3D Bioprinting

3D Printing is no longer news although I suspect most people haven’t heard of it yet. In fact there is a company within a couple of km of my office in Albany already successfully offering a variety of 3D printing services, incidentally called 3D Print. Another Aucklander, well known internationally in the  3D printing with RepRap is Vik Oliver, seen here with one of his machines.

When I heard that Richie McCaw was injured and after surgery was going to miss around 6 matches after having a titanium screw in his foot, my first reaction was, as most Kiwis, just what we need in Rugby World Cup year as he is such an amazing skipper and we want him there leading the All Blacks. Then I thought about so many other sports people who suffer injuries all the time given that they are putting their bodies on the line professionally.

Imagine a technology that rebuilds or repairs body tissue, bones, ligaments, even organs in vivo, using micro surgery techniques that mean people recover far more quickly, naturally and potentially therefore stronger than before.

Using the same types of technologies as conventional 3D printing, it will soon be possible to pattern and assemble, layer by layer, functioning living tissue, as well as non living substitutes such as ceramic and titanium according to Vladimir Mironov, an associate professor and director of the Advanced Tissue Biofabrication Center at the Department of Regenerative Medicine and Cell Biology, Medical University of South Carolina. He is also currently making waves about growing in vitro meat, something I have previously blogged about.

So this is a relatively new technology and I don’t know that it has been tested on humans yet, but the technology is already commercially available from companies such as envisionTEC.

Imagine the good this technology could do for people with problems from injuries, burns, through to the huge numbers of people who die for lack of organs for transplant.

The following video shows how bioprinters will be used in the long term. The technology will also be used to create human tissues which can be used for drug testing instead of using animals.

Of course if tissues and organs are made using material from the host, we can eliminate problems such as donor organ rejection.

Why don’t Auckland Hospitals Work Smarter Instead of Harder

A friend of mine was prepped for 2 days with nil by mouth a month or 2 ago for urgent cancer surgery. The first day she got bumped and the 2nd day was the start of a radiographers strike. Last night she was prepped for an 8 hour operation and got bumped due to a critical case that suddenly appeared. We thought she was criticial, but obviously that’s not for us to judge.

I’ve asked the question before “Is hospital the best place to be when you are sick?” and pretty  much decided unless it was a private hospital, possibly not. But of course most of us don’t have any choice especially as we get older.

It is nice to see that some things are improving. For example Auckland Health Board has decided to send some patients to private clinics for radiation treatment to reduce waiting times.

I had blogged previously about waiting times at North Shore Hospital based on experiences waiting with family members in A & E and subsequently in corridors in some cases for days, without being assigned to wards. Each time we were told that it was an exceptional case and we were just unlucky. A registrar was sick and therefore his team couldn’t operate was a common excuse. Think about it, an entire team doesn’t operate because one person doesn’t turn up? Maybe they were stretching the truth, being they are short staffed and can’t afford another registrar, and they didn’t turn up because they didn’t exist.

According to the reports, North Shore Hospital is improving and it is now only the 3rd worst in New Zealand. North Shore Hospital supports North Shore and Waitakere with an excess of 400,000 population and rapidly growing. Of course things will change with the new Super City, but the problems won’t go away.

As you can see in previous blogs I’ve written such as ‘76 Deaths, Surgical Mistakes in New Zealand Hospitals‘ I have been pushing for more specialized technology to streamline processes for many years. The technology has been around for a long time, yet we still seem to rely heavily on paper. Tablet and handheld computing has been around for a long time. Most of us use WiFi in the home, in cafe’s, at the airport and understand the power of dealing with information once, accurately and allowing instant access to anyone who needs it in a timely fashion. That’s how we live.

I now see bar codes on patient wrist bands, but I don’t see them being read by a handheld computer to check for allergies, conditions etc at the bedside. This technology could have saved many NZ lives at a tiny fraction of the cost of their lost lives, productivity etc.

When I started promoting this technology, it was with Pocket PC, Palm and Symbol technologies (handheld computers, 3D Bar Code Readers, Portable Printers, Digital Cameras which were being used in many US and European hospitals and that was 20 years ago!

Today there is superior technology such as the Panasonic Mobile Clinical Assistant CF-H1 which runs on Windows 7. The video is pretty corny but it really does illustrate how efficient it is to use mobile technology. Of course this technology has a rugged drop spec, is chemical resistant, lasts 6 hours on a standard battery.

This technology means everyone is in sync and has access to critical data on demand. Paper gets misplaced in hospitals. I had one visit with a daughter that was delayed by 90 minutes simply because someone had misplaced her file. Data can be shared with specialists and medical staff in and out of hospital, including images such as scans, x-rays, photos, test results, charts and graphs. Allergies and condition interactions can be monitored to minimise risk of causing new problems, doses can be confirmed, approvals provided remotely. Pretty much the whole world’s medical knowledge is available online today.

Today’s world should be about harnessing technology to work smarter rather than harder. I suspect the focus is on cost of the technology because our hospitals are run by administrators tasked with saving money. Of course they are largely man aged by politicians. If health is a major election platform every election, why is it that the performance is still so poor?

Next time you are in hospital, have a look at how they use or don’t use technology. Think about how you operate in your business. Think about what’s at stake and ask them why they do things the way they do.

We have national elections next year. They will be talking about improving the health system. Will they be talking about improving the ICT structure and putting information in the hands of the clinicians? Or will they be talking about saving money, improving the monitoring of staff performance and measuring waiting times in A&E?

We have an ageing population and growing population. They are going to need more services and we could increase our throughput, reduce patient risk, significantly improve outcomes by harnessing technology, working smarter rather than harder, expecting great results from staff working double shifts several times a week.

Olmesartan and Recovery from Autoimmune Disease

The following presentation is fascinating. So many people suffer from autoimmune problems. Could it be that many of them can be cured using a subset of Vitamin D?

It makes sense that many bacterial genomes damage the immune system over time and incrementally shut it down. In effect microbiota block the Vitamin D Receptors from producing antimicrobials.

Professor Trevor Marshall has worked with over 500 human subjects and demonstrated reversibility of   many autoimmune conditions including Lupus, MS, Type 2 diabetes and many more conditions, typically chronic inflammation conditions.

What is even more impressive is that as the inflammation receded, a host of other conditions that the subjects suffered from also disappeared. These included  memory loss, obsessive compulsive disorder, osteoporosis, bipolar and even cardiovascular disease.

In their research they discovered a couple of very interesting points. One is that only 1,25 dihydroxyviatmin-D can activate VDR transcription, whereas Vitamin D that we can take as pills actually inhibit it.

Could this be one of the discoveries that will help increase our life expectancy and potentially cure people from many terrible diseases?