Viz.ai Receives FDA 510(k) Clearance for Viz ANEURYSM

You'll want your hospital to have this, so demand accountability as to WHOM is responsible for bringing it in. 

Viz.ai Receives FDA 510(k) Clearance for Viz ANEURYSM

 

SAN FRANCISCO--(BUSINESS WIRE)--Viz.ai, the world leader in artificial intelligence (AI) powered care coordination, today announced it has received U.S. Food and Drug Administration (FDA) 510(k) clearance for Viz ANEURYSM. The new algorithm uses AI to detect suspected cerebral aneurysms, enabling hospital systems to ensure that once detected, patients are captured and the aneurysm workflow across an entire health system is standardized. This ensures that patients receive the appropriate follow-up care and creates significant financial benefits for hospital systems and payers. Viz ANEURYSM will serve as a first of its kind population health tool to facilitate population screening and enhanced care management.

Today, detecting cerebral aneurysms and coordinating care for patients with this condition is challenging for non-specialist centers, and care pathways can be complex. If left untreated, an aneurysm can rupture, spilling blood into the surrounding tissue, which causes a life-threatening and costly emergency called a subarachnoid hemorrhage. According to Etminan et al, approximately three percent of the population has a cerebral aneurysm and approximately 30,000 people suffer subarachnoid hemorrhage in the U.S. every year, which is associated with a 40 percent mortality rate.

A study at the University of Toronto tested the accuracy of Viz ANEURYSM using 528 CTAs with 674 aneurysms broadly distributed across the cerebral vascular territories, encompassing anterior and posterior circulation. Data analysis demonstrated 94% accuracy for the algorithm.

“[Aneurysms] can be often missed because they require a very methodical diagnostic approach. The Viz.ai aneurysm algorithm was able to detect cerebral aneurysms in consecutive CTAs. The model has demonstrated that a deep learning AI algorithm can achieve clinically useful levels of accuracy for clinical decision support and will help us to improve how we help aneurysm patients,” concluded Dr. Vitor Mendes Pereira, director of Endovascular Research and Innovation, University of Toronto.

“Viz ANEURYSM has the potential to significantly increase the number of aneurysms detected and clinically followed,” said Jayme Strauss, chief clinical officer, Viz.ai. “The combination of detection with an ability to schedule patients for neurovascular specialist follow-up is an important advancement for aneurysm patients, helping patients obtain the necessary follow-up from this potentially deadly disease and driving improved outcomes on the population health level.”

The Viz ANEURYSM module is additive to the Viz Intelligent Care Coordination Platform, which is clinically validated and reimbursed by Medicare and proven to save time, and improve patient outcomes and access to care. Viz is the most comprehensive and effective neurovascular and vascular AI platform that is already helping to coordinate care across a broad list of clinical applications, including ischemic and hemorrhagic stroke, pulmonary embolism and aortic disease in more than 1,000 hospitals

Exoskeletons help patients regain mobility

Has your hospital done one damn thing to test out these other 103 posts on exoskeletons? Of course not. Just by the fact that this exoskeleton is needed is proof that this hospital is a complete failure at stroke rehabilitation. Until we start to demand accountability our hospital will try to skate by by using the status quo. Everything in stroke is a complete failure, that needs to be shouted from the rooftops.

• exoskeleton (103)

 Exoskeletons help patients regain mobility

By Euronews• last updated: 25/06/2018

Four years ago, Pablo Albisua Albizu's life changed forever.

Just after heart surgery, this former decorator suffered a stroke that left one side of his body paralysed.
Along with undertaking hundreds of rehabilitation sessions, he also volunteered to test a new exoskeleton.
Developed by biomedical engineers, the exoskeleton is made out of aeronautical aluminium. It weighs 12 kilos and it has been designed to assist in the rehabilitation of patients like Pablo, who have suffered strokes.
And it worked, Pablo says.
"Before, when I went shopping in a car, we went around and around to find parking places as close as possible to the shops. And if I was not able to find one, I often just drove back home. I could not find the strength to walk even short distances. Now that has completely changed. I can even go to big shopping malls and I dare to walk around for a long time. That was simply not possible before. I was too tired."

Customised treatment

The exoskeleton has six motors that help patients correct their walking patterns.
Parameters like speed or movement angles can be easily customized depending on the needs of each patient.
"This exoskeleton gives us two advantages," explains Iker Mariñelarena Arrizabalaga, a biomedical engineer at Gogoa Mobility Robots, which is based in Urretxu, in northern Spain.
"First, we can correct the patient's body movements that aren't working. And second, we can give patients more customized treatments. In a classical rehabilitation, you can't always guarantee that movements are repeated in the most accurate, efficient way. Physiotherapists and patients do what they can. And patients often get tired or suffer injuries because they are forced into unnatural positions. But with an exoskeleton, you can always guarantee accuracy while repeating movements and you can also get more accurate data."

Assistance as needed

The whole system is based on the "assistance as needed" concept.
The exoskeleton only intervenes when the patient's own efforts aren't able to guarantee safe movement for the rehabilitation process
"The exoskeleton uses sensors to measure the efforts undertaken by the human body," says Juan José Iceta Yurrita, an industrial engineer at Gogoa.
"It then just supplements what the patient's body is already doing. The exoskeleton follows the optimal rehabilitation patterns but, at the same time, it motivates the patient to make as much effort as possible. The exoskeleton just supplements those efforts to achieve the final goal of the therapy. The patient follows that pattern and then we also work with them to help them internalize that pattern in their own way."

Voice control

Scientists from this European research project are now looking at ways to further improve the exoskeletons.
And they already have some ideas in mind.
"We want to be able to give voice orders to the exoskeleton, instead of using tablets or phones," says Gogoa CEO and Hank Project coordinator Carlos Fernández Isoird. "We've already tested this voice command function; it works quite well. This would be good for physiotherapists, as they would have their hands free to safely handle patients. And rehabilitation would become even more customized."
While still awaiting final product approval, the exoskeleton should come to the market - mainly hospitals and rehabilitation centers - in less than 6 months. Researchers expect the cost to be around €60,000.

Useful links:

http://gogoa.eu

• 
  

Dendritic spines provide cognitive resilience against Alzheimer's disease

You'll have to DEMAND your doctor provide you protocols that will create new dendritic spines.  And after s/he does that ask for proof that the protocols are working. You have to DEMAND accountability and responsibility from your doctors.
http://onlinelibrary.wiley.com/doi/10.1002/ana.25049/full

Authors

• Accepted manuscript online: 16 September 2017Full publication history
• DOI: 10.1002/ana.25049  View/save citation
• Cited by (CrossRef): 0 articles Last updated 23 September 2017

Abstract

Objective: Neuroimaging and other biomarker assays suggest that the pathological processes of Alzheimer's disease (AD) initiate years prior to clinical dementia onset. However some 30%-50% of older individuals that harbor AD pathology do not become symptomatic in their lifetime. It is hypothesized that such individuals exhibit cognitive resilience that protects against AD dementia. We hypothesized that in cases with AD pathology structural changes in dendritic spines would distinguish individuals that had or did not have clinical dementia.
Methods: We compared dendritic spines within layers II and III pyramidal neuron dendrites in Brodmann Area 46 dorsolateral prefrontal cortex using the Golgi-Cox technique in 12 age-matched pathology-free controls, 8 controls with AD pathology (CAD), and 21 AD cases. We used highly optimized methods to trace impregnated dendrites from brightfield microscopy images which enabled accurate three-dimensional digital reconstruction of dendritic structure for morphologic analyses.
Results: Spine density was similar among control and CAD cases but reduced significantly in AD. Thin and mushroom spines were reduced significantly in AD compared to CAD brains, whereas stubby spine density was decreased significantly in CAD and AD compared to controls. Increased spine extent distinguished CAD cases from controls and AD. Linear regression analysis of all cases indicated that spine density was not associated with neuritic plaque score but did display negative correlation with Braak staging.
Interpretation: These observations provide cellular evidence to support the hypothesis that dendritic spine plasticity is a mechanism of cognitive resilience that protects older individuals with AD pathology from developing dementia. This article is protected by copyright. All rights reserved.

A post-stroke therapeutic regimen with omega-3 polyunsaturated fatty acids that promotes white matter integrity and beneficial microglial responses after cerebral ischemia

I bet your doctor will NEVER use this on you to help your recovery and prevent more disability. If this is not in your hospital in the next couple months you need to have the stroke department head and the president fired. We need to start demanding accountability in our stroke hospitals. The time for politeness is over, start screaming in their faces; 'Why the fuck do you know nothing  newer than your medical training days about stroke?'
https://www.mdlinx.com/internal-medicine/medical-news-article/2016/10/14/myelinoligodendrogenesiscorpus-callosummicroglial-polarization/6903402/?news_id=881&newsdt=102216&subspec_id=488&utm_source=WeeklyNL&utm_medium=newsletter&utm_content=Weeks-Best-Article&utm_campaign=article-section&category=latest-weekly

Translational Stroke Research, 10/14/2016Jiang X, et al.

