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DiversityNursing Blog

Olympic Skier Mikaela Shiffrin Moved To Tears By Young Fan Who Battled Leukemia

Posted by Erica Bettencourt

Wed, Oct 15, 2014 @ 11:13 AM

By Eun Kyung Kim

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It takes nerves of steel to win World Cup, World Championship and Olympic titles like Mikaela Shiffrin. Yet, the alpine skier melted into a pool of tears after hearing from a young Swedish girl she has called her “little lucky charm.”

Shiffrin met 11-year-old Emma Lundell two years ago in Are, Switzerland, after winning her first World Cup title, NBC Sports reported. Emma was battling leukemia at the time and had asked Shiffrin for a photograph.

“That was the biggest wake up call," Shiffrin recalled for Swedish publication SPORT-Expressen, which surprised her with a video update from Emma, who is now 13 and has finished chemotherapy treatments. Emma, whose hair has grown back, says she's even healthy enough to resume cross-country skiing.

“I’m so honored that you have thought of me. To be mentioned as your lucky charm is the nicest and greatest thing ever,” she said in her message to Shiffrin, who repeatedly wiped away tears while watching.

“Wow,” Shiffrin said. “She looks so good. Oh my gosh, that makes me so happy. I wonder about her a lot actually.”

And the skier's reply to her young fan was equally moving. 

"Emma, I’m so glad that you’re healthy, and that your chemo is done, and your hair is beautiful,” she said.

“I hope I see you again, maybe in Are. I think about you a lot and I’m very glad that I met you because you keep me grounded when I get arrogant. And I think about how tough it must have been for you, and I’m so glad to have met you and I wish you the best.”

Source: www.today.com

Topics: child, cancer, patient, leukemia, olympics, Mikaela Shiffrin, fan, battling cancer

National Nursing Survey: 80% Of Hospitals Have Not Communicated An Infectious Disease Policy

Posted by Erica Bettencourt

Wed, Oct 08, 2014 @ 11:55 AM

By Dan Munro

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Released on Friday, the survey of 700 Registered Nurses at over 250 hospitals in 31 states included some sobering preliminary results in terms of hospital policies for patients who present with potentially infectious diseases like Ebola.

  • 80% say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola
  • 87% say their hospital has not provided education on Ebola with the ability for the nurses to interact and ask questions
  • One-third say their hospital has insufficient supplies of eye protection (face shields or side shields with goggles) and fluid resistant/impermeable gowns
  • Nearly 40% say their hospital does not have plans to equip isolation rooms with plastic covered mattresses and pillows and discard all linens after use, less than 10 percent said they were aware their hospital does have such a plan in place
  • More than 60% say their hospital fails to reduce the number of patients they must care for to accommodate caring for an “isolation” patient

National Nurses United (NNU) started the survey several weeks ago and released the preliminary results last Friday (here). The NNU has close to 185,000 members in every state and is the largest union of registered nurses in the U.S.

The release of the survey coincided with Friday’s swirling controversy on how the hospital in Dallas mishandled America’s first case of Ebola. The patient ‒ Thomas E. Duncan ‒ was treated and released with antibiotics even though the hospital staff knew of his recent travel from Liberia ‒ now the epicenter of this Ebola outbreak.

On October 2, the hospital tried to lay blame of the mishandled Ebola patient on their electronic health record (EHR) software with this statement.

Protocols were followed by both the physician and the nurses. However, we have identified a flaw in the way the physician and nursing portions of our electronic health records (EHR)interacted in this specific case. In our electronic health records, there are separate physician and nursing workflows. Texas Health Presbyterian Hospital Statement ‒ October 2 (here)

Within 24 hours, the hospital recanted the statement by saying no, in fact, “there was no flaw.”

The larger issue, of course, is just how ready are the more than 5,700 hospitals around the U.S. when it comes to diagnosing and then treating suspected cases of Ebola. Given the scale of the outbreak (a new case has now been reported in Spain ‒ Europe’s first), it’s very likely we’ll see more cases here in the U.S.

As an RN herself ‒ and Director of NNU’s Registered Nurse Response Network ‒ Bonnie Castillo was blunt.

