June 12, 2012 We've all pretty much come to embrace mobile health. It's helped me track my fitness goals. It's made a friend's life easier because her mom can now stay out of the hospital and be monitored safely from home for chronic heart disease. It's even helped others modify their sleep habits. Yes, we're all loving it. But the doctors? Not so much. A recent PwC survey finds that while about half of consumers believe mobile health technology will improve healthcare, and are enthusiastically using it, most doctors are not so convinced, according to a story by Paul Cerrato. Could it be because the survey found that 59 percent of those who use some form of mobile health technology say it has replaced visits to doctors and nurses? "Only 27 percent encourage patients to use mHealth apps in order to become more active in managing their health; 13 percent actively discourage it," Cerrato quotes the report, Emerging mHealth: Paths For Growth. Interestingly, at least to me, the survey revealed that 64 percent of physicians "worry that mHealth makes patients too independent," Cerrato writes, adding that, in a video posted on the PwC website, Christopher Wasden, PwC global healthcare innovation leader says, "Consumers are now empowered with information on price, services, wait times, and quality. ... So they start making decisions like they would in any other marketplace." Do doctors fear that if we have increased mobile access to medical information, they'll lose control of how medicine is practiced and – drum roll, please – lose income? And we're not the only ones. Based on two separate surveys by the Economist Intelligence Unit and an analysis of 10 nations, the report found that developing nations "are more quick to accept and adopt telehealth because it's seen as a way to increase access to healthcare, while developed nations like the United States are being dogged down by regulatory hurdles and a resistance to change among providers," according to Erik Wicklund of HIMSS. To be fair, I wouldn't like it either if someone stood over my shoulder reading my notes, or what I was writing, then changed it without my permission. It's hard to see why people learning more about their health could be a bad thing, especially in these days when so many suffer from obesity and all the conditions that come with it. With 35.7 percenting as obese in this country, you'd think physicians would be glad we're trying to take our health into our own hands. of the adult population and 16.9 percent of children qualify But many physicians worry that their traditional role will weaken as consumers use mobile health apps or access websites on their smartphones to gain more control of their own care, Cerrato writes. If one doctor charges $1,000 less than another for a colonoscopy, who do you think people will choose? That's probably not entirely what they're afraid of but if we now have the ability to find out – and compare – what minor surgeries cost and see the complication rates for local physicians, we're "empowered to choose the clinicians who offer the best service for the most reasonable fee," according to Cerrato. In fact, just last week United Healthcare came out with myHealthcare Cost Estimator, to help patients choose among doctors doing the same procedures. But physicians are worried about more than just their pocketbooks, Cerrato writes. Many worry that we may err when we self-diagnose, and even self-medicate. These concerns are legitimate. But patients feel a little more in control of their health than ever before and I can't really say it's a bad thing. I know I did all my homework when I was diagnosed with a serious illness, and it was a handy thing to have the information available to me. Would I try to diagnose myself? Probably not. I'm a hypochondriac and as my husband says, love to go to the doctor. Not really. But I do know where my knowledge ends and theirs begins. And I'm still willing to throw my lot in with them. Edited by Rachel Ramsey
Wednesday, June 13, 2012
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New combination therapy can help improve cure rates for neuroblastoma
Published on June 13, 2012 at 6:01 AM · An experimental treatment that combines intense chemotherapy with a radioactive isotope linked to synthesized neurotransmitter is being tested in newly diagnosed cases of high-risk neuroblastoma - a deadly, hard-to-cure childhood cancer. The experimental radiopharmaceutical, 131I-MIBG, has already been tested in children with relapsed and resistant neuroblastoma, with encouraging results in reducing tumor size. This has prompted doctors in a new multi-center pilot clinical trial to see if their innovative combination therapy can help improve cure rates for newly diagnosed children and young adults, according to Brian Weiss, MD, trial chair and an oncologist at the Cincinnati Children's Hospital Medical Center. Cure rates for neuroblastoma have plateaued at about 40 percent and new solutions are needed to improve outcomes, said Weiss, a member of the medical center's Cancer and Blood Diseases Institute. "Unlike some diseases, there is no single detectable biological sign of neuroblastoma, so it's hard to catch early," he explained. "Children with