ECRI Institutes 2018 Top 10 Hospital C-suite Watch List (Part 3)

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Microneedle blood-collection devices

The touch-activated phlebotomy device is a new and nearly painless method of collecting blood sample for lab tests. The FDA-approved, single-use, 1.5-inch diameter device adheres to a patient’s skin. Once tapped, the device uses 30 microneedles and a small vacuum to collect 100 microliters of capillary blood over 2 to 3 minutes until the fill indicator signals the collection is complete. Currently, the device is approved only to test HbA1c to evaluate glycemic control.

Venipuncture, which is used to currently draw blood samples, is a painful and unpleasant procedure for many. At times, more than one puncture might need to be made if not properly done. This new method is painless, simple and fast. It also reduces needle stick injuries.

Neonatal MRI system

The Embrace neonatal MRI system is designed for point-of-care imaging of the neonatal brain and head in the neonatal intensive care unit. The system reduces potential risks associated with patient transport for a standard MRI such as trauma resulting from transport, positioning, handling and also facilitates rapid emergency care, should the need arise. However, it is contraindicated for infants weighing more than 4.5 kg or with a head circumference larger than 38 cm (15 inches) and those with metallic or electronically active implants.

The system is fully enclosed and does not require a safety zone or a radiofrequency-shielded room, so it can reside in close proximity to typical medical devices lacking “MR Safe” and “MR Conditional” designations. Unlike the current noisy MRI system, this new system is significantly less noisy.

GammaTile cesium-131 (Cs-131) brachytherapy in neuro-oncology

The use of GammaTile cesium-131 (Cs-131) brachytherapy in neuro-oncology is currently under review by the FDA. This technology permits per-operative incorporation of Cs-131 brachytherapy seeds, which are embedded into a bioabsorbable collagen mesh that is sutured or stapled into place in the cavity left by an excised brain tumor. The purported advantages are faster delivery of radiation dose to the target tissue and more direct delivery of radiation dose compared to external beam radiation therapy or other forms of brachytherapy using different radioisotopes. All these reduce injury to the adjoining healthy tissue with improved patient outcomes.

Microhospitals

The concept of microhospitals is a growing trend in fast-growing suburban areas as a means to increase access to health care. Microhospitals provide inpatient services, but to a smaller scale than a full-service acute care hospital. But, they are scalable i.e. they can expand according to the needs. They provide emergency care, but not intensive care. There is no standard definition of a microhospital yet, hence, services may differ between microhospitals.

Dr KK Aggarwal

Padma Shri Awardee Vice President CMAAO Group Editor-in-chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA

Processed foods and additives exacerbate chances of acquiring inflammatory bowel diseases

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It is important to identify triggers and eliminate certain foods from the diet

New Delhi, 29 January 2018: Research indicates that there has been a spurt in the number of people with inflammatory bowel diseases (IBD) in India. The reasons attributed to this surge are usage of too many preservatives, additives, highly processed foods, and mineral water. Processed foods can alter the gut biome and eventually affect the immune system.

Emulsifiers or smoothing agents used in food to give a creamy texture can break down the heavy mucus that lines the gut and prevents bacteria from coming into contact with gut cells. In such cases, the bacteria cause inflammation in the gut, which can also lead to changes in metabolism.

Speaking about this, Padma Shri Awardee Dr K K Aggarwal, President Heart Care Foundation of India (HCFI) and Immediate Past National President Indian Medical Association (IMA), said “IBD is an umbrella term for a number of long-term conditions that involve inflammation of the digestive tract, or the gut. I t is, however, different from an irritable bowel syndrome. If not addressed on time, IBD can lead to number of complications including damage to the bowel and malnutrition. The two main types of IBD are ulcerative colitis and Crohn’s disease. The gut micro biome is the cause and cure of gut diseases. To avoid IBD, people must opt for natural organic foods which are a healthier choice. This will also help in avoiding complications in the intestine. Making better food choices will ensure that the gut has a combination of different good bacteria which help the body systems function smoothly.”

Statistics indicate that about 50 lakh people around the world have IBD or inflammatory bowel disease. In India, the number of cases exceed 12 lakh annually. Signs and symptoms of IBD include diarrhea, fever and fatigue, abdominal pain and cramping, blood in the stool, reduced appetite, and unintended weight loss.

Adding further, Dr Aggarwal, who is also Group Editor of IJCP, said, “IBD is generally treated with anti-inflammatory drugs which are special derivatives of 5 ASA derivatives. These are used either orally or through enema, corticosteroids, immunosuppressants, biological agents, antibiotics, anti-diarrheal drugs, and laxatives. Regular treatment and frequent tests are imperative.”

IBD can be controlled through certain lifestyle modifications as follows.

  • Identifying the foods that trigger the symptoms and avoiding them is crucial.
  • Avoid beans, cabbage, and cauliflower as these can cause gas. Consume more of foods that are rich in omega-3 fatty acids.
  • Eat smaller meals as this will help the digestive system to adjust better to the condition.
  • Drink plenty of water and other fluids. However, limit the consumption of caffeine and alcohol.

ECRI Institutes 2018 Top 10 Hospital C-suite Watch List (Part 2)

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Implantable loop recorder cardiac monitor

This insertable cardiac monitor connects directly with a patients smartphone via Bluetooth. With Confirm Rx, the patients smartphone proactively transmits data to the patients physician and does away with the need for the patient to use a bedside telephone transmitter. Data can be uploaded and accessed at intervals programmed by the clinician. It is most useful for long-term monitoring of patients with arrhythmias such as atrial fibrillation (AF), a common cause of stroke, which may at times not show up on 24-hour monitoring.

The implantable cardiac monitor is a new small monitoring device, which may take the place of Holter monitor, which is worn externally. Holter monitoring also requires placing of many electrodes on the chest and abdomen and for the patient to carry a recorder, which patients find inconvenient.

Distraction-based virtual reality for pediatrics

Another example of the application of digital technology in delivery of health care is the three-dimensional virtual-reality (VR) experiences to help children overcome or be suitably distracted from the fear, anxiety and pain that come with repeated injections and infusions needed for chronic conditions such as hemophilia, cancers, severe burns, which require frequent procedures, such as infusion therapy or needlesticks, especially in children who have needle phobia. An interactive computer-based system, the VR goggles enhance the entertainment experience to a 360-degree view of relaxing scenery and engaging games.

NeuroAD Therapy System for Alzheimers disease

The NeuroAD Therapy System is currently under review at FDA for clearance as treatment for Alzheimer’s disease. The system delivers sustained cognitive improvement by combining noninvasive transcranial magnetic stimulation (TMS) with computer-based cognitive training in addition to existing pharmacologic therapy. It is the first device-based treatment for AD to receive the CE mark for clinical use in the European Union. A full six-week course of five daily, one-hour treatment sessions per week reportedly costs about $6,000 to $10,000.

(To be contd)

Dr KK Aggarwal

Padma Shri AwardeeVice President CMAAOGroup Editor-in-chief IJCP Publications

President Heart Care Foundation of India

Immediate Past National President IMA

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