A Diabetic Meter That Talks to iPhones and Doctors

Personal Technology: A Diabetic Meter That Talks to iPhones and Doctors - Walt Mossberg online.wsj.com While consumer technology advances by leaps and bounds, the devices patients use to manage diseases often seem stuck in the past. A glaring example is the glucometer, the instrument diabetics use to measure the sugar in their blood—information they use to adjust their diet, exercise and medication. These meters, which analyze drops of blood drawn from fingertips, typically resemble crude PDAs from 10 or 15 years ago. They offer little feedback and can’t connect to the Internet to show results to caregivers. Most diabetics who use them log their readings on paper, which they hand doctors weeks or months later. But that is beginning to change. Next week, a small start-up will introduce a new diabetes meter it says is the first with wireless technology that instantly transmits a patient’s readings to a private online database, which can be accessed by the patient or—with permission—by a doctor, caregiver or family member. This system charts the results to highlight trends and spot problems, and can be accessed via a Web browser or an iPhone app. It automatically transmits relevant feedback—such as whether your readings seem high or low—and allows doctors to respond. I’ve been testing this new meter and service, which is called Telcare and comes from a Bethesda, Md., company of the same name. As a Type 2 diabetic myself, I found the Telcare meter a refreshing change, and a significant step toward bringing consumer medical devices closer to the world of modern technology. Despite some drawbacks, including a high price, I recommend the Telcare be considered by diabetics who want a better substitute for paper logs, or would benefit from real-time sharing of their readings. However, as with any medical decision, I urge people to consult their doctors before switching meters. Also, I evaluated this product as a consumer technology. I am not a physician or diabetes expert. While I found the Telcare meter convenient and accurate for me, your situation might differ. The Telcare device works much like a traditional meter. You insert a test strip into a slot on the meter, then prick your finger with a lancing device to get a drop of blood, touch the strip to the drop, and wait for the reading to appear. The difference is the meter immediately sends results to its online database, where you or your doctor can find it via the password-protected website or iPhone app. This transmission is achieved via a built-in cellular modem, which doesn’t involve any cellphone, carrier contract or fee. That cellular connection is used to send you messages about your readings, if necessary. In this first version, the patient can’t reply to doctors’ messages from the meter, but that’s planned for the future. Telcare typically uses T-Mobile’s network, but, if that’s not available, the meter will automatically shift to whatever compatible connection it finds. If no connection is available, it will save the results and you can transmit them manually when you’re back in range. - Posted from my iPad2

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Hospitals adopting Apple's iPad for patient and visitor kiosks

I make no bones about it I am an iPad devotee. I am also one who believes it is a great tool for the tech savvy patient. Hospitals adopting Apple's iPad for patient and visitor kiosks appleinsider.com By Neil Hughes Apple’s iPad is increasingly finding use in hospitals, where some locations have begun using the touchscreen tablet as a kiosk to allow patients and visitors to check in or access information. The iPad has helped some hospitals to streamline their operations by reducing labor costs and improving staff efficiency, according to The Point of Sale News. Hospitals have begun to use specific applications on the iPad to allow easier access to information when used as a kiosk, with the iPad held in place in a secure frame. The report notes a few uses for the iPad from hospitals around the world, including Singapore’s Changi General Hospital. There, visitors, patients and hospital staff can find their way through the facility with an iPad located in a kiosk. At Boston’s Massachusetts General Hospital, doctors access up-to-date information with an iPad before and during a visit with a patient. And New York Methodist Hospital uses kiosk-mounted iPads for EKG and other diagnostic machines. “The new system has been embraced by nurses and technicians as a great time-saver, and has proven a convenient tool for doctors as an access point to all patient data for analysis and diagnosis,” the report said. Professionals in the healthcare industry have shown great interest in Apple’s iPad since the device first launched in 2010. Its use has expanded with new applications, including one that launched last year with FDA approval for mobile diagnoses. Functionality for the iPad among doctors, nurses and others in hospitals could grow even more this year with an anticipated third-generation iPad with a high-resolution Retina Display. More pixels packed into the iPad’s 9.7-inch touchscreen could make it even better for medical imaging among healthcare professionals. - Posted from my iPad2

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A portable device now available to check on Asthmatics

