Tuesday, March 27, 2012

Oh that ringing in my ears

Buzz Kill: Self-Dissolving Tinnitus Treatment Gives New Hope: Scientific American

HEAR THAT?: Draper Laboratory in Cambridge, Mass., is fleshing out a concept for a small delivery device that can provide relief to tinnitus sufferers. The device would be inserted near the membrane-covered window separating the middle ear from the inner ear and release medication into the cochlea. Image: Courtesy of Draper Laboratory

Loud, concussive explosions on the battlefield may last only a few seconds, but many soldiers returning from combat in the Middle East are experiencing lingering symptoms that cause them to perceive sounds even when it is quiet. Doctors can do little to treat the problem—typically described as a ringing in the ears—because they lack an effective way of delivering medication to the inner ear. That could change in a few years, in the form of an implantable polymer-based microscale drug-release system that delivers medicine to the inner ear.

Called tinnitus, the condition afflicts at least one in every 10 American adults and is the most common disability among Afghanistan and Iraq war veterans, according to the U.S. Department of Veterans Affairs (VA). Up to 40 percent of all veterans may be suffering from tinnitus, and the VA spends about $1 billion annually on disability payments for tinnitus, according to a study published last year in Nature. (Scientific American is part of Nature Publishing Group.)

To address the problem, the U.S. Department of Defense has commissioned Draper Laboratory in Cambridge, Mass., to spend the next year fleshing out a concept for a small delivery device inserted near the membrane-covered window—no more than three millimeters in diameter—separating the middle ear from the inner ear. Once at the membrane the device (essentially a polymer capsule, although Draper is not developing any of medicines that might be placed inside) would release a drug into the cochlea, the tubular organ residing in the inner ear that enables us to hear. The plan is to embed wireless communications into the capsule so that a patient or doctor can control the dosage. After the capsule finishes delivering its supply of drugs, it would dissolve.

Although Draper’s project is still in the very early stages and years away from any clinical testing, it holds more promise than many of today’s most common approaches to tinnitus treatment, which include deep breathing, using background noise to drown out the ringing or simply learning to ignore the bothersome sound. Steroids injected into the eardrum have shown some promise in helping patients with certain hearing and balance disorders, but the ear begins eliminating these drugs through the eustachian tube (a passageway in the middle ear that acts as a pressure equalizer) as soon as the patient talks, swallows or even sits up. As a result, the patient must endure several injections into their ear and remain immobilized for a time after each injection to get any relief from the malady.

“By and large there aren’t that many good ways to treat tinnitus,” says Lloyd Minor, provost and senior vice president for academic affairs at Johns Hopkins University. Draper’s work “is potentially a novel way of delivering drugs to treat tinnitus. In general, we don’t have the types of drug-delivery systems that we would like to get medication into the inner ear.”

NeuroSystec Corp. is developing a neuro-active agent designed to calm the hyperactive nerves responsible for cochlear tinnitus. The Valencia, Calif., biotech start-up has licensed an osmotic pump from Durect Corp. in Cupertino, Calif., a company working on a number of drug delivery mechanisms for various parts of the body, including the inner ear.

Other advanced approaches of addressing tinnitus have been in the works for years, but most are still not ready for the market. Otonomy, Inc., in San Diego is testing a sustained release dexamethasone (a type of steroid) gel that would be injected into the middle ear, where it would stay in place, dissolving slowly and delivering treatments for hearing and balance disorders. MicroTransponder, a medical device company spun out from the University of Texas at Dallas in 2007, is looking to broaden the use of its implanted wired neuro-stimulation system for treating epilepsy to likewise help tinnitus patients.

The neuro-stimulation approach shows greater promise than those based on delivering medication to the inner ear at this time, says Michael McKenna, an otologist and neurologist at Massachusetts Eye and Ear in Boston. Targeted drug therapy is of questionable benefit because tinnitus comes from a variety of causes—including age-related hearing loss, traumatic ear injuries or circulatory system disorders—and has varying degrees of severity, he adds.

Perhaps some combination of all these efforts will end up delivering the relief that tinnitus sufferers seek. “Nothing really has been a panacea, so there is the need for further technological development,” Minor says. If Draper’s technology “works in the way they’re hoping it will work, it will potentially be a big advance for the field.”

- Posted from my iPad

Location:Georgetown TX,United States

Monday, March 26, 2012

One anti cancer drug fits all?

