Burnham Institute for Medical Research Professor Yu Yamaguchi, M.D., Ph.D., was recently awarded The Humanitarian Scientific Achievement Award by the MHE Research Foundation. The focus of the foundation is to find a cure for Multiple Hereditary Exostoses, a rare genetic bone disorder. The disorder causes people to grow exostoses (bone tumors) on their bones. MHE patients can also suffer from non-skeletal medical issues including mental and neurological issues. At this time, there is no treatment or cure. Surgery, physical therapy and pain management are currently the only options in management of the condition.
Mutations in a gene known as EXT1 cause MHE. Dr. Yamaguchi created a mouse model, in which the EXT1 gene can be experimentally disrupted in tissues and organs of interest. His research has provided insights into why MHE patients suffer from non-skeletal medical problems. Dr. Yamaguchi has recently shown that mutations in the EXT1 gene can cause dysfunction of nerve cells, providing a clue as to why MHE patients sometimes associate mental and neurological symptoms. Today, the mouse model is being used in more than 20 laboratories around the world, helping researchers explore the function of the EXT1 gene in a variety of organs and tissues.
"Dr. Yu Yamaguchi has expanded the frontiers of understanding of MHE," said Sarah Ziegler, MHE Research Foundation Vice President. "These insights also suggest potential novel approaches that can be explored in order to make the dream of a treatment into a reality." Ziegler is also the mother of a son with MHE.
A crystal plaque commemorating the award was presented to Dr. Yamaguchi during the Foundation's FUNTASIA Research Banquet held on September 30, 2007 in Brooklyn, New York. Dr. Yamaguchi was also presented citations and proclamations from U.S. Congress, New York State Senate, and the Borough of Brooklyn.
About Burnham Institute for Medical Research:
Burnham Institute for Medical Research conducts world-class collaborative research dedicated to finding cures for human disease, improving quality of life, and thus creating a legacy for its employees, partners, donors, and community. The La Jolla, California campus was established as a nonprofit, public benefit corporation in 1976 and is now home to three major centers: a National Cancer Institute-designated Cancer Center, the Del E. Webb Center for Neuroscience, Aging, and Stem Cell Research, and the Infectious and Inflammatory Disease Center. Burnham today employs nearly 800 people, ranks consistently among the world's top 20 organizations for the impact of its research publications, and rates fourth among all research institutes in the United States for obtaining grant funds from the National Institutes of Health. In 2006, Burnham established a center for vascular mapping and bionanotechnology in Santa Barbara, California. Burnham is also establishing a campus at Lake Nona in Orlando, Florida that will focus on diabetes and obesity research and will expand the Institute's drug discovery capabilities, employing over 300 people. For additional information about Burnham and to learn about ways to support its research, visit burnham/.
For more information about The MHE Research Foundation, visit mheresearchfoundation/.
Source: Andrea Moser
Burnham Institute
четверг, 20 октября 2011 г.
понедельник, 17 октября 2011 г.
'Mandela's Paradox' may show that osteoporosis propensity starts in pre-teen years
Black South African adults have very low hip fracture rate despite low calcium intake and exercise rates as youths -
After Nelson Mandela was released from prison February 11, 1990, all children born in the greater Johannesburg area were
enrolled in a 20-year longitudinal study. Officially known as "Birth to Twenty," the study and its 3,273 youth, are
colloquially referred to as "Mandela's Children." It's the largest and longest running study of child and adolescent health
and development in Africa, and one of the few large-scale longitudinal studies in the world.
One of the main aims of the study is to follow bone health in growing children, specifically the differences in bone mass
acquisition between black and white children and the factors that influence this.
Besides its obvious importance in adult health and possibly measuring the change from "third world" population to "developed
world" population, there is a situation in South Africa that's very counterintuitive, and possibly unique: "Black South
African adults have among the lowest hip fracture rates in the world," according to the study's lead author, Joanne A.
McVeigh.
"Yet our study found that, as children, blacks have significantly lower physical activity levels and calcium intakes than
age- and gender-matched white children," McVeigh adds. McVeigh is presenting the research at the 35th Congress of the
International Union of Physiological Sciences in San Diego, March 31 - April 5, 2005.
*Paper presentation: "Physical activity and bone mass accumulation patterns differ in black and white South African
children," by Joanne A. McVeigh, Shane A. Norris and John M. Pettifor, MRC Mineral Metabolism Research Unit, Department of
Paediatrics, and School of Physiology, University of Witwatersrand Medical School, Johannesburg. 12:30 p.m.-3 p.m. Sunday
April 3, Physiology session/abstract: 347.8; board #A64. On view 7:30 a.m. - 4 p.m.
9- and 10-year-olds compared for exercise level, bone mineral content
Since it's accepted that physical activity has an osteogenic effect on bone mass, the relationship between physical activity,
or exercise, and bone mineral content (BMC) levels in black and white South African children was compared across the ages of
9 and 10 - halfway through the 20-year study.
White children's mean exercise scores didn't differ between ages 9 and 10, however black children's level significantly
increased - by about 50%. "We expected that an increased exercise level would be associated with greater BMC, especially at
the hip," McVeigh said. "However, both group's BMC gains over that year were similar at the hip."
Indeed, over the same year, white kids showed a significantly greater change in height, whole body and spine BMC. Significant
positive correlations between exercise and BMC accumulation were found for white children at the whole body, hip and spine,
but not for black children.
"Nevertheless, after controlling for body weight and bone area, black children remained with the advantage of a significantly
greater hip BMC both at ages 9 and 10," McVeigh reported. This, despite the fact the researchers found that overall white
children are much more physically active and have significantly higher calcium intakes than black children.
"However, when we compared bone mass within different quartiles of activity, we found that the most active white children did
indeed have better bone mass than the most active black children, but black children have a lower and narrower range of
physical activity. Physical activity appears to be the most important modifiable factor influencing white children's bone
health," she noted.
Paradox indicates need for re-thinking osteoporosis development
"The results of our study raise an apparent paradox, which has implications on our thinking about osteoporosis, the roots of
which may well lie in the childhood years. It's obvious that intervention is becoming increasingly important during the
growing years as this is the period when physical activity and nutrition have the most impact. It is possible that with the
black South African population starting to adopt more 'Western' lifestyles, we may see an increase in fracture rates as their
genetic advantage is outweighed by lifestyle influences. It will be important to follow up on these children and our study
will continue to do this, throughout their pubertal years and until they turn 20. Only time will tell if these trends will
persist."
Funding: Research was funded by the Medical Research Council (South Africa) and the Wellcome Trust (U.K.).
The 35th Congress of the International Union of Physiological Sciences is in San Diego, March 31 - April 5, 2005. The
Congress (iups2005) is organized by the six member
societies of the U.S. National Committee of the IUPS, the American Physiological Society, the Society for Neuroscience, the
Microcirculatory Society, the Society of General Physiologists, the Biomedical Engineering Society, and the Society for
Integrative and Comparative Biology, under the auspices of the U.S. National Academy of Sciences.
The IUPS conference, held every four years, runs concurrently this year with Experimental Biology 2005 at the San Diego
Convention Center.
The American Physiological Society (APS), which is hosting IUPS, was founded in 1887 to foster basic and applied science,
much of it relating to human health. The Bethesda, MD-based Society has more than 10,000 members and publishes nearly 4,000
articles every year in its 14 peer-reviewed journals. In May, APS received the Presidential Award for Excellence in Science,
Mathematics and Engineering Mentoring (PAESMEM).
Editor's Note: For further information or to schedule an interview with a member of the research team, please contact Mayer
Resnick at the IUPS/APS newsroom 619-525-6228 (March 31-April 6), or 301-332-4402 (cell) or 301-634-7209 (office), or Stacy
Brooks at 240-432-9697 (cell) or 301-634-7253 (office).
A searchable online program for IUPS and EB is at faseb/meetings/eb2005/call/default.htm
Contact: Mayer Resnick
mresnickthe-aps
301-332-4402 (cell)
301-634-7209 (office, outside IUPS dates)
American Physiological Society
the-aps
IUPS/APS Newsroom March 29-April 6
San Diego Convention Center
Hall E Registration Area/Flex Unit
Telephone: 619-525-6228
After Nelson Mandela was released from prison February 11, 1990, all children born in the greater Johannesburg area were
enrolled in a 20-year longitudinal study. Officially known as "Birth to Twenty," the study and its 3,273 youth, are
colloquially referred to as "Mandela's Children." It's the largest and longest running study of child and adolescent health
and development in Africa, and one of the few large-scale longitudinal studies in the world.
One of the main aims of the study is to follow bone health in growing children, specifically the differences in bone mass
acquisition between black and white children and the factors that influence this.
Besides its obvious importance in adult health and possibly measuring the change from "third world" population to "developed
world" population, there is a situation in South Africa that's very counterintuitive, and possibly unique: "Black South
African adults have among the lowest hip fracture rates in the world," according to the study's lead author, Joanne A.
McVeigh.
"Yet our study found that, as children, blacks have significantly lower physical activity levels and calcium intakes than
age- and gender-matched white children," McVeigh adds. McVeigh is presenting the research at the 35th Congress of the
International Union of Physiological Sciences in San Diego, March 31 - April 5, 2005.
*Paper presentation: "Physical activity and bone mass accumulation patterns differ in black and white South African
children," by Joanne A. McVeigh, Shane A. Norris and John M. Pettifor, MRC Mineral Metabolism Research Unit, Department of
Paediatrics, and School of Physiology, University of Witwatersrand Medical School, Johannesburg. 12:30 p.m.-3 p.m. Sunday
April 3, Physiology session/abstract: 347.8; board #A64. On view 7:30 a.m. - 4 p.m.
9- and 10-year-olds compared for exercise level, bone mineral content
Since it's accepted that physical activity has an osteogenic effect on bone mass, the relationship between physical activity,
or exercise, and bone mineral content (BMC) levels in black and white South African children was compared across the ages of
9 and 10 - halfway through the 20-year study.
White children's mean exercise scores didn't differ between ages 9 and 10, however black children's level significantly
increased - by about 50%. "We expected that an increased exercise level would be associated with greater BMC, especially at
the hip," McVeigh said. "However, both group's BMC gains over that year were similar at the hip."
Indeed, over the same year, white kids showed a significantly greater change in height, whole body and spine BMC. Significant
positive correlations between exercise and BMC accumulation were found for white children at the whole body, hip and spine,
but not for black children.
"Nevertheless, after controlling for body weight and bone area, black children remained with the advantage of a significantly
greater hip BMC both at ages 9 and 10," McVeigh reported. This, despite the fact the researchers found that overall white
children are much more physically active and have significantly higher calcium intakes than black children.
"However, when we compared bone mass within different quartiles of activity, we found that the most active white children did
indeed have better bone mass than the most active black children, but black children have a lower and narrower range of
physical activity. Physical activity appears to be the most important modifiable factor influencing white children's bone
health," she noted.
Paradox indicates need for re-thinking osteoporosis development
"The results of our study raise an apparent paradox, which has implications on our thinking about osteoporosis, the roots of
which may well lie in the childhood years. It's obvious that intervention is becoming increasingly important during the
growing years as this is the period when physical activity and nutrition have the most impact. It is possible that with the
black South African population starting to adopt more 'Western' lifestyles, we may see an increase in fracture rates as their
genetic advantage is outweighed by lifestyle influences. It will be important to follow up on these children and our study
will continue to do this, throughout their pubertal years and until they turn 20. Only time will tell if these trends will
persist."
Funding: Research was funded by the Medical Research Council (South Africa) and the Wellcome Trust (U.K.).
The 35th Congress of the International Union of Physiological Sciences is in San Diego, March 31 - April 5, 2005. The
Congress (iups2005) is organized by the six member
societies of the U.S. National Committee of the IUPS, the American Physiological Society, the Society for Neuroscience, the
Microcirculatory Society, the Society of General Physiologists, the Biomedical Engineering Society, and the Society for
Integrative and Comparative Biology, under the auspices of the U.S. National Academy of Sciences.
The IUPS conference, held every four years, runs concurrently this year with Experimental Biology 2005 at the San Diego
Convention Center.
The American Physiological Society (APS), which is hosting IUPS, was founded in 1887 to foster basic and applied science,
much of it relating to human health. The Bethesda, MD-based Society has more than 10,000 members and publishes nearly 4,000
articles every year in its 14 peer-reviewed journals. In May, APS received the Presidential Award for Excellence in Science,
Mathematics and Engineering Mentoring (PAESMEM).
Editor's Note: For further information or to schedule an interview with a member of the research team, please contact Mayer
Resnick at the IUPS/APS newsroom 619-525-6228 (March 31-April 6), or 301-332-4402 (cell) or 301-634-7209 (office), or Stacy
Brooks at 240-432-9697 (cell) or 301-634-7253 (office).
A searchable online program for IUPS and EB is at faseb/meetings/eb2005/call/default.htm
Contact: Mayer Resnick
mresnickthe-aps
301-332-4402 (cell)
301-634-7209 (office, outside IUPS dates)
American Physiological Society
the-aps
IUPS/APS Newsroom March 29-April 6
San Diego Convention Center
Hall E Registration Area/Flex Unit
Telephone: 619-525-6228
пятница, 14 октября 2011 г.
Ground Breaking Ice Pack Improves Joint Mobility Among Osteoarthritis Patients And Helps Athletes Recover Faster
A ground breaking ice pack, which reduces pain and improves joint mobility among osteoarthritis patients and helps athletes recover quicker and more effectively from injury or surgery, has been launched by North Yorkshire healthcare innovations company - Salitas
The revolutionary MORPHO™ Cryo-Matrix remains colder up to 12 times longer than conventional gel packs and is not wet or messy and is easy to prepare and apply.
It can be programmed to stay at a constant 'cold' temperature (with a skin interface temperature in the ideal (7-12°C zone) for up to four hours, as opposed to the 20 minutes associated with conventional gel packs.
It is made from a unique matrix structure that moulds to the patients' contours, even when they are moving; allowing patients to receive treatment whilst taking part in exercise, training schedules or physiotherapy programmes.
These unique features allow joints and muscles to be kept at the right temperature, for the right amount of time, promoting faster recovery rates after surgery or injury.
Ideal for professional sports people who want to get back to full fitness fast, MORPHO™ can also be used as a long term treatment for osteoarthritis patients - one of the most chronic diseases affecting the elderly. A recent study carried out in Belgium concluded that if patients use MORPHO™ regularly it can be more effective than standard pharmacological treatments such as paracetamol to relieve pain and improve joint mobility.
Richard Wilson, Managing Director at Salitas, said: "The MORPHO™ Cryo-Matrix is a fantastic solution and has a number of unique qualities, which sets it aside from other cryotherapy treatments across the globe. It ensures the injured joint or muscle receives the right temperature, for the right length of time, even when moving.
"It can be used by top athletes to aid the rehabilitation of acute sport injuries, ease the effects of arthritis, rheumatism and multiple sclerosis and help millions of patients recover from injuries faster."
Salitas is a company committed to developing innovations in modern healthcare. The company is currently involved in an extensive research and development programme for a range of products designed to improve treatment and aid recovery.
With its roots as a spin-out company from the University of Bradford, Salitas has attracted significant investment which will allow it to broaden its product offering. Although now operating fully independently, the company continues to work closely with the University to develop new products and in addition, makes a direct contribution from its sales to the University's Plastic Surgery and Burns Research Unit. The company's operations are based in Knaresborough, North Yorkshire.
Source
MORPHO™ Cryo-Matrix
The revolutionary MORPHO™ Cryo-Matrix remains colder up to 12 times longer than conventional gel packs and is not wet or messy and is easy to prepare and apply.
It can be programmed to stay at a constant 'cold' temperature (with a skin interface temperature in the ideal (7-12°C zone) for up to four hours, as opposed to the 20 minutes associated with conventional gel packs.
It is made from a unique matrix structure that moulds to the patients' contours, even when they are moving; allowing patients to receive treatment whilst taking part in exercise, training schedules or physiotherapy programmes.
These unique features allow joints and muscles to be kept at the right temperature, for the right amount of time, promoting faster recovery rates after surgery or injury.