relapsed disease usually don't survive more than a few years. We want to see if giving this more intensive treatment right after diagnosis will safely decrease the chances of the cancer coming back." Neuroblastoma is one of the most commonly diagnosed childhood cancers, developing in nerve cells outside the brain. The cancer is usually first diagnosed by showing up as a lump or mass in the belly, or near the spinal cord in the chest or neck. The disease can spread to bone, the liver, lymph nodes and bone marrow. In high-risk neuroblastoma, the tumor has often spread from its primary site and is harder to treat. MIBG stands for Meta-Iodo-Benzyl-Guanidine, a synthesized form of the adrenal gland hormone and neurotransmitter adrenalin. MIBG concentrates selectively in the body's sympathetic nervous system, which helps control glands and muscles. When attached to the radioactive isotope iodine-131, it's known as 131I-MIBG. After being injected, 131I-MIBG targets and is taken up by nerve tumors like neuroblastoma. This exposes the cancer cells to very high doses of radiation from the iodine-131, with minimal toxicity to neighboring normal cells. Standard treatment for neuroblastoma normally includes several rounds of chemotherapy combined with surgery and external radiation. In the current trial, a round of chemotherapy will be replaced by injection of 131I-MIBG combined with the chemotherapy drugs vincristine and irinotecan. The chemotherapy drugs will kill some of the cancer cells and, according to research, may help 131I-MIBG do a better job of eradicating tumor cells, said Weiss.
Potential biomarker emerging for diabetic neuropathy
June 13, 2012 in Diabetes An emerging biomarker may eventually lead to new approaches for treating diabetics at risk of developing nerve damage, UNSW researchers have found. ce to your research needs. Contact us! - www.ozgene.com/transgenics The researchers say neuropathy in diabetic patients is under-diagnosed and early identification has been problematic. It is estimated that up to 50 per cent of diabetics end up with nerve damage. They tested nerve excitability in diabetics with and without neuropathy and found those without irreversible nerve damage still showed excitability abnormalities well before the development of clinical symptoms. "Excitability testing provides a biomarker to identify the early development and severity of diabetic neuropathy," the key researcher Dr Cindy Lin said. The research was led by UNSW and the School of Medical Science's Dr Cindy Lin and is published in the journal Diabetes. Professor Matthew Kiernan from UNSW says the research may lead to new therapeutic approaches for treating patients with diabetic neuropathy early. "It may yet prove possible to initiate therapy in diabetic patients well before they manifest the neurological symptoms and disability that inevitably reflects the presence clinical neuropathy," Professor Kiernan says in his commentary, also published in Diabetes. "Pharmacological manipulation of axonal membrane channels seems likely to provide further new therapeutic approaches for treating patients with diabetic neuropathy," he says.
MD Anderson installs first TomoHD System in Florida
Published on June 13, 2012 Cancer patients in the Southeast now have access to the world's most advanced radiation treatment system. MD Anderson Cancer Center Orlando has installed the first TomoHD™ System in Florida. Unlike traditional radiation therapy devices, the TomoHD System combines fully integrated CT imaging and intensity-modulated radiation therapy (IMRT) on a CT scanner platform. Each daily treatment includes a 3D image of the patient's anatomy to ensure highly accurate radiation delivery. This provides clinicians unprecedented confidence that tumors will receive their intended dosage from one day to the next. A major difference with the TomoHD System is the way that radiation is delivered to the treatment area. The radiation beam is divided into thousands of tiny "beamlets" all aiming at the tumor during multiple 360 degree rotations around the patient. The treatment dose conforms to the tumor and avoids critical organs, which can mean improved outcomes, fewer side effects and a higher quality of life for the patient. MD Anderson - Orlando has a history of being on the cutting edge of TomoTherapy radiation treatment. In 2003, the hospital became the second site in the world to receive the first generation TomoTherapy System (the Hi-Art® System) which helped the center advance the field of radiation therapy delivery worldwide. Since 2003, more than three million treatments have been delivered to nearly 200,000 patients around the world. "We have continually been a leader in delivering the most accurate and individualized TomoTherapy treatments and we are thrilled to have this state-of-the-art technology available to our patients," said Mark Roh, MD, President, MD Anderson Orlando. "Our new TomoHD System will not only provide the highest quality of radiation treatment to our patients battling complex cancers it will also be a tool for our oncologists to educate clinicians on best practice TomoTherapy treatment techniques for patients worldwide."
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