One Drug to Shrink All Tumors

by Sarah C. P. Williams on 26 March 2012, 3:05 PM | Comments

A single drug can shrink or cure human breast, ovary, colon, bladder, brain, liver, and prostate tumors that have been transplanted into mice, researchers have found. The treatment, an antibody that blocks a “do not eat” signal normally displayed on tumor cells, coaxes the immune system to destroy the cancer cells.

A decade ago, biologist Irving Weissman of the Stanford University School of Medicine in Palo Alto, California, discovered that leukemia cells produce higher levels of a protein called CD47 than do healthy cells. CD47, he and other scientists found, is also displayed on healthy blood cells; it’s a marker that blocks the immune system from destroying them as they circulate. Cancers take advantage of this flag to trick the immune system into ignoring them. In the past few years, Weissman’s lab showed that blocking CD47 with an antibody cured some cases of lymphomas and leukemias in mice by stimulating the immune system to recognize the cancer cells as invaders. Now, he and colleagues have shown that the CD47-blocking antibody may have a far wider impact than just blood cancers.

“What we’ve shown is that CD47 isn’t just important on leukemias and lymphomas,” says Weissman. “It’s on every single human primary tumor that we tested.” Moreover, Weissman’s lab found that cancer cells always had higher levels of CD47 than did healthy cells. How much CD47 a tumor made could predict the survival odds of a patient.

To determine whether blocking CD47 was beneficial, the scientists exposed tumor cells to macrophages, a type of immune cell, and anti-CD47 molecules in petri dishes. Without the drug, the macrophages ignored the cancerous cells. But when the CD47 was present, the macrophages engulfed and destroyed cancer cells from all tumor types.

Next, the team transplanted human tumors into the feet of mice, where tumors can be easily monitored. When they treated the rodents with anti-CD47, the tumors shrank and did not spread to the rest of the body. In mice given human bladder cancer tumors, for example, 10 of 10 untreated mice had cancer that spread to their lymph nodes. Only one of 10 mice treated with anti-CD47 had a lymph node with signs of cancer. Moreover, the implanted tumor often got smaller after treatment — colon cancers transplanted into the mice shrank to less than one-third of their original size, on average. And in five mice with breast cancer tumors, anti-CD47 eliminated all signs of the cancer cells, and the animals remained cancer-free 4 months after the treatment stopped.

“We showed that even after the tumor has taken hold, the antibody can either cure the tumor or slow its growth and prevent metastasis,” says Weissman.

Although macrophages also attacked blood cells expressing CD47 when mice were given the antibody, the researchers found that the decrease in blood cells was short-lived; the animals turned up production of new blood cells to replace those they lost from the treatment, the team reports online today in the Proceedings of the National Academy of Sciences.

Cancer researcher Tyler Jacks of the Massachusetts Institute of Technology in Cambridge says that although the new study is promising, more research is needed to see whether the results hold true in humans. “The microenvironment of a real tumor is quite a bit more complicated than the microenvironment of a transplanted tumor,” he notes, “and it’s possible that a real tumor has additional immune suppressing effects.”

Another important question, Jacks says, is how CD47 antibodies would complement existing treatments. “In what ways might they work together and in what ways might they be antagonistic?” Using anti-CD47 in addition to chemotherapy, for example, could be counterproductive if the stress from chemotherapy causes normal cells to produce more CD47 than usual.

Weissman’s team has received a $20 million grant from the California Institute for Regenerative Medicine to move the findings from mouse studies to human safety tests. “We have enough data already,” says Weissman, “that I can say I’m confident that this will move to phase I human trials.”

- Posted from my iPad

Location:Georgetown TX,United States

Saturday, March 24, 2012

Now your iPhone may help you diagnose Parkinson's

Device connected to an iPhone able to detect tremors associated with Parkinson’s disease
imedicalapps.com by Cory Schultz

Each year, over 50,000 patients are diagnosed with Parkinson’s disease. Add to that the scores of patients affected by Parkinson’s spectrum disorders as well as other movement disorders and the result is millions of Americans for whom the simplest of daily tasks can be an enormous challenge.

As there is no cure for most, if not all, of these conditions, there are many treatments targeted at controlling their symptoms. However, as with many chronic diseases, a fifteen or thirty minute evaluation every few months can fall short in terms of evaluating symptoms or assessing progression.

Thinking about that problem, Di Pan, a doctoral student at ASU’s Department of Biomedical Informatics (BMI), realized that the tremors associated with the disease could be detected using a smartphone and a customized app. This app is being developed by Pan in collaboration with Rohit Dhall, of the Institute’s Deep Brain Stimulation Clinic, and St. Joseph’s Hospital.