Researchers, in this present study, report a post–stroke omega–3 polyunsaturated fatty acid (n–3 PUFA) therapeutic regimen that not only confers protection against neuronal loss in the gray matter but also promotes white matter integrity. As per the outcomes the post–stroke docosahexaenoic acid (DHA) injections in combination with fish oil (FO) dietary supplement benefit white matter restoration and microglial responses, thereby dictating long–term functional improvements.

Go to PubMed Go to Abstract Print Article Summary Cat 2 CME Report

Progranulin protects against the tissue damage of acute ischaemic stroke

What is your doctor going to do with this information? NOTHING? Like all the thousands of other research articles that were ignored? And that doctor still has a job? When are YOU going to demand some accountability?
http://brain.oxfordjournals.org/content/138/7/1770 

Chunyu Zhao, Andrew Bateman

DOI: http://dx.doi.org/10.1093/brain/awv123 1770-1773 First published online: 23 June 2015

• Article
• Figures & data
• Information & metrics
• Explore
• PDF

This scientific commentary refers to ‘Multiple therapeutic effects of progranulin on experimental acute ischaemic stroke’, by Kanazawa et al. (doi:10.1093/brain/awv079).

Stroke is one of the commonest causes of death, and survivors often suffer debilitating impairments of speech, memory, movement, swallowing and other neurological functions. About 80% of strokes are ischaemic, due to thrombosis or embolism. The resultant loss of oxygen to the affected tissue depletes cells of energy and initiates a series of biological events that include the release of toxic levels of glutamate, the production of free radicals, inflammation, and blood vessel disruption. The infarct, or the region of cell death at the ischaemic core, is surrounded by an area of damaged but still living brain tissue known as the penumbra. The injured but living cells of the penumbra can be restored to functionality if the infarct is prevented from expanding into this region by, for example, restoring blood flow through early administration of the thrombolytic protein tissue plasminogen activator (tPA). Very few other drugs have proven beneficial in limiting stroke-related damage in the human brain (Donnan et al., 2008). The penumbra has been described as a transition zone where processes of cell death and injury radiate outwards from the infarct to confront counteracting mechanisms of repair that are mobilized by the brain to protect the damaged tissue (Lo, 2008). In this issue of Brain, Kanazawa and colleagues provide important insights into how a secreted protein, progranulin, protects the brain from further damage after an ischaemic stroke and suggest that progranulin could be a valuable new weapon in the development of treatments that will protect the brain from stroke-related injury (Kanazawa et al. …

A Question of Trust

From db's medical rants here is an interesting discussion on this;
Onora O’Neill on the philosophy of accountability

Book here;
http://www.amazon.com/Question-Trust-Reith-Lectures-2002/dp/0521529964
I will take these lines and apply them to the Joint Commission and stroke.
--------------------------------------------------------------------------------------------------------------
She explains beautifully that unintelligent measures do not advance either accountability or trust. Rather she cautions against easy performance measures. In these lectures she does not talk about medicine exclusively.

She worries that unintelligent measures lead to a corruption of the concept of professionalism. Too often we see restructuring of our work to achieve higher scores on performance measures. However, unless the performance measure created is clearly linked to the desired quality attribute, we too often have a spurious measure.
---------------------------------------------------------------------------------------------------------------
Take the Joint Commision ratings on stroke hospitals. They are all about doing the processes faster and more completely. There is no connection to 100% stroke recovery. This is why I think Joint Commission certification is for all practical purposes worthless.  I don't trust anything they do because they are measuring the wrong thing.

She explains beautifully that unintelligent measures do not advance either accountability or trust. Rather she cautions against easy performance measures. In these lectures she does not talk about medicine exclusively.
She worries that unintelligent measures lead to a corruption of the concept of professionalism. Too often we see restructuring of our work to achieve higher scores on performance measures. However, unless the performance measure created is clearly linked to the desired quality attribute, we too often have a spurious measure.
- See more at: http://www.medrants.com/archives/7426#sthash.NICn9jNy.dpuf

She explains beautifully that unintelligent measures do not advance either accountability or trust. Rather she cautions against easy performance measures. In these lectures she does not talk about medicine exclusively.
She worries that unintelligent measures lead to a corruption of the concept of professionalism. Too often we see restructuring of our work to achieve higher scores on performance measures. However, unless the performance measure created is clearly linked to the desired quality attribute, we too often have a spurious measure.
- See more at: http://www.medrants.com/archives/7426#sthash.NICn9jNy.dpuf