Ensuring Safe Dialysis Access in the COVID-19 Environment

Posted on by Liz Dowling

Guest Post by Jeffrey Hull, MD

In the United States alone, nearly half a million people currently suffer from end-stage kidney disease and must undergo hemodialysis several times a week. For these patients, the vascular access site is quite literally their lifeline, as it provides direct access to their bloodstream for the life-saving treatments. 

Yet due to the current COVID-19 outbreak, procedures to establish these vascular access sites have been deemed “non-essential” elective procedures by CMS and HHS, and nephrologists and vascular surgeons are finding themselves unable to secure operating room time.

Though we must all work together during this crisis to reduce the intense strain on our healthcare system, this decision could have devastating implications for patients with end-stage kidney disease — a group that is already highly vulnerable to potential complications of COVID-19. Limiting access to these procedures will increase reliance on riskier vascular access options that significantly increase patients’ chances of infection, hospitalization and even death. This will only add to the strain on resources as hospitals continue to deal with the outbreak.

Continue reading “Ensuring Safe Dialysis Access in the COVID-19 Environment” →

Using Liquid Biopsy to Capture Circulating Multiple Myeloma Cells: The Key to Personalized Treatment?

Posted on by Liz Dowling

What if you could isolate a single cancer cell from a patient and use its genetic makeup to create a personalized treatment plan optimized for that individual?

That’s exactly what Menarini Silicon Biosystems Inc. (MSB) hopes its technology could one day do for people with multiple myeloma.

Multiple myeloma is the most common hematological malignancy.  It forms in plasma cells, white blood cells found mainly in the bone marrow that protect the body from infection by producing antibodies. When these cells become malignant, abnormal plasma cells accumulate in the bone marrow, producing abnormal antibodies and crowding out normal blood-forming cells. Some of these abnormal cells, known as circulating multiple myeloma cells (CMMC), escape from the primary tumor space and travel through the bloodstream.

Current approaches for diagnosing patients with multiple myeloma require bone marrow aspiration and biopsy. These are invasive procedures that use a hollow needle inserted into the hipbone or breastbone to remove bone marrow, blood, and a small piece of bone. While generally safe, bone marrow exams can result in excessive bleeding, infection, and long-lasting discomfort.

Liquid biopsies, on the other hand, examine cancer-related material from a peripheral blood sample obtained from a simple, common blood draw. MSB has developed a method for enumerating CMMC from liquid biopsies using CELLSEARCH® and DEPArray™ technologies.

Continue reading “Using Liquid Biopsy to Capture Circulating Multiple Myeloma Cells: The Key to Personalized Treatment?” →

Transforming IV Therapy: Using the Right Approach to Get the Right Result

Posted on by Liz Dowling

 

The IV Therapy Services team at Hartford Hospital was recognized as the 2019 Clinical Team of the Year for their remarkable work in improving IV care for patients.

Patients hate needles.

This basic fact makes IV therapy a pressing healthcare issue affecting nearly every specialty, according to Lee Steere, RN, CRNI, VA-BC, Manager of IV Therapy Services at Hartford Hospital – especially when you consider that nearly 90 percent of hospitalized patients will require a peripheral IV (PIV) catheter at some point during their stay.

In the United States, PIV failure rates average around 53%, meaning one out of every two catheters fail to last until the end of treatment. This could be the reason that needle sticks are among the top ten patient fears, according to a national survey of hospitalized patients.

“Patients seeking care at healthcare facilities receive too many needle sticks,” Steere said. “My passion is to achieve the goal of one PIV per patient which entails getting an IV inserted on the first attempt and lasting until the prescribed treatment is complete.” Continue reading “Transforming IV Therapy: Using the Right Approach to Get the Right Result” →

From Reconstruction to Going Flat – Helping Women Look & Feel Better After Breast Cancer with Oncoplastic Surgery

Posted on by Greg Dennis

Barry Rosen, MD, Guest Contributor

Barry-Rosen-OR-photo-1.jpgRecovery from breast cancer can be a difficult journey, both physically and emotionally. An important part of recovery from the trauma of cancer diagnosis is to be able to put the entire experience in the rear view mirror, so to speak. But it’s hard to do that if you have a daily reminder in the form of a disfiguring scar.

It was once common for surgeons to focus solely on removing a breast cancer tumor with little regard for the appearance of the breast. But we now know we can deliver excellent cosmetic outcomes without compromising oncologic safety. There have been tremendous advances in the past 20 years in the diagnosis and treatment of breast cancer that enable us to help our patients look and feel better after breast cancer.

One of these important advances is oncoplastic surgery (OPS). Though popular in Europe for several decades, it’s only begun to gain traction in the United States within the last 10 years. OPS combines breast surgery with plastic and reconstructive techniques to achieve the best possible cosmetic outcomes without compromising cancer care. It can be as simple as closing the cavity and hiding the scar, or performing a more complex procedure like a breast lift or reduction in conjunction with removing the tumor. Continue reading “From Reconstruction to Going Flat – Helping Women Look & Feel Better After Breast Cancer with Oncoplastic Surgery” →

Following the (Investment) Money in Medical Devices

Posted on by Greg Dennis

It will come as no surprise to medical device startups that the funding climate in medical devices is still challenging. We talked recently with two experts who come to this question with two different perspectives.

– Alice McKeon is VP Healthcare Investment Banking at Network 1 Financial, which is based in Red Bank, N.J.

