Blood Test Detects Parkinson's Long Before Symptoms

A study led by the School of Health and Medicine at the University of Lancaster in the UK suggests it may be possible to detect Parkinson's disease in the early stages, long before external symptoms emerge, with a simple blood test that looks for a marker called phosphorylated alpha-synuclein. A report on the study appears in the December issue of the FASEB Journal.

Lead investigator Dr David Allsop, told the press:

"A blood test for Parkinson's disease would mean you could find out if a person was in danger of getting the disease, before the symptoms started."

Allsop and colleagues first showed phosphorylated alpha-synuclein is common in people with Parkinson's disease, and then developed a way to detect it in a blood sample.

Allsop said a diagnostic tool that helps detect Parkinson's disease at a very early stage "would help the development of medicines that could protect the brain, which would be better for the quality of life and future health of older people."

For their study, the researchers examined blood samples from a group of 32 people diagnosed with Parkinson's disease and a group of 30 healthy people of the same age who did not have the disease (the controls). They took four samples from the participants with Parkinson's disease, one every month for four months.

When they analyzed the samples they found:

"The levels of [alpha-synuclein] in plasma varied greatly between individuals, but were remarkably consistent over time within the same individual with PD [Parkinson's disease]."

They measured levels of three different forms of alpha-synuclein, including phosphorylated alpha-synuclein. 

Their analysis showed that participants with Parkinson's disease had sigificantly higher levels of phosphorylated alpha-synuclein compared to the controls. This was not the case for the other forms (oligo-alpha-synuclein, and oligo-phospho-alpha-synuclein), nor for the total of all three.

Based on these findings, Allsop and colleagues then went on to develop a simple test that detects phosphorylated alpha-synuclein in the blood that would allow Parkinson's disease to be diagnosed at the stage where brain damage has started to occur, which is long before external symptoms emerge.

They write:

"Immunoblots of plasma revealed bands (at 21, 24, and 50-60 kDa) corresponding to phosphorylated [alpha-synuclein]. Thus, phosphorylated [alpha-synuclein] can be detected in blood plasma and shows more promise as a diagnostic marker than the nonphosphorylated protein."

Dr Gerald Weissmann is Editor-in-Chief of the FASEB Journal. He said most people think of Parkinson's as the outward symptoms, the involuntary movements, but "many people with Parkinson's also develop neurological problems that may be more difficult to detect right away".

"Having a blood test not only helps doctors rule out other possible causes of the outward symptoms, but it also allows for early detection which can help patients and their caregivers prepare for the possibility of the mental, emotional, and behavioral problems that the disease can cause," he added.

The researchers also noted that:

"Longitudinal studies undertaken over a more extended time period will be required to determine whether [alpha-synuclein] can act as a marker of disease progression."

Written by Catharine Paddock PhD 
Copyright: Medical News Today 

ACUSON P10

Last week, at the 18th Annual Scientific Sessions of the American Society of Echocardiography (ASE) in Seattle, Siemens demonstrated its ACUSON P10 hand-held ultrasound unit, a "system... intended primarily for triage and screening applications in acute care settings." Currently undergoing clinical trials in the US, the device, designed for the medical lab coat pocket, has been 510(K)'ed by the FDA since January 2007.

Here's a list of ACUSON P10 features, taken from the product brochure:

# Hand-held personal imaging tool
# Fits in a lab coat pocket
# Visual reinforcement of exam findings improves patient communication
# Optimized form factor, functionality, and price to complement the physical exam
# 1.6 lbs total weight
# ~ 5-second power-up
# Excellent image quality
# Easy to use -- simple, intuitive user interface
# Stores images and video clips for permanent record-keeping
# Improved interaction with patients
# 4-2 MHz phased array transducer ideal for trauma and cardiac applications

Press release: Siemens Demonstrates New Methods of Cardiovascular Risk Assessment at the American Society of Echocardiography ...

Product page: ACUSON P10: Seeing is Believing ...

Product brochure (.pdf)

Masimo Announces Continuous Noninvasive Functional Hemodynamic Monitoring With Plethysmograph Variability Index (PVI)

Symposium presentation during the 2007 European Society of Anaesthesia Congress in Munich, Germany cites independent research showing the potential value of this new noninvasive diagnostic tool

Irvine, California June 20, 2007 - Masimo, the inventor of Pulse CO-Oximetry and Read-Through Motion and Low Perfusion pulse oximetry, reported that new independent studies presented at a symposium during the European Society of Anaesthesia in Munich, Germany last week indicated that Masimo's Plethysmograph Variability Index (PVI), a noninvasive measurement that quantifies changes in the plethysmographic waveform derived from pulse oximetry, can provide clinicians with a noninvasive way to monitor functional hemodynamics in their patients.

Clinicians who have evaluated PVI believe this technology will prove to be a valuable clinical tool with significant advantages over currently available indicators of changes in functional hemodynamics that are invasive, operator dependent, often inaccurate, and expensive. PVI displays a numeric representation of the changes to the pleth waveform on the pulse oximeter and allows clinicians to track and trend these changes over time as well as a Diagnostic Plethysmograph that maintains the morphology of the true pleth for clinicians to view.

