Johns Hopkins Makes Cancer Discovery

A team of researchers at Johns Hopkins discover the biochemical mechanism that tells cancer cells to break off from the primary tumor and spread throughout the body.

A process known as metastasiS.

That word scares the bejeebers out of patients diagnosed with cancer.  90% of cancer deaths are caused when cancer metastasizes.

Anything that helps prevent that from happening is a tremendous breakthrough in medicine.

                      [Photo Credit:  Amy Davis / Baltimore Sun]

Hasini Jayatilaka, left, a post-doctoral fellow and Denis Wirtz, professor of chemical and biomedical engineering, who work together at the Institute of NanoBioTechnology at Johns Hopkins University, discuss their discovery.

 

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BALTIMOREHasini Jayatilaka was a sophomore at the Johns Hopkins University working in a lab studying cancer cells when she noticed that when the cells become too densely packed, some would break off and start spreading.

She wasn’t sure what to make of it, until she attended an academic conference and heard a speaker talking about bacterial cells behaving the same way. Yet when she went through the academic literature to see if anyone had written about similar behavior in cancer cells, she found nothing.

Seven years later, the theory Jayatilaka developed early in college is now a bona fide discovery that offers significant promise for cancer treatment.

Jayatilaka and a team at Johns Hopkins discovered the biochemical mechanism that tells cancer cells to break off from the primary tumor and spread throughout the body, a process called metastasis. Some 90 percent of cancer deaths are caused when cancer metastasizes.

The team also found that two existing, FDA-approved drugs can slow metastasis significantly.

“A female patient with breast cancer doesn’t succumb to the disease just because she has a mass on her breast; she succumbs to the disease because (when) it spreads either to the lungs, the liver, the brain, it becomes untreatable,” said Jayatilaka, who earned her doctorate in chemical and biomolecular engineering this spring in addition to her earlier undergraduate degree at Hopkins.

“There are really no therapeutics out there right now that directly target the spread of cancer. So what we came up with through our studies was this drug cocktail that could potentially inhibit the spread of cancer.”

The study was published online May 26 in the journal Nature Communications. The next step for the team is to test the effectiveness of the drugs in human subjects.

Typically, cancer research and treatment has focused on shrinking the primary tumor through chemotherapy or other methods. But, the team said, by attacking the deadly process of metastasis, more patients could survive.

“It’s not this primary tumor that’s going to kill you typically,” said Denis Wirtz, Johns Hopkins’ vice provost for research and director of its Physical Sciences-Oncology Center, who was a senior author on the paper.

Jayatilaka began by studying how cancer cells behave and communicate with each other, using a three-dimensional model that mimics human tissue rather than looking at them in a petri dish.

Many researchers believe metastasis happens after the primary tumor reaches a certain size, but Jayatilaka found it was the tumor’s density that determined when it would metastasize.

“If you look at the human population, once we become too dense in an area, we move out to the suburbs or wherever, and we decide to set up shop there,” Jayatilaka said. “I think the cancer cells are doing the same thing.”

When the tumor reaches a certain density, the study found, it releases two proteins called Interleukin 6 and Interleukin 8, signaling to cancer cells that things had grown too crowded and it was time to break off and head into other parts of the body.

Previously, Wirtz said, the act of a tumor growing and the act of cancer cells spreading were thought to be very separate activities, because that’s how it appeared by studying cancer cells in a petri dish, rather than the 3-D model the Hopkins team used.

Many researchers study only cancer cell growth or its spread, and don’t communicate with each other often, he said.

Once the cancer cells start to sense the presence of too many other cancer cells around them, they start secreting the Interleukin proteins, Wirtz said. If those proteins are added to a tumor that hasn’t yet metastasized, that process would begin, he said.

The team then tested two drugs known to work on the Interleukin receptors to see if they would block or slow metastasis in mice.

They found that using the two drugs together would block the signals from the Interleukin proteins that told the cancer cells to break off and spread, slowing – though not completely stopping – metastasis.

The drugs the team used were Tocilizumab, a rheumatoid arthritis treatment, and Reparixin, which is being evaluated for cancer treatment.

The drugs bind to the Interleukin receptors and block their signals, slowing metastasis.

Though metastasis was not completely stopped, Jayatilaka said, the mice given the drug cocktail fared well and survived through the experiment.

She said adding another, yet-to-be-determined drug or tweaking the dose might stop metastasis entirely.

Contrary to the hair loss, nausea and other negative side effects patients undergoing chemotherapy suffer, Wirtz said the side effects from the drugs used in the study would be minimal.

Anirban Maitra, co-director of a pancreatic cancer research center at the MD Anderson Cancer Center at the University of Texas, cautioned that clinical trials in humans are needed to prove the theory.

“There’s a risk that something that looks so great in an animal model won’t pan out in a human,” he said.

But Maitra said the study looked promising, in particular because the researchers had used drugs already on the market. It can take a decade to identify a drug that would perform similarly and get it approved, and many similar observations don’t advance because of the time and expense it can take to get drug approval, he said.

Muhammad Zaman, a professor and cancer expert at Boston University, called the Hopkins discovery “exciting.”

“This paper gives you a very specific target to design drugs against,” he said. “That’s really quite spectacular from the point of view of drug design and creating therapies.”

Zaman said it was important for cancer researchers to use engineering to better understand cancer, as the Hopkins team did.

“This really brings cancer and engineering together in a very unique way, and it really takes an approach that is quantitative and rigorous,” he said. “We have to think of cancer as a complex system, not just a disease.”

Wirtz predicted a future where cancer would be fought with a mix of chemotherapy to shrink the primary tumor and drug cocktails like the one the Hopkins team developed to ensure it would not metastasize. He compared such a treatment to how HIV/AIDS is treated today.

“We’re not going to cure cancer with one therapy or even two therapies; it’s going to be drug cocktails,” Wirtz said. “That’s what saved the day with HIV/AIDS.”

Immunotherapy, which uses the body’s immune system to fight cancer, also could play a role in a combined method, Wirtz added.

“We’re, in research, sometimes incentivized to look at one pathway at a time, one type of cancer at a time,” Wirtz said. “I think oncology has started realizing we’re going to need more than one approach.”

MORE INFORMATION:

http://www.spokesman.com/stories/2017/jun/20/researchers-say-theyve-unlocked-key-to-cancer-meta/

VIDEO LINK:  

http://www.baltimoresun.com/health/93637026-132.html

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Maria Dorfner is the founder of NewsMD Communications and Healthy Within Network. This is her blog.  Contact: maria.dorfner@yahoo.com


Breakthrough: Mi-Eye2 Diagnoses Joint Injuries With Tiny Camera

TRICE MEDICAL closes $19.3M in Series C financing for their tiny needle-based camera to analyze joint injuries and expedite orthopedic diagnosis without the need for an MRI.

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Mi-Eye2 is a hand-held imaging scope which received FDA-clearance.  It enables doctors to diagnose a sports-related injury in the office, without an MRI.

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It consists of a hypodermic needle with a small camera tethered to a Microsoft surface tablet that shows high-definition pictures.

 

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Jeffrey O’Donnell, Sr. who is President and CEO of Trice Medical says this latest round of financing is a “significant milestone” and will help expand the company’s U.S. market.

Check out CBS2’s Dr. Max Gomez report:

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CBS 2’s DR. MAX GOMEZ: If you’ve ever injured your knee it can be hard to tell exactly what’s causing the pain, so the doctor usually sends you for an expensive MRI and maybe an arthroscopy in the O.R. to take a look inside. But what if you could do a scope in the doctor’s office cheaper and safer.

Lemouchi Soufinae injured his knee in a car accident two years ago. Since then he hasn’t been able to play his beloved soccer, because of the pain in his knee.

“I can’t walk more than three blocks, have to lay down, have trouble sleeping at night, lot of strong pain,” he said.

