SLEEPWALKING

About Sleepwalking

Hours after bedtime, do you find your little one wandering the hall looking dazed and confused? If you

have a sleepwalking child, you're not alone. It can be unnerving to see, but sleepwalking is very common

in kids and most sleepwalkers only do so occasionally and outgrow it by the teen years. Still, some simple

steps can keep your young sleepwalker safe while traipsing about. Despite its name, sleepwalking (also

called somnambulism) actually involves more than just walking. Sleepwalking behaviors can range from

harmless (sitting up), to potentially dangerous (wandering outside), to just inappropriate (kids may even

open a closet door and pee inside). No matter what kids do during sleepwalking episodes, though, it's

unlikely that they'll remember ever having done it!

Kids tend to sleepwalk within an hour or two of falling asleep and may walk around for anywhere from a

few seconds to 30 minutes

Causes of Sleepwalking

Sleepwalking is far more common in kids than in adults, as most sleepwalkers outgrow it by the early teen

years. It may run in families, so if you or your partner are or were sleepwalkers, your child may be too.

Other factors that may bring on a sleepwalking episode include:

lack of sleep or fatigue

irregular sleep schedules

illness or fever

certain medications

stress (sleepwalking is rarely caused by an underlying medical, emotional, or psychological problem)

Behaviors During Sleepwalking

Of course, getting out of bed and walking around while still sleeping is the most obvious sleepwalking

symptom. But young sleepwalkers may also:

sleeptalk

be hard to wake up

seem dazed

be clumsy

not respond when spoken to

sit up in bed and go through repeated motions, such as rubbing their eyes or fussing with their

pajamas

Also, sleepwalkers' eyes are open, but they don't see the same way they do when they're awake and they

often think they're in different rooms of the house or different places altogether.

Sometimes, these other conditions may accompany sleepwalking:

sleep apnea (brief pauses in breathing while sleeping)

bedwetting (enuresis)

night terrors

Reaction: As we sleep, our brains pass through five stages of sleep — stages 1, 2, 3, 4, and REM

(rapid eye movement) sleep. Together, these stages make up a sleep cycle. One complete sleep cycle

lasts about 90 to 100 minutes. So a person experiences about four or five sleep cycles during an average

night's sleep. Sleepwalking most often occurs during the deeper sleep of stages 3 and 4. During these

stages, it's more difficult to wake someone up, and when awakened, a person may feel groggy and

disoriented for a few minutes.

Where the Heart Isby Marc Engelhardt

Derick Fonyuy was 12 years old when he noticed a pain in his chest. “I didn’t know what was happening,” says the now 21-year-old Cameroonian. “I had lost all my energy, my nose bled, and I was sick time and again.” When Derick’s parents took their son to the doctor in a nearby hospital, they soon received shattering news. “They told us there was a problem with the valve on the right side of my heart and that the valve had to be replaced – a measles infection had left it damaged,” says Derick. The doctors were clear: Without surgery, Derick wouldn’t survive. His parents were shocked – but they were lucky. “At the last minute, they found a charity that paid for me to go to Paris, live with a host family, and have the operation I needed there.” Derick, who now studies medicine himself, still remembers how scared he was then. “I was alone in a foreign country, and I thought I was going to die.” But Derick lived – and returned home.Nine years after his first heart surgery, the pain returned. The doctors diagnosed a blockage of the same valve. “They told me again that I needed surgery, and fast.” But this time, everything was different. Instead of flying abroad, Derick just had to take a bus to the far west of his home country. Here, in a small town called Kumbo, the doctors at the new Cardiac Center of Shisong Hospital took care of him. “All went well, and I feel great,” he says, smiling. Three months later, he returned for a routine check-up. “All this is possible now without paying for horrendously high air fees – it’s a miracle.” Siemens Technology at the Forefront.

Reaction: It is a very clear indication that many people in the world is experiencing heart problems that is, somehow, one of the causes of deaths. Thus, medical innovations are developed to improve more efficient and reliable medical facilities, equipment, and devises in curing such illness.

CARDIOVASCULAR DISEASES HAVE THE POTENTIAL TO BECOME THE NUMBER ONE KILLER IN CAMEROON IF NOTHING IS DONE.

By: Jean Claude Ambassa, M.D.

This vision is surely already a reality with regard to the Cardiac Center. The extension to the general hospital was officially opened in 2009, after five years of construction time. Everything inside is state-of-the-art: The intensive care unit and two operating theaters are – like the rest of the cardiac wing – sealed off from the dusty environment outside. Oxygen and air supply come from tabs in the wall, a rarity in African hospitals.The flagship of the Cardiac Center, though, is its catheterization laboratory (cath lab), which boasts a Siemens AXIOM® Artis dFC all-digital, single-plane, ceiling-mounted C-arm angiography system installed in a specially fitted room that was jointly planned by Cameroonian architects and Siemens. Not only does it look like a set from Star Trek, its technical features also border on the futuresque. The AXIOM Artis enables cardiologists and cardiac surgeons for the first time in this region to offer quick and detailed diagnoses. Sharp and detailed X-rays, intravascular ultrasound-images, and angiocardiograms are the basis for the microinvasive heart treatment that Shisong offers its patients, while at the same time limiting exposure to radiation thanks to a special Siemens-package called CARE (Combined Applications to Reduce Exposure). While the AXIOM Artis with its three big screens right above the operating table give guidance to the surgeon, all the data is stored simultaneously in real time on the AXIOM Sensis XP Lite data center, an integral part of the cath lab. “In collaboration with the Italian association ‘Bambini Cardiopatici nel Mondo,’ we decided deliberately to go for the latest model,” says Sister Appolonia. The nuns of Shisong had always made clear that they wouldn’t want to go for outdated technology. “It might seem cheaper in the beginning, but then it gives you trouble later.”The nuns and Siemens agreed early that Siemens would train local technicians and engineers on how to maintain and repair the high-tech machine. “I assisted from day one,” says Shisong Hospital’s Lionel Djankou. “I am an electronic technician and an ICT-expert by training, so I knew how the machine would work in principle – the concrete bits I was taught by Siemens.” And, he learned so well that in the past two years, Djankou has been able to fix all of the few glitches that occurred. If necessary, he communicates with Siemens in Belgium, which is also where Djankou orders those spare parts he doesn’t keep in his inventory.

Reaction: The most frequent problem involves power cuts. “We had 4,000 blackouts alone last year,” says Djankou. Doctors and patients never noticed a single one of them, though – thanks to two giant batteries that keep the whole Cardiac Center going until the generators kick in.

Searching the Brain’sPathways for Autism Clues

Timothy Roberts, PhD, works in themiddle of an epidemic. In the 20 yearsthe researcher has studied autism, thediagnosis rate among children in theUnited States has risen from one in 1,000to one in 88. No one is sure of the cause,how to prevent it, or how to treat it.Some of the answers may come at TheChildren’s Hospital of Philadelphia (CHOP),where Roberts and his peers are conductingcutting-edge research on the oftendebilitating spectrum of brain disorders,aided by Siemens scanning technology.

Reacton: There, leaders in the field of autismresearch are looking for clues in the wiringof the brain that they hope will shed

light on one of modern medicine’s darkestsecrets: the cause of – and possiblecure for – autism.

How to Create Useful Knowledge from Pure Data

by Philipp Grätzel von Grätz

April 9, 2013 | Imagine a hospital where patient data from numerous sources is made accessible to ward physicians with the help of hyperlinks and intelligent indexing. Imagine a healthcare system that hands its patients – not an envelope or a CD-ROM – but an integrated dataset that allows them to truly understand their illness, and even use the Internet to obtain additional information. Imagine a radiologist who uses semantic technologies to navigate smoothly through the myriad imaging data. Welcome to the future of semantic technologies in health information retrieval.Professor Alexander Cavallaro’s vision of the educated lymphoma patient of the future is very different from today’s patient, who carries the computed tomography (CT) images of his lungs and abdomen home on a CD or DVD after a routine radiological examination. In Cavallaro’s vision of the future, the lymphoma patient would open his radiological report on a tablet-PC to find a document with the relevant hyperlinks – much like a webpage. The patient would learn, for example, that his spleen is enlarged. After clicking on “spleen,” the corresponding radiological image would appear. It would show exactly where the spleen is located and what it looks like. The patient would also learn that, although his spleen is still larger than normal, it is in fact considerably smaller than it was at his last radiological examination: a sign that the chosen cancer therapy is working.

Reaction: Another click would open a window listing hyperlinks to additional, context-specific patient information; for example, to the lymphoma pages of the Internet encyclopedia Wikipedia, to a patient self-help website or a drug database with patient information on the side effects and the importance of drug adherence.

Tracking an Elusive Thiefby Diana Smith

December 7, 2012 | A new era is dawning in the evaluation of Alzheimer’s disease, thanks to a hallmark imaging solution pioneered with the help of Siemens and a slate of dedicated researchers.

Alzheimer’s disease is truly one of the cruelest diseases that strikes the elderly, at the height of years that are supposed to be “golden.” Instead, the neuro-degenerative disorder snarls the body’s command center, slowly eroding brain function. It robs victims of their memory, steals the most basic of bodily functions and finally life, over a course that can last a decade or more.There is no known cure. Further, today’s most effective drug therapies for Alzheimer’s only assuage symptoms, doing very little to slow progression of the disease.Progressive mental decline and aging have been noted in history for hundreds of years. But it wasn’t until 1906 that a German physician, Alois Alzheimer, put together pieces of the puzzle, identifying a collection of brain cell abnormalities as a specific disease. When Alzheimer performed an autopsy on one of his patients who died after suffering for years with severe memory problems and confusion, he discovered dense deposits surrounding the nerve cells, and inside the cells, he observed twisted bands of fibers.Today, this degenerative brain disorder is named after him, and when found during an autopsy, these plaques and tangles mean a definitive diagnosis of Alzheimer’s disease.The brain lesions between cells are abnormal, insoluble protein deposits called amyloid plaques. Amyloid plaque is widely believed to be a precursor to another kind of abnormal protein, the neurofibrillary tangles (NFTs), or hairlike threads that exist within nerve cells of Alzheimer’s patients. Over time, amyloid plaque

and neurofibrillary tangles clump into a convoluted mess of blockages in the brain, halting normal nerve cell transmission. Reaction : many people have already experienced alzheimer’s deseas in the world, and many researches have been conducted but unfortunately there is no cure yet. Thus, many treatment have been conducted to patient’s experiencing this kind of illness.

