VMW Monthly - August 2010 - ISSN 1388-722X



Virtual Medical Worlds is a monthly Virtual Magazine on Telemedicine and High Performance Computing and Networking for readers interested in computer applications in medical environments. VMW is produced by an editorial team composed of professionals in publishing, and an advisory board with professionals in telemedicine, providing the embedding into the everyday practice and research. Check out the VMW Web site for the calendar of events, the various services, and the friendly advertising rates.

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*** Highlights from the International Supercomputing Conference 2010 in Hamburg ***

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Contents August 2010 Issue

 
Cross-Atlantic state-of-the-art
 
Pinpoint precision: Delivering a biochemical payload to 1 cell
Students design early labour detector to prevent premature births
University of Maryland School of Medicine receives $7,9 million grant for 'super' research magnet
Scientists design new delivery device for gene therapy
Environmental Exposure Modules for EHR and PHR Systems
 
Grid for Health
 
IBM partners with University of Missouri on Genomics Research Initiative
Rice programme takes on protein puzzle
New supercomputer connection speeds genetic research
ActiveHealth and IBM pioneer Cloud computing approach to help doctors deliver high quality and cost-effective patient care
Fujitsu launches supercomputer for anticancer drug development simulations
 
Healthcare compunetics
 
Atos Origin co-ordinates the Reaction project to monitor diabetes patients remotely
CellTrak mobile technology improves client care in Vancouver for the Community Home Support Services Association
CMS Telehealth partners with MedApps for personalized health care management of chronic conditions
Health care using telephone and telemonitoring technology benefits heart failure patients
Electronic Dental Records (EDR): 'Open Source' and Commercial-Off-The Shelf (COTS) Solutions
 
Industrial Chemist's Corner
 
GE and Intel to form new health care joint venture
Philips and Dako join forces in digital pathology
Agfa HealthCare and TomTec partner on echocardiography analysis and measurement solution
HP assists health care providers with electronic health record migration and management
Health Robotics continues growing expansion in Europe, America and Asia
 
Planet Europe in Action
 
Turning remote control into intimate support
Climbing to the next level: the German Virtual Liver Network
Playing with pills: Students gaming for knowledge
Going live to the beating heart
Wii-like technologies may help stroke survivors improve communication skills
 
The 21st century hospital
 
CSC survey reveals hospitals' focus on meaningful use and challenges in meeting incentive requirements
St. Clair Hospital, Preferred Healthcare Informatics, and GE Healthcare collaborate to create one of the most integrated electronic health record systems
Peking University People's Hospital partners with IBM to build China's first evidence-based patient centric care system
Innovative imaging system may boost speed and accuracy in treatment of heart rhythm disorder
Childrens Hospital Los Angeles eye surgeon prevents blindness in five premature infants in Armenia through new international telemedicine project
 
Virtual snap shots
 
New book encourages health care organisations to join the social media conversation
NIST software security patent to help improve health IT privacy
Electronic health records prime clinicians to provide progressive care to older adults
Scientists use computer algorithms to develop seasonal flu vaccines
Transinsight launches new version of its Enterprise Semantic Intelligence Knowledge Suite at the 2010 I-SEMANTICS
 
VMWC news bites
 
'Asynchronous telepsychiatry' found effective for assessing patients' mental health
New Invention at the Weizmann Institute enables severely disabled people to communicate and steer a wheelchair by sniffing
MIT researchers create fibers that can detect and produce sound
Engineering could give reconstructive surgery a facelift
First NOTES transoral and transvaginal gallbladder removals performed as part of United States multicentre human trial
 

