Americans spent $33.9 billion out-of-pocket on complementary and alternative medicine (CAM) over the previous 12 months, according to a 2007 government survey(1). CAM is a group of diverse medical and health care systems, practices, and products such as herbal supplements, meditation, chiropractic, and acupuncture that are not generally considered to be part of conventional medicine.

CAM accounts for approximately 1.5 percent of total health care expenditures ($2.2 trillion(2)) and 11.2 percent of total out-of-pocket expenditures (conventional out-of-pocket: $286.6 billion(2) and CAM out-of-pocket: $33.9 billion(1)) on health care in the United States.

Approximately 38 percent of adults use some form of CAM for health and wellness or to treat a variety of diseases and conditions, according to data from the 2007 National Health Interview Survey (NHIS)(3). The CAM component of the NHIS was developed by the National Institutes of Health’s (NIH) National Center for Complementary and Alternative Medicine (NCCAM) and the National Center for Health Statistics (NCHS) part of the Centers for Disease Control and Prevention. The data provide estimates of the cost of CAM use, the frequency of visits made to CAM practitioners, and frequency of purchases of self-care CAM therapies.

“With so many Americans using and spending money on CAM therapies, it is extremely important to know whether the products and practices they use are safe and effective,” said Josephine P. Briggs, M.D., director of NCCAM. “This underscores the importance of conducting rigorous research and providing evidence-based information on CAM so that health care providers and the public can make well-informed decisions.”

Of the $33.9 billion spent on CAM out-of-pocket, an estimated $22.0 billion was spent on self-care costs — CAM products, classes, and materials — with the majority going to the purchase of nonvitamin, nonmineral, natural products ($14.8 billion) such as fish oil, glucosamine and Echinacea. U.S. adults also spent approximately $11.9 billion on an estimated 354.2 million visits to CAM practitioners such as acupuncturists, chiropractors, massage therapists, etc.

To put these figures in context, the $14.8 billion spent on nonvitamin, nonmineral, natural products is equivalent to approximately one-third of total out-of-pocket spending on prescription drugs, and the $11.9 billion spent on CAM practitioner visits is equivalent to approximately one-quarter of total out-of-pocket spending on physician visits.

“These data indicate that the U.S. public makes millions of visits to CAM providers each year and spends billions of dollars for these services, as well as for self-care forms of CAM,” said Richard L. Nahin, Ph.D., MPH, acting director of NCCAM’s Division of Extramural Research and lead author of the cost of complementary and alternative medicine analysis. “While these expenditures represent just a small fraction of total health care spending in the United States, they constitute a substantial part of out-of-pocket health care costs.”

Inclusion and development of the 2007 NHIS supplement was supported, in part, by seven NIH components: NCCAM; National Heart, Lung, and Blood Institute; National Institute of Allergy and Infectious Diseases; National Institute of Mental Health; the Eunice Kennedy Shriver National Institute of Child Health and Human Development; Office of Dietary Supplements; and Office of Behavioral and Social Sciences Research.

The National Center for Health Statistics (NCHS) is a component of the Centers for Disease Control and Prevention (CDC). NCHS’s mission is to provide statistical information that will guide actions and policies to improve the health of the American people. The CDC protects people’s health and safety by preventing and controlling diseases and injuries; enhances health decisions by providing credible information on critical health issues; and promotes healthy living through strong partnerships with local, national, and international organizations. The complete data set can be found under “Questionnaires, Datasets, and Documentation” at www.cdc.gov/nchs/nhis.htm.

The National Center for Complementary and Alternative Medicine’s (NCCAM) mission is to explore complementary and alternative medical practices in the context of rigorous science, train CAM researchers, and disseminate authoritative information to the public and professionals. For additional information, call NCCAM’s Clearinghouse toll free at 1-888-644-6226, or visit the NCCAM Web site at nccam.nih.gov.

The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical, and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit www.nih.gov

NOTES:

(1) Nahin, RL, Barnes PM, Stussman BJ, and Bloom B. Costs of Complementary and Alternative Medicine (CAM) and Frequency of Visits to CAM Practitioners: United States, 2007. National health statistics reports; no 18. Hyattsville, MD: National Center for Health Statistics. 2009.

(2) Office of the Actuary, Centers for Medicare and Medicaid Services, National Health Expenditure Data for 2007. U.S. Department of Health and Human Services. Available at: http://www.cms.hhs.gov/NationalHealthExpendData/02_NationalHealthAccountsHisto rical.asp#TopOfPage. Accessed June 25, 2009.

(3) Barnes PM, Bloom B, Nahin RL. Complementary and Alternative Medicine Use Among Adults and Children: United States, 2007. National health statistics reports; no 12. Hyattsville, MD: National Center for Health Statistics. 2008.

