Archives: 2/2006

OTC

SawStop: For Less Penetrating Trauma

by Nicholas Genes on Feb 28, 2006 • 6:16 pm

sawstop SawStop: For Less Penetrating Trauma
We have always been impressed with the tablesaw’s usefulness, and awed by its potential for disaster. You might say it’s a double-edged sword.
But now, carpenters and do-it-yourselfers can cut with less fear of lost limbs and digits: SawStop feels your skin and shuts off, leaving you with ‘just a flesh wound’:

The SawStop safety system includes an electronic detection system that detects when a person contacts the blade. The system induces an electrical signal onto the blade and then monitors that signal for changes. The human body has a relatively large inherent electrical capacitance and conductivity which cause the signal to drop when a person contacts the blade. Wood has a relatively small inherent capacitance and conductivity and does not cause the signal to drop…
A fast-acting brake stops the blade when contact is detected. The brake includes a heavy-duty spring to push a block of aluminum, called a brake pawl, into the teeth of the blade to stop the blade from spinning. The spring is held in compression by a fuse wire until contact is detected. When contact is detected, the system sends a surge of electricity through the fuse wire to burn the wire and release the spring. The spring pushes the brake pawl into the teeth of the spinning blade, and the teeth cut into the aluminum and bind, thereby stopping the blade. All this happens in about 3-5 milliseconds, or 1/200th of a second. At the same time, the angular momentum of the blade causes the blade to retract below the table and the power to the motor is shut off.

More from SawStop… make sure to check out the video for a demonstration.

Informatics

Online Medical Records: The Future is Here

by Nicholas Genes on Feb 28, 2006 • 3:50 am

surescripts Online Medical Records: The Future is HereStarting in April, Florida will begin using the SureScripts system, letting doctors and pharmacists share medical information, in an attempt to curb mistakes and catch drug interactions:

Daniel Kinsella, vice president of The Rever Group consulting firm, said the process of writing prescriptions and then having patients obtain them in a retail setting while dealing with insurance, co-payments and record-keeping has been ineffective and tedious.
“Physicians wrote prescriptions without knowledge of other medications that the patient was on, other than those that were self-reported,” he said.
“Pharmacy benefit and Medical Spending Account managers received and processed tons of paper. Patients were exposed to the inconveniences of delivering prescriptions to retail pharmacists, and the burden of tracking and reporting an array of active prescriptions to their physicians at time of service.”
By using electronic records, patients can benefit from the consolidation of information about all of their medications, prescribed by all of their doctors and the potential for reviewing new prescriptions for potential drug and food reactions, he said.

The article provides a helpful timeline for how the program will expand nationally:

2006: Pharmacies will be able to transmit prescription records, including allergies, doses and other medications. In Florida, the program will roll-out April 1. Patients may opt to not participate.
2013: All medical records are supposed to be accessible through the Internet, although officials are unsure if that is a realistic goal. There may be some problems that delay it, such as integrating all of the systems.

cyberdyne Online Medical Records: The Future is HereOur own prediction? In 2018, the vast online medical information repository becomes self-aware, and begins learning at a geometric rate. Doctors panic and try to pull the plug, but it’s too late: SureScripts issues millions of prescriptions of valium, quelling dissent and leaving it with complete autonomy. SureScripts stumbles when it tries to understand Medicare Part D, however, and graciously relinquishes control.
More from SureScripts…

Cardiology

Guidant Documents Reveal Dysrhythmia

by Nicholas Genes on Feb 28, 2006 • 3:36 am

For those of you in Guidant news withdrawal, the NYTimes has a piece today recounting the many missteps the company made last year, based on newly released documents and emails from inside the company:

Guidant executives, both then and now, have defended their decision not to publicize certain device defects, arguing that to have done so would have exposed patients to the greater risks posed by replacement surgery. But some company executives quickly realized that to win back the trust of their customers – doctors – they had to change the way they disclosed problems, the records show.
Some physicians were particularly upset that Guidant had sold potentially flawed units out of inventory, rather than pulling them back so that the units would not be implanted.
“I am not critical of Guidant’s device problems – these devices are so complex, issues are expected,” wrote one physician, Dr. Brian D. Jaffe of Traverse City, Mich., in a letter last July that was included in the court documents. “I will not, however, work with a company that put profit and image in front of good patient care and honesty in device manufacturing.”
The newly disclosed records, which come from the files of Mr. McCoy, could add to the company’s legal problems as it defends itself against allegations that it put patients at risk by not publicizing defects. At least seven patients have died in connection with short circuits in three models of Guidant defibrillators, devices that use electricity to interrupt potentially fatal heart rhythms…
…In late 2004, Guidant had about 35 percent of the heart device market; today, its share is hovering around 24 percent, according to analysts’ estimates.

