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Lifestyle, Age Linked to Diabetes-related Protein

Over the last decade researchers have amassed increasing evidence that relatively low levels of a protein called sex hormone binding globulin (SHBG) can indicate an elevated risk of type 2 diabetes and metabolic syndrome years in advance.

Asthmapolis Relaunches as Propeller Health to Advance Broader Respiratory Mission

Asthmapolis, the FDA-cleared mobile health solution for chronic respiratory disease, recently announced the company is changing its name to Propeller Health. The Propeller platform is designed to help patients and their physicians better understand and control respiratory disease to reduce preventable emergency room visits, hospitalizations and unnecessary suffering.

Propeller Health will now offer providers and payers expanded mobile apps for asthma, COPD and other respiratory disease, as well as new sensors for additional inhaled medications pending regulatory clearance.

“COPD is the third leading cause of death in the United States and an extremely costly disease, both in its actual medical costs and the impairments that limit patients with this illness. I believe using technology to help improve adherence and give clinicians early indications of increasing symptoms or exacerbations is valuable and will make an important contribution to helping people successfully manage the disease,” said David Mannino, MD, professor and chair, University of Kentucky Department of Preventive Medicine and Environment, and international expert on the epidemiology and impact of COPD.

Early outcomes have been promising. In the last month, more than two-thirds of Propeller users with asthma were well-controlled or transitioned to well-controlled; by comparison, only 30-40 percent of the general population with asthma has their disease under control. In recent programs, up to 80 percent of patients with asthma remain engaged with Propeller three to six months after enrollment. As a result, the Propeller platform has yielded an 80 percent improvement in medication adherence.

“We need to be doing everything we can to help people manage their health conditions and prevent unnecessary trips to the hospital,” said Rich Roth, vice president of strategic innovation at Dignity Health. “Propeller Health is in a position to make big difference for our patients, which is why we’re excited to see the company moving in this direction.”

Propeller is a novel combination of snap-on sensors, mobile apps, analytics and personal services to empower people to achieve better self-management of their respiratory disease, while reducing the burden of chronic disease management. The HIPAA-compliant solution uses remote monitoring to track when and how often patients use their inhaled medications. This real-time information advances understanding of symptoms and triggers and reveals insights about both medication adherence and rescue medication frequency. Analytics coupled with personalized feedback and individual support, including access to health educators and community managers, inform more productive conversations between Propeller users and their care teams, contributing to positive behavior change, improved quality of life and reduced costs to manage chronic disease like asthma and COPD.

“Over the last year, we’ve grown to be the leading mobile health platform for managing asthma. Today we are charting a new course in chronic respiratory disease management, applying our proven technology and accumulated wisdom to reduce healthcare utilization for COPD,” said David Van Sickle, CEO of Propeller Health. “The Propeller brand broadens our mobile health footprint to include all disease treated with inhaled medications. It more accurately describes how we use technology to achieve momentum in self-management, but with minimal disruption to our users’ daily lives, which in turn helps improve outcomes that reduce cost.”

“Asthmapolis, now Propeller Health, is one of the leaders in mobile health sensors and apps. It is great to see their expansion from asthma to COPD,” said Eric Topol MD, CAO of Scripps Health and author of The Creative Destruction of Medicine (Topol has no relationship with the company). “Further, someday in the future there is now hope that such a platform will be able to markedly reduce asthma attacks and exacerbations of COPD.”

Propeller for COPD is available now, and the company is filing applications for international regulatory clearance for additional sensors later this year.

Source: Propeller Health

Thermo Fisher Scientific and Siemens Renew Partnership for Improved Detection of Sepsis Using B·R·A·H·M·S PCT Biomarker

Hospital laboratories outside the U.S. can benefit from a continued availability of the B·R·A·H·M·S PCT™ assay on ADVIA Centaur® systems, allowing them to diagnose sepsis early and safely.

Thermo Fisher and Siemens Healthcare Diagnostics renew their non-exclusive, long-term, royalty-bearing agreement for the use of Thermo Fisher’s Procalcitonin (B·R·A·H·M·S PCT™) technology, currently available as an automated immunoassay on the Siemens ADVIA Centaur® XP and CP systems in all countries outside the United States and China. The agreement extends a long-standing relationship between the companies.

