Sunday, July 10, 2011

Health Solutions for Space & Earth

It took a number of years, but eventually scientists were able to develop ultrasound technology to remotely guide examinations for astronauts on the International Space Station (ISS) and in outer space. This technology can be used during long spaceflights but the technology also has applications for people living in rural and underserved locations and to conduct ultrasound training courses for the medical profession.

NASA thinks that eventually ultrasound will be able to evaluate and diagnose 250 medical conditions when crews in space need treatment. Some of these conditions may include traumas to the eye, shoulder, knee, tooth abscesses, broken or fractured bones, collapsed lungs, kidney stones, organ damage, hemorrhaging, and muscle and bone atrophy, plus many other medical problems.

The first ultrasound experiment referred to as “Advanced Diagnostic Ultrasound in Microgravity” (ADUM) was accomplished on the ISS. One of the first individuals to conduct an ultrasound exam in space was former NASA Astronaut and ISS Expedition 10 Commander, Dr. Leroy Chiao. His team demonstrated that even non-physicians can produce diagnostic quality ultrasound images using remote guidance.

When the National Space Biomedical Research Institute (NSBRI), NASA, Henry Ford Hospital in Detroit, and Wyle Integrated Science and Engineering, began their first ultrasound experiments, tele-ultrasound operations were used to help astronauts interact with researchers and flight controllers on the ground during the examinations. However, today’s current ultrasound imagery enables astronauts to conduct exams when quick communication with an expert is not available from Earth.

Dr. Scott A. Dulchavsky, the Roy D. McClure Chairman of Surgery and Surgeon-in-Chief at the Henry Ford Hospital, principal investigator and a member of the NSBRI Smart Medical Systems and Technology Team, reports that using ultrasound imagery techniques in space is vital since trained radiologists, the use of CAT scans plus MRIs are not available.

Dulchavsky and his colleagues have spun off the techniques for terrestrial use and published a reference guide for conducting exams. The American College of Surgeons have used the methods developed in space and have incorporated the techniques in their ultrasound training courses for surgeons in the U.S. plus medical schools are starting to incorporate this training for all of the medical students, not just surgeons.

Ultrasound imaging techniques have been used in specialized situations:

• Trainers for some professional sports teams received ultrasound training and remote guidance to help the Detroit Red Wings, Tigers, and Lions when medical assistance is needed

• The U.S. Olympic Committee used ultrasound to send point-of-care information on athletes and their injuries obtained from the U.S. Olympic Training Facilities in California, Colorado Springs, Lake Placid, Turino, Beijing, and Vancouver. For example, a non-physician athletic trainer was remotely guided to perform a point-of-care scan on a woman skier with an injured leg. The scan was able to confirm that she could continue to compete and she won a gold metal three days later

• In the high Arctic, ultrasound technology was used to determine the status of a pregnant Inuit mother. The information gained was used to determine whether her delivery could be done safely in her village

• A Swedish climber performed a comprehensive chest ultrasound examination at the Advanced Base Camp on Mt Everest. The Climber operator had never seen an ultrasound before but was remotely guided to perform the examination over the internet via a satellite phone. The exam was completed in ten minutes and showed that the climber had excessive lung fluid due to exposure to high altitudes

To keep up with the latest ultrasound technology, NASA’s final shuttle flight on July 8th took GE Healthcare’s Vivid™q Cardiovascular Ultrasound system to the ISS. Vivid q is a compact lightweight diagnostic ultrasound system designed for cardiovascular imaging and enables assessment of LV function and cardiac performance.

Very importantly, rural locations both in the U.S. and worldwide are gaining the most from diagnostic ultrasound capabilities and from telemedicine in general. Dulchavsky is collaborating with the World Interactive Network focused on Critical UltraSound to train individuals on using ultrasound techniques in underserved regions. Some of the countries where ultrasound techniques are being implemented are Mozambique, Lesotho, Madagascar, India, Brazil, and Nicaragua with programs being planned in Honduras, Congo, and Malaysia.

During the past four years, Dulchavsky and Neri, Director of the WINFOCUS Global Ultrasound Program, have given regular updates about ultrasound potentials at the United Nation’s Economic and Social Council, the Observatory for Cultural and Audiovisual Communication in the Mediterranean, and at the World InfoPoverty conferences held in Geneva and New York.

In another research effort to help cancer patients, NASA partnered with Quantum Devices Inc. of Barneveld Wisconsin to develop the WARP 75 device that uses High Emissivity Aluminiferous Luminescent Substrate (HEALS) a type of LED technology to provide intense light energy. HEALS technology provides the equivalent light energy of 12 suns from each of the 288 LED chips.

The WARP 75 device was used to provide light therapy treatment on cancer patients during a two year clinical trial funded by NASA’s “Innovative Partnerships Program” at the Marshall Space Flight Center in Huntsville Alabama. The Clinical Trial included 20 cancer patients from Children’s Hospital of Wisconsin and 60 cancer patients from the University of Alabama at both Birmingham Hospital, and Children’s Hospital of Alabama. It was found that the 670 nanometers of light technology when used in the Clinical Trial improved the painful side effects of chemotherapy and radiation in cancer patients undergoing bone marrow or stem cell transplants.