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High blood pressure can lead to heart disease and stroke, but it often goes undetected and untreated. A new technology could change that by putting a simple blood pressure monitor in everyone’s pockets. Normally, blood pressure is measured using an inflatable cuff that presses down on an artery in the arm while a device records the effect on blood flow. Now, scientists have created a smartphone attachment that measures blood pressure directly from the finger, removing the need for any specialized equipment. The user places their finger on a pressure sensor and is guided by a chart displayed on the phone to gradually increase the applied force. Meanwhile, another sensor measures blood volume by illuminating the finger and detecting changes in how light is absorbed...More Source: http://www.sciencemag.org/news/2018/03/modified-smartphone-measures-blood-pressure-directly-your-finger

There are an estimated 50,000 people in the UK living with a spinal cord injury and each year approximately 2,500 people are newly injured. The spinal cord is responsible for communicating two way messages to and from the brain to all areas of the body – your muscles, organs and skin. A spinal cord injury occurs when the spinal cord is damaged through illness or injury. This interrupts the messages to and from the brain, leading to partial or full loss of movement in parts of your body. A spinal cord injury is life-changing. You may need to use a wheelchair to get around, deal with pain and fatigue, and manage bladder and bowel issues. Sexual function may also be affected, depending on your level of injury. Your family can also feel the impact of your injury, and may deal with feelings of guilt or uncertainty for the future. Back Up is a charity for everyone affected by spinal cord injury in the UK – we’re here to help you rebuild your confidence and independence. Your spinal cord The spinal cord is a bundle of nerves and other tissue which extends from the brain’s base at the top of your neck down the length of your back. It’s protected by the bones (or vertebrae) that make up the spine, and by spinal fluid. Your brain and spinal cord are vital for controlling your bodily functions. The spinal cord is responsible for communicating two-way messages to and from the brain to all parts of the body – your muscles, organs and your skin. We are able to feel pain and move our arms or legs because of these messages or impulses. If the spinal cord is damaged or injured, some of the messages or impulses may be ‘interrupted’. This can lead to partial or total loss of feeling or movement in parts of your body – including your limbs and your internal organs. Most injuries cause loss of movement and feeling in the parts of the body below the level of the injury. If you damage or break your spinal cord close to your neck, this will cause paralysis in a larger part of the body than damage to your spinal cord lower down your back. As well as the physical impact of a spinal cord injury, there are also emotional and psychological effects on the person concerned – and their family.

Researchers have wondered whether vitamin D may help people avoid SARS-CoV-2 infections and mitigate the effects of COVID-19. A randomized, double-blind, placebo-controlled clinical trial seeks to test vitamin D’s usefulness in combatting the disease. The study finds high doses of vitamin D have no effect on key COVID-19 outcomes in particularly ill hospitalized patients. Further research is needed to investigate whether a deficiency of vitamin D is associated with more severe cases of COVID-19. There have been numerous investigations into a possible role for vitamin D in preventing both SARS-CoV-2 infections and COVID-19 complications. These studies have drawn conflicting conclusions. Now, a study from researchers in Brazil provides a more robust answer to at least one key question: can vitamin D help prevent COVID-19 complications in particularly ill hospitalized patients? According to the results, the answer appears to be no. The study found that high doses of vitamin D administered to hospital patients with moderate or severe COVID-19 did not affect the course of the disease. “In vitro studies or trials with animals had previously shown that in certain situations, vitamin D and its metabolites could have anti-inflammatory and antimicrobial effects, as well as modulating the immune response,” explains Rosa Pereira, principal investigator for the study. “We decided to investigate whether a high dose of the substance could have a protective effect in the context of an acute viral infection, reducing either the inflammation or the viral load.” Based on the study’s results, says Pereira, “So far, we can say there’s no indication to administer vitamin D to patients who come to the hospital with severe COVID-19.” COVID-19 and vitamin D Scientists at the University of São Paulo’s Medical School (FM-USP) in São Paulo, Brazil, conducted the randomized, double-blind, and placebo-controlled clinical trial. The researchers say this study is the first of its kind. The team tracked the experiences of 240 volunteers receiving treatment for COVID-19 symptoms at FM-USP’s Hospital das Clínicas and the Ibirapuera Park field hospital in São Paulo City, from June to August 2020. All participants had tested positive for SARS-CoV-2 using a polymerase chain reaction test or via antibody testing. All of them received treatment with standard COVID-19 protocols that include antibiotic and anti-inflammatory medications. The researchers then divided them into two equal groups at random. The scientists gave participants in the first group a single 200,000-unit dose of vitamin D3 dissolved in peanut oil. They gave those in the second group unaltered peanut-oil placebos. The design of the study was to discover whether a high dose of vitamin D was associated with a shorter hospitalization — the researchers found that it was not. The investigation also found no evidence that vitamin D made a person less likely to be admitted to the intensive care unit or less likely to need intubation. Vitamin D also seemed to have no effect on mortality, although Pereira cautions that a larger study with more participants is required before researchers can draw final conclusions. https://www.medicalnewstoday.com/articles/study-confirms-high-doses-of-vitamin-d-have-no-effect-on-covid-19#COVID-19-and-vitamin-D

