A brain scan method showing a chemical abnormality in a critical part of the brain could herald an early method of diagnosis for schizophrenia thanks to the work of a collaborative team at the new Centre for Psychosis, Institute of Psychiatry at King's College London, and University College London, Institute of Nuclear Medicine.
Schizophrenia is one of the most serious mental disorders, involving disrupted thinking and behaviour and can be devastating for the sufferer and their carers alike. It is as common as diabetes in the UK affecting one per cent of the population and it can often strike young people at the height of an individual's potential, for example during A-levels, or when embarking on a career or at university. In some cases lifelong and expensive treatment is required.
"What this intriguing finding means is that for the first time we may have a non-invasive method for scanning chemicals in the brains of living patients which may lead to new treatment and diagnostic approaches in the disorder. This is work in progress and we desperately need more funding to develop and extend this very exciting development," said Professor Pilowsky.
Structural brain scans have already revealed that schizophrenic patients as a group often have smaller brains, with subtle evidence of shrinkage in particular areas associated with emotions, thinking and memory and scientists have long thought from studying patients brains at post mortem that a chemical abnormality in the NMDA system might exist . This new chemistry deficit in the temporal cortex found in living patients now confirms this. Pilowsky and her colleagues revealed this defect after a long period of investigation. This included development of the SPET scan itself, and application of the technique to scanning of schizophrenic patients, who were not being treated with anti psychotic medication. Scans of a small group of these patients were compared to healthy individuals using the most up-to-date analytic methods.
In the brain, nerve cells 'talk' to each other using special chemical messengers (called neurotransmitters). When a cell releases one of these chemical messengers it fits into its unique receptor to transmit a message. NMDA, and its messenger chemical glutamate that are essential for cell-to-cell communication within the brain. A deficiency in this system could literally result in 'loose' wiring, with fragile connections between areas of the brain that need to communicate. Schizophrenia researchers have suspected that this may be happening in the disorder, but early studies were affected by medications patients had been taking before their death, and by the event itself. SPET and PET scanning allow imaging of brain and body chemicals in humans in life.
Professor Lyn Pilowsky, supported by the Medical Research Council, has been developing this scan (called SPET) for the last five years. Her collaborators include Professor Peter Ell and his team at the Institute of Nuclear Medicine at UCL, Dr Rodrigo Bressan and Dr James Stone, King's College London, Professor John Krystal, Yale University, USA, and Professor David Wyper's team, Glasgow University. The results of this study were published in the Journal of Molecular Psychiatry, February 06.
The paper, 'First in vivo evidence of an NMDA receptor deficit in medication-free schizophrenic patients' appeared in Molecular Psychiatry, February 2006.
Professor Pilowsky is the first author of this paper and is the Professor of Neurochemical Imaging, Institute of Psychiatry, King's College London. During the course of this research Professor Pilowsky was a UK Medical Research Council Senior Clinical Research Fellow (1999-2004). Other colleagues in this collaboration included: Dr Rachel Mulligan, Austin Hosp.Melbourne, Victoria, Australia; Dr Erik Arstad, Hammersmith IMANET, Imperial College London; Physicists/Mathematical Modellers and Dr Kjell Erlandsson, Columbia University, New York. Professor Robin Murray, Institute of Psychiatry, King's College London.
The case and control subjects used in the study were from in and around London. It is particularly helpful that this research was done in collaboration with colleagues, patients and their families from the South London and Maudsley NHS Trust, and the wider London area.
The Institute of Psychiatry is part of King's College London which now hosts four prestigious Medical Research Council research centres, more than any other university in the country. King's College London is the fourth oldest university in England with more than 13,800 undergraduate students and nearly 5,700 postgraduates in nine schools of study based at five London campuses. It is a member of the Russell Group: a coalition of the UK's major research-based universities. The College has had 24 of its subject-areas awarded the highest rating of 5* and 5 for research quality, demonstrating excellence at an international level, and it has recently received an excellent result in its audit by the Quality Assurance Agency.
http://www.medicalnewstoday.com
Monday, January 29, 2007
Enhanced imaging techniques could improve medical diagnosis
Chris Wyatt is a Virginia Tech electrical engineer who is attempting to provide the medical community with better, quicker, and more relevant images of the human body. The side effects are not bad either -- lower medical costs, new treatments, and earlier disease detection.
Today, doctors and researchers can view the body's hard and soft tissues through X-rays, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) technology. With MRI and positron emission tomography (PET) scans, viewing cellular activity is also possible.
But these viewing techniques can be enhanced. Wyatt is specifically looking at improving imaging for virtual colonoscopies; developing algorithms to replace extensive manual work in brain imaging; and developing image-guided polypectomy technology.
As an example of the impact that smarter imaging techniques could have, consider the pharmaceutical industry and its drug trials. "Drug studies involve many hundreds of patients; that's a lot of data. If you're evaluating a new drug for cancer and you scan 1,000 patients three times, you have 3,000 sets of data. Can you hire a radiologist to look at all that?
"You can acquire the data, but pulling out the information you want -- such as how the lesion is changing - is a difficult, time-consuming process that right now is done manually in many cases. Trained technicians look at the images and outline the lesions by hand," said Wyatt, a faculty member in the Virginia Tech - Wake Forest University School of Biomedical Engineering and Sciences.
In brain imaging, Wyatt is concentrating on improving the medical understanding of addiction through modeling techniques. Wyatt is working with the Wake Forest University School of Medicine's Center for the Neurobehavorial Study of Alcohol (CNSA) to develop algorithms that increase the medical understanding of neurological structures beyond what is currently provided by state-of-the-art MRIs. Wyatt hopes to produce an MRI brain template for two species of macaque monkeys and verify his results using the animals in ongoing studies of alcohol abuse and alcoholism.
"Monkeys are a unique tool for alcoholism research because several aspects of their alcohol consumption closely mimic those of humans," Wyatt said. "Using monkey models and magnetic resonance imaging, it is possible to design complex studies to understand the neurological mechanisms of alcoholism without the confounding factors problematic in human research. However, current neuro-image analysis tools were designed for use on human data and do not provide the same level of accuracy and robustness when applied to monkey data," he explained. Wyatt's goal is to develop a comprehensive set of tools for the analysis of monkey images.
If Wyatt is able to improve medicine's understanding of the biological mechanisms of addiction, then he will also increase the knowledge about the influence of risk factors and the effects on the body. "As many of these mechanisms are primarily located in the brain, understanding the neurological effects of alcohol and related factors is a key aspect of alcoholism research. This knowledge is critical to diagnosis, treatment, and prevention of alcoholism," Wyatt said.
Computer-aided diagnosis could also improve the quality of evaluations. "The problem with evaluating all these images manually is that you use different people at different skill levels at different times of the day. People inherently introduce inconsistencies, whereas computers are more consistent and reliable if programmed correctly."
Wyatt is also pursing imaging advancements in the detection and treatment of colon cancer. "About 50 percent of today's colon cancer cases could have been prevented with early detection of polyps. Doctors have the screening methods, but compliance is a problem. Colonoscopies are not fun. If we can do the initial screening with more comfortable imaging instead of scoping, we can get higher compliance and detect more cases early," he said.
He is working to extend the virtual colonoscopy technology to image-guided polypectomy. "The polyps still need to be surgically removed, but patients who already know they have polyps are much more amenable to enduring a scope. A well-trained endoscopist, if there is no problem with insertion, is very fast and very good. Sometimes, though, the polyps can hide in a fold and finding them can be difficult. If we can use virtual colonoscopy to help guide the endoscope to the polyps, we can help the endoscopists become even better and faster."
While earning his Ph.D. at the Wake Forest University School of Medicine, Wyatt worked in its Virtual Colonoscopy Laboratory, which uses CT data to image the colon.
"My efforts are in connecting prior information to analyze the data we get from different imaging," he said. The prior information encompasses anatomy, physiology, and imaging experience. "Physicians and radiologists use prior knowledge of the organs and prior experience in reading images," he explained. "When they look at an image, even if it's not a good image, they impose their knowledge to extract usable information. We've been working for some time to develop algorithms to incorporate this kind of knowledge into the operating systems of imaging equipment."
http://www.medicalnewstoday.com
Today, doctors and researchers can view the body's hard and soft tissues through X-rays, ultrasound, computed tomography (CT), and magnetic resonance imaging (MRI) technology. With MRI and positron emission tomography (PET) scans, viewing cellular activity is also possible.
But these viewing techniques can be enhanced. Wyatt is specifically looking at improving imaging for virtual colonoscopies; developing algorithms to replace extensive manual work in brain imaging; and developing image-guided polypectomy technology.
As an example of the impact that smarter imaging techniques could have, consider the pharmaceutical industry and its drug trials. "Drug studies involve many hundreds of patients; that's a lot of data. If you're evaluating a new drug for cancer and you scan 1,000 patients three times, you have 3,000 sets of data. Can you hire a radiologist to look at all that?
"You can acquire the data, but pulling out the information you want -- such as how the lesion is changing - is a difficult, time-consuming process that right now is done manually in many cases. Trained technicians look at the images and outline the lesions by hand," said Wyatt, a faculty member in the Virginia Tech - Wake Forest University School of Biomedical Engineering and Sciences.
