Category Archives: Health

5 new medical technologies that will ‘wow’ you!

Despite seeing the benefits of technological innovation in our everyday lives—from computers in the palm of your hand to self-driving cars, lab-grown meat to designer babies—we often don’t think about how these things are possible, and this is especially true in the realm of medical and biological research. The simple reason? For many, science is just plain hard to understand.

Do you know how scientists isolate genes, mix and match for genetic modification?

How about the techniques involved in the search for an HIV cure?

Have you ever looked into the new cancer treatment therapies undergoing clinical trial?

I love learning how these things work. Yet, in no way do I understand every piece of science underlying these and other medical research tactics. At the same time, these are more important to everyone’s future than, say, the latest cell phone.

Look, I get it. The evening news finds it easier to explain why wine is great for heart health than how the latest advance in molecular cancer therapy works. It’s easy to understand. Plus, people love an excuse to eat or drink something they normally feel they shouldn’t. But is there a way to bring biomedical innovation to a bigger spotlight? I say yes.

The average person may not understand how stem cell therapy works, or how and why you’d put human genes in a mouse.  What do they love, though? Technology. Show a robot doing something cool or artificial intelligence beating a human in a task, and they’re hooked.

So, in the spirit of showing off biomedical advances you probably haven’t heard of, check out these cool technologies that may one day help save your life.

Robots improve upon designer microbes

Zymergen is a rising star in the biotech industry, having raised $130 million in 2016 to power their robot factory. A robot factory that takes genetically engineered microbes out of human hands and improves them using artificial intelligence.

microbiologistFirst, the robots are much more precise than humans. For instance, instead of pipetting liquid like human scientists, Zymergen robots use sound waves to send a ripple through the liquid. This results in a more precise, specifically a thousand-times smaller, droplet landing in the selected container.

Also, the robots are fast. Instead of testing maybe a dozen hypotheses a month, Zymergen’s robots can run up to 1000 experiments a week. With each experiment for a specific microbe, the computer system collects the data, then uses it to design further experiments. While there are human scientists checking the work, the artificial intelligence is the one making the decisions as to what to edit in the microbe’s genome. And so it goes until they hit something that works.

Right now, Zymergen’s robots revise and improve upon industrial microbes, such as biofuels, drugs, etc.,  that were already human engineered, finding any flaws and improving the product in ways humans may miss. The hope, however, is to one day have AI take control from the start.

Read more about Zymergen’s technology in Science.

A handheld heart scanner? European scientists hope to put them in doctors’ hands

In 2015, the European Union’s Horizon 2020 project provided a €3.6 million research grant to fund the development of CARDIS (CARdiovascular disease Detection with Integrated Silicon Photonics), a handheld doppler scanner to diagnose heard conditions.   It works like a supermarket scanner and can provide results much faster and cheaper than current methods. With cardiovascular disease listed as the leading cause of death in the world today, this new diagnostic tool is a possible game-changer in the healthcare world.

Using Laser Doppler Vibrometry, medical practitioners point the device to the chest, where it detects any change in vibration of light or sound waves and maps the chest and heart area. This allows doctors to detect conditions, such as possible stiffness in the arteries, build-up of plaque and arterial stenosis, long before cardiovascular disease is typically diagnosed.

cardis handheld doppler scanner

There are a number of reasons to hope 2018’s prototype lives up to the hype.

  1. It’s thousands of dollars cheaper than other tools. For this reason, researchers hope to put it in the hands of doctors for in-office procedures.
  2. It’s noninvasive. There’s no need for examining cardiac biomarkers, performing cardiac catheterization, cardiac MRI or Holter monitoring. Instead, CARDIS, due to its inexpensive and portable nature, can get a quick, early diagnosis to slow or reverse cardiovascular disease.
  3. It’s more accurate than other tests and provides results in a fraction of the time.

Read more about the project on the CARDIS website.