The basic functionality of the app involves the sensitive accelerometer which can be found in the majority of smartphones on the market today. A Parkinson’s patient simply has to either hold the smartphone equipped with the app in their hand or apply the device to their ankle for 30 seconds and then tap the screen. This allows the accelerometer of the tablet or smartphone to record movement.

The application measures the tremors and transmits the information to the patient’s doctor, facilitating enhanced communication between parties, where key data points can be relayed to the doctor’s office if they meet a particular predefined threshold.

“The goal of the device is to relate the information measured to a patient’s electronic medical records (EMRs) so doctors may log in and review the trends. This also swaps time-consuming patient checkups with the convenience of retrieving results from home in an efficient manner. Of course, the regularity of in-clinic patient checkups is dependent upon the stage of the disease and medication modifications. If the information received from the device is negative, meaning the disease has worsened, the patient will need to physically visit the physician at the clinic.”

The iMedicalApps team has previously reported on a similar device created by researchers at UCLA. In that article, researchers also used an iPhone 3G and a customized application to display how the characteristic Parkinson’s tremor can be diagnosed remotely using the accelerometer of the iPhone. While that was more of a proof of concept, the app designed by Pan is currently in its testing phase.

An additional report we did was over iTrem which also uses the iPhone’s built-in accelerometer to collect data on a patient in his or her home and/or office. iTrem is also a promising development in being able to measure tremors.

The implication’s of Di Pan’s new symptom detection tool are very positive. Diagnosing symptoms of Parkinson’s disease early on can help with appropriate treatment methods and can alert a patient’s doctor to a worsening of the condition. This can lead to better and more targeted options for the patient which will ultimately culminate in a better quality of life.

- Posted from my iPad

Location:Georgetown Tx,United States

Those iPad Apps may be good for your health

Doctors Believe Using Health Apps Will Cut Down on Visits [INFOGRAPHIC]

According to data revealed by Float Mobile Learning, 40% of doctors believe that using mobile health technologies such as apps that monitor fitness and eating habits can reduce the number of office visits needed by patients. About 88% of doctors are in full support of patients monitoring their health at home, especially when it comes to watching weight, blood sugar and vital signs, and many believe consumers should take advantage of the apps currently on the market to help along the process.

“With the forthcoming changes to the U.S. healthcare system, there will be an increased focus on wellness programs and preventative medicine,” Chad Udell, managing director of Float Mobile Learning, told Mashable. “Mobile health offers a tremendous opportunity for people to become more involved in their own health and wellness.”

It’s no secret that the mobile health industry is growing. There are more than 10,000 medical and healthcare apps available for download in the Apple App Store, making it the third-fastest growing app category among iPhone and Android users.

Doctors are also getting in on the trend, as 80% said they use smartphones and medical apps. Physicians are also 250% more likely to own a tablet than other consumers.

Udell noted that doctors continue to buy tablet devices in droves largely because they offer an easy way to stay in touch with their co-workers and patients. The infographic also noted that 56% of doctors said they turn to mobile devices to make faster decisions, and 40% said it reduces time spent on administration work.

“It will be interesting to see the impact of the new iPad on medical imaging professionals such as radiologists, who will be able to take advantage of its great graphic capabilities,” Udell said.

Among some of the most popular apps are Nike Plus — which turns a smartphone into a personal trainer — and iStethoscope that allows iPhone users to record and play back a heartbeat. Meanwhile, Welldoc is a series of programs and apps that can reduce hospital and ER visits in half by having patients monitor and manage their own chronic diseases.

- Posted from my iPad

Location:Georgetown,United States

First chess now Cancer

(Credit: IBM)

Memorial Sloan-Kettering Cancer Center (MSKCC) and IBM have announced an agreement to collaborate on the development of a powerful tool built upon IBM Watson to provide medical professionals with improved access to current and comprehensive cancer data and practices.

The resulting decision support tool will help doctors everywhere create individualized cancer diagnostic and treatment recommendations for their patients based on current evidence.

Instant diagnostic and treatment options

The idea is to combine the computational power of IBM Watson and its natural language processing ability with MSKCC’s clinical knowledge, existing molecular and genomic data, and a vast repository of cancer case histories to create an outcome- and evidence-based decision support system.

The goal: give oncologists located anywhere the ability to obtain detailed diagnostic and treatment options based on updated research that will help them decide how best to care for an individual patient.

