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Showing posts with label Medical Science. Show all posts
Showing posts with label Medical Science. Show all posts

Monday, 18 November 2019

New device allows dressing to be applied directly to wounds

Placing bandages or bandages directly on a wound may be difficult in some medical emergencies. The staff must handle the bandages carefully to preserve both sterility and integrity. To get around this problem, a team of bioengineers has developed a portable electrospinning device that, like a spray of paint, can spray a medical dressing directly onto a wound.

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With this new technology, medical personnel can fabricate a dressing with drug delivery capabilities directly to a wound. Electrospinning is a method of developing polymer fibers for a wide variety of applications. If biocompatible materials are used, the fibers produced can be used for biomedical applications.

However, electrospinning requires very high voltages, which makes it dangerous to deposit fiber directly on biological material because of the risk of electrocution it creates.

A group of researchers at Montana Technological University has developed a portable electrospinning device with a confined electric field that can safely deposit bandages and drugs directly onto biological surfaces. The team described the instrument in the journal Journal of Vacuum Science & Technology B .

Spray dressings on the wound like a paint spray

Instead of using the difference in tension between the tool and a surface to deposit the fibers, the new device uses air to spray the fibers on the surface, in the manner of a spray paint. " In spray painting, the pressurized gas forces the particles to go to a surface, creating a kind of deposited material, " said Lane Huston, engineer at Montana Tech.

Demonstration of the dressing projection on a gloved hand, 1 min after projection (A) and 3 min after (B). Credits: Lane G. Huston et al. 2019

As with spray painting, the EStAD device is used by directing its nozzle on the desired surface during operation, which causes the deposition of a mat of fibers on this surface ."

By applying this mechanism similar to aerosol paint, the device can be used to cover wounds and allow controlled release of the drug over time. The deposited fibers adhere to materials containing internal moisture, such as human skin.

The researchers tested the dressing projection on pork skin (top) and on fruits (bottom). Fibers adhere to many types of surfaces. Credits: Lane G. Huston et al. 2019

Although the use of electrospun fibers for effective drug delivery has been established in the past, the foregoing methods required that a wound be placed directly in the path of the electric field. In this configuration, the only safe option is to pre-deposit fibers on a surface, such as parchment paper, to collect them and store them for later use.

Assist medical staff in areas inaccessible to emergency care

The device was tested on a pork skin incision as well as on a gloved human hand. This is the first demonstration of safely depositing fibers delivering the drug directly to the wound site.

The authors hope that this new technology will be used to help doctors, first responders and medical staff treat wounds in rural areas, where immediate medical care may not be readily available.

" The bandage, as well as the drug used, can be chosen on demand if the situation warrants it, thus allowing for modular and adaptable treatment of the accessible drug in isolated areas " Huston. Although the direct deposit method is its preferred application, the researchers' new device can also be used as a traditional table electrospinning device.


 Article: Combined electrostatic and air driven electrospinning for biomedical applications featured

Journal of Vacuum Science & Technology B 37, 062002 (2019);

Lane G. Hustona), Emily A. Kooistra-Manning,  Jack L. Skinner, and Jessica M. Andriolo


Sunday, 17 November 2019

The glowing iris of a patient reveals a severe form of a rare eye syndrome

The human optical system is a complex arrangement of several anatomical components working in concert, and the pathological disorders of which it can be reached are equally complex in their turn. This is particularly the case of a rare disease, the syndrome of dispersion of pigments, which causes a depigmentation of the iris and its transillumination. In other words, exposed to light, the iris glows in a singular way. Recently, a team of doctors described the case of a particularly severe form of this syndrome.

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According to the doctors' analysis, this strange appearance turned out to be the sign of a rare disorder that caused the disappearance of the pigmentation of the eye. The 44-year-old man went to a clinic after moving to a new area to get an appointment with an ophthalmologist.

He said he has a family history of glaucoma, an eye disease that can damage the optic nerve, the bundle of nerve fibers that connects the back of the eye to the brain. This damage is usually caused by increased eye pressure. Indeed, according to the authors of the article published in The New England Journal of Medicine , the man had already been diagnosed with high eye pressure and was taking medication to reduce it.