Hate shots? Microneedle vaccinations are on the way

While I don’t personally mind most shots, I understand why both adults and kids have a fear of needles. They’re long, they go in places they seemingly shouldn’t, and they just look like they’ll hurt. Plus, some medical professionals aren’t the greatest at limiting the pain for even the simplest shots. Or hitting the vein the first time. The good news is that science is working to make the whole process a little more comfortable.

Using dissolvable microneedles, researchers at Georgia Institute of Technology and Emory University have developed a pain-free patch for vaccine delivery.  The dime-sized patch contains 100 water-soluable microneedles, and it’s so easy to use that they hope to eventually be able to mail you your flu vaccine.

According to the National Institutes of Health, it’s as simple as using a Band Aid:

Adhesive helps the patch grip the skin during the administration of the vaccine, which is encapsulated in the needles and is released as the needle tips dissolve, within minutes. The patch is peeled away and discarded like a used bandage strip.

They’re also safe for storage and disposal. Patches last for one full year without refrigeration, and you can toss them in the regular trash, no sharps container needed.

So far, the results speak for themselves. A 100-person clinical trial of 18- to 49-year-olds showed that flu vaccine patches and regular injections were equally as effective, and 70 percent of participants stated they would choose the patches over injections or nasal sprays. With such outcomes, it’s easy to imagine that, if this were to hit the market, parents would happily choose the painless option not only for themselves, but especially for their children.

Now researchers are seeking to conduct further trials in order to gain FDA approval. Even better, they’re also already working to develop patches for other vaccines.

Of course, there are going to be vaccines that may not transition to such a patch because they require deep penetration via intramuscular injection to be most effective. On the other hand, who is going to complain when fewer vaccines require normal needles? I’m sure not!

3D printing could revolutionize biomedicine

While doctors in Brazil are now using fish skin to treat wounds, multiple research groups from around the world are taking a different approach: 3D-printed human skin.

Scientists in Madrid, Spain, created a prototype 3D bioprinter that successfully prints functional human skin that’s transplant-ready. The bioinks are created with stock industrial cells or even cells from the patient’s own body. Just like your printer, the ‘inks’ are inserted into cartridges, which are inserted into a specialty printer and used for printing. They hope to have the printer on the commercial market for use in burn centers within 2 years.

Instead of printing skin to later use on wounds, researchers from the Wake Forest Institute for Regenerative Medicine are testing printing skin directly onto wounds. For their method, wound depth and size are determined with a scanner, then the details are used by the printer to print the correct kind of skin cell at the appropriate depth. Now in the second phase of their trial, researchers are testing whether a type of stem cell from the amniotic fluid or the placenta helps heal wounds.

The implications for either technique are massive. Not only can 3D printing reduce the scarring and minimize or eliminate skin-grafting surgeries, it can provide coverage for larger areas of skin and perhaps even shorten healing time. It also has the potential to provide a low-cost alternative for countries, like Brazil, who have a shortage of skin bank availability.

Even more importantly, it opens up the possibility for 3D printing of other biological materials vital to human life, such as patches of blood vessels for the ischemic heart; ear, bone, and muscle structures; nerves; and human organs.

3D imaging in medical scans

Using 3D imaging in medicine isn’t exactly new, but EchoPixel is kicking it up a notch. This new tool creates interactive, 3D holographic images of CT and MRI scans. Medical professionals can move, dissect and size parts of the patient anatomy, manipulating holograms to get a full view of the organs and better pinpoint disease.

According to the EchoPixel website, there are five key advantages to the technology:

  1. Real-Time, Interactive Virtual Reality System: True 3D moves beyond the flat screen, displaying real patient anatomy in open 3D space, with instant response and seamless interaction capabilities.

  2. Optimal Image Strategy: Anatomical information is tailored to be procedure-specific, easily accessible and unobstructed.

  3. Effortless Interpretation: True 3D provides the required visual context, with no extraneous information, significantly lowering the cognitive load for doctors.

