“so what’s with you guys removing all the ‘a’s from the English language?”

There was banter, bonhomie and bonding. There was even time to ask about the correct way to take high tea (at 3pm, with crustless cucumber sandwiches, Earl Grey leaves, and raspberry-laden scones). And then the patient cases started to come.

We know that SERMO is the number one social network for physicians in the US precisely because it allows doctors to be themselves. As Oscar Wilde wrote, “Be yourself, everyone else is taken” and such words of wisdom prevail every day within SERMO. In the first few weeks we have seen 11 percent of the medical community of the UK become members already; like their US counterparts, British doctors are keen to talk. Dialect, colloquialisms, healthcare organizations may differ between regions but the practice of medicine itself still has a common language. We saw one discussion thread where language differences were a barrier (French-English), but once the medical acronyms, lab tests and scientific procedures were detailed, members flocked to help, galvanized by the common medical cause; HCV, HbA1, ECG etc is global terminology – common talk for SERMO members.

Which is why we are excited about what’s now and what’s next. Already we are seeing the power of medical crowdsourcing provide solutions, irregardless of the origin of posting. And the humour segues to humility of physicians diligently transforming real world medicine together. Or should that be humor?

Coming soon on SERMO:

— The UK election; what do the political parties claim as part of their manifesto healthcare promises?

— Different guidelines, same patient: what experience would they have in the UK versus the US?

— Medicine – with an American accent or the Queen’s English; the differences, the similarities

If you’re an M.D. or D.O. in the US or UK, please join us inside SERMO.

The post SERMO: to talk or not to talk, that is the question appeared first on Sermo.

Perhaps you saw the Facebook request at the top of your screen this morning asking you to help Ebola?  Or maybe you read the news yesterday about Google now paying for pricey genetic testing for employees and their families who face cancer?

The fact is cash-rich companies have the power to affect real change and they are doing it increasingly in the field of medicine.  Beyond tech-heavy body trackers and health oriented software programs what does this mean for healthcare?

Google To Pay for Cancer Testing

FoundationMedicine, a company that does genetic testing to pinpoint the best cancer treatment options for patients announced a partnership with Google yesterday.  They will cover the cost of testing for any Google employee or family member who needs it.  The two tests the company offers are $5,800 and $7,200 a piece so this isn’t a light commitment.

By mapping the genome of cancer cells, scientists can cross-check against a database of successful treatment options and give an oncologist a more accurate picture of which treatments will be effective.

Facebook Fights Ebola

Facebook currently features a prominent box in your stream asking if you’d like to help fight Ebola, with a click through button to donate immediately.  Donors can choose from three charities, the International Medical Corps, the International Federation of the Red Cross and Red Crescent Societies and Save the Children.  The plea will be shown to 1.2 Billion people in hopes a big cash influx will help curb the epidemic.

Facebook has done this before raising $486 million for disaster relief after the earthquake in Haiti and $88 million to aid victims of Typhoon Haiyan.

Mark Zuckerberg, founder of Facebook, also said they will provide free internet access in Sierra Leone, Liberia and Guinea to help with the relief efforts.  Having reliable wifi connection will enable relief workers to coordinate better, distribute supplies, and help the sick.  As the countries recover from the outbreak, it will allow a better flow of communication will have an impact on their economies and culture for decades.

Zuckerburg Personally Responds to a Troll

A few critics of Zuckerberg’s Ebola campaign have criticized him for being opportunistic and simply marketing.  He responded to one troll yesterday.  What do you think of his response?

Zuckerberg responds to troll on Ebola

We have a proposal for Mr. Zuckerberg; our patient case software allows doctors to upload patient information under HIPAA guidelines to allow physicians to collaborate on diagnoses and treatment options.  We currently work with Floating Doctors in remote areas of Panama, and we’d be happy to extend our expertise to health care workers on the ground in Africa.  We also have an Infectious Disease Hub, which brings together physicians to discuss Ebola and other infectious diseases.  Seriously … call us.

As a physician what do you think about tech companies helping out in the medical space?  Do you think their abundant resources are being put to good use?  Do you think there is any marketing upside to charitable work?  We will be discussing this inside Sermo if you’re an M.D. or D.O., please join us in our community.

The post Tech Titans Wade Deeper Into Medicine appeared first on Sermo.

More than 75 percent of the adult population in the U.S. uses a smartphone. Researchers across the globe are finding innovative ways to utilize this technology for more than just posting pictures online and getting a high score on Candy Crush.

