Feather disposable scalpel: Safeshield Scalpel

Distributors wanted. Australian made ECG.

Medical Fair Thailand 12-14 Sept 2013

Professional HBP-1300 Cuffs

Ultrasound and the musculoskeletal system: swings and roundabouts

The use of ultrasound for diagnostic imaging has grown by leaps and bounds in recent years and is now the preferred approach for many applications, but according to experts the application with the biggest growth potential is imaging of the musculoskeletal system.
Major developments in the technology, which now provides a number of modes including grey scale, colour and power Doppler, spectral Doppler and elastography, allow accurate characterization of joint pathology; even the acquisition of dynamic, essentially isotropic 3D images is now possible. The biggest remaining challenge is reported to be the adequate training and monitoring of medical professionals to enable them to carry out this highly complex ultrasound application.
However, while patients ranging from young athletes with suspected torn tendons, muscles or ligaments to those suffering from chronic conditions such as rheumatoid arthritis or osteoporosis

The role of non-invasive positive pressure ventilation in the weaning and peri-extubation period

Partial support for patients with respiratory failure can be provided with invasive mechanical ventilation or non-invasive mechanical ventilation. The role of non-invasive positive pressure ventilation (NPPV) in preventing intubation for various conditions has been well studied. Less well studied is the role for NPPV in the weaning and peri-extubation period.

by Dr Brooks A. Fallis  and Dr Karen E. A. Burns

Mechanical ventilation is essential for supporting patients through episodes of respiratory failure by unloading respiratory muscles and improving gas exchange. While potentially lifesaving, invasive mechanical ventilation with an endotracheal tube or tracheostomy can be associated with important harm, in part due to complications such as ventilator associated pneumonia (VAP). VAP has been shown to increase morbidity and trends towards increasing mortality [1].

Critical care physicians strive to extubate patients as early as possible, while minimising the risk of re-intubation, which has been shown to be independently associated with increased risk of developing VAP [2]. Spontaneous breathing trials (SBT) are used to decide if a patient has been weaned.  An SBT involves a focused assessment of a patient

PACS and imaging: seeking the fourth dimension

Given their pervasiveness in hospitals, one could be forgiven to take picture archiving and communication systems (PACS) for granted. However, in reality, they have been around for less than two decades. The first PACS prototype was set up in 1990 at the University of California, and soon after at Hammersmith Hospital in London. Commercial products began to enter the market 3-4 years later but serious growth in PACS use was seen only in the early 2000s.

PACS: boost to productivity and imaging demand
PACS revolutionized workflow between radiology and other hospital departments, resulting in a gigantic leap in productivity. PACS also catalysed the growth of imaging, especially computed tomography (CT) and magnetic resonance imaging (MRI) scanners, whose huge masses of data it was able to process, store and forward to different users on demand.

Along with older X-Rays and ultrasound (whose data are also managed by PACS), CT and MRI devices have become integral to nearly every single surgical procedure, as well as the medical management of chronic diseases ranging from arthritis to cancer. In acute care settings such as A&E, their availability has directly contributed to a fall in patient waiting times and increased the efficiency of triaging.

2007: 3D video of beating heart
Until recently, 2D PACS was the only realistic choice. In spite of an explosion in core processing power and storage capacity, PACS technologies had been consistently outpaced by developments in CT, which permitted imaging of increasingly thinner slices, outputting exponentially larger volumes of data.

In 2007, Toshiba launched Aquilion One, with a capability of acquiring five 320 slices per second and attaining a highly-symbolic milestone

Protein catalysed capture agents for molecular imaging

There is a growing need for affinity agents for targeted molecular imaging of disease biomarkers. Protein catalysed capture agents (PCC agents) are assembled through target-guided in situ click chemistry and display low nanomolar affinity and specificity. The iterative design process, architecture, and composition of the resulting multi-ligands make this a promising technology for imaging agent development.

by Dr Steven W. Millward,  Dr Heather D. Agnew, Dr Suresh Pitram,  Dr Bert T. Lai, Dr Rosemary D. Rohde and Dr Norman Hardman

Personalized medicine is increasingly becoming a major component            of cancer treatment and management. Many of the advances in personalized medicine have come from high throughput genomic sequencing and multiplexed proteomic analysis of tumour and tissue specimens. While these technologies have dramatically increased our understanding of cancer and cancer heterogeneity at the molecular level, translation of this knowledge into clinical imaging agents to non-invasively characterize tumour phenotypes in vivo has lagged behind.  While small molecules (e.g. FDG) have proven very useful for clinical measurement of metabolic activity, molecular imaging of cell surface and secreted biomarkers overexpressed in cancer (e.g. IGFR, EGFR, etc.) is largely confined to the preclinical and early clinical trial setting.

While groundbreaking work to determine the biological and therapeutic roles of these proteins has produced a wealth of high affinity antibodies, antibody fragments, and peptides, attempts to translate them into radiotracers for molecular imaging have produced mixed results. Antibody-based imaging agents suffer from three disadvantages in this setting:

1) Their long serum half-lives, while advantageous for therapeutic applications, result in high background signal in perfused tissue and lengthen the time between agent administration and image acquisition.
2) Antibody-based radiotracers often show accumulation and metabolic processing in the liver, increasing nonspecific signal and potentially obscuring critical tumour-specific signal in the abdominal cavity. 
3) Antibodies are biologicals, and as such their high production costs and regulatory burdens are significant economic barriers to commercialization and clinical translation. Linear peptides derived from phage display represent a second class of potential imaging agents, however their rapid degradation in vivo typically results in nonspecific background signal and poor tumour uptake. An ideal targeted molecular imaging agent would combine the affinity and specificity of antibodies with the high bio-stability, tumour uptake, and clearance of small molecules.

PCC agent design
Protein catalysed capture (PCC) agent technology represents a novel approach to rapidly design ligands with high affinity and specificity that can be potentially adapted to a variety of research and in vivo clinical applications including molecular imaging. This technology was built upon the observation by K. Barry Sharpless and co-workers at The Scripps Research Institute that the azide-alkyne cycloaddition (a