In brain imaging, Wyatt is concentrating on improving the medical understanding of addiction through modeling techniques. Wyatt is working with the Wake Forest University School of Medicine's Center for the Neurobehavorial Study of Alcohol (CNSA) to develop algorithms that increase the medical understanding of neurological structures beyond what is currently provided by state-of-the-art MRIs. Wyatt hopes to produce an MRI brain template for two species of macaque monkeys and verify his results using the animals in ongoing studies of alcohol abuse and alcoholism.
"Monkeys are a unique tool for alcoholism research because several aspects of their alcohol consumption closely mimic those of humans," Wyatt said. "Using monkey models and magnetic resonance imaging, it is possible to design complex studies to understand the neurological mechanisms of alcoholism without the confounding factors problematic in human research. However, current neuro-image analysis tools were designed for use on human data and do not provide the same level of accuracy and robustness when applied to monkey data," he explained. Wyatt's goal is to develop a comprehensive set of tools for the analysis of monkey images.
If Wyatt is able to improve medicine's understanding of the biological mechanisms of addiction, then he will also increase the knowledge about the influence of risk factors and the effects on the body. "As many of these mechanisms are primarily located in the brain, understanding the neurological effects of alcohol and related factors is a key aspect of alcoholism research. This knowledge is critical to diagnosis, treatment, and prevention of alcoholism," Wyatt said.
Computer-aided diagnosis could also improve the quality of evaluations. "The problem with evaluating all these images manually is that you use different people at different skill levels at different times of the day. People inherently introduce inconsistencies, whereas computers are more consistent and reliable if programmed correctly."
Wyatt is also pursing imaging advancements in the detection and treatment of colon cancer. "About 50 percent of today's colon cancer cases could have been prevented with early detection of polyps. Doctors have the screening methods, but compliance is a problem. Colonoscopies are not fun. If we can do the initial screening with more comfortable imaging instead of scoping, we can get higher compliance and detect more cases early," he said.
He is working to extend the virtual colonoscopy technology to image-guided polypectomy. "The polyps still need to be surgically removed, but patients who already know they have polyps are much more amenable to enduring a scope. A well-trained endoscopist, if there is no problem with insertion, is very fast and very good. Sometimes, though, the polyps can hide in a fold and finding them can be difficult. If we can use virtual colonoscopy to help guide the endoscope to the polyps, we can help the endoscopists become even better and faster."
While earning his Ph.D. at the Wake Forest University School of Medicine, Wyatt worked in its Virtual Colonoscopy Laboratory, which uses CT data to image the colon.
"My efforts are in connecting prior information to analyze the data we get from different imaging," he said. The prior information encompasses anatomy, physiology, and imaging experience. "Physicians and radiologists use prior knowledge of the organs and prior experience in reading images," he explained. "When they look at an image, even if it's not a good image, they impose their knowledge to extract usable information. We've been working for some time to develop algorithms to incorporate this kind of knowledge into the operating systems of imaging equipment."
http://www.medicalnewstoday.com
Medical Diagnosis Being Hampered By Obesity
The increase of obesity in the United States doubled the number of inconclusive diagnostic imaging exams over a 15-year period, according to a study featured in the August issue of Radiology.
Researchers assessed all radiology exams performed at Massachusetts General Hospital (MGH) between 1989 and 2003 to determine the effects of obesity on imaging quality and diagnosis.
In an effort to quantify how obesity affects diagnostic imaging quality, Dr. Uppot and colleagues analyzed radiology records from a 15-year span at MGH. They searched for incomplete exams that carried the label "limited by body habitus," meaning limited in quality due to patient size.
"While 0.10 percent of inconclusive exams were due to patient size in 1989, by 2003 the number had jumped to 0.19 percent, despite advances in imaging technology," said Raul N. Uppot, M.D., lead author and staff radiologist at MGH. "Americans need to know that obesity can hinder their medical care when they enter a hospital."
An estimated 66 percent of adults in the United States are overweight, obese or morbidly obese, according to the Department of Health and Human Services. Additionally, more than 12.5 million American children and adolescents are overweight. Hospitals are feeling the strain--they now require larger wheelchairs and beds. Additionally, standard operating tables and imaging equipment are not suited for obese patients.
By 2003, the modality that yielded the most difficulties in rendering a diagnosis was abdominal ultrasound (1.90 percent), followed by chest x-rays (0.18 percent), abdominal computed tomography (CT), abdominal x-rays, chest CT and magnetic resonance imaging (MRI) (all anatomic regions included).
CT and MRI can be problematic because of weight limitations of the imaging table and the size of the opening on the imager (patients are inserted through a small "hole in the doughnut"). Standard CT tables can accommodate patients weighing up to 450 pounds, and MRI machines can typically obtain diagnostic-quality images in patients weighing up to 350 pounds.
For exams that require radiation exposure, such as x-rays and CT, the power can be increased on standard machines in an attempt to acquire a higher-quality image. However, this leads to an undesirable increase in radiation dose.
Incomplete examinations related to obesity can lead to serious consequences for the patient, as in the case of misdiagnosis or failure to be able to assign a diagnosis at all.
There can also be economic ramifications. Further testing might be required in the event of an inconclusive exam, as well as increased hospitalization time.
Obesity also increases stress on the imaging systems, due to increased power output and more rapid burnout (as in the case of x-ray tubes).
Dr. Uppot believes that the prevailing lifestyle in the United States and other industrialized nations that facilitates a poor diet and lack of exercise has led to our current obesity crisis.
"In the short term, the medical community must accommodate these patients by investing in technology to help them," Dr. Uppot explained. "In the long term, this country must make cultural shifts that promote more exercise and a healthier diet."
http://www.medicalnewstoday.com
Researchers assessed all radiology exams performed at Massachusetts General Hospital (MGH) between 1989 and 2003 to determine the effects of obesity on imaging quality and diagnosis.
In an effort to quantify how obesity affects diagnostic imaging quality, Dr. Uppot and colleagues analyzed radiology records from a 15-year span at MGH. They searched for incomplete exams that carried the label "limited by body habitus," meaning limited in quality due to patient size.
"While 0.10 percent of inconclusive exams were due to patient size in 1989, by 2003 the number had jumped to 0.19 percent, despite advances in imaging technology," said Raul N. Uppot, M.D., lead author and staff radiologist at MGH. "Americans need to know that obesity can hinder their medical care when they enter a hospital."
An estimated 66 percent of adults in the United States are overweight, obese or morbidly obese, according to the Department of Health and Human Services. Additionally, more than 12.5 million American children and adolescents are overweight. Hospitals are feeling the strain--they now require larger wheelchairs and beds. Additionally, standard operating tables and imaging equipment are not suited for obese patients.
By 2003, the modality that yielded the most difficulties in rendering a diagnosis was abdominal ultrasound (1.90 percent), followed by chest x-rays (0.18 percent), abdominal computed tomography (CT), abdominal x-rays, chest CT and magnetic resonance imaging (MRI) (all anatomic regions included).
CT and MRI can be problematic because of weight limitations of the imaging table and the size of the opening on the imager (patients are inserted through a small "hole in the doughnut"). Standard CT tables can accommodate patients weighing up to 450 pounds, and MRI machines can typically obtain diagnostic-quality images in patients weighing up to 350 pounds.
For exams that require radiation exposure, such as x-rays and CT, the power can be increased on standard machines in an attempt to acquire a higher-quality image. However, this leads to an undesirable increase in radiation dose.
Incomplete examinations related to obesity can lead to serious consequences for the patient, as in the case of misdiagnosis or failure to be able to assign a diagnosis at all.
There can also be economic ramifications. Further testing might be required in the event of an inconclusive exam, as well as increased hospitalization time.
Obesity also increases stress on the imaging systems, due to increased power output and more rapid burnout (as in the case of x-ray tubes).
Dr. Uppot believes that the prevailing lifestyle in the United States and other industrialized nations that facilitates a poor diet and lack of exercise has led to our current obesity crisis.
"In the short term, the medical community must accommodate these patients by investing in technology to help them," Dr. Uppot explained. "In the long term, this country must make cultural shifts that promote more exercise and a healthier diet."
http://www.medicalnewstoday.com
Thursday, January 25, 2007
Metabonomic Analysis Shows Feasibility in Meningitis Diagnosis
Dr. John S. Ford over at California Medicine Man reports how the emerging science of metabonomics shows promise in noninvasive diagnosis of meningitis, and in distinguishing between its viral and bacterial types:
Metabonomics to the rescue. No this isn't some failed theory of language education. As one definition I got from the internet, metabonomics is:
"The quantitative measurement of the dynamic multiparametric metabolic response of living systems to pathophysiological stimuli or genetic modification".
Does that clarify things for you? Yeah right!
In the setting of the above article, this means taking medical specimens and acquiring a examining the biological "signature" through the use of proton nuclear magnetic resonance and mass spectroscopy. These are very sophisticated machines that examine the physical properties of these specimens rather than their biological properties such as cell counts, antibody studies or bacterial/fungal cultures.