Leads August 2010 Issue

 
Cross-Atlantic state-of-the-art
 
Pinpoint precision: Delivering a biochemical payload to 1 cell
Full ArticleImagine being able to drop a toothpick on the head of one particular person standing among 100.000 people in a stadium. It sounds impossible, yet this degree of precision at the cellular level has been demonstrated by researchers affiliated with the Johns Hopkins University Institute for NanoBioTechnology. Their study was published on-line in June in Nature Nanotechnology. The team used precise electrical fields as "tweezers" to guide and place gold nanowires, each about one-two hundredth the size of a cell, on predetermined spots, each on a single cell. Molecules coating the surfaces of the nanowires then triggered a biochemical cascade of actions only in the cell where the wire touched, without affecting other cells nearby. According to the researchers this technique could lead to better ways of studying individual cells or even cell parts, and eventually could produce novel methods of delivering medication.
Students design early labour detector to prevent premature births
Full ArticleThe birth of a baby is usually a joyous event, but when a child is born too early, worrisome complications can occur, including serious health problems for the baby and steep medical bills for the family. To address this, Johns Hopkins graduate students and their faculty adviser have invented a new system to pick up very early signs that a woman is going into labour too soon.
University of Maryland School of Medicine receives $7,9 million grant for 'super' research magnet
Full ArticleThe University of Maryland School of Medicine has received a $7,9 million federal grant to acquire a superconducting 950 MHz Nuclear Magnetic Resonance (NMR) magnet that will help researchers unravel the mysteries of molecules and develop new agents to treat cancer, AIDS and other diseases. The grant is among the largest of its kind ever awarded by the National Center for Research Resources (NCRR), which is part of the National Institutes of Health. The funds were made available through the American Recovery and Reinvestment Act of 2009.
Scientists design new delivery device for gene therapy
Full ArticleScientists have designed a nanoparticle that appears to effectively deliver genetic material into cells with minimal toxic effects. In lab experiments, the researchers have found that this device, a vector, is able to deliver DNA deeply enough into a cell to allow genetic material to be activated - a critical step in gene therapy. This vector is between 2,5 and 10 times more effective than other experimental materials, according to the research.
Environmental Exposure Modules for EHR and PHR Systems
Full ArticleWhile there has been tremendous progress over the past decade in the design and development of electronic health record (EHR) and personal health record (PHR) systems, we still have a long way to go. Over the next decade we will see the emergence of new software modules that will be incorporated into the EHR and PHR systems of the future. These will include genetic information, environmental exposure data, integrative medicine software modules, and more. This article is aimed at providing managers of health IT and health care provider organizations with a high level overview of health information projects or systems designed to capture data related to an individual's exposure to occupational and environmental hazards. In particular, we will be honing in on exposure initiatives that include some form of interface to EHR and PHR systems.
 
Grid for Health
 
IBM partners with University of Missouri on Genomics Research Initiative
Full ArticleIBM and the University of Missouri (MU) have launched a life sciences research initiative using IBM high performance computing technologies to advance the school's bioinformatics research projects. The goal of the initiative is to develop a first-of-a-kind Cloud computing environment for genomics research collaboration at a regional level. In a Cloud computing environment, services and storage are accessed over public or private networks. The joint IBM-MU genomics Cloud would make possible large scale sharing and collaborative scientific discovery in a broad range of fields, helping advance bioinformatics research projects already underway at MU that have the potential to improve peoples' lives.
Rice programme takes on protein puzzle
Full ArticleAll proteins self-assemble in a fraction of the blink of an eye, but it can take a long time to mimic the process. And there has been no guarantee of success, even with the most powerful computers - until now. Rice University researchers have come up with a computer programme to accurately simulate protein folding dramatically faster than previous methods. It will allow scientists to peer deeper into the roots of diseases caused by proteins that fold incorrectly.
New supercomputer connection speeds genetic research
Full ArticleA Cox Business light-speed computer connection coupled with advanced, military-grade technology now provides Translational Genomics Research Institute (TGen) with the United States' fastest supercomputer link among life-sciences facilities. This enhanced capability moves data 100 times faster between TGen and Saguaro 2, Arizona State University's (ASU) supercomputer, accelerating TGen's molecular research into diseases such as Alzheimer's, diabetes and many types of cancer. The transfer and processing of data sets containing trillions of bits of DNA information that once took more than a week will now be done in just a few hours.
ActiveHealth and IBM pioneer Cloud computing approach to help doctors deliver high quality and cost-effective patient care
Full ArticleIBM and ActiveHealth Management, an Aetna subsidiary, have unveiled a new Cloud computing and clinical decision support solution that will enable medical practices, hospitals and states to change the way they deliver health care, providing better quality care at a lower cost. IBM and ActiveHealth Management worked together to create the Collaborative Care Solution that gives physicians and patients access to the information they need to improve the overall quality of care, without the need to invest in new infrastructure.
Fujitsu launches supercomputer for anticancer drug development simulations
Full ArticleFujitsu and the Research Center for Advanced Science and Technology (RCAST) at the University of Tokyo have jointly built a supercomputer system for use in the development of drugs to treat cancer relapse and metastasis. The new system began operations on August 1, 2010. The new supercomputer is a cluster employing Fujitsu's PRIMERGY BX922 S2 blade servers. Comprised of 300 nodes, the system features a theoretical peak performance of 38,3 teraflops and will be utilized in performing simulations to design genome-based antibody drugs that treat the relapse and metastasis of cancer.
 