The IBM Watson system can interpret queries in natural language and uses statistical analysis, advanced analytics, and a powerful array of processors to search millions of pages in seconds and deliver evidence-based, statistically ranked responses (credit: IBM)

MSKCC’s world-renowned oncologists will assist in developing IBM Watson to use a patient’s medical information and synthesize a vast array of continuously updated and vetted treatment guidelines, published research and insights gleaned from the deep experience of MSKCC clinicians to provide an individualized recommendation to physicians. The tool will also provide users with a detailed record of the data and evidence used to reach the recommendations.

The need for such an advanced technology arises from the steadily increasing complexity of oncology treatment.

Cancers are the second most common cause of death in the U.S., second only to heart disease, and the American Cancer Society projects that 1.6 million new cancer cases will be diagnosed in the U.S. this year, with outcomes varying widely across the country.

Cancer is not one disease but some hundreds of sub-types, each with a different genetic fingerprint.

Significant discoveries in molecular biology and genetics in the past two decades have delivered new insights into cancer biology and strategies for targeting specific molecular alterations in tumors, but these advances have also ratcheted up the complexity of diagnosing and treating each case.

Oncologists and physicians who do not specialize in specific sub-types of cancer face a significant challenge in keeping up with the magnitude of rapidly changing information.

“The combination of transformational technologies found in Watson with our cancer analytics and decision-making process has the potential to revolutionize the accessibility of information for the treatment of cancer in communities across the country and around the world,” said MSKCC President and CEO Craig B. Thompson.

“Memorial Sloan-Kettering’s evidence-based clinical approach, scientific acumen, and vast database make it the ideal partner in this ambitious project,” said Dr. Martin Kohn, chief medical scientist, IBM. “Cancer care is profoundly complex with continuous clinical and scientific advancements to consider. This field of clinical information, given its importance on both a human and economic level, is exactly the type of grand challenge IBM Watson can help address.”

“This comprehensive, evidence-based approach will profoundly enhance cancer care by accelerating the dissemination of practice-changing research at an unprecedented pace,” said Dr. Mark G. Kris, Chief, Thoracic Oncology Service at MSKCC and one of the clinicians leading the development effort. He noted that 85 percent of patients with cancer are not treated at specialized medical centers and it can take years for the latest developments in oncology to reach all practice settings.

Development work is already underway for the first applications, which include lung, breast and prostate cancers. The objective is to begin piloting the solutions to a select group of oncologists in late 2012, with wider distribution planned for late 2013.

- Posted from my iPad

Location:Georgetown,United States

Sunday, March 11, 2012

So what does the future hold?

The Weekend Interview with Michio Kaku: Captain Michio and the World of Tomorrow - WSJ.com
The Wall Street Journal | by BRIAN BOLDUC
New York

By 2020, the word “computer” will have vanished from the English language, physicist Michio Kaku predicts. Every 18 months, computer power doubles, he notes, so in eight years, a microchip will cost only a penny. Instead of one chip inside a desktop, we’ll have millions of chips in all our possessions: furniture, cars, appliances, clothes. Chips will become so ubiquitous that “we won’t say the word ‘computer,’” prophesies Mr. Kaku, a professor of theoretical physics at the City College of New York. “We’ll simply turn things on.”

Mr. Kaku, who is 65, enjoys making predictions. In his latest book, “Physics of the Future,” which Anchor released in paperback in February, he predicts driverless cars by 2020 and synthetic organs by 2030. If his forecasts sound strange, Mr. Kaku understands the skepticism. “If you could meet your grandkids as elderly citizens in the year 2100,” he offers, “you would view them as being, basically, Greek gods.” Nonetheless, he says, “that’s where we’re headed,” —and he worries that the U.S. will fall behind in this technological onrush.

To comprehend the world we’re entering, consider another word that will disappear soon: “tumor.” “We will have DNA chips inside our toilet, which will sample some of our blood and urine and tell us if we have cancer maybe 10 years before a tumor forms,” Mr. Kaku says. When you need to see a doctor, you’ll talk to a wall in your home, and “an animated, artificially intelligent doctor will appear.” You’ll scan your body with a hand-held MRI machine, the “Robodoc” will analyze the results, and you’ll receive “a diagnosis that is 99 percent accurate.”

In this “augmented reality,” as Mr. Kaku calls it, the Internet will be in your contact lens. “You will blink, and you will go online,” he says. “That’s going to change everything.” Students will look up the answers to tests while taking them. Actors will cheat from their scripts while performing onstage. Foreigners will translate their conversations with natives instantly. Job-seekers will identify “who to suck up to at any cocktail party” surreptitiously. And President Obama “will never have to have teleprompters in front of him,” he jokes.