The authors took a group of lumbar puncture specimens that were drawn from 12 patients with bacterial meningitis, 11 with viral and 27 controls (healthy people). These samples were then subjected to the high tech methods they developed and their signatures are compared statistically with the signatures of known samples. The equipment they used accurately classified every one of the specimens. This corresponds to 100% sensitivity and 100% specificity. Clearly this is the holy grail of clinical testing.
Reportedly, this test can be performed very rapidly, certainly within the time frame of an emergency room evaluation and in theory could accurately classify patients. Decisions can then be made to admit and treat those few patients with true bacterial meningitis and perhaps discharge those with more benign viral disease. The equipment to perform these analyses is currently available and though representing a high capital investment is apparently cheap to maintain and operate making it potentially available to most hospital labs.
If the technique turns out to be successful (it is only in its earliest stages of evaluation) it could make a major contribution to emergency medicine. One can only speculate on other applications of this technology.
http://www.medgadget.com
Metabonomics to the rescue. No this isn't some failed theory of language education. As one definition I got from the internet, metabonomics is:
"The quantitative measurement of the dynamic multiparametric metabolic response of living systems to pathophysiological stimuli or genetic modification".
Does that clarify things for you? Yeah right!
In the setting of the above article, this means taking medical specimens and acquiring a examining the biological "signature" through the use of proton nuclear magnetic resonance and mass spectroscopy. These are very sophisticated machines that examine the physical properties of these specimens rather than their biological properties such as cell counts, antibody studies or bacterial/fungal cultures.
The authors took a group of lumbar puncture specimens that were drawn from 12 patients with bacterial meningitis, 11 with viral and 27 controls (healthy people). These samples were then subjected to the high tech methods they developed and their signatures are compared statistically with the signatures of known samples. The equipment they used accurately classified every one of the specimens. This corresponds to 100% sensitivity and 100% specificity. Clearly this is the holy grail of clinical testing.
Reportedly, this test can be performed very rapidly, certainly within the time frame of an emergency room evaluation and in theory could accurately classify patients. Decisions can then be made to admit and treat those few patients with true bacterial meningitis and perhaps discharge those with more benign viral disease. The equipment to perform these analyses is currently available and though representing a high capital investment is apparently cheap to maintain and operate making it potentially available to most hospital labs.
If the technique turns out to be successful (it is only in its earliest stages of evaluation) it could make a major contribution to emergency medicine. One can only speculate on other applications of this technology.
http://www.medgadget.com
Handheld HIV Test
Wired brings us exciting news about a new HIV test device which is remarkably small, and which promises to diagnose the disease in minutes rather than weeks.
The device could solve one of the vexing problems of AIDS treatment in underdeveloped countries, where patients are not within easy reach of medical facilities. By providing an on-the-spot diagnosis, doctors hope to close the gap between test and treatment, and prevent known cases from slipping through the cracks.
A test that can deliver diagnosis during one doctor visit would be a major breakthrough for regions like sub-Saharan Africa, where 25 million people are living with HIV. Current tests require technicians to draw a blood sample, then ship it to a central lab where trained personnel use expensive equipment to determine the result. Locating the patients afterward can be difficult, because they often travel from remote regions to visit health clinics.
The technology is similar to "blending digital camera technology with the brains of a Palm Pilot," says Dr. Bruce Walker, director of AIDS research at Harvard Medical School. Walker is part of a team of scientists at Harvard and the University of Texas at Austin who developed the sensor system. In tests, it has detected the amount of CD4 cells in the blood in as little as 10 minutes. The CD4 count indicates the stage of HIV in a patient, and helps doctors determine the best treatment and how much of it to administer.
The new test works by dropping a patient's blood sample onto a plastic biochip, which detects elements in the blood, says John McDevitt, the University of Texas chemist who helped develop the technology. The card is then inserted into a toaster-size analyzer, which determines the CD4 cell count.
Austin biotech startup LabNow has licensed the technology and is developing it into a system that could be used to diagnose HIV quickly and cheaply. LabNow, which recently added former Sen. Bill Bradley to its board, plans to begin clinical testing in parts of the United States, China and Africa during the first quarter of 2006, says the company's CEO Rick Hawkins. If clinical testing goes well, LabNow hopes to launch the device in parts of sub-Saharan Africa by the middle of next year.
The U.S. Centers for Disease Control and Prevention intends to evaluate the LabNow CD4 prototype, says Dr. Thomas J. Spira of the CDC's global AIDS program in Atlanta. Other diagnostic instruments are on the market, but "this one has a fairly unique type of system," he says. "There is very little manipulation that needs to be done to the specimen. It's all done in a small cassette. It doesn't necessarily need trained laboratory personnel to operate it."
And HIV is likely only the beginning for McDevitt's technology. It can be reprogrammed, he says, to serve numerous application areas by simply changing the system's molecular-level code. He is developing systems for heart disease, cancer and infectious diseases, as well as bioterrorism-screening tools and environmental-monitoring aids.
"It is a lot like putting new software into a computer each time you want to work a new application area," he says. "You need not purchase a new computer; you simply use the existing infrastructure."
The Breathmeter
Reading through a stack of press releases, we have discovered that Ekips Technologies, Inc., a Norman, Oklahoma company, is reporting raising "$2.9 million to support vital business operations and marketing efforts." The company has also received a $500,000 matching grant from the National Science Foundation. It turns out that the company is working on implementing its Breathmeter™, a diagnostic device that measures biomarker molecules in exhaled breath.
The technology:
Ekips develops new products based primarily on diode laser technology. Diode laser technology has a proven track record of enabling the creation of new industries (such as the fiber optic communication and CD/DVD optical storage industries). The Breathmeter™ that Ekips has developed for diagnosing and monitoring asthma utilizes mid-infrared diode lasers. These mid-infrared diode lasers have emission wavelengths that are up to ten times longer than diode lasers used for fiber optics or CD/DVD devices. Mid-infrared lasers can rapidly measure specific molecules with better than parts-per-billion sensitivity using the fundamental technique of vibrational absorption spectroscopy. There are many applications in the areas of medical diagnostics, industrial process control, and pollution monitoring where such measurements are useful. The Breathmeter™ represents just one specific health care application for this technology platform...
Started by MIT graduate and laser technology expert Dr. Patrick McCann, Ekips Technologies has developed the first user-friendly laser-based breathalyzer that will have a significant, immediate impact on the diagnosis, treatment and management of asthma, one the fastest growing of all diseases. It has proven successful in the measurement of nitric oxide (NO) in exhaled human breath, a biomarker molecule associated with the tissue inflammation experienced by asthma sufferers. Such measurements allow a more accurate diagnosis of asthma. In addition, routine monitoring of asthma disease severity is possible with these fast and simple breath measurements. Important uses include optimizing pharmaceutical treatment and ensuring therapy compliance.
The potential of this technology in asthma screening and asthma therapeutic monitoring is significant as the Ekips Breathmeter™ is currently the only reagent-free instrument that can rapidly measure trace NO concentrations during an exhalation. We believe the highly accurate laser technology will eventually replace spirometry as a screening and monitoring tool for pulmonary, allergy and immunology lung testing. The reagent-free feature of the Breathmeter™ is important since it allows easy implementation in clinical settings.
Ekips is presently sponsoring clinical trials in collaboration physicians at the University of Oklahoma Health Sciences Center to develop additional breath tests such as one for early detection of lung cancer and measurement of specific biomarkers associated with schizophrenia.
http://www.medgadget.com
The technology:
Ekips develops new products based primarily on diode laser technology. Diode laser technology has a proven track record of enabling the creation of new industries (such as the fiber optic communication and CD/DVD optical storage industries). The Breathmeter™ that Ekips has developed for diagnosing and monitoring asthma utilizes mid-infrared diode lasers. These mid-infrared diode lasers have emission wavelengths that are up to ten times longer than diode lasers used for fiber optics or CD/DVD devices. Mid-infrared lasers can rapidly measure specific molecules with better than parts-per-billion sensitivity using the fundamental technique of vibrational absorption spectroscopy. There are many applications in the areas of medical diagnostics, industrial process control, and pollution monitoring where such measurements are useful. The Breathmeter™ represents just one specific health care application for this technology platform...
Started by MIT graduate and laser technology expert Dr. Patrick McCann, Ekips Technologies has developed the first user-friendly laser-based breathalyzer that will have a significant, immediate impact on the diagnosis, treatment and management of asthma, one the fastest growing of all diseases. It has proven successful in the measurement of nitric oxide (NO) in exhaled human breath, a biomarker molecule associated with the tissue inflammation experienced by asthma sufferers. Such measurements allow a more accurate diagnosis of asthma. In addition, routine monitoring of asthma disease severity is possible with these fast and simple breath measurements. Important uses include optimizing pharmaceutical treatment and ensuring therapy compliance.
The potential of this technology in asthma screening and asthma therapeutic monitoring is significant as the Ekips Breathmeter™ is currently the only reagent-free instrument that can rapidly measure trace NO concentrations during an exhalation. We believe the highly accurate laser technology will eventually replace spirometry as a screening and monitoring tool for pulmonary, allergy and immunology lung testing. The reagent-free feature of the Breathmeter™ is important since it allows easy implementation in clinical settings.
