For children with autism and a class of genetic disorders, exposure to diagnostic ultrasound in the first trimester of pregnancy is linked to increased autism severity, according to a study conducted by researchers at UW Medicine, University of Washington Bothell and Seattle Children’s Research Institute.
The study looked at the variability of symptoms among kids with autism, not what causes autism. The researchers found that exposure to diagnostic ultrasound in the first trimester is linked to increased autism symptom severity. The greatest link is among kids with certain genetic variations associated with autism; 7 percent of the children in the study had those variations.
Food and Drug Administration (FDA) guidelines recommend that diagnostic ultrasound be used only for medical necessity.
‘I believe the implications of our results are to bolster the FDA guidelines,’ said corresponding author Pierre D. Mourad, a UW professor of neurological surgery in Seattle. He is also a professor of engineering and mathematics at UW Bothell. As a UW Medicine scientist, he specializes in translational research on ultrasound and the brain.
Mourad said their results are related to the first trimester of pregnancy. Data from looking at the effect of ultrasound on the second and third trimester showed no link, he said.
Mourad said he and his colleagues now intend to look more closely into links between ultrasound and autism severity, as well as the possibility – thus far not shown – that ultrasound exposure could contribute to autism incidence.

UW Medicine http://tinyurl.com/hupd4oq

SpiroCall enables patients to measure lung function over a phone call. It is designed to work with any type of phone around the world, not just smartphones.
Most people in the developing world who have asthma, cystic fibrosis or other chronic lung diseases have no way to measure how well their lungs are functioning outside of a clinic or doctor visit. But many do have access to a phone, though it may be a 10-year-old flip phone or a communal village landline instead of the latest app-driven smartphone.
That’s why University of Washington computer science and engineering and electrical engineering researchers have developed SpiroCall, a new health sensing tool that can accurately measure lung function over a simple phone call.
A paper to be presented shows that SpiroCall’s results came within 6.2 percent of results from clinical spirometers used in hospitals and doctor’s offices, meaning it meets the medical community’s standards for accuracy.
‘We wanted to be able to measure lung function on any type of phone you might encounter around the world – smartphones, dumb phones, landlines, pay phones,’ said Shwetak Patel, Washington Research Foundation endowed professor of computer science & engineering and electrical engineering at the UW. ‘With SpiroCall, you can call a 1-800 number, blow into the phone and use the telephone network to test your lung function.’
In 2012, researchers from the UW’s UbiComp Lab introduced SpiroSmart – which lets people monitor their lung function by blowing into their smartphones.
The patients take a deep breath in and exhale as hard and fast as they can until they can’t exhale any more. The phone’s microphone senses sound and pressure from that exhalation and sends the data to a central server, which uses machine learning algorithms to convert the data into standard measurements of lung function.

University of Washington http://tinyurl.com/hgpmr2u

About a quarter of healthcare providers said their virtual care programmes – telemedicine and telehealth – are financially sustainable and are improving efficiency, patient volumes and loyalty by filling gaps in medical specialties or helping chronically ill patients, according to a poll conducted by KPMG LLP, the U.S. audit, tax and advisory firm.
Telehealth, which uses technology to connect clinicians with patients, is gaining credence in urgent care settings from mobile devices, ‘primary care plus’ from retail clinics or for psychiatric assessments in an emergency department. Telemedicine – clinician-to-clinician consults – has a long history in radiology and for remote, underserved patient populations where specialists are needed for their clinical expertise, but it is gaining greater use. For example, telemedicine is used for neurology consults for stroke patients and also for referring nursing home patients to hospitals if they need more acute care.
‘Healthcare providers need to think of virtual care as a means to improve patient access and provider efficiency, especially as value-based contracts and other reimbursement incentives gain a greater share of revenue, while meeting patient care needs by filling gaps for key medical specialties,’ said Dr. Richard Bakalar, managing director at KPMG and a member of the firm’s Global Healthcare Center of Excellence. ‘Telehealth is rapidly evolving beyond urgent care and is increasingly used for follow up visits and helping chronically ill patients connect with their doctor online. Health plans and government payers are seeing the value from the technology and enhancing reimbursement for virtual care.’
Yet, approximately 35 percent of respondents in the poll said they have not yet started a programme incorporating virtual care, and the remaining 40 percent are in early stages.

• KPMG’s poll found that the biggest drivers for expediting adoption of virtual care were:
• Increase patient volumes and loyalty (29 percent)
• Care coordination of high risk patients (17 percent)
• Reduce costs for access to medical specialists (17 percent)
• Meaningful use and payer incentives for adoption (13 percent)
• Patient requests/consumer demand (13 percent).

Implementing a virtual care programme is not without challenges, however. Healthcare providers cited several, including:

• Too many other technological priorities (19 percent)
• Maintaining a sustainable business model (18 percent)
• Organizational readiness to implement new services/technology (18 percent)
• Regulatory compliance and risk concerns (15 percent).

