[News release] E-skin and pocket-sized diagnostic machines give patients the power back

E-skin and pocket-sized diagnostic machines give patients the power back.

From the May 2015 Elsevier news release 

New bio-sensing technologies give us cheap, fast and convenient health data

Amsterdam, May 12, 2015

Wearable E-skin that can measure heart rate and blood pressure, and paper diagnostic machines the size of a credit card that can give instant readings on blood and saliva samples are two new bio-sensing technologies presented at Elsevier’s 4th International Conference on Bio-Sensing Technology in Lisbon, Portugal on 12 May 2015.

Bio-sensors can detect and analyze data to give patients information on their heart rate and blood pressure, blood sugar and hormone levels, and even test whether they are infected with antibiotic-resistant bacteria. This detection technology is a step forward in personal medicine, giving patients real-time information about how their bodies are functioning and suggesting the most suitable treatments.

Professor Anthony Turner, Head of the Biosensors & Bioelectronics Centre at Linköping University, Sweden, has developed an instrument the size of a credit card that can analyse blood and saliva samples. It is simple to use: you switch it on by pressing a button, then apply your sample to a circle in the bottom right corner and wait for a digital reading to be displayed and even sent to your mobile phone.

The whole instrument is printed on the card using a screen-printing technique. It could be used to monitor diabetes, kidney disease and heart disease, or to detect cancer. This, says Professor Turner, could turn a 2500-year-old paradigm on its head and put the power in the patient’s hands.

…

This means they have the potential to provide patients and doctors in developing countries with accessible, affordable medical tests. For example, the printed card could be made part of the packaging of antibiotics, helping determine which antibiotic would be best to treat a patient’s infection.

Such printable devices could also be worn like plasters or contact lenses, transmitting information to mobile phones. Similarly, e-skin devices are also designed to be wearable and portable, and to transmit data about how a patient’s body is functioning.

Professor Ting Zhang, from Suzhou Institute of Nano-Tech and Nano-Bionics, Chinese Academy of Sciences, China, is presenting a new kind of e-skin at the Conference. E-skin is developed based on flexible electronic technology and nanotechnology; because of its unique ability to detect tiny changes in pressure, e-skin can be used to monitor blood pressure, heart rate and wrist pulse.

….

Bio-sensing technologies are gaining momentum in areas like health, the environment and security. The conference brings together leaders from industry and academia to exchange and share their experiences, present research results, explore collaborations and spark new ideas, with the aim of developing new projects and exploiting new technology for bio-sensing applications.

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Presentation details:
“The Paper Potentiostat” by Professor Anthony Turner and “Flexible Nanoelectronic Skin for Wearable/attachable Health Applications” by Professor Ting Zhang are being presented on 12 May 2015 at Elsevier’s 4th International Conference on Bio-Sensing Technology in Lisbon, Portugal.

 For more information, contact Elsevier’s Newsroom at newsroom@elsevier.com or +31 20 4853564.

About the 4th International Conference on Bio-Sensing Technology
Following the success of the first 3 conferences, the 4th International Conference on Bio-Sensing Technology will continue to bring together leaders from industry and academia to exchange and share their experiences, present research results, explore collaborations and to spark new ideas, with the aim of developing new projects and exploiting new technology for bio-sensing applications. www.biosensingconference.com.

For more information go to: Elsevier Connect
http://www.elsevier.com/connect/how-printable-testing-kits-could-turn-healthcare-upside-down

– See more at: http://www.elsevier.com/about/press-releases/research-and-journals/e-skin-and-pocket-sized-diagnostic-machines-give-patients-the-power-back#sthash.QxvjdTSs.dpuf

Letting patients change their own meds using apps and connected devices

Letting patients change their own meds using apps and connected devices.

Aneroid sphygmomanometer with stethoscope, used for auscultatory blood pressure measurement. (Photo credit: Wikipedia)

From the 18 September 2014 post at iMedicalapps

A recent trial published in the Journal of the American Medical Association has demonstrated the efficacy of self-titration of blood pressure medications by patients with hypertension.

Personally, I’m a proponent of giving patients self-titration schedules, particularly in my patients with systolic heart failure in whom I’m trying to maximize medical therapy. It’s a strategy I use somewhat sparingly though in part because of the difficulty to follow the home monitoring these patients are doing between clinic visits.

