Proof - women are different!

A German study shows how the human heart twists and turns differently for men and women, and by age. Researchers at the University Hospital Freiburg describe the different heartbeats they saw in 29 men and 29 women, using an advanced imaging technology called MRI tissue phase mapping. The participants ranged in age from 20 to 60-plus.

Clear differences by age and gender emerged from the study, the report said. Among them:

• The rotation speed of the apex of the heart decreases with age.
• Younger women have higher up-and-down motion velocities along the long axis of the ventricle than younger men, but those differences were reversed in older men and women.
• Compared to men, women demonstrated reduced twisting of the ventricle, apex rotation and muscle velocity toward the center of the left ventricle during contraction.
  

The study could lead to the use of such coronary imaging in diagnosing heart problems, cardiologists say.

While this is a small study group, the findings corroborate other reports we have been reading at CMR that talk about women's physiology being indeed different from men's, which has an effect on diagnostics, treatment and devices.

Many medical device manufacturers have put a focus on women's health needs, for instance in urology, cardiology and radiology applications and some have even developed female specific products for instance, Zimmer Holdings' knee replacement designed specifically for a woman's anatomy.

The differences have also prompted the launch of research bodies such as the Society for Women’s Health Research (SWHR), which campaigns to increase awareness of the conditions affecting women. The SWHR’s work with the National Institutes of Health (NIH) in the US has encouraged the inclusion of women in clinical studies which surprisingly has only happened since 1985. Until then, clinical trials and evaluations were based on men, who were assumed to represent the norm.

The exclusion of women from clinical evaluations has created a gap in the knowledge of how devices, drugs and techniques could be optimised for better outcomes and quality of life. Sex differences are responsible for variants in bone composition, drug metabolism and the rate at which the brain synthesises neurotransmitters, chemicals important to mood and functioning.

At CMR we're pleased to see that device companies are waking up to the fact that women have a different physiology to men; maybe car manufacturers could also take note!

Global diabetes market is $34 billion

The global diabetes market, including drugs and devices, increased by 36% from 2006 to 2009, to reach a stunning $34 billion in 2009, compared to ~ $25 billion in 2006 and just over $18 billion in 2004.

The market has nearly doubled in five years, and despite the upcoming expirations of major patents and pricing pressure in self monitoring blood glucose, the growth will continue to spiral.

How could it not, given the sheer size of the diabetes population, the number of untreated and undertreated patients, the number of new diagnoses each day?

Remote patient monitoring could save £billions

We're pleased to hear about a new trial by Philips Healthcare, that monitors chronically ill patients remotely in their homes, in a bid to save billions of pounds from the UK's healthcare budget.

The Dutch company is hoping to prove to the NHS that it can stem the mounting financial burden of institutional care by using high-tech diagnostic equipment linked by the internet.
Patients in Newham, a deprived East London borough, are being monitored at home using diagnostic equipment linked via broadband internet connections to local hospitals and clinics. The Newham patients are able to test their own blood pressure or blood oxygen level and send the data in an electronic message to staff at the Primary Health Trust.

The system, known as Telehealth or Telecare, is a potential goldmine for medical technology companies, such as Philips. As governments worldwide prune their healthcare budgets, the Dutch group is broadening its business reach from sophisticated diagnostic scanners costing millions of pounds to more basic equipment that, when used in conjunction with the internet, can help governments to slow the rise in healthcare bills.

According to the DoH, 14.5 million people in Britain have long-term conditions requiring monitoring. The “whole system demonstrator” will assess the cost-benefit of monitoring patients with chronic conditions in their own homes rather than in long-stay care establishments and hospital outpatient departments. A DoH spokesman said that the technology was not intended to replace hospitals and care homes but to make better use of resources.

Savings from Telehealth are still unknown, but a study of local authority use of residential care has revealed a potential goldmine. The spokesman said: “£500 million can be taken from current spend on residential care across the country to deliver more support for people in their own homes.
“It enables people to live independently in their homes and it is more cost-effective. It reduces the burden on the system and frees up resources.”