KPMG LLPhttp://tinyurl.com/hlgwoyk

Patients who have had a stroke in the back of the brain are at greater risk of having another within two years if blood flow to the region is diminished, according to results of a multi-centre study led by researchers at the University of Illinois at Chicago. These stroke patients are the most likely to benefit from risky intervention to unblock arteries, and they can be identified using a new MRI-based technology developed at UIC.
The vertebrobasilar region in the back of the brain is responsible for locomotion and balance. Vertebrobasilar strokes can be devastating, causing partial or total paralysis. They account for 30 percent to 40 percent of all strokes, or about 200,000 cases per year in the U.S.
Stroke patients found to have narrowing of the blood vessels in the back of the brain caused by atherosclerosis can have angioplasty, a procedure to open blocked arteries, but the procedure carries its own risks. And because blockages don’t always correlate to locally reduced blood flow – thought to be the real culprit in raising stroke risk – researchers wanted to better understand the relationship between arterial blockages, blood flow, and recurrent strokes.
‘Having a blockage present in a blood vessel doesn’t always correlate to low blood flow,’ says Dr. Sepideh Amin-Hanjani, professor of neurological surgery at the UIC College of Medicine and principal investigator on the study. ‘There can be a blockage and flow can be normal, if other nearby blood vessels are able to compensate.’
She and her colleagues wanted to try to identify which stroke patients are at highest risk for further strokes and so might benefit from angioplasty despite the risks of the procedure.
They followed 72 adult patients who had a stroke or temporary symptoms of a stroke, known as a transient ischemic attack, in the back of the brain and who also had at least 50 percent blockage of the arteries in that part of the brain. The patients were followed for an average of 22 months at five academic medical centres as they continued receiving standard care for their condition from their neurologists.
Participants were evaluated for reduced blood flow in the back of the brain using NOVA, or Noninvasive Optimal Vessel Analysis, a software program that can quantify the volume, velocity, and direction of blood flowing through any major vessel in the brain using standard MRI equipment. The NOVA software was developed at UIC by Dr. Fady Charbel, professor and head of neurological surgery, who is a co-author of the new study.
One-fourth of the study participants were found to have diminished blood flow in the back of the brain, which turned out to be a significant predictor of subsequent stroke. These patients had 12- and 24-month stroke-free survival rates of 78 percent and 70 percent, respectively, compared to 96 percent and 87 percent for patients with normal blood flow.
‘At one year, the risk for patients with low blood flow was about five times as high as risk for patients without low flow in the back of the brain,’ Hanjani said. For these patients, the benefits of angioplasty probably outweigh the risks.
‘About three-quarters of patients didn’t have low blood flow in the vertebrobasilar region – other arteries are doing the job of ensuring that proper blood flow is reaching that area – and these patients would not benefit from treatments aimed at opening the vessels, such as angioplasty – in fact, the procedure would put these patients at unnecessary risk,’ Hanjani said.

University of Illinois at Chicago http://tinyurl.com/jxl37yo

The radiology/general imaging segment accounted for the major share of 30percent of the overall ultrasound market in 2015. This is primarily due to the wide adoption of ultrasound devices in the diagnosis of rising number of abdominal diseases. Urology has emerged as the fastest growing segment, registering a CAGR of 11.3percent during the forecast period, due to the growing incidences of urinary tract infections coupled with the rapidly aging patient population.
A new report published by Allied Market Research, titled, ‘Ultrasound Devices Market – Global Opportunity Analysis and Industry Forecast, 2014 – 2022’, projects that the global ultrasound market would reach $10,476 million ( Euro 9.32 milliion) by 2022. Diagnostic ultrasound system would continue to be the highest revenue-generating segment throughout the forecast period. Europe accounted for almost one-third of the market share in 2015, and is expected to dominate the overall market during the study period.
The major factors boosting the market growth include technological advancements (such as advent of 3D and 4D ultrasound that provides detailed information about a known abnormality from different angles), rising incidence of chronic diseases, and increasing geriatric population worldwide. The rising number of application areas of ultrasound coupled with increasing adoption of ultrasound systems in the obstetrics and gynecology field, is set to boost the growth of the ultrasound market worldwide. Cost effectiveness, safety, high accessibility, and clinical value in preliminary diagnosis are strengthening the technology’s value proposition in technological advancements in the ultrasound market. In addition, increase in number of diagnostic imaging procedures, and rising awareness for early diagnosis of clinical disorders are anticipated to further drive the demand for ultrasound devices. However, dearth of skilled and experienced sonographers and technological limitations of ultrasound systems are some of the factors restricting the market growth.
Diagnostic ultrasound devices such as 2D ultrasound, 3D & 4D ultrasound, and Doppler devices have given rise to new applications (such as biopsies and image-guiding interventions) across different clinical specialities. The growing demand for both ultra-portable and portable diagnostic ultrasound systems in diagnostic and image guidance area at points-of-care have further boosted the market growth. The advent of portability in ultrasound has built a strong path for the increased demand of these devices for point-of-care applications such as emergency medicine, anesthesiology, musculoskeletal, and critical care medicine. The trolley/cart-based ultrasound devices segment accounted for the major market share of the total ultrasound market in 2015, whereas, the compact/handheld ultrasound devices segment is expected to grow at a higher CAGR during the forecast period

Allied Market Research http://tinyurl.com/hgmpxfc