Mobile Applications and Wearables for Chronic Respiratory Disease Monitoring

Mobile health (mHealth) has tremendous potential to benefit patients, providers, and the entire healthcare system. Benefits for patients to adopt mHealth include more effective access to health providers, reduced costs of care, and better health control. For physicians and the healthcare system, reasons to embrace mHealth are enhanced health outcomes, facilitated access to patients for care, and decreased time required for administrative tasks. Currently, some mobile apps and wearables dedicated to respiratory health provide medical education and messaging services, enable diary logs, aid with disease self-management, and include educational games. Major challenges for mHealth to be widely adopted include lack of studies demonstrating effectiveness, limited access to technology by all patients, decreased adoption over time, high costs, and data privacy concerns

Biliary tract reconstruction using jejunal tube: an experimental study in dogs

BACKGROUND: To physiologically reconstruct the biliary tract, Crema et al suggested the application of the Monti principle to the biliary tract, already used in humans for the urinary tract. With this technique, a jejunal segment is transversely retubularized. This study aimed to evaluate the efficacy of jejunal tube interposition between the common bile duct and duodenum in dogs. METHODS: Thirteen dogs underwent a laparoscopic common bile duct ligature, followed by a biliodigestive connection by jejunal tube interposition after one week. The levels of glutamic-pyruvic and glutamic-oxalacetic transaminases, total bilirubins, alkaline phosphatase and gamma-glutamyltransferase were assessed before surgery and thereafter weekly until euthanasia, which was performed 6 weeks after biliodigestive connection. RESULTS: Data on 9 dogs were analyzed statistically. The dogs presented with obstructive jaundice after common bile duct ligature, as confirmed by biochemical examination. They showed a statistically significant reduction in cholestasis after biliodigestive connection by jejunal tube interposition and were healthy until the end of the experiment. CONCLUSION: A statistically significant reduction was seen in total bilirubin and canalicular enzymes (alkaline phosphatase and gamma-glutamyltransferase) in the 9 dogs 6 weeks after biliodigestive conviction by jejunal tube interposition.8217918

An apparatus to assay opioid activity in the infused lumen of the intact isolated guinea pig ileum

A modified apparatus is described that provides for the simultaneous bathing of the serosa of an intact piece of isolated guinea pig ileum while allowing infusion of the isolated lumen. The comparative compartmental potency of the opioid agonists morphine, casomorphins, and enkephalins to inhibit electrically driven contractions are described in this system. The rank-order potency for serosally applied opioid agonists was (IC50 values, nM): [d-Ala2,N-Me-Phe4,Gly-ol5]-enkephalin (DAMGO) (15)>[d-Ala2,d-Leu5]-enkephalin (DADLE) (35)≥morphine (46)≥[d-Ala2]-met-enkephalinamide (55)>[d-Ala2]-β-casomorphin[1–4] amide (122)>β-casomorphin[1–4] amide (940)>met- and leu-enkephalin (>6000). This contrasted to the rank-order potency for the luminally applied opioid agonists: DADLE (63)>DAMGO (135)>[d-Ala2]-met-enkephalinamide=morphine (4700)>[d-Ala2]-β-casomorphin[1–4] amide (29000). β-Casomorphin[1–4] amide, leu-enkephalin and met-enkephalin are mostly inactive when applied luminally. Furthermore, the opioid antagonists, casoxin 4 and [d-Ala2]-casoxin 4, when infused into the lumen, significantly overcame the inhibitory effect of morphine added to the serosal side. This model provides an assay and screening system to differentiate between the effects of chemical agents applied via the blood stream (serosa) or food side (lumen) on quiescent or electrically driven gut activity of the nervous plexi or receptor systems of the ileum.Glen S Patten, Richard J Head, Mahinda Y Abeywardena and Edward J McMurchi