The Benefits of Local Anesthesia: A Changing Trend

Alex Campos

Team angelMD

 

Since the introduction of anesthesiology, the traditional role of the patient has been to be asleep, however patients’ increasing unfamiliarity with current medical procedures and devices has led some to rebel against the surgeon-recommended general anesthesia in favor of local anesthetic use. As David S. Howes, a Chicago emergency physician, stated in regards to patients being awake in the operating room, “It’s not for the faint of heart.” [1]

With the possible difficulties of local anesthesia in mind, benefits have also been found. A study conducted in Saint John, New Brunswick compared the anxiety levels of 200 patients who underwent carpal tunnel release surgery, half with local and half with general anesthesia. [2] The study found that patient anxiety levels dramatically decreased while under local anesthetic, as the patient could openly communicate with the surgeon during the operation. On a 0-10 scale, the average pre-operative levels of anxiety in patients with local anesthetic use was 2.3, lower than the average anxiety level of 3.4 found in patients with general anesthetic use. [2]

Local anesthesia has done much more than reduce a patient’s surgery anxiety there are economic, time saving, and functional benefits as well. Of the 100 patients in the Saint John study who were only given local anesthesia, the average total time spent at a hospital was 2.6 hours, 35 percent less time than the 100 patients who underwent general anesthesia. [2] Additionally, blood work, electrocardiogram, and chest X-ray use was found to be needed for three percent of wide awake patients, versus 48 percent of sedated patients. [2]

It was also found that patients under local anesthesia could go back to their daily routines much quicker than if they had undergone general anesthesia. In March of 2017, a patient named in Esther Voynow underwent a De Quervain’s release for restricted base of thumb tendons, opting for a local anesthetic. Due to the lack of common dizziness and nausea resulting from general anesthesia, Voynow was able to drive herself back home merely 30 minutes after her operation had ended. [1]

These results suggest that local anesthesia may become a more frequently used method of pain medication in the future. The economic, time-saving, and functional benefits of local anesthesia seem perfect to be taken to a national scale. If so, the medical industry would be able to save millions of dollars and thousands of surgical hours, resulting in an abundance of space in hospitals. This change would reduce costs and generate profits for hospitals while producing the optimal level of medical care for patients.

Interested in improving the future of anesthesiology and patient care? Visit angelMD’s online medical investments platform, hit browse startups, and click Anesthesiology in the specialty box to discover the newest innovations coming to the field.

 

[1] “Going Under The Knife, With Eyes and Ears Wide Open” https://www.nytimes.com/2017/03/25/health/surgery-awake-anesthesia.html

[2] “The patient’s perspective on carpal tunnel surgery related to the type of anesthesia: a prospective cohort study” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3574473/

Image credit: http://www.tanner.org/media/Image/Anesthesiology-OR.jpg

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RNA: How Physicians and Researchers are using RNA to Solve Today’s Medical Problems

Brendan Long
Team angelMD

Toted by Steven Dowdy of the University of California, San Diego School of Medicine as “the future of medicine,” RNA therapeutics are an emerging class of drugs with immense potential. RNA based drugs have been in development for over 20 years and have recently seen some incredible results that are opening the door for RNA to emerge as a prominent and powerful drug class. How will this affect the cardiology market? Recent clinical results have shown that RNA development is a field to watch closely.

A prominent example comes from Imperial College London, where researchers recently finished the largest trial yet in measuring the safety and effectiveness of RNA interference (RNAi) therapy. RNAi therapy effectively turns off one of the genes associated with elevated cholesterol levels. In the trial, researchers found that one month after receiving a single treatment of inclisiran, participants’ LDL cholesterol levels had reduced by over 50 percent. Six months following this single treatment, participant’s cholesterol levels had reduced 42 percent, while in a matched placebo group, cholesterol levels had increased two percent. In all patients across different dosages and frequencies, cholesterol levels fell for at least eight months and no additional side effects were seen when compared to the placebo group.

RNA is also being increasingly used as a diagnostic tool. A leading example of how RNA can be leveraged as a testing method comes from angelMD’s own Ischemia Care. Ischemia Care has developed a test that isolates RNA from whole blood and examines immune responses with the goal of determining where ischemic strokes develop in a patient’s body. In an estimated one-third of cases, doctors aren’t able to identify a cause for a stroke. Ischemia Care’s “ISCDX” test serves to help determine whether the stroke originated in the heart or in the blood vessels, which has a “huge impact on how patients are treated and on preventing recurrent strokes,” according to CEO Jeff June. On top of pinpointing the location where strokes develop, Ischemia Care also can determine whether or not ischemic strokes that originate in the heart are caused by atrial fibrillation.