DR. MAX GOMEZ: Two MRIs later, it still wasn’t completely clear what was causing his knee pain.

Lemouchi, Liz Meris has been having severe knee pain. “I couldn’t kneel or straighten without pain, can’t get out of car, swelling in back of knee, hurts to walk, feels unstable,” she said.

DR. MAX GOMEZ: Worse yet, Liz is claustrophobic in an MRI.

“I hate em, I’m claustrophobic. I’m out, I’m in, I’m out again,” she said.

DR. MAX GOMEZ:  The next is usually a trip into the operation room to look around by sticking a scope in the knee. It’s expensive and requires anesthesia. Why not do that in the office, under a local anesthesia?

Thanks to a tiny scope with a hi-def camera on the tip, doctors can do in the office what once took a trip to the O.R.

“It’s a huge game changer, been trying to do for 10 to 15 years, clarity and resolution are now tremendous,” Dr. James Gladstone, Mt. Sinai Health System said.

DR. MAX GOMEZ:  Using only a local anesthesia, Dr. Gladstone inserts the MI-Eye-2™ into Liz’s knee. She was actually watching the same thing Dr. Gladstone was seeing.

It allows him to check and see what and where there’s damage inside the knee.

“Almost as good as O.R. scope, and in many ways better than MRI because it can give you direct visualization,” Dr. Gladstone said.

DR. MAX GOMEZ:  Better yet, if the damage is minimal it saves the patient a trip to the O.R. for a conventional scope, and here’s the best part; it costs under $500 to do this in the doctor’s office as opposed to the $1,500 or $2,000 for an MRI and thousands more for an O.R. scope.

Almost any joint that you can scope can be done with the MI-Eye™: shoulder, wrist, ankle, elbow.

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FOR MORE INFORMATION on THE INNOVATIVE MI-EYE2 VISIT:

http://www.tricemedical.com

 

Also, check out Dr. Max Gomez’s new book available for preorder on Amazon:

“Cells Are the New Cure”

by Robin Smith, MD + Max Gomez, Ph,D; Foreword by Sanjay Gupta, MD of CNN

https://www.amazon.com/Cells-Are-New-Drugs-Bre…/…/1944648801

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Maria Dorfner, a 33 year veteran of broadcast news is the founder of this blog.

Contact:  maria.dorfner@yahoo.com

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Future Health: New Device To Detect Early-Stage Colon Cancer

DANIELA SEMEDO reports on a European project, which aims to develop an innovative endoscope device that can detect and diagnose colorectal cancer in its early stages.

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Called PICCOLO, the project is funded under the European Union’s Horizon 2020 program. It’s tackling one of the world’s predominant cancers by using new optical technologies that identify precancerous polyps and early colon cancers.

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Colorectal cancer represents around one-tenth of all cancers worldwide, and nearly 95 percent of these cases are adenocarcinomas, which typically start as a tissue growth called a polyp.

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Early and accurate diagnosis and precise intervention can increase cure rates to up to 90 percent.

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A colonoscopy is currently the method used to screen for colon cancer. But while up to 40 percent of patients who undergo colonoscopy present one or more polyps, almost 30 percent of these polyps are not detected.

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Of the polyps detected by colonoscopy, 29 to 42 percent are generally hyperplastic and will not develop into cancer. The remainder are neoplastic polyps, representing colorectal cancer in its earliest stages.

There is an urgent need for new diagnostic techniques that are equipped with enough sensitivity and specificity to allow in situ assessment, safe characterization, and resection of lesions during clinical practice interventions.

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The multidisciplinary PICCOLO team proposes a new compact, hybrid, and multimodal photonics endoscope based on Optical C, a medical imaging technique that uses light to capture micrometer-resolution, three-dimensional images from within optical scattering media.

Artzai Picon of Tecnalia Research & Innovation says, “We hope that PICCOLO will provide major benefits over traditional colonoscopy. Firstly, by developing an advanced endoscope, using both optical coherence tomography (OCT) and multi-photon tomography (MPT), we will provide high-resolution structural and functional imaging, giving details of the changes occurring at the cellular level comparable to those obtained using traditional histological techniques.”

“Furthermore, when multiple polyps are detected in a patient, the current gold standard procedure is to remove all of them, followed by microscopic tissue analysis,” he said. “Removal of hyperplastic polyps, which carry no malignant potential, and the subsequent costly histopathological analysis, might be avoided through the use of the PICCOLO endoscope probe, which could allow image-based diagnosis without the need for tissue biopsies.”

Researchers behind the project believe the new device may not only add to colon cancer detection, but could also be applied to diseases in other organs of the body.

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Investigators expect their first prototype to be fully developed by the end of 2018 and plan to start testing the device in clinical studies in 2020.

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DANIELA SEMEDO, Colon Cancer News
https://coloncancernewstoday.com/2017/06/08/bristol-myers-squibb-novartis-to-test-mekinist-opdivo-combination-in-advanced-colorectal-cancer/

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http://www.fightcolorectalcancer.org

 

Maria Dorfner is the founder of NewsMD: What’s Hot in Health, a division of Healthy Within Network.  Have a story to share with healthcare consumers and media?

Contact: maria.dorfner@yahoo.com

 

GAME CHANGER: NEW SMART HEART MONITOR

 

Super excited to tell you about a new smart heart monitor you can use at home. It will help 28 million heart disease patients in the U.S. keep track of their heart.

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Keep track from the comfort of their home at any time. And it’s just been FDA approved.

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Meet Eko DUO.  The first handheld mobile, wireless, EHR-connected stethoscope, which connects to your smart phone.

It allows you to amplify, visualize and record crystal clear heart and lung sounds.

Imagine not needing to wait for your next followup appointment to transmit a concern to your physician. It works under the supervision or prescription from a physician.

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Eko Duo is set to help millions of heart disease patients who are often discharged with little more than an info packet and instructions to monitor their weight.

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Now patients can be sent home from the hospital with a direct link back to their physician, helping reduce readmissions and false alarms.

“The goal is to bring hospital-quality care to the home.”
Connor Landgraf, CEO and co-founder, Eko DUO

The device wirelessly pairs with Eko’s secure, HIPAA-compliant app, enabling remote monitoring and diagnosis by a clinician or specialist.

It works with the Eko app on any iPhone, iPad, Windows PC or Android device.

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Eko DUO can also be used by clinicians as an enhanced stethoscope for in-clinic cardiac screenings, enabling physicians to quickly diagnose and monitor patients.

Clinicians can use it bedside or remotely to quickly spot heart abnormalities including arrhythmias, heart murmurs, and valvular heart diseases.

I interviewed Ami Bhatt, M.D., a Cardiologist at Massachusetts General Hospital and Director of Outpatient Cardiology and the Adult Congenital Heart Disease Program at Massachusetts General Hospital and she believes Eko DUO will improve outcomes through early intervention.

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Dr. Bhatt says, “Cardiology programs are looking for ways to deliver hospital-quality healthcare at home.  The ability to capture digital heart sounds and an ECG expands our portfolio of mechanisms to remotely monitor the heart – and brings diagnosis and opportunities for early intervention even further upstream.” 

Heart disease can strike people of all ages.

I spoke with Stacy Bingham, a registered nurse from Oregon with 5 children, who knows this firsthand. She and her husband have no prior history of heart disease in their family, yet 3 of her 5 children end up needing heart transplants.

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When Stacy noticed her oldest child, Sierra acting tired with a loss of appetite for a few weeks, she never suspected the cause was an underlying heart condition.

“I noticed her face and eyes were swollen. She complained her stomach hurt.”

That’s when Stacy and her husband took her to a family practitioner.

“The doctor told us it’s probably a flu bug and sent us home. When her condition worsened she had an x-ray.”

