Archives: 10/2005

AICD Shocking News about Cosmic RaysAfter the Guidant fiasco this summer, makers of defibrillators are under pressure to disclose any possible defect in their implants. You might say they’re “subject to penetrating scrutiny” … or “the heat is on” … or “radiation from outer space is draining their batteries”:

“As you may be aware, background cosmic radiation bombards the Earth constantly,” reads St. Jude’s letter dated Oct. 6. “While the Earth’s atmosphere acts as a shield and absorbs much of the cosmic radiation, some amount of high-energy particles do arrive at the Earth’s surface.”
Apparently, those rays can cause a memory chip to drain the battery, sapping the devices’ ability to shock the heart, according to the letter. St. Jude, the smallest of the three players in the ICD market, was able to mimic the effect in a nuclear laboratory, prompting the advisory to doctors and US regulators.
No deaths or serious injuries have been linked to the flaw in the Photon DR, Photon Micro and Atlas VR/DR defibrillators, which are used to correct irregular heart rhythms, according to St. Jude. What’s more, the incident rate is very low. Testing showed that perhaps 60 devices out of 36,000 might be affected, the company said.

We’d venture to guess that frequent fliers will be at greater risk. But it’s worth re-iterating this point: cosmic ray exposure isn’t always a bad thing.
Flashback: Medgadget Archives on Guidant
St. Jude Medical press releases page
(hat tip: KidneyNotes)

10110501 In the Works: A No Prick GlucometerProfessor Joseph Chaiken of the Department of Chemistry at Syracuse University, has patented a technology that might result in a non-invasive and pain-free glucose meter. The technology is based on Raman spectroscopy and is called LighTouch™. From the Syracuse University press office:

The LighTouch uses a method called Raman spectroscopy to focus a laser–which Chaiken refers to as a “CD-player type of laser that has been kicked up a notch to deliver a purer red color,”–onto the fingertip and analyze the various colors of the light exiting the finger. These colors are indicative of the types and quantities of the different chemicals in the tissue being illuminated by the laser. By making two such measurements, first with the fingertip under no pressure and the second with slight pressure applied to the flesh, researchers are able to compare the measurements and analyze only those colors that come from the part of the fingertip which moves under slight pressure–the blood. The procedure is completely painless and produces results with accuracy and precision comparable to existing fingerstick devices.
“Just as an electrocardiogram machine (EKG) produces an electrocardiogram, the LighTouch produces a Ramagram,” says Chaiken. Raman spectroscopy is a spectroscopic technique used in condensed matter physics and chemistry to examine vibrational, rotational and other low-frequency modes in a system. It is named for Chandrasekhara Venkata Raman, who won the 1930 Nobel Prize in Physics for discovering “feeble fluorescence,” later known as the Raman effect, in 1928.
Experts believe Chaiken’s pioneering work will result in increased regular blood sugar testing by diabetics, a critical step in controlling diabetes.

The press release
LighTouch Medical, Inc., a spin-off, website
Flashback: Fingernail Test for Osteoporosis (via Raman spectroscopy).

cyp sm Drug Interactions with Grapefruit Juice Web SiteThe Center for Food-Drug Interaction Research and Education, an organization co-managed by the University of Florida, College of Pharmacy, and the Tufts University School of Medicine, has opened a website that helps clinicians (and patients) to identify and analyze possible food-drug interactions. Currently, only interactions of meds with grapefruit juice is available. From the website:

Grapefruit juice appeared on the food-drug interaction radar in the late 1980s when scientists discovered that it contains natural substances that can affect the way certain prescription medications are broken down (metabolized) by an enzyme, known as CYP3A4.
If a person drinks grapefruit juice and takes one of these drugs orally, more of the drug may enter the bloodstream than would have under normal circumstances. This means that grapefruit juice has the potential to enhance the absorption of these certain prescription drugs.

The site
FAQ for patients

stemblood sm Stem Cells vs CA: The Fight BeginsHuman embryonic stem cells are touted as pluripotent cells, that are able to differentiate into any human cells. Hence is the idea of replacing diseased cells–such as beta cells in diabetes or dopaminergic cells in Parkinson’s–with new ones from the stem cell line. But how about creating cancer-killing cells from the stem cell line, and opening a new front in combating the big C? Well, a team of scientists from the University of Minnesota has done it:

For the first time, stem cell researchers at the University of Minnesota have coaxed human embryonic stem cells to create cancer-killing cells in the laboratory, paving the way for future treatments for various types of cancers (or tumors). The research will be published in the October 15 issue of the Journal of Immunology.
Researchers generated “natural killer” cells from the human embryonic stem cells. As part of the immune system, natural killer cells normally are present in the bloodstream and play a role in defending the body against infection and against some cancers. The natural killer cells produced by the researchers were found capable of destroying certain human cancer cells in vitro (in the test tube).
“This is the first published research to show the ability to make cells from human embryonic stem cells that are able to treat and fight cancer, especially leukemias and lymphomas,” says Dan Kaufman, assistant professor of medicine in the Stem Cell Institute and Department of Medicine and lead author of the study…
The results also provided the researchers with a model of how the immune system develops.
Next, the researchers will test whether the human embryonic stem cell-derived natural killer cells can target cancer cells in animal models.
This research was done on two of the federally approved embryonic stem cell lines.

cell rads2 Cell Phones vs. Brain Tissue: Nothing Stressful
Another note about cell phones: While they’re not causing significant interference with medical equipment, it’s more comforting to believe they’re not frying your brain, either. This report from scientists at Wash U suggests we can speak, stress-free:

“We performed highly sensitive, extremely well-controlled tests on living cells irradiated with energy like that from mobile phones, but at levels 5 to 10 times higher than those set for the devices by regulatory agencies,” says Andrei Laszlo, Ph.D., associate professor of radiation oncology and a researcher at the Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine. “We see no indication that factors involved in the stress response increase their activity as a result of such exposures.”
Prior research into the effect of cell phones on the stress response has been fraught with contradictory results, which in part may be due to less-than-ideal experimental conditions. For example, in the past it has been difficult to prevent temperature changes caused by microwave exposure.
Because heating of tissues has been shown unlikely to be a component of the effect of cell phone radiation on biological systems, Laszlo and his group sought to reduce as far as possible any heating of the cells in culture during the study. Using sensitive equipment that continuously monitored and adjusted temperature, they were able to keep temperature variations to plus or minus 0.3 degrees centigrade.