What our surveys show is a reminder that we do not have a national health care system, but a fragmented collection of private healthcare companies each with their own way of responding. As we have been saying for many months, electronic health records systems can, and do, fail. That’s why we must continue to rely on the professional, clinical judgment and expertise of registered nurses and physicians to interact with patients, as well as uniform systems throughout the U.S. that is essential for responding to pandemics, or potential pandemics, like Ebola. Bonnie Castillo, RN ‒ Director of NNU’s Registered Nurse Response Network (press release)

As a part of their Health Alert Network (HAN), the CDC has been sounding the alarm since July ‒ and released guidelines for evaluating U.S. patients suspected of having Ebola through the HAN on August 1 (HAN #364). As a part of alert #364, the CDC was specific on recommending tests “for all persons with onset of fever within 21 days of having a high‒risk exposure.” Recent travel from Liberia in West Africa should have prompted more questioning around potential high-risk exposure ‒ which was, in fact, the case.

As it was, a relative called the CDC directly to question the original treatment of Mr. Duncan given all the circumstances.

“I feared other people might also get infected if he wasn’t taken care of, and so I called them [the CDC] to ask them why is it a patient that might be suspected of this disease was not getting appropriate care.” Josephus Weeks ‒ Nephew of Dallas Ebola patient to NBC News

The CDC has also activated their Emergency Operations Center (EOC).

The EOC brings together scientists from across CDC to analyze, validate, and efficiently exchange information during a public health emergency and connect with emergency response partners. When activated for a response, the EOC can accommodate up to 230 personnel per 8-hour shift to handle situations ranging from local interests to worldwide incidents.

The EOC coordinates the deployment of CDC staff and the procurement and management of all equipment and supplies that CDC responders may need during their deployment.

In addition, the EOC has the ability to rapidly transport life-supporting medications, samples and specimens, and personnel anywhere in the world around the clock within two hours of notification for domestic missions and six hours for international missions.

Source: Forbes

Topics: survey, Ebola, infectious diseases, policies, nursing, RN, nurse, nurses, disease, patients, hospitals

Turnover Among New Nurses Not All Bad

Posted by Erica Bettencourt

Wed, Oct 08, 2014 @ 11:43 AM

By Debra Wood

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One out of every six newly licensed nurses (more than 17 percent) leave their first nursing job within the first year and one out of every three (33.5 percent) leave within two years. But not all nurse turnover is bad, according to a new study from the RN Work Project, funded by the Robert Wood Johnson Foundation.

“It seemed high,” said Carol S. Brewer, PhD, RN, FAAN, professor at the University at Buffalo School of Nursing and co-director of the RN Work Project, the only longitudinal study of registered nurses conducted in the United States. “Most of them take a new job in a hospital. We’ve emphasized who left their first job, but it doesn’t mean they have left hospital work necessarily.”

While many nursing leaders have voiced concern that high turnover among new nurses may result in a loss of those nurses to the profession, that’s not what the RN Work Project team has found. Most of those leaving move on to another job in health care.

“Not only are they staying in health care, they are staying in health care as nurses,” said Christine T. Kovner, PhD, RN, FAAN, professor at the New York University College of Nursing and co-director of the RN Work Project. “Very few leave. A tiny percent become a case manager or work for an insurance company, verifying people had the right treatment.”

Such outside jobs tend to offer better hours, with no nights or weekends. The nurses are still using their knowledge and skills but they are not providing hands-on care.

The RN Work Project looks at nurse turnover from the first job, and the majority of first jobs are in the hospital setting, Brewer explained. However, in the sample, nurses working in other settings had higher turnover rates than those working in acute care.

Kovner hypothesized that since new nurses are having a harder time finding first jobs in hospitals, they may begin their careers in a nursing home and leave when a hospital position opens up. On the other hand, those who succeed in landing a hospital job may feel the need to stay at least a year, because that’s what many nursing professors recommend. Hospitals also tend to offer better benefits, such as tuition reimbursement and child care, and hold an attraction for new nurses.

“Our students, if they could get a job in an ICU, they’d be happy, and the other place they want to work is the emergency room,” Kovner said. “They want to save lives, every day.”

The RN Work Project data excludes nurses who have left their first position at a hospital for another in the same facility, which is disruptive to the unit but may be a positive for the organization overall, since the nurse knows the culture and policies. The nurse may change to come off the night shift or to obtain a position in a specialty unit, such as pediatrics.

“That’s an example of the type of turnover an organization likes,” Kovner said. “You have an experienced nurse going to the ICU [or another unit].”

While nurse turnover represents a high cost for health care employers, as much as $6.4 million for a large acute care hospital, some departures of RNs is good for the workplace. Brewer, Kovner and colleagues describe the difference between dysfunctional and functional turnover in the paper, published in the journal Policy, Politics & Nursing Practice.