…

In this study, the self-titration plan was agreed upon in a clinic visit and then transcribed onto a paper given to the patient. The patient then used an unconnected blood pressure cuff at home with pre-set parameters for the patient to notify their primary care physician if their readings were too high or too low. Notifications of self-titration were accomplished by having the patient send in paper notifications to their primary care physician.

There are clearly a number of opportunities here to streamline the process to help make it less cumbersome for the patient and improve the monitoring of patients undertaking this kind of self-titration strategy. There are a number of wireless blood pressure cuffs on the market as well as wired devices that can transmit data through USB connections to a computer.

With the coming standardization of health data being captured by personal health devices thanks to Google Fit and Apple HealthKit, this data can then be readily transferred into the electronic health record. Practice Fusion already does that with some personal health devices; Apple and Epic are working on developing that integration as well. Trials and pilots underway at institutions like Stanford and Duke are exploring the creation of automated alert systems to help filter the data being collected with pre-specified rules as it flows into their EHR.

There are a number of limitations in this study.

…

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• When $140,000 a Year Just Isn’t Enough
• Ten impressions of big data: Claims, aspirations, hardly any causal inference

[Reblog] The unidentified cause of one man’s hypertension: Racism

The unidentified cause of one man’s hypertension: Racism.

From the 20 January 2014 Kevin MD post

Meet Damien, my Facebook friend, photographer, and IT guy.

This morning, he messages me: “I would like to make an appointment.”

I reply: “For?”

“High blood pressure.”

 

I offer to see him, but he never comes in. Weeks later, he writes, “I got busy Pam. How are you? High blood pressure pills keep making me sick. I am doing the best I can. On bad days it is like 208/118.”

Friends don’t let Facebook friends die. And 208/118 is incompatible with life. I’m a family doc–a-sleuth. It’s my job to spy on people. On Damien’s page, I find a dozen photos of lynchings — his reaction to today’s Trayvon Martin verdict. A black boy murdered in a land where killers roam free. Trayvon died a senseless death, but Damien shouldn’t have to. I suspect today is a bad day for Damien’s arteries. So I call him up. “I’m worried about you, man. I’m coming over to check on you tonight.” An hour later, I’m in his living room.

…..

Relaxation Techniques for Health: An Introduction | NCCAM

Relaxation Techniques for Health: An Introduction | NCCAM

Excerpts from the Web page at The  National Center for Complementary and Alternative Medicine

On this page:

• Key Points
• About Relaxation Techniques
• Use of Relaxation Techniques for Health in the United States
• How Relaxation Techniques May Work
• Status of Research on Relaxation Techniques
• NCCAM-Funded Research
• Side Effects and Risks
• Training, Licensing, and Certification
• If You Are Thinking About Using Relaxation Techniques for Health
• Key References
• For More Information

Introduction

Relaxation techniques include a number of practices such as progressive relaxation, guided imagery,biofeedback, self-hypnosis, and deep breathing exercises. The goal is similar in all: to consciously produce the body’s natural relaxation response, characterized by slower breathing, lower blood pressure, and a feeling of calm and well-being.

Relaxation techniques (also called relaxation response techniques) may be used by some to release tension and to counteract the ill effects of stress. Relaxation techniques are also used to induce sleep, reduce pain, and calm emotions. This fact sheet provides basic information about relaxation techniques, summarizes scientific research on effectiveness and safety, and suggests sources for additional information.

Key Points

• Relaxation techniques may be an effective part of an overall treatment plan for anxiety, depression, and some types of pain. Some research also suggests that these techniques may help with other conditions, such as ringing in the ears and overactive bladder. However, their ability to improve conditions such as high blood pressure and asthma is unclear.
• Relaxation techniques are generally safe.
• Do not use relaxation techniques to replace scientifically proven treatments or to postpone seeing a health care provider about a medical problem.
• Tell all your health care providers about any complementary health approaches you use. Give them a full picture of what you do to manage your health. This will help ensure coordinated and safe care.

 

About Relaxation Techniques

Relaxation is more than a state of mind; it physically changes the way your body functions. When your body is relaxed breathing slows, blood pressure and oxygen consumption decrease, and some people report an increased sense of well-being. This is called the “relaxation response.” Being able to produce the relaxation response using relaxation techniques may counteract the effects of long-term stress, which may contribute to or worsen a range of health problems including depression, digestive disorders, headaches, high blood pressure, and insomnia.

