I Spy for Heart Disease

August 29, 2014 by

Aug. 29, 2014

By Medical Discovery News

Heart in chest

While a shrink ray like the kind used in science fiction is still stuck in the future, miniature devices are not. Tiny devices have been created to perform a variety of tasks, from an implantable telescope to improve vision in those with macular degeneration to the new pacemaker in clinical trials that is about the size of a large vitamin pill. Now, researchers have developed a catheter-based device smaller than the head of a pin that can provide real-time 3D images of the heart, coronary arteries, and other blood vessels. This is an important invention as the casualties of heart disease continue to rise. Statistically, one in four people will have a heart attack. 

Many Americans are at risk for developing coronary artery disease (CAD) due to the buildup of cholesterol and plaque. If there is a rupture or breakage of the plaque, creating a blood clot, that can result in a heart attack with little to no warning. Traditional diagnostic tests such as stress tests and echocardiograms show how much blood is flowing to the heart. If there are regions of the heart that are not getting as much blood as others, it might be a sign of clogged coronary arteries. However, blood flow can also appear to be normal even with plaque buildup.

Currently, there are a variety of methods that provide images of what is going on inside arteries, including magnetic resonance imaging (MRI), multi-detector Computerized Tomography (CT) scans, and injecting an iodine-based contrast agent into arteries through a catheter. But all these look at the inside of the body from the outside, which is why this new device gives an unprecedented way of viewing the heart.

This invention combines ultrasound imaging with computer processors on a single chip only 1.4 millimeters wide. The body’s signals are processed on the chip then transmitted through 13 tiny cables to a computer monitor, so doctors have a visual of the heart and arteries. The prototype took 60 images per second using very little power, therefore generating little heat. This would allow cardiologists to take real-time images of blood vessels in and around the heart to more precisely determine the extent of blockages. These images also have much higher resolution compared to those taken with machines outside the body.

The next step is to conduct studies using the device on animals to determine its safety and efficacy and to develop potential applications of this technology. Eventually, this data will be submitted to the Food and Drug Administration (FDA) to gain permission to perform clinical trials on humans. Extensive testing will be required before the FDA will approve the device for general use. The developers, a group of engineers at the Georgia Institute of Technology, are also working to shrink the device even further to .4 millimeters so it can generate images of even smaller blood vessels.

Having clearer images of blood vessels would allow surgeons to have a more complete understanding of the blockage they are dealing with before they operate. Hopefully, in the future use of this device will prevent heart attacks and save many people’s lives.

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Silent Mad Cow

February 28, 2014 by

Feb. 28, 2014

By Medical Discovery News

Ten years after bovine spongiform encephalopathy (BSE), commonly called mad cow disease, was diagnosed in cattle in Britain, the British government admitted that it could be transferred to humans in a new form called variant Creutzfeldt Jakob disease (vCJD).

Cases of BSE spread to cattle in other countries, and more people in different countries were being diagnosed with vCJD. By 2004, the U.S. had passed various laws to eliminate BSE-infected cattle from the market. However, to this day, there are still sporadic reports of cows diagnosed with BSE both in the U.S. and abroad.

BSE and vCJD are neurological diseases that arise from prion plaques that form in the brain. Prions are simply misfolded proteins. This can be caused by a genetic mutation, spontaneous misfolding, or consuming infected beef. These misfolded proteins can convert healthy or normal proteins into misfolded ones. Once they appear, abnormal prion proteins aggregate, or clump together. Investigators think these protein aggregates may lead to loss of brain cells and other brain damage. Areas of the brain’s grey matter are slowly displaced and the brain develops holes or a spongy appearance, hence the name spongiform. There is no treatment or cure and eventually the damage is severe enough to lead to death. 

Initially cattle acquired the prion proteins in feed supplements made from infected sheep brains and spinal cord tissues. Once regulators understood the source, they passed laws banning the process of feeding dead animals to livestock. Unlike meat contaminated with bacteria, cooking does not destroy prion proteins. In an effort to eliminate prions from the food supply, the U.S. Department of Agriculture has imposed a rule that the brains and spinal cords of cattle must be removed prior to processing into edible meat. 

There have been 175 people in Great Britain diagnosed with vCJD and an additional 49 people in 11 other countries. A large study indicates that 1 in 20,000 people in Britain (30,000 total) carry the misfolded prion proteins and are at risk of developing vCJD. These new results suggest that many people in Britain may be carrying the prions but are symptomless, at least for now. This could also mean that these cases are silent carriers, who will not develop clinical vCJD. It remains a mystery that only time and additional studies will solve. 

Since there is no blood test for vCJD, carriers could unwittingly pass on this disease to others when they give blood. Earlier research suggested that the incubation period for vCJD was about eight years, but now scientists think that there are at least three types of the misfolded prion proteins, with different incubation periods and different types of prion disease.

Blood tests need to be developed to protect against the inadvertent transmission of vCJD. Better farm and food practices and laws will also help eliminate other sources of prion disease. Scientists in a number of countries are exploring potential treatments for these disorders.

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