INR blood monitoring

 When I was on warfarin I had to have weekly blood draws which was only possible since my ex was not employed. A much better solution would be something like the Libre blood glucose monitoring system, but using Needle free blood draws or microneedles to monitor INR for warfarin use instead of having to come in for blood draws? We'll never know with our incompetent stroke leadership.

A great stroke association could build this and sell them to the millions of stroke survivors but we have NO STROKE LEADERSHIP. 

 

Smart Tattoo Monitors Health

Could this be used along Needle free blood draws or microneedles to monitor INR for warfarin use instead of having to come in for blood draws? We'll never know with our incompetent stroke leadership. 

Smart Tattoo Monitors Health 

Checking vital health statistics may someday be as simple as shinning a light on a tattoo.
A group of researchers from Harvard Medical School (HMS) and the Massachusetts Institute of Technology (MIT) have developed a smart tattoo ink that changes color to signal changes in various biomarkers, including if an athlete is dehydrated or if a diabetic’s blood sugar rises.
The researchers paired biosensitive inks with traditional tattoo artistry as a way to overcome some of the limitations of biomedical monitoring devices that currently do not seamlessly integrate with the body.
“We were thinking: New technologies, what is the next generation after wearables?” Ali Yetisen, who is a Tosteson postdoctoral fellow at HMS and Massachusetts General Hospital, said in a statement. “And so we came up with the idea that we could incorporate biosensors in the skin.”
The stabilizing ink does not fade or diffuse into surrounding tissue and only changes color according to the chemistry of the body’s interstitial fluid—which can be used as a surrogate for constituents of the blood.
The researchers developed a pair of inks that signify glucose concentration and sodium concentration.
The first ink will change from green to brown as glucose concentration increases, while the second ink grows a more intense green color when viewed under a blue light as sodium concentration rises, an indication of dehydration.
To test the inks, the researchers tattooed segments of pig skin and found the changes in color or intensity in response to different biomarkers.
The next step will be to test the tattoos with other diseases and biomarkers.
The researchers said a long-lasting tattoo could be used to monitor chronic conditions or a temporary design could be used for shorter-duration monitoring.
The ink can also be invisible and only viewable under certain kinds of light that may be available through a smartphone application.    

Sleep and Human Aging

What is your doctors sleep protocol doing to ensure you get your beauty sleep while in the hospital?  I got woken up almost every morning by the blood vampires coming for either me or my roommates at 7am.  Do they now know about needleless blood draws, only out since May 2016? Needle free blood draws or microneedles?
I only copied the abstract and the conclusion paragraphs so there is lots more at the link.
http://www.cell.com/neuron/fulltext/S0896-6273%2817%2930088-0

Older adults do not sleep as well as younger adults. Why? What alterations in sleep quantity and quality occur as we age, and are there functional consequences? What are the underlying neural mechanisms that explain age-related sleep disruption? This review tackles these questions. First, we describe canonical changes in human sleep quantity and quality in cognitively normal older adults. Second, we explore the underlying neurobiological mechanisms that may account for these human sleep alterations. Third, we consider the functional consequences of age-related sleep disruption, focusing on memory impairment as an exemplar. We conclude with a discussion of a still-debated question: do older adults simply need less sleep, or rather, are they unable to generate the sleep that they still need?

Main Text

Normative aging is associated with a reduced ability to initiate and maintain sleep. Moreover, deficits in sleep physiology, including those of non-rapid eye movement (NREM) sleep and its associated neural oscillations, are especially prominent in later life. Though sleep disruption is a common signature of “normal aging”, the underlying neural mechanisms explaining age-related sleep impairment are only now being revealed.

This review focuses on physiological changes associated with normative human aging. First, we characterize associated alterations in sleep structure and oscillatory activity in later life. Second, we describe emerging neurobiological mechanisms that may account for these sleep alterations. Third, we consider the functional consequences of age-related sleep disruption, focusing on memory impairment. We conclude with the exploration of a still-unresolved question: are older adults unable to generate the sleep that they need or do they simply need sleep less.

S

Sleep Restoration, Aging, and Memory

The vast majority of studies reporting an association between sleep, aging, and memory are correlational in nature. However, several studies have sought to enhance the sleep of older adults, and with it, memory. These studies are informative in at least two ways. First, they establish a causal contribution of sleep to memory in the elderly, as has been shown in young adults. Second, therapeutic interventions that restore sleep may deliver preventative benefits that reduce the risk and/or severity of cognitive decline in aging, or mechanisms and/or processes that lead to mild cognitive impairment or Alzheimer’s disease (Mander et al., 2016a), or body ill-health consequences, such as hypertension or chronic pain (Neikrug and Ancoli-Israel, 2010). However, it is important to note that these methods have not been investigated using longitudinal study designs, and thus the longitudinal utility of such methods remains unknown.