Ideal for professional sports people who want to get back to full fitness fast, MORPHO™ can also be used as a long term treatment for osteoarthritis patients - one of the most chronic diseases affecting the elderly. A recent study carried out in Belgium concluded that if patients use MORPHO™ regularly it can be more effective than standard pharmacological treatments such as paracetamol to relieve pain and improve joint mobility.
Richard Wilson, Managing Director at Salitas, said: "The MORPHO™ Cryo-Matrix is a fantastic solution and has a number of unique qualities, which sets it aside from other cryotherapy treatments across the globe. It ensures the injured joint or muscle receives the right temperature, for the right length of time, even when moving.
"It can be used by top athletes to aid the rehabilitation of acute sport injuries, ease the effects of arthritis, rheumatism and multiple sclerosis and help millions of patients recover from injuries faster."
Salitas is a company committed to developing innovations in modern healthcare. The company is currently involved in an extensive research and development programme for a range of products designed to improve treatment and aid recovery.
With its roots as a spin-out company from the University of Bradford, Salitas has attracted significant investment which will allow it to broaden its product offering. Although now operating fully independently, the company continues to work closely with the University to develop new products and in addition, makes a direct contribution from its sales to the University's Plastic Surgery and Burns Research Unit. The company's operations are based in Knaresborough, North Yorkshire.
Source
MORPHO™ Cryo-Matrix
вторник, 11 октября 2011 г.
Calcium Pills And Heart Risk - NHS Response
"Taking calcium supplements to improve bone strength in middle-age could put women at higher risk of a heart attack", the Daily Mail reported. Other newspapers also described a study that involved nearly 1,500 women in New Zealand. Some reported that this finding appeared to contradict previous evidence that showed benefits in calcium protecting against cardiovascular disease. Many advised people who have been prescribed calcium by their doctor to continue taking it.
The research behind the stories is a well-conducted community based trial. It brings to light a potentially serious adverse effect associated with calcium supplementation. However, the study has limitations including its size. Until a more definitive answer is available - such as one provided by a meta analysis - individuals should be aware of the fine balance between benefit and harm suggested by this study. Anybody with concerns should seek advice from their doctor before changing their calcium intake significantly.
Where did the story come from?
The research was conducted by Dr Mark Boland and colleagues from the University of Auckland in New Zealand. It was supported by grants from the Health Research Council of New Zealand and competing interests were declared. The study was published in the peer-reviewed: The British Medical Journal.
What kind of scientific study was this?
This was a secondary analysis of a randomised controlled trial. The authors had already published the results of their main trial, which looked at the preventive effects of calcium supplementation on bone density and fracture rates in healthy women after the menopause. During that trial and before the analysis of any data on heart disease or stroke, they wrote a detailed plan of their intentions to record the data for this present analysis.
Women were recruited to the study by advertisement and through the post using the electoral roll. In order to qualify, suitable women needed to have had their last period at least five years previously and be aged 55 or more, (meaning they were postmenopausal and had a life expectancy of more than five years). From an assessment of 2,421 women in the clinic, the researchers found 1,471 who agreed to participate and were suitable.
The women were randomly allocated to one of two groups. In the experimental group, the women received 1gram (0.03oz) of elemental calcium daily. This was taken through two tablets of calcium citrate before breakfast and three in the evening. The control group received identical dummy tablets (placebo). The research was double blinded and neither the patients nor the researchers knew who had been allocated to which group. The women were followed up every six months for five years.
The researchers looked for adverse cardiovascular events such as heart attacks, strokes (of all types) angina and death and then analysed the data in three ways. Potentially adverse events that were reported by the women themselves were analysed first. The researchers then checked the medical records at the women's hospitals and family doctors for confirmation of the event. Finally, a search of the national database of hospital admissions was carried out to identify any events that were unreported by the women.
The researchers used internationally accepted definitions of heart attack and stroke to define the adverse events.
What were the results of the study?
The two groups had similar characteristics to each other at the start of the study. The groups average age was 74.2 compared to 74.3 years and average weight was 66.8 compared to 67 Kg. Less than a quarter of each group smoked.
Over five years of follow-up, 45 heart attacks were self-reported by 31 women in the group taking calcium compared to 19 heart attacks reported by 14 women in the control group. When checking the records at the hospital and GP surgeries the researchers were able to verify fewer events, 24 events in 21 women taking calcium compared to 10 events in 10 women taking placebo. In both these analyses, this was a statistically significant doubling of risk. When the unreported events were added from the national database the increase in risk became less and did not reach statistical significance.
What interpretations did the researchers draw from these results?
The researchers conclude, "Calcium supplementation in healthy postmenopausal women is associated with upward trends in cardiovascular event rates. This potentially detrimental effect should be balanced against the likely benefits of calcium on bone." They acknowledge that some of their findings were not significant (they show a trend).
The authors also compare the results from this trial to their previous trial and report the NNT (Number Needed to Treat). This is an estimated number of patients who need to be treated to cause or prevent one adverse outcome). In this case, the number of women needed to be given calcium supplements for five years to cause one adverse event.
What does the NHS Knowledge Service make of this study?
This was a well-conducted randomised controlled trial, in which the two groups of women were well balanced at the start of the study in terms of risk factors for heart disease and stroke. This increases confidence that the effect demonstrated was not simply due to differences in overall healthiness between the two groups.
- The fact that the women were recruited from the community rather than from attendance at clinics, makes it more likely that these results are applicable to a broader range of normal healthy women. However, as the authors acknowledge, the women were mostly white and 10% of them were over 80 years old, therefore the findings may not necessarily apply to other ages or ethnicities.
- In general, caution should be used when interpreting the results of secondary analyses like this one. However, this study carefully defined its intentions and collected data before the results were known, and this minimises the risks that the results are biased.
- The numbers recruited to this study were thought to be sufficient to detect an effect on bone density and fracture rate. However, by looking at other outcomes such as heart disease, the authors have found the study had a low chance, because of the number of women recruited, of correctly detecting a real difference. The fact that their study was so small may account for the fact that so few of their results were statistically significant.
- The authors compared the results from this trial to the results of their previous trial conducted in the same women and found the balance between risk and benefit to be close. They estimated that, over a five-year period, 44 women would need to take calcium to cause one myocardial infarction, 56 women to cause one stroke, and 29 to cause one cardiovascular event. By comparison, 50 women would need to take calcium to prevent one symptomatic fracture. These estimates of benefit and harm are very similar suggesting that judgment is required by women and their clinicians when deciding whether to take or prescribe calcium.
This study indicates that future research needs to look at cardiovascular events in association with taking calcium supplements. Combining the results of current trials in a systematic review would also be helpful. This study suggests there is a fine balance between benefit and harm through taking calcium supplements. However, people taking these supplements should seek advice from their doctor before changing their calcium intake.
Links to the headlines
Calcium pills 'raise heart risk'. BBC News, January 16 2008
Calcium tablets 'raise risk of heart attacks'. The Daily Telegraph, January 16 2008
Calcium pills for strong bones may double the risk of a heart attack. The Times, January 16 2008
Doctors fear calcium supplements may raise the risk of a heart attack. Daily Mail, January 16 2008
Links to the science
Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ 2008; Jan 15
This news comes from NHS Choices
The research behind the stories is a well-conducted community based trial. It brings to light a potentially serious adverse effect associated with calcium supplementation. However, the study has limitations including its size. Until a more definitive answer is available - such as one provided by a meta analysis - individuals should be aware of the fine balance between benefit and harm suggested by this study. Anybody with concerns should seek advice from their doctor before changing their calcium intake significantly.
Where did the story come from?
The research was conducted by Dr Mark Boland and colleagues from the University of Auckland in New Zealand. It was supported by grants from the Health Research Council of New Zealand and competing interests were declared. The study was published in the peer-reviewed: The British Medical Journal.
What kind of scientific study was this?
This was a secondary analysis of a randomised controlled trial. The authors had already published the results of their main trial, which looked at the preventive effects of calcium supplementation on bone density and fracture rates in healthy women after the menopause. During that trial and before the analysis of any data on heart disease or stroke, they wrote a detailed plan of their intentions to record the data for this present analysis.
Women were recruited to the study by advertisement and through the post using the electoral roll. In order to qualify, suitable women needed to have had their last period at least five years previously and be aged 55 or more, (meaning they were postmenopausal and had a life expectancy of more than five years). From an assessment of 2,421 women in the clinic, the researchers found 1,471 who agreed to participate and were suitable.
The women were randomly allocated to one of two groups. In the experimental group, the women received 1gram (0.03oz) of elemental calcium daily. This was taken through two tablets of calcium citrate before breakfast and three in the evening. The control group received identical dummy tablets (placebo). The research was double blinded and neither the patients nor the researchers knew who had been allocated to which group. The women were followed up every six months for five years.
The researchers looked for adverse cardiovascular events such as heart attacks, strokes (of all types) angina and death and then analysed the data in three ways. Potentially adverse events that were reported by the women themselves were analysed first. The researchers then checked the medical records at the women's hospitals and family doctors for confirmation of the event. Finally, a search of the national database of hospital admissions was carried out to identify any events that were unreported by the women.
The researchers used internationally accepted definitions of heart attack and stroke to define the adverse events.
What were the results of the study?
The two groups had similar characteristics to each other at the start of the study. The groups average age was 74.2 compared to 74.3 years and average weight was 66.8 compared to 67 Kg. Less than a quarter of each group smoked.
Over five years of follow-up, 45 heart attacks were self-reported by 31 women in the group taking calcium compared to 19 heart attacks reported by 14 women in the control group. When checking the records at the hospital and GP surgeries the researchers were able to verify fewer events, 24 events in 21 women taking calcium compared to 10 events in 10 women taking placebo. In both these analyses, this was a statistically significant doubling of risk. When the unreported events were added from the national database the increase in risk became less and did not reach statistical significance.
What interpretations did the researchers draw from these results?
The researchers conclude, "Calcium supplementation in healthy postmenopausal women is associated with upward trends in cardiovascular event rates. This potentially detrimental effect should be balanced against the likely benefits of calcium on bone." They acknowledge that some of their findings were not significant (they show a trend).
The authors also compare the results from this trial to their previous trial and report the NNT (Number Needed to Treat). This is an estimated number of patients who need to be treated to cause or prevent one adverse outcome). In this case, the number of women needed to be given calcium supplements for five years to cause one adverse event.
What does the NHS Knowledge Service make of this study?
This was a well-conducted randomised controlled trial, in which the two groups of women were well balanced at the start of the study in terms of risk factors for heart disease and stroke. This increases confidence that the effect demonstrated was not simply due to differences in overall healthiness between the two groups.
- The fact that the women were recruited from the community rather than from attendance at clinics, makes it more likely that these results are applicable to a broader range of normal healthy women. However, as the authors acknowledge, the women were mostly white and 10% of them were over 80 years old, therefore the findings may not necessarily apply to other ages or ethnicities.
- In general, caution should be used when interpreting the results of secondary analyses like this one. However, this study carefully defined its intentions and collected data before the results were known, and this minimises the risks that the results are biased.
- The numbers recruited to this study were thought to be sufficient to detect an effect on bone density and fracture rate. However, by looking at other outcomes such as heart disease, the authors have found the study had a low chance, because of the number of women recruited, of correctly detecting a real difference. The fact that their study was so small may account for the fact that so few of their results were statistically significant.
- The authors compared the results from this trial to the results of their previous trial conducted in the same women and found the balance between risk and benefit to be close. They estimated that, over a five-year period, 44 women would need to take calcium to cause one myocardial infarction, 56 women to cause one stroke, and 29 to cause one cardiovascular event. By comparison, 50 women would need to take calcium to prevent one symptomatic fracture. These estimates of benefit and harm are very similar suggesting that judgment is required by women and their clinicians when deciding whether to take or prescribe calcium.
This study indicates that future research needs to look at cardiovascular events in association with taking calcium supplements. Combining the results of current trials in a systematic review would also be helpful. This study suggests there is a fine balance between benefit and harm through taking calcium supplements. However, people taking these supplements should seek advice from their doctor before changing their calcium intake.
Links to the headlines
Calcium pills 'raise heart risk'. BBC News, January 16 2008
Calcium tablets 'raise risk of heart attacks'. The Daily Telegraph, January 16 2008
Calcium pills for strong bones may double the risk of a heart attack. The Times, January 16 2008
Doctors fear calcium supplements may raise the risk of a heart attack. Daily Mail, January 16 2008
Links to the science
Bolland MJ, Barber PA, Doughty RN, et al. Vascular events in healthy older women receiving calcium supplementation: randomised controlled trial. BMJ 2008; Jan 15
This news comes from NHS Choices
суббота, 8 октября 2011 г.
The Nation's Orthopaedic Surgeons Join Provider-led Electronic Prescribing Initiative
The American Academy of Orthopaedic Surgeons (AAOS) announced their participation in "Get Connected," a program designed to help more of the nation's physicians and other prescribers use electronic prescribing. Now backed by 17 of the nation's leading medical associations, Get Connected is intended to help physicians and other prescribers take advantage of current Medicare incentives aimed at increasing the adoption and use of e-prescribing. Beginning in 2011, incentives may also be available to physicians and other prescribers who use e-prescribing as part of an electronic health record. These additional incentives fall under the HITECH provisions within the American Recovery and Reinvestment Act.
"There are many different activities driving the adoption of electronic prescribing by orthopaedic surgeons," said Stephen Makk, MD, MBA, Chair of the AAOS Practice Management Committee. "Two key drivers are the CMS-sponsored E-Prescribing Incentive Program and the American Recovery and Reinvestment Act of 2009. Through participation in the Get Connected program, the AAOS goal is to provide members with an expanded resource where they can obtain comprehensive information and support on best practices for adoption of necessary technologies for secure, direct electronic connectivity to pharmacies and payer organizations."
During the next four years, Medicare is providing incentive payments to eligible professionals who are successful electronic prescribers, as defined by the Medicare Improvement for Patients and Providers Act (MIPPA). Eligible professionals receive a 2 percent incentive payment in 2009 and 2010; a 1 percent incentive payment in 2011 and 2012; and a 0.5 percent incentive payment in 2013. Beginning January 1, 2009, those physicians using a qualified system to send electronic prescriptions (at the rate defined by MIPPA) started to receive higher levels of reimbursement under Medicare. A qualified system must be able to do all of the following:
1. Generate a medication list
2. Select medications, transmit prescriptions electronically using the applicable standards, and warn the physician of possible undesirable or unsafe situations
3. Provide information on lower-cost, therapeutically appropriate alternatives
4. Provide information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan
Go to surescripts/certified to view a list of systems that have been certified and the functionality for which they have been certified. Physicians and other prescribers should check with their vendor to confirm that their system is qualified under MIPPA guidelines and to request activation of services that deliver the required functionality.
The focal point of the Get Connected program is an online portal - GetRxConnected - where physicians and other prescribers can follow a step-by-step process designed to help them transition from paper-based prescribing to e-prescribing. Since its launch in March 2008, the Get Connected program has generated significant results:
- Thousands of communications from participating medical societies to their members promoting GetRxConnected and educating members on e-prescribing
- More than 6,800 completed technology assessments
- More than 2,400 prescribers subsequently got connected
Electronic prescribing, or "e-prescribing," replaces the need for handwritten, printed or faxed prescriptions and is seen as a more accurate and efficient means of prescribing medications. Because it is paperless, e-prescribing is also regarded as a secure alternative to paper prescriptions that can be stolen, copied, forged and otherwise manipulated.
In addition to the AAOS, Get Connected is supported by the:
- American Academy of Family Physicians (AAFP)
- American Academy of Nurse Practitioners (AANP)
- American Academy of Ophthalmology (AAO)
- American Academy of Pediatrics (AAP)
- American Academy of Physician Assistants (AAPA)
- American College of Cardiology (ACC)
- American College of Obstetricians and Gynecologists (ACOG)
- American College of Physicians (ACP)
- American Gastroenterological Association (AGA)
- American Optometric Association (AOA)
- American Osteopathic Association (AOA)
- American Urological Association (AUA)
- Connecticut State Medical Society
- Medical Group Management Association (MGMA)
- Tennessee State Medical Association
- Texas Medical Association (TMA)
If you are a member of a state medical society or national provider organization and would like to get more information about how your membership can Get Connected for e-prescribing, please contact Kate Berry (kate.berrysurescripts), executive director at The Center for Improving Medication Management and senior vice president for business development at Surescripts.