  4. Engaging User Interface: It’s intuitive to use. Specialized tools enable users to directly grasp, dissect and size key clinical features with one move.

  5. Advanced Protocols and Sharing: Expert-derived protocols facilitate specific procedures, allowing doctors to create rich data, share it with others, and improve the utility of the system across the network of users.

The video below shows how it works.

It will be interesting to see how the technology helps to improve diagnosis as it achieves more widespread use.

Other technologies to keep an eye on

New technology to manipulate cells could help treat Parkinson’s, arthritis, other diseases

Scientists replay movie encoded in DNA

Soft robot helps the heart beat

3D-printed robot aims to fight cancer

New ‘smart needle’ to make brain surgery safer

Laser printing with nanoparticles holds promise for medical research

Study: 38 percent of VA outpatient antibiotics inappropriately prescribed

Expressing alarming concern over increased antibiotic resistance in microorganisms, including deadly bacteria, the Centers for Disease Control and Prevention has recently been vocal about the dangers of antibiotic overprescription in private medical practices, and now a VA Hospital in Providence, Rhode Island, has data to support inappropriate prescribing in government-held veteran’s hospitals as well.

Investigators within Providence Veterans Affairs Medical Center conducted an internal study and found that the hospital’s outpatient primary care department had a 38.4 percent rate of prescribing unneeded antibiotics for acute respiratory infections such as bronchitis, pharyngitis, pneumonia, and sinusitis. The findings are not much different from the CDC’s study of non-governmental health settings, which found an approximate rate of one-third, but there are some striking numbers when the data are analyzed.

When comparing prescriptions from teaching clinics and non-teaching clinics, investigators found that inappropriate prescriptions skyrocketed without attending physician oversight. In fact, teaching clinics, which have physician supervision of medical residents, had a 17.6 percent rate of inappropriate prescription, whereas non-teaching clinics had a 44 percent rate. The same difference showed with antibiotic prescriptions in general, with only 37 percent of acute respiratory conditions receiving antibiotic prescriptions in teaching clinics compared to 65.9 percent in non-teaching clinics.

The data, when narrowed down by condition, shows the same trend. Va teaching clinics had a 3.8 percent rate of inappropriate prescribing for patients with pharyngitis compared with 40.3 percent in non-teaching. Sinusitis saw 0 cases of inappropriate prescribing in teaching clinics but a 69.1 percent rate in non-teaching clinics. While both clinic types were spot-on and had no inappropriate cases regarding pneumonia, both had high rates of inappropriate prescriptions for bronchitis, with 32.7 percent of teaching and 71.2 percent of non-teaching clinics providing prescriptions when they were not needed.

It’s possible that patients themselves are part of the problem. Research shows that if patients request antibiotics for an illness, physicians are pressured to prescribe them even when they are not likely needed. The good thing is that physicians aren’t more likely to see an infection as bacterial or viral; the bad news is that they are prescribing antibiotics to patients with high expectations rather than standing their ground.

The CDC and World Health Organization are trying to educate the public on, as well as reaffirm to medical workers, the dangers posed by antibiotic resistance. According to WHO, infections such as gonorrhea, pneumonia, and tuberculosis are becoming harder to treat because organisms are developing and spreading resistance to antibiotics. Antibiotic resistance in certain bacteria are contributing to this problem:

  • Acinetobacter species of bacteria are of great danger in medical settings, causing hospital-acquired pneumonia, infective endocarditis (inflammation of the inner tissues of the heart), meningitis, skin and wound infections, and urinary tract infections. It is now multi-drug resistant.
  • Klebsiella is a bacteria that can cause bloodstream infections, meningitis, pneumonia, and surgical site or wound infections. It is easily spread in healthcare settings and is now multi-drug resistant.
  • E. coli strains can cause the well-associated conditions of bowel upset and foodborne illness, but it also can cause other illnesses, some serious, including gastroenteritis, gram-negative pneumonia, sepsis, and urinary tract infections. It is multi-drug resistant.

