We rarely delve into politics. But if we must, Independence Day is probably a good occasion.

So over coffee and a brioche, we were reading Health Care Stories for America @ BarackObama.com. There we noticed an interesting pattern: scolding of health insurance companies is on at full steam, but no one wants to talk about the elephant in the room: Medicare. And that's where the real health care dollars are being sucked in, like into a giant black hole.

Don't believe our independent Medgadget team of doctors? Ask practically any other physician, and he or she will tell you about real horrors. How about stories where hundreds of thousands of dollars are spend on each patient that has practically hit the wall? How about pacemakers and AICDs on 90 year olds with Alzheimer's, Parkinson's or stroke? How about interventional radiology procedures, where a terminal elderly patient becomes a cushion pad for physicians? How about CAT scans, MRIs, leg bypasses, peripheral catheters, exploratory laparotomies, and hundreds of lab tests that are done every day, that often prolong more suffering than life?

We understand that there are many problems in healthcare when it comes to younger patients. We know that people lose jobs, have prior conditions, and as a result they end up losing their insurance coverage. We also understand there are abuses in the health insurance industry. But the real bulk of the societal problems is not with the people under 60, but with older patients. In other words, with Medicare. And when families, who don't have to co-pay for any medical services, are being asked to estimate the risk/benefits ratios of going ahead with a treatment, the hope itself forces them to go "all in." And that is how the tax payer's money are being spent nowadays. For all the talk over at the Health Care Stories for America, there is indeed little substance but lots of fear. And that is from the administration that has promised us hope.

And, finally, the real question. Why does the President and his team use the wrong symbol of Caduceus for his health care initiative? As we noted before, the Staff of Asclepius should be a single serpent encircling a staff, and no wings and no snake families, please. We hope you have a nice Independence Day!

:: Comments left behind ::

W. L. Gore & Associates just received FDA's OK to market an updated version of the firm's GORE VIABAHN® Endoprosthesis indicated for "improving blood flow in patients with symptomatic peripheral arterial disease in superficial femoral artery lesions with reference diameters ranging from 4.0 - 7.5 mm [and] in iliac artery lesions with reference vessel diameters from 4.0 – 12 mm"

The modification is a result of the precision laser trimming technology which enables the removal of excess material at the device margin, resulting in a contoured edge. The device is the only stent-graft approved by the FDA for the treatment of patients suffering from Peripheral Arterial Disease (PAD) in superficial femoral artery (SFA) lesions and iliac artery lesions. In the US alone, as many as 12 million people suffer from PAD.

The GORE VIABAHN Endoprosthesis is constructed with a durable, reinforced, biocompatible, expanded polytetrafluoroethylene (ePTFE) liner attached to an external nitinol stent structure. The outstanding flexibility of the GORE VIABAHN Endoprothesis enables it to traverse tortuous areas of the SFA and to conform to the complex anatomy of the artery. The device was initially approved by the FDA in 2005 for treating PAD in the SFA. Later in 2007, Gore made modifications to the device which includes reducing the profile and adding a Heparin Bioactive Surface.

Product page: GORE VIABAHN® Endoprosthesis

Press release: Gore Receives FDA Approval for Modification of GORE VIABAHN® Endoprosthesis

Flashbacks Gore VIABAHN® Endroprosthesis Stent: Now Approved...

:: Comments left behind ::

Elderly folks tend to prefer to live in their own homes as the years pass, but the potential for accidents to happen leads many to seek nursing homes or to live with family. Dana Blankenhorn at ZDNet Healthcare is reporting on technology from WellAWARE Systems (Charlottesville, Virginia) that monitors people in their homes with sensors in beds, bath tubs, and generally throughout the living space.

Dana Blankenhorn reports:

At this writing, 60 facilities have the WellAWARE system, company officials told ZDNet.

WellAWARE is offering a system of sensors that track a patient’s movement throughout their residence, comparing their activities to a baseline of normality, and alert caregivers to changes.

Noce explained how this worked recently with an 81 year old client aging-in-place in Hastings, NE:

"There was an alert that the woman had not slept for 26 hours. The woman was evasive, but we were able to be proactive, and the nurse was able to visit, knowing she hadn’t slept.

The woman finally admitted she’d been hallucinating. The nurse asked about medication, the woman said she had some, and the nurse found that one of the side effects of one medicine was hallucination. She was able to fix the situation in a day.

