Category Archives: BiomedNews

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.

Dormant mouse heart tissue made to regenerate

English: Medical X-rays Congestive heart failure
English: Medical X-rays Congestive heart failure (Photo credit: Wikipedia)

Heart attack and heart failure are major causes of death and disability around the world. And although when we are brand new babies, our hearts can regenerate themselves–just like our blood and skin do throughout our lives–but once we’re past infancy, this ability to automatically regenerate new heart cells disappears. That’s why the only “cure” for advanced heart failure is a heart transplant.

Now a team of Australian and Israeli researchers at the Sydney Victor Change Cardiac Research Institute and the Weizmann Institute of Science has proven a method of getting murine (mouse) heart cells (cardiomyocytes) to recharge their ability to regrow. Invoking the neonatal process, researchers developed a strategy for administering Neuregulin-1 (NRG1) and inducing co-receptor ERGG2 expression, thereby encouraging hypertrophy, then dedifferentiation and growth of the mouse heart cells. Although it’s still early days and much more research is needed, this study is extremely promising for future sufferers of heart attack and heart failure.

If they can get mice hearts to regrow their damaged cells, it’s highly likely that one day they’ll be able to get ours to do the same. Too bad most of us won’t be around for it.

Can shrimp shells solve our huge plastic waste problem?

English: A heap of Pandalus borealis shrimp. O...
English: A heap of Pandalus borealis shrimp. Originally from en.wikipedia; description page is/was here. 2005-03-09 (original upload date) Original uploader was Stemonitis at en.wikipedia (Photo credit: Wikipedia)

Imagine a moldable, sturdy, biodegradable substitute for the billions of pounds of plastics we dump into our oceans and rivers and on the ground. Scientists at the Wyss Institute at Harvard University have been working on developing just such a substance.

Their search may be yielding results. They report being able to do what they imagined with a substance called “chitosan, a form of chitin…a powerful player in the world of natural polymers and the second most abundant organic material on Earth. Chitin is a long-chain polysaccharide that is responsible for the hardy shells of shrimps and other crustaceans, armor-like insect cuticles, tough fungal cell walls — and flexible butterfly wings.”

They’ve been combining the chitosan with a protein from silk to make a pliable material that can be molded without breaking or shrinking. What’s more, it biodegrades in about two weeks, while also adding nutrients to the soil and helping plants – like the Institute’s black-eyed peas – grow in the enriched soil.

Fabulous news: recycling the Earth’s own resources to do what human civilization wants to accomplish – and not leaving more deadly waste. Can’t wait til they get this going.

Promising: Nanoparticles reverse bone loss in mice

Three osteoblast visible at 400x in developing...
Three osteoblast visible at 400x in developing bone (Photo credit: Wikipedia)

It started out in test tubes. Scientists introduced engineered 50?nm spherical silica nanoparticles into an artificial environment with a view to seeing whether they might help osteoblasts differentiate and promote bone building while also suppressing the re-absorption of osteoclasts. It worked well.

Next they found that could get the nanoparticles to help build bone in young living mice. Now in a new study they tried to get these nanoparticles to reverse bone loss in aged mice in a model of osteoporosis in elderly humans. Weekly injections of nanoparticles resulted in a significant increase in BMD, bone volume, and biochemical markers of bone formation.”

What’s even better, they couldn’t identify any abnormalities resulting from the treatment. Further studies will be conducted to see if this ability to halt and even repair age-associated bone loss might also work in humans.

As of now, broken hips in elderly women tend to lead to death within a year for many. Imagine being able to treat people before they develop a life-threatening broken hip–thus extending their lives with the greater independence that is the hallmark of higher quality of life. Read further evidence on that in the doctor’s treatise on end-of-life issues, Being Mortal. Highly recommended if you care or may have to care for elders or are getting there yourself.

 

Blueberries lower BP and raise nitric oxide levels

English: A pack of blueberries from a organic ...
English: A pack of blueberries from a organic farm co-op program. (Photo credit: Wikipedia)

News about blueberries. A small study—48 post-menopausal women who were pre- or stage 1 hypertensive—showed that participants who took 22 grams (that’s .77 of an ounce for those of us who are gram-challenged) of freeze-dried blueberry powder (equivalent to one cup of the fresh fruit) every day for a month lowered their blood pressure and limbered up their arteries compared to those who took a placebo. And they lost 10 pounds!

No. Just kidding on that last one.

But they did lower their systolic (top number) blood pressure by 5% and their diastolic (bottom number) BP by 6%, raised their nitric oxide (NO) levels by a whopping 68.5% and decreased arterial stiffness by 6.5%, as reported in a paper by Sarah A. Johnson and several other exercise and nutrition professors. Johnson is assistant director of the Center for Advancing Exercise and Nutrition Research on Aging (CAENRA) and postdoctoral fellow in the Department of Nutrition, Food and Exercise Sciences at Florida State University.

Previous studies had shown impressive benefits for blueberries, but most involved consuming huge quantities (13 cups per day in one study).

My calculations say you’d have to spend between $58.50 and $78 a month for the cup-a-day dose – and none of that would be covered by insurance.

The cost of blood pressure medication (angiotensin receptor blocker ARB) varies wildly, depending on the type prescribed and the place you buy it. One site gives ARB prices ranging from a discounted $9 to a top price of $183 for a 30-day supply.

A caveat: The study was paid for by the U.S. Highbush Blueberry Council. The Council is industry-funded and is in the business of marketing blueberries. But at least the USDA’s Agricultural Marketing Service monitors their operations.

Another study done at University of California Davis states that consuming freeze-dried blueberry powder in smoothies every day can increase insulin sensitivity—and is thus very good for anyone at risk of developing type II diabetes, a risk that increases for Baby Boomers as they age. Note: Participants had to cut back 500 calories on other foods to accommodate the calories in the two smoothies each day.

