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Surgical Robot Carries out First Operation in England

Surgeons at the Royal Marsden Hospital use the Da Vinci XI to remove a cancerous tumour

Surgeons using the da Vinci Xi surgical system carry out a colorectal surgery at the Royal Marsden in London

Surgeons using the da Vinci Xi surgical system carry out a colorectal surgery at the Royal Marsden in London Photo: PA

A surgical robot fitted with multiple arms has carried out its debut operation in England, in a technology breakthrough which will make new treatments possible for the first time.

The Da Vinci XI, which is hand operated by surgeons, has the ability to make tiny and precise incisions, replacing some traditional operations which require cutting patients open and months of recovery, with far less invasive keyhole surgery.

Surgeons at the Royal Marsden Hospital hailed the technology as pushing the boundaries in surgery, particularly in cancer care, as they completed the first operation on a patient with a tumour.

Mr Pardeep Kumar, consultant urological surgeon at the hospital, said: ”(The surgical robot) acts as an extension of the surgeon’s hands and allows us to carry out complex surgeries through tiny incisions. It miniaturises the movements of the surgeon who control it.

”Our patient today has cancer of the colon and they’ve had several surgeries in the past. That means usually we would tackle this operation with a large open incision that extends from the ribs right down to the belly button.

”This robot enables us to do that same operation through tiny incisions instead, because of the control and accuracy of it. It means the patient will wake up from surgery with little or no pain and recover incredibly quickly.

”It’s an incredible opportunity for all the surgeons here who are really looking forward to making a difference and pushing forward the boundaries of surgery for cancer.”

During the operation, four arms of the robot were used simultaneously to make separate microscopic incisions on the 58-year-old woman, while two surgeons controlled them.

As well as reducing pain and blood loss for the patient, key hole surgery also minimises the time a patient spends in hospital recovering.

The Royal Marsden Hospital said the robot is the latest model to arrive in England from the United States and puts its surgeons at the “forefront of robotic surgery” in the UK.

Although the hospital already carries out robotic surgery, the Da Vinci XI is able to work on multiple areas of the body at the same time and its arms can move independently from the body of the robot.

It was partly funded by a £1.5million donation from philanthropist and former chairman of House Of Fraser Don McCarthy, whose wife Diana was treated at the hospital for bowel cancer before her death in 2007.

Alongside the arrival of the latest surgical robot, the hospital is launching a fellowship to train up to 30 future surgeons over the next 10 years who will be able to use the technology to operate on multiple tumour types.

The hospital said it hopes to carry out one or two operations every weekday with the robot, but says 80% of operations will still be completed in a traditional way because key hole surgery is not suitable.

 

Source: telegraph.co.uk

Antibiotics as New Cancer Treatments?

A wPillsay to eradicate cancer stem cells, using the side-effects of commonly used antibiotics, has been discovered by a University of Manchester researcher following a conversation with his young daughter.

Professor Michael P. Lisanti, Director of the Breakthrough Breast Cancer Unit, led the research. He was inspired to look at the effects of antibiotics on the mitochondria of cancer stem cells by a conversation with his daughter Camilla about his work at the University’s Institute of Cancer Sciences.

His new paper, published in Oncotarget, opens up the possibility of a treatment for cancer, which is highly effective and repurposes drugs which have been safely used for decades.

Mitochondria are the ‘engine’ parts of the cells and are the source of energy for the stem cells as they mutate and divide to cause tumours. Cancer stem cells are strongly associated with the growth and recurrence of all cancers and are especially difficult to eradicate with normal treatment, which also leads to tumours developing resistance to other types of therapy.

Professor Lisanti said: “I was having a conversation with Camilla about how to cure cancer and she asked why don’t we just use antibiotics like we do for other illnesses. I knew that antibiotics can affect mitochondria and I’ve been doing a lot of work recently on how important they are to the growth of tumours, but this conversation helped me to make a direct link.”

