Web 2.0 and Medicine

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Lourdes Manahan Memorial Lecture delivered at the 2011 annual convention of the Philippine Rheumatology Association

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  • Stem cells are “non-specialized” cells that have the potential to form into other types of specific cells, such as blood, muscles or nerves. They are unlike 'differentiated' cells which have already become whatever organ or structure they are in the body. Stem cells are present throughout our body, but more abundant in a fetus.
    Medical researchers and scientists believe that stem cell therapy will, in the near future, advance medicine dramatically and change the course of disease treatment. This is because stem cells have the ability to grow into any kind of cell and, if transplanted into the body, will relocate to the damaged tissue, replacing it. For example, neural cells in the spinal cord, brain, optic nerves, or other parts of the central nervous system that have been injured can be replaced by injected stem cells. Various stem cell therapies are already practiced, a popular one being bone marrow transplants that are used to treat leukemia. In theory and in fact, lifeless cells anywhere in the body, no matter what the cause of the disease or injury, can be replaced with vigorous new cells because of the remarkable plasticity of stem cells. Biomed companies predict that with all of the research activity in stem cell therapy currently being directed toward the technology, a wider range of disease types including cancer, diabetes, spinal cord injury, and even multiple sclerosis will be effectively treated in the future. Recently announced trials are now underway to study both safety and efficacy of autologous stem cell transplantation in MS patients because of promising early results from previous trials.
    History
    Research into stem cells grew out of the findings of two Canadian researchers, Dr’s James Till and Ernest McCulloch at the University of Toronto in 1961. They were the first to publish their experimental results into the existence of stem cells in a scientific journal. Till and McCulloch documented the way in which embryonic stem cells differentiate themselves to become mature cell tissue. Their discovery opened the door for others to develop the first medical use of stem cells in bone marrow transplantation for leukemia. Over the next 50 years their early work has led to our current state of medical practice where modern science believes that new treatments for chronic diseases including MS, diabetes, spinal cord injuries and many more disease conditions are just around the corner.
    There are a number of sources of stem cells, namely, adult cells generally extracted from bone marrow, cord cells, extracted during pregnancy and cryogenically stored, and embryonic cells, extracted from an embryo before the cells start to differentiate. As to source and method of acquiring stem cells, harvesting autologous adult cells entails the least risk and controversy.
    Autologous stem cells are obtained from the patient’s own body; and since they are the patient’s own, autologous cells are better than both cord and embryonic sources as they perfectly match the patient’s own DNA, meaning that they will never be rejected by the patient’s immune system. Autologous transplantation is now happening therapeutically at several major sites world-wide and more studies on both safety and efficacy are finally being announced. With so many unrealized expectations of stem cell therapy, results to date have been both significant and hopeful, if taking longer than anticipated.
    What’s been the Holdup?
    Up until recently, there have been intense ethical debates about stem cells and even the studies that researchers have been allowed to do. This is because research methodology was primarily concerned with embryonic stem cells, which until recently required an aborted fetus as a source of stem cells. The topic became very much a moral dilemma and research was held up for many years in the US and Canada while political debates turned into restrictive legislation. Other countries were not as inflexible and many important research studies have been taking place elsewhere. Thankfully embryonic stem cells no longer have to be used as much more advanced and preferred methods have superseded the older technologies. While the length of time that promising research has been on hold has led many to wonder if stem cell therapy will ever be a reality for many disease types, the disputes have led to a number of important improvements in the medical technology that in the end, have satisfied both sides of the ethical issue.