“We Need to Reconsider Medicine.”by Philipp Grätzel von Grätz

December 7, 2012 | Returning to China in 1999, after a decade of cardiovascular research at two German university hospitals, Professor Junbo Ge turned his research into practice by helping to establish modern cardiology in a vast country that is experiencing rapid social change. His research in the 1990s taught Professor Junbo Ge to ask questions. Asking questions can also be helpful when considering the future of cardiology: Which diseases will be predominant in times of demographic change and urbanization? Do patients need so many catheterizations? How can therapy be optimized? Medical Solutions discussed these issues with the current President of the Asian-Pacific Society of Interventional Cardiology not on the top of a modern skyscraper in Ge’s hometown of Shanghai but back in Germany, in medieval Forchheim. The World Health Organization’s recent Global Atlas on Cardiovascular Disease Prevention and Control has once again identified cardiovascular diseases as the leading cause of death worldwide. And it says that this will remain the case until at least 2030. There are certain differences, though. In Europe and in the U.S., cardiovascular mortality is in fact falling. In many other countries, it is rising sharply. What is the situation in China?Ge: We have been witnessing huge changes in the spectrum of disease over the last thirty years or so. Before China started to open up to the West in 1977, we had many infectious diseases. The open policy brought more wealth to an increasing share of the Chinese population, which is good, of course. But it also led to lifestyle changes. As a consequence, we are now confronted with lifestylerelated diseases that have already been prevalent in the West for some time. We have more obesity, more diabetes, more hypertension. And these diseases have similar consequences in China like everywhere else in the world: The occurrence of cardiovascular and cerebrovascular disease has increased dramatically, and it continues to increase substantially every year. To illustrate what I mean: 30 years ago, when I was a fellow at medical school, I remember a patient with myocardial infarction who had all the typical electrocardiogram signs and enzymes that you would expect. This really interested me because it was so rare at that time. I even asked a co-fellow to swap shifts so I could observe the patient longer.

Reaction: Today, we have patients with myocardial infarction practically every day. And if I go through the wards of our department, at least 60 percent of all patients present with coronary artery disease [CAD].

Pediatric Hospital Delivers Hopeby Chris Kraul

December 7, 2012 | Armed with an ACUSON Cypress cardiovascular system, doctors from the Fundación Cardioinfantil clinic in Bogota take their diagnostic and clinical expertise into the most remote, impoverished areas of Colombia to offer help to families who would otherwise have no access to advanced medical care for their ailing children. The prognosis was grim for 11-year-old Nubia Quirino, the sickly daughter of an impoverished indigenous couple in Leticia, a steamy Amazon River port town in remote southeastern Colombia. She was born with

a host of complex heart problems, including just one atrioventricular valve instead of two. The death sentence she was living under was visible in her cyanosis, or blue-grayish complexion, her swollen toes and fingers, and her gasps for breath after the slightest exertion.Local doctors had told Nubia’s parents, Herminio and Zoila, that there was nothing they could do for the child and that she would be lucky to live to her quinceanera, the traditional 15th birthday celebration that is every Colombian girl’s rite of passage. “She has gotten weaker and weaker, so we were resigned to losing her,” says Herminio Quirino, a member of the Ticuna native community on the outskirts of Leticia, which is accessible only by boat or airplane.

Reaction: Many children in the world is experiencing this kind of trauma. Thus, it is important that hospital system in pediatric care must take this kind of problem more serious.

A Vision Becomes Realityby Tanja Berbalk

December 7, 2012 | At Astrid Lindgren Children’s Hospital in Stockholm, Sweden, a simple video-conferencing system revolutionized the way pediatric cardiology is practiced throughout Sweden. A sparsely populated country like Sweden needs intelligent healthcare solutions. How can the best healthcare that the country can offer be brought to remote areas? Bo Lundell, MD, head of the Pediatric Cardiology Department at Astrid Lindgren Children’s Hospital, had an idea about this. His department is the center of pediatric cardiology in this region, covering two million inhabitants in the Stockholm area and treating 300 inpatients and 7,000 outpatients per year. Lundell and his team have always discussed all kinds of heart problems with the other 34 pediatric cardiology teams in Sweden, until recently over the phone. But the hospitals mainly examine their patients using ultrasound systems, which usually produces videos. “Motions cannot be described over the phone. And especially in acute cases, sending files takes too much time,” says Lundell. He purchased a standard, off-the-shelf video-conferencing system and set up a communication center with monitors, cameras, microphones, and high-speed Internet to be able to access files in real-time. 

New ways of communicationThe system offers new ways to share and increase expert knowledge. If anyone in the network needs consulting on a complicated case, the doctor in charge can call his or her colleagues in Stockholm or elsewhere in Sweden. Lundell also organizes periodical conferences with all 34 children’s hospitals to discuss new and significant cases from which everyone can learn. The system can be a valuable tool to get a fast diagnosis, determine treatment, and prepare the patient’s transportation. Lastly, the implementation of the videoconferencing network streamlines workflows, making the entire Swedish healthcare system more efficient.