Created under the auspices of The Center for Improving Medication Management (founded by the AAFP, Blue Cross Blue Shield Association, Humana Inc., Intel Corporation, the MGMA and Surescripts), GetRxConnected contains urgent information and guidance for thousands of physicians and other prescribers located throughout the United States that are currently using electronic medical record (EMR) and other clinical software to fax prescriptions to pharmacies. Computer-generated faxing of prescriptions prevents physicians and other prescribers from achieving the gains in practice efficiency and patient safety associated with e-prescribing. (Important Note to Physicians and Other Prescribers Using EMRs: Most EMR users believe that they already send prescriptions to pharmacies electronically - i.e., they are unaware that it is far more likely that their EMR is generating faxes that arrive on paper at the pharmacy's fax machine. Physicians and other prescribers using EMR systems that can only send computer-generated, faxed prescriptions will not be eligible for the Medicare incentives for e-prescribing.)
How to Get Connected
Following the completion of a brief self-assessment on GetRxConnected, physicians and their staffs can find out if the software brand and version they are using is certified to generate e-prescriptions compliant with the National Council for Prescription Drug Programs (NCPDP) SCRIPT standard, as required by the new Medicare incentives. The SCRIPT standard facilitates the electronic transmission of prescriptions and prescription-related information.
The Get Connected program is equally intended for physicians, nurse practitioners, physician assistants and practice management professionals who have yet to invest in EMR or other clinical software. The portal provides guidance on how to evaluate and acquire technology that supports e-prescribing. GetRxConnected also helps physicians, nurse practitioners, physician assistants and practice management professionals assess the financial impact of e-prescribing using an interactive feature that allows them to calculate an estimate of the time and resources their practice is currently dedicating to the manual processing of prescriptions.
About The Center for Improving Medication Management
The Center for Improving Medication Management is committed to understanding how technology improves the way medications are prescribed and used safely and effectively by millions of patients every day. The Center was founded by the American Academy of Family Physicians, Blue Cross Blue Shield Association, Humana Inc., Intel Corporation, the Medical Group Management Association and Surescripts.
Source
American Academy of Orthopaedic Surgeons
"There are many different activities driving the adoption of electronic prescribing by orthopaedic surgeons," said Stephen Makk, MD, MBA, Chair of the AAOS Practice Management Committee. "Two key drivers are the CMS-sponsored E-Prescribing Incentive Program and the American Recovery and Reinvestment Act of 2009. Through participation in the Get Connected program, the AAOS goal is to provide members with an expanded resource where they can obtain comprehensive information and support on best practices for adoption of necessary technologies for secure, direct electronic connectivity to pharmacies and payer organizations."
During the next four years, Medicare is providing incentive payments to eligible professionals who are successful electronic prescribers, as defined by the Medicare Improvement for Patients and Providers Act (MIPPA). Eligible professionals receive a 2 percent incentive payment in 2009 and 2010; a 1 percent incentive payment in 2011 and 2012; and a 0.5 percent incentive payment in 2013. Beginning January 1, 2009, those physicians using a qualified system to send electronic prescriptions (at the rate defined by MIPPA) started to receive higher levels of reimbursement under Medicare. A qualified system must be able to do all of the following:
1. Generate a medication list
2. Select medications, transmit prescriptions electronically using the applicable standards, and warn the physician of possible undesirable or unsafe situations
3. Provide information on lower-cost, therapeutically appropriate alternatives
4. Provide information on formulary or tiered formulary medications, patient eligibility, and authorization requirements received electronically from the patient's drug plan
Go to surescripts/certified to view a list of systems that have been certified and the functionality for which they have been certified. Physicians and other prescribers should check with their vendor to confirm that their system is qualified under MIPPA guidelines and to request activation of services that deliver the required functionality.
The focal point of the Get Connected program is an online portal - GetRxConnected - where physicians and other prescribers can follow a step-by-step process designed to help them transition from paper-based prescribing to e-prescribing. Since its launch in March 2008, the Get Connected program has generated significant results:
- Thousands of communications from participating medical societies to their members promoting GetRxConnected and educating members on e-prescribing
- More than 6,800 completed technology assessments
- More than 2,400 prescribers subsequently got connected
Electronic prescribing, or "e-prescribing," replaces the need for handwritten, printed or faxed prescriptions and is seen as a more accurate and efficient means of prescribing medications. Because it is paperless, e-prescribing is also regarded as a secure alternative to paper prescriptions that can be stolen, copied, forged and otherwise manipulated.
In addition to the AAOS, Get Connected is supported by the:
- American Academy of Family Physicians (AAFP)
- American Academy of Nurse Practitioners (AANP)
- American Academy of Ophthalmology (AAO)
- American Academy of Pediatrics (AAP)
- American Academy of Physician Assistants (AAPA)
- American College of Cardiology (ACC)
- American College of Obstetricians and Gynecologists (ACOG)
- American College of Physicians (ACP)
- American Gastroenterological Association (AGA)
- American Optometric Association (AOA)
- American Osteopathic Association (AOA)
- American Urological Association (AUA)
- Connecticut State Medical Society
- Medical Group Management Association (MGMA)
- Tennessee State Medical Association
- Texas Medical Association (TMA)
If you are a member of a state medical society or national provider organization and would like to get more information about how your membership can Get Connected for e-prescribing, please contact Kate Berry (kate.berrysurescripts), executive director at The Center for Improving Medication Management and senior vice president for business development at Surescripts.
Created under the auspices of The Center for Improving Medication Management (founded by the AAFP, Blue Cross Blue Shield Association, Humana Inc., Intel Corporation, the MGMA and Surescripts), GetRxConnected contains urgent information and guidance for thousands of physicians and other prescribers located throughout the United States that are currently using electronic medical record (EMR) and other clinical software to fax prescriptions to pharmacies. Computer-generated faxing of prescriptions prevents physicians and other prescribers from achieving the gains in practice efficiency and patient safety associated with e-prescribing. (Important Note to Physicians and Other Prescribers Using EMRs: Most EMR users believe that they already send prescriptions to pharmacies electronically - i.e., they are unaware that it is far more likely that their EMR is generating faxes that arrive on paper at the pharmacy's fax machine. Physicians and other prescribers using EMR systems that can only send computer-generated, faxed prescriptions will not be eligible for the Medicare incentives for e-prescribing.)
How to Get Connected
Following the completion of a brief self-assessment on GetRxConnected, physicians and their staffs can find out if the software brand and version they are using is certified to generate e-prescriptions compliant with the National Council for Prescription Drug Programs (NCPDP) SCRIPT standard, as required by the new Medicare incentives. The SCRIPT standard facilitates the electronic transmission of prescriptions and prescription-related information.
The Get Connected program is equally intended for physicians, nurse practitioners, physician assistants and practice management professionals who have yet to invest in EMR or other clinical software. The portal provides guidance on how to evaluate and acquire technology that supports e-prescribing. GetRxConnected also helps physicians, nurse practitioners, physician assistants and practice management professionals assess the financial impact of e-prescribing using an interactive feature that allows them to calculate an estimate of the time and resources their practice is currently dedicating to the manual processing of prescriptions.
About The Center for Improving Medication Management
The Center for Improving Medication Management is committed to understanding how technology improves the way medications are prescribed and used safely and effectively by millions of patients every day. The Center was founded by the American Academy of Family Physicians, Blue Cross Blue Shield Association, Humana Inc., Intel Corporation, the Medical Group Management Association and Surescripts.
Source
American Academy of Orthopaedic Surgeons
среда, 5 октября 2011 г.
Enabling Orthopaedic Surgeons To Prevent Future Fractures
A major new tool to help orthopaedic surgeons better diagnose and treat osteoporosis, which globally affects one in three women, one in five men and costs billions of dollars to diagnose and treat, was launched today.
The educational training package consisting of four in-depth lectures plus one summary lecture, was announced today at a symposium chaired by Prof. Ghassan Maalouf (International Osteoporosis Foundation/Bone and Joint Decade) and Prof. Wolfhart Puhl (European Federation of National Associations of Orthopaedics and Traumatology, EFORT), at the EFORT congress in Florence, Italy and will be made available to orthopaedic surgeons worldwide.
"Orthopaedic surgeons have an important role to play in diagnosing and treating osteoporosis," noted Professor Cyrus Cooper, chairman of the IOF Committee of Scientific Advisors. "A fragility fracture can be the first indication a patient has osteoporosis. Orthopaedic surgeons are often the first healthcare professionals to see such patients and can play a pivotal role in referring a patient to a bone specialist, who will help diagnose the underlying disease and provide appropriate care."
The materials were developed by three major organizations fighting osteoporosis worldwide - International Osteoporosis Foundation (IOF), International Society for Fracture Repair (ISFR), and the Bone and Joint Decade (BJD).
The training package is in the form of a CD teaching kit, with lectures on:
В· Challenges on fragility fracture treatment (Prof. Dave Marsh)
В·
The educational training package consisting of four in-depth lectures plus one summary lecture, was announced today at a symposium chaired by Prof. Ghassan Maalouf (International Osteoporosis Foundation/Bone and Joint Decade) and Prof. Wolfhart Puhl (European Federation of National Associations of Orthopaedics and Traumatology, EFORT), at the EFORT congress in Florence, Italy and will be made available to orthopaedic surgeons worldwide.
"Orthopaedic surgeons have an important role to play in diagnosing and treating osteoporosis," noted Professor Cyrus Cooper, chairman of the IOF Committee of Scientific Advisors. "A fragility fracture can be the first indication a patient has osteoporosis. Orthopaedic surgeons are often the first healthcare professionals to see such patients and can play a pivotal role in referring a patient to a bone specialist, who will help diagnose the underlying disease and provide appropriate care."
The materials were developed by three major organizations fighting osteoporosis worldwide - International Osteoporosis Foundation (IOF), International Society for Fracture Repair (ISFR), and the Bone and Joint Decade (BJD).
The training package is in the form of a CD teaching kit, with lectures on:
В· Challenges on fragility fracture treatment (Prof. Dave Marsh)
В·
воскресенье, 2 октября 2011 г.
Bone Implants With The Ability To Carry Chemotherapeutical Drugs In Conception In CICECO
Chemotherapy, followed by the surgical removal of the affected tissue is the treatment usually adapted to bone tumors. An implant which can fill the areas of subtraction, while releasing chemotherapeutical agents locally, in a controlled manner, during the treatment period, is the aim of a research led by the Research Centre in Ceramic Material and Composites (CICECO/UA). In these experiences, specialists are using potential "anti-tumor" drugs coated by nanocapsules.
The osteosarcoma is the most common malignant primary bone tumor. Its major incidence is in children and youngsters and usually involves the amputation of arms and legs. The treatment for this type of tumor implies chemotherapy, followed by the surgical removal of the affected tissue with a safety area, in order to avoid the tumor's reappearance. This area is then filled with a bone or synthetic biomaterial implant.
Considering how important it is to avoid repeating new chemo or radiotherapy treatments in these cases when neutralizing possible residual focus, 11 researchers from the Universities of Aveiro and Coimbra intend to develop an implant which can contain chemotherapeutical agents of specific ranges of action, and also release these components in a controlled manner for a specific and adequate period of time.
"The bone implants we are studying will serve as a support and releasing agent of capsulated drugs in a ciclodextrin nanocapsule. We are currently experimenting with an active molecule with anti-cancer properties specifically directed to osteosarcomas. Nevertheless, it is intended to broaden its application to other types of cancer".
For this person, and as explained by Prof. Rui Correia, project coordinator, there is the need to proceed with the study of its mechanic and biological characteristics. "When we develop projects for these purposes, we must bear in mind their mechanic resistance, as well as other characteristics which must be taken in consideration when performing its implant in the bone. In this specific case, we are working with porous supports that contain a silica gel, manipulated to function both as a nanocapsule deposit and releaser. Its physical form will vary according to the bone area to fill.
The gel matrix will receive the anti-tumor compost (cisplatin and metallic composts), capsulated at a molecular level with ciclodextrin, coloured gello capsules which are nothing more and nothing less that sugar rings.
Prof. Ana Gil explains this innovative technique:
"A subgroup within our team, lead by researcher Susana Braga, is by the one hand, developing new metallic composts with a therapeutic potential and, by the other hand, promoting its capsulation in ciclodextrins. The use of the ciclodextrin on the coating of the medicinal molecule increases the efficiency of the drug and reduces the necessary amount. To work at a nanometric scale allows us to improve the properties, both concerning its solubility and its range of activity, allowing us to make it more specific".
The nanocapsule protects the therapeutic agent from the contact with proteins which are irrelevant to the treatment and makes its located application simpler. The use of ciclodextrins as nanocapsules should protect the organism from the expected high toxicity of the new agents to the healthy cells.
This project, financed by the foundation for the Science and Technology, also presents an innovative aspect in what concerns the study of the metabolic effects of the new compounds (capsulated or not) on the human osteosarcoma cells, as explained by the researcher: "It is important to know the response of the cancer cells to the drugs, in order to be able to adjust and adapt the drug's nature and dosage, for an effective treatment. These studies use the spectroscopy of the RMN- Magnetic Nuclear Resonance in the characterization of the cells' metabolic profile and the application of adequate statistic treatments, which help identifying specific metabolic changes and their relation with the patterns of cellular death".
With the drug in nanocapsules, there will be two types of implants to choose from: permanent titanium and biodegradable (for regenerative purposes) implants. The differences between these two are clarified by Prof. Rui Correia: "The porous supports which will allow the introduction of a chemic component in the organism are conceived from two types of biomaterials: a bio-stable one (non-degradable and biocompatible) and a polymeric, with biodegradable characteristics. The first one will be used in cases where there is a lack of ability to regenerate the bone tissue and the second in situations where there is the probability of a full natural recovery of the bone. In this last case the implant will be absorbed and progressively replaced by the natural bone".
Besides the microstructural analysis, the researchers are proceeding with mechanic, physics and chemistry and in vitro rehearsals. There will also be performed metabolomics essays with cellular cultures which are subjected to the therapeutic agents, either molecularly encapsulated or not.
Source: Aveiro Universidade
The osteosarcoma is the most common malignant primary bone tumor. Its major incidence is in children and youngsters and usually involves the amputation of arms and legs. The treatment for this type of tumor implies chemotherapy, followed by the surgical removal of the affected tissue with a safety area, in order to avoid the tumor's reappearance. This area is then filled with a bone or synthetic biomaterial implant.
Considering how important it is to avoid repeating new chemo or radiotherapy treatments in these cases when neutralizing possible residual focus, 11 researchers from the Universities of Aveiro and Coimbra intend to develop an implant which can contain chemotherapeutical agents of specific ranges of action, and also release these components in a controlled manner for a specific and adequate period of time.
"The bone implants we are studying will serve as a support and releasing agent of capsulated drugs in a ciclodextrin nanocapsule. We are currently experimenting with an active molecule with anti-cancer properties specifically directed to osteosarcomas. Nevertheless, it is intended to broaden its application to other types of cancer".
For this person, and as explained by Prof. Rui Correia, project coordinator, there is the need to proceed with the study of its mechanic and biological characteristics. "When we develop projects for these purposes, we must bear in mind their mechanic resistance, as well as other characteristics which must be taken in consideration when performing its implant in the bone. In this specific case, we are working with porous supports that contain a silica gel, manipulated to function both as a nanocapsule deposit and releaser. Its physical form will vary according to the bone area to fill.
The gel matrix will receive the anti-tumor compost (cisplatin and metallic composts), capsulated at a molecular level with ciclodextrin, coloured gello capsules which are nothing more and nothing less that sugar rings.
Prof. Ana Gil explains this innovative technique:
"A subgroup within our team, lead by researcher Susana Braga, is by the one hand, developing new metallic composts with a therapeutic potential and, by the other hand, promoting its capsulation in ciclodextrins. The use of the ciclodextrin on the coating of the medicinal molecule increases the efficiency of the drug and reduces the necessary amount. To work at a nanometric scale allows us to improve the properties, both concerning its solubility and its range of activity, allowing us to make it more specific".