    CCSVI Clinic
    CCSVI Clinic has been on the leading edge of MS treatment for the past several years. We are the only group facilitating the treatment of MS patients requiring a 10-day patient aftercare protocol following neck venous angioplasty that includes daily ultrasonography and other significant therapeutic features for the period including follow-up surgeries if indicated. There is a strict safety protocol, the results of which are the subject of an approved IRB study. The goal is to derive best practice standards from the data. With the addition of ASC transplantation, our research group has now preparing application for member status in International Cellular Medicine Society (ICMS), the globally-active non-profit organization dedicated to the improvement of cell-based medical therapies through education of physicians and researchers, patient safety, and creating universal standards. For more information please visit http://www.neurosurgeonindia.org/
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  • After 6 months of offering stem cell therapy in combination with the venous angioplasty liberation procedure, patients of CCSVI Clinic have reported excellent health outcomes. Ms. Kasma Gianopoulos of Athens Greece, who was diagnosed with the Relapsing/Remitting form of MS in 1997 called the combination of treatments a “cure”. “I feel I am completely cured” says Ms. Gianopoulos, “my symptoms have disappeared and I have a recovery of many functions, notably my balance and my muscle strength is all coming (back). Even after six months, I feel like there are good changes happening almost every day. Before, my biggest fear was that the changes wouldn’t (hold). I don’t even worry about having a relapse anymore. I’m looking forward to a normal life with my family. I think I would call that a miracle.”
    Other recent MS patients who have had Autologous Stem Cell Transplantation (ASCT), or stem cell therapy have posted videos and comments on YouTube. www.youtube.com/watch?v=jFQr2eqm3Cg.
    Dr. Avneesh Gupte, the Neurosurgeon at Noble Hospital performing the procedure has been encouraged by results in Cerebral Palsy patients as well. “We are fortunate to be able to offer the treatment because not every hospital is able to perform these types of transplants. You must have the specialized medical equipment and specially trained doctors and nurses”. With regard to MS patients, “We are cautious, but nevertheless excited by what patients are telling us. Suffice to say that the few patients who have had the therapy through us are noticing recovery of neuro deficits beyond what the venous angioplasty only should account for”.
    Dr. Unmesh of Noble continues: “These are early days and certainly all evidence that the combination of liberation and stem cell therapies working together at this point is anecdotal. However I am not aware of other medical facilities in the world that offer the synthesis of both to MS patients on an approved basis and it is indeed a rare opportunity for MS patients to take advantage of a treatment that is quite possibly unique in the world”.
    Autologous stem cell transplantation is a procedure by which blood-forming stem cells are removed, and later injected back into the patient. All stem cells are taken from the patient themselves and cultured for later injection. In the case of a bone marrow transplant, the HSC are typically removed from the Pelvis through a large needle that can reach into the bone. The technique is referred to as a bone marrow harvest and is performed under a general anesthesia. The incidence of patients experiencing rejection is rare due to the donor and recipient being the same individual.This remains the only approved method of the SCT therapy.
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Web 2.0 and Medicine

