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March 11, 2008, 9:58 PM CT

Road map to safer pain control

Road map to safer pain control
At a time when several U.S. health insurers have discontinued payment for use of the sedative propofol during most screening colonoscopies, physicians at the University of Pennsylvania School of Medicine have discovered that an alternative way to administer the drug could both save millions of health care dollars and provide a safer way to deliver optimal pain relief.

The scientists studied two groups of patients who received patient-controlled sedation administered themselves with the push of a button during their colonoscopy. One group received a combination of the sedatives propofol and remifentanil, while the other received the drugs midazolam and fentanyl. Those in the propofol arm took only about half as long to be sedated, were able to walk quicker after the procedure, and spent much less time in the recovery room.

The findings, reported in the recent issue of the journal Anesthesia and Analgesia, shed additional light on Aetna, Humana and other large health insurers recent decisions to discontinue payment for the use of the sedative propofol during most routine colonoscopies, because it generally requires an anesthesiologist to be present to monitor for adverse reactions during the procedure. Their involvement adds several hundred dollars to the cost of the procedure, but without insurance coverage for this popular pain relief choice, physicians worry that more patients will avoid the lifesaving test, which detects and removes pre-malignant polyps. Last year, 55,000 Americans died of colorectal cancer, making it the nations second-leading cancer killer.........

Posted by: Scott      Read more         Source


March 11, 2008, 9:56 PM CT

How digits grow

How digits grow
Researchers at the University of Wisconsin School of Medicine and Public Health (SMPH) are wagging a finger at currently held notions about the way digits are formed.

Studying the embryonic chick foot, the developmental biologists have come up with a model that explains how digits grow and why each digit is different from the others.

As reported in the Proceedings of the National Academy of Sciences Online Early Edition the week of March 10-14, 2008, the scientists found that the development and fate of each digit depends on a surprisingly dynamic process in unanticipated locations and involving unexpected players.

The UW-Madison team showed that growth begins in a portion of the developing digit they have named the phalanx-forming region (PFR). They illustrated that phalanges, structures that later become finger or toe bones, arise not from cartilage cells but from mesenchymal cells. And they discovered that a complex array of signals from a variety of genes at different times combine to form each phalanx.

Though the research was done on chick digits, it may have implications for humans born with a genetic condition known as bradydactyly, or stubby fingers and toes.

The work was undertaken in the laboratory of John Fallon, the Harland Winfield Mossman Professor of Anatomy at the SMPH, who for years has sought to understand how cell fate is determined and patterning-of digits, teeth and feathers-is achieved during embryonic development.........

Posted by: Scott      Read more         Source


March 11, 2008, 5:40 AM CT

Advanced-stage ovarian cancer patients with BRCA live longe

Advanced-stage ovarian cancer patients with BRCA live longe
Two abstracts underscoring the importance of testing for BRCA1/2 mutations in women with ovary cancer were presented at this week's Society of Gynecologic Oncologists 39th Annual Meeting on Women's Cancers, by scientists from The University of Texas M. D. Anderson Cancer Center.

In the first study, a multicenter research team led by M.D. Anderson found advanced- stage ovary cancer patients with non-Ashkenazi Jewish BRCA (non-AJ BRCA) mutations experience longer progression-free and overall survival rates in comparison to those with sporadic ovary cancer. The data confirms prior research which reported that among ovary cancer patients of Ashkenazi-Jewish heritage, BRCA1/2 mutations (AJ BRCA) are associated improved long-term survival.

For this study, scientists examined 85 advanced-stage ovary cancer patients with non-AJ BRCA mutations and 116 patients who did not express any type of BRCA mutation. In comparison to patients without BRCA mutations, non-AJ BRCA carriers had longer progression-free survival of 19.0 vs. 27.8 months and improved overall survival of 65.6 vs. 101.4 months. Non-AJ BRCA patients had a 2.15 times greater odds of complete response to initial chemotherapy response over sporadic, non-carrier patients.

Karen Lu, M.D., associate professor in the Department of Gynecologic Oncology at M. D. Anderson and senior author on the study said the difference in survival rates indicate that individuals with BRCA mutations might respond better to standard chemotherapy for ovary cancer. "Thus, it becomes increasingly valuable to know a patient's BRCA status to guide and personalize therapy decisions," Lu said.........

Posted by: Scott      Read more         Source


March 11, 2008, 5:37 AM CT

Breakthrough Drug for Clot Victims

Breakthrough Drug for Clot Victims
Washington University scientists have identified the mechanism that makes a bioengineered enzyme function efficiently, opening the way to clinical development of the first safe clot busting agent for treating heart attacks and strokes.