The nanocapsule protects the therapeutic agent from the contact with proteins which are irrelevant to the treatment and makes its located application simpler. The use of ciclodextrins as nanocapsules should protect the organism from the expected high toxicity of the new agents to the healthy cells.
This project, financed by the foundation for the Science and Technology, also presents an innovative aspect in what concerns the study of the metabolic effects of the new compounds (capsulated or not) on the human osteosarcoma cells, as explained by the researcher: "It is important to know the response of the cancer cells to the drugs, in order to be able to adjust and adapt the drug's nature and dosage, for an effective treatment. These studies use the spectroscopy of the RMN- Magnetic Nuclear Resonance in the characterization of the cells' metabolic profile and the application of adequate statistic treatments, which help identifying specific metabolic changes and their relation with the patterns of cellular death".
With the drug in nanocapsules, there will be two types of implants to choose from: permanent titanium and biodegradable (for regenerative purposes) implants. The differences between these two are clarified by Prof. Rui Correia: "The porous supports which will allow the introduction of a chemic component in the organism are conceived from two types of biomaterials: a bio-stable one (non-degradable and biocompatible) and a polymeric, with biodegradable characteristics. The first one will be used in cases where there is a lack of ability to regenerate the bone tissue and the second in situations where there is the probability of a full natural recovery of the bone. In this last case the implant will be absorbed and progressively replaced by the natural bone".
Besides the microstructural analysis, the researchers are proceeding with mechanic, physics and chemistry and in vitro rehearsals. There will also be performed metabolomics essays with cellular cultures which are subjected to the therapeutic agents, either molecularly encapsulated or not.
Source: Aveiro Universidade
четверг, 29 сентября 2011 г.
New, First Of-Its-Kind VIACTIV® For Teens Helps Calcium-Deficient Girls "Bone Up"
A startling nine out of 10 teenage girls between the ages of 12-19 do not get enough calcium from diet alone1. Since nearly half of all bone mass is formed during teenage years, it is important these girls supplement their diet with calcium to support growth of healthy bones. Today, McNeil Nutritionals, LLC, introduces VIACTIV® for Teens Calcium Soft Chews, a new portable, great tasting, chewable calcium supplement that provides needed calcium and suits the active lifestyle of pre-teen and teenage girls.
The National Academy of Sciences recommends girls ages nine to 18 consume 1,300 mg of calcium per day2. To aid in calcium absorption, these girls also need adequate Vitamin D daily. These nutrients are readily found in four eight-ounces servings of milk, but milk consumption, much like calcium intake, is at its lowest during the teenage years3.
"Getting recommended amounts of calcium is a critical health need for teenage girls in order to reduce their risk of developing bone-specific diseases, such as osteoporosis, later in life," said registered dietitian Maureen Conway, director of Nutrition Services, McNeil Nutritionals, LLC. "VIACTIV® for Teens Calcium Soft Chews helps to address this critical need by providing a great tasting option that helps teenage girls obtain their recommended daily intake of calcium and Vitamin D."
Each VIACTIV® for Teens Calcium Soft Chew contains:
-- 500 mg of calcium
-- 200 IU of Vitamin D to aid in calcium absorption and bone metabolism
-- 40 mcg of Vitamin K for help in the body's formation of bone proteins
-- 20 calories and 0.5 grams of fat
VIACTIV® for Teens Calcium Soft Chews, in Fudge Brownie flavor, are now available in the vitamin/mineral supplement sections at food, drug and mass retail outlets nationwide. Each canister contains 60 individually-wrapped soft chews.
About VIACTIV®
VIACTIV® Calcium Soft Chews and VIACTIV® Multi-Vitamin Soft Chews are marketed by McNeil Nutritionals, LLC. VIACTIV® products are a key part of a woman's active lifestyle. VIACTIV® Calcium and Multi-Vitamin Soft Chews provide convenient, great-tasting ways for women to supplement a healthy diet and help them obtain the recommended amount of key vitamins and calcium each day. More information is available at viactiv.
About McNeil Nutritionals, LLC
McNeil Nutritionals, LLC, is a global marketer of innovative nutritional products. The company's mission is to give people the ability to actively manage their own health. McNeil Nutritionals, LLC, markets SPLENDA® (sucralose) No Calorie Sweetener, SPLENDA® Sugar Blend, SPLENDA® Brown Sugar Blend, SPLENDA® QUICK PACK™ No Calorie Sweetener Pouches, SPLENDA® Flavor Blends for Coffee, VIACTIV® Calcium Soft Chews, VIACTIV® Multi-Vitamin Soft Chews, VIACTIV® for Teens Calcium Soft Chews, LACTAID® Milk and Dietary Supplements and BENECOL® Spreads. McNeil Nutritionals, LLC, is headquartered in Fort Washington, PA.
1 2004 National Dairy Council; eatsmart/client_images/gd20052171417501.pdf
2 "Vitamin D and calcium: strong bones for life through better nutrition," Contemporary Pediatrics, March 2003.
3 Greer FR, Krebs NF. American Academy of Pediatrics Committee on Nutrition. Optimizing bone health and calcium intake of infants, children and adolescents. Pediatrics. 2006 Feb;117(2):578-85.
VIACTIV®
viactiv
The National Academy of Sciences recommends girls ages nine to 18 consume 1,300 mg of calcium per day2. To aid in calcium absorption, these girls also need adequate Vitamin D daily. These nutrients are readily found in four eight-ounces servings of milk, but milk consumption, much like calcium intake, is at its lowest during the teenage years3.
"Getting recommended amounts of calcium is a critical health need for teenage girls in order to reduce their risk of developing bone-specific diseases, such as osteoporosis, later in life," said registered dietitian Maureen Conway, director of Nutrition Services, McNeil Nutritionals, LLC. "VIACTIV® for Teens Calcium Soft Chews helps to address this critical need by providing a great tasting option that helps teenage girls obtain their recommended daily intake of calcium and Vitamin D."
Each VIACTIV® for Teens Calcium Soft Chew contains:
-- 500 mg of calcium
-- 200 IU of Vitamin D to aid in calcium absorption and bone metabolism
-- 40 mcg of Vitamin K for help in the body's formation of bone proteins
-- 20 calories and 0.5 grams of fat
VIACTIV® for Teens Calcium Soft Chews, in Fudge Brownie flavor, are now available in the vitamin/mineral supplement sections at food, drug and mass retail outlets nationwide. Each canister contains 60 individually-wrapped soft chews.
About VIACTIV®
VIACTIV® Calcium Soft Chews and VIACTIV® Multi-Vitamin Soft Chews are marketed by McNeil Nutritionals, LLC. VIACTIV® products are a key part of a woman's active lifestyle. VIACTIV® Calcium and Multi-Vitamin Soft Chews provide convenient, great-tasting ways for women to supplement a healthy diet and help them obtain the recommended amount of key vitamins and calcium each day. More information is available at viactiv.
About McNeil Nutritionals, LLC
McNeil Nutritionals, LLC, is a global marketer of innovative nutritional products. The company's mission is to give people the ability to actively manage their own health. McNeil Nutritionals, LLC, markets SPLENDA® (sucralose) No Calorie Sweetener, SPLENDA® Sugar Blend, SPLENDA® Brown Sugar Blend, SPLENDA® QUICK PACK™ No Calorie Sweetener Pouches, SPLENDA® Flavor Blends for Coffee, VIACTIV® Calcium Soft Chews, VIACTIV® Multi-Vitamin Soft Chews, VIACTIV® for Teens Calcium Soft Chews, LACTAID® Milk and Dietary Supplements and BENECOL® Spreads. McNeil Nutritionals, LLC, is headquartered in Fort Washington, PA.
1 2004 National Dairy Council; eatsmart/client_images/gd20052171417501.pdf
2 "Vitamin D and calcium: strong bones for life through better nutrition," Contemporary Pediatrics, March 2003.
3 Greer FR, Krebs NF. American Academy of Pediatrics Committee on Nutrition. Optimizing bone health and calcium intake of infants, children and adolescents. Pediatrics. 2006 Feb;117(2):578-85.
VIACTIV®
viactiv
понедельник, 26 сентября 2011 г.
Scoliosis, What Every Parent Needs To Know
Scoliosis may sound like a frightening diagnosis, but proper treatment enables children with the condition to lead normal, active lives.
Scoliosis refers to an abnormal curvature of the spine. Small curves are a normal part of spine anatomy and are not cause for concern, according to Dr. Daniel Green, a pediatric orthopedic surgeon at Hospital for Special Surgery in Manhattan. But when the curvature exceeds a certain range, children require medical attention.
"Many cases of scoliosis are mild, and periodic checkups may be all a child needs," Dr. Green says. "But youngsters with a curve that continues to increase may need treatment."
Scoliosis tends to run in families. The most common type is called "idiopathic scoliosis," which means the cause is not known. However, studies show that scoliosis is not caused by poor posture, the use of backpacks or any type of exercise. It affects girls ten times more often than boys.
Scoliosis is often first detected during a routine visit to the pediatrician or during a school screening. "Screenings at school are an important safeguard for many children, especially those who may not have a regular healthcare provider," says Dr. Green. He worked with the New York State Society of Orthopaedic Surgeons to advocate for the continuation of scoliosis screenings in New York schools
The development of scoliosis is usually gradual and painless. A curve can develop without a parent or child knowing it, until it becomes more pronounced. Viewed from behind, a normal spine appears as a straight line from the base of the neck to the tailbone.
Signs of scoliosis:
-- one shoulder appears higher than the other
-- the waist appears uneven
-- one hip looks higher than the other
-- the ribs appear to protrude on one side
-- the child seems to be leaning to one side when standing
Parents who notice any sign of scoliosis, however subtle, should take the child to the doctor for an evaluation, according to Dr. Green. If a child does have scoliosis, early diagnosis and treatment lead to a better outcome. Although rare, severe cases of scoliosis with a large curve magnitude can cause back pain, fatigue, difficulty breathing, and can affect the heart and lungs.
The diagnosis is based on a physical examination and x-rays. A curve of greater than 10 degrees on an x-ray is considered to be scoliosis. "Treatment depends on the age of the child, the degree of the curve and how much the child will continue to grow. The goal is to slow or prevent progression of the curve and to improve the way it looks," Dr. Green explains.
For patients with smaller curves, the pediatric orthopedist may recommend continued observation. For more significant curves, the best treatment may be a brace to correct the condition, according to Dr. Green. Some braces are worn throughout the day and evening, and other braces are worn only for sleep. It's important for the child to wear the brace as instructed. Most children get used to their brace after a short time.
For children with more advanced scoliosis -- those with a curve of 45 degrees or more -- surgery may be recommended. Scoliosis surgery is a complicated operation that takes several hours. When choosing a surgeon and hospital, parents should make sure the physician specializes in this type of surgery and is highly experienced in the procedure, according to Dr. Green. Parents and children should also feel comfortable with the doctor and make sure he or she takes the time to answer all of their questions.
"Performed by an experienced surgeon, the operation generally results in an excellent correction of the curve and significant improvement in spinal alignment," Dr. Green says. "Left untreated, a curve that continues to progress may eventually affect heart and lung function. Done later in adult life, surgeries are lengthier and tend to have a less satisfactory result."
Source: Hospital for Special Surgery
Scoliosis refers to an abnormal curvature of the spine. Small curves are a normal part of spine anatomy and are not cause for concern, according to Dr. Daniel Green, a pediatric orthopedic surgeon at Hospital for Special Surgery in Manhattan. But when the curvature exceeds a certain range, children require medical attention.
"Many cases of scoliosis are mild, and periodic checkups may be all a child needs," Dr. Green says. "But youngsters with a curve that continues to increase may need treatment."
Scoliosis tends to run in families. The most common type is called "idiopathic scoliosis," which means the cause is not known. However, studies show that scoliosis is not caused by poor posture, the use of backpacks or any type of exercise. It affects girls ten times more often than boys.
Scoliosis is often first detected during a routine visit to the pediatrician or during a school screening. "Screenings at school are an important safeguard for many children, especially those who may not have a regular healthcare provider," says Dr. Green. He worked with the New York State Society of Orthopaedic Surgeons to advocate for the continuation of scoliosis screenings in New York schools
The development of scoliosis is usually gradual and painless. A curve can develop without a parent or child knowing it, until it becomes more pronounced. Viewed from behind, a normal spine appears as a straight line from the base of the neck to the tailbone.
Signs of scoliosis:
-- one shoulder appears higher than the other
-- the waist appears uneven
-- one hip looks higher than the other
-- the ribs appear to protrude on one side
-- the child seems to be leaning to one side when standing
Parents who notice any sign of scoliosis, however subtle, should take the child to the doctor for an evaluation, according to Dr. Green. If a child does have scoliosis, early diagnosis and treatment lead to a better outcome. Although rare, severe cases of scoliosis with a large curve magnitude can cause back pain, fatigue, difficulty breathing, and can affect the heart and lungs.
The diagnosis is based on a physical examination and x-rays. A curve of greater than 10 degrees on an x-ray is considered to be scoliosis. "Treatment depends on the age of the child, the degree of the curve and how much the child will continue to grow. The goal is to slow or prevent progression of the curve and to improve the way it looks," Dr. Green explains.
For patients with smaller curves, the pediatric orthopedist may recommend continued observation. For more significant curves, the best treatment may be a brace to correct the condition, according to Dr. Green. Some braces are worn throughout the day and evening, and other braces are worn only for sleep. It's important for the child to wear the brace as instructed. Most children get used to their brace after a short time.
For children with more advanced scoliosis -- those with a curve of 45 degrees or more -- surgery may be recommended. Scoliosis surgery is a complicated operation that takes several hours. When choosing a surgeon and hospital, parents should make sure the physician specializes in this type of surgery and is highly experienced in the procedure, according to Dr. Green. Parents and children should also feel comfortable with the doctor and make sure he or she takes the time to answer all of their questions.
"Performed by an experienced surgeon, the operation generally results in an excellent correction of the curve and significant improvement in spinal alignment," Dr. Green says. "Left untreated, a curve that continues to progress may eventually affect heart and lung function. Done later in adult life, surgeries are lengthier and tend to have a less satisfactory result."
Source: Hospital for Special Surgery
пятница, 23 сентября 2011 г.
Antidepressant Use May Boost Fracture Risk, From Harvard Women's Health Watch
Evidence is accumulating that
depression is a risk factor for osteoporosis, reports the June 2007 issue
of Harvard Women's Health Watch. A recent study found that people ages 50
and over who regularly took antidepressants called selective serotonin
reuptake inhibitors (SSRIs) had double the rate of fractures as people not
using such medications. Other research points to depression itself as a
source of endocrine changes that can damage bone.
Whether the danger comes from depression, the drugs used to treat it,
or something else, doctors are paying more attention to this association.
During the 1990s, depression began to emerge as a possible cause of bone
loss, rather than a result. Scientists studied women who didn't have
osteoporosis symptoms or even know they had the condition. They found lower
bone mineral density in those who were depressed. Moreover, the link was
found in both younger women and women past menopause. Other studies have
found a similar relationship, so investigators have been looking at
hormones and brain chemicals potentially involved in both depression and
bone loss.
Researchers working with an animal model found that depression triggers
the release of noradrenaline, which interferes with bone-building cells.
Moreover, they found that imipramine-a member of an older class of drugs
called tricyclic antidepressants-reversed both depression and depression-
induced bone loss.
It may be a long time before the depression-osteoporosis connection is
fully clarified. In the meantime, Harvard Women's Health Watch suggests
that you continue taking an antidepressant if you already use one;
depression is a serious illness that can have profound consequences. You
may also want to talk to your doctor about getting a bone density test, and
make sure you get adequate calcium.
Harvard Health Publications
health.harvard/women
depression is a risk factor for osteoporosis, reports the June 2007 issue
of Harvard Women's Health Watch. A recent study found that people ages 50
and over who regularly took antidepressants called selective serotonin
reuptake inhibitors (SSRIs) had double the rate of fractures as people not
using such medications. Other research points to depression itself as a
source of endocrine changes that can damage bone.
