adplus-dvertising
Connect with us

Health

‘A remarkable era’: Groundbreaking innovations in treating spinal cord injury offer new hope for patients

Published

 on

Gert-Jan Oskam could no longer walk after a cycling accident 12 years ago in China.

He suffered an incomplete spinal cord injury, so while he had some sensation in his lower body, he used a wheelchair after he returned home to the Netherlands.

But he wanted to be able to stand.

That’s why Oskam, 40, agreed to be one of three participants in a Swiss pilot study of an experimental brain implant in 2017.

The implant would allow him not just to stand, but to walk. When he pressed a button, a processor worn in a backpack would analyze his brain signals to try to activate his leg muscles for walking.

It worked, but not completely — his gait was stiff and robotic, and his steps were delayed because they were automated.

Oskam’s implant system is an upgrade on a previous version he used in a pilot project. He can now walk further, more fluidly and over uneven ground. (Nature)

Then a few years later, the researchers recruited Oskam to “test pilot” an upgraded implant system that would translate his thoughts into motion. When he thought about walking, electronic implants on his skull would pick up his brain signals, register them as instructions to move his legs, and send them to the corresponding muscles through another implant on his spine.

“You’re creating a sort of digital bridge” between the brain and spinal cord, said Canadian neurosurgeon Jordan Squair. Squair treats spinal cord injuries at the Swiss Federal Institute of Technology in Lausanne, Switzerland, where work on Oskam’s implant is based.

In May, the researchers reported on Oskam’s progress more than a year into the study. His walking is now fluid. He can climb stairs and handle rough terrain; he can walk faster and farther; and he’s able to use the technology outside the lab at his home.

“The stimulation before was controlling me, and now I’m controlling the stimulation,” Oskam said in a media briefing.

In 2024, medical researchers plan a pivotal clinical trial to test the safety of the implant in more subjects. Their goal is to miniaturize the system and make the technology available worldwide.

Implants have multiple benefits

Oskam’s progress and other advances in treatment of spinal cord injury — including a pioneering type of microsurgery that’s now being performed in Toronto — signal a promising turning point for the field.

In Canada, more than 86,000 people live with spinal cord injury, according to Praxis Spinal Cord Institute (formerly the Rick Hansen Institute). Doctors say about half to two-thirds of those are incomplete injuries like Oskam’s.

Quirks and Quarks8:39Digital bridge for spinal cord allows paralyzed man to walk again

Researchers in Switzerland have developed a system to restore communication between the brain and the spinal cord in a paralyzed man who was told he’d never walk again. By surgically implanting devices in the patient’s brain and spinal cord, they were able to digitally bridge the communication gap to allow him to control his legs again. Henri Lorach, the head of the brain interface unit at NeuroRestore and a neuroscientist at École Polytechnique Fédérale de Lausanne, said the patient can now walk with crutches even when the device is turned off. Their research was published in the journal Nature.

Squair said linking spinal cord stimulation to help people walk better by decoding their thoughts, as Oskam’s implant does, is a true technological step forward.

Not only does the approach help people with spinal cord injuries regain mobility — which they often rank as their top priority, say Squair and Praxis  — but it can help people whose injuries are in the neck to control dangerous spikes in blood pressure.

“People are experiencing a lot less episodes of what we call autonomic dysreflexia — these hypertensive episodes when blood pressure goes up really high,” he said.

“We found that over time, as people use the stimulation, that is starting to go away, which is really exciting because those episodes can be life-threatening.”

Until now, few existing treatments have worked long-term, he said.

Man smiling in his wheelchair while wearing a Maverix shirt.
Venture capitalist John Ruffolo is recovering from a spinal cord injury. A new type of microsurgery helped ease the pain in his spine. (Submitted by John Ruffolo)

‘You will feel this deadness’

John Ruffolo of Toronto takes a keen interest in how the field of spinal cord treatment is progressing as part of his own recovery from severe injuries.

When Ruffolo watches videos of Oskam walk, his reaction is: “I’ll be there soon.”

He hasn’t received an implant, though he says he would get one if he had the opportunity.

An avid cyclist, Ruffolo, 57, was riding his bike on a sunny day in September 2020. He was heading down a rural road about 50 km north of the city when he heard the screeching air brakes of a tractor-trailer coming up on his rear wheel.

He doesn’t remember the pain of being hit.

After he landed, he tried to move his legs as his upper body seared with pain.

“You will feel this deadness on your body,” he said. “My first reaction was, ‘Oh s–t, I’m paralyzed.’ I was trying to wiggle my toes, and nothing.”

On impact, his pelvis split into six pieces. The force broke every rib in multiple places, collapsing a lung and taking out a kidney. Doctors said he lost 50 per cent of his blood volume.