Professor Lisanti worked with colleagues from The Albert Einstein College of Medicine, New York and the Kimmel Cancer Centre, Philadelphia. The team used five types of antibiotics — including one used to treat acne (doxycycline) — on cell lines of eight different types of tumour and found that four of them eradicated the cancer stem cells in every test. This included glioblastoma, the most aggressive of brain tumours, as well as lung, prostate, ovarian, breast, pancreatic and skin cancer.

Mitochondria are believed to be descended from bacteria which joined with cells early on in the evolution of life. This is why some of the antibiotics which are used to destroy bacteria also affect mitochondria, though not to an extent which is dangerous to people. When they are present in stem cells, mitochondria provide energy for growth and, crucially, for division, and it is this process going wrong which leads to cancer.

In the lab, the antibiotics had no harmful effect on normal cells, and since they are already approved for use in humans, trials of new treatments should be simpler than with new drugs — saving time and money.

Professor Lisanti said: “This research makes a strong case for opening new trials in humans for using antibiotics to fight cancer. Many of the drugs we used were extremely effective, there was little or no damage to normal cells and these antibiotics have been in use for decades and are already approved by the FDA for use in humans. However, of course, further studies are needed to validate their efficacy, especially in combination with more conventional therapies.”

Dr Matthew Lam, Senior Research Officer at Breakthrough Breast Cancer, said: “The conclusions that the researchers have drawn, whilst just hypotheses at this stage, are certainly interesting. Antibiotics are cheap and readily available and if in time the link between their use and the eradication of cancer stem cells can be proved, this work may be the first step towards a new avenue for cancer treatment.

“This is a perfect example of why it is so important to continue to invest in scientific research. Sometimes there are answers to some of the biggest questions right in front of us but without ongoing commitment to the search for these answers, we’d never find them.”

Importantly, previous clinical trials with antibiotics — intended to treat cancer-associated infections, but not cancer cells — have already shown positive therapeutic effects in cancer patients. These trials were performed on advanced or treatment-resistant patients.

In the lung cancer patients, azithromycin, the antibiotic used, increased one-year patient survival from 45% to 75%. Even lymphoma patients who were ‘bacteria-free’ benefited from a three-week course of doxycycline therapy, and showed complete remission of the disease. These results suggest that the antibiotic’s therapeutic effects were actually infection-independent.

“As these drugs are considerably cheaper than current therapies, they can improve treatment in the developing world where the number of deaths from cancer is predicted to increase significantly over the next ten years,” said Dr Federica Sotgia, another leader of the study.

The research was published in the journal Oncotarget.

Source: sciencedaily.com

Doctors in the Dock

Scandal of GPs who get cash from healthcare firms for patient referrals

Investigation reveals healthcare companies offer inducements to send patients to their hospitals, leading to calls for financial interests of all UK practitioners to be made public

The financial interests of all UK doctors should be made public, the country’s leading medical journal has said, after an investigation revealed incentives, often worth tens of thousands of pounds, have been offered to doctors by private healthcare companies in exchange for referring patients to their hospitals.

An investigation in the British Medical Journal claims that the doctors’ regulator, the General Medical Council (GMC), failed to act on a warning in 2012 that the practice of offering incentives was “widespread, particularly in London, and significant in value”.

The regulator was told by a major insurance company about patients being “diverted to units in which doctors have financial interests”. The company’s investigation had uncovered a range of “covert” schemes, with some payments exceeding £100,000.

The insurance company which uncovered the practice following an internal investigation also discovered that some Harley Street practices were housed in expensive properties owned by private healthcare companies.

The report has echoes of previous concerns about drug companies offering GPs inducements – including trips to conferences – to promote their new drugs.

GMC guidelines do set standards on conflicts of interest and prohibit doctors from accepting inducements, but the BMJ said that they had shown “an unwillingness to act on possible breaches of these standards”.

New rules banning so-called “cash for referrals” schemes and some other incentives in private healthcare were issued by the Competition and Markets Authority (CMA) in October last year and will come into force in April.

The new prohibitions came after a two-year investigation into the private health sector which found the practice of offering incentives for referrals was “widespread”.

Incentives documented have ranged from direct payments to the provision of facilities, or shares in “equity participation schemes”.