Whether the danger comes from depression, the drugs used to treat it,
or something else, doctors are paying more attention to this association.
During the 1990s, depression began to emerge as a possible cause of bone
loss, rather than a result. Scientists studied women who didn't have
osteoporosis symptoms or even know they had the condition. They found lower
bone mineral density in those who were depressed. Moreover, the link was
found in both younger women and women past menopause. Other studies have
found a similar relationship, so investigators have been looking at
hormones and brain chemicals potentially involved in both depression and
bone loss.
Researchers working with an animal model found that depression triggers
the release of noradrenaline, which interferes with bone-building cells.
Moreover, they found that imipramine-a member of an older class of drugs
called tricyclic antidepressants-reversed both depression and depression-
induced bone loss.
It may be a long time before the depression-osteoporosis connection is
fully clarified. In the meantime, Harvard Women's Health Watch suggests
that you continue taking an antidepressant if you already use one;
depression is a serious illness that can have profound consequences. You
may also want to talk to your doctor about getting a bone density test, and
make sure you get adequate calcium.
Harvard Health Publications
health.harvard/women
вторник, 20 сентября 2011 г.
Knee Replacement Boosts Mobility, Physical Ability In Patients
A study published in a recent issue of Arthritis and Rheumatism found that knee replacement is effective at restoring the mobility and physical functioning of the knee and relieving patients of the irrepressible pain and significant restrictions on quality of life caused by osteoarthritis.
South Nassau Communities Hospital's Center for Advanced Orthopedics offers a comprehensive line of advanced knee replacement treatment options that are tailored to address the specific needs of the patients and repairing the damage caused by osteoarthritis.
The study, conducted by a team of researchers from Duke University, is based on data culled from Medicare Current Beneficiary Surveys from 1992-2003 that focused on the outcomes of 259 patients who received knee replacements and 1,816 patients with osteoarthritis who did not receive a knee replacement.
The study grouped patients according to baseline level of functioning (the joint's normal level of functioning prior to medical treatment, therapy, and/or surgery), demographics, and co-morbidities and used the Nagi Disability Scale (a widely accepted permutation of the World Health Organization's approach to classifying disabilities), Instrumental Activities of Daily Living Scale (IADL), and the Activities of Daily Living Scale (ADL) to assess their physical ability. Nagi Scale is based on the performance of tasks deemed the highest level of physical functioning, such as walking and strength training. IADL tasks, such as shopping, cooking, housework, are at the intermediate level of difficulty. The ADL gauges the ability to do basic level tasks, such as getting dressed or showering.
Knee replacement patients showed improvement in one basic function of self care (bathing), three intermediate tasks (light housework, heavy housework, and shopping), and two high level tasks (walking 2-3 blocks and lifting weights at least 10 pounds). The patients who did not receive a knee replacement continued to decline in overall physical functioning.
"Our approach is to provide the most effective and efficient options that will allow patients to return to the lifestyle and activities or their choice," said Craig Levitz, MD, Chief of Orthopedic Surgery and Director of the Center of Advanced Orthopedics .
Whether 35, 45, 55, 65 or older, osteoarthritis of the knee is a debilitating, painful disease that can bring life to a literal standstill. Osteoarthritis affects more than 21 million individuals in the United States . When it takes hold in the knee, the disease causes deterioration of cartilage between the femur (thigh bone) and tibia (shin bone). Without cartilage, which covers the ends of the each bone and acts like a cushion or shock absorber, the femur and tibia rub and grind against each other, causing steady decay, chipping and jagged surfaces.
South Nassau is one of just a handful of hospitals in the United States to combine minimally-invasive knee replacement with a revolutionary image guided medical technology system. This combination simplifies total knee replacement surgery and significantly improves the short- and long-term patient benefits of the operation.
Image guided surgical technology is used to determine the precise alignment of the replacement parts, improves the surgeon's view of and feel for the surgical field and reduces the size of the incisions to perform a replacement. By integrating multiple medical technologies and computerization, image-guided surgery outlines the precise alignment of the replacement components. It combines digital images of the shin bone and thigh bone with knee replacement-specific computer programming. The system puts together all of the information coming in from the patient and the instruments and tells the surgeon where the cuts should be made.
In standard knee replacement surgery, the surgeon must implant the replacement components - a metal and plastic platform atop the shinbone and a metal surface on the bottom of the thighbone - so that they rub together at precise angles to prevent premature or excessive wear of the implant. Surgical cutting blocks and acumen are used to determine where best to remove bone for the implant. Once the cut is made, the natural bone cannot be replaced.
The Mobile-Bearing Knee System is another proven knee replacement treatment provided by the Center. The system is one of the devices with the longest history in total knee replacement. Since 1977, more than 400,000 mobile-bearing knees have been implanted in the US and internationally. "A host of studies on the long-term clinical success of the system has demonstrated that average lifespan of the system is approximately 20 years in more than 96% of the patients," said Bradley Gerber, MD, Chief of Joint Replacement.
In the late 1990s, the Mobile-Bearing Knee System was updated to include additional primary and revision implant options as well as new instrumentation. "Benefits of the system include minimal incidence of patellar-femur complications (a common cause for revisions to a knee replacement) and consistent maximum contact while diffusing torsional and shear forces that can lead to implant loosening," said Dr. Gerber.
Under the direction of Dr. Levitz and Dr. Gerber South Nassau was one of the first hospitals in New York to introduce the minimally-invasive Uni-Knee® System. The Uni-Knee is a partial knee replacement that requires a two- or three-inch incision and uses precision surgical instrumentation and guides to remove the damaged bone and cartilage. Implants, which are shaped and sized to mimic and function exactly as the bone and cartilage that has been removed, are then inserted. They are secured to the bones using a solution known as bone cement.
"Benefits of the Uni-Knee System are recognized almost immediately," said Dr. Gerber. "The minimally invasive approach generally results in a shorter hospital stay (24 hours or fewer on the average), minimal blood loss, a smaller incision and, in some instances, an increase in range of motion."
Completing the prescribed rehabilitation following surgery is vital to the success of the knee replacement or transplant surgery. "This is not a stopgap, short-term solution," said Dr. Levitz. "Knee replacement is a long-term solution to restore the knee's functions. That can be achieved as long as the patient makes an inviolable commitment to physical rehabilitation."
South Nassau Communities Hospital is one of the region's largest hospitals, with 441 beds, more than 875 physicians and 2,600 employees. Located in Oceanside , NY , the hospital is an acute-care, not-for-profit teaching hospital that provides state-of-the-art care in cardiac, oncologic, orthopedic, bariatric, pain management, mental health and emergency services. In addition to its extensive outpatient specialty centers, South Nassau is a designated Stroke Center , boasts Long Island 's first Gamma KnifeГў and provides angioplasty in an emergency or as an elective procedure. South Nassau is designated as a Comprehensive Community Cancer Center by the American College of Surgeons and recognized as a Bariatric Surgery Center of Excellence by the American Society of Bariatric Surgery.
South Nassau Communities Hospital
South Nassau Communities Hospital's Center for Advanced Orthopedics offers a comprehensive line of advanced knee replacement treatment options that are tailored to address the specific needs of the patients and repairing the damage caused by osteoarthritis.
The study, conducted by a team of researchers from Duke University, is based on data culled from Medicare Current Beneficiary Surveys from 1992-2003 that focused on the outcomes of 259 patients who received knee replacements and 1,816 patients with osteoarthritis who did not receive a knee replacement.
The study grouped patients according to baseline level of functioning (the joint's normal level of functioning prior to medical treatment, therapy, and/or surgery), demographics, and co-morbidities and used the Nagi Disability Scale (a widely accepted permutation of the World Health Organization's approach to classifying disabilities), Instrumental Activities of Daily Living Scale (IADL), and the Activities of Daily Living Scale (ADL) to assess their physical ability. Nagi Scale is based on the performance of tasks deemed the highest level of physical functioning, such as walking and strength training. IADL tasks, such as shopping, cooking, housework, are at the intermediate level of difficulty. The ADL gauges the ability to do basic level tasks, such as getting dressed or showering.
Knee replacement patients showed improvement in one basic function of self care (bathing), three intermediate tasks (light housework, heavy housework, and shopping), and two high level tasks (walking 2-3 blocks and lifting weights at least 10 pounds). The patients who did not receive a knee replacement continued to decline in overall physical functioning.
"Our approach is to provide the most effective and efficient options that will allow patients to return to the lifestyle and activities or their choice," said Craig Levitz, MD, Chief of Orthopedic Surgery and Director of the Center of Advanced Orthopedics .
Whether 35, 45, 55, 65 or older, osteoarthritis of the knee is a debilitating, painful disease that can bring life to a literal standstill. Osteoarthritis affects more than 21 million individuals in the United States . When it takes hold in the knee, the disease causes deterioration of cartilage between the femur (thigh bone) and tibia (shin bone). Without cartilage, which covers the ends of the each bone and acts like a cushion or shock absorber, the femur and tibia rub and grind against each other, causing steady decay, chipping and jagged surfaces.
South Nassau is one of just a handful of hospitals in the United States to combine minimally-invasive knee replacement with a revolutionary image guided medical technology system. This combination simplifies total knee replacement surgery and significantly improves the short- and long-term patient benefits of the operation.
Image guided surgical technology is used to determine the precise alignment of the replacement parts, improves the surgeon's view of and feel for the surgical field and reduces the size of the incisions to perform a replacement. By integrating multiple medical technologies and computerization, image-guided surgery outlines the precise alignment of the replacement components. It combines digital images of the shin bone and thigh bone with knee replacement-specific computer programming. The system puts together all of the information coming in from the patient and the instruments and tells the surgeon where the cuts should be made.
In standard knee replacement surgery, the surgeon must implant the replacement components - a metal and plastic platform atop the shinbone and a metal surface on the bottom of the thighbone - so that they rub together at precise angles to prevent premature or excessive wear of the implant. Surgical cutting blocks and acumen are used to determine where best to remove bone for the implant. Once the cut is made, the natural bone cannot be replaced.
The Mobile-Bearing Knee System is another proven knee replacement treatment provided by the Center. The system is one of the devices with the longest history in total knee replacement. Since 1977, more than 400,000 mobile-bearing knees have been implanted in the US and internationally. "A host of studies on the long-term clinical success of the system has demonstrated that average lifespan of the system is approximately 20 years in more than 96% of the patients," said Bradley Gerber, MD, Chief of Joint Replacement.
In the late 1990s, the Mobile-Bearing Knee System was updated to include additional primary and revision implant options as well as new instrumentation. "Benefits of the system include minimal incidence of patellar-femur complications (a common cause for revisions to a knee replacement) and consistent maximum contact while diffusing torsional and shear forces that can lead to implant loosening," said Dr. Gerber.
Under the direction of Dr. Levitz and Dr. Gerber South Nassau was one of the first hospitals in New York to introduce the minimally-invasive Uni-Knee® System. The Uni-Knee is a partial knee replacement that requires a two- or three-inch incision and uses precision surgical instrumentation and guides to remove the damaged bone and cartilage. Implants, which are shaped and sized to mimic and function exactly as the bone and cartilage that has been removed, are then inserted. They are secured to the bones using a solution known as bone cement.
"Benefits of the Uni-Knee System are recognized almost immediately," said Dr. Gerber. "The minimally invasive approach generally results in a shorter hospital stay (24 hours or fewer on the average), minimal blood loss, a smaller incision and, in some instances, an increase in range of motion."
Completing the prescribed rehabilitation following surgery is vital to the success of the knee replacement or transplant surgery. "This is not a stopgap, short-term solution," said Dr. Levitz. "Knee replacement is a long-term solution to restore the knee's functions. That can be achieved as long as the patient makes an inviolable commitment to physical rehabilitation."
South Nassau Communities Hospital is one of the region's largest hospitals, with 441 beds, more than 875 physicians and 2,600 employees. Located in Oceanside , NY , the hospital is an acute-care, not-for-profit teaching hospital that provides state-of-the-art care in cardiac, oncologic, orthopedic, bariatric, pain management, mental health and emergency services. In addition to its extensive outpatient specialty centers, South Nassau is a designated Stroke Center , boasts Long Island 's first Gamma KnifeГў and provides angioplasty in an emergency or as an elective procedure. South Nassau is designated as a Comprehensive Community Cancer Center by the American College of Surgeons and recognized as a Bariatric Surgery Center of Excellence by the American Society of Bariatric Surgery.
South Nassau Communities Hospital
суббота, 17 сентября 2011 г.
Preliminary Draft Guidance Recommends New Osteoporosis Treatment For Women At Increased Risk Of Fractures
Postmenopausal women who are at increased risk[1] of osteoporotic fractures should be treated with denosumab if treatment with currently available oral bisphosphonates is unsuitable, according to draft guidance published today (Friday 18 June) by NICE.
Denosumab (Prolia, Amgen) is a newly-licensed treatment for women at increased risk of osteoporotic fractures, given by injection twice a year. It works by reducing bone breakdown and increases bone mass and strength.
Most postmenopausal women at increased risk of osteoporotic fractures are treated with oral bisphosphonates, but for some women these drugs may be unsuitable. Reasons for unsuitability are that a woman is unable to comply with the special instructions for the administration of oral bisphosphonates (for instance she may not be able to remain standing or sitting upright for half an hour after taking the drugs), or has a contraindication to or is intolerant of bisphosphonates. Denosumab should be an option for these women if they are judged to be at increased risk of fractures, according to the NICE draft guidance.
Dr Carole Longson, Health Technology Evaluation Centre Director at NICE said: "Our independent Appraisal Committee felt that there was good quality evidence to show that denosumab is a useful addition to the treatment options available to prevent a first fracture in women at increased risk and also at preventing further fractures in women who have already experienced one. We hope that older women at increased risk of osteoporotic fractures who cannot take oral bisphosphonates will be considered for this drug in order to help prevent the misery of breaking a bone, and we are now opening a consultation on this preliminary decision."
This is not final NICE guidance. Draft guidance has been issued for consultationments received during the consultation will be considered by the Committee and following this meeting the next draft guidance will be issued. Until NICE issues final guidance, NHS bodies should make decisions locally on the funding of specific treatments.
About the guidance
- The appraisal consultation document (ACD) will be available at guidance.nice.uk/TA/Wave20/75 from Friday 18 June 2010. Consultation will take place between 18 June and 9 July 2010. The next committee meeting will be held on 27 July. NICE expects to publish final guidance on denosumab later this year.
- The appraisal consultation document published today (18 June) states:
1.1 Denosumab is recommended as a treatment option for the primary prevention of osteoporotic fragility fractures only in postmenopausal women at increased risk of fractures:
- who are unable to comply with the special instructions for the administration of oral bisphosphonates, are intolerant of oral bisphosphonates or for whom treatment with oral bisphosphonates is contraindicated and
- who also have a combination of T-score[2], age and number of independent clinical risk factors for fracture (see section 1.3)
1.2 Denosumab is recommended as a treatment option for the secondary prevention of osteoporotic fragility fractures only in postmenopausal women at increased risk of fractures:
- who are unable to comply with the special instructions for the administration of oral bisphosphonates, are intolerant of oral bisphosphonates or for whom treatment with oral bisphosphonates is contraindicated
1.3 For the purposes of this guidance, independent clinical risk factors for fracture are parental history of hip fracture, alcohol intake of 4 or more units per day, and rheumatoid arthritis.
- Denosumab is administered as a single subcutaneous injection into the thigh, abdomen or the back of the arm. The recommended dosage is 60mg once every six months.
- Each dose costs ВЈ183, which means that the annual cost of treatment with denosumab is ВЈ366. Costs may vary in different settings because of negotiated procurement discounts.
[1] 'Increased risk' is defined by a combination of low bone mineral density, age and a number of other clinical risk factors such as parental history of hip fracture, high alcohol intake and rheumatoid arthritis.
[2] T-score relates to the measurement of bone mineral density (BMD) using central (hip and/or spine) DXA scanning, and is expressed as the number of standard deviations (SD) below peak BMD.