Learning through observation has been a cornerstone of surgical education in the United States for over a hundred years. This practice is being increasingly challenged recently by legal and ethical concerns for patient safety, 80-hour resident work week restrictions, and the cost of operating room (OR) time. The emerging field of surgical simulation and virtual training offers an opportunity to teach and practice neurosurgical procedures outside of the OR. There is enormous potential to address patient safety, risk management concerns, OR management, and work hour requirements with more efficient and effective training methods.[4] The current goal of simulator training is to help trainees acquire the skills needed to perform complex surgical procedures before practicing them on patients...More Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3114314/

Noah Pernikoff is back to his life in New York City after becoming the first patient in the world to undergo a complex three-part, robotic-assisted surgery. The robotic arms made it possible for the multidisciplinary team at Penn to successfully remove a rare tumor from Noah's neck, where the skull meets the spine. The ground breaking surgery was completed by a multi-surgeon team, led by Dr. Neil Malhotra, at the Hospital of the University of Pennsylvania in August 2017 over a span of two days and more than 20 hours...More Source: https://www.sciencedaily.com/releases/2018/05/180503142714.htm

Researchers at Dartmouth College have found a way to make back surgery safer, faster and more cost effective. MRIs and CT scans help surgeons identify spine problems, like compressed vertebrae or herniated disks, but finding a clear path to those problem areas is not always as straightforward. Tissue and bone not only stand in the way, they can also move during spinal surgery, rendering a CT scan taken prior to surgery much less accurate. To solve this problem, Dartmouth professors from the Thayer School of Engineering and the Geisel School of Medicine developed a 3-dimensional, real-time optical tracking system to guide back surgeons as they operate, like a Google Maps for the body, according to findings published in the journal Operative Neurosurgery. Using a complex software algorithm and two cameras attached to a surgical microscope, the system produces real-time 3-dimensional digitized images on a monitor, according to the study. This type of tracked, calibrated stereoscopic camera system has been extensively used in brain surgery but until now has been unexplored for use in spinal surgery...MORE Source: https://www.sciencedaily.com/releases/2018/04/180426085518.htm