X-ray results revealed Sierra’s heart was enlarged.  Dilated cardio myopathy. She later learned two of her other children also had heart problems.

“If they had not finally found Sierra’s heart condition, she may not have survived. We live in a really rural part of Eastern Oregon and we now have three kids with heart transplants that need to be monitored for life.”

Today, Stacy’s family takes nothing for granted, especially innovations that help.

“If this device can be used at home and we can rule out scary things and know when it’s not something we need to rush to a hospital for that would be wonderful.” –Stacy Bingham

James Young also knows how life can change in a heartbeat.

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Young was just 40-years-old when he first experienced symptoms of heart failure. Symptoms he ignored until they were severe and his sister insisted on it.

“I was coughing in mornings and throughout the day. I thought it was simply allergies. I vomited phlegm some mornings and still didn’t see a doctor.”

But the coughing became more painful. While shoveling, it stopped him in his tracks.

“I was outside shoveling snow when I turn behind me and  see a trail of blood.”

His sister noticed he didn’t look well and insisted he go see a physician.

“That’s when I was diagnosed with congestive heart failure. I was shocked.”

James felt anxiety, depression and uncertainty about his future at this time. Young believes Eko DUO will not only help alleviate false alarms and unnecessary hospital readmissions, but needless worrying as well.

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“Eko DUO would have given me assurance the doctor knew where I stood daily. If there were any issues outstanding needing to be addressed immediately. It gives the doctor an opportunity to respond expeditiously to those concerns.”

Today, James is doing great and is a national spokesperson and heart failure Ambassador for the American Heart Association.

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“I went from a 25% functioning heart to being an avid runner and cycler. I’ve taken on a new lease in life. As a community advocate I can help inspire others and give them hope.”

Ami Bhatt, M.D says that hope also translates to much needed continuous care rather than outpatient care.

“Robust toolkits for caring for patients in the community will hopefully lead to more appropriate healthcare utilization through continuous rather than episodic outpatient care.”

HERE’S HOW EKO WAS DEVELOPED:

Eko’s co-founder & CEO, Connor Landgraf, is also a heart disease patient.

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Connor navigated countless cardiology visits, screenings and referrals.

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In 2013, during his senior year as at the University of California at Berkeley, Connor attended a panel discussion at UC San Francisco on technological shortcomings facing modern medical practices.

One technical gap cardiologists claimed stood out beyond the rest: the stethoscope.

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So Conner and his co-founders welcomed the stethoscope, a two-century old tool, into the 21st-century.

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Photo: Connor and his co-founders, Jason Bellet and Tyler Crouch

 

The newly FDA approved Eko DUO brings that to the next level.
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To learn more about this remarkable 21st Century technology we love visit:  http://www.ekodevices.com

 

 

Factoids:

  • According to the CDC, heart disease is the leading cause of death in the U.S.
    The American Heart Associations says the U.S. currently spends over $26 billion annually on heart failure hospitalization. 25% of heart failure patients are readmitted within 30 days — 50% are readmitted in 6 months with hospitals now being penalized for high readmission rates.
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  • Fact: 83% of parents experience anxiety surrounding their child’s referral to a pediatric cardiologist for an innocent murmur.
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  • Fact: Average cash price for an echocardiogram is $2,275 and even with insurance, patients can expect to pay 10 to 30% of this cost.
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  • Fact: For a pediatric subspecialist such as a pediatric cardiologist, patients must wait between 5 weeks and 3 months to get an appointment.
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  • Fact: Internal medicine residents misdiagnose more than 75% of cardiac events.
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  • Fact: 70% of all pediatric cardiac referrals for murmurs are unnecessary.
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  • Fact: Average PCP needs to coordinate care with 99 other physicians working across 53 practices.
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  • Fact: Only 50% of initial referrals are accompanied by information from the PCP.
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  • Fact: Patients in rural communities must travel an average of 56 miles to see a specialist.
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  • Fact: About 46.2 million people, or 15% of the U.S. population, reside in rural counties.

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Eko DUO.  A real game changer for heart patients worldwide.

http://www.ekodevices.com

 

 

Expert Newborn Screenings A Heartbeat Away!

jimmy-kimmel-baby-billy2-1This week, Jimmy Kimmel shared the emotional story of his beautiful newborn son’s heart surgery.  He and his wife Molly welcomed their second child, William “Billy” Kimmel.

At three days old, Billy had successful open heart surgery at Children’s Hospital Los Angeles and is now home with his family.  On his show, Jimmy opened up about his son’s birth and health complications. He also underscored the need for the accurate and timely screening of congenital heart disease (CHD).

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Essential to early CHD diagnosis is the detection of a murmur using a stethoscope during a newborn’s first physical exam.

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But routine neonatal examination without specialist consults fail to detect more than half of babies with heart disease.

Approximately 160 infants pass away from undetected Congenital Heart Defects each year in the United States.

William “Billy” Kimmel, who is absolutely adorable below is one of the lucky ones; looks like he’s already laughing at Dad’s jokes too.

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Billy thankfully had the condition detected early, but many children with CHD get discharged with undetected or misdiagnosed conditions.

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After the events of this week, expecting parents have every right to question if their child is being screened appropriately or if clinicians known to misinterpret heart sounds are interpreting their child’s heart sounds accurately.

Kimmel’s story is really a wake-up call that we need more nurses like the wonderful ones who treated his baby boy.

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Now, there’s a device that will make sure congenital heart screenings more effective for infants.

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And it’s not just infants. Over 1.3 million adults live with congenital heart disease in the U.S, which now surpasses the number of children with congenital heart disease.

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Three entrepreneurs are well on their way to making sure accurate screenings are a heartbeat away. Their innovation paves the way for a new era of cardiac screenings.

They want to do what Shazam did for music, only for heartbeats.

Their new device called Eko [pronounced like Echo, as in a heart echo] offers the potential to dramatically improve the efficacy of newborn screenings, especially for newborns far from a pediatric cardiology center.

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The San Francisco based digital medical device company, launched Eko, an FDA-cleared digital stethoscope that enables ANY clinician, regardless of their training level, to secure a virtual pediatric cardiology opinion on heart sounds recorded with their FDA-cleared digital stethoscope.

It was a pleasure interviewing one of the founders, Jason Bellet.

Bellet says, “The silver lining in Jimmy Kimmel’s story is that the congenital heart failure was detected early through a murmur using a stethoscope and could be treated, but very often these murmurs go undiagnosed and undetected and infants leave the hospital with potentially life threatening situations.” [:27]

“Eko Devices would enable nurses and clinicians to get Cardiologist’s second opinion to immediately decrease the number of missed cases.” [:12]

Bellet is the co-founder and a brilliant former student from the University of Berkley.  He graduated in 2014 and founded Eko Devices with two fellow students, Connor Landgraf and Tyler Crouch out of the Start-up accelerator at Berkley.

The three founders successfully pitched their idea and raised $5M to bring it to market quickly and bring it to as many clinicians as they can.  It received FDA approval in September of 2015.

QUESTION: WHAT IS EKO?

ANSWER:  It’s basically a Smart Stethoscope that can bring the sounds to a trained ear immediately.

The vision is to bring machine learning and physician support tools to every clinicians stethoscope to make their screening process as easy as Shazaming a song.

QUESTION:  HOW DID YOU COME UP WITH THE IDEA FOR EKO?

ANSWER:  The idea stemmed from the fact that we realized the stethoscope is used as the primary screening tool for cardiac health, including for newborn babies.

But, it’s extremely outdated and ultimately leading to misdiagnosis and lack of cardiac conditions because you hear the heart sounds, but don’t understand what you’re hearing.

Cardiologists are the ones who can differentiate what is normal and what is not.

So, what we wanted to do was make it easy for clinicians to modernize their own stethoscopes to bring it into the modern era and send concerning or confusing heart sounds immediately to cardiologists in real time using this platform or capture it to send it to a specialist.