Healthcare compunetics
 
Atos Origin co-ordinates the Reaction project to monitor diabetes patients remotely
Full ArticleAtos Origin, an international information technology (IT) services company, is co-ordinating the European project, Reaction, for the remote monitoring of medical information related to diabetes patients and their treatment and health care. The strict monitoring of blood sugar levels is necessary in order to be able to administer the correct dose of insulin to each patient.
CellTrak mobile technology improves client care in Vancouver for the Community Home Support Services Association
Full ArticleOne of CellTrak's latest clients, Community Home Support Services Association (CHSSA) supports elderly people who live with physical and/or developmental disabilities in their homes. CHSSA provides a variety of health care services during in-home client visits by their community health workers (CHWs). Traditionally all these visits were recorded on paper along with older technologies, like voicemail, copies and faxes. Making sure that schedule changes and care plan changes were up to date and received by the CHW's became quite a problem for both the administrative and field staff.
CMS Telehealth partners with MedApps for personalized health care management of chronic conditions
Full ArticleCMS Telehealth, a provider of telehealth services and systems to promote patient self-management and remote patient monitoring to health care and related organisations, has signed a reseller partnership with MedApps Inc. for its FDA-cleared MedApps Mobile Health Monitoring System, featuring HealthPAL.
Health care using telephone and telemonitoring technology benefits heart failure patients
Full ArticleProviding patients with chronic heart failure access to remote monitoring, for example by telephone or telemonitoring using wireless technology, reduces deaths and hospitalisations and may provide benefits on health care costs and quality of life. These are the conclusions of a new Cochrane Systematic Review by an international team of researchers.
Electronic Dental Records (EDR): 'Open Source' and Commercial-Off-The Shelf (COTS) Solutions
Full ArticleApproximately 90 percent of all dentists in the U.S. now use computers in their practice. Dental informatics, a subfield of health informatics, is focused on the application of computers, telecommunications, and information science to improve all aspects of dental practice, including management, clinical care, education, and research. Use of electronic dental record (EDR) systems can boost a practice's bottom line, while directly benefiting patients. They can help reduce operating costs, streamline workflow, improve quality of care, and enhance patient safety. This article is designed to offer a high level overview on the development of computerized dental systems to date, highlighting examples of selected 'open source' and commercial-off-the-shelf (COTS) solutions. The article also offers a set of conclusions on the current state of dental information systems and a number of management recommendations.
 
Industrial Chemist's Corner
 
GE and Intel to form new health care joint venture
Full ArticleGE and Intel Corporation have entered into a definitive agreement to form a 50/50 joint venture to create a new health care company focused on telehealth and independent living. The new company will be formed by combining assets of GE Healthcare's Home Health division and Intel's Digital Health Group, and will be owned equally by GE and Intel. Pending regulatory and other customary closing conditions, the joint venture is expected to become operational by the end of the year. Financial terms were not disclosed.
Philips and Dako join forces in digital pathology
Full ArticleRoyal Philips Electronics and Dako, a Danish company specializing in tissue-based cancer diagnostics, have signed an agreement to integrate a selection of Dako's image analysis applications into Philips' future digital pathology solutions.
Agfa HealthCare and TomTec partner on echocardiography analysis and measurement solution
Full ArticleAgfa HealthCare, a provider of diagnostic imaging and health care IT solutions, has signed an agreement with TomTec, active in the sector of echocardiography image analysis, reporting and data management, for the integration of its Image-Arena solution into the company's IMPAX Cardiovascular Picture Archiving and Communication System (PACS). TomTec offers a wide range of 2D and 3D/4D technologies for visualization, analysis, reporting and archiving of echocardiography imaging data.
HP assists health care providers with electronic health record migration and management
Full ArticleHP has introduced a new programme to support and accelerate the adoption of electronic health records (EHR) among hospitals and physicians. With offerings that span records migration and management as well as financing and support, HP EHReady enables hospitals and their affiliated physicians to stay connected through an integrated EHR patient network designed to improve record security, efficiency and the quality of patient care.
Health Robotics continues growing expansion in Europe, America and Asia
Full ArticleHealth Robotics has recently signed agreements to grant exclusive CytoCare distribution rights in Spain and Portugal to world-leading IV Therapy company Grifols S.A., and to install the first-ever Cancer Therapy Robot in Spain at Vall d'Hebron University Hospital in Barcelona in November 2010. The company has also reached final agreements to acquire all assets from Italy-based MEDarchiver S.r.l. and Biomedical Technology Consulting S.r.l., merging these companies' employees and operations, re-entering direct sales activities in the Italian market, and conducting a re-organisation of its Executive Management, expecting to close these acquisitions over the next few months. In addition, Health Robotics achieved its second consecutive quarter's record-breaking results, as reported by its sales channel partner Health Robotics Canada Inc. (HRCI) since Health Robotics S.r.l. upgraded its American distribution channels this year. And BioRobotics, on the heels of its unprecedented market success with its line of Oncology Surgery robots, has exclusively selected Health Robotics' i.v.STATION Robot and i.v.SOFT Workflow Engine to complete its objective to become the gold standard for IV Admixtures Automation in the Republic of Korea, building on top of its CytoCare exclusive agreement nine months ago.
 