Researchers in Switzerland have developed a device that allows patients to self-monitor when undergoing anticoagulant therapy. This is just one of many technological advances demonstrating how we can use smartphones in healthcare.

Smartphone performs blood tests

Blood clots can lead to increased risk of heart attack and stroke. Those with a high risk of blood clots often use anti-coagulants for treatment. However, this requires patients to visit a hospital frequently in order for healthcare professionals to monitor their blood flow.

The device created by researchers in Qloudlab aims to eliminate the need for such visits.

A small single-use film, only a few micrometers thick, is attached to the screen of a smartphone. When blood enters the film through capillary action, it detects if the molecule that initiates coagulation is in the blood.

The phone then interprets the results by analyzing electric interferences on the surface of the screen. The results are sent to a specific app, also designed by Qloudlab.

This data can be sent directly to a doctor, who determines whether or not to alter a patient’s treatment.

Qloudlab is awaiting a patent for the device, but hopes they’ll be able to move toward commercialization by the end of the year.

Smartphone App for Automatic Gait Assessment

University of Illinois researchers have developed a smartphone app that could eventually replace the “six-minute walk test” performed in specialized clinics. A person’s gait can be an indication of an underlying disease, but the walk test is done so rarely it’s can’t effectively detect new or worsening conditions.

The GaitTrack app can run the walk test continuously as long as the patient is carrying the phone. It periodically collects and analyzes the data, alerting the patient or patient’s doctor when it detects a change in the gait that could indicate a decline in health.

The app can record a person’s heart rate and blood oxygenation level, in addition to their gait, for a better picture of their overall health.

When testing the app on 30 COPD patients, researchers found that the app accurately predicted a person’s FEV1 test (Forced Expiratory Volume in 1 Second) used for pulmonary function testing.

Researchers are now testing the app in larger trials, and hope to have it available for downloading later this year.

Stroke App Aims to Improve Patient Care

Dr. Claude Nguyen of the University of Pennsylvania Perelman School of Medicine created another smartphone app. The app aims to provide more effective care for patients who have suffered from acute stroke.

A doctor can enter data about a patient, such as symptom onset time, demographics, and their score on the National Institutes of Health (NIH) Stroke Scale. The app can then relay the clinical trials for which the patient is eligible.

In addition, the app has a stopwatch feature to track and record treatment times, a phonebook for quick contact of study personnel, and access to inclusion and exclusion criteria for clinical trials.

Dr. Nguyen’s main goal is the app will help identify patients eligible for clinical trials, he considers that a vital step to finding better stroke treatment.

Do you foresee smartphones becoming more involved in medical treatment in the future? If you’re an M.D. or D.O. would you consider using smartphone apps for treating certain patients or conducting tests? Please join us inside Sermo to discuss further.

The post Use of Smartphones in Medicine appeared first on Sermo.

Fans of ABC’s hit show Dancing with the Stars watched Amy Purdy, a top ranked professional adaptive snowboarder who lost both legs at age 19 as a result of meningitis, dance this season. Viewers who were unfamiliar with Purdy when the show began watched her effortlessly glide across the dance floor unaware both of her legs were prosthetics.

The ability to perform flexible dance moves is thanks to the current design of prosthetics; advanced plastic and carbon fiber composites create a lighter, durable, and more realistic prosthetic. These prosthetics are dated compared to what scientists are working on today.

Modern Prosthetics

Each device is methodically constructed to fit a person’s specific dimensions and needs. Different types of prosthetics include:

1. Body powered: Prosthetics are attached to the body, either by strapping or suctioning, and the wearer learns to move with the prosthetic, using it in conjunction with their own body’s movements.
2. External Motors: The prosthetic device has its own power source and assists the patient’s movements.
3. Myoelectric: Using the remaining muscles surrounding the missing limb, the prosthetic controlled by contracting those muscles, sending electrical signals to move the device.

Bionic Limbs, Coming of Age

Targeted muscle reinnervation (TMR) is the newest technology in development for prosthetics on the market. Developed by Dr. Todd Kuiken at the Rehabilitation Institute of Chicago, the “bionic” device allows patients the ability to perform complex motions with their prosthetic limb just by thinking.

The procedure facilitates nerve regeneration after surgery around the injury. The brain sends signals to those nerves and stimulates movement. This procedure keeps the electric signals alive and rooted into the musculature around the injury, a completely fresh approach for prosthetics. A patient simply would send a signal through his body through the newly rerouted nerves causing a contraction.

