Friday, February 5, 2010
The 2009 Medical Weblog Awards: The Polls Are Open
Filed under: Medgadget Exclusive
The polls are now open in the Epocrates sponsored Sixth Annual Medical Weblog Awards.
Gary Schwitzer's HealthNewsReview Blog
Musings of a Distractible Mind
Please vote here...
Academic Life in Emergency Medicine
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Literature, Arts and Medicine Blog
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Australian Health Information Technology
Please vote here...
technical right below elbow amputee issues
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The 2009 Medical Weblog Awards are proudly sponsored by Epocrates.
The 2009 Medical Weblog Awards announcement...
The 2009 Medical Weblog Awards Nominees...
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Under Works: Brain-Computer Interface X Prize
Filed under:
The X Prize Foundation recently announced that it's working on a new contest that will be offering $10 million to the winner to develop a breakthrough in brain-to-computer interface (BCI) technology. If the foundation comes up with adequate financing, it will be the same amount of buckaroos that they've been giving for advancements in commercial passenger space craft, automotive technology, DNA sequencing, and lunar travel. Although such BCI devices already kinda exist, they are functionally limited and don't lend themselves well to practical, especially clinical use. It is not yet known what the requirements of the Brain-Computer Interface X PRIZE will be, but considering the prize amount it should spur development in the field.
Here's a half hour video of Ray Kurzweil discussing the status and future of brain related technologies from the recent Singularity University sponsored workshop at MIT, where the idea for the BCI X Prize was presented.
Link: BCI X PRIZE - Igniting a Brain-Computer Interface Revolution...
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St. Jude Medical Gets Go Ahead for New Implantable Cardiac Devices
Filed under: Cardiac Surgery
, Cardiology
St. Jude Medical has received the European CE Mark of approval for the Fortify and Fortify ST implantable cardioverter defibrillators (ICD) and Unify cardiac resynchronization therapy defibrillator. The devices are smaller and can deliver a stronger punch than previous generation models, and they feature new heart monitoring algorithms.
These devices feature 40J of delivered energy (45J stored) - the highest energy level available in the industry - helping to ensure that therapy will be successful for those patients who require a higher energy shock for defibrillation.Because of the devices' narrower shape, physicians can implant them using a shorter incision, leading to less time spent closing the incision and a smaller scar for the patient. The company's SJ4 lead connector system further streamlines the procedure by reducing the number of connections between the defibrillation lead and the device, which can improve patient comfort by reducing the bulk of wires in the patient's chest.
The Unify CRT-D and Fortify ICD also incorporate the new CorVue(TM) pulmonary congestion monitoring algorithm. This new feature alerts physicians when a patient's heart failure may be worsening, as evidenced by changes in electrical signals that can be correlated to increased congestion, or fluid retention, in the chest area. The algorithm continuously monitors fluid retention in multiple vectors, providing an accurate diagnostic and an alert designed to minimize false positives.
Both devices also have features that are designed to assist in the reduction of unnecessary shocks, including painless anti-tachycardia pacing, which can be used for fast ventricular arrhythmias prior to or while the device is preparing to deliver shock therapy, and other enhanced technology for reducing inappropriate therapy.
In addition to the family-wide features of the Unify and Fortify devices, the Fortify ST ICD features St. Jude Medical's first-to-market ST segment monitoring diagnostic algorithm, which can add important information to assist in medical decision making and accelerate patient care. The Fortify ST ICD continuously monitors for specific changes in the ST segment of the electrocardiogram that can indicate the onset of serious conditions such as ischemia.
Press release: St. Jude Medical Announces European Approval of Smaller, Higher Power ICD and CRT-D Devices with New Heart Failure Monitors
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Nanoparticles Create Tiny Explosions to Destroy Cancer Cells
Filed under: Nanomedicine
New cancer targeting nanoparticles seem like daily news here at Medgadget. Today we have gold nanoparticles developed jointly by researchers at Rice University and A.V. Lykov Heat and Mass Transfer Institute in Minsk, Belarus that create plasmonic nanobubbles when targeted with a laser. These particles can be guided to a tumor by antibodies and then activated to generate tiny explosions, so clinicians one day will be able to stay back and enjoy.
