A new medical-diagnostic device made out of paper detects biomarkers and identifies diseases by performing electrochemical analyses – powered only by the user’s touch – and reads out the color-coded test results, making it easy for non-experts to understand.
“You could consider this a portable laboratory that is just completely made out of paper, is inexpensive and can be disposed of through incineration,” said Ramses V. Martinez, an assistant professor of industrial and biomedical engineering at Purdue University. “We hope these devices will serve untrained people located in remote villages or military bases to test for a variety of diseases without requiring any source of electricity, clean water, or additional equipment.”
The self-powered, paper-based electrochemical devices, or SPEDs, are designed for sensitive diagnostics at the “point-of-care,” or when care is delivered to patients, in regions where the public has limited access to resources or sophisticated medical equipment.
The test is initiated by placing a pinprick of blood in a circular feature on the device, which is less than two-inches square. SPEDs also contain “self-pipetting test zones” that can be dipped into a sample instead of using a finger-prick test. The top layer of the SPED is fabricated using untreated cellulose paper with patterned hydrophobic “domains” that define channels that wick up blood samples for testing. These “microfluidic channels” allow for accurate assays that change colour to indicate specific testing results. A machine-vision diagnostic application also was created to automatically identify and quantify each of these “colorimetric” tests from a digital image of the SPED, perhaps taken with a cellphone, to provide fast diagnostic results to the user and to facilitate remote-expert consultation.
The bottom layer of the SPED is a “triboelectric generator,” or TEG, which generates the electric current necessary to run the diagnostic test simply by rubbing or pressing it. The researchers also designed an inexpensive handheld device called a potentiostat, which is easily plugged into the SPED to automate the diagnostic tests so that they can be performed by untrained users. The battery powering the potentiostat can be recharged using the TEG built into the SPEDs. “To our knowledge, this work reports the first self-powered, paperbased devices capable of performing rapid, accurate, and sensitive electrochemical assays in combination with a low-cost, portable potentiostat that can be recharged using a paper-based TEG,” Martinez said.

Purdue University https://www.purdue.edu/newsroom/releases/2017/Q3/self-powered-paper-based-speds-may-lead-to-new-medical-diagnostic-tools.html

Postmenopausal hormone therapy is not associated with increased risk of stroke, provided that it is started early, according to a report from Karolinska Institutet.
Roughly three in ten women in the menopause transition are afflicted by symptoms that seriously affect their wellbeing, such as hot flushes, dry mucosa and insomnia. However, although the symptoms can be treated effectively with female sex hormones, prescriptions have been low over the past 15 years as researchers have demonstrated a link between such therapy and an increased risk of certain diseases, including stroke.
There is still, however, a need for more research on the issue, as the risk can be influenced by the time of the treatment and other factors, reasons Karin Leander, researcher at Karolinska Institutet’s Institute of Environmental Medicine.
“New research shows us that hormone therapy actually has a positive effect on blood vessels if initiated early on in the menopause, but not if initiated late,” says Dr Leander. “So there was reason to re-examine whether hormone therapy is linked to the risk of stroke, taking, of course, the time of administering into consideration.”
Dr Leander and her colleagues have now analysed data on postmenopausal hormone therapy from five Swedish cohort studies covering a total of 88,914 women, combined with data from national registries on diagnoses and causes of death during a follow-up period.
Hormone therapy was not linked to increased risk of stroke (ischemic and hemorrhagic stroke combined) if the therapy was initiated within five years of menopausal onset, regardless of means of administration (oral, via the skin or vaginal), type of therapy (combination or estrogen only), active substance and treatment duration.
In sub-analyses, however, there was an observable increase in risk for hemorrhagic stroke (the less common form) if the therapy contained the active substance conjugated equine estrogens. Drugs containing estradiol, on the other hand, were not associated with a higher risk. A higher risk was also seen for both ischemic and hemorrhagic stroke if the treatment was initiated later than five years after the onset of menopause and contained conjugated equine estrogens.
“The risk of stroke seems virtually eradicable if treatment commences early, but it’s naturally important to take account of the increase in risk that exists under certain circumstances,” says Dr Leander. “These results provide doctors with a better scientific base on which to take decisions on treatment for menopausal symptoms.”
Karolinska Institutehttps://tinyurl.com/ycqy6tdg

