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May 17, 2007, 5:25 AM CT

Ulcerative colitis quite disruptive

Ulcerative colitis quite disruptive
Nearly three out of four ulcerative colitis (UC) sufferers (73 percent) responding to a new nationwide survey say not feeling well has become a normal part of life. Furthermore, they describe UC as disruptive when it comes to their relationship with a spouse (64 percent), their sexual relations (75 percent) and their emotional state (82 percent).

UC patients "normalize" aspects of their experience to the point that they resign themselves to these burdens. The majority say that there is not much they can do beyond what they are already doing to feel better (70 percent) and they have learned to live with the disruptions that UC causes (83 percent).

"The findings sound an alarm because a diagnosis of UC shouldn't mean patients are settling for the level of burden reported in this survey for the next 50 or 60 years. UC is a manageable disease with the appropriate treatment," says David Rubin, M.D., a gastroenterologist and assistant professor of medicine at the University of Chicago Medical Center who helped design the surveys.

UC is a chronic autoimmune disease that causes inflammation in the intestine and can lead to symptoms such as severe abdominal pain and cramping, uncontrollable bloody diarrhea several times a day, fatigue and weight loss. It is typically first diagnosed in people between the ages of 15 to 30 and is estimated to affect nearly 700,000 Americans.........

Posted by: Sue      Read more         Source

April 29, 2007, 4:55 PM CT

Study to Assess Bariatric Surgery in Adolescents

Study to Assess Bariatric Surgery in Adolescents
The National Institutes of Health (NIH) today launched an observational study to evaluate the benefits and risks of bariatric surgery in adolescents. Bariatric surgery restricts stomach size and can decrease the amount of calories and nutrients the body absorbs. The Teen Longitudinal Assessment of Bariatric Surgery (LABS) study will help to determine if it is an appropriate therapy option for extremely overweight teens.

"The reasons for weight gain are complex and multifactorial, influenced by genetics, environment, eating and physical activity habits, and society. The information gathered from Teen-LABS will help determine if adolescence is the best time to intervene with this surgical treatment," says Thomas Inge, M.D., Ph.D., chair, Teen-LABS and principal investigator for the center at Cincinnati Children's Hospital Medical Center.

Overweight youth are more likely to develop serious health problems, such as type 2 diabetes and heart disease. Ideally, the goal for overweight adolescents and teens is to slow the rate of weight gain by eating fewer calories and being more physically active. However, these changes are tough to achieve and other approaches, such as drug treatment, are only approved for use in children 16 years and older.

"We know that bariatric surgery is not an easy way out for teens to control weight. They will still need to eat less food and exercise more," says Mary Horlick, M.D., project scientist for Teen-LABS and director of the Pediatric Clinical Obesity Program of the Division of Digestive Diseases and Nutrition, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), the sponsor of Teen-LABS at NIH. "We hope to learn whether or not bariatric surgery is suitable for teens and if it will help them remain at a healthy weight over the long-term".........

Posted by: Sue      Read more         Source

April 15, 2007, 8:36 PM CT

DNA Test Can Be Early Predictor Of Liver Cancer

DNA Test Can Be Early Predictor Of Liver Cancer
Scientists at Columbia Universitys Mailman School of Public Health have discovered a means for early detection of liver cancer. Using DNA isolated from serum samples as a baseline biomarker, the researchers examined changes in certain tumor suppressor genes that have been linked to the development of liver carcinomas. This is the first study to prospectively examine potential biomarkers for early detection of liver cancer in high-risk populations, including those with chronic hepatitis B and C virus infections.

Since most hepatocellular or liver carcinomas (HCC) are diagnosed at an advanced and commonly fatal stage, the development of screening methods for early detection is critical. HCC is one of the most common and rapidly fatal human malignancies. Worldwide, the almost 500,000 new cases and nearly equivalent number of fatalities illustrates the lack of effective therapeutic alternatives for this disease.

The Mailman School scientists and his colleagues studied the blood of patients enrolled in a cancer screening program in Taiwan, who provided repeated blood samples previous to diagnosis. A total of 12,000 males and over 11,900 females recruited in 1991-2 are being followed. Screenings performed by the team of Mailman School researchers found changes linked to cancer in serum DNA, presumably released from the tumor, one to nine years before actual clinical diagnosis.........

Posted by: Janet      Read more         Source

April 15, 2007, 8:29 PM CT

Genetic Risk Factors For Crohn's Disease

Genetic Risk Factors For Crohn's Disease
An international research team including researchers from Massachusetts General Hospital (MGH) and the Broad Institute of Harvard University and Massachusetts Institute of Technology has identified several novel genetic variations linked to the risk of Crohn's disease. One of the identified genes establishes a role for autophagy, a previously unsuspected biological pathway, in Crohn's disease pathology; and the report documents functional studies which establish that this gene is integral to immune responses to intestinal bacteria. The report will appear in the journal Nature Genetics and is receiving early online release.