According to Malcolm Hart, who is in charge of Philips’ medical business in Britain, the key saving for the NHS from use of the Philips system at a cost of £80 a month will be in reducing hospital visits by people with long-term illness.
Mr Hart said: “What we are trying to do is to avoid readmissions and trips to Accident & Emergency. If a patient is readmitted to hospital it costs about £2,000.
“With the recession, there is a shortage of cash. We need to find a solution to the growing demands on the system. We need to do things differently, and technology has a role to play.”

Newham, which has Britain’s highest death rate from stroke and the highest diabetes rate, suffers a big financial burden in providing long-term healthcare for more than 17 per cent of its population, the DoH says.

Some 400 patients are being monitored in Newham. Each is provided with diagnostic equipment, such as an SPO2 meter for blood oxygen, which clips on the patient’s finger. The meter is attached to a set-top box linked to the patient’s television. The readings are sent to healthcare staff of the Primary Health Trust, who contact the patient if the readings cause concern.

The Newham trial includes patients with diabetes, heart disease or breathing problems, known as chronic obstructive pulmonary disorder, a condition affecting a million Britons.
The trial will also use sensors installed in homes to monitor elderly people suffering from dementia, or individuals with Down’s syndrome who may be at risk of injury.

The DoH is sensitive to the “Big Brother” issue involved in installing surveillance equipment in homes. “These are monitoring devices and there are issues of privacy,” said a spokesman.
If the trial is successful, Philips hopes that it will lead to much wider use of its technology by healthcare organisations. Self-diagnostic systems could be used, Mr Hart says, not only to monitor illness but to check general wellbeing. Philips recently acquired Respironics, a US provider of equipment that treats sleep apnea, a respiratory ailment linked to obesity.

Originally posted at Avantrasara.com

Original article at Times Online

NICE seeking innovative new devices for adoption

For the first time, from mid 2010, medical devices will be evaluated for use in the NHS

Article summarised from "The Gray Sheet" - December 21, 2009
Device and diagnostics companies should start thinking about products they would like to offer for evaluation by the NHS under a new program in the UK.

The program, called the Evaluation Pathway Programme for Medical Technologies, is being developed by NICE in the UK, with the goal of more quickly identifying and promoting adoption of innovative new devices and diagnostics.

NICE plans by mid-2010 to begin accepting applications from manufacturers who would like to have their technologies reviewed and potentially recommended for adoption by the NHS, the publicly funded health care system in the UK.

As an independent institute that advises Britain's health system, NICE has for many years performed evaluations of medical products and procedures, but has never before concentrated on devices or diagnostics.

To qualify for evaluation, devices and diagnostics must have a European CE mark, must be available in the UK or about to be launched there, and must not have had a previous NICE review.

Bruce Campbell, chairman of NICE's newly created Medical Technologies Advisory Committee (MTAC), says:
"Of most interest is whether the technology offers advantages over products currently used by the National Health Service, such as better patient outcomes, ease of use or fewer visits to the hospital. Other advantages might be the ability to treat a larger number of patients or a particularly disabling disease, or the ability to treat or diagnose people on an outpatient basis."
"Cost is also an important consideration", Campbell admitted. "Obviously, if the technology works as well as or better than the current technology and it's cheaper, that's good value for the health service."

Numbers of amputations in Type 2 diabetes increasing

Researchers at Imperial College London have found that the number of people in England having a limb amputated because of type 2 diabetes has risen dramatically. Between 1996 and 2005, below-ankle amputations doubled to more than 2,000, and major amputations increased by 43%.

Interestingly, the team found that the number of amputations in people with type-one diabetes has dropped. We at CMR believe this indicates a strong case for people with type 2 diabetes to be testing their blood sugars to control their diabetes more closely, as is recommended for type 1 diabetes.

Study leader Dr Eszter Vamos said "there is very strong evidence that with a multidisciplinary team approach you can prevent up to 80% of the amputations.
"It highlights the importance of frequent foot checks and that it is very important to get glycaemic control and blood pressure and cholesterol control."

Diabetes UK care manager Sara Spiers said there were about 100 diabetes-related amputations each week in the UK. She added more early diagnosis was needed, as the condition could go undetected for more than 10 years and most people already had complications when they were diagnosed.