Medicine / Pediatrics NIOX MINO®, a hand-held device for the measurement of airway inflammation and monitoring of patients with asthma, has just been 510(k) cleared by the FDA. The device will “cost efficiently improve management and care of patients with inflammatory disorders, such as asthma.” The monitor is sensitive enough to detect as low as 5 particles per billion of exhaled nitric oxide. NIOX MINO Airway Inflammation Monitor is an easy-to-use handheld device that provides accurate, reproducible and immediate measurement of fractional exhaled nitric oxide (FENO). This is a proven and sensitive indicator of the inflammation that causes the symptoms of airway inflammatory diseases including asthma. Current management of airway inflammatory diseases, including asthma, is achieved primarily by monitoring symptoms and lung function, with the treatment objective of bringing the disease under control. But the underlying cause of these respiratory symptoms and asthma attacks is airway inflammation, which until now could not be routinely measured. NIOX MINO provides physicians in the U.S., for the first time ever, a powerful, easy-to-use tool that enables them to provide people living with inflammatory airway diseases, such as asthma, personalized inflammation control. By using NIOX MINO, doctors can provide the ideal level of therapy to each patient in order to achieve and maintain control of their symptoms. NIOX MINO answers the need for a simple, accurate tool for assessing asthma control and responsiveness to treatment. NIOX MINO helps physicians achieve asthma treatment and management goals, allowing people with asthma to enjoy greater quality of life. In its effort to increase clinicians’ awareness of fractional exhaled nitric oxide (FENO) monitoring, the company has put out the following white paper. - Posted from my iPad2

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Progress being made on nanomedicine computers

Tiny Biocomputers Move Closer to Reality: Scientific American scientificamerican.com Researchers in nanomedicine have long dreamed of an age when molecular-scale computing devices could be embedded in our bodies to monitor health and treat diseases before they progress. The advantage of such computers, which would be made of biological materials, would lie in their ability to speak the biochemical language of life. Several research groups have recently reported progress in this field. A team at the California Institute of Technology, writing in the journal Science, made use of DNA nanostructures called seesaw gates to construct logic circuits analogous to those used in microprocessors. Just as silicon-based components use electric current to represent 1’s and 0’s, bio-based circuits use concentrations of DNA molecules in a test tube. When new DNA strands are added to the test tube as “input,” the solution undergoes a cascade of chemical interactions to release different DNA strands as “output.” In theory, the input could be a molecular indicator of a disease, and the output could be an appropriate therapeutic molecule. A common problem in constructing a computer in a test tube is that it is hard to control which interactions among molecules occur. The brilliance of the seesaw gate is that a particular gate responds only to particular input DNA strands. In a subsequent Nature paper, the Caltech researchers showed off the power of their technique by building a DNA-based circuit that could play a simple memory game. A circuit with memory could, if integrated into living cells, recognize and treat complex diseases based on a series of biological clues. This circuitry has not been integrated into living tissue, however, in part because its ability to communicate with cells is limited. Zhen Xie of the Massachusetts Institute of Technology and his collaborators have recently made progress on this front. As they reported in Science, they designed an RNA-based circuit that was simpler but could still distinguish modified cancer cells from noncancerous cells and, more important, trigger the cancer cells to self-destruct. Both techniques have been used only in artificial scenarios. Yet the advances in DNA-based circuits offer a new, powerful platform to potentially realize researchers’ long-held biocomputing dreams. - Posted from my iPad2

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Canadian researchers believe they are near to developing a vaccine for ovarian cancer

