The Computer Assisted Medical Diagnosis and Surgery System, CAMDASS, is a wearable augmented reality prototype.

Augmented reality merges actual and virtual reality by precisely combining computer-generated graphics with the wearer’s view.

CAMDASS is focused for now on ultrasound examinations but in principle could guide other procedures.

Ultrasound is leading the way because it is a versatile and effective medical diagnostic tool, and already available on the International Space Station.

Future astronauts venturing further into space must be able to look after themselves. Depending on their distance from Earth, discussions with experts on the ground will involve many minutes of delay or even be blocked entirely.

“Although medical expertise will be available among the crew to some extent, astronauts cannot be trained and expected to maintain skills on all the medical procedures that might be needed,” said Arnaud Runge, a biomedical engineer overseeing the project for ESA.

CAMDASS uses a stereo head-mounted display and an ultrasound tool tracked via an infrared camera. The patient is tracked using markers placed at the site of interest.

An ultrasound device is linked with CAMDASS and the system allows the patient’s body to be ‘registered’ to the camera and the display calibrated to each wearer’s vision.

3D augmented reality cue cards are then displayed in the headset to guide the wearer. These are provided by matching points on a ‘virtual human’ and the registered patient.

This guides the wearer to position and move the ultrasound probe.

Reference ultrasound images give users an indication of what they should be seeing, and speech recognition allows hands-free control.

The prototype has been tested for usability at Saint-Pierre University Hospital in Brussels, Belgium, with medical and nursing students, Belgian Red Cross and paramedic staff.

Untrained users found they could perform a reasonably difficult procedure without other help, with effective probe positioning.

“Based on that experience, we are looking at refining the system – for instance, reducing the weight of the head-mounted display as well as the overall bulkiness of the prototype,” explained Arnaud.

“Once it reaches maturity, the system might also be used as part of a telemedicine system to provide remote medical assistance via satellite.

“It could be deployed as a self-sufficient tool for emergency responders as well.

“It would be interesting to perform more testing in remote locations, in the developing world and potentially in the Concordia Antarctic base. Eventually, it could be used in space.”

Funded by ESA’s Basic Technology Research Programme, the prototype was developed for the Agency by a consortium led by Space Applications Services NV in Belgium with support from the Technical University of Munich and the DKFZ German Cancer Research Centre.

Renal nerve ablation or denervation, recently introduced in Malaysia, involves destroying certain nerves around the kidney that can help regulate the body’s blood pressure.

According to interventional cardiologist Dr Yap Yee Guan, this is done by activating radio frequency waves passed through a wire inserted into the renal (kidney) arteries via a small cut in the groin.

A 2010 multi-centre clinical trial showed that the destruction of the nerves decreased the blood pres-sure of patients by an average 32/12mmHg.

Dr Yap said usually, taking a new hypertension drug would not cause a decrease of more than 10mmHg.

About 84% of patients who underwent the ablation had over 10mmHg decrease in their blood pressure, compared with 34% of the control group, which continued normal drug treatment.

Follow-ups showed that the de-crease in blood pressure was still maintained two years after the procedure with one in five able to decrease their hypertension medications after the procedure.

“It is very safe,” said Dr Yap.

The procedure is currently available at the National Heart Institute and Prince Court Medical Centre, Kuala Lumpur.

The system, called ConviDose, aims to help those who take five or more different pills and was introduced by the National Healthcare Group (NHG), Singapore in May 2010 as part of a pilot programme.

The automated packing system works by having machines pre—package patient dosage into sachets according to the stipulated quantity and time the pills need to be consumed.

To ensure patients take their medication correctly, each packet is labelled according to the specific quantity and time the pills need to be consumed.

The description of what the medication looks like, in terms of size and colour, is also included.

It is currently being used by some 3,000 patients in 14 nursing homes and four long stay wards in the Institute of Mental Health.

Toa Payoh Polyclinic has also started using the system to assess patients’ needs and fine tune the operational workflow.

NHG said ConviDose would help nursing homes free up manpower, save on storage space and improve medication safety.