“Dysfunctional is when the good people leave,” Brewer said.

The RN Work Project has not differentiated between voluntary and involuntary departures, the latter of which may be due to poor performance or downsizing. And some nurse turnover is beneficial.

“If you never had turnover, the organization would become stagnant,” Kovner added. “It’s useful to have some people leave, particularly the people you want to leave. It offers the opportunity to have new blood come in.”

New nursing graduates might bring with them the latest knowledge, and more seasoned nurses may bring ideas proven successful at other organizations.

Once again, Brewer and Kovner report managers or direct supervisors play a big role in nurses leaving their jobs. Organizations hoping to reduce turnover could consider more management training for people in those roles.

“Leadership seems a big issue,” Brewer said. “The supervisor support piece has been consistent.”

Both nurse researchers cited the challenge of measuring nurse turnover accurately. Organizations and researchers often describe it differently, Brewer said. And hospitals often do not want to release information about their turnover rates, since nurses would most likely apply to those with lower rates, Kovner added. When assessing nurse turnover data, she advises looking at the response rate and the methodology used.

“There are huge inconsistencies in reports about turnover,” Kovner said. “It’s extremely important managers and policy makers understand where the data came from.”

Source: www.nursezone.com

 

Topics: jobs, turnover, nursing, healthcare, nurses, health care, hospitals, career

After 30 Years, Blind Patient Can See With 'Bionic Eye'

Posted by Erica Bettencourt

Wed, Oct 08, 2014 @ 11:30 AM

By Linda Carroll

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For years Larry Hester lived in darkness, his sight stolen by a disease that destroyed the photoreceptor cells in his retinas. But last week, through the help of a “bionic eye,” Hester got a chance to once again glimpse a bit of the world around him.

Hester is the seventh patient to receive an FDA-approved device that translates video signals into data the optic nerve can process. The images Hester and others “see” will be far from full sight, but experts hope it will be enough to give a little more autonomy to those who had previously been completely blind.

Hester’s doctors at Duke University Eye Center believe that as time goes on the 66-year-old tire salesman from Raleigh, N.C., will be able to “see” more and more. After only five days, there has been remarkable progress.

“I hope that [after some practice] he will be able to do things he can’t do today: maybe walk around a little more independently, see doorways or the straight line of a curb. We don’t expect him to be able to make out figures on TV. But we hope he’ll be more visually connected.” said Dr. Paul Hahn, an assistant professor of ophthalmology at the university in Durham.

It was at Duke three decades ago that Hester learned that something was seriously wrong with his eyes. After a battery of tests, doctors delivered the disheartening news: Hester had retinitis pigmentosa, a disease that would inexorably chip away at the rods and cones in his retinas, eventually leaving him blind.

“It was a pretty devastating blow, frankly,” Hester said. “I was 33 at the time.”

But Larry Hester wasn’t the sort of guy to sit around feeling sorry for himself. With the support of family, friends and a devoted wife, he found a way to live his life as normally as possible, depending on his memory to help him navigate around his home and his workplace.

One day his wife, Jerry, saw a story about a device that might help Larry. The FDA had just approved it for use in people who suffer from the same condition as Larry —some 50,000 to 100,000 in the U.S.  

Larry was just the kind of patient that Hahn was looking for to try out the Argus II Retinal Prosthesis system, and he became the first to get the device at Duke.

Argus was designed to bypass damaged photoreceptors and send signals directly to the next layer of retinal cells, which are on the pathway to the optic nerve.

A miniature video camera seated in a pair of glasses captures what the patient is “looking” at and sends the video through a thin cable to a small external computer that transforms the images into signals that can be understood by that second layer of retinal cells. Those data are then sent back to the glasses, which transmit the information through a small antenna to an array of 60 tiny electrodes that implanted up against the patient’s retina.

The electrodes emit small pulses of electricity that make their way up the undamaged retinal cells to the optic nerves, creating the perception of patterns of light. The hope is that patients will learn to interpret those patterns as images.

Last week with the new glasses perched on his nose, Larry sat in a chair at Duke surrounded by medical staff and his family — all waiting for Hahn to turn on the device. Directly in front of Larry was a brightly lit screen.

“At the count of three, we’re going to hit the start button and we’ll see what happens,” Hahn said.

At three, a smile started to play on Larry’s lips.

“Yes,” he said and the smile broadened across his face. “Oh my goodness!”

Jerry looked at him and exclaimed, “Can you see, Larry?”