ADVIA Centaur® B·R·A·H·M·S PCT™ immunoassay currently offers clinicians an integrated solution for accurately diagnosing sepsis and monitoring response to antibiotic therapy allowing for improved clinical decision making. The ADVIA Centaur® systems have a large global installed base in hospital clinical laboratories.

The PCT biomarker test is the gold standard for the early detection of sepsis in critically ill patients and is recommended to initiate, monitor and discontinue antibiotic treatment in the presence of relevant bacterial infections. Broader availability of PCT testing will lead to improved hospital management and care of patients with sepsis or at high risk of developing it.

“The continuation of our close collaboration with Siemens significantly increases the global reach of this critical biomarker, making it available to a broader patient population,” said Marc Tremblay, president of Thermo Fisher Scientific’s Clinical Diagnostics division. “The key for preventing sepsis is the early diagnosis of infections. Early diagnosis also reduces the health economic burden of sepsis therapy, a medical condition that is still very common today and accounts for hundreds of thousands of deaths each year. Therefore, PCT supports hospitals in optimizing their service levels and cost effectiveness in today’s challenging economic environment.”

The worldwide number of patients affected by sepsis is estimated to be 20 to 30 million annually and claims more lives than bowel and breast cancer combined. Despite advances in modern medicine, including antibiotics and vaccines, sepsis remains the primary cause of death from infection with hospital mortality rates between 30 to 60%1. Hospital costs to treat severe sepsis in the U.S. are estimated at $16 billion dollars annually. Much of this cost is attributed to misdiagnosis or delayed diagnosis, making rapid, more reliable detection a national, if not global, imperative. Research published in Critical Care Medicine showed that each hour of delay in therapy can decrease chances of patient survival by 7.6 percent.

Source: ThermoFisher Scientific

HSS Uses Grant to Test New MRI Techniques & Biomarkers for Arthritis Prevention Treatments

In recent years, researchers have been frustrated because there are no tools to identify early stages of osteoarthritis and thus no good way to test therapies for preventing or slowing the disease. Now, three institutions have been awarded $1 million from the Arthritis Foundation to validate the use of new MRI (magnetic resonance imaging) techniques and newly identified biomarkers to solve this vexing problem. Hospital for Special Surgery in New York City, University of California-San Francisco (UCSF), and Mayo Clinic in Rochester, Minnesota will share the $1 million.

“There is no magic bullet for treatment of osteoarthritis yet, but once we have a potential oral drug, therapeutic injection, or surgery for treating the disease, we will need a way to identify patients who might need it and follow their response to the treatment,” said Scott Rodeo, M.D., orthopedic surgeon and co-chief of the sports medicine and shoulder service at Hospital for Special Surgery (HSS) and co-principal investigator of the tripartite grant. “Using X-rays to measure joint space narrowing is the gold standard for assessing the presence and progression of osteoarthritis, but X-rays are next to worthless for detecting the early changes of arthritis. This study will help us understand the early factors that lead to the degenerative changes in ACL (anterior cruciate ligament) injured knees.”

Acute ACL injury is a major risk factor for developing osteoarthritis. In the past several years, researchers have discovered that long before osteoarthritic changes in joint space can be detected on X-ray, biochemical changes can be detected in cartilage using newer quantitative MRI techniques. Many studies have also shown that ACL injury is associated with quantifiable changes in biochemical biomarkers that can be detected in synovial fluid (joint fluid), blood, and urine.

The Arthritis Foundation grant will be distributed over one year and then the three grant recipients have made an institutional commitment to provide annual patient follow up after that. Each institution will recruit 25 patients who are at a maximum of 14 days out from tearing their ACL. Patients will be evaluated at baseline, six weeks, six months, 12 months and yearly thereafter with traditional MRI and newer MRI techniques.

Specifically, the new quantitative MRI techniques, developed by researchers at HSS and UCSF, measure T1ρ and T2 values of articular cartilage and the meniscus. Articular cartilage is the smooth cushion that lines the end of the bones where they meet at the joints. The meniscus is a knee structure that spans and cushions the space between the joint surfaces of the thighbone and shinbone. In scientific speak, T1ρ measures proteoglycan depletion, and T2 evaluates abnormal collagen orientation. Proteoglycans are conjugates of proteins and long carbohydrate molecules joined together with sugars.