Witnesses, paramedics and physicians expected he’d suffocate to death because of the broken ribs around his chest, which can hinder breathing.

Paramedics rushed him to Toronto’s Sunnybrook Health Sciences Centre, a major trauma hospital.

When he made it 36 hours past the accident, doctors performed multiple surgeries to repair his pelvis and then his back, drilling vertebrae and then delicately placing rods and screws.

Each move had to be carefully planned, like removing a block from a Jenga tower, without causing more damage or even death.

Ruffolo and his wife, Carryn, were told he’d never walk again.

Asked about his reaction, Ruffolo lowers his voice to a whisper, his voice cracking.

“The issue is, never remove someone’s hope, right?”

Sunnybrook’s surgical team considered Ruffolo to have a complete injury of the spinal cord, which traditionally has a guarded prognosis.

The surgeon had to leave several large bone fragments floating in his spinal fluid because they were located in an area that made them too risky to remove. Ruffolo said his spinal cord felt like it was being squeezed and bruised.

A few weeks later, he met with neurosurgeon Michael Fehlings at the Krembil Brain Institute at Toronto’s University Health Network. Fehlings told Ruffolo he could remove the fragments with a type of microsurgery called decompression surgery.

Man in a grey suit jacket and white shirt.
Dr. Michael Fehlings, a neurosurgeon with Toronto’s University Health Network, says new international guidelines on spinal cord injury coming out in 2024 will highlight the benefits of early decompression surgery. (Submitted by Michael Fehlings)

Fehlings told him the surgery could help relieve the squeezing to improve his odds for a significant recovery, but there were risks.

“I looked at him and I said, ‘Dude, I’m a VC,'” said Ruffolo — a venture capitalist in the tech industry. “I make investments when there’s a one per cent chance. I didn’t even flinch, and I said, ‘Do it.'”

Ruffolo, founder and managing partner of Maverix Private Equity, now does 18 to 20 hours of intense physiotherapy a week. He can walk with a walker, walking poles or on a treadmill.

“You just gotta keep on going,” he said.

“I’m not stopping until I walk independently.”

Patient’s recovery ‘gratifying’ for surgeon

Ruffolo is also able to ride again using modified recumbent and upright bikes. When he shares video of his rides with Fehlings today, it inspires the physician.

“While the injury presented huge challenges to him, where he’s at now and where he might have been without the decompressive surgery, I think is quite striking,” Fehlings said. “That’s very gratifying for me to see.”

 

Rick Hansen reflects on rehabilitation journey 50 years after crash

 

Premier David Eby joined Rick Hansen and health officials at the G.F. Strong Rehabilitation Centre in Vancouver to mark Hansen’s 50 years of spinal cord injury rehabilitation, and to present the Difference Maker Awards to those who have helped him on his road to recovery.

But Fehlings, who is also a professor at the University of Toronto and a clinician scientist, notes that Oskam’s and Ruffolo’s injuries should be kept in perspective: not every patient will respond as well to treatments because no two patients are identical in the degree and location of their spinal injury. It also helps that both patients were physically active before and after their accidents.

Not everyone with a spinal cord injury is keen to receive implant technology, either, Fehlings said, although he added it is possible the Swiss implant could help Ruffolo’s motor recovery.

“The technology was really quite remarkable,” Fehlings said. He isn’t involved in the experimental device but sees how it could fit in with efforts in restorative and regenerative medicine.

Another thing giving him optimism is the set of international guidelines on treating spinal cord injury, created with Canadian input, that is set to be published in early 2024. They include evidence on the benefits of early surgical decompression to reduce pain, improve mobility and manage other symptoms like bowel and bladder control.

“We’re really on the cusp right now of a remarkable era in regenerative neuroscience,” Fehlings said.

 

728x90x4

Source link

Continue Reading

Health

What’s the greatest holiday gift: lips, hair, skin? Give the gift of great skin this holiday season

Published

 on

Give the gift of great skin this holiday season

Skinstitut Holiday Gift Kits take the stress out of gifting

Toronto, October 31, 2024 – Beauty gifts are at the top of holiday wish lists this year, and Laser Clinics Canada, a leader in advanced beauty treatments and skincare, is taking the pressure out of seasonal shopping. Today, Laser Clincs Canada announces the arrival of its 2024 Holiday Gift Kits, courtesy of Skinstitut, the exclusive skincare line of Laser Clinics Group.

In time for the busy shopping season, the limited-edition Holiday Gifts Kits are available in Laser Clinics locations in the GTA and Ottawa. Clinics are conveniently located in popular shopping centers, including Hillcrest Mall, Square One, CF Sherway Gardens, Scarborough Town Centre, Rideau Centre, Union Station and CF Markville. These limited-edition Kits are available on a first come, first served basis.