After giving her husband a kiss, she asked again, “Can you really see?”

“Yes. Flashing. Big time flashing.”

Experts see the new device as the start of something big.

“It’s a fairly limited device, but it’s an amazing leap forward,” said Dr. Colin McCannel, a retinal expert at the Jules Stein Eye Institute at the University of California, Los Angeles. “It’s not the vision you or I are used to. But for someone who has been in complete darkness it must be amazing to see again. I think it’s absolutely phenomenal.”

Dr. Neil Bressler turns to the space program for an analogy.

“It’s like the first rocket ship that went up and down, or when John Glenn went into orbit,” said Bressler, a professor of ophthalmology and chief of the retina division at Johns Hopkins Medicine. “If you asked can we put a man on the moon the next day the answer would be no. It was the first of many steps to achieve the objective of putting a man on the moon.”

While the device isn’t even close to giving Larry back the vision he was born with, he can see contrasts, which allows him, for example, to distinguish between a white wall and a darkened doorway.

If you’ve lived in darkness for decades, that little bit of new-found vision can be a huge gift.

“The other night I was sitting on a dark leather chair,” Jerry said. “He was able to scan over and see my face because it was lighter. And he reached out and touched my face. That is the first time he had done that in a long time. It was a sweet and precious moment.”

Linda Carroll is a regular contributor to NBCNews.com and TODAY.com. She is co-author of "The Concussion Crisis: Anatomy of a Silent Epidemic” and the recently published “Duel for the Crown: Affirmed, Alydar, and Racing’s Greatest Rivalry.”

Source: www.today.com

Topics: FDA, device, technology, medical, patient, blind, bionic eye, vision

Diagnosing Deadly Cancers Earlier With 'Lab-On-A-Chip'

Posted by Erica Bettencourt

Wed, Oct 08, 2014 @ 11:25 AM

By Catharine Paddock PhD

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At present, diagnosis of lung cancer relies on an invasive biopsy that is only effective after tumors are bigger than 3 cm or even metastatic. Earlier detection would vastly improve patients' chances of survival. Now a team of researchers is developing a "lab-on-a-chip" that promises to detect lung cancer - and possibly other deadly cancers - much earlier, using only a small drop of a patient's blood.

In the Royal Society of Chemistry journal, Yong Zeng, assistant professor of chemistry at the University of Kansas, and colleagues report a breakthrough study describing their invention.

For some time, scientists have been excited by the idea of testing for disease biomarkers in "exosomes" - tiny vesicles or bags of molecules that cells, including cancer cells - release now and again. When they first spotted them, researchers thought exosomes were just for getting rid of cell waste, but now they know they also do other important things such as carry messages to other cells near and far.

The challenge, however, is developing a technology that is small enough to target and analyze the contents of exosomes - mostly nucleic acids and proteins - to find unique biomarkers of disease. This is because exosomes are tiny - around 30 to 150 nanometers (nm) in diameter - much smaller, for example, than red blood cells.

Current methods for separating out and testing exosomes require several steps of ultracentrifugation - a lengthy and inefficient lab procedure, as Prof. Zeng explains:

"There aren't many technologies out there that are suitable for efficient isolation and sensitive molecular profiling of exosomes. First, current exosome isolation protocols are time-consuming and difficult to standardize. Second, conventional downstream analyses on collected exosomes are slow and require large samples, which is a key setback in clinical development of exosomal biomarkers."

Now, using microfluid technology, he and his colleagues have developed a lab-on-a-chip that can analyze the contents of targeted exosomes and spot the early signs of deadly cancer. They have already successfully tested it on lung cancer.

Lab-on-a-chip device uses smaller samples, is faster, cheaper and more sensitive

The new device, which uses much smaller samples, promises to produce results faster, more cheaply, with better sensitivity compared to conventional benchtop instruments, as Prof. Zeng continues to explain:

"A lab-on-a-chip shrinks the pipettes, test tubes and analysis instruments of a modern chemistry lab onto a microchip-sized wafer."

The technology behind the device - known as microfluidics - came out of new semiconductor electronics and has been under intensive development since the 1990s, he adds:

"Essentially, it allows precise manipulation of minuscule fluid volumes down to one trillionth of a liter or less to carry out multiple laboratory functions, such as sample purification, running of chemical and biological reactions, and analytical measurement."

Unlike breast and colon cancer, there is no widely accepted screening tool for lung cancer, which in most cases is first diagnosed based on symptoms that normally indicate lung function is already impaired.