“Imagine you are playing basketball and you jump up to make a basket, your ability to withstand the load when you come down is a function of proteoglycan,” said Hollis Potter, M.D., chief of the division of magnetic resonance imaging, director of research in the Department of Radiology and Imaging at HSS. “If you pivot and throw the ball to someone else, your ability for your cartilage to withstand that load is a function of the collagen. You need both to be healthy.” Dr. Potter is the HSS site leader of the grant.

At each time point that researchers collect MRI data, they will also collect samples of synovial fluid, blood, and urine from patients and evaluate knee function using surveys such as the Knee Outcome Survey, international knee documentation committee (IKDC) evaluation forms, and Marx Activity Level. These surveys gauge whether a patient has knee impairment; the degree of symptoms such as knee swelling and pain; and how much knee impairment impacts overall well-being, daily living, work, and athletic and social activities. The majority of participants in the study will undergo ACL reconstruction, and surgeons will evaluate these patients arthroscopically at the time of the operation. Clinicians will correlate fluid biomarkers and quantitative MRI results with traditional imaging, clinical, and functional outcomes.

Osteoarthritis is an extremely heterogeneous disorder in terms of the factors that contribute to the loss of joint function. Researchers need to be able to identify where a patient is in the progression of the disease to be able to target specific processes that are responsible for the symptoms and loss of joint function.

“Not everyone who has an ACL tear will develop osteoarthritis, but some do,” said Dr. Rodeo. “The goal is to identify biomarkers that reflect alterations in the joint environment that may be predictive of developing arthritis.” Once these are identified, researchers can test therapies to slow or prevent the disease, which can be crippling and lead to disability.

“There remain many unanswered questions regarding the optimal care of patients with ACL injuries,” said Steven Goldring, M.D., Chief Scientific Officer, St. Giles Chair, Hospital for Special Surgery. “This study is a paradigm of interdisciplinary research that brings together experts in orthopedics, radiology and basic science from multiple leading medical centers with the single goal of developing the most effective therapies to improve outcomes in patients with ACL injuries. The Arthritis Foundation should be congratulated in initiating this groundbreaking program.”

ACL ruptures affect roughly 1 in 3,000 people per year in the United States alone. The cumulative population risk of an ACL injury in people between the ages of 10 and 64 years has been estimated to be 5%, but could be considerably higher. More than 175,000 ACL reconstructions are performed each year in the United States at a cost of $2 billion. Participation in sports that involve pivoting including soccer, basketball, football, and skiing put individuals at higher risk for tearing their ACL.

Source: EurekAlert!

NEBA Health Earns Patent for Integration of NEBA Biomarker with Clinician’s ADHD Evaluation

NEBA Health, LLC recently announced that Dr. Steven M. Snyder, Research and Development Vice President, has earned US Patent 8,509,884. The patent protects a key aspect of the NEBA system: integrating the biomarker with a clinician’s workup for ADHD. “NEBA is not a standalone diagnostic,” said Dr. Snyder. “After the clinician’s ADHD evaluation, NEBA helps them determine if the symptoms are due to ADHD or if further testing is warranted.”

“Integrating the NEBA biomarker with a clinician’s initial diagnostic impression can bring a clinician’s diagnosis more in line with that of multidisciplinary team,” said Dr. Snyder. Research supports that compared to a clinician alone, a multidisciplinary team is better able to determine if ADHD-like symptoms are accounted for by another condition.

In order to diagnose ADHD, a clinician not only observes criteria regarding behavioral symptoms and impairment, but also must determine whether symptoms would be better accounted for by another condition. Because ADHD shares symptoms with other disorders, the diagnosis may be difficult. According to the US Center for Disease Control and Prevention (CDC), 9.5% of all children and adolescents have an ADHD diagnosis. The ADHD diagnosis rate is increasing. CDC states that rates of ADHD diagnosis increased an average of 3% per year from 1997 to 2006 and an average of 5.5% per year from 2003 to 2007.

“In their ADHD evaluation, clinicians may be challenged in the current medical environment to determine the primary diagnosis when overlapping symptoms are present,” said Howard Merry, President of NEBA Health. “We are delighted that the USPTO has awarded Dr. Snyder the patent. It covers NEBA’s core technology, and it’s another validation point for the 7 years we spent developing and validating NEBA.”

Source: PR Newswire