Reaction: Nationwide videoconferencing system in all 34 pediatric facilities that are connected to syngo Dynamics for data reviewing and storage. Easier way to share knowledge, More efficient healthcare system, Improved quality of life. Equality in treatment, regardless how remote the patients may live

Breast Cancer Awareness

Early detection is key! – our contribution to breast cancer awarenessFrom October 2011, the new global campaign “Turn your city pink! Raise awareness for breast cancer” will run for one year. Pink is the international color of breast cancer awareness and the goal of this campaign is to encourage participants to be creative and turn their city pink by taking action.“Turn your city pink”-actionParticipants can join pink charity runs, walk the city wearing pink, paint something pink, or distribute informative flyers about methods of early detection. Pink participants will be able to upload pictures or

videos of their creative activity to the campaign Website and share them with friends to spread even more awareness.Siemens will reward each entry with a donation of five US-dollars to a selected charity and the most popular entry wins a pink City iPad* each month (valid only from October 2011 to July 2012). The participants can select from the following organizations to be the recipient of the donation: Susan G. Komen for the Cure, the Breast Health Global Initiative, the International Breast Cancer Research Foundation, and the American Cancer Society.

Reaction: Early detection can save lives. In the early stages, the tumor is still small and the risk of metastases is significantly lower. Women who are informed about the risks, the medical care that is available to them, and receive regular screenings can help increase the chance of detecting potentially harmful tumors early.

Immediate Imaging Insight

How reviewing images from different modalities helps improve diagnosisJuly 11, 2013 | Medical experts today often have access to images from a variety of modalities, such as positron emission tomography (PET), computed tomography (CT), or magnetic resonance imaging (MRI); great numbers of images from prior examinations; and visual data from other sources. When looking at a patient with a known malignant disease, for example, the prior images – possibly even from a different type of modality – might provide the decisive information for an accurate assessment of the disease status.On the way to the clinic.A patient wants to know the reason for the pain in her back. As she was diagnosed with breast cancer a while back, she is anxious to find out whether the back pain has got anything to do with her cancer.

Go to nuclear medicine.Her doctors at Erlangen University Hospital in Germany decide to combine scintigraphy and CT to check whether the pain might be caused e.g. by bone metastases in the spine or by some kind of inflammation.

Preparing for a scintigraphy.For a scintigraphy, a radiopharmaceutical tracer is administered. The patient has to wait a while until it is evenly distributed in the body before the examination starts.

The scintigraphy is done.It shows regions of high metabolic activity. Together with the scintigraphy, a CT examination is performed. CT provides images of the bones.

Fusing the CT and scintigraphy with syngo.via1.Fusing the information from the two modalities is easy and efficient to handle and indicates the high metabolic activity and therefore the supposed source of the pain was not located within a vertebra but rather between two vertebrae. Radiologist Dr. Rolf Janka and his colleague Dr. Torsten Fritscher from nuclear medicine discuss the findings. The patient is relieved.Dr. Janka tells her that it became clear that with a very high probability her pain was an orthopedic rather than an oncological problem. He hands her a CD with all her imaging data and the reports and wishes her well.Reaction: It is also very important to have a systematic medical check up for every person.

Maternal Screening Solutions Showcased at ISPDHealthcare News | May 21, 2013

The International Society for Prenatal Diagnosis (ISPD) consists of physicians, laboratorians, and researchers interested in prenatal diagnosis and therapy. Visit Siemens at booth #10 at the 17thInternational Conference in Lisbon, Portugal from June 2-5, 2013, to learn how Siemens partners with clinicians to achieve our joint mission of fighting the most threatening diseases.Siemens’ broad menu of diagnostic tests provides prenatal care with confidence, with a wide range of systems to assist the needs of any size hospital or laboratory. With a unique combination of assays, instruments, and software for maternal screening, clinicians can get total fertility testing solutions from a single source. Our maternal screening program includes a comprehensive test menu used in conjunction with specialized PRISCA1 software to help doctors make more informed decisions about prenatal risk.

Reaction: Siemens Healthcare, a global leader in clinical diagnostics, imaging, and healthcare IT, offers a comprehensive portfolio of products helping clinicians manage patients throughout the continuum of care.

New Aid to Diagnose Diabetes and Identify At-Risk PatientsHealthcare News | May 06, 2013

Practice preventive healthcare with trusted technologyOf the 371 million people living with diabetes in 2012, half were undiagnosed1. Convenient, in-office HbA1c testing can help physicians fight this epidemic on the front lines. The DCA® HbA1c test kit, used for more than two decades to monitor patients, can now be used as an aid to diagnose diabetes and identify patients at risk for developing the disease. The dual use kit, for both monitoring and diagnosing, will be available for sale in EU countries and countries not requiring any local regulatory clearances under part #10698915 after May 2013.Siemens’ commitment to fighting the most threatening diseases includes efforts targeting chronic diseases like diabetes. Early detection and tight glycemic control help mitigate the serious conditions that accompany diabetes: heart and kidney disease, limb neuropathy, retinopathy, and stroke. More importantly, patients identified as being at risk can stop or reverse disease progression through lifestyle adjustments and/or pharmacological treatment. Availability of results at the time of visit provides healthcare providers and educators the opportunity to have meaningful, face-to-face discussions regarding treatment options. From a convenience and scheduling standpoint, it eliminates multiple visits for pre-visit blood draws or post-testing follow-up consultation.