The CMA’s investigation identified several major private healthcare companies, including BMI Healthcare, Spire and the American healthcare giant HCA, that have offered various incentives to consultants, the BMJ said.

Despite the new rules, there remain concerns that some doctors may be accepting certain incentives.

One senior surgeon told the BMJ that he had been offered a package including facilities and secretarial support worth “a six-figure sum” by a hospital group only nine months ago – long after the CMA began its investigations.

The London Clinic, the capital’s largest independent hospital – which opposes incentive schemes – said that despite the CMA’s rulings it was still seeing consultants being “approached by competitors” and warned that, in the past, under such practices its own cancer patients had been transferred to other clinics unnecessarily.

The journal’s editor-in-chief Dr Fiona Godlee said that inducements came with “a clear risk to patients of inappropriate referrals for tests and treatments”.

In a joint comment for the BMJ alongside the journal’s deputy editor Dr Kamran Abbasi and clinical fellow Kate Adlington, Dr Godlee writes: “The current GMC guidance asks that doctors declare their financial interests to their patients and in their medical notes when appropriate, but it leaves the onus on doctors to decide what and where, creating a grey area that is open to exploitation.

“Perhaps the only viable way of achieving such transparency is by a public register of payments and other benefits given to doctors.”

The GMC said it had been unable to take action over the insurance company’s misgivings because they had related to “general concerns” and “did not include any allegations of wrongdoing relating to individual doctors”.

However, the regulator will shortly be writing to all independent healthcare providers “seeking assurances from them that they are not putting their doctors in a position where they could be acting outside our guidance”, said its chief executive Niall Dickson.

“This includes the offer of any incentives that could affect the way they prescribe, treat, refer or commission services for patients,” he said.

He said the GMC would “continue to explore the possibility” of recording doctors’ commercial interests on the Medical Register, but said that such a reform would require legislation.

The regulator told the journal it “would encourage anyone who has concerns about the conduct of a doctor or evidence of wrongdoing to share this information with us in order for us to investigate”.

A senior doctor working for the insurance firm that raised concerns with the GMC told the BMJ: “It’s a sad day for the medical profession when a competition regulator has had to issue an order … because our own regulator has failed to do so.”

BMI Healthcare, the UK’s private healthcare market leader, told the journal it welcomed the CMA’s new rules. A spokesperson said the company “always explicitly supported a resolution of this historical issue across the private healthcare sector.

“Our hospitals are working with consultants to ensure our arrangements comply with the CMA’s order.”

A spokesperson for HCA told the BMJ: “Consultants should choose where they practice based on the quality of the facility, not in response to financial incentives.

“Any potential caps on incentives to consultants should be clear in scope and should apply equally to all healthcare providers.”

Major players: Private operators

BMI Healthcare (BMI) is the largest private hospital operator in Britain. It operates 69 hospitals and treatment centres. It told the CMA’s investigation into the private health market that it had stopped “direct financial incentive schemes and profit-share arrangements” in 2012. However, it told the authority that “legitimate grounds arguably did exist for payments to consultants by hospitals”.

HCA (Hospital Corporation of America), a subsidiary of America’s largest hospital group, is the third-largest provider of healthcare services in the UK. The CMA’S report said it had “a number of joint venture relationships with consultants”. HCA said these ventures provided “significant benefits for patients”.

Spire operates 38 hospitals and 31 satellite clinics throughout England, Wales and Scotland. The CMA found some of its arrangements with consultants had involved “significant payments”. Under one arrangement a surgeon was provided with consulting rooms and secretarial services. The surgeon had his professional indemnity insurance costs paid “in return for the consultant committing his practice and referrals to the hospital”, the CMA’s report said. This arrangement was “subject to such referrals being in the clinical interests of the patient”.

 

Source: independent.co.uk

Medtronic sets Sights on Hospital and Product Innovation Post-Covidien Deal Close

 

Geoff Martha, Medtronic’s Chief Integration Officer

With its $49.9 billion purchase of Covidien ($COV) under its belt, Medtronic ($MDT) is laying out goals for life as a combined company. The device giant is planning to transform healthcare delivery by broadening its product offerings and working more closely with hospitals, two strategies that could yield immediate and long-term growth.