– Dan Clark is a Cofounder and the Chief Marketing Officer at Linear Health Sciences, makers of the Orchid Safety Release Valve.

The power and policies emanating from Washington DC are on the minds of many people these days. How will the Trump Administration affect the investment climate in medical devices?Wall Street Bull image

“The short answer is, no one really knows,” McKeon said. It’s unclear what will happen to the Affordable Care Act (Obamacare). That in turn raises questions in potential investors’ minds. Continue reading “Following the (Investment) Money in Medical Devices” →

When Catheter Stabilization Isn’t Enough for Patient Safety

Posted on by Greg Dennis

1462041601658Many drivers have experienced the kind of fender-bender or sudden stop that made them glad they were wearing a seat belt. But a seatbelt can only protect us from so much — which is why airbags and more advanced safety approaches were invented.

To use another auto analogy, think of the breakaway hoses at gas stations pumps. They prevent the full hose from being pulled out of the pump when an absent-minded driver drives away without removing the nozzle from the gas tank.

Similarly in nursing care, there’s only so much that catheter stabilization can do when it comes to protecting IV lines. Given those limitations, a better safety option is now being developed to address a pain point for nurses: accidental dislodgement of IV lines. Continue reading “When Catheter Stabilization Isn’t Enough for Patient Safety” →

Why IV Lines Fail: A Crazy Little Thing Called Dislodgement

Posted on by Greg Dennis

With something like 300 million peripheral IV lines sold in U.S. each year – and a failure rate that’s often cited as being 50% – researchers continue to try to understand a problem that’s a daily headache in vascular access and infusion therapy.

4-1Common causes of line failure are dislodgement, infection, thrombosis, phlebitis and occlusion. Peripherally inserted central catheters (PICCs) and central venous catheters (CVCs) tend to be better secured than peripheral IVs, but they are also subject to high failure rates.

“Intravenous catheter dislodgement is a significant and avoidable problem,” said vascular access consultant Leigh Ann Bowe-Geddes, BSN, RN, CRNI, VA-BC, a well known vascular access clinical consultant and former president of the Association for Vascular Access. Continue reading “Why IV Lines Fail: A Crazy Little Thing Called Dislodgement” →

When a ‘Low Profile’ Is a Good Thing

Posted on by Greg Dennis

When a company comes up with something better, it typically wants a high profile for the technology. But it’s not always the case with Focal Therapeutics.

That’s because the company recently launched a low-profile version of the BioZorb® implant used in breast conservation treatment (BCT).

laidley2
Breast surgeon Alison Laidley compares the original, spiral version of BioZorb (left) to the new BioZorb Low Profile (right).

Focal’s new BioZorb LP (for “low-profile”) design means more women who need breast cancer surgery could benefit from the implantable device. BioZorb is used in “reconstructive lumpectomy” and other types of BCT. It marks in three dimensions the site from which a breast tumor is removed.

The BioZorb LP device is designed to be implanted in smaller breasts, peripheral areas of the breast, and locations with less tissue coverage.

“Everyone understands the need for delivering more personalized medicine,” said Alison Laidley, M.D., a prominent Dallas breast surgeon with Texas Breast Specialists who was among the first physicians to use BioZorb LP. “The new designs of this device enable us to provide it to many more patients.” Continue reading “When a ‘Low Profile’ Is a Good Thing” →

Does the Mammography Debate Miss a Key Point?

Posted on by Greg Dennis

Every time the US Preventive Services Task Force issues a recommendation about when women should start getting mammograms – and how often they should have these screenings – it sends shockwaves through the breast-cancer world.

modiglianiThis last time was no different.

But now two influential breast cancer experts assert that – as important as the debate is – it misses an essential point about evaluating a woman’s individual risk of getting breast cancer.

Those experts – Dallas breast surgeon Dr. Peter Beitsch and Nashville breast surgeon Dr. Pat Whitworth – say the key question is how to evaluate “risk.”

The latest recommendations from the task force call for women at “average risk for breast cancer” to begin every-other-year screening at age 50. It casts doubt on the true value of screening beginning at age 40 – citing the high number of false-positive test results in women 40 to 50, plus potential harm from overdiagnosis and unnecessary treatment. Continue reading “Does the Mammography Debate Miss a Key Point?” →

Cost Conundrum: How Accountable Are ACO’s?

Posted on by Greg Dennis

Among the many ways the Affordable Care Act tries to drive down healthcare costs is through Accountable Care Organizations.

acoJust what are ACOs? HMOs in drag? And are they working?

Here’s how we see the ACO landscape today:

  • Although their launch has been somewhat troubled, Accountable Care Organizations are here to stay.
  • The Centers for Medicare and Medicaid Services (CMS) is driving the adoption of ACOs, with some private payers joining in.
  • Data collection and analysis hold out the promise of reducing inefficiencies.
  • ACOs don’t take on a lot of risk if they can avoid it. That in turn will affect how much money they can actually save the healthcare system.
  • In a related development, some payers – including a new industry alliance – are looking closely at the role of health insurance third-party administrators (TPAs), to see if further cost can be taken out of the system there.

What Is an ACO?

First, a bit about terminology. While ACOs undertake some responsibility for the cost of delivering care, they are not “all in,” as are HMOs. (For a good video explaining ACOs, see this from Kaiser Health News.)

Here’s how healthcare economist Austin Frakt, writing in the New York Times, explains the differences between ACOs and HMOs: Continue reading “Cost Conundrum: How Accountable Are ACO’s?” →