Ken Fallin
Although these gadgets seem light years away, Mr. Kaku insists that they’re “coming very, very fast.” The military already has a prototype of the contact lens called “Land Warrior.” In 2010, he tried out the device while filming a special for the Science channel, on which he appears regularly. The Land Warrior is a helmet with an eyepiece that allows the wearer to see the entire battlefield. “You see friendly forces, enemy forces, artillery, aircraft, everything,” Mr. Kaku says, “just by flicking it down right over your eye.”

As he describes the eyepiece, Mr. Kaku peers at me through his cupped hand. We’re sitting in a side room off the lobby of his high-rise overlooking the Hudson River. With his silver-gray hair tossed behind his ears, he makes quick gestures to illustrate his points. And he laughs constantly. Despite his enthusiasm for science’s successes, he also finds humor in its failures.

Take the paperless office. Futurists predicted that the computer would make paper obsolete. Now, however, we use more paper than ever. Techies overlooked what Mr. Kaku calls “the Caveman Principle”: the fact that “our personalities haven’t changed for 100,000 years, since modern humans emerged from Africa.” The scientist likes high tech, “but the caveman likes high touch,” he explains. “People don’t feel comfortable with all the electrons on their PC screen.” With the flip of a switch, those electrons disappear, worrying our inner caveman. “We want a hard copy.”

Still, Mr. Kaku is bullish on mankind’s prospects. Propelled by advances in nanotechnology, artificial intelligence and biotech, we’ll become a fully globalized civilization by 2100, he predicts: “The planetary language will be English. The Internet will be the planetary telephone system. The European Union and big trading blocs will be the planetary economy. Soccer and the Olympics will be the planetary sports. Gucci and Chanel will be the planetary high fashion. And planetary youth culture will be rock ‘n’ roll and rap.”

Mr. Kaku has been exploring the frontiers of physics since childhood. When he was eight years old, Albert Einstein died, and the public reaction to the physicist’s passing “was as big as Whitney Houston dying,” he remembers. Amid the hullabaloo, he heard that Einstein had failed to finish his greatest work: a single, inch-long equation that would summarize the laws of physics. Einstein hoped this all-encompassing theory would explain how the universe worked. Fascinated by the idea, Mr. Kaku decided to pick up where he left off.

To understand the universe, physicists first need to figure out what it’s made of. “We had to rewrite every textbook,” Mr. Kaku recounts, “because 10 years ago they all said the universe is mainly made out of atoms. We now know that’s wrong.” In reality, atoms make up only 4% of the universe. The other 96% consists of dark matter and dark energy, two mysterious substances about which very little is known.

What’s more, physicists are still finalizing the standard model, the theory behind particles. They now know there aren’t just three types of particles—protons, neutrons and electrons—but rather, thousands of them. Physicists in Geneva are close to discovering the last particle they need to complete the model, the Higgs boson. Using a humongous atom smasher called the Large Hadron Collider, they spend their days shooting beams of protons into each other and inspecting what comes out.

Mr. Kaku is confident that researchers will discover the Higgs by the end of the year. Their next goal is to create dark matter. And eventually, they hope to nail down what exactly dark energy is. When calculating the amount of dark energy in the universe, the current theory produces an estimate that is off by by 10120. “That is the biggest mismatch ever between theory and experiment in the history of physics,” Mr. Kaku admits, chuckling. “This is very embarrassing.”

What’s also embarrassing is that the U.S. is falling behind its rivals in scientific research. The Large Hadron Collider is in Switzerland because Congress canceled the construction of our much larger atom smasher, the Superconducting Super Collider, in 1993. In addition, many of our laboratories studying nuclear fusion are closing, while France plans to open a nuclear-fusion reactor in 2019. Finally, the U.S. is ceding the manned space program to China. “In 2025, don’t be surprised if a Chinese flag is placed on the moon,” Mr. Kaku warns.

And woe to the nation that loses its edge. Great Britain became a world empire when it pioneered steam power in the 19th century, Mr. Kaku recounts. In the 1920s, however, Britain began to rest on its laurels. British industry lost its focus on developing the latest technology, thus solidifying the country’s status as a declining world power. “And who took over? Germany.” German scientists split the atom and developed aeronautics. “So the cutting edge in science shifted from England to Germany with catastrophic results” in World War II, Mr. Kaku concludes.