QUESTION:  There are other digital stethoscopes out there. Why is this one unique?

Bellet says, “Our digital stethoscope is the first to allow clinicians to stream sounds wirelessly from the stethoscope to a smartphone and to a cardiologist anywhere in the world.”  [:15]

QUESTION: Is it HIPPA compliant?

ANSWER:  It’s the ONLY digital stethoscope on the market that has built a HIPPA compliant software platform to stream heart sounds from any clinician to any specialist anywhere in the world.

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QUESTION: THAT’S GROUNDBREAKING. WHERE IS IT CURRENTLY BEING USED?

ANSWER:  Eko is now used at over 700 institutions across the country and has been adopted by pediatric cardiology programs.

QUESTION: WHO NEEDS EKO?

The technology is applicable in many aspects of patient care, but especially in newborns.

QUESTION:  WHAT IS YOUR ULTIMATE GOAL WITH EKO?

ANSWER: The ultimate goal is bringing it even one step further.  Our idea is have machine learning tied directly into the stethoscope itself, so one day clinicians can be as accurate as cardiologists in their initial interpretation of what they hear.

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Next, I spoke with renown adult congenital heart disease specialist Ami Bhatt, M.D. F.A.C.C. who says identifying congenital heart disease in the community can be challenging at any age whether we are trying to identify a high risk newborn like Jimmy Kimmel’s or catching congenital heart disease in a school age student or adulthood.

Ami Bhatt, M.D. F.A.C.C.  is director of outpatient cardiology at the Massachusetts General Hospital in Boston as well as a renown adult congenital heart disease specialist.  She innovates with the Healthcare Transformation Lab, serves as a scientific advisor for Eko Devises and runs a telemedicine practice.  She can be reached at mghachd@partners.org

Bhatt says,  “Because congenital heart disease is relatively rare it’s difficult for clinicians to identify it. The use of digital stethoscopes and other telemedicine technology which can connect the patient and caregiver in the community with experts at academic centers can improve initial diagnosis AND longterm followup.”

QUESTION:  WHAT HAPPENS WHEN KIDS WITH CONGENITAL HEART DISEASE AGE?

ANSWER:   Two things. One, as kids with congenital heart disease age, we know there are complications that may arise. Technologies like digital stethoscopes and the use of algorithms can help monitor their progression and track changes in disease BEFORE they progress too far.

And two, lack of follow-up is a persistent problem with children with congenital heart disease become adults. One of the main drivers is the challenge of access to subspecialty care.

Additionally, distance from medical centers, along with the time it takes and sometimes the cost of being away from work and family drives young adults to ignore their own healthcare needs.

The advent of digital health in congenital heart disease care empowers the patient to engage in a partnership to their health without taking away from their ability to live a full and active life.

QUESTION:  DO YOU THINK TECHNOLOGY HELPS OR HINDERS DOCTOR-PATIENT RELATIONS?

ANSWER: As the delivery of healthcare changes, caregivers are desperate to return to the ideal  doctor patient relationship, which is based on a human connection. As we build digital technology, and use machine learning to support our physicians at at time when there are so many diagnosis to be made, it allows us to concentrate on a shared patient and provider centered experience.

QUESTION:  HOW DOES AN ADULT KNOW WHEN TO GET THEIR HEART CHECKED?

ANSWER: If they had heart disease or heart surgery as a child, they should check in with their cardiologist to find out if they need any longterm care.

QUESTION: HOW DO THEY FIND A SPECIALIST?

There are advocacy websites, such http://www.ACHAheart.org which report self-identified Specialists in congenital heart disease or they can call a major center like Massachusetts General who can find a local center that can partner in their care.

QUESTION: HOW CAN THEY FIND OUT WHO USES THE EKO DEVICE?

ANSWER: If they want to find a specialist using the Eko Device people can contact Massachusetts General http://www.massgeneral.org\adultcongenitalheart for more information and ask about centers near them. They can also contact any hospital and ask for their telemedicine department and inquire if they use Eko.

QUESTION: HOW DO CLINICANS FIND EKO IF THEY’RE INTERESTED IN USING IT?

ANSWER:  Clinicians are able to access the device by going to the Eko Devices website at http://www.ekodevices.com and then if they’re interested in testing it they can purchase a unit directly from the website and send it back if they don’t like it. But that’s a rarity as the success rate has been high with over 5,000 clinicians across the country using it.

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This truly is a hot technology that will save kids like Jimmy’s, as well as those who aren’t at top hospitals in the country.

Billy will have another open-heart surgery within six months to repair the hole, and Our thoughts, well wishes and prayers are with him and his family.

“As a cardiologist, we sometimes worry about technology interfering with the doctor patient relationship. However, in these cases, it is technology that brings us to meet the patient where they live. Technology is finally bringing us home.” 

-Ami Bhatt, M.D. F.A.C.C.

If you haven’t seen Jimmy Kimmel’s story see it on Emmy-award-winning @GMA:

WATCH: @jimmykimmel shares emotional news about newborn son’s emergency heart surgery; son now at home recovering. http://abcn.ws/2pSPakE

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QUICK FACTS:

According to the CDC, 40,000 babies in the U.S. are born each year with congenital heart disease.

Recent studies estimate approximately 160 infants or 1 in 25,000 live births die per year from unrecognized CHD.

The reported sensitivity for detection of a pathologic heart murmur in newborns ranges from 80.5 to 94.9 percent among pediatric cardiologists, with specificity ranging from 25 to 92 percent.

A study in the American Journal of Medicine discovered internal medicine residents misdiagnose as many as 75% of murmurs with a stethoscope.

Routine neonatal examination fails to detect more than half of babies with heart disease; examination at 6 weeks misses one third.

A normal examination does not exclude heart disease.

Babies with murmurs at neonatal or 6 week examinations should be referred for early pediatric cardiological evaluation which will result either in a definitive diagnosis of congenital heart disease or in authoritative reassurance of normal cardiac anatomy and function.

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Take care of your heart everyone!

 

For more on Eko visit: http://www.ekodevices.com

UPDATES:

Good Morning America
ABC NEWS
May 9, 2017
Jimmy Kimmel returns to TV with update on his son’s health, defends his call for children’s health care coverage

One week after Jimmy Kimmel revealed that his son, Billy, had been born with a heart defect, the comedian returned to host his late night show with an emotional update on his son’s health and a defense of his foray into the country’s heated debate on health care.

The “Jimmy Kimmel Live!” also thanked his fans for their “humbling outpouring of support” and said that he and his wire “very grateful” for the multitude of donations made to the Children’s Hospital of Los Angeles, where his son was treated.

“First I want to tell you because so many people have asked: Our son Billy is doing very well,” Kimmel said. “He’s eating. He is getting bigger. He is sleeping well. He can read now — which they say is unusual [for a child his age].”

Kimmel, 49, revealed last Monday that his son underwent surgery on his heart three days after he was born, and will require another procedure when he’s a little bigger in three to six months.

During his monologue, Kimmel asked all politicians to come together to ensure healthcare for all Americans, especially those who have pre-existing health conditions.

Though there were many who supported Kimmel’s point of view, he noted that there were many others who called him an “out of touch Hollywood elitist.” To those critics, the late night host offered a sarcastic apology.

“I’d like to apologize for saying that children in America should have health care,” he joked. “It was insensitive – it was offensive – and I hope you can find it in your heart to forgive me.”

To further the conversation, he interviewed Bill Cassidy, a Republican senator from Louisiana who last week tweeted that there should be a “Kimmel Test” for any healthcare bill passed.

The Jimmy Kimmel Test, he noted, would be in place to ensure that any healthcare plan would adequately cover pre-existing conditions “but in a fiscally conservative way that lowers cost.”