To diagnose lung cancer, doctors have to perform a biopsy - remove a piece of tissue from the lung and send it to a lab for molecular analysis. It is rarely possible to do this in the early stages as tumors are too small to be spotted on scans.

"In contrast, our blood-based test is minimally invasive, inexpensive, and more sensitive, thus suitable for large population screening to detect early-stage tumors," says Prof. Zeng, adding that the technique offers a general platform for detecting exosomes from cancer cells. The team has already used the device to test for ovarian cancer, and in theory, says Prof. Zeng, it should also be applicable to other cancer types.

"Our long-term goal is to translate this technology into clinical investigation of the pathological implication of exosomes in tumor development. Such knowledge would help develop better predictive biomarkers and more efficient targeted therapy to improve the clinical outcome," he adds.

The team has received further funding from the National Cancer Institute at the National Institutes of Health to further develop the lab-on-a-chip.

In March 2013, Medical News Today learned how another team of scientists is developing a lab-on-a-chip that is implanted under the skin to track levels of substances in the blood and transmit the results wirelessly to a smartphone or other receiving device.

Source: www.medicalnewstoday.com

Topics: science, lab, blood, blood tests, health, healthcare, medical, cancer, testing

My Right To Death With Dignity At 29

Posted by Erica Bettencourt

Wed, Oct 08, 2014 @ 11:18 AM

By Brittany Maynard

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Editor's note: Brittany Maynard is a volunteer advocate for the nation's leading end-of-life choice organization, Compassion and Choices. She lives in Portland, Oregon, with her husband, Dan Diaz, and mother, Debbie Ziegler. Watch Brittany and her family tell her story at www.thebrittanyfund.org. The opinions expressed in this commentary are solely those of the author.

(CNN) -- On New Year's Day, after months of suffering from debilitating headaches, I learned that I had brain cancer.

I was 29 years old. I'd been married for just over a year. My husband and I were trying for a family.

Our lives devolved into hospital stays, doctor consultations and medical research. Nine days after my initial diagnoses, I had a partial craniotomy and a partial resection of my temporal lobe. Both surgeries were an effort to stop the growth of my tumor.

In April, I learned that not only had my tumor come back, but it was more aggressive. Doctors gave me a prognosis of six months to live.

Because my tumor is so large, doctors prescribed full brain radiation. I read about the side effects: The hair on my scalp would have been singed off. My scalp would be left covered with first-degree burns. My quality of life, as I knew it, would be gone.

After months of research, my family and I reached a heartbreaking conclusion: There is no treatment that would save my life, and the recommended treatments would have destroyed the time I had left.

I considered passing away in hospice care at my San Francisco Bay-area home. But even with palliative medication, I could develop potentially morphine-resistant pain and suffer personality changes and verbal, cognitive and motor loss of virtually any kind.

Because the rest of my body is young and healthy, I am likely to physically hang on for a long time even though cancer is eating my mind. I probably would have suffered in hospice care for weeks or even months. And my family would have had to watch that.

I did not want this nightmare scenario for my family, so I started researching death with dignity. It is an end-of-life option for mentally competent, terminally ill patients with a prognosis of six months or less to live. It would enable me to use the medical practice of aid in dying: I could request and receive a prescription from a physician for medication that I could self-ingest to end my dying process if it becomes unbearable.

I quickly decided that death with dignity was the best option for me and my family.

We had to uproot from California to Oregon, because Oregon is one of only five states where death with dignity is authorized.

I met the criteria for death with dignity in Oregon, but establishing residency in the state to make use of the law required a monumental number of changes. I had to find new physicians, establish residency in Portland, search for a new home, obtain a new driver's license, change my voter registration and enlist people to take care of our animals, and my husband, Dan, had to take a leave of absence from his job. The vast majority of families do not have the flexibility, resources and time to make all these changes.

I've had the medication for weeks. I am not suicidal. If I were, I would have consumed that medication long ago. I do not want to die. But I am dying. And I want to die on my own terms.

I would not tell anyone else that he or she should choose death with dignity. My question is: Who has the right to tell me that I don't deserve this choice? That I deserve to suffer for weeks or months in tremendous amounts of physical and emotional pain? Why should anyone have the right to make that choice for me?

Now that I've had the prescription filled and it's in my possession, I have experienced a tremendous sense of relief. And if I decide to change my mind about taking the medication, I will not take it.

Having this choice at the end of my life has become incredibly important. It has given me a sense of peace during a tumultuous time that otherwise would be dominated by fear, uncertainty and pain.