The patient didn’t have to do anything. The care giver was then able to provide an interaction that got correction.

More at ZDNet Healthcare...

Link: WellAWARE Systems...

:: Comments left behind ::

Researchers from the National Cancer Institute have devised a new method to watch for the presence of the HER2 protein, a commonly expressed marker of breast cancer. As you can imagine, the implications for this technology could be immense, from doing research on pathophysiology of breast CA to developing protocols for treatment.

From the statement issued by the National Cancer Institute:

... the research team used an imaging compound that consists of a radioactive atom (fluorine-18) attached to an Affibody molecule, a small protein that binds strongly and specifically to HER2. Affibody molecules, developed by Affibody AB, Bromma, Sweden, are much smaller than antibodies and can reach the surface of tumors more easily. The radioactive atom allows the distribution of the Affibody molecules in the body to be analyzed by positron emission tomography (PET) imaging.

The research team first used the radiolabeled Affibody molecule to visualize tumors that expressed HER2 in mice. The mice were injected under the skin with human breast cancer cells that varied in their levels of HER2 expression, from no expression to very high expression. After three to five weeks, when tumors had formed, the mice were injected with the Affibody molecule and PET images were recorded. The levels of HER2 expression as determined by PET were consistent with the levels measured in surgically removed samples of the same tumors using established laboratory techniques.

To determine whether their method could be used to monitor possible changes in HER2 expression in response to treatment, the team next injected the Affibody molecule into mice with tumors that expressed very high or high levels of HER2 and then treated them with the drug 17-DMAG, which is known to decrease HER2 expression. PET scans were performed before and after 17-DMAG treatment. The researchers found that HER2 levels were reduced by 71 percent in mice with tumors that expressed very high levels of HER2 and by 33 percent in mice with tumors that expressed high levels of HER2 in comparison with mice that did not receive 17-DMAG. The researchers confirmed these reductions by using established laboratory techniques to determine the concentrations of HER2 in the tumors after they were removed from the mice.

Press release: Imaging Technique Allows Researchers to Monitor Protein Changes in Mouse Tumors

Article abstract in The Journal of Nuclear Medicine: Changes in HER2 Expression in Breast Cancer Xenografts After Therapy Can Be Quantified Using PET and 18F-Labeled Affibody Molecules....

:: Comments left behind ::

As medical devices become smaller and more complex because of the ever increasing demand for greater precision in clinical and research applications, the need for smart materials is also on the rise. Many metal alloys are able to "remember" a specific shape they were in before transformation, the best example being self expanding coronary stents. Although memory retaining alloys are already being used in many fields of medicine, researchers from Fraunhofer-Gesellschaft are using computers to extend the application of these materials.

With the help of these simulations, the scientists have developed various objects, including a minuscule forceps for endoscopy. Normally, such micro forceps can only be created with joints. How can a component be produced that has such small dimensions, is elastic, can be thoroughly sterilized and has no joints? The computer supplies the answer: with the help of numerical simulation models, the researchers could calculate in advance the most important characteristics of the component, such as its strength and clamping force, and efficiently develop and manufacture the elastic component. "Normally, many tests with various prototypes would need to be conducted," Dr. Helm explains. "By using simulations, we can avoid producing most of these prototypes. This saves costs because the raw materials for the shape memory alloys are very expensive and are sometimes difficult to work with." In addition, the researchers can estimate through simulations how durable the modern materials are.

Full story: Design tool for materials with a memory

:: Comments left behind ::

Researchers from Northeastern University and Harvard Medical School have developed a miniature microfluidic device that is capable of capturing endothelial progenitor cells (EPCs) from the bloodstream, in a sample of only 200 microliters of blood. Because endothelial progenitor cells move towards injuries within blood vessels, detecting their presence can lead to a diagnostic system for various vascular diseases.

