Parkinson's disease biomarkers: perspective from the NINDS Parkinson's Disease Biomarkers Program

Biomarkers for Parkinson's disease (PD) diagnosis, prognostication and clinical trial cohort selection are an urgent need. While many promising markers have been discovered through the National Institute of Neurological Disorders and Stroke Parkinson's Disease Biomarker Program (PDBP) and other mechanisms, no single PD marker or set of markers are ready for clinical use. Here we discuss the current state of biomarker discovery for platforms relevant to PDBP. We discuss the role of the PDBP in PD biomarker identification and present guidelines to facilitate their development. These guidelines include: harmonizing procedures for biofluid acquisition and clinical assessments, replication of the most promising biomarkers, support and encouragement of publications that report negative findings, longitudinal follow-up of current cohorts including the PDBP, testing of wearable technologies to capture readouts between study visits and development of recently diagnosed (de novo) cohorts to foster identification of the earliest markers of disease onset

Southwest Research Institute assistance to NASA in biomedical areas of the technology

Significant applications of aerospace technology were achieved. These applications include: a miniaturized, noninvasive system to telemeter electrocardiographic signals of heart transplant patients during their recuperative period as graded situations are introduced; and economical vital signs monitor for use in nursing homes and rehabilitation hospitals to indicate the onset of respiratory arrest; an implantable telemetry system to indicate the onset of the rejection phenomenon in animals undergoing cardiac transplants; an exceptionally accurate current proportional temperature controller for pollution studies; an automatic, atraumatic blood pressure measurement device; materials for protecting burned areas in contact with joint bender splints; a detector to signal the passage of animals by a given point during ecology studies; and special cushioning for use with below-knee amputees to protect the integrity of the skin at the stump/prosthesis interface

Smartphone as a Personal, Pervasive Health Informatics Services Platform: Literature Review

Objectives: The article provides an overview of current trends in personal sensor, signal and imaging informatics, that are based on emerging mobile computing and communications technologies enclosed in a smartphone and enabling the provision of personal, pervasive health informatics services. Methods: The article reviews examples of these trends from the PubMed and Google scholar literature search engines, which, by no means claim to be complete, as the field is evolving and some recent advances may not be documented yet. Results: There exist critical technological advances in the surveyed smartphone technologies, employed in provision and improvement of diagnosis, acute and chronic treatment and rehabilitation health services, as well as in education and training of healthcare practitioners. However, the most emerging trend relates to a routine application of these technologies in a prevention/wellness sector, helping its users in self-care to stay healthy. Conclusions: Smartphone-based personal health informatics services exist, but still have a long way to go to become an everyday, personalized healthcare-provisioning tool in the medical field and in a clinical practice. Key main challenge for their widespread adoption involve lack of user acceptance striving from variable credibility and reliability of applications and solutions as they a) lack evidence-based approach; b) have low levels of medical professional involvement in their design and content; c) are provided in an unreliable way, influencing negatively its usability; and, in some cases, d) being industry-driven, hence exposing bias in information provided, for example towards particular types of treatment or intervention procedures

