The 32nd Korea International Medical & Hospital Equipment Show held in Seoul from 17 to 20 March showcased Korea’s important medical equipment industry.

Over the years, KIMES has grown into one of the major trade shows in Asia. This year, the event gathered more than 73,000 visitors over 38,808 square meters of exhibition space. One of its main advantages is that it acts as a showcase for Korea’s particularly strong medical equipment industry. Indeed, out of the 1,152 companies from 37 countries who were exhibiting this year, 548 were Korean manufacturers and the show provided an ideal setting for highlighting the increasingly important role played by leading Korean companies such as Samsung, Listem, JW Medical, DK Medical, BIT Computer and Alpinion to name but a few.
As a platform enabling Korea’s medical device industry to show its latest equipment and technology alongside leading global players like GE, Fuji, Shimadzu and Hitachi, KIMES has succeeded in attracting numerous contingents of foreign visitors especially from the Asia region who have a strong purchasing power, including officials in medical institutions and hospitals, radiologists, medical laboratory specialists, pharmacists and emergency medical personnel. The number of foreign visitors has increased significantly this year, reaching 3563 medical professionals from 86 countries, a growth of 17.2% versus 2015. Over the last 5 years, the total of foreign visitors has grown by 184% compared with 19% for domestic visitors. Unsurprisingly, China is top of the list accounting for more than 30% of the total of foreign visitors, followed by South East Asia with nearly 20% and Japan.
A post show survey of exhibitors conducted by the organizers showed a majority of them satisfied with the results of their participation and over 70% committing to exhibit again in 2017.

The microbiome of patients admitted to the intensive care unit (ICU) at a hospital differs dramatically from that of healthy patients, according to a new study. Researchers analysing microbial taxa in ICU patients’ guts, mouth and skin reported finding dysbiosis, or a bacterial imbalance, that worsened during a patient’s stay in the hospital. Compared to healthy people, ICU patients had depleted populations of commensal, health-promoting microbes and higher counts of bacterial taxa with pathogenic strains – leaving patients vulnerable to hospital-acquired infections that may lead to sepsis, organ failure and potentially death.
What makes a gut microbiome healthy or not remains poorly defined in the field. Nonetheless, researchers suspect that critical illness requiring a stay in the ICU is associated with the loss of bacteria that help keep a person healthy. The new study, which prospectively monitored and tracked changes in bacterial makeup, delivers evidence for that hypothesis.
‘The results were what we feared them to be,’ says study leader Paul Wischmeyer, an anesthesiologist at the University of Colorado School of Medicine. ‘We saw a massive depletion of normal, health-promoting species.’
Wischmeyer notes that treatments used in the ICU – including courses of powerful antibiotics, medicines to sustain blood pressure, and lack of nutrition – can reduce the population of known healthy bacteria. An understanding of how those changes affect patient outcomes could guide the development of targeted interventions to restore bacterial balance, which in turn could reduce the risk of infection by dangerous pathogens.
Previous studies have tracked microbiome changes in individual or small numbers of critically ill patients, but Wischmeyer and his collaborators analysed skin, stool, and oral samples from 115 ICU patients across four hospitals in the United States and Canada. They analysed bacterial populations in the samples twice – once 48 hours after admission, and again after 10 days in the ICU (or when the patient was discharged). They also recorded what the patients ate, what treatments patients received, and what infections patients incurred.
The researchers compared their data to data collected from a healthy subset of people who participated in the American Gut project dataset. (American Gut is a crowd-sourced project aimed at characterizing the human microbiome by the Rob Knight Lab at the University of California San Diego.) They reported that samples from ICU patients showed lower levels of Firmicutes and Bacteroidetes bacteria, two of the largest groups of microbes in the gut, and higher abundances of Proteobacteria, which include many pathogens.
Wischmeyer was surprised by how quickly the microbiome changed in the patients. ‘We saw the rapid rise of organisms clearly associated with disease,’ he says. ‘In some cases, those organisms became 95 percent of the entire gut flora – all made up of one pathogenic taxa – within days of admission to the ICU. That was really striking.’ Notably, the researchers reported that some of the patient microbiomes, even at the time of admission, resembled the microbiomes of corpses. ‘That happened in more people than we would like to have seen,’ he says.
American Society of Microbiology http://tinyurl.com/hz98ug9

A simple phone checklist can help detect tell-tale changes in the health status of people receiving nonmedical home care, according to the findings of a pilot study led by investigators at Harvard Medical School.

Results of the research are based on a program that requires home-care aides to record changes in status during a telephone clockout at the end of each shift.

The research was conducted in collaboration with Right at Home, a senior home care provider, and ClearCare, a company that provides a software platform for homecare agencies.

Analysis of the data captured over a six-month period across 22 Right at Home agencies reveals that changes in clinical status are relatively common — occurring in 2 percent of all caregiver shifts and affecting, on average, 2 percent of recipients. The majority of changes were in behaviour (17 percent) and skin condition (16 percent), followed by changes in eating or drinking behaviour (14 percent) and ability to stand or walk (9 percent).

