia from the canals. Using DizzyFIX, patients can effectively treat their BPPV in minutes without needing to make frequent visits to a doctor or therapist.

Results from a new University of Western Ontario study reveal that the device is highly effective in quickly treating recurrent episodes in most patients.

Internet can help you lose weight says study

2010-07-27T13:21:00Z

A new study has shown that the internet can be a valuable slimming aid. The findings, which stem from one of the longest weight loss trials in U.S history, showed that people who used a weight management website achieved the most success in keeping off the pounds.

More than 1,600 people took part in the trial, which was funded by the National Institutes of Health. They had to lose weight in the first six months by attending weekly group meetings at which they were weighed and encouraged to keep food diaries. Those who lost at least nine pounds remained in the weight loss maintenance phase, where they were divided into three groups. One group had no support, one had monthly contact with a personal health coach, and one group was given unlimited access to a weight maintenance website created for the trial.

The group with website access, which had lost an average of 19 pounds per person, were encouraged to log on at least once a week. They were prompted to record their weight, their minutes of exercise, and the number of days they kept food diaries. Consistent users who recorded their weight at least once a month for 24 months maintained the greatest weight reduction - keeping off an average of nine of the 19 pounds they'd originally shed. Those who logged on less consistently - at least once a month for 14 months - kept off an average of five pounds. Those who logged on less than that kept off an average of only three pounds of their original weight loss.

“This study shows that if people use quality weight management websites consistently, and if they stick with their program, they are more likely to keep their weight off,” says study co-author Victor J. Stevens, PhD, co-author and senior investigator at the Kaiser Permanente Center for Health Research.

Video game graphics processors cut X-ray radiation

2010-07-26T18:05:00Z

Video games are pretty these days. Dedicated graphics processors generate richly detailed, high resolution environments. But now scientists are using these high-power video processors for more than merely blasting foes on Modern Warfare 2.

A team of researchers at the University of California, San Diego has used the technology to develop a new technique for processing X-rays. This method apparently reduces the radiation that patients are exposed to during cone beam computed tomography (CBCT) and has the potential to revolutionise cancer treatment.

CBCT scans are a key part of image-guided radiation therapy (IGRT). Patients undertaking a course of radiation therapy receive repeated scans, so that doctors can pinpoint and target tumours, minimising radiation damage to the surrounding tissue. It’s proving effective, but many physicians are concerned about the effects of cumulative radiation from all the CBCT activity.

The research team wanted to reduce this dose of radiation. Turning down the X-ray generator pulse rate, pulse duration, and during a CT scan, leads to mathematically incomplete data, which took hours to process, so this was not a viable approach.

The team developed a CT reconstruction algorithm for graphics processing units – the processors used largely for gaming. The increased computational efficiency was sufficient to reconstruct a CBCT scan in around two minutes.

The average X-ray scanning protocol uses approximately 360 projections. According to the researchers, the new method uses between 20 and 40 projections, each with a lower radiation level. As a result, the patient is exposed to between 36 and 72 times less radiation during a scan.

These results of this study are being presented this week at the American Association of Physicists in Medicine's 52nd annual meeting in Philadelphia. The researchers hopes the findings will ultimately lead to GPU technology being used for more than video games and cancer treatment.

“For each year's use of today's scanning technology, the resulting cancers could cause about 14,500 deaths. Our work, when extended from cancer radiotherapy to general diagnostic imaging, may provide a unique solution to solve this problem by reducing the CT dose per scan,” says Steve Jiang, senior author of the study.

Championship software could signal the end of antibiotic resistant bacterium

2010-07-26T16:54:00Z

Scientists at North Carolina’s Duke University have developed predictive software with the aim of beating antibiotic-resistant mutations. The software works much the same way as a champion chess player does when analyzing their opponent’s moves.

The team from Duke collaborated with a group of researchers led by Amy Anderson at the University of Connecticut. They built on Duke’s existing computer program for designing enzyme structures to create an algorithm for uncovering the potential ‘moves’, or the mutations of fast-moving bugs, such as MRSA. The algorithm features a ‘dead-end elimination’ feature that can process all of the possible chemical interactions to sort through outcomes that would not work well for the bacterium.

“This work shows a way to predict bacterial resistance to antibiotics under development, before research progresses and tests of the antibiotics begin in people, and even before doing laboratory procedures to explore potential resistance,” says Bruce Donald, the William and Sue Gross Professor of Computer Science and Biochemistry at Duke University.

