Could imaging via mobile phones increase access in the developing world?

Researchers have developed a way of processing images via mobile phones, which they say could reduce costs and increase access, especially in the developing world.

They point out that in developing countries the use of imaging systems is limited by their high cost and the need for experienced users to operate and maintain them. However, mobile phone use in these countries is high, "because so little infrastructure is required to maintain wireless networks". In fact, it is estimated that over 60% of mobile phone usage is in developing countries.

The scientists, from the Hebrew University of Jerusalem and the University of California, Berkeley, used electrical impedance tomography (EIT) to image a simulated breast tumour (a gel-filled container). The raw data were collected at the patient site, and the measurements uploaded to a mobile phone and sent to a central facility for processing. The resulting image of the simulated tumour could be viewed on a mobile phone.

The group said that the system should work with any mobile phone capable of sending and receiving multimedia messages. The tool used to collect the data was made from off-the-shelf components and the researchers said it could be operated by someone with basic technical training.

Prof Boris Rubinsky, the lead investigator, believes the concept could also be valuable for developed nations. "It could be worthwhile to consider this as a way of reducing the cost of medical imaging," he said.

The "Booty Buster"

While we'd all like rock-hard abs, the enduring popularity of those belts that electronically stimulate your abdominal muscles proves that we're not so keen on the rigorous exercise regimens needed to achieve them.

A new device invented by two Hampshire, UK sisters and developed with help from the University of Portsmouth could provide a new approach. The "Booty Buster" is shaped like a wok, with an unstable base that forces you to work your stomach muscles as you sit on it. It also massages the bottom and thighs to target cellulite.

The sports scientists at the university tested it using electromyography, using small electrodes on the skin which pick up the electrical activity of the muscle underneath. Apparently, it showed more muscle activity than other devices on the market for exercising core stability.

While not exactly a medical device, anything that could help combat the oncoming "obesity epidemic" can't be bad.

MRI detects source of "booze rage"

Trouble brewing: Alcohol might encourage Dutch courage by damping down the regions of the brain that detect threatening stimuli Photo: Lukas Zeman

Ever wondered why people get more aggressive after a few pints? It turns out that alcohol damps down the regions of the brain that detect threatening stimuli.

This lack of anxiety means that people are more likely to make risky decisions, and could fail to avoid an argument or a fight. On a more positive note, it could make us less worried about chatting to new people.

Scientists at the National Institute on Alcohol Abuse and Alcoholism in Maryland gave 12 volunteers either alcohol or placebo over two 45-minute periods. They showed them photos of people with frightened facial expressions, and measured their brain activity using MRI.

Patients receiving placebo had increased activity in the amygdala, insula and parahippocampal gyrus when they saw the photos, but those receiving alcohol did now show much enhanced activity. These areas have previously been identified as important in fear.

The investigators also found that alcohol stimulated striatal areas of the brain, which are involved in feeling rewarded.

So, next time you're in the pub and someone tries to pick a fight with you, you'll know why … you might not want to point that out to them, though.

Brittle ortho shares set for big surge?

So far, it seems as if 2008 might be a difficult year for publicly-listed orthopaedic firms. Since the beginning of this year, orthopaedic specialists such as Orthofix, Orthovita and OrthoLogix have all seen their shares fall in value considerably, while the larger companies have also struggled.

The stock value of Orthofix has almost halved - it began 2008 at $58 per share and now resides at around $30. Orthovita and OrthoLogix’s shares have dropped ominously low, $2.33 and $0.97 respectively (at the close of markets on April 28).

The big players in the market have not fared spectacularly either. While Smith & Nephew and Zimmer performed admirably, Stryker, Wright Medical and Corin were unable to match their rivals. Shares in Corin have tumbled 19% during 2008 to 459.50p on the LSE, Stryker has dipped 16% to $64.30 on the Nasdaq, while Wright Medical managed to lose $5 off its share price before recovering to a 1% loss at $28.81 per share. Although Medtronic witnessed a small gain in its share price this year, this came after it navigated a substantial dip in its value.

However, if the Financial Times is anything to go by, the orthopaedic companies are set for a bright future and it would be worthwhile for investors in this space to hold on to their shares. An editorial in a recent issue stated that “the huge baby boom generation is developing creaky joints and new products aimed at early intervention could expand the customer base”.