The largest benefit from these “mind-reading” prosthetics is, according to the New England Journal of Medicine, reduced unnatural movements and errors, such as falling or user discomfort, by 44%.

What do you think about the development of prosthetics over the years? Have you worked with patients who used the newer prosthetics successfully? Please join us inside Sermo as we continue the conversation.

The post Bionic Prosthetics Are Nearly Mainstream appeared first on Sermo.

The National Cancer Institute estimates almost 3 million women are currently living with breast cancer in the United States. Approximately 12 percent of women will be diagnosed with breast cancer at some point in their lives.

Thanks to a new computer model, researchers at the Dana-Farber Institute hope to better predict tumor behavior and thus, the best treatment option available for each individual patient.

Research

The study analyzed data from pre- and post- treatment biopsies from 47 patients with breast cancer. They looked at how the tumors evolved at the molecular level as a result of chemotherapy treatment.

A tumor contains a mixture of various cancer cells which constantly change, called heterogeneity. There are two types:

• Phenotypic Heterogeneity – different sets of genes turn on and off within the cells
• Genetic Heterogeneity – cells contain different numbers of genes and chromosomes

The tumor cells’ heterogeneity and location of different types of cells within the tumor determine how the cancer evolves and how they react to treatment. In the past, cancer treatment has been complicated by these characteristics because small tissue samples may not be representative of the whole tumor, and a treatment that targets one tumor cell population may not be effective against another.

The Computer Model

The researchers integrated data on various traits of the individual tumor cells, as well as maps of where the cells were located within the tumors, in order to answer two questions:

1. How heterogeneity influences treatment outcomes
2. How treatment changes heterogeneity

The computer model found that genetic diversity within a tumor didn’t change much in cancers that had no or partial response to chemotherapy. In addition, the genetic diversity appears to directly relate to how tumors will respond to treatment. Those with lower genetic diversity are more likely to completely respond to treatment than those with high diversity.

Researchers also found that cells which are most likely to grow rapidly were more likely to be eliminated with treatment, and the model was also able to see how the locations of cell populations changed.

The Benefit

In the future, researchers expect the model to help determine how a tumor should be treated upon diagnosis, as well as help design further strategies if a tumor doesn’t respond to initial treatment. The measures of intratumor heterogeneity could also identify those at high risk of progression and occurrence.

Do you feel the computer model is applicable in treating cancerous tumors? If you have experience treating cancer, has a tumor’s heterogeneity ever been a factor in deciding treatment? If you’re a member of the Sermo community, please join us to discuss.

The post Computer Models Help Treat Diversity of Tumors appeared first on Sermo.

Researchers have recently taken adult stem cells in mice and reverted them back to the embryonic state.  This technique eliminates ethical issues and could potentially allow scientists and eventually physicians to create any cell needed to improve patient health.

Researchers have already used stems cells for regenerating skin and blood.  There has also been early lab work with cardiovascular diseases, and brain disorders.  Embryonic stem cells can be grown into any type of human cell.  Due to ethical consideration, most researchers have been working with induced pluripotent stem cells (iPS).  These adult cells are limited, however, as they can only grow into the type of cell from which they are harvested.

Imagine having your own stem cell bank

Imagine if disease strikes and you simply revert some healthy cells back to their embryonic state and then essentially grow replacement parts as needed?  There would be minimal concern about rejection from the body because you’re using your own cells.  Instead of waiting on a donor list, you’d be waiting for the lab to manufacture the tissue, perhaps on a 3D medical printer.

How it works

Brigham and Women researchers harvested mature blood cells from mice and exposed the cells to an acidic environment.  After a few days, the cells began to revert back to their embryonic stem cell state and grow in clusters.  They then removed the clusters and placed in different organs.

The investigators found that the cell clusters caused GFP+ tissues to grow in all organs of the mice that were tested. This confirmed that the cells were pluripotent.

When will stem cells be available for medical use?

Stem cells are already used with bone marrow transplants using a blood forming stem cell.  Just the cells that are needed are transported to the area in the marrow and the cells migrate, renew and rebuild the entire blood system.   There are also currently some applications for bone, skin and corneal injuries using stem cells from those organs.  The first phase 1 clinical trial has been authorized by the FDA for spinal cord injury.

In theory stem cell applications are limited only by the body tissue that needs repair.  Applications could apply to a wide array of diseases.  Having a reliable source of embryonic stem cells would be a boon to researchers and could potential help speed up therapies that are years, possibly decades away now.

