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Wed Nov 1 08:02:53 PDT 2023

Medgadget (Medical Technology) Daily Digest (Unofficial)


( Eko’s Newest CORE 500 Stethoscope: A Review
Oct 31st 2023, 13:32

Arriving in two boxes reminiscent of Apple product packaging – one for the chest piece (the part that contacts the body), and another for the detachable earpiece (tubes + ear tips) – the CORE 500 is clearly an upgrade from the ( Eko DUO stethoscope. Similar to its predecessor, the CORE 500 can be used with your own headphones, smart phone, and just the chest piece, making it free of any hassle with the earpiece tubes. It has a USB-C charging port and is good for a continuous five-hours of use.

The CORE 500 chest piece itself is a bit heavier than the DUO at 6.6 oz (instead of 3.6 oz), but the construction feels a lot more sturdy and satisfying to hold. It’s durable and has a form factor that’s more familiar and comparable to the conventional stethoscopes that most people are used to wielding (such as the Littmann Classic III).

This brings us to the burning question: does it work?

In short, yes. It works pretty well, especially with the up-to-40X digital amplification.

The Eko CORE 500 stethoscope boasts Eko’s most premium and clearest digital audio to date, built with TrueSound technology and active noise cancellation.

When testing this device outside, with airplanes overhead and car traffic nearby, it was not a problem to hear any of the sounds while testing out different filters. Both using the provided earpiece (ear tips + tubes), or your own earbuds to listen, heart, lung, and bowel sounds could all be heard as expected. We used Apple AirPods Pro (2nd gen) with active noise cancellation and the effect is similar to using the provided noise isolation eartips and earpiece.

With the external environment at its loudest, the volume had to be turned up to max, with noise cancellation on, but the amplification allowed the appropriate sounds to come through. Using a regular non-digital stethoscope in this same environment, it was a struggle to hear most sounds when the environment was loud and noisy. Of course, there is also the option to play any sounds directly from the speakers of your phone (or an external speaker your phone is connected to), though in most real-life situations earbuds or earpieces would be ideal.

Let’s also talk about the ECG features onboard the chest piece. The CORE 500 provides a 3-lead ECG (an improvement from the 1-lead ECG provided by the Eko DUO). The stethoscope comes with a few alcohol wipes for use prior to skin contact, and the on-screen mobile ECG feed will begin automatically once the chest piece has detected an acceptable signal.

The available on-screen view of the features is also a big step up from the DUO where it felt often necessary to refer to your phone to figure out the listening filter mode or other functions if you forgot which features the onboard LEDs signaled.

The Eko mobile app has since undergone multiple user interface updates and is mostly easier to navigate without knowing what settings are available. Connecting the device to a smartphone via Bluetooth was a fast and painless process. But what’s more critical is the ability to visualize and analyze data in real-time, as well as the options to record, save data, and share data.

The app is powered with Eko’s AI-assisted detection software, which is available for free through the Eko app (or for Enterprise customers: the SENSORA AI-assisted detection software). The AI is used for cardiac disease detection (AFib, bradycardia, tachycardia) and provides a pretty quick turnaround after recording an exam (<1 minute) to tell the user whether murmurs or anomalies were detected in the ECG readings. There are tutorial screens with appropriate positions shown in the app for chest piece placement.

At the price point of $429 (including a free case and engraving), this might seem a bit steep for some, but it all comes down to whether you think these features would help you in your clinical practice.

Many clinicians swear by non-digital stethoscopes, but there are also many who carry around digital stethoscopes for their amplification and recording features. In some noisier environments, such as an ambulance, the digital amplification can really make a difference. And out in the field, we’ve also heard stories where the earpiece tubing can become cumbersome when needing to access patients in less optimal positions, and the wireless listening options are great. On that front, we’d also like to note a nice hardware design detail: the quarter-turn connection to lock the chest piece and earpiece together, instead of the pieces screwing together with multiple revolutions. This made it must quicker and easier to transition between using the chest piece alone or with the earpiece.

Similarly, devices like this can also help in telehealth capacities or even more remote situations where access to certain medical equipment is more challenging. This is where the 3-lead ECG features can serve as a useful quick temporary solution for triage (short of the full ECG examination in a formal clinical setting), and in a pinch, murmurs or anomalous sounds can be quickly recorded and shared with a healthcare provider or team.

Overall, the CORE 500 is a easy to use digital stethoscope with excellent sound and features that traditional stethoscopes simply can’t provide.

Product info page: ( Eko Health | CORE 500 Digital Stethoscope

Flashbacks: ( Eko DUO Digital ECG + Stethoscope: Exclusive Interview and Review; ( Review: Eko Core Digital Stethoscope; ( Eko Releases New CORE Digital Stethoscope Offerings; ( Eko DUO Stethoscope with ECG Built-In Now Available for Purchase; ( Eko Core Stethoscope with Novel Digital Capabilities FDA Cleared

( Bacteria Tag Team Tumors with T Cells
Oct 31st 2023, 13:07

A team at Columbia University School of Engineering and Applied Science has developed a technique to enhance chimeric antigen receptor (CAR) T cell therapy in solid tumors. The technique involves engineering E. coli bacteria, that naturally tend to accumulate in the immune privileged core of solid tumors. The bacteria have been engineered to interact with tumor cells and deposit a synthetic antigen on the cells that can then be targeted by CAR T cells. The approach could enhance CAR T cell therapy in solid tumors, which hasn’t worked as well as CAR T cell therapy for blood-borne cancers to date. Creating such bacterial/T cell tag teams could expand the variety of cancers that can be treated using T cell therapy and also enhance the tumor cell killing effects of T cells.   

CAR T cells are white blood cells that have been primed to attack cancer cells. While this approach has worked reasonably well in blood-borne cancers, such as leukemia, it has proven more difficult to target solid tumors. Such solid tumors are dense, have an erratic blood supply, and the cells within the tumor contain many biochemical signals that are also found in healthy tissue, making it difficult to distinguish and target cancers. Using CAR T cells to targeting tumor antigens that naturally occur in such solid tumors does not typically appear to provide sufficient cell killing activity.

These issues prompted these Columbia  researchers to design a little helper for CAR T cells that can paint the tumor cells with an irresistible synthetic antigen that the CAR T cells are highly disposed to target. “Our probiotic platform enables CAR-T cells to attack a broad range of tumor types,” said Tal Danino, a researcher involved in the study. “Traditional CAR-T therapies have relied on targeting natural tumor antigens. This is the first example of pairing engineered T cells with engineered bacteria to deliver synthetic antigens safely, systemically, and effectively to solid tumors. This could have a significant impact on the treatment of many cancers.”

Given that the bacteria naturally tend to accumulate at a tumor core, the system may represent a universal CAR-T technology, that can be used for any solid tumor, without the need to customize the system for each tumor type or patient. This could dramatically expand the types of tumors that can be treated in this way.

“Combining the advantages of tumor-homing bacteria and CAR-T cells provides a new strategy for tumor recognition, and this builds the foundation for engineered communities of living therapies,” said Rosa Vincent, another researcher involved in the study. “We chose to bridge the individual limitations of these two cell therapies by combining the best features of each — using bacteria to place the targets, and T cells to destroy the malignant cells.”

Study in journal Science: ( Probiotic-guided CAR-T cells for solid tumor targeting

Via: ( Columbia University

Forwarded by:
Michael Reeder LCPC
Baltimore, MD

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