ConviDose is at least 14 times faster compared to the calendar blister packs used to organise medications.

“Packing of the calendar blister pack used to take us about 45 minutes per patient. And that’s the minimum,” Chan Soo Chung, executive director of NHG Pharmacy, said.

“With the machine it saves us a lot of time, I think it’s at least 14 times faster. The machine can spit out 25 sachets a minute. That’s a huge improvement.”

There are plans to extend this service to day care centres and patients under the care of private health care providers.

The Salvation Army Peacehaven Nursing Home executive director Madam Low Mui Lang said the system is convenient for her nurses.

“They (the nurses) don’t have to spend three hours a day to pack medication and can give more time to look after the residents in the nursing home,” she said.

“In Peacehaven, we have 401 residents. (Previously) you needed at least 28 hours a day to actually pack medication for all the residents in the home.”

An inaugural partnership between Maxis and Institut Jantung Negara (IJN), launched recently will provide healthcare content service via mobile phones with SMS features, smart devices or the Internet to instill awareness on health.

Maxis customers, who subscribe to the service, will receive tips on general heart-related healthcare, cardio fitness and cardiac diet via SMS three times a week at RM2 per month or RM0.20 sen per SMS.

IJN deputy chief executive officer (CEO) Prof Datuk Dr Mohd Azhari Yakub described the collaboration as a win-win partnership.

“The collaboration between IJN and Maxis will benefit Malaysians who use the service to improve their wellbeing.”

Maxis joint chief operating officer Suren J. Amarasekera said the partnership would help create public awareness of cardiovascular diseases with vital heart-related health information through mobile technology and applications.

Maxis customers may subscribe to the service by dialling *200#, select “Health and Wellness” and follow the instructions for various options that they can choose from.

Customers with iPhone and Android devices can download “myHealthy Heart” smartphone applications to access information and tools.

They also can visit health.my- launchpad.com.my for a range of health-related information which features the Heart Health section, exercises, diet ideas and other general health topics.

Europe’s environmental watchdog, the European Environment Agency, has warned that products containing endocrine disrupting chemicals should be treated with caution until their true effects are better known. However, it stopped short of recommending a ban of any specific products. A few such chemicals have already been banned, but many are still in widespread use.

Jacqueline McGlade, executive director of the EEA, said: “Scientific research gathered over the last few decades shows us that endocrine disruption is a real problem, with serious effects on wildlife, and possibly people. It would be prudent to take a precautionary approach to many of these chemicals until their effects are more fully understood.”

She singled out for particular scrutiny five classes of chemicals: phthalates, often found in pesticides; bisphenol A and other PCBs, used to make plastics and sometimes, controversially, used to make baby’s feeding bottles; parabens, found increasingly in sunscreen; and the chemicals used in contraceptive pills.

But McGlade said that the real problem was not a single chemical or product, but the fact that we are constantly exposed to so many of them, and the interactions between them in our bodies. “It’s the cocktail effect,” she said. That effect is one of the most difficult to study.

Endocrine disrupting chemicals (EDCs) interfere with the body’s hormone systems, which is why some of the most common are those found in the contraceptive pill. They are increasingly found in a wide range of products, from cosmetics to plastics. For decades, researchers have suspected potential links between the increasingly common chemicals and a range of human illnesses, and numerous studies have been undertaken.

But the EEA study is the first to take a comprehensive review of the evidence gathered over the past 15 years, and it concludes that there is serious cause for concern.

According to the study, EDCs have been found to be connected to a higher incidence of breast cancer, and an earlier onset of puberty, as well as to male fertility problems including lower semen quality.

McGlade told the Guardian that ways of dealing with the chemicals included stricter treatment of sewage, such as installing sand filtration, membrane filtration and using ozone to purify water. But she also insisted the need to look “upstream”, to the manufacture of products, to ensure their use is minimised and as safe as possible.

The EEA noted that several studies also linked exposure to some EDCs with neurodevelopmental disorders such as autism, attention deficit disorder and diminished cognitive function in children. But it concluded that more work would be needed to confirm or disprove this.

