Reducing falls in elders via treadmill training plus virtual reality

Omnidirectional treadmill immersive simulator

Omnidirectional treadmill immersive simulator (Photo credit: Wikipedia)

Over a period of two-plus years researchers tested two groups of older people (60-90 years) who’d experienced at least two falls prior to the start of the study, according to a recent Lancet article. One group received treadmill training only, three times each week. The other group received the same treadmill training but with an added component of virtual reality (VR) – audio/visual presentation of winding pathways, obstacles and other challenges that required the participant to pay careful attention.

Results showed dramatic improvement in the rate of falls in the months after the experimental training among those in the treadmill-plus-VR as opposed to a virtually unchanged rate of falls among those who had treadmill-only training.

So, it appears that having to navigate trails and overcome obstacles makes the mind-body unit more responsive to its surroundings – thus providing greater stability and protection for future ventures.

Who pays for medical breakthroughs?

So cool the discoveries/breakthroughs that are being made in medicine today. Who knows how many of us will die just before they invent the drug or procedure or protocol that will save the life of someone with the same condition ten years later? But how do we finance these breakthroughs?
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Besides the issue of getting new treatments through the R&D and approval process, there’s always the question of who will be willing to pick up the tab for them. As the U.S. moves to significantly reduce healthcare costs, everyone is worried that “the scientific trajectory towards more personalized treatments will be squelched by the countervailing pressure to pay only for treatments deemed most effective in large populations of patients.” How do insurance coverage decisions affect changes in the R&D and investment process? What influence can patient groups have on setting priorities in the research that may pit comparative treatment effectiveness against personalized medicine?
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Video: Plenary – Who will pay for tomorrow’s medical breakthroughs?  If you haven’t got a whole hour to listen, the segment from marker 30:00 to 51:16 covers a good amount of information.

 

More biomarkers making diagnostics better

The first time you learn about a biomarker being able to diagnose a condition, you hope it’s not you, getting diagnosed with congestive heart failure. If your doctor finds elevated levels of B-type natriuretic peptide (BNP) in a blood test, she knows immediately to suspect heart failure.

Researchers are now discovering more biomarkers to help diagnose and manage a variety of conditions. Mild traumatic brain injury (mTBI) or concussion, for instance, can be easily confused with potentially passing phenomena such as intoxication or delirium, according to an article online in MedPage Today. But mTBI and concussion require urgent and decisive care. A new study has found that two biomarkers can be measured in order to differentiate mTBI or concussion from other conditions and thus signal doctors to institute appropriate treatment.

In a study of patients treated at a level 1 trauma center, glial fibrillary acidic protein (GFAP) beat out ubiquitin C-terminal hydrolase L1 (UCH-L1) for detecting TBI, CT lesions, and neurosurgical intervention…reported online in JAMA Neurology.

Now they’re studying how quickly a marker can be detected and over how long a period it can be used so they can tell how accurately these biomarkers will allow doctors to gauge an injury.

Non-invasive. Always good news.

Save the date – Biotech & law conference May 5-7, 2016

The first annual Biotech & the Law Global Conference, May 5-7, 2016, takes place this year at the Monona Terrace Conference Center in Madison, Wisconsin. The conference constitutes an international gathering of biotech researchers, lawyers, and business leaders coming together to network across disciplines and make new professional connections.

Wisconsin, claiming a history of biotech innovation that reaches back more than a century, offers a unique culture of public-private tech transfer that supports over 1600 businesses and earns the state the moniker, “Biotech’s Third Coast.”

The conference presents a unique opportunity for professionals to earn continuing education and take advantage of the resources of Madison’s academic and business communities, including the University of Wisconsin-Madison, the Morgridge Institute for Discovery, and a host of private and public interests in the health care, agriculture, and environmental science fields.

Registration is now open for Biotech & the Law on the conference website.

Related articles

Marker in cells mutated back to stem-cell-state may be able to predict cancer

English: Pathway of stem cell differentiation

English: Pathway of stem cell differentiation (Photo credit: Wikipedia)

News of a marker that may serve as a way to predict which cells will become cancer comes out of a recent study by researchers at Boston Children’s Hospital. Scientists were able to isolate a substance that appeared in a cell that had reverted to its stem-cell-state and then became cancerous in zebrafish that subsequently developed melanoma.

“The spark for that change was in the crestin gene, which should only be active in embryonic tissue but became inappropriately activated again, resulting in melanoma,” according to the article online at www.newvision.co.ug/. One of the authors of the study said “the beginning of cancer occurs after activation of an oncogene or loss of a tumor suppressor, and involves a change that takes a single cell back to a stem cell state.”

Now a fish is not a human being, so this information is a long way from having practical application in your doctor’s office. But the principle behind this discovery will guide further research and additional hoped-for developments.

Non-depressed heart failure patients have 80% lower risk of early death

Millions of Americans suffer from heart failure, and it’s the leading cause of hospitalization for people over 65. It comes in four stages, from mild to severe, and is a progressive and always eventually fatal disease. But the course of the disease can be profoundly affected by other factors.

In an ongoing study of heart failure patients, after adjusting for factors such as sex, age, hypertension, severity of heart failure, and comorbidities, moderate to severe depression remained a predicting factor for all-cause mortality for heart failure patients. In other words, if you’re depressed and have heart failure, you’re five times more likely to die an early death than a similar patient who isn’t depressed.