Now, I'm able to move forward in my remaining days or weeks I have on this beautiful Earth, to seek joy and love and to spend time traveling to outdoor wonders of nature with those I love. And I know that I have a safety net.

I hope for the sake of my fellow American citizens that I'll never meet that this option is available to you. If you ever find yourself walking a mile in my shoes, I hope that you would at least be given the same choice and that no one tries to take it from you.

When my suffering becomes too great, I can say to all those I love, "I love you; come be by my side, and come say goodbye as I pass into whatever's next." I will die upstairs in my bedroom with my husband, mother, stepfather and best friend by my side and pass peacefully. I can't imagine trying to rob anyone else of that choice.

What are your thoughts about "death with dignity"?

Source: CNN

Topics: life, choice, nursing, health, nurses, health care, medical, cancer, hospital, terminally ill, brain cancer, medicine, patient, death, tumor

After 8 Years Of Infertility, Parents’ Shocked Reactions To Quadruplet Pregnancy Go Viral

Posted by Erica Bettencourt

Mon, Oct 06, 2014 @ 11:34 AM

Ashley and Tyson Gardner of Pleasant Grove, Utah, tried to conceive for eight years when they turned to in vitro fertilization this summer.

Boy, did it work. Or rather, girl, did it work. In July, they got the “surprise of our lives” when they went in for an ultrasound and found out they are expecting two sets of identical twins -- all girls.

A photo of the couple looking shocked while holding the ultrasound images has gone viral on their Facebook page, which also features photos of the moment they first found out Ashley was pregnant.

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"My whole goal in opening up about this is to promote infertility awareness," she said in a recent YouTube video. "It's not something that's talked about a lot and it's a really hard trial that people go through."

Ashley's fertility problems were caused by endometriosis, so the couple at first tried intrauterine insemination, she told BabyCenter.com. When that didn't work, they tried IVF, which cost them $12,000 out of their own pockets.

Ashley is now 18 weeks along and she and her husband are busy trying to pick names for their four girls.

"We were so blessed," she writes on her Facebook page.

Source: http://www.today.com

Topics: twins, ultrasound, viral, quadruplet, infertility, parents, nursing, health, pregnant, video, hospital, medicine, babies

An Ingestible Pill With Needles Could Be The New Form Of Injection

Posted by Erica Bettencourt

Mon, Oct 06, 2014 @ 11:25 AM

By Marie Ellis

needle pill

Imagine swallowing a pill with tiny needles instead of getting an injection. Then again, imagine swallowing a pill with tiny needles. It may sound painful, but according to the researchers who developed the novel capsule - which could replace painful injections - there are no harmful side effects.

The researchers, from the Massachusetts Institute of Technology (MIT) and Massachusetts General Hospital (MGH), have published the results of their study - which tested the microneedle pill in the gastrointestinal (GI) tracts of pigs - in the Journal of Pharmaceutical Sciences.

Though most of us would probably prefer swallowing a pill over having an injection, many drugs cannot be given in pill form because they are broken down in the stomach before being absorbed.

Biopharmaceuticals made from large proteins, such as antibodies - known as "biologics" - are used to treat cancer, arthritis and Crohn's disease, and also include vaccines, recombinant DNA and RNA.

"The large size of these biologic drugs makes them nonabsorbable," explains lead author MIT graduate student Carl Schoellhammer. "And before they even would be absorbed, they're degraded in your GI tract by acids and enzymes that just eat up the molecules and make them inactive."

In an effort to design a capsule that is capable of delivering a wide range of drugs - while preventing degradation and effectively injecting the medicine into the GI tract - Schoellhammer and colleagues constructed the capsule from acrylic, including a reservoir for the drug that is coated with hollow, 5 mm long needles made of stainless steel.

The capsule measures 2 cm long and 1 cm in diameter.

Needle capsule worked safely and effectively in pigs

The team notes that previous studies involving humans who have accidentally swallowed sharp objects have suggested swallowing a capsule coated with short needles could be safe. They explain that there are no pain receptors in the GI tract and that, as a result, patients would not feel any pain.

But to assess whether their capsule could safely and effectively deliver the drugs, the researchers tested the pill in pigs, using insulin in the drug reservoir.

The capsules took more than a week to move through the whole digestive tract, and there were no traces of tissue damage, the researchers say. Additionally, the microneedles effectively injected insulin into the lining of the pigs' stomachs, small intestines and colons, which resulted in their blood glucose levels dropping.