In young adults, transcranial direct current stimulation (tDCS) in the <1 Hz slow oscillation frequency range during slow wave sleep increases slow oscillation power and almost doubles overnight memory retention (Marshall et al., 2006). In older adults, multiple studies have shown that enhancing the slow oscillation using tDCS during an afternoon nap leads to a memory enhancement; one showing heightened SWA in the slow oscillation frequency range (<1 Hz) and word-pair performance (Westerberg et al., 2015), and another showing enhanced slow oscillation and fast sleep spindle EEG power that led to a benefit in a visual memory task (Ladenbauer et al., 2016). Auditory closed-loop stimulation during slow wave sleep has also been shown to enhance slow oscillation power and associated hippocampus-dependent memory consolidation in young adults (Ngo et al., 2013). Preliminary findings in older adults have reported increased slow oscillation power during blocks of auditory stimulation that is associated with enhanced next-day declarative memory recall (Papalambros et al., 2017). It is of note, however, that some studies implementing varied forms of brain stimulation have failed to replicate the beneficial enhancement of sleep physiology and/or memory consolidation (Eggert et al., 2013, Passmann et al., 2016, Sahlem et al., 2015). Therefore, brain stimulation methods offer potential promise as intervention tools in the context of aging, but they require further refinement and demonstration of efficacy and reproducibility before being realistic options at present.

Pharmacological methods using classic GABA-targeting hypnotics for selective NREM sleep enhancement have so far proved less promising in the context of aging and often fail to trigger any corresponding sleep-dependent memory benefit in the elderly, sometimes even causing amnestic effects (Feld et al., 2013, Hall-Porter et al., 2014, Mednick et al., 2013, Vienne et al., 2012). Little is currently known regarding the impact of more contemporary non-GABA-targeting sleep medications on enhancing sleep and/or cognition in the elderly populations at risk for dementia.

Overall, several novel, non-pharmacological approaches are emerging that may represent candidate methods for sleep restoration in the elderly and, with such restoration, improvements in those mental and physical functions that rely on sleep and are causally deficient in the elderly as a result.

Transient Micro - needle Insertion into Hippocampus Triggers Neurogenesis and Decreases Amyloid Burden in a Mouse Model of Alzheimer’s Disease

What will your doctor do to followup this and see if useful for stroke recovery? ABSOLUTELY NOTHING I BET. No contacting researchers, no updating the stroke strategy, no talking to stroke leadership? You do want neurogenesis, don't you?

Transient Micro - needle Insertion into Hippocampus Triggers Neurogenesis and Decreases Amyloid Burden in a Mouse Model of Alzheimer’s Disease

Skin patch with microneedles proves effective alternative to injections

With just a bit of innovation this could be used to monitor INR levels and not need to go to the clinic to get a blood draw. A great stroke association would direct some of their employees to solve this rather than waiting for SOMEONE ELSE TO SOLVE THE PROBLEM.  A few patents like this could provide a continuing stream of money to fund research. But that will never occur with the fucking failures of stroke associations we have now.
https://www.mdlinx.com/internal-medicine/top-medical-news/article/2017/01/04/5

KTH Royal Institute of Technology News

It’s only a matter of time before drugs are administered via patches with painless microneedles instead of unpleasant injections. But designers need to balance the need for flexible, comfortable–to–wear material with effective microneedle penetration of the skin. Researchers from KTH Royal Institute of Technology in Stockholm say they may have cracked the problem.

In a study the research team from KTH reports a successful test of its microneedle patch, which combines stainless steel needles embedded in a soft polymer base – the first such combination believed to be scientifically studied. The soft material makes it comfortable to wear, while the stiff needles ensure reliable skin penetration.

Unlike epidermal patches, microneedles penetrate the upper layer of the skin, just enough to avoid touching the nerves. This enables delivery of drugs, extraction of physiological signals for fitness monitoring devices, extracting body fluids for real–time monitoring of glucose, pH level and other diagnostic markers, as well as skin treatments in cosmetics and bioelectric treatments.

Frank Niklaus, professor of micro and nanofabrication at KTH, says that practically all microneedle arrays being tested today are “monoliths”, that is, the needles and their supporting base are made of the same – often hard and stiff – material. While that allows the microneedles to penetrate the skin, they are uncomfortable to wear. On the other hand, if the whole array is made from softer materials, they may fit more comfortably, but soft needles are less reliable for penetrating the skin.

“To the best of our knowledge, flexible and stretchable patches with arrays of sharp and stiff microneedles have not been demonstrated to date,” he says.

They actually tested two variations of their concept, one which was stretchable and slightly more flexible than the other. The more flexible patch, which has a base of molded thiol–ene–epoxy–based thermoset film, conformed well to deformations of the skin surface and each of the 50 needles penetrated the skin during a 30 minute test.