Reaction: The expanded utility of the DCA HbA1c test kit builds on Siemens track record of proven peformance. Featuring technology that has been highlighed in more than 140 clinical articles, DCA™ systems are used by three out of four phyisicians who peform HbA1c testing in the office2. The DCA Vantage®Analyzer is just one of two point-of-care HbA1c analyzers that meet NGSP 

Vitamin D showcased at 2013 Endocrine SocietyHealthcare News | May 30, 2013Clinical and Analytical Factors Impacting Vitamin D ResultsPaul E. Sibley, PhDSiemens Healthcare Diagnostics

Vitamin D research continues to cover a broad spectrum — clinically and analytically. Siemens is pleased to present an educational seminar that will discuss how clinical and analytical factors such as C3-epimer, vitamin D binding protein (DBP), and D2 supplementation may impact vitamin D values, and how this may impact clinical decisions. It will also discuss how initiatives like the NIH Office of Dietary Supplements Vitamin D Standardization Program (VDSP) will improve standardization of results.

Take your endocrinology practice to the next level.Siemens is here to provide answers. Visit our booth. Attend our educational workshop. Stop by the poster sessions. At ENDO 2013, you will find answers that help you transform your hospital and laboratory operations and set new standards in patient care. 

Reaction: Our comprehensive product portfolio includes fully coordinated laboratory diagnostics, point-of care testing, and imaging technology. Siemens solutions can help you thrive

Practical Automation for the Hematology WorkflowHealthcare News | Jan 11, 2013

Introducing CellaVision Digital Cell Morphology SystemsThe easy-to-use CellaVision analyzers save time, streamline labor-intensive processes, and enhance cell analysis and classification to support optimum patient care.Models to Suit Both High- and Mid-Volume LabsThe systems are available in two models: The CellaVision DM1200 System analyzes up to 20 slides/hour, while the CellaVision DM96 System is capable of analyzing 35 slides/hour with a continuous feed. Both systems easily integrate with Siemens ADVIA® hematology products and adapt to any hematology workflow..

Proven, Easy-to-Use Technology

The CellaVision systems produce high-quality, consistent slide images, which can be viewed on a single digital screen and magnified for additional detail. The easy-to-use software allows users to define reference cells and compare individual cells simultaneously, while adding pre-coded or free text comments to any slide, cell class, or specific cell.

The Next Level in Practical AutomationCapable of automating cell location and pre-classification processes, the systems reduce the time required for experienced laboratory technologists to screen each blood smear, allowing them to use that time more efficiently. The systems' continuous feed of slides also enables the escalation of workloads without increasing labor.

Improved Networking and CollaborationAdditionally, the CellaVision systems boost networking and collaboration capabilities through a shared database. This allows an organization to store cell images centrally and engage experts from anywhere in the network, collaborating in real time to speed decision-making. The shared database enables users to build expertise, trend and compare patients' progress over time, and access historical patient images and information.

The Partner of Choice for Any Hematology WorkflowAs the partner of choice for a highly-automated hematology workflow, Siemens is proud to pair market-leading digital cell morphology systems from CellaVision with the service, support, training, and educational resources customers have come to expect from us.Learn how the CellaVision Digital Cell Morphology Systems can help streamline and accelerate blood cell differentials.

Reaction: Siemens Healthcare Diagnostics is pleased to announce the introduction of the CellaVision® Digital Cell Morphology Systems. Now widely available, these analyzers utilize proven digital image analysis technology to locate and examine cells in blood and other body fluids, automating the time-consuming, manual effort associated with traditional microscopy.

A mobile clinic for kids in KoreaHealthcare News | Oct 08, 2012.

Siemens Korea has launched ”Siemens Mobile Clinic”, a mobile free healthcare check-up service for underprivileged children available across the country. First full-integrated free medical diagnosis service for childrenSiemens Mobile Clinic checks children’s height and weight, eyesight, blood, urine, and hearing and offers electrocardiogram and ultrasound examinations in order to check children’s growth and the status of their health. For this purpose, the Mobile Clinic is equipped with an ACUSON X300™ PE ultrasound system, a CLINITEK Stratus®+ Urine Analyzer and the audiometer Unity 2. Indeed, the main priority of the campaign is to help children improve their health and growth by reducing the possibility for diseases to occur and providing necessary medical services at the right time. Thanks to positive medical support from KSR Volunteer Group, an electrocardiogram examination has been included in the program to provide a high-quality health check-up service for all children.Siemens offered the first free health check-up service to 50 children in Youngeun Evergreen Community Children’s Center located in Gunpo, Gyeunggi Province. Following this first service, Siemens is planning to take its Mobile Clinic to nine child welfare centers in eight regions across the country, including in Gwangju, Daegu, Iksan, and Jeonju, every month on a regular basis until the end of 2012.

Comic book to teach children in healthcareAlong with free health check-up, Siemens is distributing a free cartoon healthcare booklet, entitled “Go MediKids! Adventure Inside Human Body,” to help children take an interest in their health and encourage them to become more healthy.Through this campaign, Siemens in Korea has shown how it continues to take the initiative in helping children, our future, receive regular essential health check-ups regardless of their economic status and thus protect their right to health. Siemens will continue to run the Mobile Clinic and do its best to brighten the future of the Korean society through implementing social responsibility activities such as the Mobile Clinic

Reaction: Siemens Mobile Clinic, operated jointly with social welfare organization Kids & Future Foundation, the medical volunteer group of the Korean Society of Radiology (KSR Volunteer Group), and the Korean Society for Laboratory Medicine, is a campaign in which a volunteer team composed of healthcare professionals and Siemens employees visits communities and provides free healthcare check-up service using a large-sized bus equipped with Siemens ultrasound equipment and diagnostic medical devices from Hearing Aids and Diagnostics Divisions.