The short-lived bubbles are very bright and can be made smaller or larger by varying the power of the laser. Because they are visible under a microscope, nanobubbles can be used to either diagnose sick cells or to track the explosions that are destroying them.In laboratory studies published last year, Dmitri Lapotko and colleagues at the Laboratory for Laser Cytotechnologies at the A.V. Lykov Heat and Mass Transfer Institute in Minsk, Belarus, applied nanobubbles to arterial plaque. They found that they could blast right through the deposits that block arteries.
In the current study, Lapotko and Rice colleague Jason Hafner, associate professor of physics and astronomy and of chemistry, tested the approach on leukemia cells and cells from head and neck cancers. They attached antibodies to the nanoparticles so they would target only the cancer cells, and they found the technique was effective at locating and killing the cancer cells.
Lapotko said the nanobubble technology could be used for "theranostics," a single process that combines diagnosis and therapy. In addition, because the cell-bursting nanobubbles also show up on microscopes in real time, Lapotko said the technique can be used for post-therapeutic assessment, or what physicians often refer to as "guidance."
Press release: Rice physicists kill cancer with 'nanobubbles'
More at Nanowerk: Plasmonic nanobubbles combine diagnosis and treatment in one theranostic method...
Abstract in Nanotechnology: Tunable plasmonic nanobubbles for cell theranostics
Image: Ajda Gregorcic
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"Artificial Pancreas" Using Available Commercial Technology Shows Promise
Filed under: in the news...
Clinical researchers at Cambridge University have been testing the effectiveness of combining commercial continuous glucose monitors with insulin pumps via a proprietary closed-loop algorithm developed by the researchers.. The study, performed on type 1 diabetic pediatric patients using pumps and meters from Smiths Medical, Medtronic, and Abbott, has demonstrated a significant overnight glucose management improvement over continuous drip pumps.
In the new study, 17 children and teenagers aged between 5 and 18 with type 1 diabetes were studied during 54 nights at Addenbrooke's Hospital. The team measured how well the artificial pancreas system controlled glucose levels compared with the children's regular continuous subcutaneous insulin infusion (CSII) pump, which delivers insulin at preselected rates.The study included nights when the children went to bed after eating a large evening meal or having done early evening exercise. Both are challenging to manage, a large evening meal because it can lead to so-called "insulin stacking" and, as a result, a potentially dangerous drop in blood glucose levels later in the night, and late afternoon or early evening exercise because it increases the body's need for glucose in the early morning and can therefore increase the risk of night time hypoglycaemia.
The pooled results showed the artificial pancreas kept blood glucose levels in the normal range for 60% of the time, compared with 40% for the CSII. The artificial pancreas halved the time that blood glucose levels fell below 3.9mmol/l - the level considered as mild hypoglycaemia. It also prevented blood glucose falling below 3.0mmol/l, which is defined as significant hypoglycaemia, compared with nine hypoglycaemia events in the control studies.
More from the study abstract in The Lancet: Manual closed-loop insulin delivery in children and adolescents with type 1 diabetes: a phase 2 randomised crossover trial
Press release: 'Artificial pancreas' a step nearer for children with type 1 diabetes
Image: Medtronic's Paradigm Veo Wireless Insulin Pump Helps Prevent Hypoglycemia
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New Malaria Vaccine Passes Initial Clinical Trial
Filed under: in the news...
An internationalist team of researchers has just successfully finished the first human trials of a new malaria vaccine. Tested on 100 West African children susceptible to malaria, the trial showed a high level of relevant antibodies a year after the vaccine was administered.
From a Howard Hughes Medical Institute press release:
Plowe [Christopher V. Plowe, MD, MPH, a professor of medicine at the University of Maryland School of Medicine] and a group of U.S. and Belgian collaborators from the Walter Reed Army Institute of Research, USAID and GlaxoSmithKline Biologicals have been developing and testing the vaccine with a large team of researchers led by Professors Ogobara K. Doumbo and Mahamadou A. Thera at the University of Bamako in Mali.Plowe and his colleagues tested a vaccine that targets a molecule on the malaria parasite known as apical membrane antigen 1 (AMA1). The molecule sits on the surface of the merozoite form of the parasite and helps it invade red blood cells. The human immune system recognizes the presence of AMA1 molecules and generates antibodies that prevent invasion of red blood cells by the merozoites. But the body generates antibodies only after repeated exposure to malaria. If researchers could develop a vaccine that primes the immune system to recognize AMA1 before malaria infection occurs, it would be a major advance in the effort to control and eventually eradicate the disease.