The FT points out that the orthopaedic market had $32bn in sales during 2007, and is expected to grow by 10% annually over the next three years - suggesting that the recent performance by ortho firms is merely a trough before a more considerable high.

Medical miracles?

Here’s a faith-restoring story. Keith White, a churchgoer at Immaculate Heart of Mary Church in Cincinnati, Ohio was dancing with his wife at the 60th anniversary celebrations of the parish when he suffered a cardiac arrest. The other parishioners quickly gathered around him, and their actions saved his life. Was this a case of miracle healing? Maybe, maybe not. Mr White’s life was saved by parishioners using Defibtech’s Automated External Defibrillator (AED), mentioned in a previous blog, that the parish had at its disposal. Surely, then, one would see this as a clear case of medical rather than divine intervention - until we learn that the AED had been donated to the church anonymously, just ten days earlier.

Churches have been the scenes of numerous defibrillator life-saves in the US and their installations do not appear to be ruffling the feathers of worshippers who believe in the power of spiritual healing. Pope Benedict XVI, no less, personally accepted the gift of a Defibtech AED at the Vatican on April 17. "He was genuinely interested and immediately grasped how a defibrillator can save lives," said Defibtech’s president Gintaras Vaisnys, who presented the pontiff with the device.

First implantation of a "bionic" eye

News of the first implantation of a "bionic" eye that allows retinal disease patients to see again hit the headlines this week. Tina Tan, business editor of Clinica, was interviewed by Sky News and commented on the driving forces behind technological advances in medical devices and how healthcare providers respond to these innovations.

Diagnostics key to the "nichebuster" era

The era of the blockbuster drug could soon be over.

"People are already talking about nichebusters," said Hans-Juergen Arens of Abbott at last week's Imaging in Oncology conference in London.

Diagnostics will be vital in the "nichebuster" era. "For targeted therapies, you need targeted diagnostics," Dr Arens added in his talk about "theranostics", which he described as "the marriage of drug therapy and diagnostics". He said that its goal was to be able to perform a diagnostic test that aids in the selection of patients and can monitor the biological effects of a drug therapy.

Although targeted therapies only account for a small share of the current oncology market, they make up two thirds of compounds in clinical development. The proportion in preclinical studies is even higher.

A reason for this could be that current, "traditional" therapies using a "one size fits all" approach are not very effective - as low as 25% in oncology, while other areas such as Alzheimer's disease and asthma also have lower rates than you might expect.

Also, being able to use biomarkers to test the efficacy of drugs earlier in clinical trials could cut down the time and money wasted continuing the development of duds. 70% of all drug development projects are discontinued because of low efficacy or tolerability, Dr Arens said, adding that a 10% improvement in predicting phase III failures could lead to savings of $112 million.

Several cancer therapies already use the theranostic approach, including Roche/Genentech's Herceptin (trastuzumab) and GlaxoSmithKline's Tykerb (lapatinib). Both target HER-2-overexpressing breast cancer, and Tykerb also inhibits the epidermal growth factor receptor (EGFR). HER-2 status is measured using immunohistochemistry (ICH) or fluorescence in situ hybridisation (FISH). However, problems can arise when patients are diagnosed as HER-2-positive when they are in fact negative, or vice versa. False negatives can deny patients life-extending treatment while false positives can give them false hope and also lead to patients receiving an expensive drug without any benefit, said Dr Arens, emphasising how important it is that diagnostic techniques are properly applied.

Theranostics are also used in HIV therapy, for example Pfizer's CCR5 inhibitor maraviroc (Selzentry/Celsentri), which employs Monogram Biosciences' Trofile assay to identify patients with CCR5-tropic HIV-1, who are likely to respond to the drug. GSK's antiretroviral Ziagen (abacavir) causes a hypersensitivity reaction in HLA-B*5701-positive patients (5-9% of people receiving the drug), so they have to be tested for this first. It is also possible to test treatment-naive HIV patients for resistance to antiretroviral therapy - the prevalence of resistance in these patients in the US and Europe has been estimated at around 10%.

"Prevention and managing disease will truly become a topic of the future," says Dr Arens. Here, the medical devices and diagnostic industry clearly has a large role to play.