Source: National Center for Complementary and Alternative Medicine, National Institutes of Health


Findings May Potentially Lead to New Approach to Stroke Treatment

When minimally invasive endovascular (through the vessel) therapy made its debut two decades ago, stroke care underwent a major shift as the “window of treatment” for patients suffering a stroke was expanded to eight hours within symptom onset, rather than the standard three-hour window required by the FDA-approved intravenous tPA therapy. Now, a new retrospective, multi-center study shows that endovascular therapy beyond the eight-hour window restored blood flow in the brain in approximately 74 percent of patients suffering ischemic (caused by a clot) stroke. Presented today at the Society of NeuroInterventional Surgery (SNIS) 6th Annual Meeting in Boca Raton, FL, the data suggests that this treatment is safe and potentially leads to improved outcomes for a select number of late-presenting patients, including those who awake with stroke symptoms.

According to lead author Raul Nogueira, M.D., Assistant in Neurology and Radiology at Massachusetts General Hospital — Harvard Medical School, presentation beyond eight hours of symptom onset has traditionally been the single most important factor in excluding patients from stroke treatment. Thus, continued Nogueira, when brain imaging studies revealed that a significant number of late-presenting stroke patients showed evidence of salvageable brain tissue in the area of the stroke, it was an important avenue to pursue. This meant that endovascular therapy (performed by neurointerventional specialists who use drugs or mechanical devices inserted through a catheter or narrow tube that is threaded up through the vessels directly to the problem site to dispel the clot) could potentially be utilized successfully in these patients.

“As we considered the possibilities, it became an exciting proposition to pursue our hypothesis,” said Nogueira. “Traditionally, these patients had been deemed untreatable. But if the therapeutic window could be expanded, these findings could make a significant impact on the future of stroke treatment.”

The study included a consecutive case series of 237 patients whose first angiography (a diagnostic test that infuses the blood vessels with dye in order to clearly visualize the vessel structures) confirming a clot in the brain was performed later than eight hours from the last time the patient was seen well. All patients were identified from prospectively acquire databases at 10 high volume academic stroke centers across the United States.

Of the 237 study participants, 49 percent were males and 51 percent were females, with a mean (or average) age of 64 years and whose mean time from last seen well to t reatment was 15 hours. On the standard National Institute of Health Stroke Scale (NIHSS) — a test that uses baseline data to determine severity of a stroke and projected outcome — participants registered a mean score of 15 (any score over 10 is associated with a serious stroke). Various endovascular treatments were used, including: clot-dissolving drugs in 46 percent of the cases; the MERCI Retriever, a clot-removal device, in 62 percent of cases; and other mechanical instruments, including the recently FDA-approved Penumbra Device, in 36 percent of cases.

Beyond the immediate results that showed an overwhelming success in restoring blood flow, follow-up at 90 days in 198 patients indicate that 93 (47 percent) patients registered good outcomes (meaning patients could be functionally independent) and 123 (62 percent) patients reflected acceptable outcomes. Approximately nine percent suffered a symptomatic brain hemorrhage and the overall mortality rate was 22 percent. When analyzing what factors were most closely associated with favorable outcomes, successful restoration of blood flow, younger age, lower stroke severity (as indicated by the NIHSS), and male gender were identified.

According to Nogueira, the study serves as preliminary data for DAWN, a prospective randomized trial designed to assess the benefit of this approach as compared to standard medical therapy. “We look forward to exploring this preliminary data more in-depth in order to bring more clarity to the treatment of late-presenting stroke patients. The possibilities are exciting, as these findings could very well mean that thousands of patients who would not have been previous candidates for treatment could benefit from therapies that could restore their quality of life.”

Stroke is the third leading cause of death in the United States, Canada, Europe and Japan. According to the American Stroke Association, approximately 800,000 Americans each year suffer a new or recurrent stroke. Americans will pay close to $68.9 billion in 2009 for stroke-related medical costs and disability.

Source: Society of NeuroInterventional Surgery


As we age, brown spots and splotchy skin are all too often a fact of life. But for people with darker skin, changes in pigmentation can occur without warning at any age and can be very difficult to treat. Fortunately, dermatologists can help people with skin of color diagnose and treat bothersome pigmentation problems.

At the American Academy of Dermatology’s Summer Academy Meeting 2009 in Boston, dermatologist Jonith Y. Breadon, M.D., FAAD, co-chair of Dermasurgery at John H. Stroger, Jr. Hospital of Cook County in Chicago, discussed pigmentation problems that occur more frequently in darker-skinned patients and how early diagnosis is key to stopping the progression of these skin conditions.

“Even though people with skin of color have less moles and experience less premature aging from the sun than lighter-skinned individuals, in some ways their darker pigmentation makes their skin more vulnerable to other skin problems,” said Dr. Breadon. “While these skin discolorations can be stubborn, there are treatments that offer noticeable improvement.”

Hyperpigmentation

One of the most common pigmentation problems in darker-skinned individuals is hyperpigmentation (or the darkening of the skin). Usually the result of some type of inflammation or injury to the skin, such as a cut, burn or scrape, hyperpigmentation produces darkened areas of the skin that can last months or years. Even healed acne lesions can leave permanent dark spots in darker-skinned people that, in some cases, can be more distressing than the original acne.

Dr. Breadon noted that treatments for hyperpigmentation are based on whether or not the dark areas are confined to the surface of the skin or if they have penetrated to the deeper layers of the skin. For superficial dark spots, a prescription topical medication consisting of hydroquinone, retinoic acid and mild hydrocortisone can be effective in fading skin discoloration. Deeper dark areas require an in-office surgical procedure, such as dermabrasion, chemical peels, or microdermabrasion with an infusion of hydroquinone solution. In patients with lighter skin, intense pulsed light (IPL) or one of the pigmented lasers could be considered.