So it looks like freeze-dried blueberry powder is a nutritionally equivalent substitute for the fresh fruit at a similar price—plus it keeps longer and is easier to store.And while the fruit will never replace your blood pressure meds, it still might be a worthwhile investment to get some o’ that blueberry powder.

 

Nanoparticle exposure linked to heart problems

Asbestos fibres - a single fibre is believed t...
Asbestos fibres – a single fibre is believed to cause mesothelioma (Photo credit: Wikipedia)

Asbestos was hailed, even many centuries ago, as a material that could be used to create “miraculous” solutions to multiple problems – it was fireproof, it was flexible, it had tremendous insulating properties, it was easy to manipulate, etc. But it had a powerful, long-unacknowledged dark side. It gradually disabled and then killed people who ingested or inhaled the minute fibers.

Nanoparticles are even smaller than asbestos fibers. They’re used to make things stronger, to deliver drugs directly into tumors – on and on. Yet even as the world watches with wonder and awe the exciting developments in nanoparticle research, some have been tracking its dark side. Now a team of Israeli scientists has established that exposure to nanoparticles (NPs) of silicon dioxide (SiO2) can lead directly to developing cardiovascular diseases.

Silicon dioxide powder (silica fume), 130m²/g ...
Silicon dioxide powder (silica fume), 130m²/g surface area, placed on the scanner under a blue book, scanned in at 1600dpi. (Photo credit: Wikipedia)

The exposure must be such that the nanoparticles cross the body’s natural tissue and cellular barriers and find their way into the circulatory system. That is precisely the type of environmental exposure that happens consistently to people who work in research or production and thus use, handle or dispose of nanoparticles.

When the doctor sends a drug into your body that rides inside a nanoparticle, we just want him to make sure the cure isn’t bringing its own death threat.

 

How to distinguish your stem cell research

Lonza, a life sciences company located in Maryland, has created an infographic that clearly and simply illustrates a simple history of stem cell research. The graphic allows researchers to pinpoint areas their work is focused on and helps them more easily differentiate it from work being done elsewhere.

The Genetic Engineering and BioTechnology News website says the graphic illustrates a system approach that allows researchers to better control variables involved (between kits, media, cell batches). The hope is it will help them make sure data from their studies is accurate and reproducible.

Click here for the graphic itself.

Most cancers due to random mutations

English: DNA replication or DNA synthesis is t...
English: DNA replication or DNA synthesis is the process of copying a double-stranded DNA molecule. This process is paramount to all life as we know it. (Photo credit: Wikipedia)

All the headlines are shouting: “Cancer due to bad luck!” after a recent Science magazine article proclaimed that lifestyle and environmental factors may account for only about one-third of cancers. The study cited states that two-thirds of all cancers are likely caused by random mutations during DNA replication in normal, non-cancerous cells.

Does this surprise anyone, really? To me it simply reinforces the idea that science is continually demonstrating the reality of such random events – “misfortune” the name we give the hated surprise and “miracle” the name for the lucky one (e.g., spontaneous remission).

The definition of miracle that’s most apt for this situation reads: “a highly improbable or extraordinary event, development, or accomplishment that brings very welcome consequences.”

The definition of misfortune, on the other hand, is basically “bad luck.” The events are equally random. The main difference is in how we react to them – sadness, fear and anger versus joy and relief. As science delves ever deeper into the mysteries of the universe – the impossible “miracles” of quantum physics and the impenetrable mysteries of black holes – it discovers whole new sets of seemingly inexplicable rules of order.

A favorite axiom of mine: Whereas science for a couple of centuries was all-powerful in disproving so-called naive religious beliefs, it is now the vehicle by which we continue to unearth, and be baffled by, a growing pool of phenomena that look suspiciously like some of those mysteries religion’s been talking about for centuries.

 

Paradox – obese heart failure patients live longer

Body mass index (BMI) values
Body mass index (BMI) values (Photo credit: Wikipedia)

 

They discovered a while ago that patients who were obese before they were diagnosed with heart failure tended to live significantly longer than patients who were just overweight or of normal weight. You know how many doctors automatically tell you to lose weight, no matter what condition you’re dealing with? Accordingly they’ve named this the “obesity paradox.” And now another study has solidly confirmed this apparent contradiction in regard to heart failure. The conclusion is so sure that at this point some researchers are even suggesting they ought to start considering how to identify an ideal BMI and potentially begin suggesting to patients ways to maintain that BMI.

 

 

 

Just imagine. Doctors telling you to gain weight and advising you what to eat to keep the weight on. Almost inconceivable. But hey, don’t most people – with many exceptions of course – start putting on significant weight when they hit a certain age? Most baby boomers will be nodding their heads vigorously at this point.

 

 

 

Makes me wonder if Nature doesn’t know something we don’t know about weight in older people – or something we simply haven’t been willing to consider before.

 

 

 

Scientists engineer new class of pluripotent stem cells

We’ve known for some time that pluripotent stem cells can become almost any type of cell in the human body. Working with these cells means scientists can experiment with drugs and study diseases on real human cells that are not attached to a real human being. They can learn so much without ever endangering or harming a person. These amazing cells are also responsible for the growing field of regenerative medicine in which researchers look for ways to restore lost or damaged organs and tissues.

Now scientists have discovered a new type of stem cell they have created in the lab from mouse cells and can engineer into any type of stem cell they want. They’re called F type (can you believe it? – they call them “F” because these cells tend to hang out in “fuzzy” colonies). It will take a lot more money and research to see what they can accomplish with  the F type, but this points the way to the potential for discovering other classes of stem cells.

Almost limitless. That’s what stem cell research begins now to look like in earnest.