FDA Approves Provenge

30 04 2010

Provenge (Sipuleucel T), the prostate cancer “vaccine” from Dendreon Corporation, was approved by the FDA Thursday.  The immunotherapy agent has been found in clinical trials to increase overall survival by several months compared to placebo:

“In the largest clinical trial of Provenge, involving 512 men, those who got Provenge had a median survival of 25.8 months after treatment, while those who got a placebo lived a median of 21.7 months. After three years, 32 percent of those who got Provenge were alive, compared with 23 percent of those who got the placebo. The main side effects were fever, chills, fatigue and pain.”

Results of Phase III Clinical Trial (pdf)

The agent is a cell-based vaccine created by exposing autologous antigen-presenting peripheral blood mononuclear cells (enriched for a dendritic cell fraction) to a recombinant protein consisting of granulocyte-macrophage colony-stimulating factor (GM-CSF) fused to prostatic-acid phosphatase (PAP). When the now specifically immunocompetent cells are reintroduced to the patient, the hope is that an antitumor T-cell response will be generated against tumor cells expressing PAP. (NCI)

While this is by no means a cure to the most common non-skin cancer in men, it’s a step in the right direction.  Immunotherapy is all the rage these days, and, hopefully, success stories like this will help foster further breakthroughs in the field.

[Link to New York Times Story]

[Provenge FAQ (pdf)]

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In the Market for a New Phone

26 04 2010

If you really want to get a geek going, ask them about their cell phone.  Phones have become so complex and people have become so connected that there is rehab available for addicts, and terms like ‘crackberry’ have achieved vernacular status.  I don’t think I need treatment, but I am pretty attached to my phone at all times, and I never feel the need to take tech holidays.  As a devout follower of the smart phone industry, I have decided that now is the time to start looking into upgrading from my 2-year-old HTC Touch (Verizon VX6900) to the next latest and greatest mobile device.  I will present my current impressions below, but I would love to hear the opinion of the audience, as I am far from set in stone in my decision thus far:

VERIZON

 Apple iPhone
-Announcement: June 22nd?

The Wall Street Journal seems confident that there will be a Verizon iPhone announcement in June, an idea that is very exciting to me as AT&T’s 3G coverage is notorious, especially downstate.  I’ve chided iPhone users for the past three years about the shortcomings of the iPhone, but in reality, it’s really because I was just jealous of what an amazing device it truly is, especially as the OS has advanced to include many of the original oversights that people complained about.  Still, the iPhone lacks two key features I am looking for: free GPS navigation and tethering.  I’d rather not have to jailbreak my phone every time there is an update, but I might consider it if those features never materialize, and that is assuming a CDMA version of the phone itself will actually materialize…

 

Motorola Droid
C|Net Review
-Available Now)

The Droid is a solid phone.  I thought Motorola was down for the count after trying to ride the Razr for what seems like a decade, but the Moto Droid is truly a solid phone.  I do miss not having a real keyboard for texting and e-mailing, and, to me, that is the major draw of the Droid.  What concerns me about this phone is all the drama surrounding OS updates (link) and the slightly older processor.  Again, these issues I might be able to overlook if I eventually decide that I cannot live without a physical QWERTY.

 

HTC Incredible
C|Net Review
-Available: April 29th

Verizon was supposed to get the Nexus One, but as it is looking now , it seems as if the Incredible will be sold in its stead.  The Incredible is essentially the Nexus One with a few minor, mostly cosmetic, alterations, and, unlike the Nexus One, there is a chance you might be able to actually play around with the device before purchasing it .  Set for a release date at the end of April , this HTC Android device has all the cutting-edge components available today, including a 1GHz Snapdragon processor, Android OS 2.1 with HTC Sense UI overlayed, etc.  The device even got C|Net’s Editor’s Choice Award this month.  It’s a solid phone, but is it really compelling enough?  I guess it lacks some of the gimmickry that turns me on to some of the other devices on this list, but I definitely still can’t wait to get my hands on one come the end of the month.

T-Mobile

HTC Touch HD2
C|Net Review
-Available Now

I have been watching this phone for a long time.  It finally has come state-side (was previously sold only in Europe), and I really think you need to see this phone to appreciate it.  It is simply gorgeous.  Its 4.3” capacitive touch display will just blow you away.  The interesting thing about this phone, and perhaps its ultimate downfall, is that it runs Windows Mobile 6.5.  Now, to be clear, I have been a steadfast fan of Windows Mobile despite basically everyone telling me I’m crazy, but that’s what I’ve used for the past 6 or so years, I know it inside and out, have come to appreciate it greatly, and from a hacking standpoint, it’s the fertile-est of soil.  What would have been fantastic, and in all honesty, would probably have already sold me at this point, would have been an announcement from either Microsoft or T-Mobile, that the HD2 would be upgraded to Microsoft Phone 7 when it debuts later this year; however, it seems that due to physical requirement constraints, that will not be happening.  An aside: Windows Phone 7 is also something worthy of checking out.  MS has totally overhauled its loathed and obviously outdated UI with Phone 7 to make it much more socially oriented as well as sausage-finger-friendly (link).  Finally, T-Mobile as a carrier is not strong in Albany- I don’t think I even know anyone that is part of the T-Mob come to think of it.

Sprint

 HTC Evo 4G
C|Net Review
-Available: June 13th

Announced at CTIA this year, the Evo will be the first 4G phone available in the States.  It will use Sprint’s WiMax 4G service, which, while having the largest 4G roll-out in the country, is currently not available in Albany or even New York City.  I find this phone truly drool-worthy.  It has the same dazzling screen and form factor as the HD2, but it will run Android’s most current OS instead of WinMo.  In addition, the phone has both an 8-megapixel auto-focus dual-LED flash camera on the back capable of shooting 720p HD video and a 1-megapixel front-facing camera for video conferencing or Skype.  Icing on the cake: it has a kickstand for watching TV shows/movies, HDMI-out for playing that HD video you captured back on your HDTV, and it works as a free mobile Wi-Fi hotspot for up to 8 other devices – simply stellar.  There aren’t too many drawbacks that I see here save for: the potential price, Sprint’s spotty service in Albany, and the possibility of a delayed release date.

Conclusions:

What phone is best for you really comes down to personal preference.  All of the phones discussed above are great phones for different reasons.  (Aside: as you might have noticed, there is nothing from RIM in the mix for me; I have nothing against BlackBerry (and in fact, BB’s are the only way to get hospital mail on the go as our IT department has disabled OWA), I just have little experience with them, and really want as full a web experience as possible on my device.)  So despite watching dozens of videos and reading multiple reviews, on the fence I sit.  For me, right now, it depends on how blown away I am by the Evo 4G; if not, I’ll probably wait for the now still mythical Verizon iPhone, as long as it’s not coming out in 2012…

But I’d like to hear your opinion as well!.. Thoughts?  Disagreements?





iPad + Citrix = Genius

22 04 2010

 

I guess it’s not that wild of an idea, but I love it.  Medgadget posted today about a California-area hospital that’s rolling 100 iPads out to their doctors so they can “keep track of their patients on the go”.

If you watch the first video [a local news report, linked here for now] they demonstrate a CXR and some heart rhythms- obvious applications, but again, what the iPad really has going for it is the convenience factor, unlike your much cheaper and much more well-equipped netbook.  What is troublesome for me: is it legal or reimbursable to conduct medical business on an iPad? I’ll assume no, and that the real function is to aid in patient triage.  Also, the news reporter talks about being able to look at [obviously sensitive] patient information on the go or “in the local coffee house”.  I sure hope HIPAA hasn’t seen that video!

What piqued my interest was the inclusion of a video demo of citrix for the iPad [linked here for now].  The potential utility here is very exciting.  I know there are a lot of people out there who hate Citrix, or call it a slow band-aid fix to a real problem, but in my experience it works, and it works well.  To have the ability to acess and feasibly sign-out dictated cases from anywhere with this level of convenience is certainly enticing.

Don’t get me wrong, though.  I am no Apple fanboi by any means, and I have no plans to buy an iPad any time soon.  It really is a cool but expensive tweener device in my opinion.  But as a oligopurposed medical device, I think it could actually be quite functional.

Now I just have to finish my multitouch WSI manipulation software and then we are in business! 😉

[via MedGadget]





Is it Time to Update the Blood Donation Screening Questions?

19 04 2010

There is a very interesting blog post over at Friday Puppy, a blog run by an openly gay local business owner about having his blood donation being denied due to the fact that he has relationships with other men.  The article is sharp and opinionated, but the points are fleshed out into logical arguments in the comments section below.  I think the post brings up some very interesting points.  Perhaps it is time for the FDA to update their screening questions.  Check it out here.

[Friday Puppy: You Don’t Want My Gay Blood?]





Crowdsourcing: Missing a Joystick…

19 04 2010

As a result of the move and the associated (and dreaded) cleaning out of our offices, I have since become the beneficiary of quite a few forgotten “treasures” from around the department.  The most significant of these being a Zeiss Axioscope 2 mot plus with a MCX-2 eco control box and attached VGA camera- quite an upgrade from my previous Olympus CH-2 to say the least.  Excellent, right? Well almost…

Most importantly, the joystick controller for the motorized stage is missing, or lost, or thrown out.  This beast of a microscope is currently being crippled by the lack of its controller.  I’ve done some routing around the internet in hopes of either A) finding a replacement or B) figuring out some way to operate it without its original joystick.  It appears as if the joystick control is via a proprietary port, so I am not quite sure what my options are.  I have tried to contact the manufacturer, but all I have is information I’ve gleaned on a Google results page, and those results are all in Dutch.  I have tried to contact the company, without response as of yet.  Thoughts?  Does anyone have any experience with this scope or set-up?  I would really like to get this rig up and working, but with missing hardware, I feel as if I’ve hit a wall.

