Thursday, July 2, 2009
Where Are Medicare Stories at BarackObama.com?
Filed under: Society
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 thousands 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 proposal? 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!
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Smoother GORE VIABAHN Endoprosthesis Gets Approved in US
Filed under: Vascular Surgery
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...
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WellAWARE Passive At Home Sensors Help Monitor Independent Elderly
Filed under: Geriatrics
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...
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New Imaging Technology Monitors HER2 Protein
Filed under: in the news...
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....
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Computer Simulations Extend Abilities of Shape Memory Alloys
Filed under:
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
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Device Captures Endothelial Progenitor Cells; May Help Detect Vascular Disease Early
Filed under: Medicine
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)
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Mysteries of Salamander Regeneration Revealed
Filed under: in the news...
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.
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Nephros' Dual Stage Ultrafilter System Guarantees Clean Fluids for Dialysis Machines
Filed under: Medicine
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...
Press release: Nephros Receives 510k Approval for Dual Stage Ultrafilters...
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Wednesday, July 1, 2009
DIY Circumcision Makes Writing This Post Difficult
Filed under: not funny
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
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