“Patients with any type of hyperpigmentation problem need to use a sunscreen with a high sun protection factor (SPF) regularly – the higher SPF the better,” said Dr. Breadon. “There is no cure for this condition, so even when patients experience clearing, it can come back. For most patients, I usually recommend a three-month topical regimen then long-term maintenance with a sunscreen.”

Melasma

Often referred to as the “mask of pregnancy,” melasma is a skin condition marked by brown patches on areas such as the face, neck and arms that most often affects dark-skinned people and women in particular. Many dermatologists have long believed that there may be a hormonal component to melasma, and a recently published study found that there were an increased number of estrogen receptors in areas where patients developed melasma.

For this reason, Dr. Breadon advises patients with melasma to consider stopping oral contraceptives and hormone replacement therapy due to the large amount of estrogens in these medications. Regular sunscreen use is vital to protect the skin from further hyperpigmentation.

With melasma, the skin can be affected in three different ways: on the epidermis (superficial layer), in the dermis (deep layer) or a mixture of both the epidermis and dermis. Dermatologists use a light device known as the Woods lamp, which shows skin diseases as specific colors, to determine how deep melasma has penetrated the skin.

For superficial melasma, the triple cream combination of hydroquinone, retinoic acid and mild hydrocortisone with regular sunscreen use can be effective, with clearance occurring in about three months for most patients. Dr. Breadon noted that cases where melasma has penetrated the dermis are very difficult to treat and the combination triple cream medication will not be effective in these patients. However, some patients may experience improvement with microdermabrasion, dermabrasion, chemical peels or lasers. In cases where both the epidermis and the dermis are involved, the triple cream medication may offer some improvement for some patients.

“Melasma is hard to define, as it can occur in women during or after pregnancy or in women who have never been pregnant or used oral contraceptives,” said Dr. Breadon. “While lasers can be effective, there are risks of further hyperpigmentation and results vary greatly from person to person. Dermatologists can help patients decide the best course of treatment, depending on the severity of the condition.”

Lichen Planus

Lichen planus is a common inflammatory disease of the skin and the mouth that is characterized by a rash of round, or oval, violet-colored lesions. While lichen planus can affect people of all races and genders, it is more pronounced in people with darker skin since, as the lesions heal, the affected skin can develop very dark, leopard-looking spots.

When caught early, steroid injections are used to reduce the inflammation thereby minimizing hyperpigmentation. However, if the condition progresses before it can be treated and dark spots appear, Dr. Breadon explained that the triple cream topical medication, mild or systemic steroids, or lasers can be used with varying degrees of success to try to lighten the darkened areas of the skin.

“Detecting lichen planus early can make all the difference between spots that heal without hyperpigmentation and spots that are extremely pronounced and do not fade on their own,” said Dr. Breadon. “That’s why it is critical that people who experience an unexplained rash see their dermatologist immediately for proper diagnosis and treatment.

Ashy Dermatosis

Another skin condition that affects people of color, and especially African-Americans, is ashy dermatosis. While the cause of ashy dermatosis is unknown, it usually starts as a flat, dark grayish-brown rash that appears bi-laterally (or on both sides of body, such as both arms or both legs).

Ashy dermatosis closely resembles a condition known as fixed drug eruption, which causes the same type of pigmentation problem and is the result of an allergy to a food, medication or workplace trigger. For example, one of Dr. Breadon’s patients with this type of rash noticed a flare when she would consume a particular sugar substitute – which was eventually identified as the trigger.

“Based on my evaluation of numerous cases of ashy dermatosis and fixed drug eruption, my theory is that these two conditions are actually one in the same,” said Dr. Breadon. “That’s why I think it is so important to identify the trigger, as this can help alleviate the rash and prevent its spread. I encourage my patients to keep a food diary or a list of any medications or items with which they come into contact to see if we can identify the source of the problem.”

Dr. Breadon noted that ashy dermatosis and fixed drug eruption can be very difficult to treat. A compound lotion of salicylic acid, a mid-potency steroid and hydroquinone can offer gradual clearing. Regular use of sunscreen with a high SPF also is highly recommended to avoid further hyperpigmentation.

“It is important for people with darker skin to be aware of any changes in their skin and to see a dermatologist at the first sign of anything unusual,” said Dr. Breadon. “Dermatologists not only can diagnose and provide the best treatment options for a particular pigmentation problem, but also can rule out a serious condition, such as skin cancer.”

Source: American Academy of Dermatology


Diabetes gene raises odds of lower birth weight

  • Author: Health Informer
  • Filed under: Health News
  • Date: Jul 30,2009

Pediatric researchers have found that a gene previously shown to be involved in the development of type 2 diabetes also predisposes children to having a lower birth weight. The finding sheds light on a possible genetic influence on how prenatal events may set the stage for developing diabetes in later childhood or adulthood.

Researchers from The Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine published the study July 10 in the online version of the journal Diabetes.