Planet Europe in Action
 
Turning remote control into intimate support
Full ArticleAll the remote controls lying around our houses or fixed to our walls can be combined via new standardised middleware. Combined control enables new levels of home support to the elderly and disabled. Any networked home appliance or software service can be integrated with any user interface, via an open standardised middleware developed by researchers on a project called I2HOME.
Climbing to the next level: the German Virtual Liver Network
Full ArticleIn April 2010, an ambitious new project was launched in Germany: The German Virtual Liver Network. The aim of the unique research consortium is to grasp the whole organ and its functions in a computer model. Funded by the Federal Ministry of Education and Research (BMBF), this major interdisciplinary research initiative is the only one of its kind in the world that focuses effort on a single organ across multiple scales of complexity. With an allocated budget over five years of approximately 43 million euro, it is also the only research network worldwide to be financed by a single national organisation in systems biology. The Network's goal is to create a computer model of the liver as a complete organ with all of its diverse and essential functions. Thus it should be possible to better understand the processes in the liver and to develop tailor-made medications.
Playing with pills: Students gaming for knowledge
Full ArticleA specially made computer game, developed at the University of Stavanger (UiS), is set to help Norwegian nursing students pass a vitally important exam. If you mention the words "drug calculations" to a nursing student, it is likely that you receive a sigh in return. Not only is it a difficult subject, the students also have to master it to perfection. A single mistake in the examination leads to fail, which again bars you from working as a nurse because wrong dosage of medication can be fatal.
Going live to the beating heart
Full Article"Please hold absolutely still": This instruction is crucial for patients being examined by magnetic resonance imaging (MRI). It is the only way to obtain clear images for diagnosis. Up to now, it was therefore almost impossible to image moving organs using MRI. Max Planck researchers from Göttingen have now succeeded in significantly reducing the time required for recording images - to just one fiftieth of a second. With this breakthrough, the dynamics of organs and joints can be filmed "live" for the first time: movements of the eye and jaw as well as the bending knee and the beating heart. The new MRI method promises to add important information about diseases of the joints and the heart. In many cases MRI examinations may become easier and more comfortable for patients.
Wii-like technologies may help stroke survivors improve communication skills
Full ArticleMotion sensing technologies, such as the Nintendo Wii Remote, could be used in the rehabilitation of people with aphasia - a language impairment, commonly caused by a stroke, that affects around 250.000 people in the United Kingdom. The research is being carried out by a team at City University London, in collaboration with the Stroke Association and funded by the Engineering and Physical Sciences Research Council (EPSRC). The aim is to develop an affordable, computer-based technology to help stroke survivors, who have limited spoken or written output, learn how to "gesture" independently at home.
 