Co-lead author Giovanni Traverso, a research fellow at MIT's Koch Institute for Integrative Cancer Research and gastroenterologist at MGH, notes that the pigs' reduction in blood glucose was faster and larger than the drop observed from insulin injection.

"The kinetics are much better and much faster-onset than those seen with traditional under-the-skin administration," he says. "For molecules that are particularly difficult to absorb, this would be a way of actually administering them at much higher efficiency."

'Oral delivery of drugs is a major challenge'

Though they used insulin for their tests in pigs, the researchers say they envision their capsule being used to deliver biologics to humans.

"This could be a way that the patient can circumvent the need to have an infusion or subcutaneous administration of a drug," says Traverso.

Prof. Samir Mitragotri, a professor at the University of California-Santa Barbara - who was not involved in the research - says:


"This is a very interesting approach. Oral delivery of drugs is a major challenge, especially for protein drugs. There is tremendous motivation on various fronts for finding other ways to deliver drugs without using the standard needle and syringe."

In terms of future modifications, the team plans to alter the capsule so that contractions of the digestive tract slowly squeeze the drug out of the capsule as it travels through the body, and they also want to make the needles out of degradable polymers and sugar that break off, becoming embedded in the gut lining and slowly disintegrating.

Source: http://www.medicalnewstoday.com

Topics: drugs, researchers, innovation, injections, pills, health, healthcare, medicine

Nobel Prize in Medicine is Awarded for Discovery of Brain’s ‘Inner GPS’

Posted by Erica Bettencourt

Mon, Oct 06, 2014 @ 11:14 AM

By 

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A British-American scientist and a pair of Norwegian researchers were awarded this year’s Nobel Prize in Physiology or Medicine on Monday for discovering “an inner GPS, in the brain,” that makes navigation possible for virtually all creatures.

John O’Keefe, 75, a British-American scientist, will share half of the prize of 8 million kronor, or $1.1 million, in what is considered the most prestigious scientific award. May-Britt Moser, 51, and Edvard I. Moser, 52, who are married, will share the other half, said the Karolinska Institute in Sweden, which chooses the laureates.

The three scientists’ discoveries “have solved a problem that has occupied philosophers and scientists for centuries — how does the brain create a map of the space surrounding us and how can we navigate our way through a complex environment,” the institute said in a news release.

The positioning system in the brain that they discovered helps us know where we are, find our way from place to place and store the information for the next time, said Goran K. Hansson, secretary of the Karolinska’s Nobel Committee, in announcing the laureates.

The researchers documented that certain cells are responsible for higher cognitive function that steers the navigational system, the committee said.

Dr. O’Keefe began using neurophysiological methods in the late 1960s to study how the brain controls behavior. In 1971 he discovered the first component of the inner navigational system in rats. He identified nerve cells in the hippocampus region of the brain that were always activated when a rat was at a certain location. He called them “place cells” and showed that the cells registered not only what they saw, but also what they did not see, by building up inner maps in different environments.

Dr. O’Keefe was born in New York City and graduated from the City College of New York. He earned a Ph.D. in physiological psychology at McGill University in Montreal, in 1967, and moved for postdoctoral training to University College London, where he remains. He is a professor of cognitive neuroscience.

In 2005, the Mosers discovered a second crucial component of the brain’s positioning system by identifying another type of nerve cell that permits coordination and positioning. The scientists, who work at the Norwegian University of Science and Technology in Trondheim, called the cells grid cells. While mapping connections to the hippocampus in rats moving about a room in a laboratory, “they discovered an astonishing pattern of activity in a nearby part of the brain called the entorhinal cortex,” the Nobel committee said.

When the rat passed multiple locations, the cells formed a hexagonal grid. Each cell activated in unique spatial patterns. Their research showed “how both ‘place’ and ‘grid’ cells make it possible to determine position and to navigate,” the committee said.

The Mosers grew up in rural Norway and came from nonacademic families. May-Britt was born in Fosnavag and Edvard in Alesund. Although they went to the same high school, they did not know each other well until they were undergraduates at the University of Oslo. They married while they were college students and have two daughters. Both are professors at the university in Trondheim.

At one point they were visiting scientists at University College London, studying under Dr. O’Keefe.

The three also won Columbia University’s Louisa Gross Horwitz Prize last year for their discoveries.

Only a handful of married couples have shared a Nobel Prize, and the Mosers are only the second in the medicine category, which has been awarded since 1901. Fewer than a dozen women have been named laureates in medicine.