RNA is a developing and intriguing topic in healthcare that has shown potential in both testing and treatment, and investors have taken notice. One private company, Moderna Therapeutics, has reportedly raised nearly $2 billion to develop a “platform for inventing new RNA treatments. For a long time, the main obstacle facing RNA therapeutics was cost. Companies like Alnylam dug over a billion dollars into research without releasing a single tangible product.

People like former Alnylam senior executive Rachel Meyers, however, are starting to realize the place for RNA drugs in healthcare. Meyers sees RNA therapeutics as being versatile in its ability to tackle unique problems. About RNA therapies Meyers believes, “It’s those ones that don’t have a good alternative where you say, ‘Oh my gosh, we can really change the world, or someone’s life, with this.’”

In the long-time stagnant field of RNA therapeutics, people are starting to see results. This makes RNA a topic to watch closely.

Sources:
https://www.technologyreview.com/s/603871/how-a-boys-lazarus-like-revival-points-to-a-new-generation-of-drugs/
http://www3.imperial.ac.uk/newsandeventspggrp/imperialcollege/newssummary/news_17-3-2017-14-40-10

A new blood test could help doctors pinpoint the cause of a stroke

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Digital Health Makes Strides in Diabetes Care

Susana Machado
Team angelMD

Over 29 million people in the U.S. have diabetes, and some 27 percent haven’t been diagnosed. [1] To make matters worse, the rate of new cases has been on the rise in U.S.[2] The CDC estimates the total cost of diabetes in the U.S. in 2012 alone was $425 billion, and the average medical expenditures among people with diagnosed diabetes was 2.3 times higher than people without diabetes.[1]

Type 2 diabetes is highly preventable and treatment is straightforward, though it can be difficult for patients to adopt. With the extreme cost of treatment and burden on patient well-being, it is clear that there needs to be a different approach to patient care, something that can lower cost without impacting effectiveness. Enter digital health.

A new literature review, analyzing the success of digital health interventions on diabetes patients, found that the effects of obesity-related apps on patient satisfaction and adherence were positive and cost effective.[3]

angelMD is proud to have companies on our platform like Rimidi tackling this important issue. Rimidi’s cloud-based platform Diabetes+Me has demonstrated an ability to produce results. A study showed that patients who used Rimidi’s intervention dropped their hemoglobin A1c levels by two percentage points more than standard treatments. Their total cholesterol also decreased by 50 mg/dL more than standard treatments.[4] Rimidi’s success has earned them recognition and they recently presented at the 2017 Healthcare Information and Management Systems Society conference.

Continued developments in the digital health sector are increasingly important due to decreased funding to public health initiatives. This funding drought in combination with increasing care costs sets up the digital health industry for significant growth. According to one report, the digital health market will hit $117 billion in 2020.[5] Physicians have widely recognized this area of growth, with 86 percent agreeing that mobile apps would be central to care in 2020.[5]

Interested in learning about more innovative startups tackling diabetes care from a digital health perspective? Browse relevant companies on angelMD here by selecting the “Digital Health” category and typing “Diabetes” in the search box.

[1] According to a 2014 CDC report https://www.cdc.gov/diabetes/pubs/statsreport14/national-diabetes-report-web.pdf
[2] According to April 2016 CDC report https://www.cdc.gov/diabetes/statistics/slides/long_term_trends.pdf
[3] http://perspectives.ahima.org/canmhealthrevolutionize/
[4] http://www.mobihealthnews.com/content/mobile-diabetes-intervention-reduced-hba1c-2-percentage-points-more-standard-care
[5] http://actonline.org/wp-content/uploads/2016_State_of_App_Economy.pdf

Featured Image (CC0): https://pixabay.com/en/diabetes-blood-sugar-diabetic-528678/

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Announcing a New Open Syndicate for Otomagnetics

angelMD is pleased to announce that we are opening a syndicate for investment in Otomagnetics, a startup developing an innovative, non-invasive magnetic delivery system for drugs and other therapeutic payloads. If you’re interested in learning more about Otomagnetics, please visit our info form to request more information.