Research by Barrow Neurological Institute physicians and University of Washington scientists on novel imaging technology for malignant brain tumors was published in the April issue of World Neurosurgery. The research was conducted by Drs. Evgenii Belykh and Mark Preul at the Barrow Neurological Institute Neurosurgery Research Laboratory with technology developed by Drs. Eric Seibel and Leonard Nelson from the Department of Mechanical Engineering and the Human Photonics Laboratory at the University of Washington. At Barrow they used a Scanning Fiber Endoscope (SFE) to detect the glow produced by adding the pro-drug 5-ALA to experimental models of malignant brain tumors. 5-ALA is metabolized in tumors to a fluorescent Porphyrin and is approved for administration to patients to increase the detection of the margin of invading brain glioma tumors, and thereby allow for a wider or more extensive brain tumor removal. SFE allows the neurosurgeon to visualize the fluorescent light produced by 5-ALA earlier and for longer periods of time than visually possible with a standard operative microscope. SFE offers sufficient image resolution to observe individual brain and tumor cells and the scanning feature reduces the photobleaching of the fluorescent signal which can be problematic in the operating room. The SFE scope uses low-power laser light that is scanned with an actuator at the tip of a highly flexible shaft with overall diameter about the thickness of a nickel. For surgical guidance, two modes of imaging are generated concurrently at video rates, fluorescence to see the tumor, and reflectance imaging to see the surgical field and the surgical tools. Drs. Seibel and Nelson commented, "The combination of high sensitivity and long viewing time of the fluorescently-labeled cancer should allow the guidance necessary for more complete tumor margin clean-up.'' MORE Source: https://www.news-medical.net/news/20180510/New-technology-detects-the-glow-to-guide-brain-tumor-resection.aspx

Spine deformities, such as idiopathic scoliosis and kyphosis (also known as “hunchback”), are characterised by an abnormal curvature in the spine. The children with these spinal deformities are typically advised to wear a spine brace that fits around the torso and hips to correct the abnormal curve. Bracing has been shown to prevent progression of the abnormal curve and avoid surgery. The underlying technology for bracing has not fundamentally changed in the last 50 years. While bracing can stop the progression of abnormal spine curves in adolescents, current braces impose a number of limitations due to their rigid, static, and sensor-less designs. In addition, users find them uncomfortable to wear and can suffer from skin breakdown caused by prolonged, excessive force. Moreover, the inability to control the correction provided by the brace makes it difficult for users to adapt to changes in the torso over the course of treatment, resulting in diminished effectiveness. To address these deficiencies, Columbia Engineering researchers have invented a new Robotic Spine Exoskeleton (RoSE) that may solve most of these limitations and lead to new treatments for spine deformities. The RoSE is a dynamic spine brace that enabled the team to conduct the first study that looks at in vivo measurements of torso stiffness and characterises the three-dimensional stiffness of the human torso. The study was published in March in IEEE Transactions of Neural Systems and Rehabilitation Engineering. “To our knowledge, there are no other studies on dynamic braces like ours. Earlier studies used cadavers, which by definition don’t provide a dynamic picture,” says the study’s principal investigator Sunil Agrawal, professor of mechanical engineering at Columbia Engineering and professor of rehabilitation and regenerative medicine at Columbia University Vagelos College of Physicians and Surgeons. “The RoSE is the first device to measure and modulate the position or forces in all six degrees-of-freedom in specific regions of the torso. This study is foundational and we believe will lead to exciting advances both in characterizing and treating spine deformities.” Developed in Agrawal’s Robotics and Rehabilitation (ROAR) Laboratory, the RoSE consists of three rings placed on the pelvis, mid-thoracic, and upper-thoracic regions of the spine. The motion of two adjacent rings is controlled by a six-degrees-of-freedom parallel-actuated robot. Overall, the system has 12 degrees-of-freedom controlled by 12 motors. The RoSE can control the motion of the upper rings with respect to the pelvis ring or apply controlled forces on these rings during the motion. The system can also apply corrective forces in specific directions while still allowing free motion in other directions. Eight healthy male subjects and two male subjects with spine deformities participated in the pilot study, which was designed to characterise the three-dimensional stiffness of their torsos. The researchers used the RoSE, to control the position/orientation of specific cross sections of the subjects’ torsos while simultaneously measuring the exerted forces/moments. The results showed that the three-dimensional stiffness of the human torso can be characterised using the RoSE and that the spine deformities induce torso stiffness characteristics significantly different from the healthy subjects. Spinal abnormal curves are three-dimensional; hence the stiffness characteristics are curve-specific and depend on the locations of the curve apex on the human torso. “Our results open up the possibility for designing spine braces that incorporate patient-specific torso stiffness characteristics,” says the study’s co-principal investigator David Roye, a spine surgeon and a professor of paediatric orthopaedics at the Columbia University Irving Medical Center. “Our findings could also lead to new interventions using dynamic modulation of three-dimensional forces for spine deformity treatment.” “We built upon the principles used in conventional spine braces, i.e., to provide three-point loading at the curve apex using the three rings to snugly fit on the human torso,” says the lead author Joon-Hyuk Park, who worked on this research as a PhD student and a team member at Agrawal’s ROAR laboratory. “In order to characterise the three-dimensional stiffness of the human torso, the RoSE applies six unidirectional displacements in each DOF of the human torso, at two different levels, while simultaneously measuring the forces and moments.” While this first study used a male brace designed for adults, Agrawal and his team have already designed a brace for girls as idiopathic scoliosis is 10 times more common in teenage girls than boys. The team is actively recruiting girls with scoliosis in order to characterise how torso stiffness varies due to such a medical condition. “Directional difference in the stiffness of the spine may help predict which children can potentially benefit from bracing and avoid surgery,” says Agrawal. Picture caption: The Robotic Spine Exoskeleton consists of two six-degrees-of-freedom parallel-actuated modules connected in series, each with six actuated limbs. Each module controls the translations/rotations or forces/moments of one ring in three dimensions with respect to the adjacent ring. Source:

A team of Calgary surgeons has successfully used a robot to remove a tumour from a young woman's brain. The surgical robotic system, called NeuroArm, helped surgeons remove the tumour from 21-year-old Paige Nickason. "I had to have the tumour removed anyway so I was happy to help by being a part of this historical surgery," Nickason said in a statement from her hospital room less then 24 hours after her May 12 operation. The system was developed by a team of scientists led by Dr. Garnette Sutherland, a neurosurgeon with Calgary Health Region and a professor of neurosurgery in the faculty of medicine at the University of Calgary. The machine is being dubbed the world's first MRI-compatible robot that is able to perform both surgery and biopsies that are less invasive for patients. "This is a turning point in the performance and teaching of neurosurgery," Sutherland said in a statement. "NeuroArm will improve surgical outcomes as it is less invasive and more delicate in its touch." The robot is controlled by a surgeon via computer and works in tandem with what the team has dubbed intraoperative magnetic resonance imaging (MRI). This allows the MRI to enter the operating room on command and provide images of the surgery without putting the patient in danger. The research team says that NeuroArm will revolutionize all types of surgery because, for example, it is not susceptible to the types of limitations that affect a surgeon's work, such as hand tremors. "NeuroArm allows us to harness the capabilities and advantages of both human and machine," Alex Greer, the robotics engineer, said in a statement. "By providing updated imaging and navigation, the surgeon has the tools to better plan and execute complex neurosurgical procedures." The development has intrigued many in the medical community. "For many years now we have been hoping that robotics might have a place in neurosurgery," Dr. Peter Black, a neurosurgery professor at Harvard Medical School, said in a statement. "We look forward with great excitement to the adoption of this technology at other centres." The robot was designed and built with MacDonald, Dettwiler and Associates, which also built Canadarm and Canadarm2, the robotic arm technology that supports astronauts during space walks. Source: https://www.ctvnews.ca/canadian-made-robot-helps-remove-brain-tumour-1.296419

A team of researchers in the U.S. has given three quadriplegic people the ability to use an off-the-shelf tablet computer with impressive ease. The researchers used a BrainGate2 neural interface that relies on an intracortical electrode array implant to allow direct communication between the brain and the tablet. The high-end system connected to the tablet via good-old Bluetooth so that the user was able to control a cursor with traditional point-and-click usability. The patients were able to do all sorts of things, like emailing relatives, web browsing, selecting music to listen to, and just about anything else that anyone else can do on a tablet. Two of the patients even chatted directly with each other in real time, perhaps a first for severely disabled people. Source: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0204566