In the trial, 100 healthy Malian children received either the vaccine or, as a control, a rabies vaccine. Some of the children experienced temporary pain and swelling at the site of the injections, but the effects were generally "well-tolerated," according to Plowe.
Prior to receiving the vaccine, the children in the trial had only low levels of antibodies against AMA1 in their blood. Those antibody levels increased more than 100-fold in the children receiving the malaria vaccine and remained high during a year of follow-up blood tests.
Based on its safety profile and strong immune response, Plowe and his U.S. and Malian collaborators are now testing the vaccine in 400 children. The results of the larger trial will shed light on a key uncertainty surrounding malaria vaccines. The AMA1 molecule occurs in many different forms both within Africa and around the world, and a vaccine against some forms of the molecule may not protect against other forms.
More: New Vaccine Shows Promise Against Malaria in Early-Stage Study...
Full paper in PLoS ONE: Safety and Immunogenicity of an AMA1 Malaria Vaccine in Malian Children: Results of a Phase 1 Randomized Controlled Trial
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Ins and Outs
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Thursday, February 4, 2010
ReShape Inflatable Gastric Balloon Going on Trial as Weight Loss Option
Filed under: GI
Here's the latest report from the obesity epidemic front. The Orange County Register is reporting that clinical trials are soon to begin on the intragastric balloon developed by ReShape Medical out of San Clemente, CA. The device, already approved in Europe, is inserted endoscopically using the ReShape delivery system into the stomach and then inflated with normal saline, effectively reducing the capacity and will of the patient to intake and digest food. Unlike gastric banding, the procedure is done on an outpatient basis and the device can be easily removed at a later time.
From the product page:
The delivery system is a long insertion catheter with the deflated balloons attached to the end. The balloons are inserted through the mouth, and filled with saline once it is placed in the stomach. The ReShape intragastric balloon is designed to fit comfortably in the stomach while maximally filling the stomach area.The ReShape intragastric balloon is comprised of two balloons attached to each other by a flexible tube. Each balloon has independent channels so that unintentional leaks or deflation in one balloon are designed not to impact the other balloon. The device is used in conjunction with diet and exercise.
OC Register: Doctors to study stomach balloon for weight loss...
Product page: ReShape intragastric balloon...
Flashbacks: EndoBarrier, an Internal Condom, Gets Positive Results in Diabetic Clinical Trial ; EndoBarrier Bypasses Gastric Bypass for Obesity, Diabetes Treatment
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Technology Behind Second Sight Retinal Prosthesis
Filed under: Ophthalmology
Lawrence Livermore National Lab (LLNL) is touting its role in the development of the 60 electrode artificial retinal prosthesis, now being trialed by Second Sight of Sylmar, CA. The device is manufactured in batches of 12 on specialty developed wafers. LLNL produced a fascinating video showing their lab that is working on the prosthesis.
Researchers at Lawrence Livermore are today using advanced polymer-based micro-fabrication methods to further develop a biocompatible microelectrode array for the third-generation artificial retina device.The LLNL team contributes three major components to the artificial retina: the thin-film electrode array that contains the neural electrodes; the biocompatible electronics package that contains the electronics for stimulating the retina and wireless power and communications; and an ocular surgical tool that will enable the insertion, attachment, and re-insertion of the thin-film electrode array.
The second-generation device represents a substantial performance improvement over the first-generation device in speed of recognition and resolution. Objects can now be recognized within 2-3 seconds instead of the previous 15, and the device’s 60 electrodes have improved image resolution over the 16-electrode prosthesis.
The prosthesis is now of sufficient resolution to allow recognition of doors, windows, edges, low-lying branches and a basketball backboard. The goal of the DOE project is to produce a prosthesis with more than 1,000 electrodes, which would allow facial recognition.
Expertise in biomedical microsystems at Lawrence Livermore’s Center for Nano- and Microtechnology was tapped to develop a “flexible microelectrode array,” able to conform to the curved shape of the retina, without damaging the delicate retinal tissue, and to integrate electronics developed by University of California at Santa Cruz. The device serves as the interface between an electronic imaging system and the human eye, directly stimulating neurons via thin film conducting traces and electroplated electrodes.
Link: Lab plays key role in Department of Energy's artificial retina project...
Flashbacks: Second Sight Medical Retinal Prosthesis Receives FDA Approval for Clinical Trials; Second Sight Medical Retinal Prosthesis to Receive a Wider Trial
LLNL video of wafer manufacturing after the fold (direct link to Quicktime video file):
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