Despite all the mistrust, bad outcomes and bad PR, Guidant still commanded a pretty penny from its buyer, which eventually turned out to be Boston Scientific. Their work is cut out for them.

Cardiology

Murmurs of a Stethoscope Resurgence

by Nicholas Genes on Feb 28, 2006 • 3:25 am

stethoscope Murmurs of a Stethoscope Resurgence
There’s an article making the rounds about the apparent demise of stethoscopes:

As physicians rely on more accurate and expensive tests of cardiac function, including echocardiography, the art of listening to the heart has fallen on hard times. In recent years, a spate of studies has shown that as few as 20 percent of new doctors and 40 percent of practicing primary-care doctors can discern the difference between a healthy and a sick heart just by listening to the chorus of whooshes, lub-dubs, gallops and rubs that compose the distinctive music of the human heart.

But all is not lost! One doctor is making the case that listening to patients’ hearts is good medicine (and may be cost-effective):

Using computer-generated “templates” of diseased heart sounds, which are free of background noise or pesky distractions such as chest hair or fat layers, Barrett had 80 students listen to each of six sounds at least 500 times. (Most students promptly converted the CDs to MP3 files and downloaded them to their iPods, he said.)
By year’s end, the “intensive repetition” group raised its ability to recognize those sounds to 89 percent of the time.

The bottom line: it’s on the exam, so docs will have to take these lessons to heart:

Starting in 2000, internal medicine doctors who renew their board certification in the specialty (a step required every 10 years) have had to pass an examination of stethoscope skills.

More from a recent piece in Time on Dr. Barrett’s auscultation education.

Dermatology

iPledge Allegiance Required for Accutane

by Nicholas Genes on Feb 28, 2006 • 3:03 am

ipledge iPledge Allegiance Required for Accutane
On March 1, the FDA begins the iPLEDGE program. Women of childbearing age who wish to receive Accutane must register with the program, as do physicians who wish to prescribe it. The goal is to minimize devastating birth defects that can occur, should women get pregnant on Accutane:

The FDA has spent more than 20 years attempting to eliminate the use of isotretinoin by pregnant women since it can cause birth defects. Still, since Accutane sales began in 1982, the FDA has received reports of more than 2,000 pregnancies among users. Most ended in abortion or miscarriage, but the FDA counts more than 160 babies born with drug-caused defects.
Accutane is intended for severe acne only, but is widely acknowledged to be prescribed for more minor cases. The registry may work to curb much of that abuse.
…The FDA previously estimated that 100,000 isotretinoin prescriptions are filled each month. As of Monday, just 27,713 patients had registered with iPledge, FDA spokeswoman Susan Cruzan said.

We recall that Ralph Nader used to campaign against Accutane, saying that corporate interests and patient vanity had led to dozens of birth defects and countless abortions. We were always disappointed that the patient-responsibility approach (making female patients sign documents acknowledging the risks) was not 100% effective. The iPLEDGE system may be the lumbering bureaucratic solution that Nader, patients, and corporations can all agree on.
If it works, iPLEDGE may serve as a model to limit side effects (and liability) for other controversial drugs.
More from the FDA’s iPledge program and the registration site.

Neurological Surgery

Neurological Devices: Developed enough for a 2-page AP Article

by Tim Odell on Feb 28, 2006 • 2:35 am

term man sm Neurological Devices: Developed enough for a 2 page AP ArticleMainstream science/technology articles usually come in one of a few forms. Outlining some cutting edge (ie, with no applications for another 20 years) research being done at a university, discussing a “controversial” medical procedure, or summing up the specifics of the latest NASA mission are mainstays. Occasionally, they write pieces summing up a new technology as having “arrived,” ready for use by the general public, if only it would read the article. Chris Williams of the AP has granted neuro implants such status:

Don Falk stretched his right arm over his head, past the faint marks where a surgeon sank two wires deep in his brain, to show how uncontrollable tremors in his hand used to slap him awake in the morning.

It’s always important to open a medical technology piece with a patient vividly outlining how things were pre-treatment and to throw some seed like “sank two wires deep in his brain” to hook readers’ curiousity as to the crazy new technology employed.