Ronak Shah and Sabyasachi Ghosh, of Future Market Insights, questions whether 3D printing technology holds the potential to transform the personalised manufacturing landscape of spinal organs for tumour replacement and complex deformity surgery The disruptive capabilities of 3D printing technology, or additive manufacturing, are being leveraged in prototyping of dental implants and custom prosthetics. While this can be traced back to the 1990s, 3D printing technology continues to discover ample applicability in the medical and healthcare industries. Once an ambitious dream in the pipeline, additive manufacturing technology has come a long way, banking on several R&D ventures that have made it what 3D printing technology is today. The technologically-abreast healthcare industry is poised to leverage it to a degree that perfectly complements the ‘minimally invasive’ trend in the surgical space. As the wave of personalisation hits the healthcare industry, medical personnel worm their way into the 3D printing technology landscape, in an effort to harvest opportunities available in enhancing the patient care journey with utmost convenience and ease. Given the complex anatomy and sensitivity of spine, it is challenging for surgeons to reconstruct deformed bones with ‘off-the-shelf’ implants, such as an artificial disc, and that’s where the biocompatibility of 3D-printed implants offers a personalised solution. 3D printing technology in spinal surgery; though in its infancy, holds enormous potential as it allows for the development of a prosthetic that could perfectly replace a fractured bone. In recent times, surgeons are increasingly relying on 3D printing technology for intra-operative surgical guides, surgical planning, and customised prostheses to achieve stability of spine with enhanced implant properties, better patient outcomes, and reduced surgical time. Since the success of the surgery depends on the accurate planning given the complexities associated with surgeries, surgeons acquire MRI and CT scans of a patient’s spinal cord. These scans help them design 3D virtual models of the deformed/damaged bones, which are the used in the development of their ideal replica by using a 3D printer. With a 3D-printed implant, surgeons are able to successfully resect the fractured bone and attribute stability to the spine. Source: https://www.spinalsurgerynews.com/2019/10/fusion-with-3d-printing-technology-is-redefining-the-future-of-spinal-surgeries/43632

Yoga postures that flex the spine beyond its limits may raise the risk of compression fractures in people with thinning bones, according to research from Mayo Clinic. The results appear in Mayo Clinic Proceedings. Researchers at Mayo Clinic and elsewhere have described injuries from yoga. This study examines injuries in people with osteoporosis and osteopenia. Researchers reviewed the health records of 89 people – mostly women – referred to Mayo Clinic from 2006 to 2018 for pain they attributed to their yoga practice. Some were new to yoga, others had practised for years. They had pain in their back, neck, shoulder, hip, knee or a combination. Patients identified 12 poses they said caused or aggravated their symptoms. The most common postures involved extreme flexing or extending of the spine. Researchers used patients’ health records, medical exams and imaging to confirm and categorise the injuries as soft tissue, joint or bone injuries. Researchers identified 29 bony injuries, including degeneration of disks, slippage of vertebrae and compression fractures. The latter appeared to be related to postures that put extra pressure on the vertebra and disks. “Yoga has many benefits. It improves balance, flexibility, strength and is a good social activity,” says Mehrsheed Sinaki, a Mayo Clinic physical medicine and rehabilitation specialist and the study’s senior author. “But if you have osteoporosis or osteopenia, you should modify the postures to accommodate your condition. As people age, they can benefit by getting a review of their old exercise regimens to prevent unwanted consequences.” Patients who incorporated recommendations to modify their movements reduced their pain and improved their symptoms. In a separate commentary, Edward Laskowski, co-chair of Mayo Clinic Sports Medicine, called on providers, patients and yoga teachers to work together to produce an individual exercise prescription that considers the yoga student’s medical history to protect against injury and provide optimal benefit. Source: https://www.spinalsurgerynews.com/2019/04/people-with-osteoporosis-should-avoid-spinal-poses-in-yoga/39285