Unlike other drugs, new antibiotics aren’t released every time you turn on the television. The last new class of antibiotics to hit consumer markets was discovered in 1984. Yes, Teixobactin, a new antibiotic, was discovered recently, but it’s still years away from availability, and there’s no guarantee it will survive clinical trials. For citizens around the globe, this could become a time-sensitive life-or-death situation, so it’s important we don’t put all our eggs in one basket.

Luckily, countries are looking ahead and taking the threat seriously. In 2016, the United States and Britain teamed up to form CARB-X, a public-private partnership dedicated to funding and promoting biomedical research that leads to antibiotic drug development. With $44 million earmarked for the first year, the governments, along with their academic, industry and other private partners, hope to get more antibiotics into clinical development, and eventually through government approval.

But despite former President Barack Obama’s commitment to the partnership, President Donald Trump’s proposed budget is planning cuts to almost everything, including medical funding. It’s not clear whether he will keep the commitment the United States made to CARB-X.

No matter the government’s decision, both doctors and patients, in the private sector and in government healthcare settings, should take the threat more seriously and carefully consider the need before requesting or prescribing antibiotics.

Bird flu in Tennessee: first case of 2017 found in commercial flock (updated)

The United States Department of Agriculture’s (USDA) Animal and Plant Health Inspection Service (APHIS) issued a press release on Sunday to confirm highly pathogenic avian influenza was found in a commercial chicken breeder’s flock in Lincoln County, Tennessee.

The 73,500-bird flock experienced an increased number of deaths, raising a red flag and leading to laboratory testing that revealed the infection. Tennessee’s Kord Animal Health Diagnostic Laboratory completed initial testing, and the APHIS National Veterinary Services Laboratories in Iowa confirmed the results.  While the isolation of the subtype of virus is not yet complete, it is expected to be the neuraminidase protein, or “N-type.” The USDA characterizes the differences among subtypes as follows:

AI viruses are classified by a combination of two groups of proteins: hemagglutinin or “H” proteins, of which there are 16 (H1–H16), and neuraminidase or “N” proteins, of which there are 9 (N1–N9). Many different combinations of “H” and “N” proteins are possible. Each combination is considered a different subtype, and can be further broken down into different strains. AI viruses are further classified by their pathogenicity (low or high)— the ability of a particular virus strain to produce disease in domestic chickens.

The Tennessee Department of Agriculture is already working to ensure facility workers “are taking the proper precautions to prevent illness and contain disease spread.” They have also quarantined the facility and will destroy the animals to prevent further spread. The flock will not be used as food.  

According to the USDA, wild birds can carry the illness without appearing sick and transmit it to other bird populations they encounter. Since there are large chicken-producing facilities in surrounding states, state and local officials are working together to surveil and test nearby commercial facilities, live bird markets, and migratory birds in order to prevent a similar outbreak to that of 2015, which killed more than 48 million birds after the virus spread through equipment, employees, and other animals:

The virus was introduced into the U.S. by wild migratory waterfowl and then spread from farm to farm in a number of ways.  This included farms sharing equipment, vehicles moving between farms without being cleaned or disinfected, employees moving between infected and non-infected farms, rodents and small wild birds reported inside some poultry houses, and feed stored outside or without appropriate biosecurity measures. The virus spread was also assisted by instances of noncompliance with industry-recommended biosecurity practices.

So far there is no evidence that other facilities or populations have been infected.

Citizens are urged to report sick birds or unusual bird deaths to their state officials, or to the USDA at 1-866-536-7593.

 Update 3/7/17 4:18 am EST:

According to Reuters, Asian countries are now reacting to the news by limiting imports of poultry:

South Korea will ban imports of U.S. poultry and eggs after a strain of H7 bird flu virus was confirmed on Sunday at a chicken farm in Tennessee, South Korea’s agriculture ministry said.