From the abstract:

The surface of a variable-shear-stress microfluidic device was conjugated with 6 different antibodies [anti-CD34, -CD31, -vascular endothelial growth factor receptor-2 (VEGFR-2), -CD146, -CD45, and -von Willebrand factor (vWF)] designed to match the surface antigens on ovine peripheral blood-derived EPCs. Microfluidic analysis showed a shear-stress-dependent decrease in EPC adhesion on attached surface antigens. EPCs exhibited increased adhesion to antibodies against CD34, VEGFR-2, CD31, and CD146 compared to CD45, consistent with their endothelial cell-specific surface profile, when exposed to a minimum shear stress of 1.47 dyn/cm(2). Bone-marrow-derived mesenchymal stem cells and artery-derived endothelial and smooth muscle cells were used to demonstrate the specificity of the EPC microfluidic device. Coated hematopoietic specific-surface (CD45) and granular vWF antibodies, as well as uncoated bare glass and substrate (1% BSA), were utilized as controls. Microfluidic devices have been developed as an EPC capture platform using immobilized antibodies targeted as EPC surface antigens.

Abstract in FASEB Journal: Development of microfluidics as endothelial progenitor cell capture technology for cardiovascular tissue engineering and diagnostic medicine

(hat tip: Gizmag)

:: Comments left behind ::

A collaborative group of German and American researchers has identified the important biochemical processes involved in the regeneration of limbs of salamanders. Nearly unique in their great ability to replace lost appendages, salamanders were thought to possess pluripotent stem cells with greater abilities to differentiate than those of mammals. Turns out that in salamanders cells located at the location where the damage has occurred keep a memory of what was in the vicinity, providing guidance for regrowth of future cells. The finding opens the possibility that scientists will be able to replicate this phenomenon in humans, leading to treatments for spinal cord injury, loss of arms and legs, and other serious injury.

From the study abstract:

During limb regeneration adult tissue is converted into a zone of undifferentiated progenitors called the blastema that reforms the diverse tissues of the limb. Previous experiments have led to wide acceptance that limb tissues dedifferentiate to form pluripotent cells. Here we have reexamined this question using an integrated GFP transgene to track the major limb tissues during limb regeneration in the salamander Ambystoma mexicanum (the axolotl). Surprisingly, we find that each tissue produces progenitor cells with restricted potential. Therefore, the blastema is a heterogeneous collection of restricted progenitor cells. On the basis of these findings, we further demonstrate that positional identity is a cell-type-specific property of blastema cells, in which cartilage-derived blastema cells harbour positional identity but Schwann-derived cells do not. Our results show that the complex phenomenon of limb regeneration can be achieved without complete dedifferentiation to a pluripotent state, a conclusion with important implications for regenerative medicine.

Full story: Scientists: Salamanders, regenerative wonders, heal like mammals, people....

Abstract in Nature: Cells keep a memory of their tissue origin during axolotl limb regeneration

Images: Top: Axolotl salamander by cataclico; Side: Green nerve cells cluster around a growing nerve in this cross-section of a regenerating limb. D.Knapp/E.Tanaka.

:: Comments left behind ::

Nephros, Inc., out of River Edge, New Jersey, received FDA approval for the firm's Dual Stage Ultrafilter system. The device is designed to provide redundant filtration for purifying of dialysate fluid and bicarbonate solution.

From the product page:

The Nephros DSU has a 0.005 micron filter pore size designed to remove a broad spectrum of bacteria, viral agents and biological toxins. These toxins include salmonella, hepatitis, HIV, Ebola viruses, legionella, fungi and e-coli. The DSU removes these harmful substances more effectively than other microwater filters currently on the market.

The Nephros DSU's unique design and materials ensure high flow rates and long life. The true redundant design provides the highest confidence in filter integrity and performance. The Nephros DSU is a truly cost effective, simple and compact means to reliably produce on-site ultrapure water where you need it, when you need it.

Product page: Dual Stage Ultrafilter...

Nephros DSU brochure...

Press release: Nephros Receives 510k Approval for Dual Stage Ultrafilters...

:: Comments left behind ::

An English gentleman, possibly skeptical of the offerings provided by the National Health Service (NHS), decided to perform his own circumcision at home. Apparently not aided by anything other than some ethanol, the patient/physician brought a pair of nail clippers to the surgical theatre/kitchen sink. Inevitably something went terribly wrong and medics had to be brought out.

The Telegraph quotes one from the rescue team:

"This is something we would advise men never to attempt," a medic said, "The results can be quite horrific and long-lasting and have quite an affect on a man's sexual performance.

"Using a pair of nail clippers must have caused excruciating pain, even if he had had a few drinks beforehand."

More from The Telegraph...