“I happen to like [it] a lot,” Kimmel said. “He is a doctor – a gastroenterologist. He is married to a retired doctor — his wife Laura, was a surgeon. And he co-founded the Greater Baton Rouge Community Clinic, which provides free dental care and health care to the working uninsured. So obviously – this is someone who cares about people’s health.”

 

 

Startup Reduces Needles for Blood Draws

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FDA-cleared to improve patient and practitioner experience in healthcare settings.

Full Story:  http://fortune.com/2016/05/20/startup-blood-draws/

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Or visit:  http://velanovascular.com/in-the-news/velano-vascular-needleless-blood-draw-technology-relieves-anxiety-for-patients-practitioners-and-hospitals/

 

New 30-Min. Tech for Weight Loss

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There is now a non-surgical alternative to gastric bypass.

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It’s for people with a BMI of at least 30-40 who despite changing habits can’t lose weight.

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It’s called ORBERA and it involves inflatable balloons that help you shed 20 to 80 pounds.

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ORBERA balloon is inserted down throat and into stomach using an endoscope in less than 30 min.

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The balloons are then filled with saline, filling up space in the stomach.

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The Food and Drug Administration recently approved the dual balloon technology and NYC Gastroenterologist Dr. Prem Chattoo of Hudson River Gastroenterology is one of the first doctors to offer the procedure.  His office is located in lower Manhattan.

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“It’s not a long term solution like bariatric surgery. The procedure is used for a quick, six-month weight loss to get rid of 10 percent of your body weight. After six months, the balloon is removed and you should see a pretty noticeable weight loss,” Dr. Chattoo says.

 

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The end result is weight loss and reduced hunger.

After the procedure, ORBERA has a 12-month diet and exercise program to follow.

The biggest benefits about ORBERA, according to Dr. Chattoo, are that no abdominal surgery is needed and that the procedure is completed in the same day.

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The procedure is recommended to those with a body mass index (BMI) of 30-40 or those who have other risk factors for heart disease such as diabetes or high blood pressure. A BMI or 30 or higher is defined as obese. More than a third of U.S. adults fit that range.

The procedure costs 6-8K and is not covered by insurance.

One procedure will be donated for free to one person in need who meets requirements. Contact: maria.dorfner@yahoo.com   Write:  Orbera in Subject, include your contact information.

Additional Images for Media:  https://apolloendo.box.com/s/t7ukrrujfjk4mrgjwo5l5w5obd3djmbt

For more information contact Dr. Prem Chattoo at http://www.hudsonrivergi.com

For more information about the Orbera procedure visit: http://www.orbera.com

Stay healthy!
MD

####

 

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“Always remember the benefits of daily exercise for your mind, body and spirit. If you hate or dread exercise start with walking. Break it up into 15 minutes at a time until you reach 30 minutes. Then, increase it to 45 or 60 minutes. You don’t even need a gym to do that.

Remove  all junk food from your home. Load up on healthy snacks. Remove all processed foods and soda. Drink lots of water. You’ll begin to notice a difference in 6 months. In one year, it will all be a habit.

No matter what help you get surgically or non-surgically, you always want to strive to develop lifelong healthy habits. Address the underlying of ‘why’ you select unhealthy foods. Stressed?  Find someone to talk to. There are lots of free counselling services where you can call and talk to someone confidentially.

Rushed?  Fix meals the night before.  Hate your job? Start looking for a new one.  Sit at a computer all day?  Get up every 15 minutes and walk around office. Take stairs. Depressed?  Again, find someone to talk to and exercise daily. Make an appointment with a professional psychologist if it’s really bad. When exercising,  don’t focus on the physical. Focus on the mental benefits when you start. Physical has a way of catching up when you fix your mind and thoughts first. Stay positive.

Good things take commitment, dedication and time.

Your goal should never be a quick fix, but to change habits that got you to the place where you feel tired, sluggish and unhealthy and replace them with new, better, healthy ones. You can do it.  One day at a time. ”  -Maria Dorfner

Interesting research shared by Melissa Robinson:

Brown Fat, Triggered by Cold or Exercise, May Yield a Key to Weight Control

Fat people have less than thin people. Older people have less than younger people. Men have less than younger women.

It is brown fat, actually brown in color, and its great appeal is that it burns calories like a furnace. A new study finds that one form of it, which is turned on when people get cold, sucks fat out of the rest of the body to fuel itself. Another new study finds that a second form of brown fat can be created from ordinary white fat by exercise.

Of course, researchers say, they are not blind to the implications of their work. If they could turn on brown fat in people without putting them in cold rooms or making them exercise night and day, they might have a terrific weight loss treatment. And companies are getting to work.

But Dr. André Carpentier, an endocrinologist at the University of Sherbrooke in Quebec and lead author of one of the new papers, notes that much work lies ahead. It is entirely possible, for example, that people would be hungrier and eat more to make up for the calories their brown fat burns.

“We have proof that this tissue burns calories — yes, indeed it does,” Dr. Carpentier said. “But what happens over the long term is unknown.”

Until about three years ago, researchers thought brown fat was something found in rodents, which cannot shiver and use heat-generating brown fat as an alternate way to keep warm. Human infants also have it, for the same reason. But researchers expected that adults, who shiver, had no need for it and did not have it.

Then three groups, independently, reported that they had found brown fat in adults. They could see it in scans when subjects were kept in cold rooms, wearing light clothes like hospital gowns. The scans detected the fat by showing that it absorbed glucose.

There was not much brown fat, just a few ounces in the upper back, on the side of the neck, in the dip between the collarbone and the shoulder, and along the spine. Although mice and human babies have a lot more, and in different places, it seemed to be the same thing. So, generalizing from what they knew about mice, many researchers assumed the fat was burning calories.

But, notes Barbara Cannon, a researcher at Stockholm University, just because the brown fat in adults takes up glucose does not necessarily mean it burns calories.

“We did not know what the glucose actually did,” she said. “Glucose can be stored in our cells, but that does not mean that it can be combusted.”

A new paper in The Journal of Clinical Investigation by Dr. Carpentier and his colleagues answers that question and more. By doing a different type of scan, which shows the metabolism of fat, the group reports that brown fat can burn ordinary fat and that glucose is not a major source of fuel for these cells. When the cells run out of their own small repositories of fat, they suck fat out of the rest of the body.

In the study, the subjects — all men — were kept chilled, but not to the point of shivering, which itself burns calories. Their metabolic rates increased by 80 percent, all from the actions of a few ounces of cells. The brown fat also kept its subjects warm. The more brown fat a man had, the colder he could get before he started to shiver.

Brown fat, Dr. Carpentier and Jan Nedergaard, Dr. Cannon’s husband, wrote in an accompanying editorial, “is on fire.”

On average, Dr. Carpentier said, the brown fat burned about 250 calories over three hours.

But there is another type of brown fat. It has been harder to study because it often is interspersed in the white fat and does not occur in large masses. Investigators discovered it in mice years ago. Now, in a recent article, Bruce Spiegelman, professor of cell biology and medicine at the Dana-Farber Cancer Institute, and his colleagues report that, in mice at least, exercise can make it appear, by turning ordinary white fat brown.

When mice exercise, their muscle cells release a newly discovered hormone that the researchers named irisin. Irisin, in turn, converts white fat cells into brown ones. Those brown fat cells burn extra calories.

Dr. Spiegelman said the brown fat he studies is different from the type that appears in large, distinct masses in rodents, the type Dr. Carpentier was examining in his subjects. That brown fat is derived from musclelike cells and not from white fat.

Dr. Spiegelman suspects that humans, like mice, make brown fat from white fat when they exercise, because humans also have irisin in their blood. And human irisin is identical to mouse irisin.

“What I would guess is that this is likely to be the explanation for some of the effects of exercise,” Dr. Spiegelman says. The calories burned during exercise exceed the number actually used to do the work of exercising. That may be an effect of some white fat cells turning brown.