Go here for the entire article

 

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• National Institute on Health article on Benefits of Yoga
• Massage Therapy for Health Purposes
• Breathing stimulates relaxation
• Acupuncture – An Introduction
• NCCAM- Herbs at a Glance
• The director of NCCAM wants a “nuanced conversation” about “complementary and alternative medicine”

 

[Reblog] Saying No to “Know Your Numbers” campaigns – Health News Watchdog blog

Saying No to “Know Your Numbers” campaigns – Health News Watchdog blog.

Saying No to “Know Your Numbers” campaigns

Posted by Gary Schwitzer in Health care journalism, Risk communication

4 COMMENTS

“Know Your Numbers” campaigns can serve a useful purpose.

But they can also be guilty of non-evidence-based fear-mongering.  They can fuel obsessions with numbers that fully-informed people might just as soon not know anything about. There can be harm living our lives worrying about numbers, test results – making ourselves sick when we are, in fact, healthy.

Here’s a screenshot of just a tiny part of a Google search result of “Know Your Numbers” campaigns.  The list goes on and on and on.

The most recent that I saw was in the January 2014 edition of Prevention magazine.  It’s entitled, “Know Your Numbers: The 5 Health Stats You Should Know.”

While we acknowledge the prestige of the Cleveland Clinic and its chief wellness officer, we point out that there is a lot of debate in medical science circles about what is laid out in this Preventionmagazine piece. For example:

• The Eighth Joint National Committee (JNC 8) recently published evidence-based guidelines for managing high blood pressure in adults. They wrote:

“There is strong evidence to support treating hypertensive persons aged 60 years or older to a BP goal of less than 150/90 mm Hg and hypertensive persons 30 through 59 years of age to a diastolic goal of less than 90 mm Hg; however, there is insufficient evidence in hypertensive persons younger than 60 years for a systolic goal, or in those younger than 30 years for a diastolic goal, so the panel recommends a BP of less than 140/90 mm Hg for those groups based on expert opinion”

So if 140/90 is where this group starts thinking about treatment, and if even the American Heart Association says normal is “less than 120/80,” what we have with an announcement that 115/75 is “ideal” is mission creep, medicalizing normal blood pressure, or disease-mongering. Where does this “ideal” come from?  It may only be a few points of difference, but with a few points, thousands of Americans suddenly become “less than ideal”…or, as we often call them, patients. One minute they’re healthy.  And then – voila – with a prestigious organization’s spokesman proclaiming a new “ideal” – they’re sick, abnormal, patients.

• Cholesterol.  Hmmm.  Let’s see what the Cleveland Clinic website says about LDL and HDL. The Clinic’s own website says the LDL goal value should be less than 130 for people who don’t have heart or blood vessel disease or high risk.  And since a Prevention magazine article reaches a broad audience, that’s the crowd we’re talking about. And the Clinic website says HDL goal value should be greater than 45.  So the Prevention magazine targets of LDL under 100 and HDL over 50 are again mission creep, medicalizing normal blood tests, or disease-mongering.  Please note:  we could (but won’t herein) write volumes about much broader questions about being obsessed over LDL or HDL numbers, which are surrogate markers that don’t tell people everything they need to know.

• This is the one that bugs me the most.  The article lists C-reactive protein as one of the “5 health stats you should know.”  What you should know is that the US Preventive Services Task Force does not share in that endorsement.  The USPSTF states that “the current evidence is insufficient to assess the balance of benefits and harms of using the (the test) to screen asymptomatic men and women with no history of coronary heart disease (CHD) to prevent CHD events.” Even a brief look at other guidelines by other groups shows that the promotion of this test as a “stat you should know” is not as simple and uncomplicated as the Prevention magazine article makes it out to be.

Please note that almost exactly 2 years ago we wrote, “Cleveland Clinic’s Top 5 Tests for 2012 clash with many guidelines.” C-reactive protein was on that list as well.

And you may be interested in some of my past articles about “Know Your Numbers” campaigns:

• TV station should stop promoting questionable screening tests at MN State Fair
• Star Tribune is wrong about experts recommending annual physicals

Comments

Laurence Alter posted on January 13, 2014 at 10:00 am

Dear Gary & Staff:

1. “Live by the numbers; die by the numbers”
2. “The facts speak for themselves”

Live by the first expression or idiom; die by the second one.

Fine physicians give subtlety and nuance behind “the numbers.”

Laurence Alter

Reply

Gary Schwitzer posted on January 13, 2014 at 12:06 pm

Laurence,

Thanks for your note, but for the umpteenth time, there is no staff.