Japan and Taiwan will block poultry from the state, while Hong Kong will restrict imports from the Tennessee county where the infected flock was located, said James Sumner, president of the USA Poultry & Egg Export Council, a trade group.

Fish skin to treat burns? Doctors in Brazil are paving the way

Doctors in Fortazela, Brazil, may have finally found a solution to their shortage of burn dressing options through a clinical trial that, at least temporarily, gives patients a fish-like appearance, according to a report by STAT.

With only three functional skin banks in the entire country, and a lack of access to human, pig and artificial skins available in countries like the United States, doctors in Brazil face a big problem: too often the only option available for burn victims is a gauze and silver sulfadiazine cream bandage, a dressing that must be changed daily, which is very painful to the patient and prolongs healing time.

In response to this problem, researchers at the Federal University of Ceará began to study tilapia skin to determine its possible application in burn victims.

Clinical trial leader Dr. Edmar Maciel, a plastic surgeon and burn specialist, explained to STAT that researchers were surprised by what they found.

“We got a great surprise when we saw that the amount of collagen proteins, types 1 and 3, which are very important for scarring, exist in large quantities in tilapia skin, even more than in human skin and other skins,” Maciel said. “Another factor we discovered is that the amount of tension, of resistance in tilapia skin is much greater than in human skin. Also the amount of moisture.”

To prepare the skin for medial applications, researchers used sterilizing agents and radiation to remove bacteria, muscle tissue, scales, toxins, viruses, and other dangers from the skin, then packaged and refrigerated the 10cm by 20cm skins, which can last for up to two years. And because Brazil farms tilapia in mass, researchers will easily be able to keep the stock up. Now, instead of throwing away the skin, the Brazilian healthcare system can use what was formerly trash as an important medical treatment.

According to Dr. Maciel, tilapia skin is flexible like human skin, allowing it to mold to the body easily, and serves as an ideal bandage because it reduces the number of bandage changes, healing time, risk of infection, and the use of pain medication. For instance, with the tilapia skin, a patient with a superficial second-degree burn will not require a bandage change before scarring occurs, whereas with the gauze and cream, the patient would require regular bandage changes.  

The clinical trial’s first 50 patients started treatment in December 2016. 

Patient Maria Ines Candido da Silva (see above video) compared the treatment to a sci-fi movie and stated that she’d recommend the treatment to other burn patients.

Another patient, Antônio dos Santosm, told STAT that the skin reduced his pain.

While countries like the United States might not have much use for the skin due to sustained access to alternative options, developing countries with the resources to safely mass produce the product will find real promise in the success of the clinical trials.

With positive initial results, doctors are looking to the future. Successful clinical trials will open the door for companies to produce the product and sell it to the healthcare system, giving Brazilian physicians a better option for treatment and improving the quality of care for the country’s burn patients.

Study: patient expectations influence prescribing of antibiotics

An experiment published by the American Psychological Association (APA) shows that doctors are more likely to prescribe antibiotics if patients have high expectations of receiving them, even if the probability of bacterial infection is low. Researchers referred to this as the “expectations effect.”

The APA’s findings are based on two similar experiments that were designed to 1) test how low versus high expectations for antibiotics influenced the frequency of antibiotic prescriptions and 2) observe whether higher expectations for antibiotics increased the perceived probability of bacterial infection by doctors.

A total of 305 family doctors completed the first experiment, and a total of 131 completed the second. In both experiments, doctors were presented with an online survey that used vignettes, or accounts, of patients presenting with illnesses ranging from colds to ear infections. Some patients had high expectations for antibiotics (for instance, because of an upcoming swim meet or the need to return to work), and some patients had low expectations (no time-sensitive events or patient requests hurrying recovery).