Otomagnetics is a spin-out startup from the University of Maryland at College Park. Their team has developed a magnetic field-generating small device that works with proprietary nano-particle formulation to carry drugs, proteins, or genes. The effect of the localized magnetic field on the nano-particles allows therapeutics to be carried across tissue barriers, and allows delivery to hard-to-reach targets in the body that would otherwise require needles or surgery.

angelMD had a chance to talk to Otomagnetics’ CEO, Dr. Benjamin Shapiro, and learn more about their important work. We hope you enjoy this conversation. If you would like to know more about this innovative angelMD company, please click on this link to be included in exclusive communications.

1. How did you develop the idea to use magnets and magnetized particles as a drug delivery platform?

We got a phone call from an otolaryngology group that was interested in effective but non-invasive drug delivery to the cochlea. This group had found us based on our work in magnetic drug delivery. They were envisioning a large and complex magnetic instrument that would pull particles into the cochlea from the opposite side of the head. Instead, we were able to design a device that pushed (injected) instead of pulled, which allowed the device to be small, simple, and effective. The device was patented, built, and tested first in the lab, and then in animals (and now also in human cadavers). Hence we started as an ear company to fill an unmet drug delivery need.

The same novel magnetic push concept (till then, all other magnetic delivery systems could only pull) has also shown it can deliver therapy into the eye and through the skin, without needles. The system is therefore now also being developed for vision and dermatology.

2. Do you consider Otomagnetics a device or pharma company?

We consider Otomagnetics a biotech company. We have a platform technology. Our delivery system acts like a syringe, but the needle has been replaced by magnetic forces acting on bio-compatible nano-particles that can carry drugs, proteins, or gene therapy. We can reach targets that cannot be reached by current standards-of-care, or that would otherwise require an invasive surgery to reach.

3. Your first target customer is prevention and treatment of sudden hearing loss. How does your approach improve on current therapies?

Current administration methods do not effectively reach the cochlea, and therefore do not treat sudden hearing loss effectively. For oral administration, less than 1 out of 10,000,000 drug molecules reach the cochlea; for trans-tympanic administration, the number is less than 1 out of 40,000 [Juhn, 2001; Inamura & Salt, 1992; Bird, 2007].

We deliver therapy 1,000x more efficiently to the cochlea and have shown we can restore hearing, suppress tinnitus, and prevent hearing loss due to chemotherapy regimens in recognized animal models.

4. What other applications are there for your therapeutic delivery system and what advantages will you offer in those markets?

In addition to treating the cochlea, we can magnetically deliver into the middle ear without needles or surgery. In animal studies, we have shown we can clear middle ear infections. (Chronic and recurrent middle ear infections/inflammations are currently treated by surgical insertion of tubes through the ear drum, the most common pediatric surgery in the US.) For macular degeneration and other eye conditions, we can delivery therapy without needle insertions into the eye.

Animal studies have also shown magnetic forces can deliver therapy through the skin, which enables improved drug delivery to burns, wounds, or diabetic ulcers.

Otomagnetics Magnetic Injection Technology

Learn about Otomagnetics' innovative magnetic injection technology.

5. What third-party validation have you received from the scientific community?

The technology was developed in response to a clinical need articulated by otolaryngologists, a need that is well recognized in the field. Clinicians at Johns Hopkins, Children’s National Medical Center, Sunnybrook Health Sciences Center, and the University of Nottingham have reached out to us, and have initiated projects with our group. In England, the Action of Hearing Loss supports and has helped fund our research and efforts.

6. What interest in Otomagnetics have you had from industry?

Angel investors at Keiretsu envision Otomagnetics as a Star Trek technology, a technology of the future. They are currently in the due-diligence phase and we expect them to conclude their process in next few months. Two pharmaceutical companies are already interested in our magnetic delivery because they recognize it could enable them to deliver their therapeutic compounds safely and effectively to new targets, and we are in discussions with additional companies.

7. How do you think syndicating an investment with AngelMD will benefit Otomagnetics?

Our interest in AngelMD is the access to clinical expertise that it will provide. We started as a company that was motivated by a clinical need in otolaryngology (we were not a technological hammer looking for nails, instead we developed the magnetic injection technology to address a pressing and unmet need). Now that the system has also shown utility for delivering therapy magnetically into eyes and through the skin, without needles or surgery, we would welcome the opportunity to collaborate with clinicians to expand our technology to additional applications and clinical needs.

8. Tell us about your team and their unique capability in this specific field?

Dr. Benjamin Shapiro, PhD, CEO is an expert in magnetic drug targeting, nano-therapy, lab-on-chip/microfluidics. He is a Fulbright scholar, the inventor of the magnetic injection technology, and is currently responsible for the operations for Otomagnetics. He has helped raise over $6M in non-dilutive grant funding for the effort thus far.