Canadian researchers close in on vaccine for ovarian cancer montrealgazette.com Brad Nelson, a molecular and cellular biologist and project leader of the research at the B.C. Cancer Agency's Deeley Research Centre, said the team believes it is three to five years away from clinical trials of a vaccine. Nelson said this has been made possible by breakthroughs in recent years in DNA sequencing. "It's a whole new approach to cancer vaccines that's never been used before," he said. According to Ovarian Cancer Canada, more than 2,600 Canadian women are diagnosed with the disease every year and it kills 1,750 annually. If it is detected early, survival rates can reach 90 per cent. But no screening tools exist to test for it, and symptoms can be vague and easily missed. Most diagnoses occur when the cancer has reached an advanced stage. Ovarian cancer cells can be shed into surrounding bodily fluid. They can then implant on other structures, including the uterus, bladder or bowel, forming new tumours. He said the course of treatment for ovarian cancer is normally surgery followed by chemotherapy. Patients usually respond well at first, but within two to three years, the cancer often reappears. By that time, the cancer cells often have become resistant to chemotherapy drugs, and survival rates start to drop off. Nelson said his research is geared toward a therapeutic vaccine that would be administered after surgery and chemotherapy have beaten down the cancer cells. The vaccine would work by educating the body's immune system to recognize cancerous cells and attack them. Nelson said the planned vaccine would be personalized by creating a DNA profile of the patient's tumours. With ovarian cancer, cells with mutations begin to arise and together band into tumours. By performing a DNA analysis of the tumour, a more targeted vaccine can be developed. It would alert the immune system of a particular patient to recognize and attack the mutated cells of tumours. Also, if the cancer should reappear, another personalized vaccine can be created. This new version could target cells of the second cancer, which likely would have mutated from the first. "There really is no limit to how long you can play this strategy," Nelson said. Furthermore, because cancer cells tend to mutate into hundreds of DNA sequences, the vaccine would target five of the mutations, giving the patient's immune system a good chance of winning. "The chance a tumour will be able to bypass all five is very low," he said. It's an approach similar to modern drug cocktail treatments for HIV. A variety of drugs are used to beat back the AIDS virus as it mutates into various forms. "Viruses are like tumours â they are dumb," Nelson said. "They aren't really trying to kill you, they just keep on blindly evolving." Researchers in the U.S. are taking a similar approach to developing personalized vaccines for different cancers. But Nelson said the B.C. Cancer Centre in Victoria offers him a unique, "front-line" scientific environment. Nelson bumps shoulders every day with clinical doctors and patients. "You start to think differently," he said. "What can I do in three to five years that is going to make a difference?" Meanwhile, Lorraine Dixon of Saltspring Island, a survivor of ovarian cancer and one of the nearly 100 women who have agreed to donate tissue and blood samples to help out, is glad to hear the work is going well. Dixon reports every year to have blood drawn for research. Since she was diagnosed in 2008, Dixon has had two bouts of surgery, one round of chemotherapy and one round of radiation therapy. The tests show she has responded well. But Dixon said she has a vested interest beyond her own body. She also has a grown daughter, two granddaughters and five nieces. "I agreed (to the research) before my first surgery," she said. Nelson's work has been funded by Genome B.C., an organization supported by government partnering with private industry to act as a catalyst in life-sciences research, including medicine. - Posted from my iPad2

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An X-Ray Machine The Size Of An iPhone That Looks Like A Star Trek Tricorder

An X-Ray Machine The Size Of An iPhone That Looks Like A Star Trek Tricorder

BY Neal Ungerleider Thu Dec 8, 2011

California startup Tribogenics is betting that their technology will transform health care--and investors seem to agree.
X-ray machines traditionally use bulky power sources to generate rays. However, California startup Tribogenics is betting that a novel method of powering X-ray machines will revolutionize medical care and airport security. The best part? Tribogenics has already developed prototypes that fit in a pocket.

Tribogenics' products rely on a counterintuitive discovery: X-rays are generated when unrolling Scotch tape in a vacuum. In a Nature article, UCLA researchers Carlos Camara, Juan Escobar, Jonathan Hird, and Seth Putterman detailed how Scotch tape can generate surprisingly large amounts of X-rays thanks to visible radiation generated by static electricity between two contacting surfaces. The research encountered challenges thanks to the fact that Scotch tape and generic brand adhesive tapes generated slightly different energy signatures; the composition of Scotch tape adhesive is a closely guarded 3M trade secret. Camara is Tribogenics' chief scientist; the company is headed by Dale Fox, best known for developing the first screen overlay protectors for mobile phones.

Fox told Fast Company that “every other X-ray source in the world uses a high-voltage transformer connected to a vacuum tube. In contrast, we've harnessed the power of the immense voltages in static electricity to create tiny, low-cost, battery-operated X-ray sources for the first time in history. It's like the jump the electronics industry took when it moved from vacuum tubes to transistors.” According to Fox, Tribogenics has already developed X-ray energy sources the size of a USB memory stick. While Tribogenics representatives declined to discuss pricing for upcoming products, the firm “very comfortably” promised that the cost would be less than 10% than that of any existing X-ray technology.

Tribogenics' effort to bring products to market received a major boost on Tuesday, December 6, thanks to $2.5 million in funding received from Flywheel Ventures and an assortment of angel investors. The firm was founded in 2009 and appears to have completed the difficult step of finding commercial applications for pure research.

The guts of Tribogenics' ultra-portable X-ray machines can be traced, like so many other things, to DARPA. UCLA received research funding from the government agency in 2007; DARPA literature has detailed their hope that cheap, portable X-ray machines could revolutionize battlefield medicine, emergency first response, and airport security. Additional funding was received from the U.S. Army Telemedicine & Advanced Technology Research Center. The technology was later featured on the television show Mythbusters.

While no commercial products have been released by Tribogenics yet, several prototypes show potential. The company appears to be banking most of their hopes on a product called a Pocket XRF Analyzer (pictured), which representatives explicitly compared to a Star Trek tricorder. The XRF Analyzer, which is approximately the size of an iPhone, can identify gold or other precious jewels for jewelers, detect lead traces in toys, and can find traces of radioactive elements in airport security settings.

However, ultra-portable X-ray machines show the greatest potential for becoming a disruptive medical technology. Tribogenics' methods have revolutionary ramifications for catheterized radiation therapy, which currently poses significant radiation risks for patients, doctors, and nurses. According to Fox, the company's products eliminate the need for radioactive isotopes.

Release dates for Tribogenics products for the consumer market have not been announced; however, the firm claims that Pocket XRF Analyzers will drop to a price point affordable for the mass market--and not just for specialists. However, the firm will face challenges in transforming devices that generate large amounts of radiation into consumer products.


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Hydrogel helps grow new scar-free skin In treatment of third-degree burn

In third-degree burn treatment, hydrogel helps grow new, scar-free skin
nextbigfuture.com


In third-degree burn treatment, hydrogel helps grow new, scar-free skin

Johns Hopkins researchers have developed a jelly-like material and wound treatment method that, in early experiments on skin damaged by severe burns, appeared to regenerate healthy, scar-free tissue.

In the Dec. 12-16 online Early Edition of Proceedings of the National Academy of Sciences, the researchers reported their promising results from mouse tissue tests. The new treatment has not yet been tested on human patients. But the researchers say the procedure, which promotes the formation of new blood vessels and skin, including hair follicles, could lead to greatly improved healing for injured soldiers, home fire victims and other people with third-degree burns.

Dextran hydrogel for burn wound healing. (A) Surgery procedure: We placed wounds on the posterior-dorsum of each mouse and performed burn wound excisions after 48 h. We covered wounds with either dextran hydrogels or control scaffold, followed by their coverage with dressing. We covered the control wounds only with dressing. (B) Photo image of wound healing within 21 d demonstrate a more complete wound healing in burn wounds treated with dextran hydrogel than in wounds treated with control scaffolds or dressing alone.

The treatment involved a simple wound dressing that included a specially designed hydrogel—a water-based, three-dimensional framework of polymers. This material was developed by researchers at Johns Hopkins’ Whiting School of Engineering, working with clinicians at the Johns Hopkins Bayview Medical Center Burn Center and the Department of Pathology at the university’s School of Medicine.

Third-degree burns typically destroy the top layers of skin down to the muscle. They require complex medical care and leave behind ugly scarring. But in the journal article, the Johns Hopkins team reported that their hydrogel method yielded better results. “This treatment promoted the development of new blood vessels and the regeneration of complex layers of skin, including hair follicles and the glands that produce skin oil,” said Sharon Gerecht, an assistant professor of chemical and biomolecular engineering who was principal investigator on the study.


n early testing, this hydrogel, developed by Johns Hopkins researchers, helped improve healing in third-degree burns. Photo by Will Kirk/HomewoodPhoto.jhu.edu

Gerecht said the hydrogel could form the basis of an inexpensive burn wound treatment that works better than currently available clinical therapies, adding that it would be easy to manufacture on a large scale. Gerecht suggested that because the hydrogel contains no drugs or biological components to make it work, the Food and Drug Administration would most likely classify it as a device. Further animal testing is planned before trials on human patients begin. But Gerecht said, “It could be approved for clinical use after just a few years of testing.”

