Archives: 2/2007

43621qg Non Invasive Preemptive Sepsis Monitor for the Smallest PatientsDrs. Pam Griffin and Randall Moorman at the University of Virginia Health System have developed a bedside monitoring device that detects unique cardiac rhythms, which their research shows are characteristic for the development of neonatal sepsis.

Dr. Randall Moorman, study co-author and cardiologist at the UVa Health System, was instrumental in developing the novel bedside monitoring system to predict the likelihood that sepsis will occur in a baby in the next 24 hours. The new system analyzes heartbeat signals obtained from a standard bedside heart rate monitor and looks for patterns that give an early indication that the baby is getting sick. Characteristics such as decreased variability of the heart rate along with brief episodes of slowing of the heart rate indicate that the infant may be getting an infection. These characteristic patterns can serve as an early warning to the physicians and nurses caring for the infants.
“At UVa we found characteristic heart rate patterns in infants twelve or more hours before they were known to be infected, and we designed a computer program to detect these patterns,” said Moorman. “We worked with colleagues at Wake Forest to be sure that these heart rate characteristics typical of illness happened in sick infants elsewhere.”
Now after years of testing and clearance from the Food and Drug Administration, academic research hospitals are participating in a multi-center National Institutes of Health-sponsored study to further test if heart rate characteristic monitoring improves outcomes for NICU babies.

Link . . .

Some doctors are stuck ‘in the box’, but not Dr. Palter; he’s been locked in the machine for some time now. Luckily, it has been time well spent because he has another excellent piece about potential medical breakthroughs that we can thank DARPA for.

MAJOR FUTURE ICONIC PLANS: The Strategic plan for 2007 lays out the following major strategic plans of focus- along with my view of potential medical applications.

  • Chip-Scale Atomic Clock: miniaturizing an atomic clock to fit on a chip to provide very accurate time as required, for example, in assured network communications – technology could be used on various implantable diagnostic devices as well as for implantable next generation pacemakers and regulatory bioimplants.
  • Global War on Terrorism: technologies to identify and defeat terrorist activities such as the manufacture and deployment of improvised explosive devices- will lead to the development of new smart diagnostic chips and devices. While initally (sic) these will screen for explosives and threat molecules, in the future these could identify tumor markers, metabolomic molecules, drug levels, and countless diagnostic and therapeutic molecules.
  • Air Vehicles: unmanned air vehicles that quickly arrive at their mission station and can loiter there for very long periods. The development of unmanned rover devices will directly affet (sic) the ability to produce and control impnatable (sic) miniaturized diagnostic rovers placed into the human body.
  • Check out the rest of his predictions . . .

    7654567env2 Enviga in Hot WatersEnviga, a Coca Cola and Nestlé drink touted to have negative caloric balance, is now under legal fire. We have reported about the product and our scepticism on its wondrous waters back in October.
    From the statement by the Center for Science in the Public Interest (CSPI):

    The Center for Science in the Public Interest (CSPI) is suing Coca-Cola and Nestlé for making fraudulent claims in marketing and labeling for Enviga, a new beverage labeled “the calorie burner” on its cans. Enviga is claimed to have “negative calories” and to “keep those extra calories from building up.” The product’s Web site also says the drink is “much smarter than following fads, quick fixes, and crash diets.” CSPI’s suit document http://www.casewatch.org/civil/enviga/complaint.shtml states:
    **Enviga consists of carbonated water, calcium, concentrated green tea extract, various “natural flavors,” and ingredients typically found in diet soda, such as caffeine (three diet colas’ worth), phosphoric acid, and the artificial sweeteners aspartame and acesulfame potassium. The company says its green tea extracts are high in an antioxidant called epigallocatechin gallate, or EGCG.
    **Enviga’s main claims are based on a 72-hour Nestlé-funded study of 31 people who were given a drink containing amounts of EGCG and caffeine equivalent to three cans of Enviga. An abstract of the unpublished study stated that on average, those subjects expended more energy. However, none of the 31 were overweight or obese when the study began.
    **The study showed that, at best, healthy, active, average-weight people might see a 100-calorie drop every day they drink three cans of Enviga. It would take 35 days of constant consumption of Enviga-105 cans at a cost of about $146 (at $1.39 per can)-to see even one pound of possible weight loss-and that assumes that the consumers would not eat 100 extra calories worth of other foods.
    **No test of Enviga has lasted more than three days. One European study found that EGCG and caffeine did not increase energy expenditure after one month and did not help people lose weight. One longer-term Japanese study did show that a tea fortified with EGCG and caffeine helped people lose more weight than a control tea, but that study was conducted by a tea company and the subjects of the study were 38 of that company’s male employees.
    CSPI’s scientists have concluded that “Enviga is just a highly caffeinated and overpriced diet soda, and is exactly the kind of faddy, phony diet aid it claims not to be.”