The 21st century hospital
 
CSC survey reveals hospitals' focus on meaningful use and challenges in meeting incentive requirements
Full ArticleAccording to a survey of United States hospital executives released by CSC, steps to meet meaningful use requirements were already a priority for hospitals before the final rules to establish an incentive programme for electronic health records were announced by the United States Department of Health and Human Services (HHS) on July 12. Titled, "Health Reform: Priorities and Challenges for Hospital Executives", the survey conducted in June and July concludes that 90 percent of participating hospital executives report that achieving meaningful use of an inpatient EHR is one of their top two priorities, and 67 percent say it is their highest priority. For 42 percent of the respondents, helping owned and/or affiliated physicians' practices achieve meaningful use of an ambulatory EHR ranked second on the business agenda.
St. Clair Hospital, Preferred Healthcare Informatics, and GE Healthcare collaborate to create one of the most integrated electronic health record systems
Full ArticleSt. Clair Hospital is teaming with Preferred Healthcare Informatics (PHI) and GE Healthcare to place St. Clair Hospital and its physicians among the most integrated users of electronic health records (EHR) in the region.
Peking University People's Hospital partners with IBM to build China's first evidence-based patient centric care system
Full ArticleIBM and and Peking University People's Hospital have built an evidence-based patient centric care (ePC3) system to enable co-operation and resource sharing among medical services providers for improved patient care. The ePC3 system, developed by scientists at IBM Research - China and People's Hospital, will provide better clinical decision support at the point of care by offering a comprehensive overview of a patients' health data as well as best practices from previous diagnoses, treatment and research. As a result, it has the potential to reduce medical errors and enable better interactions with patients and increase physicians' efficiency, thus making health care services more accessible and affordable to patients.
Innovative imaging system may boost speed and accuracy in treatment of heart rhythm disorder
Full ArticleResearchers at the University of Maryland School of Medicine in Baltimore have developed a novel 3D imaging approach that may improve the accuracy of treatment for ventricular tachycardia, a potentially life-threatening heart rhythm disorder that causes the heart to beat too fast. The new approach couples computed tomography (CT) images with conventional ablation techniques to eliminate erratic electrical circuits in the heart that produce arrhythmias. The results of a feasibility study have been published on-line in Circulation: Arrhythmia and Electrophysiology, a journal of the American Heart Association.
Childrens Hospital Los Angeles eye surgeon prevents blindness in five premature infants in Armenia through new international telemedicine project
Full ArticleIn collaboration with the Armenia Eye Care Project (AECP), Thomas C. Lee, MD, from The Vision Center at Childrens Hospital Los Angeles recently traveled to Armenia in an effort to prevent blindness in premature infants through the launch of a new international telemedicine system. Through the AECP, local neonatal intensive care units (NICUs) in Armenia installed two RetCams, which are advanced imaging devices that can scan the retinas of premature infants. This imaging device was first developed by ophthalmologists at Childrens Hospital Los Angeles 25 years ago.
 
Virtual snap shots
 
New book encourages health care organisations to join the social media conversation
Full ArticleThe growth of social networking has been dramatic, and the applications are quickly finding their way into health care organisations. Social Media in Healthcare provides an overview of the social media tools health care organisations are using to connect, communicate, and collaborate with their patients, physicians, staff, vendors, media, and the community at large. It describes the major social media applications and reviews their benefits, uses, limitations, risks, and costs. It also provides tips for creating a social media strategy based on an organisation's specific needs and resources. Real-world examples illustrate how social media can improve the efficiency, effectiveness, and marketing of a health care organisation.
NIST software security patent to help improve health IT privacy
Full ArticleA computer security invention patented a decade ago at the National Institute of Standards and Technology (NIST) by John Barkley - titled "Workflow Management Employing Role-Based Access Control", U.S. Patent No. 6,088,679. July 11, 2000 - is now poised to help safeguard patient privacy in hospitals. The invention - an algorithm that can be built into a larger piece of software - is designed to control access to information systems, and it has attracted the attention of a company that is putting it to use in the health care field. John Barkley, the algorithm's creator, said the idea could solve one of the pervasive issues in the United States' health care system.
Electronic health records prime clinicians to provide progressive care to older adults
Full ArticleIn 20 years, approximately 72 million older adults will reside in the United States, almost double the current number, according to the United States Administration on Aging. Potential issues are compounded by the projected shortage of health care workers needed to provide elder care. As part of the solution, an interdisciplinary team of University of Missouri (MU) researchers is refining electronic health record (EHR) technology to more efficiently meet increasing health care demands.
Scientists use computer algorithms to develop seasonal flu vaccines
Full ArticleDefeating the flu is challenging because the virus responsible for the disease undergoes frequent changes of its genetic code, making it difficult for scientists to manufacture effective vaccines for the seasonal flu in a timely manner. Now, a University of Miami (UM) computer scientist, Dimitris Papamichail, and a team of researchers from Stony Brook University have developed a rapid and effective approach to produce vaccines for new strains of influenza viruses. The researchers hope to develop the new technology and provide an efficient method to confront the threat of seasonal epidemics.
Transinsight launches new version of its Enterprise Semantic Intelligence Knowledge Suite at the 2010 I-SEMANTICS
Full ArticleOne of the biggest challenges companies face in their efforts to remain competitive is being able to manage the ever-increasing amount of unstructured data. "Information at your fingertips", was the promise that giant Microsoft made years ago. However, this promise went unfulfilled - not just by Microsoft, but also by other software providers that made similar claims. Today, searching for information remains an arduous task for most companies because of their lack of intelligent search technologies. Transinsight's Enterprise Semantic Intelligence Knowledge Suite fills the gap, offering semantic technologies that take the search process to new levels of efficiency. The 2010 version pushes the limits of semantic excellence even further.
 