“It’s a bit unusual to find a gene linked to both prenatal events and to a disease that occurs later in life,” said study leader Struan F.A. Grant, Ph.D., a researcher at the Center for Applied Genomics of The Children’s Hospital of Philadelphia. “This gene variant carries a double whammy, in raising the risk of both lower birth weight and the development of type 2 diabetes in later life.”

Type 2 diabetes occurs either when the pancreas produces too little insulin or when the body cannot efficiently use the insulin that is produced. Formerly called adult-onset diabetes and still most common in adults, type 2 diabetes has been increasing sharply among children.

Grant and study co-leader Hakon Hakonarson, Ph.D., director of the Center for Applied Genomics at Children’s Hospital, investigated 20 gene locations previously reported to be associated with type 2 diabetes. Drawing on a cohort of some 5,700 Caucasian children in an ongoing genome-wide association study of childhood obesity at Children’s Hospital, the researchers compared birth weights with the occurrence of the 20 gene variants.

They found that one of the gene variants, called CDKAL1, had a strong association with lower birth weight — a finding that supports the so-called fetal insulin hypothesis. Previous studies by European diabetes researchers, said Grant, had suggested that CDKAL1 was implicated in both lower birth weight and type 2 diabetes, and the current study, using a large sample size, reinforced that association.

Under the fetal insulin hypothesis, a slight underproduction of insulin, an important fetal growth factor, during the prenatal period may cause a baby to be born smaller. Low birth weight is already known to increase the risk of disease later in life, and the fetal insulin hypothesis proposes that the same gene that causes lower birth weight also increases the risk of developing type 2 diabetes.

“The mechanisms by which CDKAL1 may act are not well understood, but it is believed to reduce insulin secretion, and that underproduction contributes to type 2 diabetes,” said Grant. He added that further research may investigate biological pathways on which the gene functions, and may also study whether it may influence the risk of developing other diseases in later life.

The National Institutes of Health, the Cotswold Foundation and The Children’s Hospital of Philadelphia supported this study. Grant and Hakonarson, and their co-authors, are from both The Children’s Hospital of Philadelphia and the University of Pennsylvania School of Medicine.

Source: The Children’s Hospital of Philadelphia


Same Day Procedure May Transform Treatment Approach to Retinoblastoma

Expanded results of a study conducted on children with eye cancer (retinoblastoma) shows that chemotherapy delivered through endovascular (through the vessel) means not only successfully cures the cancer in a majority of cases, but achieves this cure with preserved vision. Study outcomes were presented this week at the Society of NeuroInterventional Surgery (SNIS) 6th Annual Meeting in Boca Raton, FL by lead author Pierre Gobin, Professor of Radiology in Neurosurgery and Neurology at the Weill Cornell Medical Center at New York Presbyterian Hospital in New York City.

“This is an exciting development in the neurointerventional community, as results prove that chemotherapy delivered through endovascular techniques is a powerful tool in addressing the most severe forms of retinoblastoma,” says Gobin, who says that the study is the product of teamwork between New York Presbyterian Hospital and the Eye Cancer Center of Memorial Sloan Kettering Cancer Center, New York City, with support from David Abramson, M.D., Brian Marr, M.D., Ira Dunkel, M.D. And Scott Brodie, M.D.

Retinoblastoma, the seventh most common pediatric cancer, is a malignant eye tumor in children that arises in cells in the developing retina. Typically, this cancer is associated with a late diagnosis as one of the only symptoms, a white pupil replacing the normal black, presents when the tumor occupies over one-third of the eye. Conventional therapy for this cancer includes laser treatment, as well as techniques that utilize extreme cold to freeze and destroy abnormal cells or deliver radioactive substances in timed intervals to kill the tumor. If these treatments fail, physicians resort to intravenous chemotherapy or radiation therapy. Despite this wide array of treatment options, however, a late diagnosis often requires the removal of the eye.

According to Gobin, the study was initiated in 2006 to determine if chemotherapy delivered through endovascular methods (through a catheter inserted in the groin and threaded up through the vessels to the site of the tumor), otherwise known as chemosurgery, would produce better outcomes for retinoblastoma patients, including preserving the eye and vision as well as avoiding intravenous chemotherapy, which is administered over the course of six months to a year and can be frequently associated with port infections and sickness for the duration of that time. Since the study was initiated, 49 children, ranging in age from 1 month to 10 years, have been treated with this technique. Of this number, all suffered from advanced retinoblastoma and were candidates for removal of the eye. Additionally, half of the patients had already failed prior conventional treatments, including intravenous chemotherapy or radiation therapy; nine patients had already had an eye removed.

Study participants were chosen following an eye examination under anesthesia, allowing physicians to confirm the diagnosis and determine the extent of the disease. For those who qualified, chemosurgery was performed soon thereafter, and was repeated every three to four weeks, up to six times.

To date, 144 chemosurgeries have been performed, which equates to a mean of three per patient. Results indicate that physicians were able to technically perform the procedure successfully in almost every case. Short-term follow-up, occurring after six or more months of stability after the last treatment, showed that of 27 eyes, 21 are cured (77 percent) and 13 are cured with preserved vision (48 percent). Six eyes could not be saved. Overall, of the population of eyes that were treated, 50 percent of patients would have lost an eye on conventional treatment; of those who kept an eye, a majority would not have experienced useful vision. With chemosurgery, only ten percent of patients lost an eye.