Image: mokolabs

:: Comments left behind ::

Any kind of circumcision has horrifying, damaging, life-long effects on a man's sexual performance. I feel awful for this man, who clearly was brainwashed by the media and mainstream medicine and believed it necessary to remove a healthy, functional part of his genitals. I hope he seeks psychological help immediately, and I wish him a fast recovery. It is shameful and an enduring atrocity to human rights that circumcision is still legal at all, especially infant circumcision. End the bloodshed NOW.

www.nocirc.org
www.norm.org
www.doctorsopposingcircumcision.org

The liberty brigade, fighting for the rights of uncircumcised infants, is here. The concern these people have for the tips of penile skin is truly incredible. Fight on, valiant soldiers, the unyielding force for freedom that you are. No brigade of such fearless troops has existed before.

uhm... Darwinism?

Yanko Design blog is featuring the work of Elijah Stillson who offers a new design idea for a respirator. Although, when wearing this thing, one would be the most attractive person in a crowd of evacuees, let's hope the device can seal around the face to stay tight with this design.

Link: Respirator Mask Design by Elijah Stillson

(hat tip: Gizmodo)

:: Comments left behind ::

This gas mask looks ridiculous . Also if it rains you would be screwed !

ps If paris had a mask id be definitely pink !

Brainsway Ltd. out of Jerusalem, Israel, a company we've been covering over the last few years, has received local approval to conduct clinical trials of its deep transcranial magnetic stimulation (TMS) as an aid in quitting smoking. The drastic approach is to be tested on about 100 lung cancer patients that have not been able to quit using other methods.

More from Globes Online...

Flashbacks: Magnetic Brain Stimulation for Cocaine Addiction, Multiple Sclerosis?; Positive Results Reported for Deep TMS H System For Depression; Deep TMS Technology by Brainsway

:: Comments left behind ::

Crospon, out of Galway, Ireland, recently received Frost & Sullivan's 2009 European Gastroenterology Technology Implementation of the Year Award for the Endoflip device. The Endoflip delivers a balloon catheter to the gastroesophageal sphincter, a junction between the esophagus and stomach, and can test the strength of the muscles controlling its closure. Already approved in the EU, the company is seeking FDA's approval for the US market.

From the manufacturer:

Crospon has addressed the need for a GERD-focussed diagnostic platform by developing an integrated solution which facilitates real-time imaging of the lower esophageal sphincter in less than 10 minutes. The EndoFLIP® system constitutes a set of 16 electrodes that sit within a balloon catheter which is attached to a data recorder with a touch screen. This series of electrodes is capable of measuring resistance or impedance to calculate cross-sectional areas at different points along the balloon. At the commencement of the procedure, the deflated balloon catheter is attached to a prefilled syringe, which is inserted into the syringe pump on the front of the EndoFLIP® tool. Subsequently, the deflated balloon is then passed trans-orally or trans-nasally to the gastroesophageal junction whereby it permits a challenge test to the lower esophageal sphincter to determine its functionality.

The scientific principle behind EndoFLIP®’s implementation is impedance planimetry. This is a technique that can measure cross-sectional area electrically which in turn enables 16-slice display images. This display shows the changes in the estimated diameters of sphincteric regions in the body in real time, thereby permitting a real time image of the geometry in vivo of the human esophagus to be obtained. Crospon has submitted an application to the FDA for EndoFLIP®’s clearance in the US market. The company has already received CE mark certification from the National Standards Authority of Ireland.

Video below fold demonstrating the placement of the device:

Press release: 2009 European Gastroenterology Technology Implementation of the Year Award...

More literature about the device...

:: Comments left behind ::

Scientists from the Max Planck Institute of Colloids and Interfaces have developed a new process to put together nanoparticles directly in the environment that is being studied. Additionally, this technique has led to the creation of tiny "light bulbs" that can be attached to specific proteins, opening a new modality for visualizing biochemical processes.

From a statement by the Max Planck Society:

"We used the fact that cells represent a closed reaction container as a model for the synthesis of nanoparticles," says Rumiana Dimova. Her group at the Max Planck Institute of Colloids and Interfaces studies membranes - the cell envelope. The scientist and her colleagues form bubbles that are around 50 micrometres in size from lecithin membranes, which are similar to biological membranes. Like cells, membrane bubbles - or vesicles as scientists refer to them - also provide a closed reaction container. The scientists load the membrane bubbles with one of two reactants for the nanoparticles.

