Monitoring the heart’s mitochondria to predict cardiac arrest?

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Credit: Dr. John Kheir, Boston Children’s Hospital & Shutterstock

A new device can assess in real time whether the body’s tissues are receiving enough oxygen and, placed on the heart, can predict cardiac arrest in critically ill heart patients, report researchers at Boston Children’s Hospital and scientists from Cambridge device maker Pendar Technologies. Their study, conducted in animal models, is the cover article in today’s issue of Science Translational Medicine.

 

“With current technologies, we cannot predict when a patient’s heart will stop,” says John Kheir, MD of Boston Children’s Heart Center, who co-led the study. “We can examine heart function on the echocardiogram and measure blood pressure, but until the last second, the heart can compensate quite well for low oxygen conditions. Once cardiac arrest occurs, its consequences can be life-long, even when patients recover.”

The device uses a technology called resonance Raman spectroscopy to measure whether enough oxygen is reaching the mitochondria, the organelles that provide cells with energy. In critically ill patients with compromised circulation or breathing, oxygen delivery is often impaired, making it hard for mitochondria to do their job. This is especially a problem for the heart, which has constant high energy needs.

The current standard for measuring tissue oxygenation, known as mixed venous saturation (SvO2), requires repeated blood draws, adding extra risk in critically ill patients. More importantly, SvO2 cannot tell whether oxygen supply is sufficient to meet the dynamic demands of heart muscle.

“We wanted to create an organ-specific, continuous, reliable readout of how adequately mitochondria are being fed oxygen,” says Kheir. “This is the first demonstration of a device that can monitor mitochondria in living tissues to predict impending organ failure.”

Using light to monitor mitochondria

This technology is the product of a collaboration between the Translational Research Lab in Boston Children’s Heart Center, co-led by Kheir and Brian Polizzotti, PhD, and Pendar Technologies (Cambridge, Mass.). “At the bedside, we saw patients who had a limitation to coronary blood flow, and wanted a device that could provide an early warning sign,” Kheir says.

The team created a metric they call 3RMR that uses light readings generated by resonance Raman spectroscopy to quantify oxygenation and mitochondrial function in real time.

 

Read More: http://snip.ly/bt6o8#https://scienmag.com/monitoring-the-hearts-mitochondria-to-predict-cardiac-arrest-2/

Brain Activity and Good Diet May Prevent Insomnia-Related Depression

Brain Activity and Good Diet May Prevent Insomnia-Related Depression
While lack of sleep is a major risk factor for depression, not everyone who tosses and turns at night becomes depressed. According to a study, individuals whose brains are more attuned to rewards may be protected from the negative mental health effects of poor sleep. The findings revealed that students with poor quality sleep were less likely to have symptoms of depression if they also had higher activity in a reward-sensitive region of the brain.”This helps us begin to understand why some people are more likely to experience depression when they have problems with sleep,” said Ahmad Hariri, Professor at the Duke University in North Carolina, US. “This finding may one day help us identify individuals for whom sleep hygiene may be more effective or more important,” Hariri added.

For the study, appearing in The Journal of Neuroscience, the team examined a region deep within the brain called the ventral striatum in 1,129 college students. Ventral striatum helps regulate behaviour in response to an external feedback as well as reinforce behaviours that are rewarded, while reducing behaviours that are not. The results showed that those who were less susceptible to the effects of poor sleep showed significantly higher brain activity in response to positive feedback or reward compared to negative feedback.

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The effects of poor sleep showed significantly higher brain activity

“Poor sleep is not good, but you may have other experiences during your life that are positive. And the more responsive you are to those positive experiences, the less vulnerable you may be to the depressive effects of poor sleep,” Hariri said.

 

Read More: http://snip.ly/ttax2#http://food.ndtv.com/health/brain-activity-and-good-diet-may-prevent-insomnia-related-depression-1753267

FDA Finalizes Guidance on Interoperable Medical Devices

On September 6, 2017, FDA finalized a guidance document entitled “Design Considerations and Pre-Market Submission Recommendations for Interoperable Medical Devices” (“Final Guidance”). In the Final Guidance, the agency outlines design considerations for manufacturers when developing interoperable medical devices, as well as recommendations about information to include in premarket submissions and device labeling. Interoperability of devices can encourage the availability and sharing of information across systems, even when products from different manufacturers are used. A draft of this guidance was issued on January 26, 2016.

The Final Guidance defines “interoperable medical devices” as medical devices “that have the ability to exchange and use information through an electronic interface with another medical/non-medical product, system, or device.” These functions can consist of a one-way data transmission to another device or product, or more complex interactions in which command and control is exercised over another device. An “electronic interface” is defined as the medium by which systems communicate with each other, and includes both the type of connection and the information content.