"Our discovery of several new genetic risk factors for Crohn's should improve understanding of the true causes of this disease and reveal new causal pathways that can be targeted therapeutically," says Mark Daly, PhD, of the MGH Center for Human Genetics Research and the Broad Institute, co-senior author of the Nature Genetics paper. "The study takes advantage of new knowledge of genetic variation patterns and new technology for assessing genetic variation that have only recently become available."

A chronic inflammatory bowel disease for which no single causative factor has been identified, Crohn's commonly affects the small intestine, causing abdominal pain and chronic diarrhea. Serious symptoms can include ulceration, bleeding, the development of fistulas openings from affected areas into other organs or intestinal blockage. About half a million people in the U.S.are affected by Crohn's, and another half-million have a related condition called ulcerative colitis. Since Crohn's can run in families and is more common in some ethnic populations, it is likely to have genetic components. Prior studies have identified two genetic variations as increasing the risk for Crohn's, but those factors only account for a small percentage of inherited cases.........

Posted by: Sue      Read more         Source

April 13, 2007, 4:43 PM CT

New Reflux Guidelines Released

New Reflux Guidelines Released
New, updated guidelines for esophageal reflux testing appear in The American Journal of Gastroenterology. Developed and approved by the American College of Gastroenterology, these guidelines summarize advances in gastroesophageal reflux disease (GERD) diagnostic testing and how they have modified the clinical management of esophageal disorders.

"Gastroenterologists are confronted with an increasing number of patients presenting symptoms of GERD that are unresponsive to drug treatment," says lead author Dr. Ikuo Hirano. "These patients may have typical reflux symptoms of heartburn and regurgitation but also may complain of chest pain, asthma, chronic cough and chronic laryngitis." This confusing list of symptoms, coupled with the fact that a number of of these patients do not have visible esophageal erosions, makes diagnosis and therapy of GERD a challenge. Furthermore, non-gastrointestinal entities, such as cardiac or pulmonary disease, may produce symptoms that are similar to those attributable to GERD.

Some new technologies offer opportunities for more accurate diagnoses. "Wireless capsule pH monitoring, bile acid reflux monitoring devices and esophageal impedance can all improve the detection of reflux," says Dr. Hirano. These technologies have helped gastroenterologists to discover new forms of reflux, and to better characterize traditional acid reflux.........

Posted by: Sue      Read more         Source

April 11, 2007, 10:21 PM CT

Liver regeneration may be simpler

Liver regeneration may be simpler
The way the liver renews itself may be simpler than what researchers had been assuming. A new study, appearing in the April 13 issue of The Journal of Biological Chemistry, provides new information on the inner workings of cells from regenerating livers that could significantly affect the way physicians make livers regrow in patients with liver diseases such as cirrhosis, hepatitis, or cancer.

"The human liver is one of the few organs in the body that can regenerate from as little as 25 percent of its tissue," says Seth Karp, assistant professor of surgery at Harvard Medical School, Boston, and main author of the study. "It is not known how the liver does it, but our results provide some details of what makes the liver so unique."

Eventhough organ regeneration has been observed in a number of animals, the details of how it happens at the cellular level are not yet completely understood. So far, researchers have shown that cells that participate in tissue regeneration behave as if they were part of a growing organ in an embryo. In other words, the cells act as if the liver is growing, as do other organs in a developing embryo.

A number of of the proteins that induce organ regeneration have been identified and researchers are now trying to make organs regrow by stimulating these proteins. Regrowing livers this way would be particularly useful for patients whose livers are so damaged say, by a tumor that has spread to most of the liver that a large part would be removed. Unless such patients receive the right amount of liver transplant from an organ donor, they do not always survive. Quickly stimulating the growth of the remaining portion of their liver could be their only chance of survival.........

Posted by: Sue      Read more         Source

March 15, 2007, 6:20 PM CT

Why do you Bleed during endoscopy?

Why do you Bleed during endoscopy?
Does an aspirin-a-day increase the risk of bleeding during invasive diagnostic procedure? This is an important concern for a number of patients who take these and other antiplatelet agents in an effort to reduce heart attacks or strokes. Scientists at the MUHC have shown that antiplatelet drugs do not contribute to post-endoscopic bleeding. Their findings appear in this month's issue of Alimentary Pharmacology and Therapeutics.

"Clinical guidelines for use of antiplatelets during these procedures have been ambiguous," says Dr. Alan Barkun, MUHC Chief of Gastroenterology. "Some suggest withholding or stopping these medications ten days previous to the endoscopic procedure. Others will not perform the procedure if the patient was taking antiplatelet agents. In some cases this could have serious negative clinical implications. Our findings show that these precautionary measures are not necessary".

Barkun and colleagues, including Nadeem Hussain, a physician at the University of Western Ontario, compared the use of antiplatelets in patients who experienced bleeding with those who did not. Out of 126 endoscopy patients, they demonstrated that exposure to antiplatelets was not significantly linked to post procedure bleeding.