  1. 1. Web 2.0 & MedicineIris Thiele Isip Tan MD, FPCP, FPSEMClinical Associate Professor,UP College of MedicineMS Health Informatics (cand.)Section of Endocrinology, Diabetes &Metabolism, Department of MedicinePhilippine General Hospital Philippine Rheumatology Association 5 Feb 2011
  2. 2. Web 2.0 Blogs Podcasts Wikis RSS Tagging Social Media VodcastsSmartphones HTC Desire by Eric Homfeldt, 9 Feb 2010. http://www.flickr.com/photos/3bilder/4406656206/
  3. 3. Web 1.0 vs Web 2.0 by Andre Pan, 5 Sept 2006.http://www.flickr.com/photos/popoever/234877734/
  4. 4. http://blog.vovici.com/blog/bid/18085/Web-1-0-vs-Web-2-0 Accessed 27 Jan 2011
  5. 5. “Distributed technologies built to integrate, that collectively transformmass participation into valuable emergent outcomes.” Ross Dawson Future Exploration Network Harness collective intelligence ... Tim O’Reilly
  6. 6. Digital Native“native speaker” of thedigital language of theInternetDigital Immigrantnot born in the digitalworld but haveadopted newtechnology Prensky M. “Digital Natives, Digital Immigrants” From On the Horizon NCB University Press 9(5), Oct 2001
  7. 7. Eysenbach G. J Med Internet Res 2008;10(3)
  8. 8. Are you stuck in Web 1.0? PubMed Google Scholar Medline Plus
  9. 9. Blogs Podcasts Wikis RSSTagging Vodcasts Social Media http://www.blogcatalog.com/blogs/webdesign-social-marketing- gadget-tech-and-web-20-news Accessed 27 Jan 2011
  10. 10. Blog A personal diary. A daily pulpit.short for “web log” A collaborative space. A political soapbox. A breaking-news outlet. A collection of links. Your own private thoughts. Memos to the world. http://www.blogopreneur.com/2006/12/27/blogs-versus-forums/ Push-Button Publishing Accessed 27 Jan 2011
  11. 11. http://lupusurvivor.com http://despitelupus.blogspot.comhttp://headstrongwithlupus.blogspot.com http://sistersagainstlupus.blogspot.com
  12. 12. http://lupusurvivor.com http://despitelupus.blogspot.comhttp://headstrongwithlupus.blogspot.com http://sistersagainstlupus.blogspot.com
  13. 13. http://lupusurvivor.com http://despitelupus.blogspot.comhttp://headstrongwithlupus.blogspot.com http://sistersagainstlupus.blogspot.com
  14. 14. http://lupusurvivor.com http://despitelupus.blogspot.comhttp://headstrongwithlupus.blogspot.com http://sistersagainstlupus.blogspot.com
  15. 15. http://www.lupus.ph
  16. 16. Medscape Blogs http://blogs.medscape.com/brunooliveirahttp://blogs.medscape.com/elizabethtindall
  17. 17. Medscape Blogs http://blogs.medscape.com/brunooliveirahttp://blogs.medscape.com/elizabethtindall
  18. 18. http://services.psoriasis.org/drtellme/ http://rawarrior.com
  19. 19. http://services.psoriasis.org/drtellme/ http://rawarrior.com
  20. 20. http://www.webicina.com/rheumatology/
  21. 21. http://www.webicina.com/rheumatology/
  22. 22. Playable On DemandPodcasts + BroadcastVodcasts Series of digital files (audio or video) Released episodically Often downloaded through web syndication Image from http://fuzionpodcastnetwork.com/ http://en.wikipedia.org/wiki/Podcast
  23. 23. iTunes U iPod nano image from http://www.ableweb.org/news/fall2009/firstpage-f09pub.htm
  24. 24. Podcasts in iTunes
  25. 25. Podcasts in iTunes
  26. 26. Podcasts in iTunes
  27. 27. ChannelRSS FeedReally Simple Syndication Webfeed Format used to publish frequently updated works Full or summarized text Metadata (publishing dates and authorship) For readers to subscribe to timely updates of websites Aggregate feeds into one place http://en.wikipedia.org/wiki/File:Feed-icon.svg http://en.wikipedia.org/wiki/RSS
  28. 28. Google reader
  29. 29. Find the RSS icon on your favorite page Click to subscribe!
  30. 30. Find the RSS icon on your favorite page Click to subscribe!
  31. 31. Find the RSS icon on your favorite page Click to subscribe!
  32. 32. Find the RSS icon on your favorite page Click to subscribe!
