The Future of Medicine: Brain Scan Databanks

AI_picCloud computing and the internet are having a profound effect on the field of medicine. As more and more patients have their records digitized and posted in online medical sources, doctor’s are able to better track patient histories, conduct referrals, and make speedier diagnoses. And now, doctors at John Hopkins University are working on a cloud-computing project specifically for children’s brain scans.

By collecting and categorizing thousands of MRI scans from kids with normal and abnormal brains, they say the resulting database will give physicians a sophisticated, “Google-like” search system to help find similar scans as well as the medical records of those children. Such a system could help not only enhance the diagnosis of brain disorders, but the treatment as well, maybe even before clinical symptoms are obvious to the naked eye.

Miller_JohnHopkinsMichael I. Miller, a lead investigator on the project who also heads up the university’s Center for Imaging Science, said in a news release:

If doctors aren’t sure which disease is causing a child’s condition, they could search the data bank for images that closely match their patient’s most recent scan. If a diagnosis is already attached to an image from the data bank, that could steer the physician in the right direction. Also, the scans in our library may help a physician identify a change in the shape of a brain structure that occurs very early in the course of a disease, even before clinical symptoms appear. That could allow the physician to get an early start on the treatment.

Susumu Mori, a radiology professor at the Johns Hopkins School of Medicine and co-lead investigator on what he calls the “biobank,” says that a collection of brain scans of this size will also help neuroradiologists and physicians identify specific malformations far faster than is currently possible.

brain-activityMori has spent the past four-plus years working on a clinical database of more than 5,000 whole brain MRI scans of children who’ve come through Johns Hopkins. This project involved indexing anatomical data on 1,000 structural measurements in 250 brain regions that were ultimately sorted into 22 brain disease categories, including infections, psychiatric disorders, epilepsy, and chromosomal abnormalities.

The project, which was made possible by a three-year $600,000 grant from the National Institutes of Health, is still in its pilot stage and available only to physicians and patients within the Johns Hopkins medical system. But the researchers say it could open up and expand to other networks in the coming years. Such an expansion would presumably benefit not only other physicians and patients, but the database itself.

brainscansResearchers are also working on a similar project to collect scans of elderly patients to focus on age-related diseases and neurological disorders. Combined with the pediatric databank, this new brain scan archive will not only help recognize established neurological disorders, but could even possibly help identify and classify new ones as well.

But one of the key words here in anonymous. While cloud computing and patient files may raise the specter of privacy for many, the current project maintains patient confidentially. And one can further assume that voluntary compliance will be maintained as databases like these expand. After all, one does not need to know a patient’s name in order to examine what anomalies their brains exhibit.

And in the meantime, be sure to check out this video of Michael Miller explaining the new brain scan project and computational anatomy in greater detail:


Source:
news.cnet.com

Year-End Health News: From Cancer Prevention to Anti-Aging

medical technology The year of 2013 ended with a bang for the field of health technology. And in my haste to cover as many stories as I could before the year ended, there were some rather interesting news developments which I unfortunately overlooked. But with the New Year just beginning, there is still plenty of time to look back and acknowledge these developments, which will no doubt lead to more in 2014.

The first comes from the UK, where the ongoing fight against cancer has entered a new phase. For years, researchers have been developing various breathalyzer devices to help detect cancer in its early phases. And now, a team from the University of Huddersfield plans to introduce one such cancer-detecting breathalyser (known as the RTube) into pharmacies.

lung-cancer-xrayAccording to Dr Rachel Airley, the lead researcher of the Huddersfield team, these molecules – which consist of genes, proteins, fragments of cells, secretions and chemicals produced by the metabolism of living tissue with the disease – form a kind of chemical and biological signature. Using breath testing devices like the RTube, Dr Airley developed a project to define a lung cancer “biomarker signature” that is detectable in breath.

According to Dr Airley:

When you get certain chemicals in someone’s breath, that can be a sign that there is early malignancy. We are looking to be able to distinguish between patients with early lung cancer and patients who have maybe got bronchitis, emphysema or non-malignant smoking related disease… or who have maybe just got a cough.

cancer_breathalyserThe goal of the project is to validate the signature in a large number of patients to ensure it can reliably distinguish between lung cancer and non-cancerous lung disease. Dr. Airley told us that this will require tracking the progress of patients for up to five years to see if the disease develops and can be linked back to a signature picked up in the patient’s breath at the beginning of the project.

So far, the project has secured £105,000 (US$170,000) in funding from the SG Court Pharmacy Group with the University of Huddersfield providing matching funding. The SG also operates the chain of pharmacies in the South East of England where the initial trials of the breathalyzer technology will be carried out.