In general, patients tolerated the procedure well with minimal side effects that resolved once

addressed. In only four out of 46 eyes treated did severe complications occur which eventually led to blindness. All four eyes had received previous extensive treatment consisting of intravenous chemotherapy and radiation therapy.

Due to the overwhelming success observed with chemosurgery, Gobin says this treatment option has considerably reduced the number of conventional treatments, including the toxic intravenous chemotherapy, and most significantly, the number of eye losses. “The results really do have the potential to change the entire treatment approach to advanced retinoblastoma. In our center, chemosurgery is now the first line of treatment for this potentially devastating condition.”

Retinoblastoma occurs in approximately 350 – 400 children each year. Approximately 80 percent of patients are diagnosed under 3 years of age.

Source: Society of NeuroInterventional Surgery


Scientists Track Impact of DNA Damage in the Developing Brain

  • Author: Health Informer
  • Filed under: Health News
  • Date: Jul 28,2009

St. Jude technique yields clues about brain cells targeted by faulty single-strand DNA repair and offers new hints about the roots of neurological disease

Switching off a key DNA repair system in the developing nervous system is linked to smaller brain size as well as problems in brain structures vital to movement, memory and emotion, according to new research led by St. Jude Children’s Research Hospital scientists.

The work, published in the August issue of the journal Nature Neuroscience, also provides the first evidence that cells known as cerebellar interneurons are targeted for DNA damage and are a likely source of neurological problems in humans. The cerebellum coordinates movement and balance. The cerebellar interneurons fine tune motor control.

“These data will be important for understanding the role the DNA damage response plays in preventing neurological disease,” the investigators wrote.

The study also marks the first time researchers have switched off a pathway for repairing damaged single DNA strands in an organ system, in this case the mouse brain and nervous system. While the results suggest certain brain cells are particularly vulnerable, investigators report that with time DNA damage accumulates throughout the nervous system. Some mice in the study eventually develop seizures and difficulty walking.

Peter J. McKinnon, Ph.D., a member of St. Jude Genetics and Tumor Cell Biology, said the work provides a new model for understanding how single-strand DNA damage affects the nervous system and offers a new focus for tracking the origins of neurological disease.

The research also reflects growing scientific interest in damage to single strands of DNA. “A variety of human disease syndromes result from problems in the DNA-repair system,” explained McKinnon, the paper’s senior author.

DNA is the double-stranded molecule found in nearly every cell. In organisms both simple and complex, it serves as the biochemical blueprint for assembling and sustaining life. Diseases like cancer have long been associated with unrepaired damage to both strands of DNA. Single-strand DNA damage is far more common, but was generally considered less catastrophic to the cell.

But the last decade brought evidence linking single-strand DNA damage with human diseases, including ataxia with oculomotor apraxia (AOA1) and spinocerebellar ataxia with axonal neuropathy (SCAN1). Both disorders are inherited and are characterized by progressive difficulty with walking and other movement. AOA1 is among the most common form of certain inherited movement disorders in Japan and Portugal. McKinnon said those reports sparked new interest in single-strand DNA repair.

This study focused on Xrcc1, a protein long recognized as the master regulator of a pathway essential for single-strand DNA repair in the nervous system. The brain is thought to be particularly susceptible to such damage because neurons consume large amounts of oxygen, which can result in excessive production of free radicals and leave them vulnerable to single-strand DNA damage. Because brain cells do not divide, they cannot use the backup repair systems found in other tissues.

Investigators developed a way to switch off Xrcc1 production in the mouse brain and nervous system as development began. The system meant Xrcc1 still worked normally in the rest of the body.

The strategy used mice developed to make a particular enzyme, known as cre recombinase, in just the nervous system. St. Jude researchers then developed a mouse that carried an Xrcc1 gene outfitted with biochemical tags targeting the gene for inactivation by the enzyme. The result was a mouse whose nervous system lacked Xrcc1 and so was unable to efficiently repair the single-strand DNA damage.

The shutdown triggered a dramatic decline of interneurons throughout the cerebellum. In a subgroup of those cells, the damage triggered apoptosis, or programmed cell death. But the findings suggested the greatest loss occurred as the immature cerebellar interneurons, or progenitor cells, were poised to complete differentiation. In those cells, McKinnon said, loss of Xrcc1 activated the p53 pathway and blocked the cells from completing the cell cycle. “The cells appear to undergo permanent arrest,” said McKinnon, noting it is one of the few in vivo examples of the p53 pathway leading to cell cycle arrest rather than apoptosis.

In the hippocampus, which plays a role in memory and emotion, investigators reported abnormal gene expression and neuronal function. Some neurons were eventually replaced by scar tissue in a process known as gliosis. Overall changes in the hippocampus mimicked those found in the brains of adults with the seizure disorder known as temporal lobe epilepsy. In this study, the loss of Xrcc1 also resulted in seizures in mice.