“These kits combine our best-selling products, bundled to address the most relevant skin concerns we’re seeing among our clients,” says Christina Ho, Senior Brand & LAM Manager at Laser Clinics Canada. “With several price points available, the kits offer excellent value and suit a variety of gift-giving needs, from those new to cosmeceuticals to those looking to level up their skincare routine. What’s more, these kits are priced with a savings of up to 33 per cent so gift givers can save during the holiday season.

There are two kits to select from, each designed to address key skin concerns and each with a unique theme — Brightening Basics and Hydration Heroes.

Brightening Basics is a mix of everyday essentials for glowing skin for all skin types. The bundle comes in a sleek pink, reusable case and includes three full-sized products: 200ml gentle cleanser, 50ml Moisture Defence (normal skin) and 30ml1% Hyaluronic Complex Serum. The Brightening Basics kit is available at $129, a saving of 33 per cent.

Hydration Heroes is a mix of hydration essentials and active heroes that cater to a wide variety of clients. A perfect stocking stuffer, this bundle includes four deluxe products: Moisture 15 15 ml Defence for normal skin, 10 ml 1% Hyaluronic Complex Serum, 10 ml Retinol Serum and 50 ml Expert Squalane Cleansing Oil. The kit retails at $59.

In addition to the 2024 Holiday Gifts Kits, gift givers can easily add a Laser Clinic Canada gift card to the mix. Offering flexibility, recipients can choose from a wide range of treatments offered by Laser Clinics Canada, or they can expand their collection of exclusive Skinstitut products.

 

Brightening Basics 2024 Holiday Gift Kit by Skinstitut, available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Hydration Heroes 2024 Holiday Gift Kit by Skinstitut – available exclusively at Laser Clincs Canada clinics and online at skinstitut.ca.

Continue Reading

Health

Here is how to prepare your online accounts for when you die

Published

 on

 

LONDON (AP) — Most people have accumulated a pile of data — selfies, emails, videos and more — on their social media and digital accounts over their lifetimes. What happens to it when we die?

It’s wise to draft a will spelling out who inherits your physical assets after you’re gone, but don’t forget to take care of your digital estate too. Friends and family might treasure files and posts you’ve left behind, but they could get lost in digital purgatory after you pass away unless you take some simple steps.

Here’s how you can prepare your digital life for your survivors:

Apple

The iPhone maker lets you nominate a “ legacy contact ” who can access your Apple account’s data after you die. The company says it’s a secure way to give trusted people access to photos, files and messages. To set it up you’ll need an Apple device with a fairly recent operating system — iPhones and iPads need iOS or iPadOS 15.2 and MacBooks needs macOS Monterey 12.1.

For iPhones, go to settings, tap Sign-in & Security and then Legacy Contact. You can name one or more people, and they don’t need an Apple ID or device.

You’ll have to share an access key with your contact. It can be a digital version sent electronically, or you can print a copy or save it as a screenshot or PDF.

Take note that there are some types of files you won’t be able to pass on — including digital rights-protected music, movies and passwords stored in Apple’s password manager. Legacy contacts can only access a deceased user’s account for three years before Apple deletes the account.

Google

Google takes a different approach with its Inactive Account Manager, which allows you to share your data with someone if it notices that you’ve stopped using your account.

When setting it up, you need to decide how long Google should wait — from three to 18 months — before considering your account inactive. Once that time is up, Google can notify up to 10 people.

You can write a message informing them you’ve stopped using the account, and, optionally, include a link to download your data. You can choose what types of data they can access — including emails, photos, calendar entries and YouTube videos.

There’s also an option to automatically delete your account after three months of inactivity, so your contacts will have to download any data before that deadline.

Facebook and Instagram

Some social media platforms can preserve accounts for people who have died so that friends and family can honor their memories.

When users of Facebook or Instagram die, parent company Meta says it can memorialize the account if it gets a “valid request” from a friend or family member. Requests can be submitted through an online form.

The social media company strongly recommends Facebook users add a legacy contact to look after their memorial accounts. Legacy contacts can do things like respond to new friend requests and update pinned posts, but they can’t read private messages or remove or alter previous posts. You can only choose one person, who also has to have a Facebook account.

You can also ask Facebook or Instagram to delete a deceased user’s account if you’re a close family member or an executor. You’ll need to send in documents like a death certificate.

TikTok

The video-sharing platform says that if a user has died, people can submit a request to memorialize the account through the settings menu. Go to the Report a Problem section, then Account and profile, then Manage account, where you can report a deceased user.