Evidence that place and grid cells exist in humans comes from recent studies using brain imaging techniques and from patients who have undergone neurosurgery.

The laureates’ findings may eventually lead to a better understanding of the spatial losses that occur in Alzheimer’s and other neurological diseases. The hippocampus and entorhinal cortex are often damaged in early stages of Alzheimer’s, with affected individuals’ losing their way and failing to recognize the environment. The findings also open new avenues for understanding cognitive processes like memory, thinking and planning, the Nobel Committee said.

According to The Associated Press, May-Britt Moser said the couple was elated. “This is such a great honor for all of us and all the people who have worked with us and supported us,” she said in a telephone interview with The A.P. “We are going to continue and hopefully do even more groundbreaking work in the future.”

Her husband was flying when the prize was announced, she said, and he later told the Norwegian news agency NTB that he learned about it when he landed and turned on his cellphone, to a barrage of messages and calls. “I didn’t know anything. When I got off the plane there was a representative there with a bouquet of flowers who said ‘congratulations on the prize,’   ” The Associated Press reported.

The laureates traditionally receive their awards at a banquet in Stockholm on Dec. 10, the anniversary of the death in 1896 of the prize’s creator, Alfred Nobel, an industrialist and inventor of dynamite.

Source: http://www.nytimes.com

Topics: study, science, Nobel Prize, physiology, health, healthcare, brain, medicine

Android App That Helps The Deaf Have A Conversation On The Phone

Posted by Erica Bettencourt

Wed, Oct 01, 2014 @ 10:57 AM

By Federico Guerrini

RogerVoice phone app for deaf people1 940x380 resized 600

I just had a Skype chat with entrepreneur Olivier Jeannel about his new product. It was a text chat, as Olivier – just like roughly 70 million people in the world (of which approximately 26 million of Americans) – suffers from profound hearing loss. If he has his way, soon this is no longer going to be a problem. Together with his associate Sidney Burks and product manager Pablo Seuc-Rocher, he’s working on the launch of RogerVoice, an Android app that has been designed from the ground up for those who cannot hear on the phone.

With RogerVoice, the deaf or hard-of-hearing person starts a call and receives on his smartphone instant live transcriptions of what the other speaker is saying, regardless if he is speaking in English or another of the many other languages recognized by the system (Spanish, Portuguese, French, Italian, German, Greek and Japanese top the list).

While the idea, generally speaking, is brilliant, there are still some hurdles to overcome. Automatic speech recognition (ASR) technology is still far from flawless; also, unlike other softwares (Dragon and friends) that can be trained to recognize a single voice, improving this way the recognition rate, RogerVoice has to work with any kind of voice, so don’t imagine you can have a long, complex conversation without any trouble.

“You might use it to confirm an appointment with a doctor – Olivier says – or tell a plumber to come”. Basic stuff, but enough to significantly improve the quality of life of a deaf person, allowing he or she to rely less on other people’s intervention. It’s also up to the hearing person to make a better effort to enunciate, to help the voice recognition software’s performance. So you could in fact have a long and articulate conversation, provided that the counterpart is a relative, a friend, or someone that’s kind enough not to speak in a rush.

I asked Jeannel if – when the problem is not too severe – an hearing aid wouldn’t work as well, and the answer was quite interesting, because it pointed to the social implications of suffering from hearing loss.

“The interesting fact is – he says – that most deaf people don’t wear hearing aids, only 1 in 5 apparently bother to get equipped. This is because wearing hearing aids is often associated to a kind of social stigma. Also, of the profoundly deaf population, most manage to speak, but understanding a conversation without visual cues is difficult, if not impossible. In my case, impossible without lip-reading. More and more profoundly deaf use cochlear implants, which is a revolution: it helps a lot to understand speech, but it’s still quite difficult over a phone”.

The app is designed to be Bluetooth compatible, meaning that the RogerVoice app could connect directly to a Bluetooth-equipped hearing aid for a better listening experience and, after the launch of the Android version, the team will start working on the iOS and Windows ones.

The business model will be based on subscriptions, with one year of unlimited calls priced at $59 for those that will contribute to the Kickstarter campaign that’s currently running to support the product’s development. As for the time to market, if the $20,000 is reached on Kickstarter, founder hope to release the product by the end of the year. “Hopefully for Christmas – Jeannel says”.

Source: http://www.forbes.com

Topics: deaf, hearing, hearing loss, voice, technology, medical, patients, app

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