Hello Health Rounds readers! The end of having to store and ship certain vaccines and medicines under cold conditions may be on the horizon due to a new technique that could save money and improve access where refrigeration is not readily available. We also report on potential health benefits of wearable devices and robotic surgery.

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A new storage technique can keep protein-based drugs and vaccines stable without keeping them cold, potentially eliminating the need for refrigeration for hundreds of life-saving medicines, researchers reported in Nature Communications.

“Over 80% of biologic drugs and 90% of vaccines require temperature-controlled conditions” to retain their structure and function, study leader Scott Medina of Pennsylvania State University said in a statement.

The new technique could save billions of dollars currently spent on cold chain storage, Medina said, referring to keeping these products cold throughout the supply chain. It could also allow their use in places where constant refrigeration is not possible, he added.

Vaccines and many drugs are currently stored in water-based solutions in vials. The researchers created a new perfluorocarbon oil storage solution and a substance known as a surfactant to coat the surface of the drug molecules.

The surfactant’s protective shell keeps the medicine stable at temperatures up to 212 degrees Fahrenheit (100°C), the boiling point of water, the researchers said.

The new approach has the potential to reduce costs and “allow the drugs to be distributed in resource-scarce environments across all populations,” Medina said. “We could even use this... on the battlefield, where these therapies would be needed but access to refrigeration is limited.”

With an assist from artificial intelligence, wearable devices can help diagnose, and even predict, flares of inflammatory bowel diseases weeks in advance, a new study suggests.

Current monitoring methods rely on patients directly interacting with their doctors in ways that can be inconvenient and invasive.

“Commonly used wearable devices such as Apple Watches, Fitbits, and Oura Rings can be effective tools in monitoring chronic inflammatory diseases like IBD,” study leader Dr. Robert Hirten of the Icahn School of Medicine at Mount Sinai in New York said in a statement, adding that wearables allow for monitoring remotely, continuously, and potentially in real time.

Hirten and colleagues enrolled 309 volunteers with ulcerative colitis or Crohn’s disease. Participants wore devices, answered daily symptom surveys, and provided blood and stool samples for assessments of inflammation.

Their circadian patterns of heart rate, heart rate variability, oxygenation, and daily activity, all measured by the wearable devices, were significantly altered when intestinal inflammation or symptoms were present, the research team reported in Gastroenterology.

Moreover, these physiological markers could detect inflammation in the intestines even in the absence of symptoms, up to seven weeks before symptomatic flares developed.

The researchers were not able to account for patients’ medication regimens and certain other factors, and so more work is needed to confirm the results, they said.

“These findings open the door to leveraging wearable technology for health monitoring and disease management in innovative ways we haven’t previously considered,” and for other inflammatory diseases, too, Hirten said.

Complicated liver surgeries might best be done by robots, according to a new study.

Surgeons at one large New York City hospital looked back at 353 operations done between 2017 and 2023 in which pieces of the patient’s liver were removed, including 112 open surgeries done through large incisions, 107 done by surgeons laparoscopically, and 134 done by surgical robots.

After accounting for patients’ individual risk factors and the complexity of each case, those who underwent laparoscopic or robotic procedures had 39% and 43% shorter median lengths of stay, respectively, and 89% and 62% lower odds of complications compared to patients having open procedures.

The robotic procedures were also 87% less likely than the laparoscopic surgeries to require a switch to open surgery in the middle of the operation, according to a report in Surgical Endoscopy.

In operations done for malignancies, the odds of clean margins with no cancer left behind were similar regardless of the surgical approach.

Over the course of the study period, the use of the robots increased, and the surgeons were able to take on more difficult cases, they said.

The study was not a randomized trial and cannot prove conclusively that robotic surgery is safest for liver resections. But while laparoscopic approaches in general are known to reduce blood loss, complications, and hospital stay, they have been less than ideal for complex liver cases, the researchers said.

“Transitioning to robotic hepatectomy may bridge this complexity gap,” they concluded.

This newsletter was edited by Bill Berkrot; additional reporting by Shawana Alleyne-Morris.