A team of scientists at Oregon Health & Science University and Washington University in St. Louis have described for the first time the mechanism that gives a mutant enzyme molecule that they have engineered - and patented - the potential to become a breakthrough drug for treating heart attacks and strokes.

The team described how their genetically modified enzyme, called WE-thrombin, functions as a potent clot busting agent while retaining little of the power that thrombin, its non-engineered parent, has to cause the opposite result, a cascade of clot building. They did so in a paper published recently in Arteriosclerosis, Thrombosis, and Vascular Biology (ATVB), a peer-evaluated journal of the American Heart Association. An editorial commentary in ATVB hailed this breakthrough as "a significant advance in understanding the functions and antithrombotic potential of (WE thrombin) in particular, and the approach of using engineered human proteins more broadly..".

"The successful development of WE-thrombin would be a major medical breakthrough in antithrombotic treatment, ultimately saving thousands of lives worldwide each year," said the lead investigator AndrĂ¡s Gruber, M.D., associate professor of biomedical engineering and of medicine in the division of hematology and medical oncology, OHSU School of Medicine.........

Posted by: Scott      Read more         Source


March 9, 2008, 6:03 PM CT

Brain network linked to contemplation

Brain network linked to contemplation
A brain network associated with introspective tasks -- such as forming the self-image or understanding the motivations of others -- is less intricate and well-connected in children, researchers at Washington University School of Medicine in St. Louis have learned. They also showed that the network establishes firmer connections between various brain regions as an individual matures.

The researchers are working to establish a picture of how these connections and other brain networks normally develop and interact. They want to use that picture to conduct more detailed assessments of the effects of aging, brain injuries and conditions such as autism on brain function.

"Having this information will not only help us understand what's going wrong in these patients, it will also allow us to better assess whether and how future interventions are providing those patients with effective therapy," says senior author Bradley L. Schlaggar, M.D., Ph.D., associate professor of pediatrics, radiology, neurology and anatomy and neurobiology.

The results appear online this week in The Proceedings of the National Academy of Sciences.

Neuroresearchers including co-author Marcus E. Raichle, M.D., professor of radiology, of anatomy and neurobiology and of neurology first identified the network, which is called the default network, in 1996. Since then, researchers have linked it to many inward-looking activities, including the creation of the "autobiographical self," a person's internal narrative of their life story; and "mentalizing," the ability to analyze the mental states of others and use those insights to adjust the self's behavior appropriately.........

Posted by: JoAnn      Read more         Source


March 9, 2008, 4:54 PM CT

Lasik Patients Report More Than 95 Percent Satisfaction Rate

Lasik Patients Report More Than 95 Percent Satisfaction Rate
Worldwide, an average 95.4 percent of LASIK patients are satisfied with their new vision, as per the first review of the world body of scientific literature, the American Society of Cataract and Refractive Surgery announced recently.

With 16.3 million patients having had LASIK worldwide, and more than a decade of clinical study and technological innovation behind it, LASIK is considered among the most successful elective procedures available today.

"We find that there is solid evidence in the world's scientific literature to affirm that there is an exceptionally high level of satisfaction in patients who have had LASIK surgery. While no surgery is perfect, certainly the 19 peer-evaluated studies of the 2,199 patients studied show extremely high satisfaction rates," said Richard L. Lindstrom, M.D., president of the American Society of Cataract and Refractive Surgery. "While patient satisfaction is extremely high, we recognize that there are patients who have unsatisfactory outcomes. As surgeons, we have taken the Hippocratic Oath. The well being of all of our patients is central to what we do and what we are. As such, and as the history of medicine has shown, we are committed to advancing our technology, patient selection, and surgical techniques so that we can continue to enhance the quality of our patient's lives," Lindstrom added.........

Posted by: Mike      Read more         Source


March 7, 2008, 5:29 AM CT

Breakthrough in birth-defect research

Breakthrough in birth-defect research
Researchers have discovered how to prevent certain craniofacial disorders in what could ultimately lead to at-risk babies being treated in the womb.

University of Manchester researchers, working with colleagues at the Stowers Institute for Medical Research in Kansas, have successfully treated mice with Treacher Collins syndrome a rare genetic disorder characterised by underdeveloped facial bones, absent or deformed ears and occasionally cleft palate.

The team had previously observed that the condition, which affects one in 10,000 individuals, was caused by a mutation in a single gene called TCOF1. They later discovered that this mutation causes cells, known as neural crest cells, to die prematurely in the early stages of pregnancy resulting in the facial anomalies.

Now, writing in the journal Nature Medicine, the scientists have shown that preventing the neural crest cells from dying allowed mice with the Treacher Collins gene to develop normally. The principle, say the authors, could also be applied to other single-gene birth defects.

