Philips leads HeartCycle project for telemonitoring solutions

Philips will lead a new European Union (EU) funded research project aimed at improving care of heart patients through the development of innovative telemonitoring solutions. Following the highly successful MyHeart project, the HeartCycle project, which began on 1 March 2008, will be one of the largest biomedical and healthcare research projects within the EU.

The HeartCycle consortium will work to improve the quality of care for coronary heart disease and heart failure patients by developing systems for monitoring their condition at home and involving them in the daily management of their disease. These systems will comprise unobtrusive sensors built into the patient’s clothing or bed sheets and home appliances such as weight scales and blood pressure monitors. The consortium aims to develop dedicated software that analyses the acquired data, and that can be programmed to provide feedback on the patient’s health status, plus his or her adherence to prescribed therapies and progress towards achieving health status milestones. It also aims to develop mechanisms to report relevant data back to clinicians automatically so that they can prescribe personalised therapies and lifestyle recommendations.

Public and private partners from 18 research, academic, industrial and medical organisations from nine European countries and China will team up in the project. HeartCycle will run for four years and has a budget of approximately EUR 21 million, of which approximately EUR 14 million will be funded by the European Union as part of the EU 7th Framework Program.

“The greatest challenge and opportunity for the management of long-term medical conditions is to help patients to help themselves,” says Professor John Cleland MD, Head of the Department of Cardiology at the University of Hull (UK), past chairman of both the Working Group on Heart Failure of the European Society of Cardiology and of the British Society for Heart Failure and Chief Medical Officer of the HeartCycle project. “Investing directly in people who need help, and not just in services that do things to or for them, makes sense in terms of improved care, greater affordability and the effective deployment of scarce nursing and medical resources.”

Henk van Houten, senior vice president of Philips Research and head of the Healthcare Research programme, said: “By developing systems that remotely monitor heart patients and motivate them to adhere to treatment regimes and adopt beneficial lifestyles, we hope to improve the survival of people with heart disease as well as to contain the overall cost of care.”

“The development of such systems can only be achieved efficiently via multi-disciplinary partnerships between hardware engineers, software engineers, textile manufacturers, industrial designers, clinical experts and healthcare providers, as is the case in the HeartCycle project.”

Baxter in heparin recall after adverse reactions

Baxter International is proceeding with the voluntary recall of all remaining lots and doses of its heparin sodium injection multi-dose, singledose vials, and HEP-LOCK heparin flush products.

The company initially recalled 9 lots of heparin sodium injection multi-dose vials on 17 January 2008 as a precautionary measure due to a higher than usual number of reports of adverse patient reactions involving the product and suspended production early February.

Given the widespread use of this blood thinner and the impact a product shortage would have on operating rooms, dialysis centers, and other critical care areas, the FDA and Baxter concluded that removing additional lots and doses of Baxter's heparin from the market earlier would have created more risk to patients requiring heparin therapy than the increased potential for experiencing an adverse reaction.

This recall does not involve Baxter's heparin pre-mix IV solutions in bags: heparin sodium in 5% dextrose injection and heparin sodium in 0.9% sodium chloride injection.

Nearly all reported adverse reactions have occurred in 3 specific areas of product use: renal dialysis, invasive cardiovascular procedures, and apheresis procedures. Reported adverse patient reactions have included: stomach pain or discomfort, nausea, vomiting, diarrhea, decreased or low blood pressure, chest pain, fast heart rate, dizziness, fainting, unresponsiveness, shortness of breath, the feeling of a strong or rapid heartbeat, drug ineffectiveness, burning sensation, redness or paleness of skin, abnormal sensation of the skin, mouth or lips, flushing, increased sweating, decreased skin sensitivity, headache, feeling unwell, restlessness, watery eyes, throat swelling, thirst, bleeding tendencies, and difficulty opening the mouth. Some of these reactions, particularly profound and refractory hypotension, may be severe or life threatening. Customers have been instructed to discontinue use and segregate the recalled product from the rest of their inventory.

Tobacco taxes 500 times that spent on controls

The World Health Organisation (WHO) in February released new data showing that while progress has been made, not a single country fully implements all key tobacco control measures, and outlined an approach that governments can adopt to prevent tens of millions of premature deaths by the middle of this century.