Linking EDCs to specific ailments is difficult: although tests on animals have shown clear links between the chemicals and a range of ill effects, this does not translate directly into problems for human health if these chemicals are dispersed in the wider environment.

The EEA said another complicating factor was that if these chemicals were harming the early development of the brain, reproductive, immune and metabolic systems, this could be invisible until several years or even decades after exposure.

The EEA report builds on a landmark study, the 1995 Weybridge report, that recorded serious questions over the chemicals but lacked long-range data in some key areas.

University of Chicago Medicine researchers surveyed nearly 1,900 heart attack survivors for the study. Among patients who were sexually active before their heart attack, those who received counseling about sex before they were discharged from the hospital were 1.5 times more likely to carry on with their sex lives.

Patients who did not receive medical advice about their sex lives often either unnecessarily delayed their return to sexual activity or refrained from sex altogether.

The study also found that less than half of male patients and about one-third of female patients recalled receiving predischarge instructions on when to return safely to sexual activity.

One year after being discharged from the hospital, only 41% of men and 24% of women said they’d had a discussion with their doctor about sex since their heart attack.

The findings, published in the May 10 issue of the American Journal of Cardiology, show the need for doctors to regard sex as an important part of overall function, even after a life-threatening event such as a heart attack, said study author Dr. Stacy Tessler Lindau, an associate professor of obstetrics and gynecology at the University of Chicago Medicine.

“Doctors need to understand the significant role they play in helping [heart attack] patients avoid needless fear and worry about the risk of relapse or even death with return to sexual activity,” Lindau said in a university news release.

“Receiving instructions prior to hospital discharge about resuming sex was a major predictor of whether patients resumed sexual activity in the year following [heart attack],” Lindau said. “For women, this was the only significant predictor. The discharging cardiologist has detailed knowledge of the patient’s condition, has provided lifesaving care and is best positioned to advise on the safety of engaging in physical activity, including sex.”

If heart attack survivors don’t receive professional advice, they have to make their own, often incorrect, assumptions about the risks associated with sexual activity, Lindau said.

The toxins known as Botox are famous for their use in cosmetic treatments, to fill soft tissue and remove wrinkles.

But the National Institute for Health and Clinical Excellence (NICE) announced on Friday that its appraisal committee is backing the use of Botox injections for migraine sufferers for whom other treatments have not worked.

Thousands of people across Britain suffer from chronic migraine, defined by the regulatory body as headaches on at least 15 days per month of which at least eight days are with migraine. The organisation estimates that chronic migraines afflict around 1.6 percent of adults.

“Chronic migraines are extremely debilitating and can significantly affect a person’s quality of life,” said Professor Carole Longson, director of the health technology evaluation centre at NICE.

“We are pleased that the committee has been able to recommend Botox as a preventative therapy for those adults whose headaches have not improved despite trying at least three other medications and whose headaches are not caused by medication overuse.”

NICE had been asked to advise the NHS on whether Botox, known chemically as botulinum toxin type A and manufactured by Allergan, would provide value for money in treating chronic migraine in England and Wales.

The appraisal committee has come out in favour of the treatment after obtaining more information and analyses from Allergan.

Longson said: “We have published our final draft guidance so that registered stakeholders can highlight any factual errors or appeal against our provisional recommendations. We have not yet issued guidance to the NHS on the use of this drug.”

Once the final guidance has been published, the NHS must allocate funding for the use of Botox as defined in the guidance within three months, under the rules of the NHS constitution.

Infections cause about 2 million cancer cases a year, and 80 % of those cases occur in less developed areas of the world, according to the study, which was published online May 8 in The Lancet Oncology. Of the 7.5 million cancer deaths worldwide in 2008, about 1.5 million were due to potentially preventable or treatable infections.

“Infections with certain viruses, bacteria and parasites are one of the biggest and most preventable causes of cancer worldwide,” lead authors Catherine de Martel and Martyn Plummer, from the International Agency for Research on Cancer in Lyon, France, said in a journal news release. “Application of existing public-health methods for infection prevention – such as vaccination, safer injection practice or antimicrobial treatments — could have a substantial effect on future burden of cancer worldwide.”