Source:
NICE
View drug information on Prolia.
Denosumab (Prolia, Amgen) is a newly-licensed treatment for women at increased risk of osteoporotic fractures, given by injection twice a year. It works by reducing bone breakdown and increases bone mass and strength.
Most postmenopausal women at increased risk of osteoporotic fractures are treated with oral bisphosphonates, but for some women these drugs may be unsuitable. Reasons for unsuitability are that a woman is unable to comply with the special instructions for the administration of oral bisphosphonates (for instance she may not be able to remain standing or sitting upright for half an hour after taking the drugs), or has a contraindication to or is intolerant of bisphosphonates. Denosumab should be an option for these women if they are judged to be at increased risk of fractures, according to the NICE draft guidance.
Dr Carole Longson, Health Technology Evaluation Centre Director at NICE said: "Our independent Appraisal Committee felt that there was good quality evidence to show that denosumab is a useful addition to the treatment options available to prevent a first fracture in women at increased risk and also at preventing further fractures in women who have already experienced one. We hope that older women at increased risk of osteoporotic fractures who cannot take oral bisphosphonates will be considered for this drug in order to help prevent the misery of breaking a bone, and we are now opening a consultation on this preliminary decision."
This is not final NICE guidance. Draft guidance has been issued for consultationments received during the consultation will be considered by the Committee and following this meeting the next draft guidance will be issued. Until NICE issues final guidance, NHS bodies should make decisions locally on the funding of specific treatments.
About the guidance
- The appraisal consultation document (ACD) will be available at guidance.nice.uk/TA/Wave20/75 from Friday 18 June 2010. Consultation will take place between 18 June and 9 July 2010. The next committee meeting will be held on 27 July. NICE expects to publish final guidance on denosumab later this year.
- The appraisal consultation document published today (18 June) states:
1.1 Denosumab is recommended as a treatment option for the primary prevention of osteoporotic fragility fractures only in postmenopausal women at increased risk of fractures:
- who are unable to comply with the special instructions for the administration of oral bisphosphonates, are intolerant of oral bisphosphonates or for whom treatment with oral bisphosphonates is contraindicated and
- who also have a combination of T-score[2], age and number of independent clinical risk factors for fracture (see section 1.3)
1.2 Denosumab is recommended as a treatment option for the secondary prevention of osteoporotic fragility fractures only in postmenopausal women at increased risk of fractures:
- who are unable to comply with the special instructions for the administration of oral bisphosphonates, are intolerant of oral bisphosphonates or for whom treatment with oral bisphosphonates is contraindicated
1.3 For the purposes of this guidance, independent clinical risk factors for fracture are parental history of hip fracture, alcohol intake of 4 or more units per day, and rheumatoid arthritis.
- Denosumab is administered as a single subcutaneous injection into the thigh, abdomen or the back of the arm. The recommended dosage is 60mg once every six months.
- Each dose costs ВЈ183, which means that the annual cost of treatment with denosumab is ВЈ366. Costs may vary in different settings because of negotiated procurement discounts.
[1] 'Increased risk' is defined by a combination of low bone mineral density, age and a number of other clinical risk factors such as parental history of hip fracture, high alcohol intake and rheumatoid arthritis.
[2] T-score relates to the measurement of bone mineral density (BMD) using central (hip and/or spine) DXA scanning, and is expressed as the number of standard deviations (SD) below peak BMD.
Source:
NICE
View drug information on Prolia.
среда, 14 сентября 2011 г.
Chronic Back Pain Linked To Changes In The Brain
A German research team using a specialized imaging technique revealed that individuals suffering from chronic low back pain also had microstructural changes in their brains. The findings were presented at the annual meeting of the Radiological Society of North America (RSNA).
The researchers, led by Jurgen Lutz, M.D., a radiology resident at University Hospital, Ludwig-Maximilians University in Munich, Germany, used a technique called diffusion tensor imaging (DTI) to track the movement of water molecules in the brain's gray and white matter.
"A major problem for patients with chronic pain is making their condition believable to doctors, relatives and insurance carriers. DTI could play an important role in this regard," Dr. Lutz said. "With these objective and reproducible correlates in brain imaging, chronic pain may no longer be a subjective experience. For pain diagnosis and treatment, the consequences could be enormous."
Individual water molecules are constantly in motion, colliding with each other and other nearby molecules, causing them to spread out, or diffuse. DTI allows scientists to analyze water diffusion in the tissues of the brain that indicate changes in brain cell organization.
"In normal white matter, water diffuses in one main direction," Dr. Lutz explained. "But when fiber pathways are developing during childhood or are extensively used, their microstructural organization becomes more organized and complex with measurable changes in diffusion."
Dr. Lutz and colleagues studied 20 patients experiencing chronic back pain with no precisely identifiable cause and 20 age- and gender-matched healthy control patients. DTI was performed to measure the diffusion in several areas of each patient's brain.
Compared to the healthy volunteers, the patients with chronic low back pain had a significantly more directed diffusion in the three pain-processing regions of the brain, including the cingulate gyrus, postcentral gyrus and superior frontal gyrus.
"Our results reveal that in chronic pain sufferers, the organization of cerebral microstructure is much more complex and active in the areas of the brain involved in pain processing, emotion and the stress response," said co-author Gustav Schelling, M.D., Ph.D. from the Department of Anaesthesiology at Munich University.
The researchers said the findings may help explain the extreme resistance to treatment for chronic low back pain and provide much-needed evidence for individual sufferers. However, it is unclear which occurs first, the chronic back pain or the microstructural changes in the brain.
"It's difficult to know whether these are pre-existing changes in the brain that predispose an individual to developing chronic pain, whether ongoing pain creates the hyperactivity that actually changes the brain organization, or if it is some mixture of both," Dr. Schelling said. "DTI may help explain what's happening for some of these patients, and direct therapeutic attention from the spine to the brain," he added.
Co-authors are Maximilian F. Reiser, M.D., Olaf Dietrich, Ph.D., Lorenz Jaeger, M.D. and Robert Stahl, M.D.
RSNA is an association of more than 40,000 radiologists, radiation oncologists, medical physicists and related scientists committed to promoting excellence in radiology through education and by fostering research, with the ultimate goal of improving patient care. The Society is based in Oak Brook, Ill.
The data in these releases may differ from those in the printed abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting.
Contact: Maureen Morley
Radiological Society of North America
The researchers, led by Jurgen Lutz, M.D., a radiology resident at University Hospital, Ludwig-Maximilians University in Munich, Germany, used a technique called diffusion tensor imaging (DTI) to track the movement of water molecules in the brain's gray and white matter.
"A major problem for patients with chronic pain is making their condition believable to doctors, relatives and insurance carriers. DTI could play an important role in this regard," Dr. Lutz said. "With these objective and reproducible correlates in brain imaging, chronic pain may no longer be a subjective experience. For pain diagnosis and treatment, the consequences could be enormous."
Individual water molecules are constantly in motion, colliding with each other and other nearby molecules, causing them to spread out, or diffuse. DTI allows scientists to analyze water diffusion in the tissues of the brain that indicate changes in brain cell organization.
"In normal white matter, water diffuses in one main direction," Dr. Lutz explained. "But when fiber pathways are developing during childhood or are extensively used, their microstructural organization becomes more organized and complex with measurable changes in diffusion."
Dr. Lutz and colleagues studied 20 patients experiencing chronic back pain with no precisely identifiable cause and 20 age- and gender-matched healthy control patients. DTI was performed to measure the diffusion in several areas of each patient's brain.
Compared to the healthy volunteers, the patients with chronic low back pain had a significantly more directed diffusion in the three pain-processing regions of the brain, including the cingulate gyrus, postcentral gyrus and superior frontal gyrus.
"Our results reveal that in chronic pain sufferers, the organization of cerebral microstructure is much more complex and active in the areas of the brain involved in pain processing, emotion and the stress response," said co-author Gustav Schelling, M.D., Ph.D. from the Department of Anaesthesiology at Munich University.
The researchers said the findings may help explain the extreme resistance to treatment for chronic low back pain and provide much-needed evidence for individual sufferers. However, it is unclear which occurs first, the chronic back pain or the microstructural changes in the brain.
"It's difficult to know whether these are pre-existing changes in the brain that predispose an individual to developing chronic pain, whether ongoing pain creates the hyperactivity that actually changes the brain organization, or if it is some mixture of both," Dr. Schelling said. "DTI may help explain what's happening for some of these patients, and direct therapeutic attention from the spine to the brain," he added.
Co-authors are Maximilian F. Reiser, M.D., Olaf Dietrich, Ph.D., Lorenz Jaeger, M.D. and Robert Stahl, M.D.
RSNA is an association of more than 40,000 radiologists, radiation oncologists, medical physicists and related scientists committed to promoting excellence in radiology through education and by fostering research, with the ultimate goal of improving patient care. The Society is based in Oak Brook, Ill.
The data in these releases may differ from those in the printed abstract and those actually presented at the meeting, as researchers continue to update their data right up until the meeting.
Contact: Maureen Morley
Radiological Society of North America
воскресенье, 11 сентября 2011 г.
New MRI Signaling Method Could Picture Disease Metabolism In Action
Duke University chemists are using modified magnetic resonance imaging to see molecular changes inside people's bodies that could signal health problems such as cancer.
Their new method, reported in the March 27 issue of the research journal Science, makes more of the body's chemistry visible by MRI, said Warren Warren, James B. Duke Professor of chemistry at Duke.
Standard MRI and the functional MRI used for brain imaging enlist the hydrogen atoms in water to create a graphic display in response to magnetic pulses and radio waves. But a huge array of water molecules are needed to pull that off.
"Only one out of every 100,000 water molecules in the body will actually contribute any useful signal to build that image," Warren said. "The water signal is not much different between tumors and normal tissue, but the other internal chemistry is different. So detecting other molecules, and how they change, would aid diagnosis."
The Duke team has been able to see these other molecules with MRI by "hyperpolarizing" some atoms in a sample, adjusting the spins of their nuclei to drastically increase their signal. This creates large imbalances among the populations of those spin states, making the molecules into more powerful magnets.
Unlike normal MRI, hyperpolarization and a technique called "dynamic nuclear polarization" (DNP) which was used for this research, can produce strong MRI signals from a variety of other kinds of atoms besides water. Without hyperpolarization, detecting signals from atoms besides water is exceedingly difficult because the signal size is so small. But "these signals are strong enough to see, even though the molecules are much more complex than water," Warren said.
Warren's group uses what he calls the "first DNP hyperpolarizer in the South," which is installed in his laboratory. It also uses Duke's Small Molecule Synthesis Facility to create custom molecular architectures.
"You thus have a signal that, at least transiently, can be thousands or ten thousands times stronger than regular hydrogen in an MRI," Warren said. "It lets you turn molecules you are interested in into MRI lightbulbs."
Duke's hyperpolarizer includes a superconducting magnet, a cryogenic cooling system that initially plunges temperatures to a scant 1.4 Kelvin degrees while microwave radiation transfers spin polarization from electrons to nuclei, and a heating system to rapidly warm the molecules back up.
Hyperpolarized spin states don't last for long inside the body, but ways have been found to lengthen them. Several years ago, another group discovered a method to make DNP work at room temperature in some biological molecules by substituting carbon-13 atoms for some of those molecules' normal carbon-12s. Unlike carbon-12, carbon-13 emits an NMR signal like hydrogen atoms do.
Using this room-temperature DNP, the biological molecule pyruvate can retain its MRI signal for as long as 40 seconds -- long enough to observe it undergoing rapid chemical change. "So you can watch pyruvate metabolize to produce lactate, acetic acid and bicarbonate -- all breakdown products that might correlate with cancer," Warren said. But most biological processes are much slower, and thus can't be seen with this method.
In its Science report, the Duke team describes a new method that can further extend the signals of molecules carrying swapped carbon-13s. It works by temporarily bottling-up the hyperpolarization in the longest-lived spin states -- called "singlet eigenstates" -- within specially designed molecular architectures. "You can actually use their own chemistries to get the molecules in and out of those protected states," Warren said.
For example, hyperpolarized populations locked within a specially prepared form of diacetyl -- a bacterially-made chemical that imparts buttery flavoring to foods -- can be stored using this method, according to the report. Once triggered, the MRI signal can be extended over many minutes before the spin states decay.
Thus bottled-up, the signals could be kept in temporary isolation. By dehydrating and shielding them from water within microscopic capsules, for example, these "signaling" molecules could be transported through the bloodstream to a potential disease site, Warren said.
Once at that site, a focused burst of ultrasound or heat could restore the molecules' missing water. That would cause a telltale signal to be released just as a rapidly progressing metabolic event was unfolding.
The Duke group is evaluating the potentials for a number of other possible signaling molecules, such as those involved in Parkinson's disease, osteoporosis and bladder control, said Warren, who has filed for a provisional patent.
Notes:
The research was funded by the National Institutes of Health and the North Carolina Biotechnology Center.
Other authors of the Science report were graduate student Elizabeth Jenista, and Duke assistant research professors Rosa Tamara Branca and Xin Chen.
Source:
Monte Basgall
Duke University
Their new method, reported in the March 27 issue of the research journal Science, makes more of the body's chemistry visible by MRI, said Warren Warren, James B. Duke Professor of chemistry at Duke.
Standard MRI and the functional MRI used for brain imaging enlist the hydrogen atoms in water to create a graphic display in response to magnetic pulses and radio waves. But a huge array of water molecules are needed to pull that off.
"Only one out of every 100,000 water molecules in the body will actually contribute any useful signal to build that image," Warren said. "The water signal is not much different between tumors and normal tissue, but the other internal chemistry is different. So detecting other molecules, and how they change, would aid diagnosis."
The Duke team has been able to see these other molecules with MRI by "hyperpolarizing" some atoms in a sample, adjusting the spins of their nuclei to drastically increase their signal. This creates large imbalances among the populations of those spin states, making the molecules into more powerful magnets.
Unlike normal MRI, hyperpolarization and a technique called "dynamic nuclear polarization" (DNP) which was used for this research, can produce strong MRI signals from a variety of other kinds of atoms besides water. Without hyperpolarization, detecting signals from atoms besides water is exceedingly difficult because the signal size is so small. But "these signals are strong enough to see, even though the molecules are much more complex than water," Warren said.
Warren's group uses what he calls the "first DNP hyperpolarizer in the South," which is installed in his laboratory. It also uses Duke's Small Molecule Synthesis Facility to create custom molecular architectures.
"You thus have a signal that, at least transiently, can be thousands or ten thousands times stronger than regular hydrogen in an MRI," Warren said. "It lets you turn molecules you are interested in into MRI lightbulbs."
Duke's hyperpolarizer includes a superconducting magnet, a cryogenic cooling system that initially plunges temperatures to a scant 1.4 Kelvin degrees while microwave radiation transfers spin polarization from electrons to nuclei, and a heating system to rapidly warm the molecules back up.
Hyperpolarized spin states don't last for long inside the body, but ways have been found to lengthen them. Several years ago, another group discovered a method to make DNP work at room temperature in some biological molecules by substituting carbon-13 atoms for some of those molecules' normal carbon-12s. Unlike carbon-12, carbon-13 emits an NMR signal like hydrogen atoms do.
Using this room-temperature DNP, the biological molecule pyruvate can retain its MRI signal for as long as 40 seconds -- long enough to observe it undergoing rapid chemical change. "So you can watch pyruvate metabolize to produce lactate, acetic acid and bicarbonate -- all breakdown products that might correlate with cancer," Warren said. But most biological processes are much slower, and thus can't be seen with this method.
In its Science report, the Duke team describes a new method that can further extend the signals of molecules carrying swapped carbon-13s. It works by temporarily bottling-up the hyperpolarization in the longest-lived spin states -- called "singlet eigenstates" -- within specially designed molecular architectures. "You can actually use their own chemistries to get the molecules in and out of those protected states," Warren said.
For example, hyperpolarized populations locked within a specially prepared form of diacetyl -- a bacterially-made chemical that imparts buttery flavoring to foods -- can be stored using this method, according to the report. Once triggered, the MRI signal can be extended over many minutes before the spin states decay.