A successful microneedle product could have major implications for health care delivery. “The chronically ill would not have to take daily injections,” says co–author Niclas Roxhed, who is research leader at the Department of Micro and Nano Systems at KTH.

In addition to addressing people’s reluctance to take painful shots, microneedles also offer a hygiene benefit. The World Health Organization estimates that about 1.3 million people die worldwide each year due to improper handling of needles.

“Since the patch does not enter the bloodstream, there is less risk of spreading infections,” Roxhed says.

The report, Flexible and Stretchable Microneedle Patches with Integrated Rigid Stainless Steel Microneedles for Transdermal Biointerfacing, was published in the journal PLOS ONE.

Can a hi-tech plaster stop fatal blood clots that cause strokes and heart attacks? A new patch 'turbocharges' the body's blood-thinning molecules, making its defences more effective

Pretty cool idea. Should be able to do INR testing this way also and deliver warfarin in the right dose
http://www.dailymail.co.uk/health/article-4026284/Can-hi-tech-plaster-stop-fatal-blood-clots-cause-strokes-heart-attacks-new-patch-turbocharges-body-s-blood-thinning-molecules-making-defences-effective.html

• Millions are already taking tablets containing heparin to reduce the risk of clots
• The new patch automatically injects the same drug through miniature needles
• This prevents patients from taking too much, which can cause fatal bleeding

A high-tech skin patch could prevent deadly blood clots that cause strokes and heart attacks.

The patch detects when a clot is in danger of developing and automatically releases a blood thinner into the bloodstream in time to stop it.

It does this through micro-needles in the patch which gently pierce tiny blood vessels — called capillaries — just beneath the skin.

As blood passes by, the needles — each one not much thicker than a human hair — monitor levels of thrombin, a clotting agent which increases in the blood when it is becoming dangerously thick and prone to clotting.

If thrombin levels are abnormally high, tiny amounts of a drug called heparin are released to thin the blood and reduce the clotting risk.

Heparin works by 'turbocharging' the body's own blood-thinning molecule, called antithrombin III, making it up to 2,000 times more effective.

Millions of people in Britain already take heparin tablets daily to reduce the risk of clots, or thrombosis.

Some are prescribed it because they have atrial fibrillation, an irregular heartbeat which can make blood pool inside the heart, increasing the chances of a clot breaking away and travelling to the brain — causing a stroke.

Others take the drug because they have already had a stroke and are at high risk of another.

Patients who have had major surgery — such as hip or knee replacement — are also put on short courses of heparin tablets or injections as immobility puts them at high risk of a clot because blood pools in their legs.

But those on drugs such as heparin need frequent blood tests to ensure they are getting exactly the right dose.

Too much medicine can cause potentially fatal bleeding, because blood is too thin to clot. Too little means they can still be in danger of a potentially lethal clot.

The postage stamp-sized patch, developed at North Carolina State University, keeps a round-the-clock check on thrombin levels and so does away with the need for repeated blood tests.

On one side it is covered in more than 100 miniature plastic needles. These are covered in a coating containing liquid heparin and a special chemical containing amino acids that binds the drug to the surface of the needles.

When thrombin levels are elavated, a chemical reaction takes place within the amino acid coating — and releases heparin into the blood. So far, the disposable patch, which can be changed daily, has only been tested on mice.

Scientists injected them with large amounts of thrombin — enough to cause a fatal blood clot — after giving them a patch or a heparin jab.

HIGHER RISK OF BLOOD CLOTS FOR THOSE TAKING TESTOSTERONE PILLS

The risk of blood clots increases in the first six months after starting testosterone therapy for erectile dysfunction, according to a report in the BMJ.

Researchers studied 19,000 patients who had developed blood clots and found that compared with men who hadn't used testosterone, current users had a 25 per cent higher risk. Why is unclear, but researchers say men should discuss it with doctors after starting testosterone treatment.

The results, published last month in the journal Advanced Materials, showed all the mice with the patch survived but 80 per cent of those on a heparin injection died from the results of a clot.

Researchers said early results suggest the patch is faster and more effective than injecting the drug, or taking it orally. The team now plan to run studies testing the patch on patients.

Professor Martin Cowie, a professor of cardiology at Imperial College London, says the smart patch could improve anticoagulation for patients at risk of clots.

'The concept of a self-regulating patch that tailors the release of a drug as needed into the body is very innovative. It's well worth pursuing,' he adds.

Professor Jeremy Pearson, an associate medical director at the British Heart Foundation, believes that the patch is 'an ingenious approach'.

'It may have advantages over current treatment which requires repeated injections of heparin,' he says. 'The initial results in mice show promise. It will be interesting to see whether these can be reproduced in human studies.'