Medtronic is conducting trials of new products for heart-failure patients, attempting to show that its devices’ high price tags are justified by fewer hospital stays and longer life for patients, Chief Integration Officer Geoff Martha toldBloomberg. In the long-term, data gathered from the study could allow Medtronic to get better coverage and higher reimbursement for its products, all while creating a more efficient healthcare model.

There have been a few internal squabbles about the tests, as Medtronic executives are worried that they won’t produce the desired results, Martha told the news outlet. But if the trials do not yield the answers the company is looking for, Medtronic will adjust accordingly.

“We want to show our therapies don’t just help people get better, but the return on investment makes sense,” he said. “We believe the long-term solution is helping hospitals, helping governments, solve their problems, and we want to be compensated and rewarded based on outcomes.”

Developing new products is not the companies’ only course of action; Covidien and Medtronic will also collaborate on existing devices to gain ground within the industry. In particular, Medtronic’s recently approved drug-coated balloon to treat blood clots in the leg holds promise in the hands of Covidien’s sales force, which leads the industry in peripheral vascular products.

Proving the economic value of its products might take some time, but the merger also has “more tangible short-term benefits,” CEO Omar Ishrak told Bloomberg. The deal also positions Medtronic and Covidien to gain more clout with hospital administrators, a group that is rapidly gaining purchasing power as doctors become employees and hospitals limit which brands they can carry, BMO Capital Markets analyst Joanne Wuensch told Bloomberg. Post-deal Medtronic will boast offerings in 6 of the 10 purchasing arms of the hospital, allowing them to negotiate for better deals.

“They can go in not just with a bucket of products as they have previously, but with a full buffet table,” Wuensch said. “It does facilitate the partnership between the device manufacturers and the hospital providers, being able to make more purchases from a fewer number of sellers.”

 

Source: fiercemedicaldevices.com

 

3D Printed Heart Saves Baby’s Life as Medical Technology Leaps Ahead

Surgeons at a New York hospital have credited 3D printing with helping to save the life of a 2-week-old baby who required complicated heart surgery.

Using MRI scan data, Morgan Stanley Children’s Hospital in New York City 3D printed a copy of the child’s heart, which was both riddled with holes and structured unusually.

Surgery was going to be complicated and dangerous, but this 3D printed heart provided the surgeons the opportunity to study the organ, and develop a detailed surgery strategy.

“The baby’s heart had holes, which are not uncommon with CHD, but the heart chambers were also in an unusual formation, rather like a maze,” Dr Emile Bacha, who performed the surgery,told Connecticut local media.

“In the past we had to stop the heart and look inside to decide what to do. With this technique, it was like we had a road map to guide us. We were able to repair the baby’s heart with one operation.”

The project was funded by Matthew’s Hearts of Hope, a Connecticut –based foundation.

They have said that another 3D printed heart is in the making, with details to follow in the next month.

Marie Hatcher, the foundation’s founder, told The Independent:“This is a game changer for CHD babies with complicated heart anatomy.

Normally the first time the surgeon sees the heart is when the chest is open, now they have the ability to plan out the surgery ahead of time while looking at a 3 D Heart of the baby or child’s heart.”

 

Source: independent.co.uk

Medtronic-Covidien Deal Is Done

Medtronic as of Monday expected to complete its $48 billion merger with Covidien—after clearing its final hurdle with the Irish High Court’s sanctioning of the deal.

Bloomberg dubbed the merger the biggest inversion ever, while noting that the merger could make the firm savvier in negotiating deals with U.S. hospitals. The publication quoted analyst Joanne Wuensch of BMO Capital Markets (New York City) as saying: “[The deal] does facilitate the partnership between the device manufacturers and the hospital providers, being able to make more purchases from a fewer number of sellers.”

The new entity, which will be known as Medtronic plc, could be traded on the New York Stock Exchange as soon as January 27.