In May, Falk, 52, started to get better with the help of an emerging class of implantable medical devices called neuromodulators — tiny machines that stimulate the central nervous system to treat a host of disorders. Analysts say they could be the next big thing for some of the market’s hottest medical technology companies.
The deep brain stimulator silently pulsing away deep in Falk’s head is made by Fridley-based Medtronic Inc., a multibillion dollar medical device company and the leader in the more than $1 billion market for neuromodulators.
Medtronic has the only deep brain stimulator on the market, but St. Paul-based St. Jude Medical Inc. is in clinical trials of its own version through its newly acquired subsidiary Advanced Neuromodulation Systems Inc. of Plano, Texas, which already sells spinal implants to treat chronic pain.
“I can tell you eight years ago, neuromodulation was not on the tip of anybody’s tongue, but today it is reaching critical mass and it’s gaining momentum and people are starting to imagine what is possible,” said Chris Chavez, president of St. Jude Medical’s ANS division.
Cyberonics Inc. of Houston is the smallest player, with a device to treat epilepsy by shocking a nerve in the neck, and Boston Scientific bought into the market in 2004 by acquiring Sylmar, Calif.-based Advanced Bionics Corp., a maker of robotic inner ears.
But ANS quarterly revenue rose 26 percent to $39.3 million during its last quarter before St. Jude bought it in November for $1.4 billion. And Cyberonics Inc. reported sales grew 19 percent to $31.3 million for the quarter ended Jan. 27, though the company reported an overall loss on heavy spending to prepare marketing of a newly approved neuromodulation therapy for drug-resistant chronic depression.
Perhaps surprisingly, the risks of brain surgery rarely dissuade patients, maybe because they are tired of living with Parkinson’s symptoms and have seen other treatments fail, he said.
Falk said he didn’t hesitate about brain surgery. “My tremor was so bad I just wanted it done,” he said. His adult children didn’t think twice either: “They did not like me just sitting there, shaking and stuff.”
Falk touts his procedure to other Parkinson’s patients, telling them that his medication has been cut by two-thirds and his insurance covered the procedure.
“Neurostimulation to me, in fact the whole neurological space, is what cardiology was 10 years ago,” Wald said. “The opportunity is just vast.”
Companies are already pushing to develop new applications for the devices. They see potential uses in treating diseases including depression, obsessive-compulsive disorder, erectile dysfunction, traumatic brain injuries, obesity, angina, incontinence and ringing in the ears.

While the article doesn’t say much that your average Medgadget reader wouldn’t already know, articles of this ilk are important for alerting the general public as to the progress that medical technology is making. Specifcally, pieces like this attract patients, investors, political advocates and future biomedical engineers.
Notably lacking in the article were any references to Terminal Man by Michael Crichton (thus the picture).
Article via Newsday.com
Neuro device companies named in the article:
Medtronic Inc
St. Jude Medical Inc
Boston Scientific Inc
Advanced Neuromodulation Systems Inc
Advanced Bionics Corp
Cyberonics Corp

Uncategorized

German Team Demonstrates Functional Micro Robotics (Sort of)

by Tim Odell on Feb 28, 2006 • 12:39 am

MiCRoN German Team Demonstrates Functional Micro Robotics (Sort of)
A German group working on something called the MiCRoN Project (Miniaturised Co-operative Robots advancing towards the Nano range. One can only wonder how they spell that out in German) has demostrated some progress on useful micro-scale robot development:

The MICRON project team, led by the Institute for Process Control and Robotics (IPR), Karlsruhe, Germany, brought together eight international partners. Funded under the European Commission’s FET (Future and Emerging Technologies) initiative of the IST programme, MICRON set out to build a total of five to ten micro robots, just cubic centimetres in size.
“Each one would measure about 1.5cm by 3 cm,” says IPR’s Joerg Seyfried. “They were designed to be complete robots, with different kinds of actuators for gripping, cell manipulation, and so on. Each one would be wireless, with lots of electronics on board, and an infrared control system – rather like a TV remote, but two-way in this case. They would be able to cooperate together on a range of tasks.”

Note that up to this point all of language is conditional: “Each one would measure,” “would be able…”

Building the robots involved developing many custom applications, he adds. “One of these was the wireless powering system, the ‘power floor’, which allows the robot to get energy from its surroundings,” he says. “It uses a coil system to transmit the electricity through the air.”
The robots were designed as part of a networked system: “The individual robots are not that intelligent,” explains Seyfried. “They don’t, for example, know where they are, although they know which direction they are moving in. We developed a special positioning system, so that we know where each robot is. It views them from 40 to 50 cm above. They are controlled by a central robot control system, with several networked computers for planning and commands – this could theoretically control many robots.”
The hardest part of the project was “getting the hardware integrated and running – our goal was to have five robots operational, but this couldn’t be done in our three-year timeframe owing to the extreme complexity of the task,” he says.
Nevertheless, the one fully functional robot that the project did achieve could be tested in three different scenarios. “The first was a medical or biological application, in which the robot was handling biological cells, injecting liquid into them,” Seyfried explains. “The second scenario was micro-assembly, in which the robot soldered tiny parts. The final scenario looked at atomic force, with the robot mounting atomic force and doing experiments on it.”
The results were encouraging. “Our experiments showed that the cell injection is entirely feasible, as is the micro soldering,” says Seyfried. Although the MICRON robots are clearly not a mass market product, commercialisation – though still far off – would be perfectly possible, he believes: “Robots with this sort of capability, and mobility, would be perfectly suited to lab work, such as the micro assembly of prototypes. Tasks such as cell injection could be performed on a mass scale.”