Now, add that fact to this one: heart failure patients who exercise more have fewer hospitalizations and better outcomes on all scores. Another recent study examined how levels of social support and barriers to exercise affected heart failure patients’ willingness to keep up with exercise programs. Not surprisingly, when patients completed surveys about the types of support they received and their barriers to exercise, those who had worse situations in regard to finances, weather, transportation, and/or childcare had less success in adhering to exercise regimens. And those with reduced barriers did, in fact, exercise more and have better outcomes.

Medical experts can only surmise why exercise helps depression, but there’s clear evidence that it does. So, what is the cost of having millions of heart failure patients regularly re-hospitalized versus helping reduce those social barriers and giving them the chance to experience longer and better-quality lives?

Sausages made with berries

English: Schwartz's smoked meat medium fat Mon...

English: Schwartz’s smoked meat medium fat Montreal Quebec 2010 (Photo credit: Wikipedia)

Remember when scientists first discovered “antioxidants” back in the 1990s? These molecules began to be touted as miracle-workers, and food and drink purveyors took off in hot pursuit of profits. But since then, further sober consideration has heated up the debate as to how beneficial they are. Read this from Harvard Health about the true value of antioxidants for good health.

Meanwhile, researchers at Lund University in Sweden, the Swedish University of Agricultural Sciences (SLU) and four other European research institutions have launched a joint project to create a way to produce sausages and smoked meats made with antioxidants extracted from berries. The ultimate aim is to reduce the risk of colon cancer, one of the most common cancers in Sweden.

World Health Organisation (WHO) recently classified smoked and processed meat products as Group 1 carcinogens, the same group that includes tobacco products and alcohol. Hmmm. So, are all those Italian eating the Mediterranean diet—which includes generous portions of sausages and smoked “salumi“—quaking in their boots? Unlikely, since their way or eating has long been considered the gold standard of diets for long life.

Simply explained, the project involves extracting antioxidants from plants and berries, and then prepare [sic] meat products with these antioxidants. Animal testing will afterwards show whether this reduces the occurrence of cancer or not.

The question is, can extracted isolated antioxidants have the same effects as the complete “package of antioxidants, minerals, fiber, and other substances found naturally in fruits, vegetables, and whole grains” that are known to help prevent a variety of chronic diseases? Research in this area has generally come up empty. It’ll be interesting to see where this one goes.

Patient satisfaction surveys barking up the wrong tree?

Trying to achieve perfect customer satisfaction is not only nearly impossible in most businesses, but is often found to be, including in the case of medical care, completely the wrong approach to improving quality. Quality measurement is more readily applied to easily tracked process measures, like using checklists and giving discharge instructions. But improvements here don’t necessarily lead to improvements in patient outcomes, according to a recent Modern Healthcare article.

Getting medical staff to complete checklists of action items doesn’t focus on the real goals–lower mortality and lower readmission rates–and can lead to unintended consequences like acceding to a patient’s demand for medically unnecessary care.

Someone wrote once that traditional businesses ought to have a dissatisfaction rate of at least ten percent. If not, they were focusing too much on trying to please everyone, rather than doing the best possible job for the greatest number of customers. iSixSigma writes here about the pitfalls of relying too heavily on customer satisfaction surveys.

“The squeaky wheel gets the grease,” and other such aphorisms may apply just as well for medical care issues as they do for other businesses.

New microneedle biosensor detects nitric oxide during cancer diagnosis

"Cancer - Early Diagnosis Would Save 50,0...

“Cancer – Early Diagnosis Would Save 50,000 Lives Every Year” – NARA – 514027 (Photo credit: Wikipedia)

Nitric oxide NO) plays a variety of complex roles in the genesis, growth and death of cancer cells/tumors. As it does in so many physiological processes, it exhibits both pro- and anti-tumor activities, and researchers are still discussing the implications of these data on the use of NO as a therapeutic agent for the treatment of cancer.

A recent study takes advantage of NO activity to make diagnosing cancer more certain. A novel microneedle biosensor electrically detects NO emissions from cancer tissues in real-time for in situ cancer diagnosis during endomicroscopy. Researchers showed that using this as a dual diagnostic system yields high resolution imaging and provides a new way to easily, quickly and accurately diagnose cancers.

Nitric oxide once again takes a starring role in science’s efforts to understand how the human body works.

Plant-based nanofibers don’t harm lungs – unlike carbon nanotubes

nanofiber

nanofiber (Photo credit: Wikipedia)

Plant-based cellulose nanofibers, as opposed to carbon nanotubes suitable for similar purposes, don’t pose a short-term danger to human lungs, particularly when the fibers are very short. So says a study done as part of National Research Programme “Opportunities and Risks of Nanomaterials” (NRP 64).

Rather than experimenting on animals, researchers used human lung tissue in test tubes to develop a simulated 3D lung system that mimics human lungs. They found short nanofibers were fairly easily eliminated, but lung cells were less efficient at getting rid of longer fibers, as is true of humans inhaling asbestos fibers.

The study issues a recommendation that, in order to best protect technicians working with nanomaterials, manufacturers should develop and use soft, pliable, short, plant-based nanofibers rather than longer, rigid tubes. Thankfully, some specific safety guidelines for workers in this burgeoning field of bioscience.