John Harmon, a professor of surgery at the Johns Hopkins School of Medicine and director of surgical research at Bayview, described the mouse study results as “absolutely remarkable. We got complete skin regeneration, which never happens in typical burn wound treatment.”

If the treatment succeeds in human patients, it could address a serious form of injury. Harmon, a coauthor of the PNAS journal article, pointed out that 100,000 third-degree burns are treated in U. S. burn centers like Bayview every year. A burn wound dressing using the new hydrogel could have enormous potential for use in applications beyond common burns, including treatment of diabetic patients with foot ulcers, Harmon said.

Guoming Sun, Gerecht’s Maryland Stem Cell Research Postdoctoral Fellow and lead author on the paper, has been working with these hydrogels for the last three years, developing ways to improve the growth of blood vessels, a process called angiogenesis. “Our goal was to induce the growth of functional new blood vessels within the hydrogel to treat wounds and ischemic disease, which reduces blood flow to organs like the heart,” Sun said. “These tests on burn injuries just proved its potential.”

Gerecht says the hydrogel is constructed in such a way that it allows tissue regeneration and blood vessel formation to occur very quickly. “Inflammatory cells are able to easily penetrate and degrade the hydrogel, enabling blood vessels to fill in and support wound healing and the growth of new tissue,” she said. For burns, the faster this process occurs, Gerecht added, the less there is a chance for scarring.

Originally, her team intended to load the gel with stem cells and infuse it with growth factors to trigger and direct the tissue development. Instead, they tested the gel alone. “We were surprised to see such complete regeneration in the absence of any added biological signals,” Gerecht said.

Sun added, “Complete skin regeneration is desired for various wound injuries. With further fine-tuning of these kinds of biomaterial frameworks, we may restore normal skin structures for other injuries such as skin ulcers.”

Gerecht and Harmon say they don’t fully understand how the hydrogel dressing is working. After it is applied, the tissue progresses through the various stages of wound repair, Gerecht said. After 21 days, the gel has been harmlessly absorbed, and the tissue continues to return to the appearance of normal skin.

The hydrogel is mainly made of water with dissolved dextran—a polysaccharide (sugar molecule chains). “It also could be that the physical structure of the hydrogel guides the repair,” Gerecht said. Harmon speculates that the hydrogel may recruit circulating bone marrow stem cells in the bloodstream. Stem cells are special cells that can grow into practically any sort of tissue if provided with the right chemical cue. “It’s possible the gel is somehow signaling the stem cells to become new skin and blood vessels,” Harmon said.

Neovascularization is a critical determinant of wound-healing outcomes for deep burn injuries. We hypothesize that dextran-based hydrogels can serve as instructive scaffolds to promote neovascularization and skin regeneration in third-degree burn wounds. Dextran hydrogels are soft and pliable, offering opportunities to improve the management of burn wound treatment. We first developed a procedure to treat burn wounds on mice with dextran hydrogels. In this procedure, we followed clinical practice of wound excision to remove full-thickness burned skin, and then covered the wound with the dextran hydrogel and a dressing layer. Our procedure allows the hydrogel to remain intact and securely in place during the entire healing period, thus offering opportunities to simplify the management of burn wound treatment. A 3-week comparative study indicated that dextran hydrogel promoted dermal regeneration with complete skin appendages. The hydrogel scaffold facilitated early inflammatory cell infiltration that led to its rapid degradation, promoting the infiltration of angiogenic cells into the healing wounds. Endothelial cells homed into the hydrogel scaffolds to enable neovascularization by day 7, resulting in an increased blood flow significantly greater than treated and untreated controls. By day 21, burn wounds treated with hydrogel developed a mature epithelial structure with hair follicles and sebaceous glands. After 5 weeks of treatment, the hydrogel scaffolds promoted new hair growth and epidermal morphology and thickness similar to normal mouse skin. Collectively, our evidence shows that customized dextran-based hydrogel alone, with no additional growth factors, cytokines, or cells, promoted remarkable neovascularization and skin regeneration and may lead to novel treatments for dermal wounds.
4 pages of supplemental information



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