Liječenje dijabetesa tipa 1 hibridnom zatvorenom petljom

Introduction: Type 1 diabetes mellitus (T1DM), in which the pancreas is no longer able to produce insulin to naturally control blood sugar, can be a major problem for the patient in terms of disease management. Closed-loop hybrid systems are designed to automate insulin delivery to improve T1DM outcomes and reduce the burden and distress for the user. The hybrid closed-loop makes an important contribution to reducing the difficulties of disease, also its control and management. Research goal: The goal is to examine how the closed hybrid loop system has contributed to the management of T1DM and improved the quality of life of patients. Participants and Methods: The survey was based on a non-experimental quantitative method with a questionnaire developed for the study. The surveys were distributed on Facebook in groups dedicated to patients with T1DM. The survey covered hybrid closed-loop users in Slovenia. Descriptive and inferential statistics were used for the statistical processing of the obtained data. IBM SPSS Statistics (version 20) was used. Results: The hybrid closed-loop system provides respondents with better management of T1DM and a better quality of life. 82.9% of respondents have fewer hypoglycaemic episodes than before using the hybrid system, 65.7% of respondents detect signs of hypoglycaemia earlier and fear of hypoglycaemia is reduced. 70.3% of respondents say they have less worries about diabetes. Conclusion: The study confirmed the prediction that respondents with T1DM are satisfied with the hybrid closed-loop system and notice fewer fluctuations in their blood sugar. The latest treatment method also helps to improve the quality of life. Because of its benefits, respondents recommend using a hybrid closed-loop system.Uvod: Kod dijabetes mellitus tipa 1 (T1DM), gušterača uopće ne proizvodi inzulin potreban za prirodnu regulaciju šećera u krvi, što stvara mnoge poteškoće kod oboljelih. Hibridni sustav zatvorene petlje djeluje na način da kontinuirano isporučuje inzulin s ciljem jednostavnijeg kontroliranja T1DM-a, a ujedno doprinosi smanjenju komplikacija za korisnike, odnosno oboljele. Cilj: Utvrditi kako hibridni sustav zatvorene petlje pomaže u kontroliranju bolesti dijabetesa tipa 1 i poboljšanju kvalitete života oboljelih. Ispitanici i metode: Istraživanje se temeljilo na neeksperimentalnoj kvantitativnoj metodi s upitnikom konstruiranim za potrebe istraživanja. Upitnik je bio proslijeđen u grupe namijenjene oboljelima od dijabetesa tipa 1 na društvenoj mreži Facebook, u kojima su pozvani korisnici hibridnog sustava zatvorene petlje. Za statističku obradu prikupljenih podataka pomoću upitnika korištena je deskriptivna i inferencijalna statistika. Korišten je program IBM SPSS Statistics (verzija 20). Rezultati: Hibridni sustav zatvorene petlje ispitanicima omogućava lakše kontroliranje T1DM-a, a time i bolju kvalitetu života. Ukupno 82,9 % ispitanika bilježi manje učestale hipoglikemije nego prije korištenja hibridnog sustava zatvorene petlje. Nadalje, 65,7 % ispitanika zbog ovog sustava ranije prepoznaje znakove hipoglikemije i samim se time njihov strah od hipoglikemije smanjuje. Kod 70,3 % ispitanika zahvaljujući korištenju hibridnog sustava zatvorene petlje smanjena je zabrinutost zbog dijabetesa zbog čega se osjećaju mnogo slobodnije. Zaključak: Istraživanje je potvrdilo pretpostavku da su ispitanici koji boluju od T1DM-a zadovoljni hibridnim sustavom zatvorene petlje te također potvrđuju da bilježe manje oscilacija šećera u krvi. Najnovija metoda liječenja hibridnim sustavom zatvorene petlje doprinosi boljoj kvaliteti života oboljelih. Zbog svih prednosti koje donosi korištenje hibridnog sustava zatvorene petlje, ispitanici preporučuju korištenje ovog sustava

Non-invasive Electronic Biosensor Circuits and Systems

An aging population has lead to increased demand for health-care and an interest in moving health care services from the hospital to the home to reduce the burden on society. One enabling technology is comfortable monitoring and sensing of bio-signals. Sensors can be embedded in objects that people interact with daily such as a computer, chair, bed, toilet, car, telephone or any portable personal electronic device. Moreover, the relatively recent and wide availability of microelectronics that provide the capabilities of embedded software, open access wireless protocols and long battery life has led many research groups to develop wearable, wireless bio-sensor systems that are worn on the body and integrated into clothing. These systems are capable of interaction with other devices that are nowadays commonly in our possession such as a mobile phone, laptop, PDA or smart multifunctional MP3 player. The development of systems for wireless bio-medical long term monitoring is leading to personal monitoring, not just for medical reasons, but also for enhancing personal awareness and monitoring self-performance, as with sports-monitoring for athletes. These developments also provide a foundation for the Brain Computer Interface (BCI) that aims to directly monitor brain signals in order to control or manipulate external objects. This provides a new communication channel to the brain that does not require activation of muscles and nerves. This innovative and exciting research field is in need of reliable and easy to use long term recording systems (EEG). In particular we highlight the development and broad applications of our own circuits for wearable bio-potential sensor systems enabled by the use of an amplifier circuit with sufficiently high impedance to allow the use of passive dry electrodes which overcome the significant barrier of gel based contacts