Ekips is presently sponsoring clinical trials in collaboration physicians at the University of Oklahoma Health Sciences Center to develop additional breath tests such as one for early detection of lung cancer and measurement of specific biomarkers associated with schizophrenia.
http://www.medgadget.com
Reading through a stack of press releases, we have discovered that Ekips Technologies, Inc., a Norman, Oklahoma company, is reporting raising "$2.9 million to support vital business operations and marketing efforts." The company has also received a $500,000 matching grant from the National Science Foundation. It turns out that the company is working on implementing its Breathmeter™, a diagnostic device that measures biomarker molecules in exhaled breath.
The technology:
Ekips develops new products based primarily on diode laser technology. Diode laser technology has a proven track record of enabling the creation of new industries (such as the fiber optic communication and CD/DVD optical storage industries). The Breathmeter™ that Ekips has developed for diagnosing and monitoring asthma utilizes mid-infrared diode lasers. These mid-infrared diode lasers have emission wavelengths that are up to ten times longer than diode lasers used for fiber optics or CD/DVD devices. Mid-infrared lasers can rapidly measure specific molecules with better than parts-per-billion sensitivity using the fundamental technique of vibrational absorption spectroscopy. There are many applications in the areas of medical diagnostics, industrial process control, and pollution monitoring where such measurements are useful. The Breathmeter™ represents just one specific health care application for this technology platform...
Started by MIT graduate and laser technology expert Dr. Patrick McCann, Ekips Technologies has developed the first user-friendly laser-based breathalyzer that will have a significant, immediate impact on the diagnosis, treatment and management of asthma, one the fastest growing of all diseases. It has proven successful in the measurement of nitric oxide (NO) in exhaled human breath, a biomarker molecule associated with the tissue inflammation experienced by asthma sufferers. Such measurements allow a more accurate diagnosis of asthma. In addition, routine monitoring of asthma disease severity is possible with these fast and simple breath measurements. Important uses include optimizing pharmaceutical treatment and ensuring therapy compliance.
The potential of this technology in asthma screening and asthma therapeutic monitoring is significant as the Ekips Breathmeter™ is currently the only reagent-free instrument that can rapidly measure trace NO concentrations during an exhalation. We believe the highly accurate laser technology will eventually replace spirometry as a screening and monitoring tool for pulmonary, allergy and immunology lung testing. The reagent-free feature of the Breathmeter™ is important since it allows easy implementation in clinical settings.
Ekips is presently sponsoring clinical trials in collaboration physicians at the University of Oklahoma Health Sciences Center to develop additional breath tests such as one for early detection of lung cancer and measurement of specific biomarkers associated with schizophrenia.
http://www.medgadget.com
The technology:
Ekips develops new products based primarily on diode laser technology. Diode laser technology has a proven track record of enabling the creation of new industries (such as the fiber optic communication and CD/DVD optical storage industries). The Breathmeter™ that Ekips has developed for diagnosing and monitoring asthma utilizes mid-infrared diode lasers. These mid-infrared diode lasers have emission wavelengths that are up to ten times longer than diode lasers used for fiber optics or CD/DVD devices. Mid-infrared lasers can rapidly measure specific molecules with better than parts-per-billion sensitivity using the fundamental technique of vibrational absorption spectroscopy. There are many applications in the areas of medical diagnostics, industrial process control, and pollution monitoring where such measurements are useful. The Breathmeter™ represents just one specific health care application for this technology platform...
Started by MIT graduate and laser technology expert Dr. Patrick McCann, Ekips Technologies has developed the first user-friendly laser-based breathalyzer that will have a significant, immediate impact on the diagnosis, treatment and management of asthma, one the fastest growing of all diseases. It has proven successful in the measurement of nitric oxide (NO) in exhaled human breath, a biomarker molecule associated with the tissue inflammation experienced by asthma sufferers. Such measurements allow a more accurate diagnosis of asthma. In addition, routine monitoring of asthma disease severity is possible with these fast and simple breath measurements. Important uses include optimizing pharmaceutical treatment and ensuring therapy compliance.
The potential of this technology in asthma screening and asthma therapeutic monitoring is significant as the Ekips Breathmeter™ is currently the only reagent-free instrument that can rapidly measure trace NO concentrations during an exhalation. We believe the highly accurate laser technology will eventually replace spirometry as a screening and monitoring tool for pulmonary, allergy and immunology lung testing. The reagent-free feature of the Breathmeter™ is important since it allows easy implementation in clinical settings.
Ekips is presently sponsoring clinical trials in collaboration physicians at the University of Oklahoma Health Sciences Center to develop additional breath tests such as one for early detection of lung cancer and measurement of specific biomarkers associated with schizophrenia.
http://www.medgadget.com
Researching the Use of Nanotechnology for Diagnostics
Nanotechnology is revolutionizing the way things are constructed -- from stain resistant clothing to stronger, yet lighter tennis rackets. However, the biggest impact of nanotechnology in the future is expected to be in the healthcare industry.
"While the mortality rates of many cancers have decreased significantly in recent decades, the rate for ovarian cancer had not changed much in the last 50 years, primarily due to delays in diagnosis," said Dr. Jacob Rotmensch, section director of gynecologic oncology at Rush. "By exploiting the unique properties of nanotechnology, we hope to detect ovarian cancer earlier using highly sensitive imaging tools and develop drug carriers that can deliver therapeutic agents inside tumor cells."
"A nanotechnology based approach is needed because diagnosis of early stage cancer requires the detection and characterization of very small quantities of biomarker" added Dr. Liaohai Chen, a molecular biologist and leader of the nano-bio group in the Biosciences Division at Argonne, and an adjunct faculty at Rush University Medical Center.
A nanometer is one billionth of a meter or 1/80,000 the width of a human hair. Nanoscale devices can perform tasks inside the body that would otherwise not be possible, such as entering most cells and moving through the walls of blood vessels. As a result, nanoscale devices can readily interact with individual molecules on both the cell surface and within the cell, in ways that do not alter the behavior of those molecules.
One area of research involves developing a screening test that would not require removal of the ovary for biopsy. Collaborating with Dr. Rong Wang, an associate professor at Illinois Institute of Technology, the research team is using an atomic force microscope, a very-high resolution microscope that can investigate the interaction of individual protein molecules. With this microscope the research team can study the molecular structure of cancer versus non-cancer cells and compare the stiffness. Cancer tissues are more stiff than healthy tissues. Instead of removing the ovary to determine if cancerous tissue is present, a probe is currently under development to follow the tissue stiffness in vivo to diagnose cancer.
http://www.medgadget.com
Wednesday, January 24, 2007
Unbound Medicine releases Harrison's Practice
Unbound Medicine and McGraw-Hill have released Harrison's Practice, a completely new resource from the editors of Harrison's Principles of Internal Medicine. Topics in Harrison's Practice cover the most frequently seen medical conditions and deliver practical, concise answers on diagnosis and management in an innovative and easy-to-navigate format.
With Unbound Medicine's unique PDA, Web and Wireless platform, mobile clinicians can access Harrison's Practice anywhere. Intuitive built-in navigation helps users quickly review information and link to related content. Regular updates are delivered automatically on the Web and during PDA synchronization.
On the Web, Unbound's search engine delivers high quality results, allowing users to quickly locate the information they seek. Users can link to abstracts and citations at PubMed from the references, and link to drug monographs with pill photos and patient handouts in English and Spanish. Each topic also includes links to websites with additional information appropriate for both patients and professionals.
PDA, Web, and wireless access are included for one price. The Unbound™ platform supports Palm OS, Pocket PC, and wireless devices such as Treo™ Smartphone and BlackBerry™.
http://www.medgadget.com
With Unbound Medicine's unique PDA, Web and Wireless platform, mobile clinicians can access Harrison's Practice anywhere. Intuitive built-in navigation helps users quickly review information and link to related content. Regular updates are delivered automatically on the Web and during PDA synchronization.
On the Web, Unbound's search engine delivers high quality results, allowing users to quickly locate the information they seek. Users can link to abstracts and citations at PubMed from the references, and link to drug monographs with pill photos and patient handouts in English and Spanish. Each topic also includes links to websites with additional information appropriate for both patients and professionals.
PDA, Web, and wireless access are included for one price. The Unbound™ platform supports Palm OS, Pocket PC, and wireless devices such as Treo™ Smartphone and BlackBerry™.
http://www.medgadget.com
Eye Laser for Early Alzheimer's Dx
Here's how the Alzheimer's Association describes promising research that might offer an early diagnosis of Alzheimer's by detecting beta-amyloid protein plaques in the lens of the eye:
Building on their discovery that people with Alzheimer's have Beta-amyloid deposits that appear as unusual cataracts in the lens of the eye, Lee E. Goldstein, MD, PhD, of Brigham & Women's Hospital and Harvard Medical School [an accredited institution -ed.], Boston, and colleagues have developed a new, non-invasive, laser technology that may detect Alzheimer's at its earliest stages.