Pigment dispersion syndrome: transillumination of the iris

Nevertheless, tests revealed that the pressure in his eye was very slightly higher than normal. In addition, when the doctor performed an eye examination using a microscope and a bright light, the evaluation revealed "transillumination of the iris" in both eyes of the patient. In other words, the light shone through the iris. This occurs when sections of pigment are missing at the iris, allowing the light to pass through.

In pigment dispersion syndrome, pigment agglomerates separate from the iris, allowing light to pass through and be reflected in the background. Credits: OPTH

Doctors have diagnosed in humans a syndrome of dispersion of pigments. According to this eye condition, the pigment is detached from the back of the iris. These pigment clumps can clog the drainage system of the eye, causing an increase in eye pressure, which can lead to glaucoma. Pigment dispersion syndrome is rare, although it is more commonly diagnosed in men aged 20 to 30 and may have a genetic component.

In this case, the man was laser treated to open the drainage channels of the blocked eyes. This therapy helps liquids to flow out of the eye and reduces eye pressure. However, patients often need to continue taking pressure-reducing eye medication after surgery, as was the case for this patient.


Friday, 15 November 2019

Artificial intelligence can predict the risk of death in the short term, and researchers are confused about how it works

Artificial intelligence can predict the risk of an individual's short-term death (during the year) by examining the results of his or her heart tests, which sometimes may seem "normal" to doctors. Scientists currently do not know exactly how this AI works to achieve this.

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Brandon Fornwalt, from health care provider Geisinger in Pennsylvania (US) and colleagues, asked artificial intelligence to examine some 1.77 million ECG results from nearly 400,000 people , in order to predict which would be at higher risk of death in the next year.

As a first step, you should know that an ECG records the electrical activity of the heart: it changes in case of heart disease, including before or after heart attacks, in people with atrial fibrillation (a disorder of rhythm cardiac) or other diseases.

The team created two versions of the AI. A first whose algorithm only received the raw ECG data (which reveals the electrical activity over time). And a second who received the ECG data combined with the age and sex of the patients.

The researchers then measured the performance of the AI ​​using a metric called AUC, which defines to what extent a model distinguishes two groups of people: in this case, the patients who died during the year and those who survived ... The AI ​​consistently scored above 0.85 (the perfect score being 1, and a score of 0.5 would not distinguish between the two groups). " The AUCs for the risk rating models currently used by physicians range from 0.65 to 0.8,  " explains Fornwalt.

For comparison, the researchers also created an algorithm based on ECG features currently measured by physicians, such as certain record regularities. " Anyway, the stress-based model has always been better than any model we can build from features we already measure from an ECG, " says Fornwalt.

AI has accurately predicted the risk of death, even among those considered by cardiologists to have a normal ECG result. The three cardiologists who examined the normal-looking ECGs separately were not able to detect the risk profiles identified by the AI.

This discovery suggests that the AI ​​identifies risks that doctors probably can not see, or at least they ignore and think normal,  " says Fornwalt. " Artificial intelligence can potentially teach us things that we may have misunderstood for decades, " he added.

At present, we still do not know which specific patterns are detected by the AI, which makes some doctors reluctant to use such algorithms. "  This research is based on historical data, and it will be important to demonstrate in clinical studies that such an algorithm improves outcomes for patients,  " says Christopher Haggerty, a Fornwalt collaborator.

Two studies on the performance of this new AI will be presented tomorrow, November 16, 2019, at the American Heart Association's Scientific Sessions.


Tuesday, 12 November 2019

Virologists discover a new strain of HIV

One of the major obstacles in the fight against HIV is the extremely high mutation rate of the virus. This is why virologists are striving to detect and study new strains of the virus in order to better understand it and develop more effective treatments; the ultimate goal being the production of a vaccine. Recently, a team of virologists discovered a new strain of HIV through improved sequencing techniques. Results that should provide a more detailed description of the virus and its mechanisms.