Now, he says, the U.S. is losing its edge because we’re not producing enough scientists. “Fifty percent of Ph.D. physicists are foreign-born, and they’re here compliments of the H1-B visa,” Mr. Kaku relates. “There’s a brain drain into the United States; that’s why we’re still No. 1. But it can’t last forever.” China and India are slowly luring back their natives, while our top students are eschewing the hard sciences for lucrative careers in areas such as investment banking.

“I have nothing against investment banking,” Mr. Kaku says, “but it’s like massaging money rather than creating money. If you’re in physics, you create inventions, you create lasers, you create transistors, computers, GPS.” If you’re an investment banker, on the other hand, “you don’t create anything new. You simply massage other people’s money and take a cut.”

It’s a shame, because Mr. Kaku believes humans are natural-born scientists. “When we’re born, we want to know why the stars shine. We want to know why the sun rises.” But then we hit “the danger years” for young people: high school. “And we lose them by the millions—literally by the millions. Why? It’s a combination of bad teachers and no inspiration.”

After the Soviet Union launched Sputnik in 1957, Mr. Kaku’s hobby became a vocation: “It was this huge national outrage that the Russians were beating us left and right. It was your patriotic duty to become a physicist.” Today, unfortunately, no such catalyst exists for our students: “It’s all gone.” Mr. Kaku has spent his life trying to fill the void: “I want to inspire young kids to have their ‘Sputnik moment.’”

Despite his concerns that his country is losing its edge, Mr. Kaku can’t help but be optimistic. Just last month, scientists announced they had found a planet very likely to have liquid oceans (and thus the potential for life) 22 light years from the Earth. He predicts that within this century, we’ll find evidence that “we’re not the only game in town.”

In short, physicists will keep pushing the frontiers of science ahead, whether or not the U.S. is in the lead. Mr. Kaku just hopes we won’t let ourselves fall too far behind.

- Posted from my iPad2

Location:Georgetown TX,United States

Tuesday, March 6, 2012

Video Games may well improve decision making

Not my usual post material but it was an interesting video based on a large data set.


- Posted from my iPad2

Location:Georgetown TX,United States

Sunday, March 4, 2012

Healthcare, There's an app for that

I have made no secret of the fact that I am an iPad lover. I will not bore you with the multiple reasons for my affection for a piece of silicon, aluminum, glass, wire, and assorted metals.

Having said that, it's use in both the personal and professional components of healthcare are growing daily. Besides the apps noted in the following article, let me suggest several others.

Livestrong - Weight Control
Micromedex - Medications
WebMD - Medical information
Mayo Clinic - Medical Information
My Medical for iPad - Electronic Health Record
Virtual Heart - A unique look at the human heart

As a point of interest, I have no relationship, financial or otherwise,
with the developers or companies of the applications mentioned

Three Free Healthcare Apps That Empower Patients | TechCrunch

Editor’s Note: Iltifat Husain is the founder and Editor-in-chief of iMedicalApps.com, a physician-operated technology review publication and is currently an Emergency Medicine resident physician at Wake Forest University’s School of Medicine.

The significant adoption of smartphones among physicians has not only led to an explosion of medical apps aimed at healthcare providers, but it has also cultivated an emerging trend of health and wellness apps aimed at empowering patients.

While great innovation is happening in the health and wellness mobile ecosystem, it’s difficult for patients and physicians to navigate through the large database of apps to
find ones they can actually use. My experience reviewing health and medical apps as a writer, combined with my experiences in a high volume Emergency Department that sees a diverse patient population, has allowed me to get a unique sense of this space.

Looking back, I’ve come to realize that there are three apps in particular that I routinely prescribe to my patients, as they are not only meaningful to physicians, but truly empower patients (and their families) and help them better understand their treatment and what’s going on with their bodies.

These three apps help patients and their family members get a better understanding of the cancer treatment process, help women in pregnancy understand their baby’s development, and help children and adults learn how to manage their diabetes.

All three apps are backed by venerable organizations already trusted by millions of patients worldwide. And just to make it clear up front: I have no relationships, financial or personal, with the developers or companies of the applications mentioned.


Cancer.net, an oncologist approved cancer information website from the American Society of Clinical Oncology (ASCO), released an iOS app last year that brought their website’s functionality and much more to mobile form. When I reviewed the app last year, I was impressed with the unique mobile-specific features.

My favorite area of the app is the “questions and answers” section, which enables patients to store questions they can ask their oncologist and other physicians later. However, the most impressive part of the app an area that suggests questions that cancer patients and family members should consider asking — empowering patients and family members to ask relevant questions.

The functionality is extended by enabling patients to store questions in voice format. This is a critical feature for cancer patients as many of them are undergoing chemotherapy that can make typing or finger manipulation difficult due to neuropathy in their fingers. Furthermore, it helps patients record their physicians response accurately — so when patients are asked by family members “What did the doctor think?” — they can easily share the recording. Study after study shows patient recall after a physician visit is not optimal, and there is good evidence to suggest audio recordings, especially of oncology visits, are beneficiary to patients and their family members.

Other features that empower patients is an area where side effects of their medications can be meticulously stored and an area where patients can see various videos suggested by ASCO.

Available for iOS and Android is pending.

Carb Counting with Lenny

Carb Counting with Lenny is made by Medtronic, the goliath medical device company. The app is designed to help children learn about diabetes and to get a better understanding of carb counting. Those with diabetes or those with family members with diabetes know how crucial carbohydrate counting is. It is crucial for diabetics to be able to approximate how many carbohydrates they are consuming so they can titrate their medications effectively.

The app incorporates gamification into teaching, making the app playful and fun to use. The games show you all the basic food groups and enables patients to easily understand how various carbs can affect their blood sugar adversely.

Although this app is aimed at children, I have suggested it to adults patients as well. The app does a great job of getting patients to understand how many carbohydrates they are consuming, and how it can affect their blood sugar.

You can find it on iOS here.

Hello Baby Pregnancy Calendar

Hello Baby Pregnancy Calendar is produced by Pampers, and was released just a few months after the introduction of the first iPad. The app allows expecting mothers to get a better idea of the various stages of their pregnancy and their baby’s development.

The app shows expectant mothers the different stages of their baby’s anatomy week by week. One of my favorite parts of this app is the great medical education delivered — such as explaining to patients when and why physicians would want to do an amniocentesis. These types of tips enable patients to be better prepared when they go for their prenatal check ups.

The app also included a parenthood video series, and even a quirky “Womb Translator” portion that enables you to hear what your baby is hearing while in your Womb. Frankly, I don’t know how scientifically accurate this portion is as various variables such as amount of amniotic fluid surrounding the baby would impact this, but it’s endearing and if it gets expectant mothers to learn more and be better prepared during pregnancy I’m all for it.

As smartphones become more ubiquitous, it’s critical that health care providers, as well as patients, get a better understanding of how to utilize these devices for improving overall patient care.

You can find it on the App Store here.

- Posted from my iPad2

Location:Georgetown TX,United States

Social Networks, Can They Help The Healthcare Crises?

Lucien Engelen: how social networks can solve the healthcare crisis | Technology | The Observer
The Guardian World News
Interview by Ian Tucker

Lucien Engelen is researching ways that new technology can improve healthcare provision.
Lucien Engelen is director of the Radboud REshape & Innovation Centre at Radboud University Nijmegen medical centre in the Netherlands. His work looks at how new technologies can change patient care models in the context of rising demand for healthcare, shortages of skilled staff and restrictive budgets. He is organising TEDxMaastricht “The Future of Health” on 2 April.

How could social networks be used to improve healthcare provision?

We tend not to use the biggest resource in healthcare – the patients themselves. So I’m trying to figure out possible uses for digital technologies like Facebook but also real-life social networks to improve healthcare provision.

How have we got to this position, where patients aren’t listened to?

Over the past decades we have tended to take healthcare away from the people themselves. This started with bringing people into hospitals rather than caring for them in their homes. Healthcare has become centralised in institutions, rather than in networks as it was in the old days. But new technology is enabling us to reverse that, while keeping the same high standards.

For example?

I wanted patients to be able to talk to their physician via video much like they would via Skype – however Skype is not secure enough for healthcare legislative standards. There are video conferencing systems but they require dedicated hardware. So we designed a hardware-free system. This means that patients who would normally have to visit their physician four times a month, for example, can know do three of these consultations via video.

What do doctors think about this?

Doctors are aware of the challenges of double health care demand – the idea that, mainly because of demographic changes, the demand on healthcare professionals over the next 20 years will double. Moreover their budgets are frozen and there are shortages of skilled personnel, so we have to come up with smart solutions. This is one of the examples that could help to make healthcare provision affordable and easier.

Older people are big users of healthcare. Are you concerned that some might not want to use computers?

It’s a misconception that people over 65 do not use computers. They love them, they are always consulting Dr Google.