Many questions remain. The only brown fat that can be easily seen in people is the muscle-derived fat that shows up in scans. And that brown fat, notes Dr. C. Ronald Kahn, chief academic officer at the Joslin Diabetes Center in Boston, is visible in people only when it is turned on by making them cold.

Almost everyone of normal weight or below shows this brown fat if they are chilled, although individuals vary greatly in how much they have. But this brown fat almost never shows up in obese people. Is that one reason they are obese, or is their extra body fat keeping them so warm that there is no reason to turn on their brown fat?

There is also an intriguing relationship between the brown fat that emerges under the skin and the density of bone. Dr. Clifford Rosen, a professor of medicine at Tufts University School of Medicine in Boston, is studying mice that cannot make brown fat and was astonished by the state of their bones.

“The animals have the worst bone density we have ever seen,” Dr. Rosen said. “I see osteoporotic bones all the time,” he added, “but, oh my God, these are the extreme.”

And while exercise may induce brown fat in humans, it remains to be seen how important a source of calorie burning it is, researchers say.

As for deliberately making yourself cold if you want to lose weight, Dr. Carpentier said, “there is still a lot of research to do before this strategy can be exploited clinically and safely.”

 

Brown Fat Burns Ordinary Fat, Study Finds – NYTimes.com

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ABOUT THIS BLOG:

 

newsmd1    MARIA DORFNER is the founder of NewsMD Communications and Healthy Within Network.  This blog is a part of that.  She began her career in 1983 at NBC News in NYC where she continued to work behind-the-scenes on TODAY SHOW, NIGHTLY NEWS and all programs until 1989 when she helped launch CNBC.

As a producer, she has produced talk shows, segments and series and travelled extensively. In 1993, she developed and senior produced 7 health series: Healthy Living, Healthcare Consumers, Healthcare Practitioners, Lifestyles and Longevity and Green Magazine.

She co-anchored Healthy Living and Healthcare Consumers airing on CNBC for three years before launching NewsMD Communications. Her clients include a Who’s Who in Medical/Health, the Journal of the American Medical Association (JAMA) which she shot, wrote and produced weekly segments for  NBC, CBS, ABC, CNN and Fox. Discovery Health Channel, where she wrote, produced and directed the documentary series, 21st Century Medicine. She has helped raise multi-millions of dollars for hospitals in need and has been a part of several successful health startups.  She has worked as Director of Research for Roger Ailes at Ailes Communications, his consulting and production company and again as a producer. Her articles have been published in Broadcasting & Cable Magazine and she has hosted The Secret to Success.

She has continued to be a go-to person for network heath shows, stories and content. She was awarded a health reporting scholarship from The American Medical Association (AMA), a Freddie Award for Excellence in Medical Reporting, an Outstanding Achievement Award from the March of Dimes, an Angel of a Sponsor Award from Make A Wish Foundation and an Outstanding Leadership Abilities from her alma mater, Pace University and Commitment to the Advancement of Women in Media Award.

In 2014, she published 3 books. She was also awarded a scholarship to Columbia University by NBC News. She also received  Media Recognition Award from the American Heart Association for her series Heart Smart. She has been specializing in Medical/Health for 23 years, and has worked in Media for 33 years after starting as an intern during college.  In her spare time, she enjoys reading, learning, writing, nature, hiking, swimming, bike riding, working out, cooking, exploring museums and travel. She is a certified scuba diver and aerobics swim instructor.

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“Health has been a passion of mine since I was a kid.  What I do and who I am are seamless.  I come from a large Italian family. If someone is sick I’m the one they call for research. My best friend growing up in Brooklyn was my cousin Josephine, and we’re still close. We were little health nerds. She became a pediatric nurse.  We loved researching everything to death and still do.  Two things I love and know well. Media and Medical.  Yet, I think in both, they’ve forgotten the most important person –the patient. So, I want to help put the ME back in MEdia and MEdical.  Today, it’s SO hard to know who to trust in both.  Fortunately, people are smart and they are now well aware of the various financial ties “experts” and physicians and media have to promoting certain medications or other large companies, products or services that absolutely do not serve our health or our best interests. The worst part is when we learn they knew and do not reveal it to consumers for decades, which contradicts the oath, “First do no harm.”  So  much damage has been done and no one is accountable. How do you like that. Well, ethics matter. People matter. And people want and will choose what is best for their health. People are empowered and will use their money to denounce those companies aligned with making them sick.  I created this blog to be a trusted resource for people. I do it for free because I believe Virgil is right. There is no greater wealth than health and you absolutely have to trust who is telling you information and why more than any other time in your life.  It’s even worse if you’re rich because then people try to sell you even more things. That may be fine when it’s a handbag, but your health is too precious and there are no returns or refunds if you end up paying a price for trusting the wrong advice. Remember, “expert” doesn’t always mean that.   I feel extremely blessed to be healthy.  I’ve been healthy all my life. I’ve never even had stitches.  I love to help people and my career became a vocation when I was able to utilize my communication and journalism skills to do that.” 

-Maria Dorfner

Thanks for following my health blog.

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Future Health: Lung Cancer Vaccine 5 to 10 Years Away

by Seth Augenstein, Digital Reporter

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  President Barack Obama’s visit to Cuba this month will be the first by an American president in nearly a century. The thawing relations between the two countries are expected to bring a bumper crop of famed Cuban among other imports.

Strangely enough, another eagerly anticipated product is a lung cancer vaccine some say could be a breakthrough in oncology.

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CimaVax has reportedly been in development in Cuba for 25 years, partly because lung cancer is one of the leading causes of death in the Caribbean nation.

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Health reporter, Maria Dorfner spoke with Dr. Kelvin Lee from Roswell Park Cancer Institute, located in Buffalo, New York.  He says Roswell Park is finalizing an application to the FDA seeking permission to conduct a U.S. clinical trial of  the cancer vaccine and that , depending on the results from that and any subsequent studies, it would likely be 5 or more years before the drug could be widely available for patients in the U.S.   CimaVax is already an approved cancer therapy in Cuba and Peru.

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HOW IT WORKS

The injection is not like the other cancer-fighting immunotherapies being developed in hundreds of American labs, said Kelvin Lee, the chair of immunology at the Roswell Park Cancer Institute in Buffalo, N.Y.

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Lee and other doctors have visited the island nation several times to meet with its Cuban developers and hear updates on their progress –and they found that the vaccine was a promising potential breakthrough.  He wrote in a post on Roswell Park’s Cancer Talk blog:

“Unlike other immunotherapies, CimaVax does not target cancer directly and it is not personalized. Rather, the vaccine targets a growth factor (EGF) necessary for the cancer to survive,” Lee said. “By targeting and effectively depleting this growth factor, the cancer starves and its progress slows, prolonging patients’ lives.”

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The results so far show that patients’ lives were extended from six to an average of 18 months with the vaccine treatment,  but there are reports of patients treated with the vaccine living five years or more.

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Lee and the other doctors see the possibility that the vaccine’s efficacy may translate to colon, head and neck, prostrate, breast and pancreatic cancers as well, and that CimaVax may prove effective in preventing some cancers from developing or recurring.

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Some studies have shown promise in CimaVax, as it has cut back the EGF needed for the cancer to progress.

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It has done this with minimal side effects, including nausea, fever and vomiting.  Survival dramatically improved in those patients with advanced Stage 3 and Stage 4 tumors, according to a Cuban study conducted in 2007.

 

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However, the vaccine has only been administered to a few thousand people worldwide –and it is still far from FDA approval, the doctor said.

A possibility of skipping Phase I testing exists, Lee added. The FDA inspection period should end sometime this year, allowing testing to begin. Lee and the other doctors envision the vaccine’s efficacy translating over to other head and neck cancers, as well.

