Health Care "Telepresence Robot" to aid high dependency care at Northern Ireland Hospital

A Northern Ireland Health Trust is the first in the UK to use a robot which allows intensive care specialists from one hospital to remotely assess patients in another.

The 'telepresence' robot enables doctors to examine and interact with patients in different locations.

It will be used at Daisy Hill Hospital in County Down.

Stormont Health Minister Edwin Poots said the new technology would create an "effective hospital network".

The robot has the ability to transmit heart and breath sounds and it is hoped it will prevent the need to transfer patients to intensive care in some cases.

It enables Dr Charles McAllister, based at Craigavon Area Hospital in County Armagh, to speak to staff and patients at a bedside in the Southern Trust in Newry more than 20 miles away.

"It means that although there are no intensivists on site in Daisy Hill Hospital, it means there will be 24/7 access to the intensivists on the Craigavon site to give advice and support on any patients in a high dependency unit or throughout the hospital," he said.

"You can get a huge amount of information via the robot.

"You can get real time information from the monitor, you can see the patient up close in high definition and look at all the charts and observations.

"There is also a facility for listening to the patient's lungs and heart through a stethoscope at the back of the robot."

More about "Telepresence" and robots, here.

Malaria: Cell Phone Cameras Capture Microscopic Images

Smart phone apps can help you check your vision, keep tabs on your blood-glucose levels and track your blood pressure. Earlier this year the U.S. Food and Drug Administration even approved an app that allows doctors to view scans on an iPhone or iPad to help them make diagnoses on the go.

But fancy apps aside, the cameras on these devices and others can help health care workers in remote or understaffed areas submit photos of complicated conditions to doctors who can verify or make a diagnosis.

One question that quickly surfaces is whether cell phone cameras are good enough to transmit microscopic information to experts.

A new study found that many simple bar phones with cameras could snap a good enough picture through a standard microscope to allow a remote assessment of a sample. The results were published online Wednesday in PLoS ONE.

“Poor and vulnerable populations are most affected by weak laboratory services because they carry the largest burden of ill health,” noted the researchers behind the study, which was led by Coosje Tuijn, of the Royal Tropical Institute of Biomedical Research in Amsterdam.

And although microscopy is often pivotal in diagnosing common diseases, such as malaria, tuberculosis and other bacterial or parasitic diseases, in poor areas, “microscopy services are often suboptimal,” the researchers noted.

And “as a result, many common diseases are misdiagnosed and improperly treated, ” which can affect patients—and cost the health system time and money.

In Uganda, where there are only eight physicians for every 100,000 people, getting a definitive diagnosis can be difficult. The research team enlisted local health workers to try using their own (or borrowed) cell phones to capture photos and videos of microscopic images to send off for remote diagnosis.

The best images were obtained with cameras that were two megapixels or higher, which are common in smart phones and are in some slimmer Nokia, Samsung and Sony bar phones.

And some of the most successful diagnoses were those of samples that contained malaria parasites, which “were often so clear that specific stages of the malaria parasite could be identified”—thus improving targeted treatment.

TB was a little more challenging (owing to the small size of its bacteria) and required a fluorescent microscopy and a five-megapixel camera.

But phones with video could also grab clips that revealed some other microbes as they moved around, helping to improve the remote diagnosis.

Once the pictures were snapped, health workers could send them directly to a website that could make them accessible to experts for diagnosis and/or students for training.

Direct feedback, via phone call or text, could then be sent to the user’s phone.

Alcohol consumption after breast cancer diagnosis may increase recurrence risk

In the Life After Cancer Epidemiology (LACE) study, 1,897 participants diagnosed with early-stage breast cancer between 1997 and 2000 and recruited on average 2 years post-breast cancer diagnosis were evaluated for the association between alcohol intake and breast cancer recurrence and death.

The women, who were generally light drinkers, were followed for an average of 7.4 years. The study reported an increase in risk of breast cancer recurrence and breast cancer death, but no effect on total mortality, to be associated with consumption of 3 to 4 or more drinks per week when compared with women not drinking following their cancer diagnosis.

Previous research has been mixed on this topic. Almost all large studies have shown no increase in all-cause mortality for women who drink moderately following a diagnosis of breast cancer (as does this study).

As for recurrence of breast cancer, most have shown no increase in risk, although one previous study of women with estrogen-receptor + tumors found an increased risk of a primary cancer developing in the contralateral breast to be associated with alcohol intake of more than 7 drinks per week.

Because of conflicting results among studies on this topic, further research will be needed to determine the extent to which alcohol following a diagnosis of breast cancer may relate to subsequent disease and death.

Glaucoma's unique protein expression could enhance diagnosis and treatment

An eye under pressure appears to express a unique set of proteins that physicians hope will one day help them better diagnose and treat glaucoma.

Glaucoma, the second leading cause of blindness worldwide, tends to progress silently until decreased vision indicates trouble, said Dr. Kathryn Bollinger, Medical College of Georgia clinician-scientist specializing in glaucoma.

But inside fluid-filled eyeballs, a changing protein profile -- 30 with significant increases and 17 with significant decreases identified among hundreds of proteins present -- appears to also give a heads-up, Bollinger reported during the Association for Research in Vision and Ophthalmology Annual Meeting April 30-May 6. The MCG ophthalmologist received the 2010 ARVO/Alcon Early Career Clinician-Scientist Research Award for the study.

With glaucoma, elevated pressures inside the eyeball stress the optic nerve and nerve arms -- called axons ? that reach out to communicate with the brain. Over time, increased pressure can kill nerve cells and axons and decrease vision. "At this point, we don't have a regenerative strategy," Bollinger said.

The pressure results from an imbalance in fluid production and loss. In a healthy eye, the fluid, called the aqueous humor, moves continually from the back to the front of the eye where it exits ? mostly via a natural tract between the iris and cornea ? first into spongy tissue near the cornea's base called the trabecular meshwork then into the venous system and back into the body.

In open-angle glaucoma, the most common type in this country, the tract remains open but fluid still backs up and scientists suspect changes in the permeability of the trabecular meshwork may be to blame. Topical glaucoma treatments work by reducing fluid production or increasing outflow through a secondary drainage system, also near the front of the eye. Ophthalmologists such as Bollinger can also create a new pathway surgically if needed.

To get a better picture of what happens to the trabecular meshwork, Bollinger examined tissues from the outflow tracts and trabecular meshwork of patients with and without glaucoma. She added TGF-?, a protein and inflammatory element known as a cytokine that is consistently found at high levels in patients with open-angle glaucoma. After comparing treated and untreated tissue, she found that TGF-? resulted in a similarly unique protein pattern. Current therapies don't target TGF-? or its effects in the trabecular meshwork.

Next steps include identifying additional proteins expressed in glaucoma, determining the impact of the unique protein profile on the trabecular meshwork and clarifyingTGF-?'s normal role inside the eye, Bollinger said.

Risk factors for glaucoma include age, a family history and black and Asian ethnicity.


Link: http://www.mcg.edu