Mr. Ting Pau Oei, MBA, Chairman of the Board, has extensive operating and investing experience in the healthcare industry. He has been a venture capital partner in both a corporate strategic venture capital firm and in an independent venture capital partnership. He was a Vice President of Johnson & Johnson Development Corporation, J&J’s venture capital arm. He has invested in over 50 life sciences, medical device and healthcare information technology companies and served on the board of over 25 of these portfolio companies.

Ms. Abhita Batra, MS, MBA, Chief Business Officer, is the Founder and Managing Director of Advanced Biopharma Consulting (ABC), a strategic advisory firm that offers business development and commercialization services to life science companies. She is co-owner of Admac Group of Companies, wherein she managed a product portfolio encompassing 150 generics. She is a co-founder and former COO of Navya, a biotechnology company developing and commercializing PHF for destruction of solid tumors. Abhita completed her Global MBA at UCLA Anderson and NUS, and has a Masters in Biotechnology with specialization in Pharmaceutical Sciences from University of Pennsylvania.

We have expert regulatory advisors, including a former FDA Branch Chief and a former Vice President of R&D at AMAG Pharmaceuticals who previously took two iron-oxide (magnetic) nano-particles through FDA regulatory approval and to market for millions of patients.

9. What are your key company goals for the next 12 months?

Complete FDA-mandated large and small animal safety studies to enable entry into human clinical trials.


angelMD is pleased to announce a new syndicate for investment in Otomagnetics. If you are considering joining this exciting angelMD syndicate, please visit this link to request more information.

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Hay Fever a Reminder of the Market Scope of Allergy/Immunology

It’s that beautiful time of year dreaded by many who suffer from grass pollen allergies. Grass pollen allergy creates symptoms of a runny or stuff nose, scratchy throat, and itchy or watery eyes, and can foster a dangerous environment for patients diagnosed with asthma or other breathing conditions. There are companies on angelMD, such as Sparo Labs, that seek to mitigate the dangers facing individuals with asthma. Sparo Lab’s Wing product allows its users to track their lung function on a digital health app using an FDA cleared and over the counter sensor, a feature that could help the precautions necessary for those with asthma during the season of grass pollen allergy.

Overall, this season can have a seismic impact on the allergy/immunology sector. Reportedly*, 1 in 5 Americans have allergy or asthma symptoms, and the average yearly cost of allergies to the health care system – and businesses – is $7.9 Billion. In total, 4 million workdays each year have been lost to hay fever, with the duration of pollen allergy season seemingly extending by 4 weeks over the past 10-15 years.

Whether you are an up and coming startup or a health care professional, these figures hold enough weight to influence your day to day business. According to a report distributed by Miltech, this is what the role of allergies could mean for the wider market:


North America has the largest market for allergy diagnostics, followed by Europe. This is due to the rise in number of people with allergies, better government support, improved medical insurance policies, increased health care expenditure, advanced diagnostic technologies, and good healthcare infrastructure in these regions. The allergy diagnostics market in Asia is expected to experience a high growth rate in the next few years due to developing health care infrastructures, increasing prevalence of allergic diseases, increasing disposable income, and aging population in the region. These factors, along with an alarming rise in pollution across the globe are expected to drive the global market for allergy diagnostics. Moreover, growing prevalence of lifestyle diseases, rise in healthcare expenditure, and rapidly increasing global population of children below 14 years of ages are the other factors driving this market. However, high capital requirement and strict regulations set by various governments are some major factors restraining the growth for the global allergy diagnostics market.

Increase in population and growth in economies in developing countries, such as India and China are expected to drive the allergy diagnostics market in Asia. Increase in the number of mergers and acquisitions, rise in the number of collaborations and partnerships, new product launches and increasing research and development activities are some of the latest trends that have been observed in the global allergy diagnostics market.

The major companies operating in this market worldwide are bioMérieux, Danaher Corporation, Hitachi Chemical Diagnostics, HOB Biotech Group Co., Ltd., HYCOR BioMedical, Inc., Omega Diagnostics Ltd., Stallergenes, Lincoln Diagnostics, Inc., Siemens Healthcare, and Thermo Fisher Scientific, Inc.


Based on information from Persistence Market Research

* http://www.webmd.com/allergies/allergy-statistics

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