The researchers examined data on 27 cancers in 184 countries and calculated that about 16 percent of all cancers in 2008 were infection-related. The rate of infection-related cancers was 23 percent in developing countries and 7 percent in developed countries.

Rates of infection-related cancers ranged from 3 percent in Australia and New Zealand to 33 percent in sub-Saharan Africa.

“Many infection-related cancers are preventable, particularly those associated with human papillomavirus (HPV), Helicobacter pylori, and hepatitis B and hepatitis C viruses,” the researchers said.

In 2008, these four main infections together caused 1.9 million cancers, mostly of the stomach, liver and cervix. Cervical cancer accounted for about half of infection-related cancers in women, and liver and gastric cancers accounted for more than 80 percent of infection-related cancers in men.

The study findings “show the potential for preventive and therapeutic programs in less developed countries to significantly reduce the global burden of cancer and the vast disparities across regions and countries,” Goodarz Danaei, of the Harvard School of Public Health in Boston, wrote in an accompanying editorial.

“Since effective and relatively low-cost vaccines for HPV and [hepatitis B] are available, increasing coverage should be a priority for health systems in high-burden countries,” Danaei added.

Pregabalin is licenced to treat peripheral and central neuropathic pain, generalized anxiety disorder (GAD) in adults as well as an adjunctive therapy for partial seizures with or without secondary generalization in adults.

Berkeley Phillips, Medical Director of Pfizer Ltd declared:

“By bringing pregabalin oral solution to the UK market, we can provide patients who are candidates for treatment but experience difficulty swallowing, with an alternative option. The difficulties associated with dysphagia for those who are required to take medicines orally are widely accepted. It is our hope that this new oral solution formulation will provide an appropriate alternative, which will be more convenient for these patients.”

Dysphagia is linked to certain diseases and disorders, such as diabetes, epilepsy, multiple sclerosis (MS) and Parkinson’s disease (PD) and can also occur as a side effect to some types of medication. The risk of dysphagia increases with age and the condition can make it difficult for patients to swallow medications that are in solid form.

5% of over 79 year olds and 16% of those aged over 87 years report to suffer from symptoms of dysphagia. These figure rise to up to 60% amongst the elderly who live in nursing homes or sheltered accommodation. 24% of patients who are mildly impaired due to MS suffer from permanent dysphagia, however the prevalence increases progressively together with rising disability, with 65% of severely disabled MS sufferers experiencing permanent dysphagia. According to estimates, almost 40% of patients who suffered a stroke also suffer from swallowing problems.

Crushing pills or opening capsules to ease ingestion for those who have difficulty in taking medication in tablet or capsule form can change a drug’s bioavailability, the rate in which a drug is being absorbed, and it may also affect a drug’s therapeutic benefits and/or risk of adverse events. According to research, patients who experience difficulty in swallowing pills have poorer health outcomes and higher health care costs.

Martin Johnson, GP and RCGP Pain Champion explained:

“A wide range of patients with dysphagia will benefit from the introduction of the new oral formulation. The introduction of the oral solution will help us in our treatment of peripheral and central neuropathic pain in the elderly, those with epilepsy, diabetes, multiple sclerosis, stroke and Parkinson’s disease, and of course palliative patients as well.”

According to recommendations from the National Electronic Library for Medicine, doctors should wherever available administer licensed alternatives, like oral solutions to those patients who are unable to take medicines in solid oral dosage forms. The announcement was made after the Committee for Medicinal Products for Human Use (CHMP) positive opinion regarding an oral solution of prebabalin in 2010, a decision ratified by the EU in 2011.

Nodding off behind the wheel is not the only threat from a lack of sleep. Evidence is growing that people who regularly sleep too little and at the wrong time suffer long-lasting consequences that a nap will not cure: increased risk of diabetes, heart disease and other health problems.