In a new report which presents the first comprehensive analysis of global tobacco use and control efforts, WHO finds that only 5% of the world’s population live in countries that fully protect their population with any one of the key measures that reduce smoking rates. The report also reveals that governments around the world collect 500 times more money in tobacco taxes each year than they spend on anti-tobacco efforts. It finds that tobacco taxes, the single most effective strategy, could be significantly increased in nearly all countries, providing a source of sustainable funding to implement and enforce the recommended approach, a package of six policies called MPOWER (see below).

“While efforts to combat tobacco are gaining momentum, virtually every country needs to do more. These six strategies are within the reach of every country, rich or poor and, when combined as a package, they offer us the best chance of reversing this growing epidemic,” said Dr Margaret Chan, directorgeneral of WHO.

The six MPOWER strategies are:

● Monitor tobacco use and prevention policies
● Protect people from tobacco smoke
● Offer help to quit tobacco use
● Warn about the dangers of tobacco
● Enforce bans on tobacco advertising, promotion and sponsorship
● Raise taxes on tobacco

The report also documents the epidemic's shift to the developing world, where 80% of the more than eight million annual tobacco-related deaths projected by 2030 are expected to occur.

This shift, the report says, results from a global tobacco industry strategy to target young people and adults in the developing world, ensuring that millions of people become fatally addicted every year. The targeting of young women in particular is highlighted as one of the “most ominous potential developments of the epidemic’s growth”.

Other key findings in the report include:
● Only 5% of the global population is protected by comprehensive national smoke-free legislation and 40% of countries still allow smoking in hospitals and schools;
● Only 5% of the world’s population lives in countries with comprehensive national bans on tobacco advertising and promotion;
● Just 15 countries, representing 6% of the global population, mandate pictorial warnings on tobacco packaging;
● Services to treat tobacco dependence are fully available in only nine countries, covering 5% of the world’s people;
● Tobacco tax revenues are more than 4,000 times greater than spending on tobacco control in middleincome countries and more than 9,000 times greater in lower-income countries. High- income countries collect about 340 times more money in tobacco taxes than they spend on tobacco control.

Carestream Health scoops Frost & Sullivan award

Frost & Sullivan has awarded the 2008 Global Radiology Information Systems Market Penetration Leadership Award to Carestream Health, for its steady growth in the Radiology Information Systems (RIS) market. Growth in new markets, exceptional customer service, successful product and distribution strategies coupled with new product development, and focused marketing alliances have enabled Carestream Health to optimise market penetration around the world.

“Carestream Health’s RIS is a highly advanced information system designed to reduce the complexity of radiology administrative operations,” explains Frost & Sullivan research analyst Ranjit Ravindranathan. “This innovative system supports the automation of radiology, including efficient management of patient data maintenance, order entry and distribution of critical results.”

The company’s RIS is a flexible system that can be tailored to suit existing workflows. The system features automated order entry, Web communication, multiple site scheduling, monitoring, documentation, integration with PACS, work list management, strategic management decision-support tools and seamless integration with network peripherals, thereby reducing demands on hospitals’ IT staff.

Dark-field x-ray offers more detail

Researchers at the Paul Scherrer Institute (PSI) and the EPFL in Switzerland have developed a novel method for producing dark-field x-ray images at wavelengths used in typical medical and industrial imaging equipment.

Dark-field images provide more detail than ordinary x-ray radiographs and could be used to diagnose the onset of osteoporosis, breast cancer or Alzheimer’s disease, to identify explosives in hand luggage, or to pinpoint hairline cracks or corrosion in functional structures.

Up until this point, darkfield x-ray imaging required sophisticated optics and could only be produced at facilities like the PSI’s 300m-diameter, $200-million synchrotron. With the new nanostructured gratings described in this research, published online 20 January in Nature Materials, dark-field images could soon be produced using ordinary x-ray equipment already in place in hospitals and airports around the world.

Unlike traditional x-ray images, which show a simple absorption contrast, dark-field images capture the scattering of the radiation within the material itself, exposing subtle inner changes in bone, soft tissue, or alloys. The overall clarity of the images is striking. The improved sensitivity in measuring bone density and hairline fractures could help diagnose the onset of osteoporosis. Because cancer or plaque cells scatter radiation slightly differently than normal cells, dark-field x-ray images can also be used to explore soft tissue, providing safer early diagnosis of breast cancer or the plaques associated with Alzheimer’s disease.