The approval of the Irish court was necessary because Covidien was legally headquartered in Dublin, and the merger would relocate the new firm’s legal headquarters to the Emerald Isle. The news completes a seventh-journey for Medtronic, which is moving its official headquarters from Minnesota to Ireland as it creates a new Medtronic that will rival Johnson & Johnson as the largest medical device company in the world. The new company will have $27 billion in revenue and more than 85,000 employees.

Progressive politicians in the United States criticized and threw up roadblocks against the deal amid complaints that it would allow Medtronic to avoid paying corporate taxes on overseas profits. But Medtronic and Covidien officials maintained all along that the merger was highly strategic.

“This proposed acquisition was conceived and undertaken for strategic reasons and is intended to create a company that can treat more patients, in more ways and in more places around the world,” Omar Ishrak, chairman and CEO of Medtronic, said at one point. “We believe our combination will be uniquely positioned to help advance the goals of the Affordable Care Act in the U.S. as well as the objectives of virtually all health systems—to drive access to high-quality, affordable healthcare for patients around the world.”

Meanwhile, the United States in general and the state of Minnesota in particular could see some benefits from the deal, as Medtronic announced plans to add 1000 jobs while investing $10 billion in the United States over the next decade.

 

Source: qmed.com

10 Barriers to Healthcare Innovation

Hurdle
 A successful collaboration among all parties – manufacturers, providers, the NHS and patients – is critical. Photograph: Clive Brunskill/Getty Images

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Innovative new products can and do transform industries every day, and the pace of change has accelerated due to massive technological breakthroughs such as the internet, smartphones and wireless technology. But when it comes to innovation, not all industries are created equal.

The healthcare sector is highly complex, and the medical care delivery ecosystem is under increasing pressures due to rising costs and patient expectations. These pressures and the inherent nature of the industry itself make innovation in healthcare more complicated than in the consumer products sector.

To break through the complexity and move innovation in medicine forward, inventors and product research and manufacturing companies must first overcome the many barriers to healthcare product development. Here are 10 of the top barriers healthcare innovators regularly face.

1. Medical efficacy review

To be successful, a new healthcare innovation must improve upon the current standard of medical care without causing harm to the patient and ideally lower costs simultaneously. But gaining access to medical professionals with the appropriate specialised expertise to determine medical efficacy can pose a major obstacle to even the largest, most established companies, not to mention the individual inventor. The diverse sets of clinical expertise necessary to review projects are rarely found in-house and can be expensive to purchase from outsiders.

2. Product distribution

Unlike consumer products, healthcare products are distributed through a more complex supply chain that involves multiple parties, including medical device manufacturers and distributors, the NHS purchasing and supply agency, physicians and nurses who provide the product to the end user, and the patient, who generally has no input on product or pricing considerations. Determining how best to break into this elaborate network can be daunting, if not truly insurmountable for inventors.

3. Manufacturer access

Gaining access to quality manufacturers is a major hurdle for many healthcare inventors because of concerns that manufacturers have about “intellectual property contamination” issues. In this scenario, manufacturers avoid learning about an individual inventor’s idea since it may be too similar to an innovation their internal research and development team is already working on; manufacturers do not want to run the risk of having to later prove to the inventor (or to a judge) that the idea was not stolen.

4. Lack of access to NHS purchasing data

Even large, well-connected medical manufacturing companies may find it difficult to access purchasing and product needs data and input from NHS. And operating in the absence of this information makes accurately estimating product adoption rates and potential market size virtually impossible.

5. Regulatory oversight

While it’s necessary to enforce strict guidelines on healthcare product manufacture and distribution to prevent incompetent or unscrupulous suppliers from harming patients, the EU regulatory environment slows the innovation process considerably.

6. Intellectual property complexity

Intellectual property rights have always been a confusing aspect of the inventing process for the majority of individual inventors. It can be virtually impossible to navigate without professional help.

7. Healthcare culture

By nature and for good reason, the healthcare industry is incredibly risk averse. As one doctor said: “The moment we step into medical school, we are trained to identify the most statistically proven method for treating a particular disease, and we are taught to not deviate from that path until a better method has been found and proven.” Compounding this issue is the fact that the majority of healthcare workers are increasingly time-pressed today, and so learning and adopting new systems, new methods of care or new devices often take a backseat to day-to-day patient care.