The results, researchers said, underscore the potential of real-time monitoring systems to spot problems and avert complications before they escalate enough to require hospitalization. Indeed, over the course of the six-month trial, 14 percent of the home-care recipients were hospitalized.

Recipients of non-medical home care often have chronic health conditions that lead to hospitalizations, some of which may be preventable.

The research team cautioned that whether the real-time monitoring system could, in fact, prevent hospitalizations and reduce cost of care remains unknown. That, they said, is the subject of an ongoing randomized trial across 400 home-care locations in the United States. However, the research team said, the fact that a basic phone questionnaire could capture important indicators in clinical status points to the value of harnessing simple technologies to monitor those receiving care at home.

‘Millions of elderly Americans receive supportive home-care services each year, and many of them require frequent hospitalizations, so we set out to determine whether a simple real-time checklist could help improve outcomes and lower health care spending,’ said study leaderDavid Grabowski, Ph.D., professor of health care policy at Harvard Medical School. ‘Our results are a first step to answering that question.’

Under the pilot program, home caregivers were required to do a phone clock out at the end of their shifts. Caregivers receive an automated phone message prompting them to report any changes in health status. The message included a list of questions pertaining to changes in mental, neurologic, gastrointestinal, urinary and other indicators. Any changes reported via the automated system were immediately dispatched to a manager at the home-care agency office for further assessment and triage. The care manager determined whether the condition required closer monitoring, a change in care, a call into the doctor’s office or all of the above. The idea, researchers said, is to prevent complications before they become grave enough to require hospitalization.

Patients who may benefit the most include those with chronic conditions such as diabetes, neurologic disorders or cardiovascular disease, in whom even seemingly innocuous changes could spell bigger trouble. That theme, researchers said, emerged clearly in a series of interviews with home-care workers. For example, one manager relayed the story of a person with diabetes whose caregiver reported a foot ulcer through the phone-based checklist. Normally, that injury would not have been reported until the end of the week, but because of the prompt alert, the care manager reached out to the patient’s nurse, who initiated treatment immediately. One week later, the wound had healed. Sores, wounds and injuries are particularly dangerous in people with diabetes and can lead to rapid decay of tissue and, in some cases, limb amputations.

EurekAlert www.eurekalert.org/pub_releases/2016-08/hms-pcc081116.php

A novel measure for assessing the body’s response to surgery may allow for better anesthesia management in the O.R., less pain when regaining consciousness from anesthesia and better postoperative outcomes, according to a study. The measure, called the nociception (pain) level index, allowed physicians to more accurately evaluate responses to painful stimulation in patients under general anesthesia, compared to traditional measures.
‘There’s currently no standardized, objective method for physicians to monitor the effectiveness of pain-relieving drugs being administered during surgery,’ said Ruth Edry, M.D., lead study author and senior physician anesthesiologist at Rambam Medical Centre in Haifa, Israel. ‘Not effectively monitoring bodily responses to painful stimulation can lead to insufficient amounts of pain medication being administered, which can result in the patient having severe pain upon regaining consciousness from anesthesia, while too much medication may cause other side effects such as nausea and vomiting or respiratory complications.’
Under general anesthesia, patients are unconscious, but their body still shows reflex responses to the surgical procedure, including changes in heart rate, blood pressure, eyes tearing or sweating. These unwanted reflexes can in some cases be dangerous, and anesthesiologists adjust the amount of anesthesia and pain medication when they occur. The nociception (pain) level index, which uses an algorithmic combination to process multiple hormonal and neurological reactions, aims to provide a better, earlier measure of the body’s reflex response to painful stimulation during surgery, compared to the traditional monitoring of individual factors such as changes in heart rate or blood pressure.
In the study, 58 patients who had general anesthesia for a variety of different surgical procedures were examined. Routine anesthesia monitoring was supplemented with a pain monitoring device (PMD-100; Medasense Biometrics; Ramat-Gan, Israel), which generated the nociception (pain) index. The patients’ index was compared to individual, more traditional measures, including heart rate and blood pressure. This index was assessed at several stages including intubation and skin incision, which were designated ‘noxious’ stimuli that would be painful in the conscious person, and where then compared to other non-painful periods.
Compared to other accepted monitors for measuring the body’s response to painful stimulation during surgery, the nociception (pain) index better discriminated presumed pain-causing stimuli from non-pain-causing stimuli. The index also accurately quantified the body’s response to increasingly more painful stimulation, with high sensitivity and specificity, as well as showed a decrease when pain medication was administered.
‘Our results demonstrate the superiority of combining multiple physiologic measures over any individual parameter in the evaluation of the body’s response to pain during surgery,’ said Dr. Edry. ‘The article presents an effective index for trending the body’s response to painful stimulation in the anesthetized patient. Once in clinical practice, we can conduct large-scale studies to better assess the influence of this monitor on patient outcomes.’

The American Society of Anesthesiologisthttp://tinyurl.com/johadqm