Of the quarter- million women diagnosed with breast cancer every year in the United States, about 180,000 undergo surgery to remove the cancerous tissue while preserving as much healthy breast tissue as possible.
However, there’s no accurate method to tell during surgery whether all of the cancerous tissue has been successfully removed. The gold-standard analysis takes a day or more, much too long for a surgeon to wait before wrapping up an operation. As a result, about a quarter of women who undergo lumpectomies receive word later that they will need a second surgery because a portion of the tumour was left behind.
Now, researchers at Washington University School of Medicine in St. Louis and California Institute of Technology report that they have developed a technology to scan a tumour sample and produce images detailed and accurate enough to be used to check whether a tumour has been completely removed.
Called photoacoustic imaging, the new technology takes less time than standard analysis techniques. But more work is needed before it is fast enough to be used during an operation.
"This is a proof of concept that we can use photoacoustic imaging on breast tissue and get images that look similar to traditional staining methods without any sort of tissue processing," said Deborah Novack, MD, PhD, an associate professor of medicine, and of pathology and immunology, and a co-senior author on the study.
The researchers are working on improvements that they expect will bring the time needed to scan a specimen down to 10 minutes, fast enough to be used during an operation. The current gold-standard method of analysis, which is based on preserving the tissue and then staining it to make the cells easier to see, hasn’t gotten any faster since it was first developed in the mid-20th century.
To speed up the process, the researchers took advantage of a phenomenon known as the photoacoustic effect. When a beam of light of the right wavelength hits a molecule, some of the energy is absorbed and then released as sound in the ultrasound range. These sound waves can be detected and used to create an image.
"All molecules absorb light at some wavelength," said co-senior author Lihong Wang, PhD, who conducted the work when he was a professor of biomedical engineering at Washington University’s School of Engineering & Applied Science. He is now at Caltech. "This is what makes photoacoustic imaging so powerful. Essentially, you can see any molecule, provided you have the ability to produce light of any wavelength. None of the other imaging technologies can do that. Ultrasound will not do that. X-rays will not do that. Light is the only tool that allows us to provide biochemical information."
The researchers tested their technique by scanning slices of tumours removed from three breast cancer patients. For comparison, they also stained each specimen according to standard procedures.
The photoacoustic image matched the stained samples in all key features. The architecture of the tissue and subcellular detail such as the size of nuclei were clearly visible.
"It’s the pattern of cells – their growth pattern, their size, their relationship to one another – that tells us if this is normal tissue or something malignant," Novack said. "Overall, the photoacoustic images had a lot of the same features that we see with standard staining, which means we can use the same criteria to interpret the photoacoustic imaging. We don’t have to come up with new criteria."
Having established that photoacoustic techniques can produce usable images, the researchers are working on reducing the scanning time.

Siteman Cancer Center http://tinyurl.com/y87u35l5

It’s no secret that depression is a commonly reported symptom of the menopause transition. Several small trials have previously suggested that transdermal estradiol therapy (i.e., an estrogen patch) effectivelytreats perimenopausal depression. But this is the first study to examine its effectiveness in preventing the onset of perimenopausal depression among women who were previously not depressed. Estradiol is the primary estrogen (female sex hormone) that is produced during a woman’s reproductive years, impacting reproduction as well as sexual function.
A 12-month intervention conducted by Drs. David Rubinow and Susan Girdler and their team at the University of North Carolina at Chapel Hill demonstrated that transdermal estradiol was more effective than placebo in maintaining a more positive mood and in preventing the emergence of clinically significant depression particularly among women in the early menopause transition (as opposed to women in the late menopause transition or postmenopausal period). The effectiveness of treatment on mood was also stronger in women who reported a greater number of stressful events in the six months preceding enrollment.
“This study suggests that the stabilization of fluctuating estradiol levels, which are characteristic of the menopause transition, with transdermal estradiol may represent one option for preventing the development of depressive symptoms in the menopause transition,” says Dr. Jennifer Gordon, a lead researcher on the study team from the University of Regina in Saskatchewan, Canada.
“An interesting finding in this study is the impact of recent life events, which signals that healthcare providers may need to inquire about such events when determining whether or not to prescribe transdermal estradiol to influence mood in perimenopausal women experiencing depressive symptoms,” says Dr. JoAnn Pinkerton, NAMS executive director.”

The North American Menopause Society
www.menopause.org/docs/default-source/default-document-library/transdermal-estradiol-for-depression-10-2-17.pdf
 

Sphere Medical, an innovative company in critical care monitoring and diagnostics equipment, announces that its Proxima™ bedside blood gas monitoring system is compatible with Philips IntelliVue Patient Monitoring Systems through the Philips IntelliBridge Interface Module.
Sphere Medical’s Proxima is an acute respiratory and metabolic monitoring system used in critical care settings which supports proactive patient care, particularly at critical times.  It enables rapid and frequent blood gas, glucose and electrolyte measurements directly at the bedside without the caregiver leaving the patient. Philips compatibility means that Proxima’s results can be recorded and displayed alongside other critical monitoring information, such as blood pressure, ECG, EEG, respiratory rate, cardiac output and temperature. Such consolidated information gives a comprehensive patient overview, enhancing patient management. With the increasing adoption of electronic data record systems in critical care settings, Philips compatibility will also give Proxima customers a very simple means of integrating their data into electronic medical record systems (EMR).
Commenting on the additional point-of-care connectivity functionality of the Proxima bedside blood gas analyser, Wolfgang Rencken, CEO of Sphere Medical said, “We are extremely pleased with the confirmation that Proxima is compatible with Philips IntelliVue patient monitors through the Philips IntelliBridge EC10 medical device interfacing module. Many of our customers use Philips monitoring and data management systems and this connectivity further helps the practical implementation of Proxima as an acute respiratory and metabolic monitoring device in critical care settings.”
www.spheremedical.com