According to the Final Guidance, the agency considers the management of risks associated with an electronic interface incorporated into a medical device to be part of a comprehensive quality system under 21 C.F.R. Part 820. Manufacturers of interoperable medical devices should perform a risk analysis and conduct appropriate testing addressing the risks associated with interoperability, the anticipated users, reasonably foreseeable misuse, and reasonably foreseeable combinations of events that can result in a hazardous situation. In particular, the Final Guidance identifies the following considerations that manufacturers should take into account and “appropriately tailor[]” to the device’s interface technology, intended use, and use environments

Read More: http://snip.ly/jeird#https://www.lexology.com/library/detail.aspx?g=54c0daa5-aed0-4976-995b-5e0204c336c4

Graham-Cassidy health care bill: What you need to know

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Sens. Lindsey Graham of South Carolina and Bill Cassidy of Louisiana have drafted the latest Republican attempt to repeal Obamacare. The bill would overhaul or eliminate major sections of the health care law, including its subsidized insurance coverage and Medicaid expansion. Instead, states would receive block grants, or a lump sum of money from the federal government, which they could use largely as they see fit.

How Graham-Cassidy would alter federal funding

Center on Budget and Policy Priorities analysis

The liberal-leaning think tank Center on Budget and Policy Priorities released estimates of how federal funding would change if the bill became law. In its analysis, California would be hardest hit, losing $27.8-billion in funding.

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Graham-Cassidy-Heller-Johnson block grant model

Cassidy’s office released its own estimates. Massachusetts takes the hardest hit with a more than $5 billion loss in funding. Overall, Southern states that did not expand Medicaid are poised to receive more in federal funding.

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The bill comes after three failed GOP repeal attempts in the Senate, and a proposal from Sen. Bernie Sanders to extend the reach of government subsidized health care to all Americans.

But Republicans are up against a tight deadline. Their budget reconciliation bill, which allows them to overhaul Obamacare with a simple majority, expires on Sept. 30. The deadline could work to Graham’s and Cassidy’s advantage, however, by spurring hesitant Republicans to seize what may be their last opportunity to deliver on their seven-year promise to repeal Obamacare.

 

Read More: http://snip.ly/v5ygq#http://www.politico.com/interactives/2017/graham-cassidy-health-care-bill-what-you-need-to-know/

Hermetic Packaging, Connectors for Medical Implant Industry

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Hermetic Implantable Packaging and Connectors for Medical Components

PA&E works with leading medical implant designers to advance integration and performance for hermetic implantable packaging and connectors in one of the most unique and critical environments known: the human body.

PA&E has created proprietary materials and encapsulations with hermetic seals that enable implantable medical devices to bypass the human body’s natural defenses and perform with greater reliability.

Precision Machining of Implantable Devices

PA&E’s unique precision machining techniques for materials and components are used to create implantable packaging and connectors for applications such as: cochlear implants, pacemakers, and other cardiac-function implants.

Here’s what PA&E can offer to medical implant designers:

Implantable Packaging and Connectors Example
PA&E’s unique brazing technologies allows materials like titanium and zirconia to be hermetically joined for applications that require an RF transparent package.

Medical Implantable Packaging — Devices implanted in the human body are at the leading edge of medical science. Advancing that technology and making more implantable medical components and devices possible requires overcoming several complex challenges. For example, medical implants must be as small as possible. However, the performance of new devices is often constrained by material selection and thickness. External communication with the implant is critical. Current communication technology relies on case material and size. Reliability and implantable viability are always issues because it is important that the body does not reject a newly-implanted device.

Read More: http://snip.ly/14fsc#http://pacaero.com/industries/medical/

Teens also at risk for organ damage from high blood pressure

Teens also at risk for orga

And the damage to the heart and blood vessels can occur in youth at that are below the clinical definition of hypertension in youth.

High blood pressure in youth is defined differently than it is in adults. In childhood, high blood pressure is based on percentiles, rather than blood pressure level. Researchers looked at whether in teens develops below the 95th percentile, which is the clinical definition of in youth.

Researchers studied blood pressure and measured organ damage in 180 teenagers (14-17 years old, 64 percent white, 57 percent males). They found evidence of organ damage even among the youth categorized as “normal” with blood pressure less than in the 80th percentile. They also found heart and vessel damage in the mid-risk group, which had blood pressures in the 80th to 90th percentiles and the high-risk group, with blood pressures above the 90th percentile.

 

Read More: http://snip.ly/0v63t#https://medicalxpress.com/news/2017-09-teens-high-blood-pressure.html

OSHA Proposes Extending Compliance Deadline for Crane Operator Certification Requirements to 2018

OSHA Proposes Extending

The Occupational Safety and Health Administration (OSHA) today issued a Notice of Proposed Rulemaking to extend the employer’s responsibility to ensure crane operator competency and enforcement for crane operator certification to Nov. 10, 2018.

OSHA issued a final rule in September 2014, extending the deadline by three years for crane operator certification requirements in the Cranes and Derricks in Construction standard. The final rule also extended by three years the employer’s responsibility to ensure that crane operators are competent to operate a crane safely.

The agency is now proposing an extension of the enforcement date to address stakeholder concerns over the operator certification requirements in the Cranes and Derricks in Construction standard.

 

Read More: http://snip.ly/l4l6i#http://www.forconstructionpros.com/rental/lifting-equipment/crane/press-release/20974421/occupational-safety-health-administration-osha-proposes-extending-compliance-deadline-for-crane-operator-certification-requirements-to-2018