The researchers predict that people visiting their local pharmacy for medication or advice to help them quite smoking will be invited to take a quick test, with the goal of catching the disease before the patients start to experience symptoms. Once symptoms present themselves, the disease is usually at an advanced stage and it is often too late for effective treatment.

cancer_cellDr Airley stresses that the trial is to test the feasibility of the pharmacy environment for such a test and to ensure the quality of the test samples obtained in this setting are good enough to pick up the signature:

There are 12,000 community pharmacies in Britain and there is a big move for them to get involved in primary diagnostics, because people visit their pharmacies not just when they are ill but when they are well. A pharmacy is a lot less scary than a doctor’s surgery.

Dr Airley also says her team is about to start collecting breath samples from healthy volunteers and patients with known disease as a reference point and hope to start the pharmacy trials within two years. If all goes well, she says it will be at least five years before the test is widely available.

max_plank_testThe next comes from Germany, where researchers have created a test that may help doctors predict one of the most severe side effects of antidepressants: treatment-emergent suicidal ideation (TESI). The condition is estimated to affect between four and 14 percent of patients, who typically present symptoms of TESI in the first weeks of treatment or following dosage adjustments.

So far doctors haven’t been able to find the indicators that could predict which patients are more likely to develop TESI, and finding the right medication and testing for side-effects is often a matter of simple trial and error. But a new test based on research carried out by the Max Planck Institute of Psychiatry in Munich, Germany, could change all that.

genetic_circuitThe researchers carried out genome-wide association studies on 397 patients, aged 18 to 75, who were hospitalized for depression, but were not experiencing suicidal thoughts at the time they began treatment. During the study, a reported 8.1 percent of patients developed TESI, and 59 percent of those developed it within the first two weeks of treatment.

To arrive at a list of reliable predictors, the team genotyped the whole group and then compared patients who developed TESI with those who didn’t. Ultimately, they found a subset of 79 genetic variants associated with the risk group. They then conducted an independent analysis of a larger sample group of in-patients suffering from depression and found that 90 percent of the patients were shown to have these markers.

antidepressantsIn short, this test has found that the most dangerous side-effect of antidepressant use is genetic in nature, and can therefore be predicted ahead of time. In addition, the research shed new light on the age of those affected by TESI. Prior to discovering that all age groups in the study were at risk, the assumption had been that under-25s were more at risk, leading to the FDA to begin issuing warnings by 2005.

According to some experts, this warning has had the effect of reducing the prescription of antidepressants when treating depression. In other words, patients who needed treatment were unable to get it, out of fear that it might make things worse. This situation could now be reversed that doctors can avail themselves of this new assessment tool based on the research.

DNA-MicroarrayThe laboratory-developed test, featuring a DNA microarray (chip), is being launched immediately by US company Sundance Diagnostics, ahead of submission to the FDA for market clearance. As Sundance CEO Kim Bechthold said in a recent interview:

A DNA microarray is a small solid support, usually a membrane or glass slide, on which sequences of DNA are fixed in an orderly arrangement. It is used for rapid surveys of the presence of many genes simultaneously, as the sequences contained on a single microarray can number in the thousands.

Ultimately, according to Bechthold, the aim here is to assist physicians in significantly reducing the risk of suicide in antidepressant use, and also to provide patients and families with valuable personal information to use with their doctors in weighing the risks and benefits of the medications.

Wow! From detecting cancer to preventing suicides, the New Year is looking bright indeed! Stay tuned for good news from the field of future medicine!

Sources: gizmag.com, hud.ac.uk, (2), mpg.de

The Future of Medicine: Anti-Bleeding Clamps

itclamp2For centuries, medics have been forced to deal with cuts and lacerations by simply binding up wounds with bandages and wraps. Time has led to refinements in this process, replacing cloth with sterile bandages. But the basic process has remained the same. But now, severe cuts and bleeding have a new enemy, thanks to a new breed of clamping devices.

One such device is the iTClamp Hemmorage Control System, which won an award for top innovation in 2012 and was recently approved by the FDA. Basically, this clamp is placed over an open wound and then controls bleeding by sealing the edges shut to temporarily create a pool of blood under pressure and thereby form a clot that helps reduce more blood loss until surgery.

itclampThis past summer, the clamp got its first field test on a man who fell prey to a chainsaw wound on his upper arm just outside of Olive Branch, Mississippi. The hospital air crew who arrived on scene quickly determined that a tourniquet would not work, but were able to stop the bleeding and stabilize the patient within minutes, at which point they transported him to the Regional Medical Center of Memphis.

The clamp was invented by Dennis Filips, who served three tours in Afghanistan as a trauma surgeon for the Canadian Navy. With the saving of a life in the US, he has watched what began as an idea turn into a dream come true:

To have our first human use in the US turn out so well is thrilling, and we look forward to getting the iTClamp into the hands of first responders across the country and around the world.

ITClamp3The clamp is currently being sold for around $100 via various distributors across the US, and it’s available in Canada and Europe as well. At that price it could very well end up being adopted not only by first responders, but climbers and other adventurers looking to beef up their first-aid kits — and maybe the cautious chainsaw wielders among us as well.

And be sure to check out this video simulation of the iTClamp in action:


Sources: news.cnet.com, theepochtimes.com