In his presentation in Munich, Maxime Cannesson, MD from the Claude Bernard University and Louis Pradel Hospital in Lyon, France cited research he co-authored entitled Ability of a Novel Algorithm for Noninvasive Automatic Estimation of the Respiratory Variations in the Pulse Oximeter Waveform to Detect Changes in Ventricular Preload scheduled for publication in the journal Anesthesiology later this year that indicates Masimo's PVI method of quantifying changes in ventricular preload, and therefore the ability of the heart to pump adequate blood to the tissues, correlated well with invasive methods.1

Dr. Cannesson said the authors had demonstrated in an earlier study that a change in the beat to beat amplitude of the oximeter waveform of greater than 15% predicted whether a patient was able to adapt to fluid restoration with an appropriate physiological response.2

Dr. Cannesson said that it was his belief that "Pleth Variability Index can automatically and noninvasively detect changes in ventricular preload in mechanically ventilated patients in the operating room. PVI shows great promise for use in perioperative fluid optimization which will have both clinical and economical impact. Other clinical applications for PVI are in the areas of fluid depletion/restriction, mechanical ventilator settings/adjustments, detection of changes in myocardial contractility."

Other clinicians have concurred with these observations and feel that the ability of Masimo Rainbow SET oximeters to display PVI may provide them with a useful clinical data point in the management of their patients.

Dr. Mitchell Goldstein of Loma Linda University Children's Hospital said "Trending of PVI may be useful in monitoring critical care and surgical patients, both intraoperatively and postoperatively, for appropriate hydration and ventilation status."

Dr. Dan Redford of the University of Arizona, University Medical Center added "PVI may be useful in monitoring surgical patients, for appropriate intravascular volume status. For example, a rising PVI may indicate developing hypovolemia, and a falling PVI post-fluid resuscitation is evidence of an appropriate fluid responsiveness, and important measure in the critical care/OR environment."

About Masimo
Masimo develops innovative monitoring technologies that significantly improve patient care-helping solve "unsolvable" problems. In 1995, the company debuted Read-Through Motion and Low Perfusion pulse oximetry, known as SET and with it virtually eliminated false alarms and increased pulse oximetry's ability to detect life-threatening events. More than 100 independent clinical studies have confirmed that Masimo SET technology allows clinicians to accurately monitor blood oxygen saturation in critical care situations-establishing the technology as the "gold standard" pulse oximetry and substantially contributing to improved patient outcomes. In 2005 Masimo introduced Masimo Rainbow SET Pulse CO-Oximetry, which, for the first time, noninvasively monitors the level of carbon monoxide and methemoglobin in the blood, allowing early detection and treatment of potentially life-threatening conditions. Masimo, founded in 1989, has the mission of "Improving Patient Outcomes and Reducing Cost of Care by Taking Noninvasive Monitoring to New Sites and Applications." Additional information about Masimo and its products may be found at www.masimo.com.

1 "Ability of a Novel Algorithm for Noninvasive Automatic Estimation of the Respiratory Variations in the Pulse Oximeter Waveform to Detect Changes in Ventricular Preload", Maxime Cannesson, Bertrand Delannoy, Antoine Morand, Pascal Rosamel, Jean-Jacques Lehot. Anesthesiology 2007 (In Press).
2 "Relation Between Respiratory Variations in Pulse Oximetry Plethysmographic Waveform Amplitude and Arterial Pulse Pressure in Ventilated Patients", Maxime Cannesson, Cyril Besard, Pierre G. Durand, Julien Bohe, and Didier Jacques. Critical Care 2005.

The genuine Ambu bag has become even better

The genuine Ambu bag was introduced in Denmark 50 years ago. Dr. Holger Hesse, founder of Ambu, designed it in collaboration with professor Henning Ruben. The double wall concept revolutionized manual resuscitation and changed the way healthcare providers responded to emergency breathing conditions forever.

Immediately recognized as a milestone in emergency medical care, the genuine Ambu bag became an international sensation. Today, genuine Ambu bags are used for manual resuscitation in hospitals, by ambulance services – in fact in all kinds of emergency environments all over the world.

The double wall concept has evolved over the years, and the Mark III generation is still by many considered the best resuscitator in the world. After listening to the needs of critical and emergency respiratory care providers around the world, we have now redesigned the genuine Ambu bag.

The new and improved Mark IV resuscitators are easier to hold, easier to use, completely autoclavable for reuse and even more effective at what Ambu bags have been especially designed to help you do for more than fifty years - keep patients breathing.

Read more here

Welch Allyn to Employ Oridion’s Microstream® Capnography

Jerusalem/Boston – April 10, 2007 – Oridion Systems Ltd. (SWX: ORIDN) and Welch Allyn, Inc. announced that they have signed an agreement that provides for Welch Allyn to employ Oridion Microstream® EtCO2 sampling technology (capnography) in its next generation patient monitoring products.