Archive | November 2012

Let the cyber knife take away your pain

In 1983, the World Health Organization put cancer as a leading cause of death in South Korea. It has an immense impact with 64,000 people dying every year in Korea due to the disease. Luckily, the latest development in cancer treatment is available in Korea: Cyber Knife Radio Surgery. There are currently some hundred cyber knife systems installed in only few countries in the world. Korea was among the first to implement it and today, it has one of the most numbers of installed systems. Compared to UK and US, a cyber knife treatment costs less in Korea.

Cyber knife systems have been used to treat tumors in upper spine, head and neck since 1999 and in the rest of the body since 2001. John Adler invented the system for cancer treatment. It is made to deliver radiotherapy for malign and benign cancer tumors at all stages in specific parts of the body in a non-invasive way. It uses a real-time image guide to find tumors even if the patient is moving, and to deliver radiation with highest accuracy. It eliminates the need for invasive surgeries.

There are various benefits of the technique, e.g. faster procedures in comparison to other radiation methods, no requirement for hospitalization, no need for anesthesia and almost no post-operative care. Cyber knife surgery can even be used for tumors that have already received the maximum dose of radiation. There are no incisions or cuts, and recovery time is not needed. It can even be used for tumors in the spine, which are hard to treat because they are moving while the patient is breathing. The cyber knife can pinpoint the exact location of the tumor and beam into it without damaging other surrounding tissues. That leads to a shorter treatment period and a quick recovery. Treatment can be finished in less than five days on an outpatient basis, without spending a single night at the hospital.

One hospital in Korea is specialized in treating spine cancer. The oncology experts in Korea are highly trained and have years of experience in radiology and cyber knife cancer treatment. Medical staff in Korean hospitals are English speaking and communication will not be a problem when getting medical treatment there.

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Cyber knife surgery abroad:
http://www.medicaltourismco.com/oncology/cyber knife-cancer-radiotherapy-overseas.php

Cyber knife Treatment for Spine Cancer
http://www.medicaltourismco.com/south-korea-hospitals/cyber knife-surgery-korea.php

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The Rheumatic Crash of the Silver Wave

Rheumatoid Arthritis (RA) is a chronic condition that affects between 0,5-1% of the general population. It is considered an autoimmune disorder as the inflammatory system attacks joint locations of the body — typically in the hands but also other areas such as the feet.

Enough damage will considerably lower or possibly prevent the individual’s ability to perform motor activity.

Whether the inflammatory arthritides, including RA, have a distinct presentation and course in older as compared to younger subjects as first postulated in 1941 remains unsettled. The issue has gained significant importance as the proportion of the population who are over the age of 60 continues to grow in developed nations. As multiple newer treatment strategies emerge for RA, the efficacy and safety of these in elderly populations need to be evaluated as a distinct clinical issue.
— Aviva Hopkins, MD, and Carlos J. Lozada, MD

Traditionally, treatments known as Disease-Modifying Antirheumatic Drugs (DMARDs) have been used to treat RA in order to slow the progression of the condition — with methotrexate being the gold standard. In cases of heavy or severe inflammation and/or when DMARDs fail, glucocorticoids (corticosteroids) are also used in tablet or IV form. When used over time, these drugs cause considerable damage to the body. Immunosuppressives such as cyclophosphamide are also used in cases of strong inflammation and these drugs bear considerable toxicity — including the risk of developing infertility (which is vital to understand, especially considering the majority of cases are female; 3:1 in younger-onset RA). With these factors in mind, several new treatments have been made available and the most notable are called biologic drugs. These drugs are created from a biological process rather than being chemically synthesized; most often involving recombinant DNA technology to create, for example, monoclonal antibodies and fusion proteins. An example of a monoclonal antibody used in RA is rituximab, which was created as an “antibody” to specifically target B cells — which are a vital part of the immune response. Where a healthy immune system equates to a healthy person, in the case of an autoimmune patient the inflammatory response goes out of control and must be suppressed. Taking these drugs of course can lead to a rise in the rate of infections as they very effectively do what they were made for — lowering the immune response. However, a search on PubMed or any other medical database reveals a very positive force for the usage of biologic drugs; as they are also considered safer than some traditional DMARDs. Biologics have existed for approximately 20 years, but despite evidence showing them to be significantly more effective than DMARDs, they are quite costly. Therefore, biologics are typically reserved for those patients who do not respond well to DMARDs.

If there would be a way to make these biologic drugs more cost effective, these drugs are an important milestone for an answer to worldly health with the rising rates of elderly who may potentially develop RA. Novel drugs which may be considered similar to biologics have just been introduced within the past few years and these are known as protein kinase inhibitors. More research will show if these drugs will prove to be more cost effective than the competitive biologics.

References

http://www.clinicalgeriatrics.com/articles/Rheumatoid-Arthritis-Elderly-Distinct-Clinical-Entity?page=0,2

http://www.cdc.gov/arthritis/basics/rheumatoid.htm

http://en.wikipedia.org/wiki/Biologic_medical_product

http://www.ncbi.nlm.nih.gov/pubmed/12833650

Science fiction medicine from Sweden

Imagine you were able to simply replace one of your organs once you fall sick. You just go to the hospital and quickly come out with a new intestine, kidney, liver or even heart, if an incurable disease was present.  This sounds more like an idea from a science fiction movie than a like a feasible therapeutic option, but research on regenerative medicine and the engineering of “artificial” organs is happening to make these options a reality for many patients worldwide in the near future.