Thus bottled-up, the signals could be kept in temporary isolation. By dehydrating and shielding them from water within microscopic capsules, for example, these "signaling" molecules could be transported through the bloodstream to a potential disease site, Warren said.
Once at that site, a focused burst of ultrasound or heat could restore the molecules' missing water. That would cause a telltale signal to be released just as a rapidly progressing metabolic event was unfolding.
The Duke group is evaluating the potentials for a number of other possible signaling molecules, such as those involved in Parkinson's disease, osteoporosis and bladder control, said Warren, who has filed for a provisional patent.
Notes:
The research was funded by the National Institutes of Health and the North Carolina Biotechnology Center.
Other authors of the Science report were graduate student Elizabeth Jenista, and Duke assistant research professors Rosa Tamara Branca and Xin Chen.
Source:
Monte Basgall
Duke University
четверг, 8 сентября 2011 г.
Many teenage girls lacking in vitamin D
A University of Maine (USA) researcher has found evidence that many girls in Maine are not getting enough vitamin D, either from their diets or sun exposure. Lack of the critical nutrient could lead to health risks later in life, especially for osteoporosis. Vitamin D is necessary for the growth of healthy bones and may be critical in other bodily processes as well.
Over the last three years, Susan Sullivan of the Dept. of Food Science and Human Nutrition has monitored sun exposure, diet and blood levels of vitamin D in 23 girls from ages 10 to 13 years old. All of her subjects live in the Bangor, Maine area.
She conducted the study with Dr. Cliff Rosen of the Maine Center for Osteoporosis Research and Education, St. Joseph Hospital in Bangor. In her research and previous experience as a clinical dietitian at Massachusetts General Hospital, Sullivan has focused on the medical consequences of dietary habits.
For her 1995 doctoral degree at Boston University, she studied the relationship between fat intake and blood cholesterol levels in kidney transplant recipients.
Vitamin D is an emerging area of medical research, says Sullivan. Medical scientists have yet to understand the whole story about vitamin D and the body. 'We've known for a long time that vitamin D has a role in getting calcium into bones.
Researchers are now finding evidence that vitamin D could play other roles in health such as cancer prevention and controlling blood pressure. There are vitamin D receptors in lots of tissues in the body that aren't related to bone,' she explains.
The largest single source of vitamin D is the skin, which makes the nutrient when it is exposed to sunlight. Diet plays a less important role but, for people at high northern latitudes, helps to supplement the body's vitamin D store during the winter months when sunlight is less intense.
Since having adequate levels of vitamin D supports bone growth, Sullivan monitored bone density in her subjects. She confirmed that as they go through puberty, girls rapidly add calcium to their bones.
'Puberty is a very critical time when up to half of a person's adult bone mass is being deposited. If you think about life span, peak bone mass occurs at about the age of 30. This is such an important time when girls are growing their bones.'
Sullivan's results were presented in 2003 at the Annual Meeting of the American Society for Bone and Mineral Research.
Almost half of the Bangor area girls in her study had insufficient levels of vitamin D in their blood in March, a time of the year when the nutrient usually falls to its lowest level over the course of the year. In September, when the nutrient is usually at its highest level, 17 percent also fell below the standard, currently 20 nanograms per milliliter of blood.
As scientists uncover more details about the role that vitamin D plays in the body, they have begun to suggest that the standard be raised to about 30 nanograms per milliliter, Sullivan adds. 'How much vitamin D is necessary for optimal health? We don't really know. There's a real need for more research on that question,' she adds.
To generate vitamin D, Sullivan and other nutritionists recommend getting five to ten minutes of sun exposure between roughly 10 a.m. and 2 p.m. daily in the summer. Sunscreen lotions should be used after the first five or ten minutes.
Vitamin D fortified foods such as milk, some varieties of orange juice, yogurt, margarine and cereals are helpful. Fatty fish such as salmon also provide a vitamin D boost. Eating three servings per day of dairy products fortified with vitamin D will provide both the vitamin D and calcium to build strong bones.
'People who practice sun avoidance, who never go out in the sun without covering up completely, run a real risk of insufficient vitamin D levels,' Sullivan adds. Sullivan has received support for her study from the Maine Dairy and Nutrition Council. Dr. Michael F. Holick of the Boston University School of Medicine also contributed to the study by conducting laboratory analyses and assisting with the interpretation of the data.
Contact: Susan Sullivan, Ph.D.
susan_sullivanumenfa.maine
207-581-3031
University of Maine
Over the last three years, Susan Sullivan of the Dept. of Food Science and Human Nutrition has monitored sun exposure, diet and blood levels of vitamin D in 23 girls from ages 10 to 13 years old. All of her subjects live in the Bangor, Maine area.
She conducted the study with Dr. Cliff Rosen of the Maine Center for Osteoporosis Research and Education, St. Joseph Hospital in Bangor. In her research and previous experience as a clinical dietitian at Massachusetts General Hospital, Sullivan has focused on the medical consequences of dietary habits.
For her 1995 doctoral degree at Boston University, she studied the relationship between fat intake and blood cholesterol levels in kidney transplant recipients.
Vitamin D is an emerging area of medical research, says Sullivan. Medical scientists have yet to understand the whole story about vitamin D and the body. 'We've known for a long time that vitamin D has a role in getting calcium into bones.
Researchers are now finding evidence that vitamin D could play other roles in health such as cancer prevention and controlling blood pressure. There are vitamin D receptors in lots of tissues in the body that aren't related to bone,' she explains.
The largest single source of vitamin D is the skin, which makes the nutrient when it is exposed to sunlight. Diet plays a less important role but, for people at high northern latitudes, helps to supplement the body's vitamin D store during the winter months when sunlight is less intense.
Since having adequate levels of vitamin D supports bone growth, Sullivan monitored bone density in her subjects. She confirmed that as they go through puberty, girls rapidly add calcium to their bones.
'Puberty is a very critical time when up to half of a person's adult bone mass is being deposited. If you think about life span, peak bone mass occurs at about the age of 30. This is such an important time when girls are growing their bones.'
Sullivan's results were presented in 2003 at the Annual Meeting of the American Society for Bone and Mineral Research.
Almost half of the Bangor area girls in her study had insufficient levels of vitamin D in their blood in March, a time of the year when the nutrient usually falls to its lowest level over the course of the year. In September, when the nutrient is usually at its highest level, 17 percent also fell below the standard, currently 20 nanograms per milliliter of blood.
As scientists uncover more details about the role that vitamin D plays in the body, they have begun to suggest that the standard be raised to about 30 nanograms per milliliter, Sullivan adds. 'How much vitamin D is necessary for optimal health? We don't really know. There's a real need for more research on that question,' she adds.
To generate vitamin D, Sullivan and other nutritionists recommend getting five to ten minutes of sun exposure between roughly 10 a.m. and 2 p.m. daily in the summer. Sunscreen lotions should be used after the first five or ten minutes.
Vitamin D fortified foods such as milk, some varieties of orange juice, yogurt, margarine and cereals are helpful. Fatty fish such as salmon also provide a vitamin D boost. Eating three servings per day of dairy products fortified with vitamin D will provide both the vitamin D and calcium to build strong bones.
'People who practice sun avoidance, who never go out in the sun without covering up completely, run a real risk of insufficient vitamin D levels,' Sullivan adds. Sullivan has received support for her study from the Maine Dairy and Nutrition Council. Dr. Michael F. Holick of the Boston University School of Medicine also contributed to the study by conducting laboratory analyses and assisting with the interpretation of the data.
Contact: Susan Sullivan, Ph.D.
susan_sullivanumenfa.maine
207-581-3031
University of Maine
понедельник, 5 сентября 2011 г.
Potential Treatment For Osteoporosis In Fabled 'Vegetable Lamb' Plant
The "vegetable lamb" plant - once believed to bear fruit that ripened into a living baby sheep - produces substances that show promise in laboratory experiments as new treatments for osteoporosis, the bone-thinning disease. That's the conclusion of a new study in ACS' monthly Journal of Natural Products.
Young Ho Kim and colleagues point out that osteoporosis is a global health problem, affecting up to 6 million women and 2 million men in the United States alone. Doctors know that the secret to strong bones involves a delicate balance between two types of bone cells: Osteoblasts, which build up bone, and osteoclasts, which break down bone.
Seeking potential medications that might tip the balance in favor of bone building, the researchers turned to the "vegetable lamb" plant as part of a larger study plants used in folk medicine in Vietnam. In the 16th and 17th centuries, some of the world's most celebrated scientists believed the plant (Cibotium barmoetz) fruited into a newly born lamb, which then grazed on nearby grass and weeds. Kim's group isolated compounds from C. barmoetz and showed that they blocked formation of bone-destroying osteoclasts formation in up to 97 percent of the cells in laboratory cultures without harmful effects on other cells. The substances "could be used in the development of therapeutic targets for osteoporosis," the article notes.
ARTICLE: "Inhibitors of Osteoclast Formation from Rhizomes of Cibotium barometz" pubs.acs/stoken/presspac/presspac/full/10.1021/np9004097
Source:
Michael Woods
American Chemical Society
Young Ho Kim and colleagues point out that osteoporosis is a global health problem, affecting up to 6 million women and 2 million men in the United States alone. Doctors know that the secret to strong bones involves a delicate balance between two types of bone cells: Osteoblasts, which build up bone, and osteoclasts, which break down bone.
Seeking potential medications that might tip the balance in favor of bone building, the researchers turned to the "vegetable lamb" plant as part of a larger study plants used in folk medicine in Vietnam. In the 16th and 17th centuries, some of the world's most celebrated scientists believed the plant (Cibotium barmoetz) fruited into a newly born lamb, which then grazed on nearby grass and weeds. Kim's group isolated compounds from C. barmoetz and showed that they blocked formation of bone-destroying osteoclasts formation in up to 97 percent of the cells in laboratory cultures without harmful effects on other cells. The substances "could be used in the development of therapeutic targets for osteoporosis," the article notes.
ARTICLE: "Inhibitors of Osteoclast Formation from Rhizomes of Cibotium barometz" pubs.acs/stoken/presspac/presspac/full/10.1021/np9004097
Source:
Michael Woods
American Chemical Society
пятница, 2 сентября 2011 г.
Managing MicroRNAs
Two independent, upcoming G and D papers lend new insight into the expression of microRNAs and their targets during vertebrate development.
Dr. David Bartel and colleagues describe a novel experimental system for genome-wide quantitative analysis of miRNA target expression in miRNA-expressing cells. They found that in the developing zebrafish embryo, miRNA targets are commonly expressed at lower levels in miRNA-expressing cells, suggesting that miRNAs work in concert with other regulatory processes to dampen target gene expression in specific miRNA-expressing cells.
Separately, Dr. Antonio Giraldez and clleagues detail their identification of the muscle-specific miRNA targets in the zebrafish embryo. They report that miR-1 and miR-133 are they key muscle regulatory miRNAs, and that they function by mediating actin organization in the developing muscle.
Source: Heather Cosel-Pieper
Cold Spring Harbor LaboratoryCold Spring Harbor Laboratory
Dr. David Bartel and colleagues describe a novel experimental system for genome-wide quantitative analysis of miRNA target expression in miRNA-expressing cells. They found that in the developing zebrafish embryo, miRNA targets are commonly expressed at lower levels in miRNA-expressing cells, suggesting that miRNAs work in concert with other regulatory processes to dampen target gene expression in specific miRNA-expressing cells.
Separately, Dr. Antonio Giraldez and clleagues detail their identification of the muscle-specific miRNA targets in the zebrafish embryo. They report that miR-1 and miR-133 are they key muscle regulatory miRNAs, and that they function by mediating actin organization in the developing muscle.
Source: Heather Cosel-Pieper
Cold Spring Harbor LaboratoryCold Spring Harbor Laboratory
вторник, 30 августа 2011 г.
Calcium-Related Disease: X-Rays Offer First Detailed Look At Hotspots
Calcium regulates many critical processes within the body, including muscle contraction, the heartbeat, and the release of hormones. But too much calcium can be a bad thing. In excess, it can lead to a host of diseases, such as severe muscle weakness, a fatal reaction to anesthesia or sudden cardiac death.
Now, using intense X-rays from the Stanford Synchrotron Radiation Lightsource (SSRL) at the Department of Energy's SLAC National Accelerator Laboratory, researchers have determined the detailed structure of a key part of the ryanodine receptor, a protein associated with calcium-related disease. Their results, which combine data from SSRL and the Canadian Light Source, pinpoint the locations of more than 50 mutations that cluster in disease "hotspots" along the receptor.
"Until now, no one could tell where these disease mutations were located or what they were doing," said principal investigator Filip Van Petegem of the University of British Columbia in Vancouver.
The ryanodine receptor controls the release of calcium ions from a storehouse within skeletal-muscle and heart-muscle cells as needed to perform critical functions. Previous studies at lower resolution indicated that mutations cluster in three regions along the receptor, but without more detailed information it remained unclear exactly how they contributed to disease.
In a study published this week in Nature, Van Petegem and his group describe the structure of one of these hotspots in extremely fine detail and predict how the mutations might cause the receptor to malfunction and release calcium too soon.
The receptor is made up of more than 20,000 molecules called amino acids. Van Petegem's group studied a string of about 560 amino acids, where they found 57 mutations. In 56 cases, the mutations involved a change in a single amino acid, while the last one involved a deletion of 35 amino acids from the string.
"These mutations most likely cause the same disease effects, but a severe mutation leads to stronger symptoms, and doesn't require as big of a stimulus to induce disease," Van Petegem said.
In the heart, the receptor is stimulated to open about once a second when the body is at rest, sending regular pulses of calcium into the rest of the cell. In skeletal muscles, the timing of the pulses is determined by how often the muscles contract. Each time the receptor opens, certain amino acids rearrange themselves to facilitate the calcium release. Mutations can disrupt this process by causing the receptor to open either earlier or more easily than it should.
This premature release of calcium produces extra electrical signals within the cells. In skeletal muscle, this can lead to fatal rises in body temperature under certain anesthetics, or the failure of major muscles. In cardiac muscle it can trigger an arrhythmia, resulting in sudden cardiac death. While it is difficult to determine the exact number of people with these mutations, it is estimated that as many as one in 10,000 may be at risk for disease.
"Thanks to the technological capabilities at SSRL, we were able to rapidly screen hundreds of crystallized samples of this receptor protein to find ones with the best quality, giving the best structure. This study is a good first step toward designing new molecules that could be used as a drug," Van Petegem said. "These mutations could be a very promising therapeutic target for treating heart disease."
Future studies at SSRL and other synchrotron facilities will map out other receptor hotspots where these disease mutations cluster and use the detailed information to better understand the complex functions of the protein.
"It is very exciting to see the significant impact of our advanced structural biology technologies in helping users address difficult projects," said SSRL staff scientist Michael Soltis.
This research was supported by the Canadian Institutes of Health Research. The Stanford Synchrotron Radiation Lightsource is supported by the U. S. Department of Energy Office of Science. SLAC National Accelerator Laboratory is a multi-program laboratory exploring frontier questions in photon science, astrophysics, particle physics and accelerator research. Located in Menlo Park, California, SLAC is operated by Stanford University for the U.S. Department of Energy Office of Science.
Source:
Melinda Lee
DOE/SLAC National Accelerator Laboratory
Now, using intense X-rays from the Stanford Synchrotron Radiation Lightsource (SSRL) at the Department of Energy's SLAC National Accelerator Laboratory, researchers have determined the detailed structure of a key part of the ryanodine receptor, a protein associated with calcium-related disease. Their results, which combine data from SSRL and the Canadian Light Source, pinpoint the locations of more than 50 mutations that cluster in disease "hotspots" along the receptor.
"Until now, no one could tell where these disease mutations were located or what they were doing," said principal investigator Filip Van Petegem of the University of British Columbia in Vancouver.
The ryanodine receptor controls the release of calcium ions from a storehouse within skeletal-muscle and heart-muscle cells as needed to perform critical functions. Previous studies at lower resolution indicated that mutations cluster in three regions along the receptor, but without more detailed information it remained unclear exactly how they contributed to disease.