"Approximately 70 percent of individuals over the age of 65 are taking non steroidal anti-inflammatory medications or aspirin regularly. Our findings show that withholding these is not necessary for patients undergoing therapeutic endoscopic procedures," adds Dr. Barkun, a professor of medicine at McGill University. "This will also help ease any potential worry patients coming in for their screening colonoscopy exams may have. It is indeed important that individuals at risk for developing colorectal cancer come in for their procedures."........

Posted by: Sue      Read more         Source

February 26, 2007, 7:52 PM CT

The metabolic response to colitis

The metabolic response to colitis
A new study being published by the American Physiological Society ( finds that the body responds differently to colitis (inflammation of the colon) based on whether the disease is acute (sharp and brief) or chronic (long-term). Researchers, using an experimental mouse model of colitis, discovered that the effects of acute colitis were linked to decreased body weight, food intake, and body fat content. Chronic colitis was linked to reduced body fat content, decreased bone mineral density and attenuated use of energy, termed energy expenditure. The discovery may help lead to better symptom management for the 500,000 Americans who live with the disease.

The study, "Mice With Experimental Colitis Show an Altered Metabolism With Decreased Metabolic Rate, " was conducted by Silvia Melgar and Erik Michalsson, Integrative Pharmacology, GI Biology, AstraZeneca; Lennart Svensson, Department of Molecular Pharmacology, AstraZeneca; Anna-Karin Gerdin and Mohammad Bohlooly-Y, AstraZeneca Transgenics and Comparative Genomics Centre, AstraZeneca, Molndal, Sweden; and Mikael Bjursell, Department of Physiology/Endocrinology, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Goteborg University, Sweden and AstraZeneca Transgenics and Comparative Genomics Centre, AstraZeneca, Molndal, Sweden. Their study appears in the Articles in Press Section of the American Journal of Physiology, Gastrointestinal and Liver Physiology. The journal is one of 11 peer evaluated scientific publications issued each month by the American Physiological Society (APS).........

Posted by: Sue      Read more         Source

December 20, 2006, 7:18 PM CT

Snake-like Robot Could Assist Surgeons

Snake-like Robot Could Assist Surgeons The snake-like robot designed by Johns Hopkins engineers
Credit: Will Kirk/JH
Drawing on advances in robotics and computer technology, Johns Hopkins University scientists are designing new high-tech medical tools to equip the operating room of the future. These systems and instruments could someday help doctors treat patients more safely and effectively and allow them to perform surgical tasks that are nearly impossible today.

The tools include a snakelike robot that could enable surgeons, operating in the narrow throat region, to make incisions and tie sutures with greater dexterity and precision. Another robot, the steady-hand, may curb a surgeon's natural tremor and allow the doctor to inject drugs into tiny blood vessels in the eye, dissolving clots that can damage vision.

These and other projects are being built by teams in the National Science Foundation Engineering Research Center for Computer-Integrated Surgical Systems and Technology, based at Johns Hopkins. Launched in 1998 with funding from the NSF, the center aims to transform and improve the way a number of medical procedures are performed.

Working closely with physicians from the Johns Hopkins School of Medicine, the center's engineers and computer researchers are building robotic assistants intended to enhance a surgeon's skills. They are devising detailed visual displays to guide a doctor before and during a difficult medical procedure and planning digital workstations that would give the doctor instant access to an enormous amount of medical information about the patient.........

Posted by: Scott      Permalink         Source

December 20, 2006, 4:08 AM CT

Majority Of Ulcerative Colitis Patients Are Not Compliant

Majority Of Ulcerative Colitis Patients Are Not Compliant
New York, NY December 18, 2006 A new, large survey supported by the Crohn's & Colitis Foundation of America (CCFA) finds that 65 percent of ulcerative colitis (UC) patients are less than fully compliant with first-line therapies to treat their disease. The findings are significant because an earlier study observed that patients less than fully compliant experience five times the number of disease flare-ups.

Respondents to the CCFA survey were taking a variety of aminosalicylates, medications which help relieve symptoms and inflammation for a number of UC sufferers, but which require multiple pills be taken two to four times a day. CCFA conducted the survey to gain a better understanding of patients' experiences with UC and these medications.

The most usually reported reasons for non-compliance with medications were the dosing frequency, the number of pills and the inconvenience linked to the medication. Seventy-four percent of the 1,595 UC sufferers included in the survey experienced at least one flare-up of UC during the prior year. Flare-ups can involve heightened symptoms such as diarrhea, abdominal pain, loss of appetite, fatigue as well as complications such as anemia.

"The study shows that a number of patients struggle to comply with their current medicine regimen because they have to take multiple pills throughout the day," said the survey report's author Edward V. Loftus, Jr., a gastroenterologist at Mayo Clinic in Rochester, MN. "And we know that when UC patients don't take their medications as prescribed, it can have a significant impact on their health and quality of life".........

Posted by: Sue      Permalink         Source

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Did you know?
The number of bariatric surgeries performed in the U.S. increased by 450 percent between 1998 and 2002, a growth the scientists say could be linked with use of the minimally invasive laparoscopic technique, according to an article in the recent issue of Archives of Surgery, one of the JAMA/Archives journals. Archives of gi news blog

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