Donald points out that the process for redesigning a drug once bacteria has become resistant is very expensive and labour-intensive, yet some bacteria constantly evade antibiotic efficacy—evolving mutations to change the shape of the active site of their enzymes. “We used our algorithm to find mutation candidates that satisfy both a positive design—structures that still allow the bacterial enzyme to do its work—and also negative design—they block the ability of a brand new antibiotic drug to do its job,” says Donald. “The protein-design algorithms that predict mutations could be used in a drug-design strategy against any pathogen target that could gain resistance through mutation,” he says.

Cancer study finds telecare reduces pain and depression

2010-07-23T16:21:00Z

Cancer patients experience many symptoms, but pain and depression are two of the most prevalent. Unfortunately, it’s all too easy for them to go unrecognised and untreated, especially if the patients are in rural or hard to reach locations. But a team of researchers in Indiana, US, suggests that there is a way for patients to manage the disease more effectively – telecare.

The scientists have published the results of a year-long clinical trial in the Journal of the American Medical Association (JAMA). The Indiana Cancer Pain and Depression (INCPAD) trial examined how a collaborative telecare approach could help cancer sufferers manage their disease. 405 patients from 15 oncology practices completed a questionnaire about pain and depression. The participants were then split into two groups at random. 203 received standard care. The other 202 had access to telecare.

The patients with telecare worked with a primary care physician and nurse team. The participants reported their symptoms electronically, either by telephone voice recording or over the Internet. They also received direct phone calls from the nurse, who provided information about symptoms, encouraged them to stick to their treatments, and assessed symptom response to medication.

Depression and pain symptoms were evaluated at the beginning of the trial, and at the three, six and 12 month points. At the end of the trial, researchers discovered that the patients in the telecare group experienced a 30 percent or greater reduction in pain and a 50 percent or greater reduction in depression compared to those receiving regular treatment. Doctors were also able to provide patients with better quality care, without increasing their own workloads.

Blood test could identify depression

2010-07-23T13:22:00Z

Although blood tests are a tried and trusted way for doctors to diagnose patients’ physical ailments, they’re not much use when identifying mental disorders such as depression. But an article published in Biological Psychiatry (Volume 68, Issue 2, July 15 2010) suggests that this could change.

A team of Dutch researchers affiliated with VU University in Amsterdam and Leiden University Medical Centre, has conducted a study into depression, using gene expression profiling, which measures RNA levels produced from DNA as an indication of the activity levels of particular genes. The scientists examined blood gene expression profiles in healthy individuals and patients diagnosed with major depressive disorder (MDD). The team identified a set of seven genes in blood, which distinguished un-medicated MDD patients from the healthy control group.

The researchers hope that the findings will eventually lead to blood tests that can identify depression in patients. Indeed, a physical test would offer a number of advantages over psychiatric diagnosis. Blood tests could reduce the chance of bias during diagnosis. It would be particularly useful for medical professionals who are treating a patient unwilling or unable to communicate clearly. The tests could also reduce the stigma that can come with mental health problems.

As well diagnosing depression, the scientists hope the study is a step towards identifying markers to predict treatment outcome and recurrence.

The findings are fascinating. But, as Dr John Krystal, Editor of Biological Psychiatry is keen to point out, more research is needed before solid conclusions can be drawn. He says: “It is far too early to be confident that gene expression profiling will lead us to diagnostic or prognostic tests for depression... In the past, many types of tests have been explored as potential diagnostic markers, but they all have failed to have sufficient sensitivity and specificity to guide doctors in making psychiatric diagnoses or choosing between treatments. I look forward to seeing whether the patterns of gene expression profiling are replicable and diagnostically specific as multiple groups report their findings.”

Will thought-controlled prosthetic arm get thumbs up?

2010-07-23T10:23:00Z

Scientists in America are getting ready to test a new type of artificial arm – one that is controlled by a patient’s mind. The scientists hope that the handy prosthetic will give patients greater control over their arm movements, and make it easier to perform everyday tasks, such as picking up and holding a cup of coffee.

The Modular Prosthetic Limb (MPL) is controlled by micro-arrays implanted into the brain. These record signals and transmit them to the device. Essentially, the patient’s thoughts control the arm. The prosthetic limb weighs around nine pounds, which is approximately the same as a standard human arm. It has 22 degrees of motion, and each finger can be moved independently. It also provides the patient with feedback, simulating a sense of touch.