    Full press release
    Legal docs by CSPI…
    Flashback: Coca-Cola Claims Breakthrough; Dismissed by Medgadgeteers, Others

    fatima New Hospital Gown Fights Deadly BacteriaIn the never ending crusade against drug resistant bacteria, researchers at the University of Portsmouth and DCS Designs Ltd., a spinoff company, designed a new type of hospital gown for patients with a special anti-bacterial coating. Predictably, neither the university nor the company are eager to reveal the technology’s details:

    The patient gown combines a new and innovative design with an anti-microbial finish that controls the growth of bacteria.
    The gown’s unique design aims to reduce the spread of infection by minimising patient handling. It facilitates access to the patient’s body for examination and makes it easier to change than regular gowns. Less patient handling means less contact with nurse’s uniforms which reduces the chance of cross-contamination.
    The gown was designed by DCS Designs, a graduate start-up company emerging from the University of Portsmouth. Fatima BA-Alawi invented the design while she was still a student and working in a hospital as a health care assistant where she noticed improvements could be made to the conventional patient gown.
    She has teamed up with Carrington Career & Workwear Ltd whose product, Permagard, provides the bug-busting ingredient.
    “I’m thrilled that my design is being used for the trial. I designed the gown to promote patient dignity, comfort and safety but I’m delighted that it might help prevent the spread of diseases like MRSA,” Fatima said.

    Press release by the University of Portsmouth . . .
    DCS Designs’ uninformative website

  • Technology captures tumors’ genetic profile, guides cancer treatment
    [EurekAlert]
  • Say It With Molecules: Molecular Jewelry
    [Medpundit]
  • Cleft Palate in Fetal Mice Prevented In Utero with Molecule
    [EurekAlert]
  • New Weapon Against Cancer: HIV Protein Enlisted To Help Kill Cancer Cells
    [ScienceDaily]
  • A Website to Improve Asthma Care by Suggesting Patient Questions for Physicians: Qualitative Analysis of User Experiences
    [Dissect Medicine]
  • 100 devices, 60 hospitals: More often, doctors visit bedside via robot
    [AMNews]
  • 3652exo1 Your Central Nervous System; Our Exoskeleton
    For patients status post stroke, or status post peripheral neuropathy, the device described as a “robotic exoskeleton controlled by the wearer’s own nervous system” is an exciting possibility to recover motor function the high-tech way:

    A robotic exoskeleton controlled by the wearer’s own nervous system could help users regain limb function, which is encouraging news for people with partial nervous system impairment, say University of Michigan researchers.
    3652exo3 Your Central Nervous System; Our ExoskeletonThe ankle exoskeleton developed at U-M was worn by healthy subjects to measure how the device affected ankle function. The U-M team has no plans to build a commercial exoskeleton, but their results suggest promising applications for rehabilitation and physical therapy, and a similar approach could be used by other groups who do build such technology.
    “This could benefit stroke patients or patients with incomplete injuries of the spinal cord,” said Daniel Ferris, associate professor in movement science at U-M. “For patients that can walk slowly, a brace like this may help them walk faster and more effectively.”
    Ferris and former U-M doctoral student Keith Gordon, who is now a post-doctoral fellow at the Rehabilitation Institute of Chicago, showed that the wearer of the U-M ankle exoskeleton could learn how to walk with the exoskeleton in about 30 minutes. Additionally, the wearer’s nervous system retained the ability to control the exoskeleton three days later.
    Electrical signals sent by the brain to our muscles tell them how to move. In people with spinal injuries or some neurological disorders, those electrical signals don’t arrive full strength and are uncoordinated. In addition, patients are less able to keep track of exactly where and how their muscles move, which makes re-learning movement difficult.
    Typically, robotic rehabilitative devices are worn by patients so that the limb is moved by the brace, which receives its instructions from a computer. Such devices use repetition to help force a movement pattern.
    The U-M robotic exoskeleton works the opposite of these rehabilitation aids. In the U-M device, electrodes were attached to the wearer’s leg and those electrical signals received from the brain were translated into movement by the exoskeleton.
    3652exo2 Your Central Nervous System; Our Exoskeleton“The (artificial) muscles are pneumatic. When the computer gets the electrical signal from the (wearer’s) muscle, it increases the air pressure into the artificial muscle on the brace,” Ferris said. “Essentially the artificial muscle contracts with the person’s muscle.”
    Initially the wearer’s gait was disrupted because the mechanical power added by the exoskeleton made the muscle stronger. However, in a relatively short time, the wearers adapted to the new strength and used their muscles less because the exoskeleton was doing more of the work. Their gait normalized after about 30 minutes.

    Press release
    Human Neuromechanics Laboratory at University of Michigan…
    Videos
    Medgadget archives: Exoskeleton

    0876lap1 LAP Mentor™ and other Sims from Simbionix
    In an article at the Globes [online] we read about Israeli company Simbionix Ltd., a medical simulator start-up. The company has many interesting simulators such as GI Mentor (i.e. upper & lower GI scopes), URO Mentor (i.e. endourology), PERC Mentor (i.e. fluoroscopy-assisted percutaneous procedures), and ANGIO Mentor (i.e. self-explanatory).
    We were particularly intrigued by LAP Mentor, a laparoscopic sim system.
    Company’s take on its device:

    Our new 2nd generation LAP Mentor II Simulator features an advanced, ergonomic design that is both portable and user-friendly. The simulator handles on this sleek system are completely extractable for easy switching to suturing handles.
    0876lap22 LAP Mentor™ and other Sims from SimbionixIn addition, the improved haptic interface on the new LAP Mentor II offers enhanced tactile feedback, performance and reliability…
    The following features are an integral part of the simulator:

  • Growing library of modules and training curricula
    The LAP Mentor training system incorporates a variety of practice opportunities, and provides a laparoscopic training curriculum made up of basic skills, tutorials of procedural tasks, and simulation of a full procedure. This cost-effective simulator design can accommodate on-going development, including the addition of new procedures and a wider variety of virtual patients and tasks.
  • Realism – realistic visualization of the human anatomy that provides a life-like view of the intraabdominal cavity. One can maneuver the gallbladder, expose the cystic duct and artery, clip and cut the cystic duct and artery and separate the gallbladder from the liver with electrocauterization.
  • Tactile sensations – Provides realistic surgical simulations by incorporation of tactile sensations in the use of laparoscopic instruments that imitate real-life (haptic system).
  • Management mode – for organization of trainees, courses and workshops. The data collection and exporting features of this mode facilitate research work as well.
  • Extensive evaluation parameters for each performance on the simulator.
  • Variety of educational aids.
  • The company’s software modules for LAP Mentor feature such procedures as “Basic Tasks”, Suturing, Lap Chole, Ventral Hernia, and Gastric Bypass. Below is a screen shot of the ventral hernia repair module.
    0876lap3 LAP Mentor™ and other Sims from Simbionix
    Company website

    1bubl1 The Bubble LogicMIT researchers created a microfluidic device in which tiny bubbles, while undergoing chemical reactions inside, function essentially like electrons in a microprocessor:

    The team, based at MIT’s Center for Bits and Atoms, reports that the bubbles in their microfluidic device can carry on-chip process control information, just like the electronic circuits of a traditional microprocessor, while also performing chemical reactions. The work will appear in the Feb. 9 issue of Science.
    “Bubble logic merges chemistry with computation, allowing a digital bit to carry a chemical payload. Until now, there was a clear distinction between the materials in a reaction and the mechanisms to control them,” said co-author Neil Gershenfeld, director of the Center for Bits and Atoms.
    Microfluidics allow scientists to create tiny chips where nanoliters of fluids flow from one part of the chip to another, undergoing controlled chemical reactions in different parts of the chip and replacing the conventional test tubes and glassware used for chemistry for centuries.
    The technology has the potential to revolutionize large-scale chemical analysis and synthesis, environmental and medical testing and industrial production processes, but applications outside of the laboratory have been limited so far by the external control systems–valves and plumbing–required for its operation.
    1ohd88 The Bubble LogicBut now, the MIT researchers are able to control microfluidic chips via the interactions of bubbles flowing through microchannels, eliminating the need for external controls. “Now you can program what’s happening inside the lab on a chip, by designing bubble logic circuits that function just like their electronic counterparts,” said Manu Prakash, Gershenfeld’s co-author and graduate student.
    Controlling chemical reactions will likely be a primary application for the chips, according to the researchers. It will be possible to create large-scale microfluidic systems such as chemical memories, which store thousands of reagents on a chip (similar to data storage), using counters to dispense exact amounts and logic circuits to deliver them to specific destinations.
    Other applications include combinatorial synthesis of many compositions at the same time, programmable print heads that can deposit a range of functional materials, and sorting biological cells.
    The researchers modeled their new microfluidic chips on the architecture of existing digital circuits. But instead of using high and low voltages to represent a bit of information, they use the presence or absence of a bubble. They report on nitrogen bubbles in water, but any other combinations of materials that don’t mix would work, such as oil and water.
    In the Science paper they demonstrate all of the elements needed for any new logic family, including gates, memories, amplifiers and oscillators. The speed of operation is about 1,000 times slower than a typical electronic microprocessor, but 100 times faster than the external valves and control systems used in existing microfluidic chips. Gershenfeld and Prakash anticipate that its invention will allow existing circuit designs (and designers) to work in the domain of microfluidics.

    Link
    Flashback: Computer with DNA Circuits Plays Games; One Day to Go Diagnostic

    1jhrortho The Navitracker™
    ORTHOsoft, Inc., a Montreal, O’Canada firm, is planning to introduce an advanced Computer-Assisted Surgery tracking device called the Navitracker™ at this year’s American Academy of Orthopedic Surgeons Annual Meeting, to be held February 14-16 in San Diego. Medgadget has obtained the picture and description of the device by the company:
    1jhrortho2 The Navitracker™

    While the NavitrackER technology answers economic constrains in the market with the reduction in cost per surgery, it has superior tracking capability compared to spheres, giving clients a better product at reduced cost.
    The key features and benefits are:
    1. Increased visibility
    Due to the placements of reflective discs in an angular arrangement the range of visibility compared to spheres increases from 127° to 135°.
    2. Increased accuracy
    The accuracy of the NavitrackER tracker technology is higher compared to spheres. NavitrackER also has a more linear behaviour showing a similar tracking error independent of angle towards the camera, whereas spheres accuracy depends on angle of the tracker towards the camera.
    3. Increased robustness
    1jhrortho3 The Navitracker™The design of the NavitrackER tracker provides superior resistance to contamination with tissue and liquids. In tests spheres exhibited a 63% loss of visibility when exposed to animal tissue. Wiping with surgical gauze restored 30% of this lost visibility, but the remaining 33% was not recovered. NavitrackER shows minimal loss of visibility which is fully restored after wiping with no remaining loss of visibilty.
    The NavitrackER technology will be compatible to all existing instruments and following software will be supported: Universal Hip, Universal Knee, TKR Ct-Less 1.0 to 1.11, THR Ct-Free 1.0, FluoroSpine and Durom.

    Press release
    ORTHOsoft site