There wasn’t even any staff when we had funding. So there certainly isn’t any staff in the unfunded era.

Whereas I once had help from as many as almost 40 different part-time contributors, they were not staff, just very limited part-time contributors.

It’s just me, flying solo these days.

Reply

Gwyneth Olwyn posted on January 14, 2014 at 10:50 pm

Dear Gary By Himself:

1. Live by the numbers, die anyway.
2. Unequivocally one death per person.

There is no subtlety or nuance to be had for fine physicians in an era of standard of care and fear of litigation from failing to screen aggressively for potential disease.

Therefore a person needs to know ahead of getting his or her numbers checked whether he or she is ready to inadvertently become a patient based on numbers and that the treatments to change those numbers may have little to no evidence to support them.

Reply

shaun nerbas posted on January 20, 2014 at 3:01 pm

It seems that the patient must look out for themselves, ask questions, and not just accept the standard script of medical people. I had an MI 4 years ago (stent placed in the LAD which was nearly 100% blocked ) , but in the 2.5 months before that I saw 4 different doctors who told me nothing was wrong. I had normal LDL and total cholesterol,but I did have low HDL, which I had recently raised up to a ” nearly normal ” value using niacin. I walked for 1.5 hours a day, but in that 2.5 month period before the MI, while walking, I started to get increasing shortness of breath, indigestion, and a pain in my upper back, between the shoulder blades. My doctor gave me Nexium . My doctor didn’t think it was my heart. He based that on having two relatives of his with heart disease, my normal ECG, and my normal cholesterol numbers. I saw other doctors, as my shortness of breath got worse, but again, they didn’t think it was my heart. Then one day I got the symptoms while eating lunch. I went to the local hospital,who after being in communication with a larger specialized hospital, sent me to that larger center, which put the stent in. I eventually learned that over 62% of MIs happen to people with ” normal cholesterol ” . How is it possible that the cholesterol numbers used by lay doctors are so useless for diagnosis ? Does heart disease have multiple causes or do we just not have a good understanding of how do diagnose and track it ? I almost never see this inadequacy discussed by the experts ! Subsequent to my MI I became a vegan to improve my diet to remove saturated fat, which along with a grandmother who had a heart problem, were, in my mind, the reasons for my heart disease. My cardiologist acted as if I was misguided with the vegan approach, which he felt was a path almost nobody could follow.. ….. just take the statins. Maybe Cardiology is a very lucrative occupation that keeps us coming back…..see you next time ! Sorry for being so cynical, but that’s how I feel.

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[Repost] Here comes the sun to lower your blood pressure

Here comes the sun to lower your blood pressure.

From the 14 January 2014 ScienceDaily article

Exposing skin to sunlight may help to reduce blood pressure and thus cut the risk of heart attack and stroke, a study published in theJournal of Investigative Dermatology suggests.

Research carried out at the Universities of Southampton and Edinburgh shows that sunlight alters levels of the small messenger molecule, nitric oxide (NO) in the skin and blood, reducing blood pressure.

Martin Feelisch, Professor of Experimental Medicine and Integrative Biology at the University of Southampton, comments: “NO along with its breakdown products, known to be abundant in skin, is involved in the regulation of blood pressure. When exposed to sunlight, small amounts of NO are transferred from the skin to the circulation, lowering blood vessel tone; as blood pressure drops, so does the risk of heart attack and stroke.”

…

English: blood pressure measurement Deutsch: :deBlutdruckmessung (Photo credit: Wikipedia)

Read the entire article here

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• Could Sunlight Lower Blood Pressure?

High Blood Pressure May Lead To Missed Emotional Cues

 

Image via Wikipedia

From the 6 November 2011 Medical News Today article

A recently published study by Clemson University psychology professor James A. McCubbin and colleagues has shown that people with higher blood pressure have reduced ability to recognize angry, fearful, sad and happy faces and text passages.

“It’s like living in a world of email without smiley faces,” McCubbin said. “We put smiley faces in emails to show when we are just kidding. Otherwise some people may misinterpret our humor and get angry.”

Some people have what McCubbin calls “emotional dampening” that may cause them to respond inappropriately to anger or other emotions in others.

“For example, if your work supervisor is angry, you may mistakenly believe that he or she is just kidding,” McCubbin said. “This can lead to miscommunication, poor job performance and increased psychosocial distress.” …

Read the entire article