As a physician are there any stem cell therapies that you are looking forward to?  We will be continuing the conversation inside Sermo.  If you’re an M.D. or D.O., we’d love to have you join us.

The post Embryonic Stem Cells Without the Embryo appeared first on Sermo.

What are companies actually creating with their 3D printers?  What will be their impact on improving healthcare and patient outcomes?

Skin
The University of Liverpool is currently developing synthetic skin, where through 3D camera technology and image processing, they hope can replicate a person’s real skin so that it appears natural, regardless of age, gender, or skin color.  Meanwhile, scientists from the Laser Center Hannover in Germany utilized laser printing to create a skin substitute.  The challenges with creating skin for patients such as burn victims is how to engineer the skin tissue so that it can mimic real skin and appear as it would in real life, with wrinkles, freckles, and other types of blemishes.

Organs
Organovo, a San Diego-based company, is one of the leading innovators of tissue engineering.  In January 2014, they announced that they had delivered their first 3D Liver tissue through their 3D bioprinting technology.  Later in 2014, they plan to release additional data regarding their 3D Kidney tissues and breast cancer tissues, currently in development.  What their achievement signifies is that in the future, patients may not have to rely on long donor waiting lists for an organ transplant; an organ specific to a patient can be created.

Germany-based Fraunhofer Institute developed a method of creating artificial blood vessels from a 3D printer.  The blood vessels were created from a composite of biomolecules and synthetic polymers.  Currently, they’re not suitable for human transplantation yet, but this is the beginning of what can be created to solve vascular issues in the future.

Bones and Skulls
Bonus Biogroup, an Israeli biotechnology company, has developed an innovative technology to manufacture human bones, where the regenerated bones would then be used in orthopedic and dental bone transplantations.  The process begins by extracting live fat from the patient through liposuction.  Mesenchymal cells are produced from the fat tissue.  A scaffolding of the patient’s bone, created with a 3D printer, is then seeded with the stem cells, and allowed to grow under laboratory conditions outside of the body.  When the bone is ready, it is transplanted into the body.  Using this technology, the company plans to develop joint replacements in the future.

Alternatively, Oxford Performance Materials, a company from South Windsor, CT, is manufacturing medical devices and implants not with human cells, but by creating implant parts with PEKK polymer.  In 2013, their OsteoFab™ Patient Specific Cranial Device (OPSCD) was approved by the FDA for cranial implantation.  “FDA clearance of this device marks the first approval for an additively manufactured polymer implant.”  The company hopes to move beyond the cranium, developing processes for bones from other parts of the anatomy.

Are you excited about the promising usage of 3D printing in medicine?  What other medical advances are taking advantage of the 3D printing technology?  How will this impact patient care?  What are the unforeseen ethical, political, and moral challenges of growing human parts?  We will be discussing this more inside Sermo, please join us if you’re an M.D. or D.O.

The post 3D Printing: What does it mean for the future of medicine? appeared first on Sermo.

The contact lens is embedded with sensors that are able to detect glucose levels in tears, as often as once per second. The creators are also thinking about adding a tiny LED light that will alert the wearer when glucose levels are too high or too low.

This may sound like crazy science fiction, but the idea has actually been around for a few years. According to The Verge, one of the co-creators, Babek Parviz, envisioned a contact lens that could track several vital signs back in 2009 and the University of Washington, backed by Microsoft, had a similar idea in 2011.

The tiny wireless chip and glucose sensor are embedded between two layers of soft contact lens material so it’s noticeable to the wearer. Google said they were in discussions with the FDA to explore how to bring the device to market and they have “multiple clinical research studies” to refine their prototype. There is no word on when this device will hit the market.

Medical body trackers

Body trackers have become all the rage in the past few months. Amazon reported that Fitbit, a device that tracks sleep patterns and counts steps, was their top selling fitness item. There are even devices for tracking sleeping infants. Expanding body trackers to also include a strong clinical focus opens up the door for many options. Perhaps a more sensitive cardiac tracking device? How about improved wearable tech for tracking Alzheimer patients if they wander off? There is even an app used by the MIT Media Lab that can tell, before the user, when they are coming down with flu-like symptoms.

What do you think of this cutting edge technology that might be part of a doctor’s arsenal in coming years? Do you think body trackers, in general, have a place in medicine? If you’re an M.D. or D.O., we’ll be discussing this in more detail inside Sermo. Please come join us.

The post Contact Lens Tracks Glucose Levels: Diabetes Breakthrough appeared first on Sermo.