Clumps of abnormal Beta-amyloid protein (known as "plaques") accumulate outside the brain's nerve cells in people with Alzheimer's. As Goldstein and colleagues previously reported in the British medical journal The Lancet, these same Beta-amyloid clumps also collect in the lens of the eye as unusual "supranuclear cataracts." These Alzheimer's cataracts are different from common, age-related cataracts. This is the first evidence to date that Alzheimer's-related amyloid pathology may occur outside the brain.
In their most recent experiments to be reported in Madrid, the researchers used genetically engineered Alzheimer's mice to test a new, non-invasive molecular diagnostic technology. Goldstein and his team directed a brief pulse of infrared light - barely visible to humans - into the eye of each of four non-anesthetized Alzheimer mice and four age-matched normal mice every month starting at five months of age. Analysis of how the light bounced back from the lens completely separated the two types of mice by 10 months of age, when amyloid lesions were not detectable in the brain or eye by conventional means. The scientists believe that this technology, known as quasi-elastic light scattering (QLS), may detect the very earliest stages of Beta-amyloid pathology, even in eyes that are completely clear.
"Amyloid in the lens can be detected using extremely sensitive, non-invasive optical techniques. This makes the lens an ideal window for early detection and disease monitoring in Alzheimer's," Goldstein said.
Spinal Fusion vs. Disc Replacement: To Fuse or Not to Fuse
How would you like heading into surgery, not knowing if the vertebrae in your neck were going to be fused together, or if the disc between your vertebrae was going to be replaced? And, knowing that your surgeons didn't know, either?
That's what happened with Auburn's Jim Traver, 48, who hurt his neck when he fell 15 feet from a building where he was working construction.
Surgeons opened an envelope the day he had his operation in October at Upstate Medical University. Instructions inside told them Traver would get the Porous Coated Motion cervical artificial disc, a new device under FDA study. Upstate is one of 20 sites in the country participating in the study for the Food and Drug Administration.
Patients in the study randomly receive either fusion or the replacement disc. "It's the only way of lowering the bias," explains Dr. Amir Fayyazi, an associate professor and one of Traver's surgeons. Scientists want to determine whether disc replacement is more effective than spinal fusion. Letting surgeons pick which patients get what surgery would, potentially, taint the results.
Replacement discs are a new concept.
"This is relatively early in motion preservation of the cervical spine," says Fayyazi. "We've been doing cervical fusion for over 50 years."
Optical Frequency-Domain Imaging Offers 'Virtual Biopsies'
Investigators from Wellman Center for Photomedicine at MGH have demonstrated how a new optical imaging technique can be used to visualize internal surfaces of blood vessels and mucous membranes:
A new optical imaging technique, developed at the Wellman Center for Photomedicine at Massachusetts General Hospital (MGH), can provide three-dimensional microscopic views of the inner surfaces of blood vessels and gastrointestinal organs. In their report in the journal Nature Medicine, receiving early online release today, the MGH-Wellman researchers describe using optical frequency-domain imaging (OFDI) to visualize broad areas of the esophagus and coronary arteries of living pigs. The technique is an advance over optical coherence tomography (OCT) -- another noninvasive MGH-developed technology that details much smaller areas -- and could be useful for identifying precancerous lesions and dangerous deposits of plaque in the coronary arteries.
While OCT can examine surfaces one point at a time, OFDI is able to look at over 1,000 points simultaneously by using a new type of laser developed at MGH-Wellman. Inside the fiberoptic catheter probe, a constantly rotating laser tip emits a light beam with an ever-changing wavelength. Measuring how each wavelength is reflected back, as the probe moves through the structure to be imaged, allows rapid acquisition of the data required to create the detailed microscopic images.
In the Nature Medicine paper, the MGH-Wellman team reports that OFDI successfully imaged the inner esophageal surfaces of living pigs, revealing the structural details and vascular networks of 4.5-centimeter-long segments with less than 6 minutes scanning time. Scans of coronary artery surfaces were similarly successful, producing three-dimensional microscopic images of the surfaces of segments 24 to 63 millimeters long. An experiment designed to evaluate OFDI's ability to detect damage to arterial surfaces confirmed that the technique could differentiate between healthy and damaged tissue.
Among potential applications for OFDI could be diagnosis of Barrett's esophagus, a precursor to esophageal cancer that can be identified with OCT, provided the affected tissue is scanned. The researchers estimate that the esophageal scan conducted in this study could be reduced from 6 minutes to less than 1 with more powerful computer processing. Another major application would be examining coronary arteries for the vulnerable plaques believed most likely to rupture and produce heart attacks...
The MGH-Wellman researchers also anticipate extending the technology's capabilities into other fields. "One of the most exciting concepts would be to directly link OFDI with the delivery of therapy, such as laser treatment for early cancer," says Bouma. "Our hope is that, thorough one minimally invasive probe, clinicians will be able to diagnose and precisely treat diseased tissue while sparing adjacent healthy tissue." Bouma is an associate professor of Dermatology at Harvard Medical School.
http://www.medgadget.com
15-Minute Biochip Assay
Argonne National Laboratory is reporting that its scientists have designed a novel type of biochip. Based on the polymerase chain reaction, an old technology by now (isn't it?), the lab-on-a-chip should offer rapid diagnostic testing capabilities for a variety of diagnostic needs:
The biochip system can identify infectious disease strains in less than 15 minutes when testing protein arrays and in less than two hours when testing nucleic acid arrays. The system can be used in hospitals and other laboratories as well as in the field. The technology provides a point-of-care diagnostic system that would save time and money compared to current systems, which require sending samples to a centralized lab for confirmatory diagnosis.
Each biochip has hundreds to thousands of gel drops, each about 100 microns in diameter -- 100 microns is about the width of an average human hair. A segment of a DNA strand, protein, peptide or antibody is inserted into each drop, tailoring it to recognize a specific biological agent or biochemical signature. These drops are in known positions so when a sample reacts, the reaction position can be detected, identifying the sample.
"The array of gel drops can be tailored to detect specific strains of infectious diseases or other biological organisms," said Schabacker. "Each drop can detect trace quantities of the agents for which they are specific."
The biochip can also be used to identify biological warfare agents. Easy sample preparation, standard operating protocols and a portable biochip reader that is smaller than a lunchbox make the system suitable for use in the field by first responders, military personnel and medical technicians.
The system makes use of the polymerase chain reaction (PCR), a universal method for replicating billions of copies from one piece of genetic material. PCR allows trace quantities of DNA to be replicated to a level where they can be detected in the biochip system.
A sample to be tested is applied to a biochip, which is then put in a reader and scanned using patented side illumination laser technology to detect reaction sites. Automated algorithms determine the agents present in the sample...
The biochip system also has great potential as a discovery tool. Current research aimed at the development of proteome chips has shown great promise. Proteome chips, which are biochips displaying all the proteins expressed by an organism at a specific time, provide the ability to screen for new cancer biomarkers, vaccine targets and therapeutic targets, as well as provide a means of characterizing disease states.
Tuesday, January 23, 2007
Can I Get that Diagnosis in Arabic, Please
MIT's Technology Review brings us a bit of technology called IraqComm, developed by SRI International. IraqComm is a translation device based on a Windows computer (mind the BSOD) that uses intelligent statistical methods to translate spoken words from English to Iraqi Arabic and back again...
A person speaks into a microphone and the words are collected and analyzed by speech-recognition software, called DynaSpeak, a system developed at SRI. The laptop screen then shows the phrase as the computer heard it. With a tap (of the "T" key), the phrase is spoken in the Iraqi Arabic. If the software has misheard some words, the speaker can choose from a list of other likely phrases, explains Kristin Precoda, director of the Speech Technology and Research (STAR) Laboratory at SRI and lead developer on the project.
After DynaSpeak converts the spoken words into text, software performs the translation. The software consists of two components, developed with the assistance of the Information Sciences Institute (ISI) at the University of Southern California (USC) in Los Angeles. The first module uses rule-based algorithms, explains Precoda, written to recognize specific rules of grammar and usage. They're somewhat limited, however, because people use so many different words to convey ideas.
Thus, for more complicated sentences, the translation software turns to a type of algorithm that performs a kind of statistical analysis on the language. It works by assigning the likelihood that a word or phrase will follow another word or phrase, like a complicated version of predictive text messaging used on some mobile phones.
So...how does this qualify as a medgadget?
Currently, IraqComm can draw from a vocabulary of 40,000 words in English and 50,000 in Iraqi Arabic -- not surprisingly, with a heavy emphasis on military and medical terminology.
IraqComm was developed under the Spoken Language Communication and Translation System for Tactical Use, a Defense Advanced Research Projects Agency (DARPA) program. SRI is one of six organizations developing English-Iraqi Arabic translation systems that are mobile and can translate military- and medical-oriented conversations in the presence of ambient noise.
http://www.medgadget.com
A person speaks into a microphone and the words are collected and analyzed by speech-recognition software, called DynaSpeak, a system developed at SRI. The laptop screen then shows the phrase as the computer heard it. With a tap (of the "T" key), the phrase is spoken in the Iraqi Arabic. If the software has misheard some words, the speaker can choose from a list of other likely phrases, explains Kristin Precoda, director of the Speech Technology and Research (STAR) Laboratory at SRI and lead developer on the project.