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The researchers identified a new sub-group of the human immunodeficiency virus (HIV) for the first time in nearly two decades. The discovery comes from samples taken in the last 30 years in the Democratic Republic of Congo.

As reported in the Journal of Acquired Immune Deficiency Syndrome , the new strain is the L subtype of the HIV-1 M group . Its existence has long been suspected, since two samples were studied, one taken in 1983 and the other in 1990.

Improved sequencing techniques for identifying new viral strains

To confirm the existence of a new strain, it is necessary to obtain three independent samples. A sample taken in 2001 had promising similarities, but it was difficult to sequence completely. But technological improvements in recent years have allowed researchers to obtain complete genomes faster and from smaller samples. This eventually allowed this team to check whether the 2001 sample was really evidence of a new strain.

The new strain of HIV (red) discovered by virologists will help to better understand the virus and its mechanisms. Credits: Yamaguchi J. et al. 2019

" Identifying new viruses like this is like looking for a needle in a haystack. By advancing our techniques and using next-generation sequencing technology, we 'remove the needle with a magnet'. We are making this new strain available to the research community to assess its impact on diagnostic tests, treatments and potential vaccines, "said Mary Rodgers, head of Abbott's global viral surveillance program.

The discovery of new strains is crucial in the fight against viruses. The new strains give viruses the ability to avoid detection during testing, to be resistant to current treatments, and to be another barrier to the difficult path to vaccine.

" This discovery reminds us that in order to end the HIV pandemic, we must continue to explore this evolving virus in greater depth and use the latest advances in technology and resources to monitor its evolution, " says Carole McArthur. from the University of Missouri, Kansas.


Monday, 11 November 2019

The cerebrospinal fluid flows in waves across the brain and seems to "cleanse" it during sleep

Cerebrospinal fluid (CSF) is a biological fluid contained in the meninges and in which the brain and spinal cord swim. It helps to absorb the physical shocks to which the brain can be subjected, and also to eliminate molecules and other physiological waste. For the first time, neurobiologists have seen how LCS flows in waves through the brain during sleep. Observations that could lead to a better understanding of certain neurological disorders.

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This latest study shows waves of cerebrospinal fluid (CSF), pulsating rhythmically during sleep, while eliminating the toxins accumulated during the day. The team explains that these findings could help in the study of various neurological and psychological disorders, particularly those associated with sleep disorders. The study was published in the journal Science .

" We have known for a long time that there are electrical waves of activity in neurons. But so far, we have not realized that there are really waves in the LCS,  "says neuroscientist Laura Lewis of Boston University.

The pulsatile rhythm of the cerebrospinal fluid

Previous studies have suggested that LCS is important for the elimination of brain toxins, but so far neuroscientists have not known or been able to observe this pulsating action. Combined with slow-wave brain activity (which partly serves to fix our memories) and the decreased blood flow that occurs during sleep, these CSF waves seem to eliminate unnecessary protein.

Graph showing a rise in the frequency of CSF waves during sleep (blue zone) compared to the waking state (pink zone). The data was obtained by fMRI. Credits: Nina E. Fultz et al. 2019

As the slow frequency of brain waves declines as we get older, the new study may help research into normal age-related problems as well as specific disorders. The researchers' work also means that it is now possible to know if a person is sleeping or not, simply by analyzing the LCS patterns on a brain scan.

Better understand the synchronization of physiological processes during sleep

For the purpose of the study, 13 subjects aged 23 to 33 years were followed during their sleep during an MRI. Future research could also focus on older subjects - again to try to detect the deterioration of the process as we get older. The researchers suggest that another improvement in follow-up studies might be finding ways to eliminate MRI: the noise it generates is not very conducive to sleep.

It remains to be seen how the LCS, brain waves and blood flow synchronize so effectively. It may be that when neurons are inhibited for the night, they do not need a lot of blood - and as the blood flows, the pressure in the brain is maintained by the influx of LCS.

Video showing the pulsatile flow of the LCS: