Archives: 4/2005

ClozeX ClozeX Wound Closure DeviceMore developments in the field of wound closure, from the recent MDEA award winner, ClozeX:

ClozeX is a hypoallergenic, needleless, film device which replaces sutures, staples and glues for skin closure of surgical incisions and traumatic lacerations. These devices provide immediate and excellent cosmetic results without track marks associated with other methods. ClozeX offers a simple, fast, high-precision skin closure and greater safety in avoiding needlestick injuries. The product does not require a removal visit and provides patients with high levels of comfort. Its non-invasive design helps to avoid infection and other potential complications.

More detail is on their web site:

The device design consists of two pieces of interlaced, multi-layered, transparent films coated with medical grade, hypoallergenic, non-latex adhesives coated in specific zones. The adhesives are designed to affix the transparent breathable attaching pads securely to the skin adjacent to the wound and to lock the device in its final closed position. The device has six colored liners — three on each part. The liners are color coded red, white and blue, in sequence of liner removal, to simplify and enhance recall of the application process.
Once the color-coded liners are removed, the ClozeX provides a transparent closure that offers immediately visible results in comparison to closure with sutures or staples.

It looks like steri-strips on steroids. Apparently, ClozeX technicians need to be on-hand to supervise initial physician training with this device. The flash animation, however, really simplifies it.
More at ClozeX
NOTE: This is the first post by Nicholas Genes, currently a medical student and soon to be an emergency medicine intern. We are psyched to have him on board! Welcome, Nick!

keyboard nosoc Hospital Computer Keyboards: a Role in Nosocomial Transmission?No surprises here:

Harmful bacteria can linger on computer keyboards in hospitals, making it easy for the germs to spread to patients, a new study finds.
To combat the problem, a research team led by Dr. Gary Noskin, medical director for healthcare epidemiology and quality at Northwestern Memorial Hospital in Chicago, suggests that those using multi-user computers should wash their hands after each use. In addition, computer keyboards should be disinfected regularly.
Another expert, Dr. Philip Tierno, director of clinical microbiology and immunology at New York University Medical Center and author of The Secret Life of Germs, goes even further and advises that computer keyboards in schools and libraries should be disinfected often to prevent the spread of harmful bacteria.

Washing your hands after computer use in the office, and even at home, should be your routine as well. You will certainly reduce your chances of contracting some nasty infectious contagions.
More at HealthDay

Gluco wrist 1 GlucoWatch G2 BiographerIn a must see article at IVD Technology, we see a mention of the GlucoWatch G2 Biographer by California-based Cygnus Inc.
The company describes its reverse iontophoresis device:

The GlucoWatch G2 Biographer uses an extremely low electrical current to extract glucose molecules through the skin using patented sampling processes. The glucose is extracted from interstitial fluid that surrounds skin cells, rather than from blood, eliminating the need for multiple finger pricks to provide glucose readings. The Biographer can be worn like a wristwatch and functions like a computer, analyzing and responding to data received from the AutoSensor. The AutoSensor uses proprietary biosensor technology and snaps into the back of the Biographer. The AutoSensor is calibrated with a standard blood glucose measurement and takes two hours to warm up. After the warm-up period, the AutoSensor automatically and non-invasively extracts and measures glucose every 10 minutes for a period of up to 13 hours before requiring replacement. The patient will receive up to six glucose readings per hour.

As you can see from the description above, the device needs one-a-day glucose measuring needle stick for calibration. On the plus side, GlucoWatch G2 Biographer has FDA approval, and the device can store up to 8,500 records.
DiabetesUK provides more details.
More at Cygnus

i pot i potJapan’s Zojirushi Corp. is offering a way to monitor the elderly. The San Jose Mercury News reports:

But more and more Japanese these days are like Kijima: elderly and living alone. Still, Kijima, 83, a widower with no children, does have someone watching out for him via a bit of technology embedded in his kitchen.
His electric kettle, an “i-pot” (for information pot), not only boils water for his instant miso soup and green tea but it also records the times he pushes a button and dispenses the water. A wireless communication device at the bottom of the i-pot sends a signal to a server. Members of the service can see recent records of i-pot usage on a Web site. In addition, twice a day the server e-mails the most recent three usage times to a designated recipient.
For Kijima, that recipient is neighbor Tadahiro Murayama. “Once, I didn’t use the i-pot for a day, and I got a phone call from Mr. Murayama,” Kijima said. The i-pot, he said, helps him feel he’s not alone.
Electronics maker Zojirushi began the service four years ago. The company rents the pot for a $50 deposit and charges $30 a month for e-mail and Internet service.

In the picture above the inset demonstrates the built-in data communication transmitter. To see how the system works see the illustration on this Japanese page. Pretty nifty indeed. This is one of those smart appliances we’ve been waiting to finally arrive at the martket.
Zojirushi Corp’s website in Japanese

dura seal DuraSeal™DuraSeal™ is a new, synthetic gel designed to seal the sutured dura following cranial neurosurgical procedures. It has been approved by the FDA last week. The dura mater is the outermost tough membrane surrounding the brain and the spinal cord. The cerebrospinal fluid leakage through incompletely closed dura can cause persistent, often severe, headache, meningitis, or even death.
Confluent Surgical, Inc. describes its product:

DuraSeal™ is a new, synthetic hydrogel designed to augment sutured dura closures following cranial surgical procedures. The device can be stored at room temperature and prepared in minutes. A blue dye has been added to DuraSeal, which allows for improved visualization. When sprayed on tissue, a strong, adherent hydrogel layer is produced, effectively sealing the suture line.
The hydrogel continues to seal the suture line as healing progresses under the gel. After several months the hydrogel breaks down into water-soluble molecules that are absorbed and cleared through the kidneys.

More at Confluent Surgical

OTC

walk4life pedo Walk4Life PedometersIn an article at the Chicago Tribune about medgadgets, we read about Walk4Life pedometers and their uses. According to the Tribune “modem-ready, easy-to-wear pedometers are used in school, college and university physical education programs around the world.”
Walk4Life, the manufacturer, describes positive results from a recent scientific study of its pedometers:

In the first study to assess the accuracy of pedometer activity time, researchers from Oregon State University found that the activity time feature of the Walk4Life 2505 (Duo) 2-function pedometer was a more accurate way of measuring true activity levels in children. Published in the March issue of the official journal of the American College of Sports Medicine, the study confirmed that across all speeds and between units, the Walk4Life activity time did not vary more than 5.3 seconds from actual time. The study also confirmed the step count accuracy of Walk4Life pedometers, one of several validation studies in the last several years.
Reporting their results in Medicine & Science in Sports & Exercise, Vol., 37, No. 3, researchers Michael W. Beets, Megan M. Patton and Stacey Edwards of the Department of Public Health at Oregon State University in Corvallis, said “we found that pedometer time (Walk4Life 2505) was accurate independent of step count accuracy or speed of walking. While the steps may or may not be an exact representation of the amount of activity one is accruing, pedometer time is.”

To be frank, I am not really sure what all this means. The bottom line is that pedometers are also getting better and better over time, thanks to the innovative pedometer companies.
If you would like to learn more about Walk4Life pedometers, go here. Otherwise I am totally clueless about these gadgets.

leech nostril A Strange Case of Intranasal Foreign EntityThe Hong Kong Medical Journal describes a case of a Chinese woman who was presented to a doctor with unilateral epistaxis (nose bleed). And the diagnosis?
From the case report:

Endoscopic examination with a 2.7-mm rigid telescope was performed… A live leech was noticed at the left middle meatus with a large part of its body inside the left maxillary antrum (Fig 1). Five percent xylocaine nasal spray was applied to the left middle meatus to anaesthetise the leech and facilitate removal. After 2 minutes, the leech moved slowly out of the antrum and was retrieved with forceps. Magnetic resonance imaging of the paranasal sinus revealed only congested nasal mucosa and confirmed complete removal of leech.

More at the Hong Kong Medical Journal: abstract, full article (.pdf)

Some rather interesting research is coming out of Stanford:

Scientists have believed that neurons need a long period of fine-tuning and training with other neurons before they take on their adult role. But after using new technology for the first time to watch these cells develop, a team of researchers at the Stanford University School of Medicine found that neurons come into this world with a good idea about what they’ll become as adults.
The work, which is detailed in a paper in the March 24 issue of Neuron, took place in the brain of a small see-through fish called a zebra fish. Stephen Smith, PhD, professor of molecular and cellular physiology, and graduate student Christopher Niell immobilized a young fish at an age when the nerves first grow from the eye to reach the brain. Then, with the aid of a 6-foot-long laser and some fancy microscopy, the researchers were able to watch individual neurons as they matured in real time.
The pair specifically monitored hundreds of neurons in the region of the brain that respond to images. Niell set up a tiny LCD screen showing squares the size of the fish’s favorite planktonic food moving up and down or left and right.
They expected to find that young neurons fire in response to a variety of different images, then refine their role over time so that in the adult fish the neurons only respond to images moving in a certain direction or near the left or right side of the visual field.
What they found was a surprise. As soon as the neurons were old enough to respond to the LCD screen, they specifically fired when they sensed only one type of movement. When the tiny square moved left to right, a distinct population of neurons turned fluorescent colors to indicate their activity. Moving the square the reverse direction triggered a different population of neurons to light up.
“At first we felt like we let some air out of our own tires with this finding,” said Smith. His previous work had supported the prevailing idea that neurons need a period of fine-tuning before establishing their final identity.
Still, the experiments mark the first time researchers have been able to watch neurons in an entire region of the brain as they fire one by one in real time. The technical savvy involved in monitoring neurons will allow researchers to conduct experiments that were previously not possible.
While the research showed neurons firing in a more mature way than expected, it also revealed that neurons take their time establishing the final wiring of the brain. Young neurons send out branches in all directions in the hopes that some branches will connect to other neurons and form synapses that transfer information. As the neuron matures, some of these branches form stable synapses while others recede. This trial-and-error process is what establishes the final interconnected mesh of the brain.
Because the group could see the full branching structure of a neuron each time it fired, they could watch the branches grow and recede like a tree waving in the wind, losing the occasional twig. Over time, the network of branches stabilized into the mature form.
“We’re looking at a dynamic process that nobody has ever seen before,” Smith said.

More here.

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