After DynaSpeak converts the spoken words into text, software performs the translation. The software consists of two components, developed with the assistance of the Information Sciences Institute (ISI) at the University of Southern California (USC) in Los Angeles. The first module uses rule-based algorithms, explains Precoda, written to recognize specific rules of grammar and usage. They're somewhat limited, however, because people use so many different words to convey ideas.
Thus, for more complicated sentences, the translation software turns to a type of algorithm that performs a kind of statistical analysis on the language. It works by assigning the likelihood that a word or phrase will follow another word or phrase, like a complicated version of predictive text messaging used on some mobile phones.
So...how does this qualify as a medgadget?
Currently, IraqComm can draw from a vocabulary of 40,000 words in English and 50,000 in Iraqi Arabic -- not surprisingly, with a heavy emphasis on military and medical terminology.
IraqComm was developed under the Spoken Language Communication and Translation System for Tactical Use, a Defense Advanced Research Projects Agency (DARPA) program. SRI is one of six organizations developing English-Iraqi Arabic translation systems that are mobile and can translate military- and medical-oriented conversations in the presence of ambient noise.
http://www.medgadget.com
Targeted Molecular Diagnosis and Therapy in Rare Neonatal Diabetes
The University of Chicago Medical Center has an interesting account about a rare form of diabetes, caused by a mutation that prevents the pancreas cells from secreting insulin, and a novel, extremely effective approach in treating the condition. Unlike the more common autoimmune disorder, the diabetes caused by Kir6.2 mutation seems to be rare but easily treated by sulfonylurea meds. The details of the treatment are still being worked on.
For the first time in more than six years, Lilly no longer gets insulin. She takes five sulfonylurea pills twice a day, for now. That will be reduced to two as her team settles on the optimal dose."Lilly has always been an active child, involved in soccer and ballet," said her mother, "but now she has the freedom to be a normal active child. She can go to sleepovers or playdates without Mom coming along to do blood sugar tests and operate her pump. She can eat snacks without counting carbohydrates or testing her blood. Just like all of us, it is important that Lilly continue a healthy, physically active lifestyle for her health, but this will greatly enhance her long-term prognosis."
http://www.medgadget.com
Resonant Acoustic Profiling (RAP) Technology
The technology of Cambridge-based Akubio Ltd. has attracted UK government to invest £826,000 to develop a "new portable and low cost, rapid response disease diagnosis device, which could help doctors make instant and accurate diagnoses for diseases such as malaria and meningitis," according to the company.
Substantially different from other diagnostic devices currently on the market (which require the addition of expensive chemicals to a sample to enable disease detection), the device, which utilises the quartz crystal element from a simple wristwatch and can be powered by standard batteries, could enable doctors to make instant, accurate, at-the-bedside or in-the-field medical diagnoses from blood or other samples.
Here's how the company explains its RAP technology:
Resonant acoustic profiling (RAP) is based on resonating quartz technology optimised for the detection of molecular interactions.Akubio's AKT.av sensor cassettes use gold electrodes on the crystal surface to apply a precise current. This drives the crystal and creates resonance which reduces in proportion to the mass of molecules interacting on the surface. Analysis of the interaction data is used to accurately determine the concentration of target molecules across a broad range of concentrations, the on and off rate of binding events and molecular affinity. All of these are important parameters in understanding biological interactions and the potential effectiveness of candidate treatment regimes.
Using manufacturing skills and proprietary techniques the crystal surface is processed to introduce a biologically inert chemical layer which allows specific targets to be coupled. A variety of surface chemistries are available, giving the user freedom to couple the target in the most convenient way.
The coated crystal is encapsulated in a flow cell which is used to introduce reagents containing biological samples. The sensitivity of the system is highlighted by the reproducible measurement of changes down to 0.3Hz.
These features lead to a powerful real-time bioassay with processing times of between 60 seconds and 5 minutes suitable for use in a wide range of application areas.
Currently, few technologies offer life scientists the ability to detect real-time kinetic data of this quality across such a broad range of samples, sample purity and sample concentrations.
http://www.medgadget.com
BreakPoint(R) Self-Adhesive Label tells You If A Vaccine Or Diagnostic Kit Has Been Frozen
In the light of the success of its innovative labels which guarantee the traceability of chilled products (Time-Temperature indicators), CRYOLOG announces the launch of BreakPoint(R), a revolutionary threshold crossing indicator.
Certain vaccines, blood, and diagnosis kits must not be frozen. How can these products, which could be rendered ineffective or dangerous, be detected?
Today, and for the first time, CRYOLOG renders this information accessible in a simple and immediately readable manner. Taking the form of a self-adhesive label, BreakPoint(R) changes colour irreversibly (from white to red) if a product has been frozen.
Up until now, these temperature indicators were reserved for large-scale conditioning (containers, palettes, parcels), but because of their cost and their size, it had never been possible to include them on a more detailed level of conditioning : individual doses or dispensing units.
BreakPoint(R) comes in the form of rolls of self-adhesive labels. This form and the unit price mean that for the first time they can be used on individual units, in order to reveal any cases of exposure to negative temperatures.
Renaud Vaillant, CEO of CRYOLOG, said:
"BreakPoint(R) is the fruit of intensive R&D efforts stimulated by the express requirements of our health clients and prospects. This new label integrates perfectly into our range of solutions for the dynamic monitoring of temperature and product quality and confirms the truly innovative position of CRYOLOG in the market for traceability and smart labels."
As a logical addition to the range of freshness labels which includes TRACEO(R) and (eO)(R), BreakPoint(R) provides a concrete response to the risk that sensitive products may have been frozen.
Currently in the process of being industrialised, the first application of the BreakPoint(R) label will be rolled out in the 4th quarter of 2007, in the health sector.
The BreakPoint(R) technology can be integrated into all types of packaging and placed on any support using a simple labelling gun.
http://www.medicalnewstoday.com
Certain vaccines, blood, and diagnosis kits must not be frozen. How can these products, which could be rendered ineffective or dangerous, be detected?
Today, and for the first time, CRYOLOG renders this information accessible in a simple and immediately readable manner. Taking the form of a self-adhesive label, BreakPoint(R) changes colour irreversibly (from white to red) if a product has been frozen.
Up until now, these temperature indicators were reserved for large-scale conditioning (containers, palettes, parcels), but because of their cost and their size, it had never been possible to include them on a more detailed level of conditioning : individual doses or dispensing units.
BreakPoint(R) comes in the form of rolls of self-adhesive labels. This form and the unit price mean that for the first time they can be used on individual units, in order to reveal any cases of exposure to negative temperatures.
Renaud Vaillant, CEO of CRYOLOG, said:
"BreakPoint(R) is the fruit of intensive R&D efforts stimulated by the express requirements of our health clients and prospects. This new label integrates perfectly into our range of solutions for the dynamic monitoring of temperature and product quality and confirms the truly innovative position of CRYOLOG in the market for traceability and smart labels."
As a logical addition to the range of freshness labels which includes TRACEO(R) and (eO)(R), BreakPoint(R) provides a concrete response to the risk that sensitive products may have been frozen.
Currently in the process of being industrialised, the first application of the BreakPoint(R) label will be rolled out in the 4th quarter of 2007, in the health sector.
The BreakPoint(R) technology can be integrated into all types of packaging and placed on any support using a simple labelling gun.
http://www.medicalnewstoday.com
Genetic Signs Of Lung Cancer Detected In A Patient's Sputum By Simple Diagnostic Test
DNA coughed up along with phlegm could point to lung cancer, say researchers at the University of Maryland School of Medicine who are developing an inexpensive and non-invasive gene probe to help diagnose early stage lung cancer in current and former smokers.
In the January 15 issue of Clinical Cancer Research, the researchers report that their fledgling test, designed to check whether two genes believed to be tumor suppressors are deleted in cells found in sputum, identified 76 percent of stage I lung cancer patients whose tumors also showed the same genetic loss. Existing sputum "cytology" tests, which look for changes in cell structure, identified only 47 percent of the patients, they say.
While no other simple sputum analysis has found such a high correlation with lung cancer, it is not yet good enough for the clinic, researchers say, and so they are now expanding their test to screen for up to eight genes.
"There is an urgent need to develop reliable early diagnostic biomarkers for lung cancer that can be detected non-invasively, and these two genes look to be great candidate markers for such a test," said Feng Jiang, M.D., Ph.D., assistant professor of pathology at the University of Maryland School of Medicine. "We need to validate our findings, of course, but we have shown that the genetic aberrations seen in sputum reflect the same genetic aberrations found in lung tumors, and that these molecular changes occur before any morphological changes can be seen in a cytology test."
Sputum cytology is still used in some clinics, but has largely been found to be insensitive, Jiang said. For that reason, he and his collaborators have been working for years on a simple, effective way to detect changes in the genes of cells in the bronchial airway that signify early cancer is developing somewhere in the lung system. Many cells within the airway exhibit a similar pattern of genetic abnormalities that leads to lung cancer development, the researchers say, but the challenge is to find altered genes that are only predictive of cancer, and not just of general cellular damage from smoking.