Experiments like this are no substitute for large-scale prospective studies on cell phone-using populations (where will they find a control group of non-cell users?) Still, it’s nice to know that mobile phones aren’t causing harm to cells in vitro.
More: Recent articles in Radiation Research: this stress-factor article, and a piece on oncogene expression after irradiation. Drs. Laszlo’s and Roti Roti’s work was supported by Motorola.

cell rads Cell Phones vs Hospital Equipment: Less Interference, Still AnnoyingMany of us who work in hospitals have an anecdote like this one, about a surgeon whose cell phone goes off at an inopportune moment. Some medical students express shock — shock! — that attendings could violate hospital policy so brazenly. But alas, these docs are simply following evidence-based medicine:

In their most recent analysis of cellular telephones and medical equipment, Mayo Clinic researchers report in the October issue of Mayo Clinic Proceedings that the cellular telephones tested did not interfere with medical devices that were more than three feet away, marking an improvement. In the current study, 44 percent of the devices recorded some interference from the cellular telephones but the vast majority of this interference should not have had any significance for the patient.
…Sixteen different medical devices were tested and interference occurred in seven (44 percent). The researchers conducted 510 tests by holding the phone next to the devices and then rotating it once a call was received from a wired telephone. The cellular phones were placed near vulnerable sites on the device, such as serial ports, cable connection ports and displays.
The farthest distance away that a device was affected was 32 inches. Most interference occurred with devices that display electrocardiographic (ECG) or electroencephalographic (EEG) waveforms and involved noise interference… Two ventilator devices also experienced interference.

The rules restricting cell phone usage in hospitals dates back to those crazy analog phones, which could disrupt TV transmissions and bring down airliners. The rules are still posted in hospitals, we suspect, for legal coverage, crowd-control purposes — and because there’s something unseemly about a patient animatedly gabbing away while being wheeled around on a stretcher.
Flashback: Cell Phone Restrictions Under Review

The New York Times asks:

What if scientists could produce embryonic cells without the embryos and make nearly everyone happy?

Unfortunately, since the USA has a pre-Darwinistic political climate when it comes to fetal stem cell research (and to Darwin), the question is a very essential one. The answers are here.

versaform lr Versaform: Free Electronic Medical Record Keeping
Versaform kindly informs us their electronic medical records program, EMR Basic, is available for download. Their site looks like it has a few bugs in it, but we assume their software is more robust.

VersaForm Systems Corporation announced that its new Electronic Medical Records (EMR) program- VersaForm EMR Basic Edition- is available free to health care providers. With VersaForm EMR, clinicians can quickly create patient and visit records, track problems, medications and labs, and create progress notes. All aspects of a patient’s visit can be recorded electronically. VersaForm EMR can significantly reduce potential medical errors due to incomplete, illegible or lost handwritten records and charts. The program can be downloaded over the Internet from www.versaform.com.
…VersaForm EMR includes a set of pre-defined templates that address frequently seen conditions. Templates can be customized or created by any user to suit the practice, and can record all aspects of an encounter, including the billing.
VersaForm EMR also allows for existing paper records to be scanned into the system virtually eliminating the need for paper charts. VersaForm EMR runs on computers using Windows 2000 or XP and can be networked for multi-user environments.

Some of us are now working in a paperless emergency department, and can’t imagine going back to handwritten orders, transcribing lab values, bulky paper charts and manila folders (except when the systems goes down, once every few months, and we do just that).
More from VersaForm
Flashback: Medicare and EMR, DIY Medical Records

syringe Anxiety in the BloodResearchers at Hebrew University are developing a simple blood test to screen for anxiety. This could open the door to a new era in psychiatric diagnostics, and should challenge the perception that such disorders are “all in your head” (they seem to be in the blood, as well). IsraCast’s Iddo Genuth has more:

Over the years studies have shown that when the body feels stress (for example when a child jumps in front of your car) the level of ACh in the synapses rises. In order for the body to return to normal levels of ACh a special enzyme called Acetylcholinesterase (AChE) which breaks down the ACh, springs into action. Normally the levels of ACh and AchE decrease after the cause of the stress disappears, but people suffering from anxiety disorders continue to maintain high levels of ACh and AChE. As is the case with many other complex interactions inside the body, there are more than just two factors responsible for each behavioral pattern. Previous studies on mice suggested that two other enzymes called butyrylcholinesterase (BChE) and paraoxonase (PON) are also involved in the anxiety controlling mechanism.
Since it is currently too complex to measure ACh directly, Professor Soreq and her team aimed at testing if people with abnormal levels of AChE, BChE and PON would also show anxiety symptoms and comparing this data to the psychological tests conducted separately. The results surprised even Soreq herself as she admitted in an interview to IsraCast. Her team found more than a 90% correlation between people who were diagnosed with higher than usual anxiety by a psychologist and people with abnormal AChE, BChE and PON levels.

Of course, if a patient is anxious about needles or blood, this test is revealing, even before it is conducted…
More from Professor Soreq’s PNAS paper