Southwest Research Institute assistance to NASA in biomedical areas of the technology utilization program

The activities are reported of the NASA Biomedical Applications Team at Southwest Research Institute between 25 August, 1972 and 15 November, 1973. The program background and methodology are discussed along with the technology applications, and biomedical community impacts

Aerospace medicine and biology: A continuing bibliography with indexes, supplement 125

This special bibliography lists 323 reports, articles, and other documents introduced into the NASA scientific and technical information system in January 1974

Towards Stable Electrochemical Sensing for Wearable Wound Monitoring

Wearable biosensing has the tremendous advantage of providing point-of-care diagnosis and convenient therapy. In this research, methods to stabilize the electrochemical sensing response from detection of target biomolecules, Uric Acid (UA) and Xanthine, closely linked to wound healing, have been investigated. Different kinds of materials have been explored to address such detection from a wearable, healing platform. Electrochemical sensing modalities have been implemented in the detection of purine metabolites, UA and Xanthine, in the physiologically relevant ranges of the respective biomarkers. A correlation can be drawn between the concentrations of these bio-analytes and wound severity, thus offering probable quantitative insights on wound healing progression. These insights attempt to contribute in reducing some impacts of the financial structure on the healthcare economy associated with wound-care. An enzymatic electrochemical sensing system was designed to provide quick response at a cost-effective, miniaturized scale. Robust enzyme immobilization protocols have assisted in preserving enzyme activity to offer stable response under relevant variations of temperature and pH, from normal. Increased hydrophilicity of the sensor surface using corona plasma, has assisted in improving conductivity, thus allowing for increased electroactive functionalization and loading across the substrate’s surface. Superior sensor response was attained from higher loading of nanomaterials (MWCNT/AuNP) and enzymes (UOx/XO) employed in detection. Potentiometric analyses of the nanomaterial modified enzymatic biosensors were conducted using cyclic voltammetry (CV) and differential pulse voltammetry (DPV) modalities. Under relevant physiological conditions, the biosensor was noted to offer a variation in response between 10 % and 30 % within a week. Stable, reproducible results were obtained from repeated use of the biosensor over multiple days, also offering promise for continuous monitoring. Shelf life of the biosensor was noted to be more than two days with response retained by about 80 % thereafter. Secondary analyses have been performed utilizing the enzymatic biosensor to explore the feasibility of target biomarker detection from clinical extracts of different biofluids for wound monitoring. Biosensor response evaluation from the extracts of human wound exudate, and those obtained from perilesional and healthy skin, provided an average recovery between 107 % and 110 % with a deviation within (+/-) 6 %. Gradual decrease in response (10-20 %) was noted in detection from extracts further away from injury site. Increased accumulation of biofluids on the sensor surface was studied to explore sensor response stability as a function of sample volume. With a broad linear range of detection (0.1 nM – 7.3 mM) and detection limits lower than the physiological concentrations, this study has assessed the viability of stable wound monitoring under physiologically relevant conditions on a wearable platform

Evaluation and treatment of resistant hypertension

Hypertension is a major cause and contributor to stroke, heart and kidney disease. Despite the development of an arsenal of medication to treat hypertension over the past half-century, adequate treatment continues to be a major problem in the United States. The Third National Health and Nutrition Examination Survey (NHANES-III) shows that only 29% of hypertensive patients reach a blood pressure less than 140/90 mm Hg. Resistant hypertension is defined as a blood pressure greater than 140/90 mm Hg despite a rational combination of three or more blood pressure medications including a diuretic. The prevalence of true resistant hypertension in hypertension clinics is only about 11-13%. Higher prevalence rates are evident in populations with evidence of end-organ disease such as cardiac or renal disease where lower blood pressure targets have now been established. Ascertaining the possible cause(s) for resistant hypertension is a challenge to all clinicians, but critical in eventual determination of a therapeutic solution. The following review will hopefully help guide clinicians in their discernment of causes and potential treatments for resistant hypertension. The diagnosis and treatment of the more common secondary causes will be described and treatment options for patients with resistant hypertension are discussed. Newer options, some still under clinical investigation, will be described and their future utility will be discussed. (Cardiol J 2007; 14: 329-339