You recently conducted a project for young cancer patients…

At the hospital we have a hang-out spot for young cancer patients, with internet and coffee and someone to talk to about problems – for example problems at work, or how to get finance. They asked us to set up an online version, so they could interact with each other when they weren’t undergoing chemotherapy. So we built a secure online community called AYA4 (“all information you have ever asked for”) for young Dutch cancer patients. The nice thing is that in this online community there are no physicians or nurses, we just have a community manager to answer technical queries. There is a button for medical questions, which are sent directly to an oncologist who answers back to the community.

The users love it. They can talk about their health problems, which they can’t on Twitter. We can point them to the right information about their cancer, so they get peace of mind. The community includes information about diet, finance, law etc, and they give us feedback on how we could do a better job. We are now rolling it out to six other hospitals in the Netherlands.

You have also built an app so users can report the location of automated external defibrillators (AEDs) throughout Holland…

Yes, at present we have 17,000 locations and we are in contact with 10 other institutions to set up maps in their countries. No one is registering their AEDs – I can buy one and no one knows I have it. The Dutch Red Cross is helping us validate the locations, so over time the database will become more accurate. Then if a someone you are with has a cardiac problem you can use the app to find the nearest AED, saving valuable time.

You also tried uploading your weight to Google health and tweeting it every morning…

Yes I was flabbergasted by the reaction. People would say “Lucien you should have a light lunch today” – it was peer pressure. Setting this up in closed communities for obese people or people who want to stop smoking could help them stay more healthy.

Privacy is a controversial topic and health data is particularly sensitive…

I think we overestimate this – youngsters are far less engaged with privacy than people of a mature age. They share a lot of things that you and I would get grey hair about. But we need more legislation to guide it.

What do we do with this incredible amount of health data?

That is a real challenge. We need new ways of finding our way through it. On the intersection between big data and narration is where we can really change healthcare for the better.

You want people to take control of their own health?

Only if they want to. If they want to but they can’t, we will teach them. If they want to but they can’t because there is no system or technology, we will build it for them. But if they don’t want to we will deliver healthcare in the regular way. Some people think it is one way or the other, but it’s not.

- Posted from my iPad2

Location:Georgetown TX,United States

Cancer Treatment Moves From Science Fiction to Reality

Gamma Knife and Laser Therapy for Cancer Treatment?
hivehealthmedia.com | by Thomas Stone

Though they may sound like the stuff of science fiction, phrases like “particle beam,” “proton beam,” “gamma knife” and “laser therapy” may conjure comic book-like images. But these therapies are very real, and are an integral part of modern cancer treatments.

Shooting Lasers to Fight Cancer?

For patients and their families, the idea of using lasers to fight cancer may seem more than a little exotic—it may seem a little frightening, too. But treatments like proton therapy aren’t exotic or new; in fact, many of these therapies have been around– in some form or another – since the 1940s.

Ionizing Radiation for Cancer Treatment

Radiosurgery and stereotactic surgery (SRS) use the principle of ionizing radiation with surgical precision on a variety of cancers. The techniques also offer the benefit of leaving healthy tissue and organs surrounding the cancerous site unscathed during and after treatment. The “surgical” effects of photon therapy reveal the precision and effectiveness of these treatments.

Gioblastoma Treatment

Glioblastoma, a type of brain cancer, is the most resistant cancer to any treatment. This brain cancer is resistant to even proton beam therapy; but this type of therapy at least helps to preserve the healthy tissue surrounding the site of the cancer while working in hopes of eradicating the cancerous cells from the body.
Proton therapy and children

Parents considering proton therapy might be concerned that those powerful rays could damage the organs of still-growing children. But using proton therapy to treat children with cancer can be especially effective, since proton therapy can pinpoint the cancer without damaging healthy, growing tissue.

Proton Therapy for Cancer Treatment

Though this therapy is valuable for children, medical professionals choose not to perform it on children younger than five years old to avoid damaging their still developing brains. Some of the children’s cancers that can be treated by proton therapy include astrocytoma, a type of brain cancer, ependymoma and germinoma (both cancers of the central nervous system), and some types of sarcomas, which affect the body’s soft tissue like bone and muscle. It’s important that patients considering proton therapy have hopeful—but realistic—expectations for treatment.

Each patient who receives such a diagnosis in any of these cancers should seek out a specialist who has expertise in oncology to discuss the least invasive and most effective treatment possible to expeditiously treat the cancerous site without damaging neighboring cells and organs.

- Posted from my iPad2

Location:Georgetown TX ,United States