The other authors of this paper were Youngsoo Lee, Sachin Katyal, Yang Li and Helen R. Russell, all of St. Jude; and Sherif F. El-Khamisy and Keith W. Caldecott of the University of Sussex, Brighton, UK.

The work was supported in part by the National Institutes of Health and ALSAC.

Source: St. Jude Children’s Research Hospital


Dr. Rezaian has created a method of minimally invasive laser back surgery to treat herniated discs in the spine. Anyone who has experienced the pain involved with a herniated spinal disc knows that it can be excruciating.

Since cartilage discs separate the spinal vertebrae and provide cushioning for the impact involved in daily movement, a herniated disc results in extreme pain that can cause immobility. Herniated discs also tend to push into the nerves surrounding the spine, resulting in pain that spreads throughout the arms and legs. Without spinal surgery, a herniated disc can rupture and cause irreversible paralysis.

Traditional spinal surgery for herniated discs has proven to be an inadequate solution for the ailment. Not only does the traditional back surgery involve deep incisions, risky general anesthesia and a very invasive procedure, it is only effective in relieving back pain for about 70% of the people who undergo surgery. The biggest concern is that, for many, pain after spine surgery can be even worse than the pain before the procedure.

Knowing that there was to be a better way to treat herniated discs, Los Angeles orthopaedic and spinal surgeon Dr. Rezaian, of the California Orthopaedic Medical Clinic, worked for years to help perfect a laser back surgery technique. His laser surgery technique, known as Universal Endoscopic Laser Discectomy (UED), is 98% effective in relieving patients of their back pain. Even more impressive than the success rate, however, is the rapid recovery time and minimally invasive nature of the laser back surgery. Unlike traditional back surgery to remove herniated discs, laser surgery does not leave any scars and allows patients to recover in an abbreviated time frame. Instead of spending weeks or months out of commission, patients are able to return to work quickly without excruciating back pain or lifelong scarring.

The laser back surgery procedure has been successfully performed on people of all ages, from 13 year old teenagers to senior citizens at the ripe age of 93. Since laser back surgery only requires local anesthesia, it is an all-around safer procedure and can be performed on people whose health may not permit undergoing general anesthesia.

For more information  http://www.laserbacksurgery.com/


A breakthrough in transgenic animal production enables development of new human disease models

Scientists from The Medical College of Wisconsin in Milwaukee, Sangamo Biosciences, Inc., Sigma-Aldrich Corporation, Open Monoclonal Technology, Inc. and INSERM announced the creation of the first genetically modified mammals developed using zinc finger nuclease (ZFN) technology.

In a paper published in the July 24, 2009 issue of Science, researchers describe the novel application of ZFNs to generate rats with permanent, heritable gene mutations, paving the way for the development of novel genetically modified animal models of human disease. ZFN technology will make the generation of such animals faster and will create new opportunities in species other than mice.

“Until now, rat geneticists lacked a viable technique for ‘knocking out,’ or mutating, specific genes to understand their function,” said Howard Jacob, Ph.D. Director of the Human and Molecular Genetics Center at the Medical College of Wisconsin. “This study demonstrates that ZFN technology bypasses the current need to conduct cumbersome experiments involving nuclear transfer (cloning) or embryonic stem cells and allows rapid creation of new animal models.”

In the study published in Science titled “Knockout Rats via Embryo Microinjection of Zinc Finger Nucleases,” (Geurts, et al.) scientists used ZFNs to knock out an inserted reporter gene and two native rat genes without causing measurable effects on other genes. Importantly, offspring of the ZFN-mutated rats also carried the modifications, demonstrating the genetic changes were permanent and heritable. Together, these results demonstrate the ability to deliver engineered ZFNs into early-stage embryos and rapidly generate heritable, knockout mutations in a whole organism.

Rats are physiologically more similar to humans than are mice for many traits and are ideal subjects for modeling human diseases. Extensive genetic characterization has revealed that approximately 90 percent of the rat’s 25,000-30,000 estimated genes are analogous to those in humans and mice, and their larger size makes them a superior model for drug-evaluation studies using serial sampling. Generating rats with knockout mutations has been a major challenge, but the new technique will increase the rat’s usefulness in research pertaining to physiology, endocrinology, neurology, metabolism, parasitology, growth and development and cancer. Along with his colleagues, Dr. Jacob’s team hopes to use knockout rats to gain a better understanding of disease processes related to hypertension, heart disease, kidney failure and cancer.

ZFNs are engineered proteins that induce double strand breaks at specific sites in an organism’s DNA. Such double-strand breaks stimulate the cell’s natural DNA-repair pathways and can result in site-specific changes in the DNA sequence. Previously, ZFNs were used to knock out specific genes in fruit flies, worms, cultured human cells and zebrafish embryos and are now in human clinical trials for the treatment of HIV/AIDS. This is the first example of successful gene editing in mammalian embryos using this technology.

“Our ZFN technology is widely applicable across species,” stated Philip Gregory, D.Phil., Sangamo’s vice president of research. “Used in conjunction with standard laboratory techniques, ZFNs provide a powerful solution to the challenge of making gene knockouts in cells and in whole organisms. We believe that this technology will become the method of choice for genome engineering in cells, plants and transgenic animals.”