Research data on tau proteinHealthcare News | Oct 01, 2012

Colleagues at Siemens Healthcare's Molecular Imaging team recently published research data on a compound that selectively targets neurofibrillary tangles (NFTs) of tau protein, one of two prominent hallmark of Alzheimer’s disease. Tau as Alzheimer’s hallmarkNFTs of hyperphosphorylated tau protein are one of two critical protein abnormalities, Amyloid and Tau, associated with Alzheimer’s disease and are considered to be target for therapeutic intervention, in addition to being imaging biomarker for diagnostic in vivo imaging agents. The severity of tau abnormalities and NFT burden consistently correlates with the degree of cognitive impairment and neuronal circuitry deterioration associated with Alzheimer’s disease dementia, whereas the presence of senile brain plaques lack that correlation. For this reason, NFT can potentially be an additional imaging biomarker for Alzheimer’s-related dementia, in addition to the recently released and in clinical use Amyloid imaging biomarker.

Research on the compoundA research team led by Hartmuth C. Kolb, PhD, vice president of Molecular Imaging Biomarker Research at Siemens Healthcare, designed, synthesized, and tested more than 900 compounds in an effort to identify [18F]-PET tracers that possess strong binding affinity and selectivity toward tau protein tangles. Researchers created a competitive autoradiography assay to test compounds that would bind to native tau tangles and beta-amyloid plaques on sections of postmortem human brain tissue. In in vitro assays, the compound [18F]-T808 displayed a high level of binding affinity and good selectivity for tau aggregates. The compound demonstrated rapid uptake and washout in rodent brains. The researchers’ in vivo and in vitro studies suggest that [18F]-T808 possesses suitable properties and characteristics to be a specific and selective Tau PET tracer for the imaging of paired helical filament tau in human brains. [18F]-T808 is the first highly selective and specific PET tracer with potential for in vivo neurological imaging of tau pathologies.

Reaction: The [18F]-T808 compound is used in positron emission tomography (PET) imaging and is being developed as a potential agent for commercialization. The data appeared in the study “A Highly Selective and Specific PET Tracer for Imaging Tau Pathologies” and was published in the August 2012 issue of the Journal of Alzheimer’s Disease.

How to cope with the cardiovascular epidemicHealthcare News | Sep 12, 2012

Changes in demography and lifestyle are leading to an increase in cardiovascular morbidity and mortality. Professor Junbo Ge, President of the Asian-Pacific Society of Interventional Cardiology, pleads for better lifestyle education and improved access to cardiovascular diagnosis and treatment.China is a perfect example of what is driving cardiovascular diseases in many parts of the world. “We have been witnessing huge changes in the spectrum of disease,” says Professor Junbo Ge. “The open policy of the last 30 years has brought more wealth, but also more lifestyle-related diseases like hypertension, hyperlipidemia, obesity, and coronary artery disease.“

The consequence is that China is currently witnessing a steep increase in the number of patients and cardiovascular treatments required. The number of cardiac interventions in China has risen from around 4,500 in 1999 to more 300,000 today. This number is set to rise even further, says Ge, since there are still huge discrepancies in access to cardiovascular care between different parts of China. “Companies like Siemens have a lot of responsibility here. They should be helping to train young doctors to use the available technologies properly. But better access to treatment is only one way to improve cardiovascular care. Ge believes that investing in education is even more important: ”We have to tell people what a better and healthier life looks like.

Reaction: Many people are simply not aware of how to live healthily.” The emerging middle class is particularly vulnerable when it comes to lifestyle-related diseases. One reason, says Ge, is that one of the first things people do when they become wealthier is change their eating habits.

Healthcare IT solutions open up new dimensionsHealthcare News | Sep 12, 2012

The emergency department at Fernando Fonseca Hospital is one of the busiest in Portugal. The unit sees up to 800 emergency patients each day. The state-run hospital in Amadora, a city of 180,000 just outside Lisbon, serves about 700,000 people in the local area – and growing.

Still, numbers like these are no longer a headache for Professor Henrique Martins, MD, the hospital’s Chief Medical Information Officer. Since July 2011, the clinical IT system Soarian® Clinicals, which was specially adapted by Siemens to accommodate the Manchester Triage System (MTS) for the evaluation of emergency patients, has been installed in all emergency departments.The triage system, which is used for initial assessment of the urgency of treatment and is embedded in the Soarian Clinicals Emergency Department (ED) module, helps make processes faster and simpler in order to get the emergency department ready for growing challenges. “Using the MTS system supported by Soarian Clinicals to quickly categorize treatment priorities and to provide direct access to findings and data by attending physicians has made our work in the emergency department faster and more efficient,” Martins explains.

A comprehensive viewThere are plans to equip the other units in the hospital with the IT system by the end of 2012. From admitting a patient in the emergency department up to the point of discharge from the hospital, all information will be fed into the system.Supporting the triage system with Soarian has a number of advantages, Martins explains: “Soarian makes processes more transparent and minimizes duplication of work. Now, everyone who needs the information – be they in the emergency department, the operating theatre, or in the wards – can always see what has already been done with a patient and what steps still need to be taken.”Although the work of an emergency department is difficult to plan, the IT system allows doctors to maintain a comprehensive view of what is going on throughout the emergency department, plan processes better in advance, and respond to possible peak periods and staffing shortages..