"Most heavy smokers never develop lung cancer, even though cells in their airways show genetic damage," Jiang said. "The trick is to find the genes that are only cancer related."
The research group had previously identified a set of genes that were deleted in lung cancer tumors, and in this study, they tested three of them (HYAL2, FHIT, and SFTPC) in sputum samples taken from 38 patients with stage 1 non-small cell lung cancer, 36 cancer-free smokers and 28 healthy nonsmokers.
Given that sputum contains expectorated airway cells, the researchers asked each of the participants to cough into a cup first thing in the morning for three days. Investigators then examined the sputum with both traditional cytology and with fluorescent in situ hybridization (FISH). The FISH technique uses fluorescently labeled single-strand DNA probes to bind to the complementary strand of a specific gene. The presence, or absence, of a fluorescent signal produced when the strands bind can be detected and scored with use of a special microscope.
"As a diagnostic tool to identify early stage lung cancer patients who would then benefit most from curative therapies, FISH is very cheap and convenient," Jiang said. "The technique may be also useful in monitoring lung cancer patients for response to treatment, disease progression and early evidence of relapse in the future."
They found that FISH could not detect deletions in the SFTPC gene in sputum, although it was absent in 71 percent of tumors. But the loss of HYAL2 and FHIT in a patient's tumor could be detected in that person's sputum. The investigators specifically found that HYAL2 and FHIT were deleted in 84 percent and 79 percent of tumors and in 45 percent and 40 percent of matched sputum, respectively. Combining both HYAL2 and FHIT deletions increased sensitivity to 76 percent (compared to 46 percent for cytology tests) and the combined probe had a specificity of 92 percent.
The false positive rate of about eight percent occurred because HYAL2 was found in sputum of four cancer-free smokers and FHIT deletions was found in three cancer-free smokers. However, the deletions were not found in the sputum of healthy non-smokers. "Those deletions in cancer-free smokers could represent an early indication that lung cancer is developing that has not yet been detected, but we won't know that without longer follow-up study," Jiang said.
The study was funded by the National Cancer Institute, and a researcher from The University of Texas M. D. Anderson Cancer Center participated with University of Maryland investigators in the study.
The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 24,000 basic, translational, and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 70 other countries. AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special Conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment, and patient care. AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. Its most recent publication, CR, is a magazine for cancer survivors, patient advocates, their families, physicians, and scientists. It provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship, and advocacy.
http://www.medicalnewstoday.com
In the January 15 issue of Clinical Cancer Research, the researchers report that their fledgling test, designed to check whether two genes believed to be tumor suppressors are deleted in cells found in sputum, identified 76 percent of stage I lung cancer patients whose tumors also showed the same genetic loss. Existing sputum "cytology" tests, which look for changes in cell structure, identified only 47 percent of the patients, they say.
While no other simple sputum analysis has found such a high correlation with lung cancer, it is not yet good enough for the clinic, researchers say, and so they are now expanding their test to screen for up to eight genes.
"There is an urgent need to develop reliable early diagnostic biomarkers for lung cancer that can be detected non-invasively, and these two genes look to be great candidate markers for such a test," said Feng Jiang, M.D., Ph.D., assistant professor of pathology at the University of Maryland School of Medicine. "We need to validate our findings, of course, but we have shown that the genetic aberrations seen in sputum reflect the same genetic aberrations found in lung tumors, and that these molecular changes occur before any morphological changes can be seen in a cytology test."
Sputum cytology is still used in some clinics, but has largely been found to be insensitive, Jiang said. For that reason, he and his collaborators have been working for years on a simple, effective way to detect changes in the genes of cells in the bronchial airway that signify early cancer is developing somewhere in the lung system. Many cells within the airway exhibit a similar pattern of genetic abnormalities that leads to lung cancer development, the researchers say, but the challenge is to find altered genes that are only predictive of cancer, and not just of general cellular damage from smoking.
"Most heavy smokers never develop lung cancer, even though cells in their airways show genetic damage," Jiang said. "The trick is to find the genes that are only cancer related."
The research group had previously identified a set of genes that were deleted in lung cancer tumors, and in this study, they tested three of them (HYAL2, FHIT, and SFTPC) in sputum samples taken from 38 patients with stage 1 non-small cell lung cancer, 36 cancer-free smokers and 28 healthy nonsmokers.
Given that sputum contains expectorated airway cells, the researchers asked each of the participants to cough into a cup first thing in the morning for three days. Investigators then examined the sputum with both traditional cytology and with fluorescent in situ hybridization (FISH). The FISH technique uses fluorescently labeled single-strand DNA probes to bind to the complementary strand of a specific gene. The presence, or absence, of a fluorescent signal produced when the strands bind can be detected and scored with use of a special microscope.
"As a diagnostic tool to identify early stage lung cancer patients who would then benefit most from curative therapies, FISH is very cheap and convenient," Jiang said. "The technique may be also useful in monitoring lung cancer patients for response to treatment, disease progression and early evidence of relapse in the future."
They found that FISH could not detect deletions in the SFTPC gene in sputum, although it was absent in 71 percent of tumors. But the loss of HYAL2 and FHIT in a patient's tumor could be detected in that person's sputum. The investigators specifically found that HYAL2 and FHIT were deleted in 84 percent and 79 percent of tumors and in 45 percent and 40 percent of matched sputum, respectively. Combining both HYAL2 and FHIT deletions increased sensitivity to 76 percent (compared to 46 percent for cytology tests) and the combined probe had a specificity of 92 percent.
The false positive rate of about eight percent occurred because HYAL2 was found in sputum of four cancer-free smokers and FHIT deletions was found in three cancer-free smokers. However, the deletions were not found in the sputum of healthy non-smokers. "Those deletions in cancer-free smokers could represent an early indication that lung cancer is developing that has not yet been detected, but we won't know that without longer follow-up study," Jiang said.
The study was funded by the National Cancer Institute, and a researcher from The University of Texas M. D. Anderson Cancer Center participated with University of Maryland investigators in the study.
The mission of the American Association for Cancer Research is to prevent and cure cancer. Founded in 1907, AACR is the world's oldest and largest professional organization dedicated to advancing cancer research. The membership includes more than 24,000 basic, translational, and clinical researchers; health care professionals; and cancer survivors and advocates in the United States and more than 70 other countries. AACR marshals the full spectrum of expertise from the cancer community to accelerate progress in the prevention, diagnosis and treatment of cancer through high-quality scientific and educational programs. It funds innovative, meritorious research grants. The AACR Annual Meeting attracts more than 17,000 participants who share the latest discoveries and developments in the field. Special Conferences throughout the year present novel data across a wide variety of topics in cancer research, treatment, and patient care. AACR publishes five major peer-reviewed journals: Cancer Research; Clinical Cancer Research; Molecular Cancer Therapeutics; Molecular Cancer Research; and Cancer Epidemiology, Biomarkers & Prevention. Its most recent publication, CR, is a magazine for cancer survivors, patient advocates, their families, physicians, and scientists. It provides a forum for sharing essential, evidence-based information and perspectives on progress in cancer research, survivorship, and advocacy.
http://www.medicalnewstoday.com
Friday, January 19, 2007
Understanding Dual Diagnosis
Dual Diagnosis, Dual Disorders and MoreThe term dual diagnosis is a common, broad term that indicates the presence of two independent medical disorders. Recently, within the fields of mental health, psychiatry, and addiction medicine, the term has been popularly used to describe the coexistence of a mental health disorder and drug addiction / alcohol addiction problems. The equivalent phrase dual disorders also denotes the coexistence of two independent (but invariably interactive) disorders, and is the preferred term used in this Treatment Improvement Protocol (TIP).
The acronym MICA, which represents the phrase mentally ill chemical abusers, is occasionally used to designate people who have an drug addiction / alcoholism disorder and a markedly severe and persistent mental disorder such as schizophrenia or bipolar disorder. A preferred definition is mentally ill chemically affected people, since the word affected better describes their condition and is not pejorative. Other acronyms are also used: MISA (mentally ill substance abusers), CAMI (chemical abuse and mental illness), and SAMI (substance abuse and mental illness). Dual Diagnosis ExamplesCommon examples of dual diagnosis include the combinations of major depression with cocaine addiction, alcohol addiction with panic disorder, alcoholism and heroin addiction with schizophrenia, and borderline personality disorder with episodic drug abuse.