In the first commercial application of this technique, OMT, a private biotechnology company developing a new rat-based human antibody platform, used Sangamo’s ZFNs to knock out the gene encoding rat immunoglobulin M (IgM), an important gene for rat antibody production. Inactivation of rat IgM expression is the first step in generating rats that exclusively express human antibodies encoded by transgenic human immunoglobulin genes. “Creating a knockout rat was the biggest challenge OMT faced,” said Dr. Roland Buelow, CEO of OMT and a senior author of the paper. “Inactivation of endogenous rat antibody expression is essential for human antibody expression in genetically engineered animals. To solve this problem, we used ZFN technology in an application that has the potential to revolutionize genetic engineering of animals.”

“We have invested our time and resources to develop the CompoZr platform because we see enormous potential in a technology that can precisely manipulate the genome of living organisms,” said Dr. David Smoller, President of Sigma-Aldrich’s Research Biotech business unit. “We are proud to be part of the public-private collaboration developing the proof-of-concept for this technique, which we believe will become the standard for the creation of genetically engineered research animals.”

Sigma-Aldrich, the sole source of commercial zinc finger nucleases for the research community, markets Sangamo’s ZFN technology through its CompoZr(TM) line of products and services. To get more information, please visit http://www.compozrzfn.com/.

Source: Sigma-Aldrich


Survey Reveals Women Aren’t Doing All They Can to Support Breast Health

  • Author: Health Informer
  • Filed under: Health News
  • Date: Jul 26,2009

One A Day Launches Online Campaign to Urge Women to Take A Stand Against Breast Cancer

A recent Yankelovich survey unveiled that although a large majority of women know there are simple steps they can take to support breast health, few women are taking the necessary actions. What’s more, 80 percent of the women surveyed have been personally affected by breast cancer or know someone who has been. To address this issue, One A Day Women’s Multivitamins is encouraging women to join a virtual march against breast cancer through the One A Day Women’s Take A Stand Campaign.

From now through the end of October, everyone will have the opportunity to show that they’re taking a stand against breast cancer by going to www.oneaday.com and creating a customizable character in honor of someone special.

The survey also found that one in five women who support breast health or breast cancer awareness causes wish they could do more, and 60 percent of women who have not supported breast cancer organizations and causes say they lack the time or money. Joining the Take A Stand virtual march provides a quick, easy and free way for women to help raise funds to support breast cancer awareness and research. For each character created, the One A Day brand will make a donation to a breast cancer cause selected by consumers. The organizations that will be included are: The Breast Cancer Research Foundation, the American Cancer Society and Breast Cancer Network of Strength.

“This program is part of our continued efforts to increase awareness about the importance of supporting breast health,” said Barton Warner, Vice President of Marketing and New Business for Bayer Consumer Care. “Last year One A Day Women’s woke women up about breast cancer through the One A Day Women’s Wake-Up Call program, and now it’s time women answer the call by taking a stand.”

The goal of this program is not only to raise breast cancer awareness and reach thousands of women by the end of October, but also to get women to take action to promote their own breast health. Each character created will help to spread the word about the simple things women can do.

“I encourage women to take a proactive approach to their overall health by exercising and maintaining a well-balanced diet,” said Lisa Drayer, MA, RD, author and health reporter. “I was surprised that the survey found that only half of women know that taking a daily multivitamin with vitamin D is an essential behavior that supports breast and bone health. Just a few simple things can make a big difference like doing self-exams and if you are over 40, getting mammograms regularly. Also, women should eat healthy, exercise and take a multivitamin with high levels of vitamin D.”

One A Day Women’s multivitamins are formulated with 800 IUs, twice the daily value of vitamin D. Emerging research suggests that 1000 IUs of vitamin D per day can help support breast health.

For more information on One A Day Multivitamins and on how to join the march, visit www.oneaday.com.

About the Survey

The survey was conducted by Yankelovich, part of The Futures Company, on behalf of Bayer HealthCare. Results were obtained through telephone interviews among a nationally representative sample of 500 women 18 years of age and older. Interviews took place June 19-21, 2009. Additional findings include:

– Despite knowing what to do for breast health, many women are not taking such actions on a regular basis
– 95 percent know it’s important to eat a healthy diet for breast health, but only 53 percent report doing so regularly
– 93 percent know they should conduct regular breast self-exams, but only 47 percent do regularly
– 88 percent know they should get a mammogram every year, but only 68 percent of women 45 and older report doing so
– 84 percent know they should exercise, but only 33 percent say they regularly exercise vigorously for at least 30 minutes
– 59 percent know they should take a multivitamin daily with vitamin D; 53 percent report taking a multivitamin daily
– Eight in ten women have supported a breast cancer organization or cause
– 71 percent have given money; 32 percent have volunteered
– 80 percent have been personally affected by breast cancer or know someone who has been, with 16 percent being personally affected by breast cancer and 75 percent who were affected through someone they knew
– 21 percent of these breast health supporters are interested in becoming more active
– 60 percent of women who are not active say they lack the time or money

Breast Cancer

According to the American Cancer Society, breast cancer is the second most common cancer among women (after skin cancer), accounting for more than 1 in 4 cancers diagnosed in US women. In addition, 1 out of 8 women will be diagnosed with breast cancer in her lifetime. The cause of breast cancer is unknown, and there is no known way to prevent breast cancer from occurring. However, women can learn the risk factors and promote early detection with regular breast self-exams, annual mammograms and clinical check-ups.