From this point, the researchers have developed two different sets of protocols. In one case, they produce bubbles loaded with one of the two reactants, sodium sulphide or cadmium chloride. The scientists then bring the bubbles with the different loads together and fuse two vesicles to form a bigger vesicle - this is done by subjecting the bubble cocktail to a short but very strong electrical pulse. The electric shock fuses the membranes of two adjacent bubbles.

In many cases, this results in the fusion of two bubbles containing different reactants. These then react to form cadmium sulphide, which is not water soluble and thus precipitates in the form of nanoparticles. "Because the reactants are only present to a limited extent in the fused bubbles, the particles only grow to a size of four nanometres," explains Rumiana Dimova. The scientists were able to track the entire process directly under the microscope because they had added different fluorescent molecules to the membranes of the differently loaded vesicles. The researchers were also able to see the nanoparticles forming as the particles shone like tiny lamps.

In the second process, the researchers only produce vesicles with one of the reactants. When the vesicles have formed, unlike in the first procedure, the researchers do not remove them from the production chamber. Instead, the bubbles remain attached to their substrate via small membrane channels, like balloons tied to strings, and stand in a solution that is the same as the one inside them. The researchers working with Rumiana Dimova then altered this situation: they substituted the solution with the first ingredient for the nanoparticles with a second component. This causes no change inside the vesicles at first. The second ingredient only creeps gradually between the substrate and membrane into the channel and to the vesicle. In the vesicle, where the other ingredient is already waiting, the nanoparticles grow again - this time to a size of 50 nanometres.

Press release: Making nanoparticles in artificial cells...

:: Comments left behind ::

Eshel Ben Jacob, a professor of physics at Tel Aviv University, beautified photos of bacteria growing in Petri dishes with a bit of color and shading to create an amazing collection you can browse yourself.

Here's what the artist/scientist tells Medgadget about the works:

They illustrate the coping strategies that bacteria have learned to employ, strategies that involve cooperation through communication. These selfsame strategies are used by the bacteria in their struggle to defeat our best antibiotics. Thus, if we understand the mechanisms behind the patterns, we can learn how to outsmart the bacteria - for example, by tampering with their communication - in our ongoing battle for our health.

In a sense, the strikingly beautiful organization of the pattern reflects the underlying social intelligence of the bacteria. The once controversial idea that bacteria cooperate to solve challenges has become commonplace, with the discovery of specific channels of communication between the cells and specific mechanisms facilitating the exchange of genetic information. Retrospectively, these capabilities should not have been seen as so surprising, as bacteria set the stage for all life on Earth and indeed invented most of the processes of biology. As we try to stay ahead of the disease-causing varieties of these versatile creatures, we must use our own intelligence to understand them. These images remind us never to underestimate our opponent.

Link: Theories of Mind Art Gallery...

:: Comments left behind ::

A team of Canadian researchers analyzed the air traffic patterns during March and April of this year, looking for correlation between departure/arrival cities of passengers and the spread of H1N1 swine-origin influenza. Turns out that the two are closely correlated and confirm that airports are gateways of pathogens as well as vacationing tourists.

Our analysis showed that in March and April 2008, a total of 2.35 million passengers flew from Mexico to 1018 cities in 164 countries. A total of 80.7% of passengers had flight destinations in the United States or Canada; 8.8% in Central America, South America, or the Caribbean Islands; 8.7% in Western Europe; 1.0% in East Asia; and 0.8% elsewhere. These flight patterns were very similar to those during the same months in 2007 (see Fig. 1 in the Supplementary Appendix). We then compared the international destinations of travelers departing from Mexico with confirmed H1N1 importations associated with travel to Mexico, and we found a remarkably strong degree of correlation. Of the 20 countries worldwide with the highest volumes of international passengers arriving from Mexico, 16 had confirmed importations associated with travel to Mexico as of May 25, 2009. A receiver-operating-characteristic (ROC) curve plotting the relationship between international air-traffic flows and H1N1 importation revealed that countries receiving more than 1400 passengers from Mexico were at a significantly elevated risk for importation. With the use of this passenger threshold, international air-traffic volume alone was more than 92% sensitive and more than 92% specific in predicting importation, with an area under the ROC curve of 0.97.

Letter to NEJM: Spread of a Novel Influenza A (H1N1) Virus via Global Airline Transportation

:: Comments left behind ::