VMWC news bites
 
'Asynchronous telepsychiatry' found effective for assessing patients' mental health
Full ArticleA new study by researchers at the University of California (UC) Davis School of Medicine has found that psychiatrists can accurately assess a patient's mental health by viewing videotaped interviews that are sent to them for consultation and treatment recommendations. The approach, called asynchronous telepsychiatry, uses store-and-forward technology, in which medical information is retrieved, stored and transmitted for later review using e-mail or Web applications. It has been used extensively for specialties like dermatology, with photos of skin conditions sent to dermatologists, or x-rays sent to radiologists for assessment.
New Invention at the Weizmann Institute enables severely disabled people to communicate and steer a wheelchair by sniffing
Full ArticleA unique device based on sniffing - inhaling and exhaling through the nose - might enable numerous disabled people to navigate wheelchairs or communicate with their loved ones. Sniffing technology might even be used in the future to create a sort of "third hand", to assist healthy surgeons or pilots. Developed by Professor Noam Sobel, electronics engineers Dr. Anton Plotkin and Aharon Weissbrod and research student Lee Sela in the Weizmann Institute's Neurobiology Department, the new system identifies changes in air pressure inside the nostrils and translates these into electrical signals. The device was tested on healthy volunteers as well as quadriplegics, and the results showed that the method is easily mastered. Users were able to navigate a wheelchair around a complex path or play a computer game with nearly the speed and accuracy of a mouse or joystick. in air pressure inside the nostrils and translates these into electrical signals. The device was tested on healthy volunteers as well as quadriplegics, and the results showed that the method is easily mastered. Users were able to navigate a wheelchair around a complex path or play a computer game with nearly the speed and accuracy of a mouse or joystick.
MIT researchers create fibers that can detect and produce sound
Full ArticleFor centuries, "man-made fibers" meant the raw stuff of clothes and ropes; in the information age, it's come to mean the filaments of glass that carry data in communications networks. But to Yoel Fink, an Associate professor of Materials Science and principal investigator at Massachusetts Institute of Technology (MIT)'s Research Lab of Electronics, the threads used in textiles and even optical fibers are much too passive. For the past decade, his lab has been working to develop fibers with ever more sophisticated properties, to enable fabrics that can interact with their environment.
Engineering could give reconstructive surgery a facelift
Full ArticleFacial reconstruction patients may soon have the option of custom-made bone replacements optimized for both form and function, thanks to researchers at the University of Illinois and the Ohio State University Medical Center. Whether resulting from illness or injury, loss of facial bones poses problems for reconstructive surgeons beyond cosmetic implications: The patient's chewing, swallowing, speaking or even breathing abilities may be impaired.
First NOTES transoral and transvaginal gallbladder removals performed as part of United States multicentre human trial
Full ArticleThe Natural Orifice Surgery Consortium for Assessment and Research (NOSCAR), a joint effort of the American Society for Gastrointestinal Endoscopy (ASGE) and the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), has completed the first transoral and transvaginal cholecystectomies (gallbladder removal) using Natural Orifice Translumenal Endoscopic Surgery (NOTES) in a multicentre human trial in the United States. Santiago Horgan, MD, at the University of California, San Diego (UCSD) School of Medicine, removed the gallbladder of a patient through the mouth and John Romanelli, MD, Baystate Medical Center in Springfield, Massacusetts, removed the gallbladder of a patient through the vagina as part of the NOSCAR human trials. NOTES is performed by using the patient's natural openings for surgery. These human trials are the first in the world comparing oral and transvaginal NOTES to traditional laparoscopy.
 

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