In experiment one, doctors were presented with five hypothetical patients, each randomly associated with one of four conditions. Parents’ expectations for antibiotics were also presented to address the idea that parents’ expectations impact the prescription of antibiotics and have a large influence on the expectations effect. The order of the questions about probability of infection and prescribing of antibiotics was randomized to see if the order impacted the decision to prescribe.

In experiment two, doctors were presented with only two patients, one with a cold and one with an ear infection. Both were adults advocating on behalf of his or her self. The question and vignette orders were fixed in this experiment, with the decision to prescribe antibiotics coming before the probability of infection and the ear infection vignette coming before the cold vignette.

doctor clipboard

The results of both experiments show both good and bad news: While doctors were more likely to prescribe antibiotics to patients with high expectations, this did not influence their view on whether infections were likely bacterial or viral. The common cold worked as a good sort of control for this, as it is well-known to be a viral infection, with only 12.2% of doctors prescribing antibiotics despite a high expectation from the patient, which is a drastic drop-off from the expectations effect in the other vignette (at 51.9%) in the second experiment.

Results also show that more experienced doctors were just as susceptible to the expectations effect as less experienced doctors, with experience having a positive association with prescribing antibiotics.

Researchers came to the following conclusion regarding decreasing the overprescription of antibiotics:

From a clinical point of view, nonclinical factors and, specifically, social influences might contribute to the overprescribing of antibiotics and, in turn, to the increased antibiotic resistance (Costelloe et al., 2010). This is particularly important in situations in which most of the interventions designed to reduce antibiotic overprescribing are focused on clinical guidelines (National Institute for Health Care Excellence, 2015). To reduce overprescribing of antibiotics, potential interventions should target patients’ expectations, physicians’ beliefs about these expectations, and physicians’ skills in managing these expectations. Consistently with such a conclusion, prior complex intervention studies have found the most effective interventions to be those that target patients and clinicians during consultations, facilitating shared decision-making (Coxeter, Del Mar, McGregor, Beller, & Hoffmann, 2015; Ranji, Steinman, Shojania, & Gonzales, 2008; Vodicka et al., 2013).

These suggestions go hand-in-hand with the World Health Organization’s (WHO) urgent calls to control the spread of antibiotic resistance and to develop new drugs to fight specific families of bacteria.

Alarmingly, for the first time in their history, WHO recently published a list of “priority pathogens” that are antibiotic-resistant and present a need for immediate research and the development of drugs. The list is divided into three priority groups: critical, high and medium.

The most critical group of all includes multidrug resistant bacteria that pose a particular threat in hospitals, nursing homes, and among patients whose care requires devices such as ventilators and blood catheters. They include Acinetobacter, Pseudomonas and various Enterobacteriaceae (including Klebsiella, E. coli, Serratia, and Proteus). They can cause severe and often deadly infections such as bloodstream infections and pneumonia.

These bacteria have become resistant to a large number of antibiotics, including carbapenems and third generation cephalosporins – the best available antibiotics for treating multi-drug resistant bacteria.

The second and third tiers in the list – the high and medium priority categories – contain other increasingly drug-resistant bacteria that cause more common diseases such as gonorrhea and food poisoning caused by salmonella.

Washing HandsIn addition, WHO provides the following suggestions for individuals to help slow the spread of antibiotic resistance in these and other families of bacteria:

  • Only use antibiotics when prescribed by a certified health professional.

  • Never demand antibiotics if your health worker says you don’t need them.

  • Always follow your health worker’s advice when using antibiotics.

  • Never share or use leftover antibiotics.

  • Prevent infections by regularly by washing hands, preparing food hygienically, avoiding close contact with sick people, practising safer sex, and keeping vaccinations up to date.

Doctors have their own set of guidelines, including infection control techniques, education of patients and the public, careful prescribing, and the reporting of resistant bacteria.

Both doctors and patients must take responsibility for the use of antibiotics.

As an individual, you can make the first move by not asking for antibiotics with every illness. Let your doctor make his or her decision without the expectations effect.

Read a PDF of the full experiment results.