Once an account has been memorialized, it will be labeled “Remembering.” No one will be able to log into the account, which prevents anyone from editing the profile or using the account to post new content or send messages.

X

It’s not possible to nominate a legacy contact on Elon Musk’s social media site. But family members or an authorized person can submit a request to deactivate a deceased user’s account.

Passwords

Besides the major online services, you’ll probably have dozens if not hundreds of other digital accounts that your survivors might need to access. You could just write all your login credentials down in a notebook and put it somewhere safe. But making a physical copy presents its own vulnerabilities. What if you lose track of it? What if someone finds it?

Instead, consider a password manager that has an emergency access feature. Password managers are digital vaults that you can use to store all your credentials. Some, like Keeper,Bitwarden and NordPass, allow users to nominate one or more trusted contacts who can access their keys in case of an emergency such as a death.

But there are a few catches: Those contacts also need to use the same password manager and you might have to pay for the service.

___

Is there a tech challenge you need help figuring out? Write to us at onetechtip@ap.org with your questions.

Source link

Continue Reading

Health

Pediatric group says doctors should regularly screen kids for reading difficulties

Published

 on

 

The Canadian Paediatric Society says doctors should regularly screen children for reading difficulties and dyslexia, calling low literacy a “serious public health concern” that can increase the risk of other problems including anxiety, low self-esteem and behavioural issues, with lifelong consequences.

New guidance issued Wednesday says family doctors, nurses, pediatricians and other medical professionals who care for school-aged kids are in a unique position to help struggling readers access educational and specialty supports, noting that identifying problems early couldhelp kids sooner — when it’s more effective — as well as reveal other possible learning or developmental issues.

The 10 recommendations include regular screening for kids aged four to seven, especially if they belong to groups at higher risk of low literacy, including newcomers to Canada, racialized Canadians and Indigenous Peoples. The society says this can be done in a two-to-three-minute office-based assessment.

Other tips encourage doctors to look for conditions often seen among poor readers such as attention-deficit hyperactivity disorder; to advocate for early literacy training for pediatric and family medicine residents; to liaise with schools on behalf of families seeking help; and to push provincial and territorial education ministries to integrate evidence-based phonics instruction into curriculums, starting in kindergarten.

Dr. Scott McLeod, one of the authors and chair of the society’s mental health and developmental disabilities committee, said a key goal is to catch kids who may be falling through the cracks and to better connect families to resources, including quicker targeted help from schools.

“Collaboration in this area is so key because we need to move away from the silos of: everything educational must exist within the educational portfolio,” McLeod said in an interview from Calgary, where he is a developmental pediatrician at Alberta Children’s Hospital.

“Reading, yes, it’s education, but it’s also health because we know that literacy impacts health. So I think that a statement like this opens the window to say: Yes, parents can come to their health-care provider to get advice, get recommendations, hopefully start a collaboration with school teachers.”

McLeod noted that pediatricians already look for signs of low literacy in young children by way of a commonly used tool known as the Rourke Baby Record, which offers a checklist of key topics, such as nutrition and developmental benchmarks, to cover in a well-child appointment.

But he said questions about reading could be “a standing item” in checkups and he hoped the society’s statement to medical professionals who care for children “enhances their confidence in being a strong advocate for the child” while spurring partnerships with others involved in a child’s life such as teachers and psychologists.

The guidance said pediatricians also play a key role in detecting and monitoring conditions that often coexist with difficulty reading such as attention-deficit hyperactivity disorder, but McLeod noted that getting such specific diagnoses typically involves a referral to a specialist, during which time a child continues to struggle.

He also acknowledged that some schools can be slow to act without a specific diagnosis from a specialist, and even then a child may end up on a wait list for school interventions.

“Evidence-based reading instruction shouldn’t have to wait for some of that access to specialized assessments to occur,” he said.

“My hope is that (by) having an existing statement or document written by the Canadian Paediatric Society … we’re able to skip a few steps or have some of the early interventions present,” he said.

McLeod added that obtaining specific assessments from medical specialists is “definitely beneficial and advantageous” to know where a child is at, “but having that sort of clear, thorough assessment shouldn’t be a barrier to intervention starting.”

McLeod said the society was partly spurred to act by 2022’s “Right to Read Inquiry Report” from the Ontario Human Rights Commission, which made 157 recommendations to address inequities related to reading instruction in that province.

He called the new guidelines “a big reminder” to pediatric providers, family doctors, school teachers and psychologists of the importance of literacy.

“Early identification of reading difficulty can truly change the trajectory of a child’s life.”

This report by The Canadian Press was first published Oct. 23, 2024.

Source link

Continue Reading

Trending