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/

Immune cells may heal bleeding brain after strokes

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Credit: Courtesy of Aronowski lab, University of Texas Health Science Center, Houston.

While immune cells called neutrophils are known to act as infantry in the body’s war on germs, a National Institutes of Health-funded study suggests they can act as medics as well. By studying rodents, researchers showed that instead of attacking germs, some neutrophils may help heal the brain after an intracerebral hemorrhage, a form of stroke caused by ruptured blood vessels. The study suggests that two neutrophil-related proteins may play critical roles in protecting the brain from stroke-induced damage and could be used as treatments for intracerebral hemorrhage.

“Intracerebral hemorrhage is a damaging and often fatal form of stroke for which there are no effective medicines,” said Jaroslaw Aronowski, M.D., Ph.D., professor, department of neurology, at the University of Texas Health Science Center at Houston, and senior author of the study published in Nature Communications. “Our results are a hopeful first step towards developing a treatment for this devastating form of stroke.”

Accounting for 10 to 15 percent of all strokes, intracerebral hemorrhages happen when blood vessels rupture and leak blood into the brain, often leading to death or long-term disability. Chronic high blood pressure is the leading risk factor for these types of strokes. The initial phase of damage appears to be caused by the pressure of blood leaking into the brain. Over time, further damage may be caused by the accumulation of toxic levels of blood products, infiltrating immune cells, and swelling.

 

Decades of research suggest that neutrophils are some of the earliest immune cells to respond to a hemorrhage, and that they may both harm and heal the brain. In this study, the researchers found that interleukin-27 (IL-27), a protein that controls the activity of immune cells, may shift the role of neutrophils from harming the brain to helping with recovery.

Injections of IL-27 after a hemorrhage helped mice recover. Days after the strokes, the treated mice had better mobility, including walking, limb stretching and navigating holes in a floor. In contrast, injections of an antibody that blocked natural IL-27 activity slowed recovery. The brains of the mice treated with IL-27 also showed less damage. They had less swelling around the hemorrhages and lower levels of iron and the blood protein hemoglobin, both of which are toxic at high

Read More: http://snip.ly/5llk8#https://scienmag.com/immune-cells-may-heal-bleeding-brain-after-strokes/

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/

Shipley Center Website Offers Prostate Cancer Facts for Patients

One in every seven men in the United States will get prostate cancer, making it the second most common type, after skin cancer, for American men. It tends to be a slow-growing disease, but can sprint to life-threatening severity if detected too late. Screening for prostate cancer can yield false-positive findings, but those most at risk for the disease—men whose father or a brother had prostate cancer, African American men, overweight men, and those in their 60s and 70s who are in good health and could expect years more of life—still should ask their doctors whether screening makes sense for them.

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The website for the Shipley Prostate Cancer Research Center provides basic information about the prostate gland and how disease affects it.

That information comes from the just-launched website of the Shipley Prostate Cancer Research Center at the School of Medicine. Created with a $10.5 million gift from BU trustee Richard Shipley (Questrom’68,’72), the center’s labs will be in the Conte Building on the Medical Campus when it opens. The center’s research will be focused on finding genomic approaches to determine which prostate cancers are aggressive and need treatment, and which can simply be monitored.

The center’s website and its Facebook page and Twitter account are up and running now, offering easy-to-follow, impartial information on practically everything anyone needs to know about prostate cancer. There’s “Prostate 101,” an overview about the prostate, information about prostate cancer and getting a second opinion, and a checklist of symptoms; information on screening; treatment options; and the state of research.

This knowledge is available to patients everywhere, “irrespective of where they choose to get their medical care or where they are in terms of testing, diagnosis, or treatment,” says site editor Gretchen Gignac, a School of Medicine associate professor of hematology and medical oncology.

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Most cases of prostate cancer are slow-growing tumors that have a very high cure rate, but some cases are fast-growing.

For its founding donor, the center is as much a beacon of information to patients as an incubator for medical research. Shipley was diagnosed with prostate cancer in 2014 and chose focal laser ablation, a new and less invasive treatment than surgery and other therapies.

“The website will be unique in that it will provide up-to-date information, both on diagnostic and treatment options, in a form the layman can easily understand,” Shipley says.