Source: Bayer Consumer Care


Quest Diagnostics Incorporated announced that the U.S. Food and Drug Administration (FDA) has granted an emergency use authorization to the company’s Focus Diagnostics business for its test for detecting the 2009 H1N1 influenza virus (the “pandemic flu virus”), a strain of influenza A virus initially referred to as the swine flu virus.

The Influenza A H1N1 (2009) Real Time RT-PCR test is the first commercial lab test to be granted an emergency use authorization by the FDA for testing for the 2009 H1N1 influenza virus. It is also the first test to qualitatively detect RNA of the pandemic flu virus in a patient’s nasal or nasopharyngeal specimens. The test targets two separate regions of the hemagglutinin gene of the 2009 H1N1 influenza virus to differentiate the presence of the pandemic virus from seasonal human influenza A virus. Turnaround time for reporting results is typically within 24 hours of receipt of specimen.

“This emergency use authorization means that the Influenza A H1N1 (2009) Real Time RT-PCR, when combined with clinical and epidemiological assessments, can aid physicians in diagnosing patients infected with the 2009 H1N1 influenza virus versus other influenza A virus strains,” said Jon R. Cohen, M.D., senior vice president and chief medical officer, Quest Diagnostics. “This capability could be critically important in aiding clinicians in determining which Influenza A virus is causing an infection should there be a surge in flu cases during the fall and winter flu season. We will continue to work closely with public health officials, who have done an outstanding job managing the pandemic, to mitigate its effect on public health.”

Quest Diagnostics’ Focus business, which has a track record of being first to market with new laboratory testing services for emerging infectious diseases, developed and, in May 2009, launched the laboratory developed test to help offload an expected backlog of testing from public health laboratories. In the U.S., public health labs employ the CDC’s rRT-PCR test, which the FDA authorized for emergency use in April 2009. Public health labs may use the CDC test to determine if certain high-risk patients who test positive for influenza A virus by commercial tests are infected with the pandemic flu virus.

Since Focus Diagnostics began to perform its laboratory developed test at its Cypress, CA, laboratory two months ago, orders placed by physicians for patients suspected of being infected with the 2009 H1N1 influenza virus increased dramatically before peaking in late June. While test volume has since declined, it remains more than 30 times higher than the company’s typical rate of influenza virus testing in July.

Of those samples tested by Focus Diagnostics, approximately three fourths for patients between the ages of five and 20 years have tested positive for the 2009 H1N1 influenza virus. By comparison, positivity rates in adults 21 to 40 years of age have averaged approximately 49 percent over the past two months. Adults 41 to 60 years of age have experienced positivity rates of 36 percent, while those 61 to 80 years of age have experienced positivity rates of approximately 14 percent.

“Our data are consistent with CDC data suggesting that this pandemic flu virus is disproportionately affecting children and young adults, as compared to older adults,” Jay M. Lieberman, M.D., medical director, Focus Diagnostics, said. “In fact, almost 60 percent of all positive results identified by our test have been in children 18 or younger.

“In addition, our data, consistent with CDC data, reveal that not only has this pandemic virus not faded away, it is behaving differently than the seasonal flu, which is typically absent during the summer months in the Northern Hemisphere,” Dr. Lieberman continued. “When you also factor in the rapid global spread of the virus, particularly the increasing number of cases in certain countries in the Southern Hemisphere, it appears increasingly likely that this novel H1N1 virus could be a major influenza strain circulating in the U.S. this flu season.”

Quest Diagnostics is currently in the process of validating the test at a number of its CLIA high complexity laboratories around the U.S. capable of performing the test in compliance with the emergency use authorization. The Quest Diagnostics Focus laboratory in Cypress, CA, currently is the only laboratory performing this test.

For more information about Quest Diagnostics and influenza testing options, please visit www.QuestDiagnostics.com/2009H1N1 or www.FocusDx.com.

About the FDA’s Emergency Use Authorization

The U.S. Secretary of Health and Human Services has declared a public health emergency because of the outbreak of the pandemic flu virus. The FDA, in response to requests from the CDC, has issued emergency use authorizations to make important diagnostic and therapeutic tools available to public health and medical personnel in order to identify and respond to the 2009 H1N1 influenza virus under certain circumstances.

The FDA has not cleared or approved any tests for the identification of the 2009 H1N1 influenza virus. The emergency use authorization authority allows the FDA, based on the evaluation of available data, to authorize the use of unapproved or uncleared medical products or unapproved or uncleared uses of approved or cleared medical products following a determination and declaration of emergency, provided certain criteria are met. In the case of the Influenza A H1N1 (2009) Real Time RT-PCR, the FDA has only authorized its use for the duration of the declaration of emergency, which is currently set to expire on April 26, 2010, unless it is terminated, revoked sooner or renewed.


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