Have you ever been asked to rate your level of pain on a scale from 1 to 10? As a person’s pain level is completely subjective, it can be confusing and difficult to gauge where you fit on that scale. If the worst injury you’ve had is a minor, how do you know what a “10” feels like?

Researchers at Stanford University are hoping their findings will allow patients and doctors to have a more objective way of evaluating pain, enabling better and more efficient treatment.

Current Situation

Right now, there is no method in place to objectively measure pain intensity. Physicians have to rely on patients verbalizing their pain level and pain location, which can be especially difficult if the patient is unable or unwilling to communicate effectively.

However, past studies have proven a connection between pain and a protein called a sodium channel. Sodium channels help nerve cells transmit pain and other sensations to the brain, and are overproduced at the site of an injury.

Seeing Pain

In a study published in the Journal of the American Chemical Society, scientists say they’ve developed a new technique using sodium channels that could help doctors pinpoint the location of pain, as well as find better ways to relieve pain and track the healing process.

Researchers attached a signal to saxitoxin, a small molecule produced by certain types of microscopic marine life, and administered it to injured rats. They were then able to track the molecule’s process through the body using PET imaging.

Results showed that the saxitoxin molecules pooled at the sites where rats had nerve damage, thereby marking where the sodium channels were located.

Researchers are hoping this technology can be used in the future to monitor changes of the sodium channels that occur as a part of wound healing and/or drug treatment.

How do you feel about current processes for monitoring and tracking pain? Do you think the subjectivity surrounding pain assessments results in ineffective treatment plans or misdiagnoses? We will be continuing this conversation inside our online physician community, if you’re an M.D. or D.O., please join us.

The post Seeing Pain? New Technique Sheds Light appeared first on Sermo.

If you’ve ever had to deal with someone who has “difficult” veins, you know that a simple act like drawing blood can turn into quite an ordeal. Patients sometimes need to be stuck with a needle multiple times before an adequate vein is found, and when small children are involved, the results can be downright traumatic.

However, a study conducted by Mercy Hospital Oklahoma City shows that with the use of vein-detecting devices this problem can be alleviated.

VeinViewer Study

The VeinViewer is one such product that uses near-infrared light to illuminate veins under a patient’s skin to help medical professionals improve surface vein access. It projects the image directly onto the surface of the skin in real time.

Mercy Hospital Oklahoma City analyzed 210 patients in the center’s Neonatal Intensive Care Unit (NICU) to evaluate the impact of the VeinViewer on unnecessary PICC replacements and the number of attempts to insert peripheral intravenous (PIV) catheters.

Prior to the study, the NICU department recorded an average of 5.2 IV sticks per child, with some even in double-digit attempts. The number of unnecessary PICCs was one for every 13 patients.

After using the VeinViewer, the number of IV sticks per child dropped to 3.1, and the number of unnecessary PICCs decreased to one for every 25 patients.

Other similar devices include the AccuVein AV400 which also produces a vasculature map on the surface of the skin, and the Veinlite, which produces a ring of bright light that illuminates the superficial tissues inside the ring. The veins show as dark lines within the illuminated area.

Patient Satisfaction and the Afforable Care Act

With the implementation of the Affordable Care Act, medical professionals have even more incentive to use devices that improve patient care. One provision of the Affordable Care Act ties patient satisfaction to hospital reimbursement and vein-viewing devices like those above are helping to win praise from patients.

The new rule mandates that Medicare reward hospitals with the highest patient satisfaction through an initiative called the Hospital Value-Based Purchasing Program. Although patients aren’t directly asked about IV placement or sticks, they are asked about pain control and their overall satisfaction with care received.

The VeinViewer and similar devices seem to be gaining ground in the hospital setting. Revenue at Christie Medical Holdings, owner of the VeinViewer, gained 65 percent in 2012 compared to the previous year.

Value-Based Purchasing

Companies selling devices that increase satisfaction and efficiency in health care can likely expect continued growth in the future as well.

Value-based purchasing more actively engages health care purchasers in the purchasing process. Instead of simply writing checks, purchasers are now attempting to measure, monitor, and improve the quality for every dollar spent. Devices that increase patient satisfaction are a large component of this.

Do you have any experience using the VeinViewer or having it used on you? Do you feel it improves patient satisfaction? If you’re an M.D. or D.O., please join us inside Sermo for further discussion.

The post Improving Patient Satisfactions When Needles Are Involved appeared first on Sermo.