8. High-stress environment

 

Healthcare workers have high-stress jobs and often work long hours. They are dedicated to delivering great patient care, but the nature of the job can make it difficult for innovative thinking to flourish, since creativity naturally diminishes when an individual is in steady “fight or flight mode”.

9. Complex value analysis model

In the healthcare sector, it is difficult for a product developer or individual inventor to generate data on how the product affects not only direct treatment but also the downstream healthcare supply chain, which means that determining the true value of a new innovation idea is difficult.

10. Misconceptions about what constitutes innovation

Within healthcare, those traditionally tasked with product development (ie engineers and technical experts) are generally not the same people who are actually living with or treating a particular healthcare challenge.

As this list demonstrates, there are numerous and significant barriers to healthcare innovation, but there are also common themes throughout: an industry that is evolving rapidly and a lack of centralised expertise that skews perspectives and limits resources. Consumer product inventors face many daunting challenges, but the institutional, industrial and knowledge barriers that confront innovators in the healthcare field are unique.

To truly optimise healthcare innovation, individual inventors and companies must find a way to overcome these barriers. A successful collaboration among all parties – manufacturers, providers, the NHS and patients – is critical.

Everyone who has a role in the healthcare delivery process and the influence necessary to bring about change must be invited to play a part, since only by combining each party’s respective strengths through collaboration can we overcome these hurdles and begin to deliver truly exceptional healthcare.

Source: theguardian.com

New Device Delivers Sound Through Tongue to Let Deaf People Hear

tongue-for-hearing

While we naturally think that we hear with our ears, it is really the brain that converts sound waves into what we perceive as sound. Our most distinctive organ also has a lot of plasticity, being able to adapt its regions to perform tasks normally not assigned to them. Blind people, for example, often have the part of the brain responsible for vision working to more precisely interpret audio and create a better mental picture of what’s around. This principle is what led researchers at Colorado State University to attempt to use the tongue as a medium for passing sound to the brain in deaf people.

The researchers developed a flat shaped neurostimulator with a bunch of electrodes in a grid at one end. It’s connected wirelessly via Bluetooth to an earpiece that captures sound. The system processes the audio signals received by the earpiece and converts them into electrical pulses that are delivered through the stimulator. The user simply presses his tongue against the electrodes on the mouthpiece and feels tingling or vibration. The idea is that this sensation, really sound interpreted another way, can be translated by the brain into perceived audio if given proper training.

There’s much work to be done to prove the technology and make it practical. Currently, the researchers are mapping out the tongue’s nerves and studying how volunteers respond to the electrical stimulation. They’re trying to figure out whether the device will work uniformly for all people or whether it will need to be individually customized. The researchers hope that this technology will become a new option competing with cochlear implants and that it may help overcome hearing loss for a wide variety of people.

 

Source: medgadget.com

How accurate is the BMI

The Body Mass Index is widely used to assess if an individual is overweight or not. DietDoc investigates how accurate this tool really is. 0 Body Mass Index from Shutterstock ~ This is the new load shedding schedule for Cape Town Your brain on sex This week’s topic was inspired by a question on the DietDoc Message Board: “How accurate is the BMI?”

This question encouraged me to start reading scientific literature to provide an up-to-date answer to this query. The BMI (Body Mass Index) is widely used as a tool to assess if an individual is overweight or not. However, as the questioner pointed out, some people have a normal BMI and yet their waist circumference measurement is above the normal range, while conversely some people are fit and healthy and yet their BMI exceeds 25, the upper level of normal. The reader also wanted to know if there are more accurate methods of determining overweight or obesity than the BMI.