This is the first time that a congenital defect has been successfully treated and provides genuine hope within a realistic timeframe of one day preventing these conditions in humans, said Professor Mike Dixon in Manchesters Faculty of Life Sciences.........

Posted by: JoAnn      Read more         Source


March 5, 2008, 9:28 PM CT

Earlier, More Accurate Diagnosis of Alzheimer's Disease

Earlier, More Accurate Diagnosis of Alzheimer's Disease
Scientists involved in a large, multi-institutional study using positron emission tomography (PET) imaging with the radiotracer fluorodeoxyglucose (FDG) were able to classify different types of dementia with very high rates of success, raising hopes that dementia diagnoses may one day be made at earlier stages.

"Previously, researchers have been able to look only at the surface of the brain to differentiate various types of dementia," said Lisa Mosconi, Ph.D., assistant professor of psychiatry at the New York University School of Medicine. "With FDG PET, we were able to develop standardized disease-specific patterns from which we could correctly classify dementia more than 94 percent of the time."

The study, which was published in the recent issue of the Journal of Nuclear Medicine, measured the cerebral metabolic rate of glucose (CMRglc)-the amount of sugar the brain uses to fuel its activities-in various areas of the organ. A decrease in this rate is indicative of a loss of nerve cells and of dysfunction linked to dementia. Because FDG behaves like glucose when injected into the body, its location in the PET scans pinpointed the specific area where glucose utilization had fallen below normal levels as in comparison to an age-appropriate control group.

"Each type of dementia examined-Alzheimer's disease (AD), frontotemporal dementia (FTD), and dementia with Lewy bodies (DLB)-affects a different area of the brain. Based on where in the brain this decrease occurred, we were able to determine which type of dementia a patient had," Mosconi explained.........

Posted by: Daniel      Read more         Source


March 4, 2008, 6:18 PM CT

Costly placebo works better than cheap one

Costly placebo works better than cheap one
A 10-cent pill doesn't kill pain as well as a $2.50 pill, even when they are identical placebos, as per a provocative study by Dan Ariely, a behavioral economist at Duke University.

"Physicians want to think it's the medicine and not their enthusiasm about a particular drug that makes a drug more therapeutically effective, but now we really have to worry about the nuances of interaction between patients and physicians," said Ariely, whose findings appear as a letter in the March 5 edition of the Journal of the American Medical Association.

Ariely and a team of collaborators at the Massachusetts Institute of Technology used a standard protocol for administering light electric shock to participants wrists to measure their subjective rating of pain. The 82 study subjects were tested before getting the placebo and after. Half the participants were given a brochure describing the pill as a newly-approved pain-killer which cost $2.50 per dose and half were given a brochure describing it as marked down to 10 cents, without saying why.

In the full-price group, 85 percent of subjects experienced a reduction in pain after taking the placebo. In the low-price group, 61 percent said the pain was less.

The finding, from a relatively small and simplified experiment, points to a host of larger questions, Ariely said.........

Posted by: Scott      Read more         Source


March 4, 2008, 5:34 PM CT

Achievement gaps within racial groups

Achievement gaps within racial groups
A University of Michigan study finds that when it comes to achievement gaps within racial groups, catching up over time is common.

In the first known study to analyze reading and math achievement within racial groups during elementary school, scientists found high achievers within all groups and that a substantial proportion of children catch up to the high achievers in their groups over time.

The study, presented today in Washington, D.C. at the annual meeting of the Society for Research on Educational Effectiveness, analyzes data on a national sample of 8,060 students, collected at four points in time, starting in kindergarten and ending in the spring of fifth grade.

"We found significant achievement gaps within racial and ethnic groups," said Pamela Davis-Kean, a developmental psychology expert at the U-M Institute for Social Research (ISR) who conducted the study with U-M post-doctoral fellow Justin Jager.

"We also found a significant proportion of students who caught up to the high achievers in their groups by the end of fifth grade, particularly in reading. This shows that schooling does have an impact in closing the achievement gap for substantial numbers of children".

In reading, the scientists observed that there were high-performing groups in all races. "This is a fact that sometimes gets lost in discussions of the achievement gap between white students and students of other races," Davis-Kean said.........

Posted by: Scott      Read more         Source



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Did you know?
Scientists at Yale have brought to light a mechanism that regulates the way an internal organelle, the Golgi apparatus, duplicates as cells prepare to divide, according to a report in Science Express.Graham Warren, professor of cell biology, and colleagues at Yale study Trypanosoma brucei, the parasite that causes Sleeping Sickness. Like a number of parasites, it is exceptionally streamlined and has only one of each internal organelle, making it ideal for studying processes of more complex organisms that have a number of copies in each cell.

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