The research is backed by the Defense Advanced Research Projects Agency (DARPA), the research and development division of the Pentagon. Much of the progress can be attributed to a team from John Hopkins University in Baltimore, U.S. That team has just received a U.S.$34.5 m contract to test and further develop the arms. Over the next two years, researchers plan to test the prosthetic in five patients.

Other scientists, at the University of Pittsburgh, University of Utah and the University of Chicago, also hope to improve the limb by incorporating pressure and touch.

The MPL sounds promising, but according to Wired, there is a potential flaw. DARPA recently started a new initiative to overcome some fundamental problems with the technology. For example, the neural recording devices in the brain only have a two-year lifespan. Still, if this problem can be overcome, the MPL could revolutionise treatment for patients with missing limbs.

3D heart scans could help heart patients avoid surgery

2010-07-22T09:48:00Z

People with heart problems could avoid surgery in the future thanks to a new technique for creating 3D images of the organ. Using the technology, which has been developed at Southampton General Hospital in the UK, doctors get a 3D image of an echocardiography test, which creates a moving image of a patient’s heart. They can then slice up the 3D image to gain a clear picture of what’s actually going on inside the organ.

Consultant congenital cardiologist Dr Joseph Vettukattil, who pioneered the technology known as multiplane review (MPR) 3D echocardiography, now hopes the system will replace traditional scans. He says: “The 2D images show pictures of the heart in two planes, so it just takes one slice of the heart and, because it has not been easy to know without doubt what the problem is, surgeons have often had to perform exploratory operations as well. “Now, though, we are able to visualise even more than a surgeon can during an operation, minimising the need for additional and invasive assessments.”

Vettukattil, who is a children’s heart specialist, believes that the technique could eventually replace magnetic resonance imaging for most aspects of cardiac imaging. He says: "You can chop the heart into small pieces and see what is wrong and exactly where it is wrong on the screen. By using MPR, because you are slicing and seeing it in three different planes, you can get a clear understanding of a patient - especially in a child whose heart is congenitally malformed.”

Look, but don’t touch says maker of new non-contact thermometer

2010-07-21T19:21:00Z

Traditionally, the only way to take a patient's temperature is to insert the thermometer into the body. But medical device manufacturer Sanomedics has a less invasive way to get the information: non-contact thermometers.

The Florida-based company has unveiled the technology at the National Association of County and City Health Officials Annual Conference in Tennessee, United States (U.S.). The company claims the devices can take temperature readings without any intrusive body contact, such as probes or strips. The thermometer is held two inches away from a patient’s skin – either the forehead or behind the ear. Readings are displayed on the front of the device within seconds.

The non-contact thermometer is available for professionals, home use, and for dogs. The company believes that the professional version offers doctors tremendous advantages over standard thermometers because the thermometers do not make contact with the skin and so reduce the chance of disease spreading between patients. The device also stores 34 measurements, which can help a doctor track a patient’s progress and identify trends.

According to Craig Sizer, Co-Founder and Chairman of Sanomedics, the thermometer will “have a positive impact on the way in which public health departments nationwide deliver medical care anywhere in the field, whether in clinics, patient’s homes or at the scene of a public health emergency. The ability to accurately and swiftly assess the potential presence of illness is invaluable.”

It’s an intriguing device, and it will be interesting to see if medical professionals take to the technology.

New tissue scaffolds support off-the-shelf transplants

2010-07-21T17:14:00Z

A technique for creating biological scaffolds should make it quicker and easier to perform transplants. Researchers at the University of Leeds in the UK, have found a way to build the scaffolds from human or animal tissue, and then use them for repairing arteries, tendons, ligaments, and even heart valves.

John Fisher, a Professor at the University of Leeds says: “If you take a natural tissue and strip off all of the donor's cells you're left with a biological scaffold made mostly of a protein called collagen, which is compatible with the patient receiving the scaffold.

“That scaffold is good from an engineering perspective because it's strong, flexible and retains the properties of the natural tissue. It also has the appropriate shape and size, and from a biological perspective is good because a patient's cells can bind to it and repopulate it easily.”

The technique should overcome the long-term challenge of the body rejecting “living” organs. Currently, organs such as heart valves from pigs, which have been used in human transplants for many years, are chemically treated and strengthened to avoid rejection. However, the process leaves them lifeless and inert, so that they degrade over time and need replacing.

Professor Fisher says: “These new biological scaffolds will provide off-the-shelf tissues for surgeons for repairing blood vessels after surgery for blocked arteries, for repairing meniscus after sporting injuries and cartilage tears, for repairing torn ligaments or tendons, and for heart valve repair or replacement.”