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Cancer Research UK urged patience in looking to CimaCax, in a statement released last year.

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“This research is promising but this is a small trial and we will need more trial results before we know exactly how well the vaccine works for people with lung cancer. A phase 3 trial is currently in progress in Cuba,” they said in a statement.

Obama announced the U.S. was “extending a hand of friendship” to Cuba – just 90 miles from Florida – in December 2014. The cooperation between Cuban and American doctors began in 2011 and gained momentum with New York Governor Andrew Cuomo’s trade mission to Cuba in  April 2015. Since then, the U.S. has restored up to 110 daily flights to Havana.

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Among the critics of Obama’s March 21 visit to the island nations are Sens. Marco Rubio and Ted Cruz, both presidential hopefuls who are of Cuban descent.

 

Scientists ‘find cancer’s Achilles heel’

  • Lung cancerImage copyright SPL

Scientists believe they have discovered a way to “steer” the immune system to kill cancers.

Researchers at University College, London have developed a way of finding unique markings within a tumour – its “Achilles heel” – allowing the body to target the disease.

But the personalised method, reported in Science journal, would be expensive and has not yet been tried in patients.

Experts said the idea made sense but could be more complicated in reality.

However, the researchers, whose work was funded by Cancer Research UK, believe their discovery could form the backbone of new treatments and hope to test it in patients within two years.

They believe by analysing the DNA, they’ll be able to develop bespoke treatment.

People have tried to steer the immune system to kill tumours before, but cancer vaccines have largely flopped.

One explanation is that they are training the body’s own defences to go after the wrong target.

The problem is cancers are not made up of identical cells – they are a heavily mutated, genetic mess and samples at different sites within a tumour can look and behave very differently.

‘Exciting’

They grow a bit like a tree with core “trunk” mutations, but then mutations that branch off in all directions. It is known as cancer heterogeneity.

The international study developed a way of discovering the “trunk” mutations that change antigens – the proteins that stick out from the surface of cancer cells.

Professor Charles Swanton, from the UCL Cancer Institute, added: “This is exciting. Now we can prioritise and target tumour antigens that are present in every cell – the Achilles heel of these highly complex cancers.

“This is really fascinating and takes personalised medicine to its absolute limit, where each patient would have a unique, bespoke treatment.”

There are two approaches being suggested for targeting the trunk mutations.

The first is to develop cancer vaccines for each patient that train the immune system to spot them.

The second is to “fish” for immune cells that already target those mutations and swell their numbers in the lab, and then put them back into the body.

‘Early days’

Dr Marco Gerlinger, from the Institute of Cancer Research, said: “This is a very important step and makes us think about heterogeneity as a problem and why this gives cancer this big advantage.

“Targeting trunk mutations makes sense from many points of view, but it is early days and whether it’s that simple, I’m not entirely sure.

“Many cancers are not standing still but they keep evolving constantly. These are moving targets which makes it difficult to get them under control.

“Cancers that can change and evolve could lose the initial antigen or maybe come up with smokescreens of other good antigens so that the immune system gets confused.”


Analysis

James Gallagher, health editor, BBC News website

Harnessing the power of the immune system – what’s known as immunotherapy – is the most exciting field in cancer and probably in all of medicine right now.

But while that excitement is justified, claims that a cure for cancer is around the corner are not.

Medical research is littered with the graves of hyped treatments that just never worked.

Two decades ago, gene therapy was “hype-central” and we’re still waiting for it to transform medicine.

This study demonstrates some spectacular science that furthers understanding of how the immune system and cancer interact.

But this new knowledge has not been used to treat a single patient. There have not even been animal studies. So there is a real risk it will not work.

Even if it does, this is an hugely expensive approach that would need to be customised to every patient in a process that takes more than a year from start to finish.


Some immunotherapy treatments work spectacularly with some patients’ cancer disappearing entirely.

They take the brakes off the immune system, freeing it up to fight cancer.

The researchers hope the combination of removing the immune system’s brakes and then taking over the steering wheel, will save lives.

Professor Peter Johnson, from Cancer Research UK, said the research had shown “impressive results in the clinic” and although “the technology is complicated and quite recent… once you start doing it the cost will come down”.

‘Elegant study’

Dr Stefan Symeonides, clinician scientist in experimental cancer medicine at the University of Edinburgh, said designing a personalised vaccine was currently impractical, especially when a patient needed treatment straight away.

But he added that the “very elegant” study did provide a ground-breaking insight into current immunotherapy drugs, which do not yet work for most people.

“It’s not just the number of antigens, it’s how many of the cancer cells have them,” he said.

“This data will be quoted in discussions for years, as we try to understand which patients benefit from immunotherapy drugs, which ones don’t, and why, so we can improve those therapies.”

Follow James on Twitter.

Body Bioelectronics: 5 Technologies that Could Flex with You

by Alyssa Danigelis

Wearable Electronic Patch

Innovations in soft materials and electronics are helping researchers create wearable electronic patches.

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Photo Credit: Donghee Son and Jongha Lee, Seoul National University

No more tough breaks. As “smart” electronics get smaller and softer, scientists are developing new medical devices that could be applied to — or in some cases, implanted in — our bodies.

And these soft and stretchy devices shouldn’t make your skin crawl, because they’re designed to blend right in, experts say.

We want to solve the mismatch between rigid wafer-based electronics and the soft, dynamic human body, said Nanshu Lu, an assistant professor of aerospace engineering and engineering mechanics at the University of Texas at Austin.

Lu, who previously studied with John Rogers, a soft-materials and electronics expert at the University of Illinois Urbana-Champaign, focuses her research on stretchable bioelectronics.

Lu and her colleagues have invented a cheaper and faster method for manufacturing electronic skin patches called epidermal electronics, reducing what was a multiday process to 20 minutes.

Smart and flexible enough to essentially meld with the human body.

From the latest advancements in smart tattoos to injectable brain monitoring to stretchable electronics for drug delivery, here are five fascinating technologies that could soon be on (or inside) your body.

Smart temporary tattoos

“When you integrate electronics on your skin, it feels like part of you,” Lu said. “You don’t feel it, but it is still working.” That’s the idea behind “smart” temporary tattoos that John Rogers and his colleagues are developing. Their tattoos, also known as biostamps, contain flexible circuitry that can be powered wirelessly and are stretchy enough to move with skin.

These wireless smart tattoos could address clinically important — but currently unmet — needs, Rogers told Live Science.

Although there are numerous potential applications, his team is focused now on how biostamps could be used to monitor patients in neonatal intensive care units and sleep labs.

MC10, the Massachusetts-based company Rogers helped start, is conducting clinical trials and expects to launch its first regulated products later this year.

Biochemical Sensors – Temporary Tattoos

Nanoengineers at the University of California, San Diego, have tested a temporary tattoo that both extracts and measures the level of glucose in the fluid in between skin cells.
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Photo Credit: Joseph Wang, University of California, San Diego

Skin-mounted biochemical sensors

Another new body-meld technology in development is a wearable biochemical sensor that can analyze sweat through skin-mounted devices and send information wirelessly to a smartphone. These futuristic sensors are being designed by Joseph Wang, a professor of nanoengineering at the University of California, San Diego, and director of the Center for Wearable Sensors.

“We look at sweat, saliva and tears to provide information about performance, fitness and medical status,” Wang told Live Science.

Earlier this year, members of Wang’s lab presented a proof-of-concept, flexible, temporary tattoo for diabetics that could continuously monitor glucose levels without using needle pricks.

He also led a team that created a mouth-guard sensor that can check levels of health markers that usually require drawing blood, like uric acid, an early indicator for diabetes and gout.

Wang said the Center for Wearable Sensors is pushing to commercialize these emerging sensor technologies with the help of local and international companies.