Soarian helps save time and moneySoarian also helps the hospital save on costs since orders for tests or X-rays, for example, can be performed much faster due to the direct access the system offers to individual departments, Martins explains.

Reaction: The time and cost savings are considerable. And that is certainly an interesting aspect, particularly during the current economic crisis

Significant changes thanks to hybrid surgeryHealthcare News | Aug 27, 2012

Today, Japan’s population is living longer than ever, but that also means a higher national incidence of elderly patients needing heart valve replacements. Siemens is collaborating with surgeons at Kurashiki Central Hospital to introduce lower-risk catheter-based procedures that eliminate the need for open-heart surgery in many of these cases.Kurashiki Central Hospital is among three Japanese medical institutions whose multidisciplinary surgery teams conducted clinical trials of catheter-delivered Edwards prosthetic valves over the past year. All of these institutions are equipped with Siemens hybrid rooms – a conventional operating room (OR) equipped with an angiography system to allow for both open and minimally invasive treatment in one room. The first round of clinical trials is especially important in Japan, where many elderly people among the aging population are outliving the normal lifespan of their heart valves. Catheter delivery minimizes or eliminates the need for open-heart surgery along with the trauma of opening large parts of the thorax. The patient also spends far less time in surgery, and there is no longer a need for external blood circulation with a cardiopulmonary bypass machine.

A multi-disciplinary team in a multi-disciplinary room“The methods for implanting heart valves cannot be learned on one’s own because close teamwork is essential among the different specialists, including interventional cardiologists, echocardiographers, imaging specialists, and heart surgeons like myself,” says Tatsuhiro Komiya, MD, Chief of the hospital’s Cardiovascular Surgery Department.

The Kurashiki heart team is focusing on two different options for catheter-delivered replacements of the heart valves, transapical and transfemoral. The aortic valve from Edwards is replaced through a transapical insertion on a valve-mounted catheter, which is introduced through a surgical puncture into the apex of the left ventricle. Kurashiki Central and two other hospitals – in Osaka and Sakakibara – are now tracking the recuperation phase of some 50 patients who volunteered for the heart valve trials. Among this cohort, some also received Medtronic’s CoreValve, an aortic valve that is being implanted via the femoral arteries instead of the apex of the heart..

Positioning mattersNavigation of a valve into the correct location demands orchestration of many components, including several high-tech imaging modalities, intensive planning and preparation, real-time monitoring, and multidisciplinary collaboration in ensemble. “A vast amount of planning precedes the operation,” Komiya states. Echocardiograms, pre-operative computed tomography and intra-operativesyngo® DynaCT images provide the heart team with a three-dimensional schema of the target region.The aortic valve trials at Kurashiki Central have spurred development of valves of smaller diameter that are more suitable for Japanese patients who on average are smaller than European or American patients.

Reaction: The technique is rapidly developing, and Japanese patients and physicians are expressing enthusiasm,” Komiya concludes. “This is a new frontier for medical science and surgical practice worldwide and here in Japan.

Monitoring immunosuppressant drugsHealthcare News | Jun 08, 2012

Making transplants work: In Bristol, UK, the Bristol Royal Infirmary uses the Siemens’ Viva-E® Drug Testing System and Dimension® Integrated Chemistry System to monitor the concentration of immunosuppressant drugs (ISDs). The results of such testing are vital to the success of organ transplants. Demand for organ transplants – especially kidneys – outpaces the supply of donated organs worldwide. The body’s natural defences will try to reject the grafted organ and must be overcome using ISDs. While many health facilities are switching to outsourced laboratory services, there are important advantages to doing testing in-house with ISD monitoring: Bristol Royal Infirmary (BRI) is a good example of how well this can work.

Walking the tightropeTransplant recipients run risks from insufficient ISD concentrations, which may lead to organ rejection, or excessive ones, which can cause infections and cancers. So their blood must regularly be checked for both situations. The Siemens analyzers can do this and offer an alternative to mass spectrometry or chromography. BRI has embraced Siemens technology and as a result has brought ISD monitoring in-house. It was previously carried out externally. This is important, as organ transplant demand continues to grow, given an aging population and medical advances.

Speed and costOne advantage is that ISD tests can now be done in 30 minutes, compared to a day previously. “With transplants, a 24-hour delay can be enough for rejection of the newly grafted organ,” explains Amy Hayes, Senior Biomedical Scientist. Her boss, Chief Biomedical Scientist Carolyn Perry, describes another key benefit: “I could teach anyone to use the system properly within two hours, whatever their background.

Reaction: Both the reduced training requirement and the avoidance of charges for external testing are important economic benefits for BRI. Maintenance needs are also minimal and generally covered by a visit from Siemens every four months.

Brain plaques in multiple sclerosis patientsHealthcare News | Apr 05, 2012

From black holes…T1-weighted sequences are used to differentiate irreversible brain tissue damage commonly called “black holes”. Black holes are associated with the progression of MS and cerebral atrophy. Spin-echo T1-weighted images show a proportion of T2 hyperintense lesions or black holes that appear hypointense to the surrounding normal-appearing white matter for an extended period of time. The study included 20 patients with relapsing-remitting MS from the outpatient clinics of the NeuroCure Clinical Research Center. There were 11 male and nine female patients with a mean age of 42 years and mean disease duration of 3.1 years. For comparison purposes, 14 healthy control subjects also were enrolled. All 34 subjects received brain scans using the 7 Tesla MAGNETOM MRI system from Siemens with a 24-channel head coil. In addition, a subgroup of 18 patients with MS received brain scans with a 1.5 Tesla system.