Second caveat, the rig came with a PC that had, at one point, ran image analysis!  The software suite is called AIMS: Autocyte Image Management System.  This was very exciting until I realized that the company is now out of business and no longer supports the software at all, so I am not sure as of yet if that whole aspect is actually a – as well.  If so, I’d have liked to connect the camera to my laptop for simple image acquisition, but I believe the camera interface is proprietary as well (there is a special PCI card for it in the desktop containing 3 rows of pins), so no-go there either (if it’s 50-pin SCSI, maybe there’s an SCSI/USB converter out there somewhere??).  If for nothing else, it really is quite amazing to see how technology has so drastically evolved in the past ten years, and also how annoying a lack of cable standards was before USB (although proprietary parts are certainly not a thing of the past even today)!

UPDATE: I have gotten the PC up and running, and communication between the scope and the PC works- the Zeiss software can tell what objective is currently in place and I am able to adjust the focus using the included software.  There is a setting for X-Y control but it is grayed out unfortunately.  Still no luck in that department…

Any thoughts?  Should I just scrap the whole rig?  I’ve spoken with our scope guy, and he said he couldn’t help me.  Hopefully a little crowdsourcing can help me get this scope up and running!





Female Plasma Debate Back in the News

19 04 2010

Mark Pool over at the Daily Sign-Out links to a story on Smart Brief about a recent study that was published in Anesthesiology news in which “researchers found that patients undergoing cardiac surgery who received transfusions of plasma from female donors were less likely to die or stay longer in hospitals and had a lower incidence of pulmonary dysfunction compared with those who received plasma from male donors.”

That quote seemingly argues against the current AABB recommendations and, therefore, indicates the need for further studies to reevaluate whether or not the recommendations should be amended.

While you are at it, maybe consider revamping those for blood donation as well?

Below is a short CP talk I gave on female plasma a couple of years ago.  Enjoy.





Ventana Came to Visit.

14 04 2010

Ventana Symphony H&E Discreet Slide Stainer

Our department here at Albany Medical Center has been searching for a cover-slipping solution for some time now.  Their searching brought them to the Ventana Symphony H&E Discreet Slide Stainer.  I saw the Symphony demo-ed at the USCAP meeting last year and was quite impressed, so I was excited about the possibility of the piece of equipment being brought into our lab.

This morning,  Ventana set up a small in-service for us which included a presentation on digital pathology from Drazen Jukic from UPMC, followed by a virtual demo of the Symphony, followed by a Q&A session.

Dr. Jukic’s presentation was spectacular.  He outlined the pros and cons of digital pathology from WSI to bar-coding, and discussed the real-world impact of such technologies on the day-to-day work-flow at UPMC  (I must try to track down a copy of his ppt).  I think it was really important for the AMC staff to hear, as we lag behind many other institutions in this area- whether it be due to lack of knowledge on the subject, budgetary constraints or individual resistance to the adoption of new technologies.  Hopefully the talk opened some minds to the amazing possibilities out there today, and planted some seeds re: the possibilities to come in the near future.

The first talk was followed up by sales pitch and question and answer session from Ventana about their Symphony stainer.  It was a flash-based demo that let the audience look inside a 3D rendered machine.  The presenter did a fine job answering the numerous questions we peppered him with.  Interestingly, Ventana brought at least 5 employees to the talk; I’m not sure if there was training going on, or if it was just a show of moral support.  But overall it was a good presentation.

Something that I hadn’t heard of before is the machine’s ability to have different H&E staining profiles.  For example, Dr. Jukic, in his talk, showed how different reagent times, etc yielded a wide variety of H&E staining results: one profile that he showed us accentuated dermal mucin, another drastically increased detail in cancer nuclei.  While the slides were still just H&E-stained, the contrast and color intensity were quite different.

The stainer looks like a solid addition to any histology lab, and it also appears to be able to be upgradeable in-place in the future.  The major draw-back that I saw was daily through-put.  AMC currently outputs around 50,000 surgical and derm cases per year, which is at the very cusp of the Symphony’s output capabilities, and that is assuming 100% up-time; therefore, more than likely, we would require two to handle our current load and enable future expansion, and I’m not sure the lab was planning on that in their budget (Ventana: how about a buy-one-get-one program?).

A question for you: is there anyone out there that is currently using the Ventana Symphony Discreet H&E Slide Stainer?  Love it?  Hate it?  Please sound off below.

Thanks again to Ventana and Dr. Jukic for a lively morning.








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