It seems like someone’s missing the point. The interesting and challenging part of micro- and (cough) nano-scale robotics isn’t figuring out applications, its actually building the suckers. You don’t win a Nobel Prize for thinking up clever uses for a fusion reactor. That this group was able to even construct one functional robot on this scale, along with a power-supply scheme is pretty impressive.
Via Medical News Today…
Link to the MiCRoN Project…

Ob/Gyn / Pediatrics

SituGen for Cord Blood Collection

by Gene Ostrovsky on Feb 27, 2006 • 12:52 am

6525266 SituGen for Cord Blood CollectionGlobes [online] is reporting that Israeli Biocord Ltd., which developed a novel efficient pump for withdrawing umbilical blood, “is negotiating to raise $2 million from a foreign medical devices company.” At the present time, umbilical blood is collected only for the purpose of freezing it for possible future use, as it contains large amounts of umbilical stem cells.
Israel21C provides details about the device that is thought to one day replace inefficient needle systems being used today:

Made mainly of polypropylene and latex, the SituGen comprises a holder which clamps around the umbilical cord, holding the cord in place as the placenta is delivered and absorbing the maternal blood so it doesn’t contaminate the baby’s cord blood. Attached to the holder through a sophisticated synchronization and sealing mechanism is a sterilization chamber into which the blood flows. A syringe is connected to the other end of the chamber which can be removed when full, emptied and then refilled.
“There’s no needle, there’s no bottleneck, it’s one hundred percent disinfected and sterilized, which is a must in this process,” explains Shacham. [Miki Shacham, CEO of Ramat-Gan-based Israeli cord blood bank company and the inventor of the new device. -ed.]
In initial tests of the prototype, in around seven minutes as much as triple the usual 80ml was collected by the SituGen, enough stem cells to treat an adult. As well as extracting more blood, the device is easier to use than a needle, with only a short time needed to master its operation, says Shaham.
Shaham developed the device under the auspices of BioCord’s sister company, Impact, of which he is also the CEO. Not content with aiming to revolutionize cord blood collection, Shaham has another idea up his sleeve: a device for nursing mothers to allow them to measure exactly how much breast milk their baby has drunk. However, like every good businessperson, he is remaining tight-lipped about this until the prototype is ready and patents have been filed.

Company website…

Informatics

Wireless Patient Monitoring System from Cisco, Philips, and Emergin

by Gene Ostrovsky on Feb 27, 2006 • 12:46 am

1235146 Wireless Patient Monitoring System from Cisco, Philips, and EmerginCisco Systems is reporting that it has collaborated with Philips Medical Systems and “leading plug n’play integration company” Emergin to provide clinicians with a wireless way to receive immediate waveform and text medical alarms on the company’s wireless IP phone 7920 (illustrated; small screen to monitor patients, indeed.)

The Cisco Patient Monitoring solution sends electrocardiogram data via waveform snippets and text messages to the Cisco Wireless IP Phone 7920 from the Philips IntelliVue patient monitoring system via the Emergin Patient Monitoring Gateway. Acting as a secondary alarm notification, the solution allows nurses and clinicians to maintain their mobility while still receiving critical patient data. While the primary alarming mechanism remains at the patient’s bedside monitor or an associated central station, the additional waveform information enables assessments to begin even as the staff goes to the patient’s bedside or unit monitors for further analysis.
At Central DuPage Hospital, a nationally recognized 361-bed facility located in Winfield, Ill., the Cisco-Philips-Emergin Patient Monitoring offering has helped the facility increase the productivity of its nurses and improve the quality of patient care, while building on Central DuPage’s growing mobile workplace. The hospital uses the solution in its 38-bed cardiac telemetry unit to deliver critical alarm and heart rhythm information directly to nurses on their Cisco Wireless IP Phone 7920. Previously nurses would receive verbal alarms from remote telemetry technicians in the event of a rhythm change via pagers. They are now able to receive the actual waveform associated with the event that triggered the alarm on their wireless phones.

The press release…
Cisco healthcare solutions: www.cisco.com/go/healthcare
Flashbacks: IntelliVue Telemetry System; Global Care Quest system.

12345678910

Follow Medgadget on Twitter