…to clarity in imagingThe analysis found that the use of MPRAGE in 7T provided evidence for a total of 728 lesions, compared with 584 lesions with 7 Tesla FLASH and 399 lesions with conventional 1.5 Tesla MPRAGE. In addition, 7 Tesla T2-weighted FLASH revealed 604 cerebral lesions in the patients with relapsing-remitting MS, with a mean of 30.2 lesions per patient. T1-weighted MPRAGE at 7 Tesla is highly sensitive in detecting multiple sclerosis plaques within white and gray brain matter, and the technique depicted structural damage in each lesion.

Reaction: In MAGNETOM 7T At the NeuroCure Clinical Research Center at Charité Medical University in Berlin, researchers used MAGNETOM 7 Tesla1 magnetic resonance imaging (MRI) system with an A T1-weighted magnetization-prepared rapid acquisition and multiple gradient-echo (MP-RAGE) protocol helps to clearly visualize cortical lesions in multiple sclerosis (MS) patients.

What is liver fibrosis?

Liver fibrosis is the scarring process that represents the liver’s response to injury. In the same way as skin and other organs heal wounds through deposition of collagen and other matrix constituents so the liver repairs injury through the deposition of new collagen. Over time this process can result in cirrhosis of the liver, in which the architectural organization of the functional units of the liver becomes so disrupted that blood flow through the liver and liver function become disrupted. Once cirrhosis has developed, the serious complications of liver disease may occur, including portal hypertension, liver failure and liver cancer. The risk of liver cancer is greatly increased once cirrhosis develops, and cirrhosis should be considered to be a pre-malignant condition. Cirrhosis and liver cancer are now among the top ten causes of death worldwide, and in many developed countries liver disease is now one of the top 5 causes of death in middle-age.1,2

 The biology of liver fibrosis The main liver cells that produce matrix are Hepatic Stellate Cells (HSC). This resident cell population exist in a resting phenotype as the body’s major store of vitamin A. However on activation they transform to adopt a myofibroblast phenotype capable of secreting collagen. This fibrous tissue can then be remodelled through digestion of matrix by matrix metaloproteinases (MMPs). In turn the digestion of matrix is checked through the inhibition of MMPs by tissue inhibitors of matrixmetaloproteinases (TIMPs) of which TIMP-1 is of major importance. Liver fibrosis, previously thought to be merely the accumulation of scar tissue, is now recognised to be a dynamic process that can progress or regress over periods as short as months.3

 

What are the causes of liver fibrosis?All chronic liver diseases (CLD) can lead to liver fibrosis. Over many years the principle causes of CLD have been chronic viral hepatitis B (CHB) and alcoholic liver disease (ALD). While rates of alcoholism and ALD are falling in many countries, hazardous drinking amongst young people is resulting in alarming rates of ALD in several northern European countries.4,5 Over the last few decades two other diseases have emerged to make a major contribution to the burden of CLD. Chronic hepatitis C (CHC) and non-alcoholic fatty liver disease (NAFLD) are recognised to have already had a major impact on CLD incidence. Hepatitis C virus (HCV) is transmitted in blood and blood products through unsafe injection practices and the therapeutic use of infected blood products. It is thought that the world prevalence of CHC is nearly 200 million people.6,7 In the developed world with rapidly increasing rates of obesity, NAFLD is considered to represent a major cause of significant fibrosis.

Reaction: Although it appears that only a minority of patients with NAFLD (maybe 20%) develop significant fibrosis, due to the vast prevalence of the at-risk overweight population, NAFLD may give rise to an epidemic of liver fibrosis.

Orthopedic and Trauma SurgeryOperating with confident guidance

Minimally invasive procedures are also becoming more and more commonplace in orthopedic and trauma surgery. This is partly due to cost pressures and time constraints, but primarily in the effort to minimize tissue damage and improve patient recovery time.Advanced imaging tools such as C-arms offer surgeons ideal support. The use of navigation in spine surgery can increase the precision of procedures while also saving time and dose. 3D imaging provides excellent support for delicate placement tasks, reduces the rate of second interventions, and has revolutionized the entire workflow.

Reaction: this is one of the medical innovations that is very important to be developed and introduced often to the public.

Physician Information

3gAllergy Helps Screen, Diagnose, and Monitor PatientsAllergies are often inherited. Children with one or more allergic parents should be assessed for atopic risk by testing for specific IgE to common food and inhalant allergens. A clinical history of skin, gastrointestinal, or respiratory symptoms that are suggestive of allergy often prompts a pediatrician or family doctor to prescribe specific IgE testing. Food allergies are more frequently seen in young children, while inhalant allergies usually appear later in childhood. Consequently, it is recommended that children under the age of 2 be tested for specific IgE (antibodies) to common food allergens initially, and then tested for inhalant allergies when they get older. The 3gAllergy™ assay is a third-generation allergen-specific IgE assay that aids in the diagnosis and early treatment of allergy patients. The 3gAllergy assay delivers fast and accurate results to help enhance the quality of care and service provided to the patient.

Reaction: The 3gAllergy proven technology assay can be used by physicians to identify, monitor, and manage patients with allergic diseases