Calculating the BMI Let’s first go back to how to calculate the BMI. The standard formula is as follows: Weight in kilograms divided by height in metres squared (height in metres times height in metres). Read: Obesity For example: To calculate the BMI of a woman who is 1.6 m tall and weighs 59 kg, you would use the following equation: 59 ÷ (1.6 x 1.6) = 59 ÷ 2.56 = 23,04. In other words this woman has a BMI value of 23 which falls nicely within the normal range. The different ranges for the BMI are divided into: Underweight: less than 18.5 Normal: 18.5 to 24.9 Overweight: 25.0 to 29.9 Obesity, Class I: 30.0 to 34.9 Obesity, Class II: 35.0 to 39.9 Extreme Obesity, Class III: more than 40.0

Why use the BMI? Mahan and her co-authors admit: “It is possible to be overweight according to BMI standards, but not be overfat or obese. It is also possible to have excessive fatness, and yet not be overweight.” This is an example of why people often challenge the usefulness of the BMI as an accurate measure of fatness. The BMI is useful to assess fatness particularly when the patient is not sitting in the dietician’s office so that she or he can carry out a variety of other measurements such as: Determination of the waist circumference

Use of a formula (e.g. the Deurenberg formula) to calculate percentage body fat Use of devices to measure bioelectrical impedance (this method is popular in gyms) Whole body underwater weighing (usually only used in scientific studies) Use of radioactive markers to determine body composition (also usually only used in scientific studies) Determination of the BMI is thus rapid, inexpensive and has a reported accuracy of 88% (Formula Medical, 2015), which is regarded as more than adequate. Read: BMI can predict heart disease

The public are probably aghast that any measure which does not reach an accuracy of 99.9999% is regarded as good and usable, but it is important to keep in mind when we work with biological systems such as the human body, that we have to deal with a great deal of variation unlike precise formulas used in maths or physics. An accuracy of close to 90% is, therefore, a good indication if someone’s weight falls outside the normal range for height.

When should the BMI not be used? The BMI should not be used for athletes or pregnant and lactating women, because it will probably overestimate body fatness. In older individuals who have lost a lot of muscle tissue (sarcopenia) or patients suffering from wasting diseases, the BMI will underestimate body fat and other measures such as skinfold thickness readings should rather be used. The same applies to eating disorders associated with wasting like anorexia nervosa.

Experts also discourage the use of the BMI to assess the fatness of persons in Obesity Class III, which is described as “extreme”(values exceeding 40). Read: Weight and BMI affect fertility In general, the BMI is not used for children under the age of 18, where age-specific tables are more accurate. In all cases where the BMI should rather not be used, further measurements should be made by trained and experienced evaluators such as your dietician, biokineticist or medical doctor.

The combination of BMI and Waist Circumference, or skinfold measurement, or fat percentage calculations using the Deurenberg formula for example, should be able to determine if a patient is overweight or obese and if her or she is at risk of developing diseases of lifestyle.

An honest look in the mirror may also be valuable both for individuals who are overweight or obese, and those who are suffering from anorexia. If you can’t see yourself or your child realistically, consult a dietician or your medical doctor to help you assess your weight or the weight of your child.

 

Source: health24.com

How Flexible Implants Make Paralyzed Rats Walk Again

Researchers from Ecole Polytechnique Federale de Lausanne have developed implants to restore movement in rats with a broken spinal cord.

Source: NCCR

Led by Stéphanie Lacour who holds the Bertarelli Foundation Chair in Neuroprosthetic Technology at the School of Engineering at the Ecole Polytechnique Fédérale de Lausanne, a Swiss team has developed an implant that might change the lives of thousands of paralyzed people in the world.

In the past, the researchers came up with a devise that made it possible that rats with a damaged spinal cord were able to walk again via electrical stimulation. The problem was that such an implant wouldn’t be feasible in the every day life, since the wire electrodes were too bulky and hard to position accurately. Also, implants that were directly connected to the spiral cord damaged the tissue over time.

In cooperation with the Swiss National Centre of Competence in Research Robotics (NCCR), the researchers engineered a new implant they called e-dura which is flexible enough to avoid these problems.

In a paper published in Science, they described how the implant that was placed beneath the dura mater was used in rats for months without issues. After two weeks of training the rats were able to walk again. According to the press release, the researchers are now entering into clinical trials to develop the device to market.

Source: emdt.co.uk

 

 

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