Nowadays, chronic diseases are a major health issue in almost every country – they cannot be cured and the patient’s best bet is to prevent those diseases and their complications. We are talking about e.g. diabetes, heart and kidney failure, hepatic disease and hypertension. After treatment has failed the last resort for many patients is organ transplantation. However, as simple as it may sound, there are countless complications involved, as the organ has to be compatible with the patient. The patient will have to remain on medication to lower his immune system response to the minimal for the rest of his life, which can make him more vulnerable to infections.

By the year 2010, over 90,000 people were signed in for the waiting list for a kidney transplant in the US and 3,000 at any given day for a heart transplant. Many patients who have no other choice of treatment wait, and most of the times death arrives faster than the suitable organ.

What if you could build a custom-made organ according to a patient’s need? A group of biomedical researchers at Karolinska Institutet in Sweden have pioneered what can be the first step in the beginning of a science fiction medicine: working with stem cells, which are cells capable of giving rise to any human tissue. They have managed to make a fully artificial trachea from scratch and implant it in a patient with cancer without any immunological reaction. The newly formed organ is built on a PET mold, yes the same used in bottles, which is as anatomically identical to the patient’s actual trachea – not only in shape but also in composition.  The mold is filled with stem cells from the patient himself. Giving rise to a new and fully functional organ ready to be replaced.

The patient who went under this treatment is currently under annual checkups while living a normal life without health related restrictions. This is only the first step, but it is a firm step.

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Thanks to Antonio Beltrán Rodríguez for sharing this post with our silverevolution-readers. Antonio is a biomedical student at Karolinska Institutet. Contact: antonio.beltran@stud.ki.se

Senior-friendly Smartphones

In the case of increasing life expectancy and low fertility rates, the percentage of elderly in Singapore is on a rise. The percentage of elderly aged 65 and above increased from 7.3% in 2000 to 9.3% in 2011.

This percentage is expected to rise up to 18.7% by 2030. This shows that the percentage of elderly in Singapore has been and will be increasing drastically over the years. Indeed, the ‘silver tsunami’ is approaching Singapore.

With the growing concern for the elderly, ideas and innovations are constantly tapped into to find new ways to counter the problems the elderly faces.One such take was by a Singapore-based sustainable business incubator, Silverline — which has decided to take on an initiative with SingTel. While several elderly are unable to afford to buy and use smartphones due to the price and perhaps not being IT-savvy enough, Silverline has offered an ingenious way which can kill two birds with one stone. One, it solves the problem the elderly faces. Two, it also reduces e-waste, which is an environmental problem.

 “The mobile phone industry works by enticing customers to swap their old phones for new ones in just a year or two. That is a tremendous waste. Electronic devices can leak toxic chemicals once they are disposed of.” – Silverline

Sliverline saw an opportunity in these wastes and decided to turn it into their advantage to them. By introducing a new policy, SingTel customers who are renewing their contract and purchasing a new smartphone with SingTel will be offered the option of gifting their old devices to a senior citizen. In this way, both parties are able to gain something out of it. When the user decides to get the newest model, his/her older phone still can come into good use and benefit the society (in this case, the elderly) and also the environment (in this case, decreasing e-waste).

By collaborating with SingTel, the user also gets to enjoy the benefits such as having a cut in their monthly bills.

Therefore and however, these smartphones that the elderly can expect are not just any ordinary smartphones. They are refurbished second-hand devices that come along with senior-friendly apps installed.

An example of such an application is Connect, which presents the contact list in a visual format to aid the visually impaired.  Another senior-friendly application, Well Being, provides reminders for taking medicine, drinking water, and doing exercise.

These are just some of the apps that are available out of several others, which can be found here.

Furthermore, if a user decides to nominate a senior citizen they know (normally it would be their parents), a refurbished smartphone by Silverline will be provided on the spot — with the addition of a mobile plan being fee for the senior citizen and will be added to the customer’s existing monthly mobile bills. This in turn for the business parties involved will create a new market.

The solution also poses some challenges to be overcome. Even though social workers are available to help out the elderly in using the smartphones, it will still take time for the elderly to get used to it.

Here is a video on how one of the many elderly is being impacted.

http://www.youtube.com/watch?v=9ug8wSAGfSU&feature=player_embedded

We believe that this project is the start of a neat solution socially, environmentally and economically.

Sources and references:

1)    http://www.singstat.gov.sg/stats/themes/people/popinbrief2011.pdf

2)    http://sgentrepreneurs.com/2012/10/15/with-its-senior-friendly-smartphones-newton-circus-silverline-hopes-to-reduce-digital-divide-save-environment/

3)    http://silverline.mobi/

4)    http://www.intmath.com/blog/singapores-population-bubble/808

5)    http://www.youtube.com/watch?v=9ug8wSAGfSU&feature=player_embedded