  33. 33. WebicinaPeRSSonalized Rheumatology
  34. 34. WebicinaPeRSSonalized Rheumatology
  35. 35. WebicinaPeRSSonalized Rheumatology
  36. 36. WebicinaPeRSSonalized Rheumatology
  37. 37. WebicinaPeRSSonalized Rheumatology
  38. 38. Rheumatology: Images in Clinical Medicine http://clinicalcases.org
  39. 39. Rheumatology: Images in Clinical Medicine http://clinicalcases.org
  40. 40. WikiHawaiian word for “quick” Website that allows creation and editing of any number of interlinked web pages via a web browser Often used to create collaborative works http://en.wikipedia.org/wiki/File:Wikipedia-logo-v2.svg http://en.wikipedia.org/wiki/Wiki
  41. 41. http://askdrwiki.comhttp://www.wikimd.org
  42. 42. http://askdrwiki.comhttp://www.wikimd.org
  43. 43. http://askdrwiki.comhttp://www.wikimd.org
  44. 44. TagTagging A non-hierarchical keyword or term assigned to a piece of information Description that allows item to be found again by browsing or searching Tag Cloud A visual depiction of user- generated tags Importance of each tag is shown with font size or color http://en.wikipedia.org/wiki/File:Web_2.0_Map.svg http://en.wikipedia.org/wiki/Tag_cloud
  45. 45. http://www.delicious.com
  46. 46. http://www.delicious.com
  47. 47. Tagging
  48. 48. Tagging
  49. 49. Tagging
  50. 50. Social Media Internet-based applications that allow the creation and exchange of user-generated content Six types Collaborative projects Blogs and microblogs Content communities Social networking sites Virtual game worlds Virtual communities http://en.wikipedia.org/wiki/Social_mediahttp://www.blogcatalog.com/blogs/webdesign-social-marketing- gadget-tech-and-web-20-news Accessed 27 Jan 2011
  51. 51. Facebook
  52. 52. Facebook
  53. 53. Facebook
  54. 54. Facebook
  55. 55. Facebook
  56. 56. Facebook
  57. 57. Facebook
  58. 58. Twitter Tweet 140-character message Using Twitter Find and follow Check it often Take it with you Hashtag (#) Keyword for tweets http://www.flickr.com/photos/svartling/3638204140/ http://support.twitter.com
  59. 59. Live-tweeting at medical conferences Sharing links/articles of interest 140 Health Care Uses of Twitterhttp://philbaumann.com/2009/01/16/140-health-care-uses-for-twitter/ http://techcrunch.com/2010/09/14/the-new-twitter/
  60. 60. Twitter
  61. 61. Twitter
  62. 62. Twitter
  63. 63. Twitter
  64. 64. Twitter
  65. 65. Web 2.0 Blogs Podcasts Wikis RSS Tagging Social Media VodcastsSmartphones HTC Desire by Eric Homfeldt, 9 Feb 2010. http://www.flickr.com/photos/3bilder/4406656206/
  66. 66. “Mobile technologyhas the potential torevolutionize the wayphysicians practicemedicine.” Burdette et al. Clin Inf Dis 2008;47:117-22
  67. 67. http://www.flickr.com/ photos/3bilder/4406656206/ More than basic cellphone capabilitieshttp://www.gomonews.com http://www.macworld.com SMS Miniature MMS No industry computerVoice calls standard with phonePhonebook definition capability Wikipedia http://www.unwiredview.com Smartphone Do you own one?
  68. 68. Smartphone PlatformMarket Share Palm Google 6% 9% Microsoft 16% 43% RIM Apple 26% comScore Feb 2010 USA
  69. 69. US Physicians Usinga SmartphoneNosmartphone 36% 36% 27% iPhone 64% 37% Blackberry 2009 Manhattan Research Study “Taking the Pulse”
  70. 70. Epocrates
  71. 71. Social MediaMeets Mobile http://www.blogcatalog.com/blogs/webdesign-social-marketing- gadget-tech-and-web-20-news Accessed 27 Jan 2011 http://londoncalling.co/2009/10/when-social- media-meets-mobile-a-perfect-match/
  72. 72. RSS reader lifehacker.com http://www.mobiletor.com
  73. 73. Web 2.0 Blogs Podcasts Wikis RSS Tagging Social Media VodcastsSmartphones HTC Desire by Eric Homfeldt, 9 Feb 2010. http://www.flickr.com/photos/3bilder/4406656206/
  74. 74. Web 3.0 Second Life
  75. 75. Web 3.0 Second Life
  76. 76. Web 3.0 Second Life
  77. 77. !ank Y"http://www.endocrine-witch.net

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