Read More: http://snip.ly/olj5q#http://www.bu.edu/today/2017/shipley-center-website-offers-prostate-cancer-facts-for-patients/

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/

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

Congress, keep hands off employer sponsored plans in healthcare fights

Congress, keep hands

Lawmakers are back in town and soon the Senate Health, Education, Labor and Pensions (HELP) Committee will once again take up the beast that is healthcare.

Some will be tempted to merely throw more money and the semblance of flexibility into a broken system — we urge them  to reject this Band-Aid, and to instead implement real reforms. The ERISA Industry Committee (ERIC) implores Congress not to take this opportunity to protect the employer-sponsored health insurance system, which is the single most common source of health coverage in the nation, providing 178 million Americans with access to healthcare.

Congress is focused on stabilizing endangered exchange marketplaces. ERIC heartily agrees that market stabilization is important for everyone, but addressing the cost sharing reduction (CSR) payments to insurance companies is just a small part of solving the problem.

 

Last month, ERIC, along with several other organizations, sent a letter to Congress with policy recommendations that would help stabilize the market, while also ensuring the future of affordable employer-provided health benefits.

We recommended Congress should fund CSR payments to improve affordability in the individual market. Congress should also repeal the 40 percent “Cadillac” tax on employer-sponsored health plans, with no new taxes on health benefits. And lawmakers should repeal the health insurance tax on fully insured health plans, which a recent Oliver Wyman study found will cost Americans $22 billion next year alone. They should also enable employers to innovate with Health Savings Accounts (HSAs) and protect the ability of employers to offer uniform benefits to employees and their families — no matter where they live, work, or receive medical care.

Tax relief is key to protecting the employer-sponsored system. Since World War II, the American tax code has encouraged employers to set up quality health plans for their employees by exempting company health benefit expenditures from income and payroll taxes. The Affordable Care Act placed a crippling financial burden on plan sponsors through the employer mandate and the taxes mentioned above.

An easy place to start would be fully repealing the highly unpopular Cadillac tax. It has already been delayed until 2020 and lawmakers have voted to repeal it twice. The first time in 2015 and the most recent during the healthcare votes this past July.

The Cadillac tax will hit more than 50 percent of the workforce within ten years of its implementation, according to a January study by the consulting firm Milliman —that’s 60 million Americans. These employees could see their benefits slashed by thousands of dollar while their salaries stay flat.

Some economists theorize that because of the Cadillac tax, workers might see their pre-tax wages increase as employers switch to cheaper plans. But if that happens, employees would also pay a lot more in taxes, costing 12.1 million employees upwards of $1,000 in higher payroll and income taxes.

In fact, 80 percent of the revenue raised by the Cadillac tax is expected to come from workers paying more income and payroll taxes, according to the Joint Committee on Taxation and the Congressional Budget Office.

Aside from health tax relief, another way to improve the healthcare system is updating consumer-directed health options like Health Savings Accounts (HSAs). The Committee and Congress should raise HSA contribution limits, ensuring that HSA and high-deductible plan beneficiaries have access to supplemental benefits. They should also allow consumers to use their HSAs to purchase over-the-counter medicines while updating rules to ensure those enrolled in HSA-compatible plans can benefit from first-dollar coverage for prescription drugs and other medical products and services likely to prevent or reduce catastrophic episodes in the future.

The Senate HELP Committee must also look at value-based healthcare options, which are ways plan sponsors and consumers can spend healthcare dollars smarter. Earlier this year, The ERISA Industry Committee and the Pacific Business Group on Health launched the DRIVE Health Initiative, a campaign to accelerate economic growth by controlling health costs and improving quality through the rapid adoption of value-based healthcare. The initiative calls for targeted deregulation and the use of market-based purchasing strategies by Medicare and other federal health programs.

Fixing healthcare is not easy. As lawmakers move forward in crafting new legislation, they must be sure it protects the employer-sponsored system that has provided affordable, quality coverage to more than half of the population for decades and allow for continued improvement and innovations.

If they don’t, the employer-sponsored health insurance system could be in jeopardy, creating a much bigger problem than that of the ACA exchanges.

James Gelfand is the senior vice president for health policy at The ERISA Industry Committee (ERIC). ERIC is the only national association that advocates exclusively for large employers on health, retirement and compensation public policies at the federal, state and local levels.