“We have a societal conspiracy for sleep deprivation,” says Russell Sanna of Harvard Medical School’s sleep medicine division, who attended a TEDMED conference last week where scientists called sleep loss one of health care’s big challenges.

Just how unhealthy is it? Consider how sleep may play a role in the nation’s diabetes epidemic.

Studies have long shown that people who sleep fewer than five hours a night have an increased risk of developing Type 2 diabetes, the kind that tends to strike later in life.

Rotating shift work, three or more night shifts a month interspersed with day or evening hours, raises the risk, too, says a recent report from researchers who analyzed years of medical records from the huge Nurses’ Health Study.

Diet and physical activity are big factors in Type 2 diabetes. Certainly it is harder to work out or choose an apple over a doughnut when you’re tired, especially at 3 a.m. when your body’s internal clock knows you should be sleeping.

A study published last week, however, shows sleep plays a more complex role than that. As sleep drops and normal biological rhythms are disrupted, a person’s body physically changes in ways that can help set the stage for diabetes, reports neuroscientist Orfeu Buxton of Boston’s Brigham and Women’s Hospital.

Buxton’s team had 21 healthy volunteers spend almost six weeks living in a laboratory where their diet, physical activity, sleep and even the light was strictly controlled.

The volunteers started out well-rested. But for three of those weeks, they were allowed only about 5{ hours of sleep every 24 hours – at varying times of the day or night, to mimic a bad shift rotation or prolonged jet lag. That knocked out of whack the body’s “circadian rhythm,” a master biological clock that regulates such patterns as when a person becomes sleepy or how body temperature rises and falls.

What happened was startling: Blood sugar levels increased after meals, sometimes to pre-diabetic levels, because the pancreas stopped secreting enough insulin, Buxton reported in the journal Science Translational Medicine.

At the same time, the volunteers’ metabolic rate slowed by 8 percent. The researchers had them on a diet so they did not gain weight, but Buxton says typically, a metabolism drop of that size could mean gaining 10 to 12 pounds over a year.

The results make sense, says Dr. Michael Thorpy, sleep center director at New York’s Montefiore Medical Center and a neurology professor at Albert Einstein College of Medicine.

“If we’re going to spend a third of our day sleeping, there’s got to be a good reason for it,” says Thorpy, who notes that diabetes is far from the only worry.

Up to 70 million Americans are estimated to suffer from chronic problems with sleep, from insomnia to sleep apnea. Impaired sleep has been linked to high blood pressure, heart disease, obesity, depression, memory impairment and a weakened immune system. Still another concern: The World Health Organization has classified night shift work as a probable carcinogen, because too much light at night may hamper a hormone involved both with sleep and suppressing tumor cells.

Don’t people adjust to the night shift if they are on it long enough? Buxton says rotating shifts probably are most worrisome. In his study, the volunteers’ bodies went back to normal after nine nights of sufficient sleep at the right time. No one knows how long it takes before sleep deprivation and an off-kilter biological clock may cause permanent damage.

Montefiore’s Thorpy says natural night owls seem to adapt better to night shifts, but that people never fully adapt if they swing back to daytime schedules on their days off. Also, about 30 percent of regular night workers have trouble sleeping during their off hours or are particularly fatigued, he says, something termed “sift work disorder.”

The consumer message:

-The National Institutes of Health says adults need between seven and nine hours of sleep daily for good health.

-People you work nights, should go straight to bed when they get home, Buxton advises. Avoid too much light along the way. Thorpy says earing yellow- or orange-tinted sunglasses on the drive home can block short-wavelength “blue light” that triggers wakefulness.

-Let natural light help keep the biological sleep clock on schedule, advises Harvard’s sleep-education Web site. For most people, sunlight in the morning is crucial. For the night shift, more bright light in the evening shifts people’s internal clock, Buxton explains.

-For anyone, a sleep-inducing bedroom is one that’s dark, quiet and cool. Avoid caffeine, alcohol and stressful situations near bedtime. Electronics right before bed aren’t advised, either. Going to bed and waking up a the same time every day also helps.