 Nanomaterial drug delivery

Dae-Hyeong Kim, an associate professor of chemical and biological engineering at Seoul National University in South Korea, and his colleagues are pursuing nanotechnologies to enable next-generation biomedical systems. Kim’s research could one day yield nanomaterial-enabled electronics for drug delivery and tissue engineering, according to Lu. “He has made stretchable memory, where you can store data on the tattoo, ” she said.

In 2014, Kim’s research group made a stretchable, wearable electronic patch that contains data storage, diagnostic tools and medicine. “The multifunctional patch can monitor movement disorders of Parkinson’s disease,” Kim told Live Science. Collected data gets recorded in the gold nanoparticle device’s memory.

When the patch detects tremor patterns, heat and temperature sensors inside it release controlled amounts of drugs that are delivered through carefully designed nanoparticles, he explained.

Injectable Electronic Mesh

This nanoscale electronic mesh can be injected into brain tissue through a needle.

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Photo Credit: Lieber Research Group, Harvard University

Injectable brain monitors

Although implantable technology exists for monitoring patients with epilepsy or brain damage, Lu pointed out that these devices are still sharp and rigid, making long-term monitoring a challenge. She compared soft brain tissue to a bowl of tofu constantly in motion. “We want something that can measure the brain, that can stimulate the brain, that can interact with the brain — without any mechanical strain or loading,” she said.

Enter Charles Lieber, a Harvard University chemistry professor whose research group focuses on nanoscale science and technology. His group’s devices are so small that they can be injected into brain tissue through a needle. After injection, nanoscale electronic mesh opens up that can monitor brain activity, stimulate tissue and even interact with neurons. “That,” said Lu, “is very cutting edge.”

Long-term implantable devices

Spinal Cord Implant

The e-Dura spinal cord implant.

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Photo Credit: Laboratory for Soft Bioelectronic Interfaces, EPFL
 

Stéphanie Lacour and Grégoire Courtine, scientists at the École Polytechnique Fédérale de Lausanne’s School of Engineering, announced in early 2015 that they had developed a new implant for treating spinal cord injuries.

The small e-Dura device is implanted directly on the spinal cord underneath its protective membrane, called the dura mater. From there, it can deliver electrical and chemical stimulation during rehabilitation.

The device’s elasticity and biocompatibility reduce the possibility of inflammation or tissue damage, meaning it could stay implanted for a long time.

Paralyzed rats implanted with the device were able to walk after several weeks of training, the researchers reported in the journal Science.

Lu called e-Dura one of the best-functioning, long-term implantable flexible stimulators. “It shows the possibilities of using implantable, flexible devices for rehabilitation and treatment,” she said.

Meanwhile, technologies that replicate human touch are growing increasingly sophisticated.

Stanford University chemical engineering professor Zhenan Bao has spent years developing artificial skin that can sense pressure and temperature and heal itself.

Her team’s latest version contains a sensor array that can distinguish between pressure differences like a firm or limp handshake.

Lu said she and her colleagues in this highly multidisciplinary field hope to make all wafer-based electronics more epidermallike. “All those electronic components that used to be rigid and brittle now have a chance to become soft and stretchable,” she said.

Follow @livescience, Facebook & Google+.  Original article on Live Science at:

http://www.livescience.com/health/

 

Also  Check Out Editor’s Recommendations at http://www.livescience.com

•5 Amazing Technologies That Are Revolutionizing Biotech
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Twitter: https://twitter.com/LiveSciHealth

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First Uterus Transplant in U.S. Gives Hope to Infertile

 

 

 

Uterus Transplant
Photo provided by Cleveland Clinic Center, a team of Cleveland Clinic transplant surgeons and gynecological surgeons perform the nation’s first uterus transplant during a nine-hour surgery in Cleveland.

UPDATE TO ORIGINAL STORY:

 

Statement from Cleveland Clinic

March 9, 2016 Update on 1st Uterus Transplant

We are saddened to share that our patient, Lindsey, recently experienced a sudden complication that led to the removal of her transplanted uterus.

On February 25, Cleveland Clinic announced the first uterus transplant as part of a clinical study for women who suffer from uterine factor infertility. At this time, the circumstance of the complication is under review and more information will be shared as it becomes available.

There is a known risk in solid organ transplantation that the transplanted organ may have to be removed should a complication arise. The medical team took all necessary precautions and measures to ensure the safety of our patient.

While this has been difficult for both the patient and the medical team, Lindsey is doing well and recovering.

The study, which has been planned to include 10 women, is still ongoing with a commitment to the advancement of medical research to provide an additional option for women and their families.”

Statement from Lindsey

“I just wanted to take a moment to express my gratitude towards all of my doctors. They acted very quickly to ensure my health and safety. Unfortunately I did lose the uterus to complications. However, I am doing okay and appreciate all of your prayers and good thoughts.”

 

ORIGINAL STORY:

Surgeons at the Cleveland Clinic have performed the first uterus transplant in the United States on a 26-year-old, using a uterus from a deceased organ donor.

The operation took 9 hours and the woman is in stable condition.

The procedure is to help women who had their uterus removed, or were born without one.

Following a transplant, the woman needs to wait a year before trying to become pregnant.

Then she will need in vitro fertilization to become pregnant.

Before the transplant, the patient had eggs removed surgically, fertilized with her husband’s sperm and frozen.

The embryos will be transferred into her uterus.

If the procedure is successful, any children will be born by cesarean section and the mother will have the transplanted uterus removed after having one or two babies.

The transplant will be temporary: The uterus will be removed after the recipient has had one or two babies, so she can stop taking anti-rejection drugs.

Uterus Transplant
Photo provided by Cleveland Clinic Center

The Cleveland hospital’s ethics panel has given it permission to perform the procedure 10 times, as an experiment.

Officials will then decide whether to continue, and whether to offer the operation as a standard procedure. The clinic is still screening women who may be candidates for the operation.

The leader of the surgical team is Dr. Andreas G. Tzakis, who has performed 4,000 to 5,000 transplants of kidneys, livers and other abdominal organs.

To prepare for uterus transplants, he traveled to Sweden and worked with doctors at the University of Gothenburg, the only ones in the world to have performed the procedure successfully so far.

About 50,000 women in the United States are thought to be candidates for transplanted uteruses.

 

THE DONOR     Surgeons remove the uterus, cervix and part of the vagina from an organ donor who has recently died, along with the small uterine vessels that carry blood to the organ. The uterus can survive outside the body for at least six to eight hours if kept cold.

THE RECIPIENT     The donor’s uterus is connected to the recipient’s vagina and the uterine vessels are redirected to large blood vessels running outside the pelvis. The recipient’s ovaries are left in place, and if she has any remnant fallopian tubes, they are not connected to the transplant. The recipient will wait a year to heal before having in vitro fertilization.

ccf5  Sources: Dr. Tommaso Falcone, Cleveland Clinic; BioDigital


By The New York Times

In an interview in October, Dr. Tzakis said that although women without a uterus could adopt children or hire surrogates to carry a pregnancy for them, many find those options unacceptable “for reasons that are personal, cultural or religious.”

At that time, a 26-year-old woman who was being screened as a potential candidate explained why she wanted a chance to become pregnant and give birth.

“I crave that experience,” she said. “I want the morning sickness, the backaches, the feet swelling. I want to feel the baby move. That is something I’ve wanted for as long as I can remember.”

babybaby10
Link to: Cleveland Clinic:  http://www.clevandclinic.org

A version of this article appears in print on February 26, 2016, on page A13 of the New York edition with the headline: National Briefing | Midwest; Ohio: Uterus Transplant Is First in United States.

Order Reprints| Today’s Paper | Subscribe by clicking here:

LINK:  http://www.nytimes.com/pages/todayspaper/index.html

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She can be reached at maria.dorfner@yahoo.com
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