Although the focus of this volume is on dual diagnosis, some patients have more than two disorders, such as cocaine addiction, personality disorder, and AIDS. The principles that apply to dual diagnosis generally apply also to multiple disorders. The combinations of drug addiction / alcohol addiction problems and psychiatric disorders vary along important dimensions, such as severity, chronicity, disability, and degree of impairment in functioning. For example, the two disorders may each be severe or mild, or one may be more severe than the other. Indeed, the severity of both disorders may change over time. Levels of disability and impairment in functioning may also vary.Thus, there is no single combination of dual diagnosis; in fact, there is great variability among them. However, patients with similar combinations of dual diagnosis are often encountered in certain treatment settings. For instance, some methadone treatment programs treat a high percentage of opiate-addicted patients with personality disorders. Patients with schizophrenia and alcohol addiction are frequently encountered in psychiatric units, mental health centers, and programs that provide treatment to homeless patients. Dual Diagnosis: Drug Addiction and Alcoholism
Patients with mental disorders have an increased risk for drug addiction / alcohol addiction disorders, and patients with AOD disorders have an increased risk for mental disorders. For example, about one-third of patients who have a psychiatric disorder also experience drug abuse at some point (Regier et al., 1990), which is about twice the rate among people without psychiatric disorders. Also, more than half of the people who suffer from drug abuse or alcohol abuse have experienced psychiatric symptoms significant enough to fulfill diagnostic criteria for a psychiatric disorder (Regier et al., 1990; Ross et al., 1988), although many of these symptoms may be AOD related and might not represent an independent condition. Compared with patients who have a mental health disorder or an drug abuse or alcohol abuse problem alone, patients with dual diagnosis often experience more severe and chronic medical, social, and emotional problems. Because they have two disorders, they are vulnerable to both AOD relapse and a worsening of the psychiatric disorder. Further, addiction relapse often leads to psychiatric decompensation often leads to addiction relapse. Thus, relapse prevention must be specially designed for patients with dual diagnosis. Compared with patients who have a single disorder, patients with dual diagnosis often require longer treatment, have more crises, and progress more gradually in treatment.
The acronym MICA, which represents the phrase mentally ill chemical abusers, is occasionally used to designate people who have an drug addiction / alcoholism disorder and a markedly severe and persistent mental disorder such as schizophrenia or bipolar disorder. A preferred definition is mentally ill chemically affected people, since the word affected better describes their condition and is not pejorative. Other acronyms are also used: MISA (mentally ill substance abusers), CAMI (chemical abuse and mental illness), and SAMI (substance abuse and mental illness). Dual Diagnosis ExamplesCommon examples of dual diagnosis include the combinations of major depression with cocaine addiction, alcohol addiction with panic disorder, alcoholism and heroin addiction with schizophrenia, and borderline personality disorder with episodic drug abuse.
Although the focus of this volume is on dual diagnosis, some patients have more than two disorders, such as cocaine addiction, personality disorder, and AIDS. The principles that apply to dual diagnosis generally apply also to multiple disorders. The combinations of drug addiction / alcohol addiction problems and psychiatric disorders vary along important dimensions, such as severity, chronicity, disability, and degree of impairment in functioning. For example, the two disorders may each be severe or mild, or one may be more severe than the other. Indeed, the severity of both disorders may change over time. Levels of disability and impairment in functioning may also vary.Thus, there is no single combination of dual diagnosis; in fact, there is great variability among them. However, patients with similar combinations of dual diagnosis are often encountered in certain treatment settings. For instance, some methadone treatment programs treat a high percentage of opiate-addicted patients with personality disorders. Patients with schizophrenia and alcohol addiction are frequently encountered in psychiatric units, mental health centers, and programs that provide treatment to homeless patients. Dual Diagnosis: Drug Addiction and Alcoholism
Patients with mental disorders have an increased risk for drug addiction / alcohol addiction disorders, and patients with AOD disorders have an increased risk for mental disorders. For example, about one-third of patients who have a psychiatric disorder also experience drug abuse at some point (Regier et al., 1990), which is about twice the rate among people without psychiatric disorders. Also, more than half of the people who suffer from drug abuse or alcohol abuse have experienced psychiatric symptoms significant enough to fulfill diagnostic criteria for a psychiatric disorder (Regier et al., 1990; Ross et al., 1988), although many of these symptoms may be AOD related and might not represent an independent condition. Compared with patients who have a mental health disorder or an drug abuse or alcohol abuse problem alone, patients with dual diagnosis often experience more severe and chronic medical, social, and emotional problems. Because they have two disorders, they are vulnerable to both AOD relapse and a worsening of the psychiatric disorder. Further, addiction relapse often leads to psychiatric decompensation often leads to addiction relapse. Thus, relapse prevention must be specially designed for patients with dual diagnosis. Compared with patients who have a single disorder, patients with dual diagnosis often require longer treatment, have more crises, and progress more gradually in treatment.
Dual Diagnosis: Drug Addiction, Alcoholism and Associated Psychiatric Disorder
A person who suffers from alcohol abuse / alcoholism, drug abuse / drug addiction and an emotional/psychiatric problem is said to have a dual diagnosis. To recover fully, the person will require addiction treatment and psychiatric treatment for both problems.
How Common Is Dual Diagnosis?
Dual diagnosis is a common diagnosis. According to a report published by the Journal of the American Medical Association: * Thirty-seven percent of people with alcohol abuse and fifty-three percent of people with drug abuse also have at least one serious mental illness. * Of all people diagnosed as mentally ill, 29 percent suffer from alcohol abuse or drug abuse.
What Type of Mental Health Problems are Seen in People with Dual Diagnosis?
The following psychiatric problems occur in Dual Diagnosis - i.e., in tandem with alcoholism or drug addiction. * disorders, such as depression and bipolar disorder. * Anxiety disorders, panic disorder, obsessive-compulsive disorder, and phobias. * Other psychiatric disorders, such as schizophrenia and personality disorders.
The following table based on a National Institute of Mental Health study, lists seven major psychiatric disorders and shows how much each one increases an individual`s risk for drug addiction. Psychiatric Disorder Increased Risk For Substance Abuse Antisocial personality disorder 15.5% Manic episode 14.5 Schizophrenia 10.1 Panic disorder 4.3 Major depressive episode 4.1 Obsessive-compulsive disorder 3.4 Phobias 2.4
Thus, someone suffering from schizophrenia is at a 10.1 percent higher-than-average risk of alcohol addiction or drug addiction. Someone who is having an episode of major depression is at a 4.1 percent higher-than-average risk of having alcoholism or drug addiction……………….
Drug Addiction, Alcohol Addiction or the Emotional Problem….Which Came First? Often the psychiatric problem develops first. In an attempt to feel calmer, more peppy, or more cheerful, a person with emotional symptoms may drink or use drugs; doctors call this "self-medication." Frequent self-medication may eventually lead to physical or psychological dependency on alcohol or drugs, alcohol addiction or drug addiction. If it does, the person then suffers from not just one problem, but two. In adolescents, however, drug or alcohol abuse may merge and continue into adulthood, which may contribute to the development of emotional difficulties or psychiatric disorders. Dual diagnosis is a complex disorder to diagnose.
If a Person Suffers From Drug Addiction, Alcoholism and a Mental Health Disorder, Which Should Be Treated First? In a perfect world, both problems should be treated simultaneously. For any substance abuse problem, however, the first step in treatment must be detox - a period of time during which the body is allowed to cleanse itself of alcohol or drugs. Ideally, detox should take place under medical supervision. It can take a few days to a week or more, depending on what substances the person abused and for how long.
Until recently, alcoholics and drug addicts dreaded detox because it meant a painful and sometimes life-threatening "cold turkey" withdrawal. Now, doctors are able to provide those people with a drug addiction or alcohol addiction carefully chosen medications while in detox, which can substantially ease withdrawal symptoms. Detox done under medical supervision, is safer for the dually diagnosed.
Defying Your Medical Diagnosis
Medical doctors can have tremendous negative effects on your life if you relinquish the responsibility for and power over your health to them.
Now I'm not talking just about doctors who are negligent or psychopathic. I'm also referring to the competent and humane ones. The ones who do their jobs to perfection. The one’s who care. The one's who go the extra mile to figure out what's wrong with you. The one's who then present their findings to you in the form of a diagnosis.
But isn't that what doctors are supposed to do? Isn't that what we go to them for? Isn't that a sign of good medical practice?
Well if you allow yourself to become married to a diagnosis, especially one that has a poor prognosis (i.e. a poor long-term outcome based on statistics) then you are as good as dead. You will however be making your doctor feel like they’ve served you well through their efforts to provide you the diagnosis.
Now you might be scratching your head wondering what I'm talking about so let me be clearer.
A doctor's diagnosis is often taken by patients as "God's Truth", a truth that is thought to be inevitable, unchangeable, and irreversible and so on.
Why is this? Well because most patients have given away their power over their own lives to these doctors. Whatever they say then becomes the truth and the whole truth.
How many times have you heard a story of a doctor telling a patient that the cancer they have will kill them in a matter of months? When an individual buys this news as the truth what do you think happens to them? Well they fulfill the doctor's prophecy don't they?
There are however the conscious and, shall we say "stubborn", few who refuse to buy into this kind of news. What happens to them? Well in a large number of cases they beat and even defeat the prophecy.
So what does this tell you about the power of one's beliefs?
Well in my experience it says that it is the belief in the diagnosis that kills you in the end, that is if you accept it as true.
Working with clients over the last ten years employing a powerful modality called the Mind Resonance Process(TM) (MRP) I have helped individuals release deeply imprinted beliefs about their health that were "imprinted" literally into their minds and bodies by well meaning doctors.
In doing so they have experienced remarkable shifts in their level of emotional and physical empowerment and thus their ability to tap into healing capacities they had forgotten they had.
In my view this phenomenon must be acknowledged by individuals if they are to reclaim these unique abilities and thereby assume responsibility for themselves once and for all.
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