In a study published this week in Nature, Van Petegem and his group describe the structure of one of these hotspots in extremely fine detail and predict how the mutations might cause the receptor to malfunction and release calcium too soon.
The receptor is made up of more than 20,000 molecules called amino acids. Van Petegem's group studied a string of about 560 amino acids, where they found 57 mutations. In 56 cases, the mutations involved a change in a single amino acid, while the last one involved a deletion of 35 amino acids from the string.
"These mutations most likely cause the same disease effects, but a severe mutation leads to stronger symptoms, and doesn't require as big of a stimulus to induce disease," Van Petegem said.
In the heart, the receptor is stimulated to open about once a second when the body is at rest, sending regular pulses of calcium into the rest of the cell. In skeletal muscles, the timing of the pulses is determined by how often the muscles contract. Each time the receptor opens, certain amino acids rearrange themselves to facilitate the calcium release. Mutations can disrupt this process by causing the receptor to open either earlier or more easily than it should.
This premature release of calcium produces extra electrical signals within the cells. In skeletal muscle, this can lead to fatal rises in body temperature under certain anesthetics, or the failure of major muscles. In cardiac muscle it can trigger an arrhythmia, resulting in sudden cardiac death. While it is difficult to determine the exact number of people with these mutations, it is estimated that as many as one in 10,000 may be at risk for disease.
"Thanks to the technological capabilities at SSRL, we were able to rapidly screen hundreds of crystallized samples of this receptor protein to find ones with the best quality, giving the best structure. This study is a good first step toward designing new molecules that could be used as a drug," Van Petegem said. "These mutations could be a very promising therapeutic target for treating heart disease."
Future studies at SSRL and other synchrotron facilities will map out other receptor hotspots where these disease mutations cluster and use the detailed information to better understand the complex functions of the protein.
"It is very exciting to see the significant impact of our advanced structural biology technologies in helping users address difficult projects," said SSRL staff scientist Michael Soltis.
This research was supported by the Canadian Institutes of Health Research. The Stanford Synchrotron Radiation Lightsource is supported by the U. S. Department of Energy Office of Science. SLAC National Accelerator Laboratory is a multi-program laboratory exploring frontier questions in photon science, astrophysics, particle physics and accelerator research. Located in Menlo Park, California, SLAC is operated by Stanford University for the U.S. Department of Energy Office of Science.
Source:
Melinda Lee
DOE/SLAC National Accelerator Laboratory
суббота, 27 августа 2011 г.
University Of Montreal And Hospital Maisonneuve-Rosemont To Receive Hip Society's John Charnley Award
A team of orthopedic surgeons and kinesiologists from the UniversitГ© de MontrГ©al and its affiliated Maisonneuve-Rosemont Hospital Research Centre will be honoured with the Hip Society's John Charnley Award - the most prestigious award in the field of hip surgery. The award will be presented on February 28, 2009, in Las Vegas.
As North American pioneers in the development of new knee and hip replacement technologies, Drs. Pascal-André Vendittoli, Martin Lavigne, and Alain Roy, in collaboration with kinesiologists Marc Therrien, Julie Nantel, and François Prince, have carried out an important study assessing the performance of hip resurfacing surgery compared with total hip replacement using large-diameter heads.
"The Hip Society's John Charnley Award is the highest honour our team could have ever expected to receive," said Dr. Vendittoli.
Less invasive than total hip replacement
Drs. Roy, Vendittoli and Lavigne were the first in North America to introduce the use of a hip resurfacing prosthesis back in 2003. The Durom® prosthesis, which the team used, is a small metal cup that's placed on the femoral head. It is used as an alternative to a total hip prosthesis, which is usually implanted in the femur. Hip resurfacing is hugely advantageous because it is bone-conserving and much less invasive than a total hip replacement.
For the first time, these studies provide solid scientific data highlighting the pros and cons of new joint replacement implants for active young subjects.
As part of a new 24-month study, the research team compared hip resurfacing and total hip prostheses with metal on metal surfaces of 28 mm. Their findings revealed that hip resurfacing has functional superiority and little chance of luxation. This study will be published in the American Journal of Bone and Joint Surgery in 2009.
The researchers brought their investigation one step further with a second study, where they conducted a comparative on hip resurfacing and total hip prostheses with metal on metal surfaces of large diameter. This second study - conducted without any of the patients' or examiners' knowledge of which implant was used - is being recognized with the John Charnley Award. Sophisticated methods such as Vicon cameras were used to examine all of the patients. The study showed that both groups received equivalent results after six months, and concluded that the single advantage of hip resurfacing over total hip prostheses of large diameter is femoral conservation.
This release is available in French.
Arthrosis of the hip joint, or coxarthrosis, is the most common joint disorder after arthrosis of the knee and afflicts almost 15 percent of the population.
On the Web:
About the UniversitГ© de MontrГ©al: umontreal.ca/english/index.htm
About the HГґpital Maisonneuve-Rosemont: maisonneuve-rosemont/pages/H/index.aspx
Source: Pascal Mailhot
University of Montreal
As North American pioneers in the development of new knee and hip replacement technologies, Drs. Pascal-André Vendittoli, Martin Lavigne, and Alain Roy, in collaboration with kinesiologists Marc Therrien, Julie Nantel, and François Prince, have carried out an important study assessing the performance of hip resurfacing surgery compared with total hip replacement using large-diameter heads.
"The Hip Society's John Charnley Award is the highest honour our team could have ever expected to receive," said Dr. Vendittoli.
Less invasive than total hip replacement
Drs. Roy, Vendittoli and Lavigne were the first in North America to introduce the use of a hip resurfacing prosthesis back in 2003. The Durom® prosthesis, which the team used, is a small metal cup that's placed on the femoral head. It is used as an alternative to a total hip prosthesis, which is usually implanted in the femur. Hip resurfacing is hugely advantageous because it is bone-conserving and much less invasive than a total hip replacement.
For the first time, these studies provide solid scientific data highlighting the pros and cons of new joint replacement implants for active young subjects.
As part of a new 24-month study, the research team compared hip resurfacing and total hip prostheses with metal on metal surfaces of 28 mm. Their findings revealed that hip resurfacing has functional superiority and little chance of luxation. This study will be published in the American Journal of Bone and Joint Surgery in 2009.
The researchers brought their investigation one step further with a second study, where they conducted a comparative on hip resurfacing and total hip prostheses with metal on metal surfaces of large diameter. This second study - conducted without any of the patients' or examiners' knowledge of which implant was used - is being recognized with the John Charnley Award. Sophisticated methods such as Vicon cameras were used to examine all of the patients. The study showed that both groups received equivalent results after six months, and concluded that the single advantage of hip resurfacing over total hip prostheses of large diameter is femoral conservation.
This release is available in French.
Arthrosis of the hip joint, or coxarthrosis, is the most common joint disorder after arthrosis of the knee and afflicts almost 15 percent of the population.
On the Web:
About the UniversitГ© de MontrГ©al: umontreal.ca/english/index.htm
About the HГґpital Maisonneuve-Rosemont: maisonneuve-rosemont/pages/H/index.aspx
Source: Pascal Mailhot
University of Montreal
среда, 24 августа 2011 г.
PAC Looks At Osteoporosis - Our $7b Health Problem, Australia
Osteoporosis is a major public health problem in Australia which sees, on average, 260
people hospitalised every day with an osteoporotic fracture - or one person every six
minutes.
The total annual cost to the community of such hospitalisations as well as the treatment for
osteoporosis means the condition costs $7 billion in total.
Osteoporosis is characterised by low bone mass, micro-architectural deterioration of bone,
bone fragility and increased risk of fracture.
The rate of incidence is staggering with osteoporotic fractures occurring in 1 in 2 women
and 1 in 3 men over the age of 60.
Pharmacists need to understand the condition and how best to treat it and those attending
the Pharmacy Australia Congress in October will be able to hear one of the country's leading
pharmacy presenters, Professor Peter Carroll, speak on the subject of Osteoporosis -
Prevention and Treatment.
Professor Carroll says non-modifiable risk factors for developing osteoporosis include
advanced age, being female, early menopause and family history.
Modifiable risk factors include low body weight or slim build, inadequate calcium intake, low
Vitamin D levels, sedentary lifestyle, smoking and some medications such as glucocorticoids
and anticonvulsants.
"Recent evidence also suggests that therapy with selective serotonin reuptake inhibitors,
proton pump inhibitors or glitazones may increase the risk of fracture," he says.
"Lifestyle issues, adequate calcium intake and appropriate vitamin D levels play a major role
in the prevention of osteoporosis, and the role of the pharmacist in counselling patients about
these issues will be discussed."
Apart from calcium and vitamin D supplements, medications used in the treatment of
osteoporosis include the bisphosphonates, raloxifene, strontium ranelate and teriparatide.
Professor Carroll will examine the place of each of these medications in the treatment of
osteoporosis, including their side effect profiles.
The duration of bisphosphonate therapy, as well as bisphosphonate induced osteonecrosis of
the jaw, will also be discussed.
This year's PAC in Sydney being held at the Sydney Hilton from 15-18 October under the
overarching theme of Securing Your Practice Advantage.
Source
Pharmaceutical Society of Australia
people hospitalised every day with an osteoporotic fracture - or one person every six
minutes.
The total annual cost to the community of such hospitalisations as well as the treatment for
osteoporosis means the condition costs $7 billion in total.
Osteoporosis is characterised by low bone mass, micro-architectural deterioration of bone,
bone fragility and increased risk of fracture.
The rate of incidence is staggering with osteoporotic fractures occurring in 1 in 2 women
and 1 in 3 men over the age of 60.
Pharmacists need to understand the condition and how best to treat it and those attending
the Pharmacy Australia Congress in October will be able to hear one of the country's leading
pharmacy presenters, Professor Peter Carroll, speak on the subject of Osteoporosis -
Prevention and Treatment.
Professor Carroll says non-modifiable risk factors for developing osteoporosis include
advanced age, being female, early menopause and family history.
Modifiable risk factors include low body weight or slim build, inadequate calcium intake, low
Vitamin D levels, sedentary lifestyle, smoking and some medications such as glucocorticoids
and anticonvulsants.
"Recent evidence also suggests that therapy with selective serotonin reuptake inhibitors,
proton pump inhibitors or glitazones may increase the risk of fracture," he says.
"Lifestyle issues, adequate calcium intake and appropriate vitamin D levels play a major role
in the prevention of osteoporosis, and the role of the pharmacist in counselling patients about
these issues will be discussed."
Apart from calcium and vitamin D supplements, medications used in the treatment of
osteoporosis include the bisphosphonates, raloxifene, strontium ranelate and teriparatide.
Professor Carroll will examine the place of each of these medications in the treatment of
osteoporosis, including their side effect profiles.
The duration of bisphosphonate therapy, as well as bisphosphonate induced osteonecrosis of
the jaw, will also be discussed.
This year's PAC in Sydney being held at the Sydney Hilton from 15-18 October under the
overarching theme of Securing Your Practice Advantage.
Source
Pharmaceutical Society of Australia
воскресенье, 21 августа 2011 г.
Potential New Therapy For Spinal Cord Injury-Induced Spasticity And Rigidity
Research led by scientists at the University of California, San Diego (UCSD) School of Medicine has identified a target with potential as an effective new therapy for chronic spasticity and rigidity, a painful condition that often results from spinal cord injury.
In work with rats, Martin Marsala, M.D., a professor in the Department of Anesthesiology at the University of California, San Diego (UCSD) School of Medicine, demonstrated that an AMPA receptor antagonist called NGX424 (tezampanel), being developed by TorreyPines Therapeutics, Inc., of La Jolla, California, is highly potent in suppressing spasticity and rigidity. The study will be published in the October 17 issue of the Journal of Neuroscience.
Paraplegia from spinal cord ischemia is a serious complication that occurs in 20 to 40 percent of patients undergoing a surgical process called aortic cross-clamping. When the surgeon works on the aorta to correct a potentially lethal aneurysm, this large vessel carrying all of the blood flow from the heart must be temporarily blocked. If clamping occurs for more than 30 minutes, the procedure can result in the loss of specialized spinal cord neurons called spinal inhibitory neurons. Loss of these neurons can lead to irreversible spasticity and rigidity, or loss of muscle control, in the lower limbs.
"This exaggerated muscle tone, or uncontrolled spasms, is a serious complication of either ischemic or traumatic injury to the spinal cord -- such as injuries resulting from a diving or car accident," said Marsala. Several other conditions can lead to spasticity/rigidity, including brain trauma, multiple sclerosis, cerebral palsy or Parkinson's disease -- all of which lead to increased peripheral muscle tone.
The most effective treatment for the spastic muscle condition -- which results in pain and tremendous spasms, even in those patients who have partial motor recovery -- has been a drug called Baclofen, a GABA-B receptor agonist that is delivered either systemically or spinally to patients. However, according to Marsala, patients taking this drug often develop tolerance and need increased dosage to achieve the same effect.
"A new therapy to control spasticity is very important," said lead author Michael P. Hefferan, Ph.D., of UCSD's Department of Anesthesiology. "This AMPA receptor blockade offers a novel means of reducing the spasticity and rigidity in muscles because it works through a totally different receptor system than current drugs being used."
Spinal spasticity is the result of increased spinal neuronal excitability. The NGX424 compound -- which is delivered via intrathecal catheters that inject the drug into the fluid surrounding the spinal cord -- suppresses the AMPA-mediated neuronal excitation, relieving otherwise increased muscle tone.
The authors also demonstrated that intrathecal delivery of GluR1 antisense (a treatment that blocks expression of one of the subunits in the AMPA receptor complex) provides a similar antispasticity effect. This further demonstrates a role for AMPA receptors in spasticity and rigidity, and indicates that blockade of this subunit by NGX424 likely plays a key role in the observed antispasticity effect.
Marsala added that additional large animal safety testing will be required before the researchers can consider clinical trials in humans. However, the rat data from this study indicates no toxicity using infused NGX424. Subcutaneous delivery of the drug is currently being evaluated for treating migraines.
Additional researchers include Karolina Kucharova, Kiyohiko Kinjo, Osamu Kakinohana, Tony L. Yaksh, UCSD Department of Anesthesiology; Gabriella Sekerkova, Feinberg School of Medicine, Northwestern University; Seiya Nakamura and Tatsuya Fuchigami, UCSD Department of Anesthesiology and University of the Ryukyus, Okinawa, Japan; Zoltan Tomori, Institute of Experimental Physics, Slovak Academy of Scineces; and Neil Kurtz, TorreyPines Therapeutics, Inc., La Jolla.
Funding for the research was provided by the National Institutes of Health, an American Heart Association post-doctoral fellowship and TorreyPines Therapeutics Inc.
Source: Debra Kain
University of California - San Diego
In work with rats, Martin Marsala, M.D., a professor in the Department of Anesthesiology at the University of California, San Diego (UCSD) School of Medicine, demonstrated that an AMPA receptor antagonist called NGX424 (tezampanel), being developed by TorreyPines Therapeutics, Inc., of La Jolla, California, is highly potent in suppressing spasticity and rigidity. The study will be published in the October 17 issue of the Journal of Neuroscience.
Paraplegia from spinal cord ischemia is a serious complication that occurs in 20 to 40 percent of patients undergoing a surgical process called aortic cross-clamping. When the surgeon works on the aorta to correct a potentially lethal aneurysm, this large vessel carrying all of the blood flow from the heart must be temporarily blocked. If clamping occurs for more than 30 minutes, the procedure can result in the loss of specialized spinal cord neurons called spinal inhibitory neurons. Loss of these neurons can lead to irreversible spasticity and rigidity, or loss of muscle control, in the lower limbs.
"This exaggerated muscle tone, or uncontrolled spasms, is a serious complication of either ischemic or traumatic injury to the spinal cord -- such as injuries resulting from a diving or car accident," said Marsala. Several other conditions can lead to spasticity/rigidity, including brain trauma, multiple sclerosis, cerebral palsy or Parkinson's disease -- all of which lead to increased peripheral muscle tone.
The most effective treatment for the spastic muscle condition -- which results in pain and tremendous spasms, even in those patients who have partial motor recovery -- has been a drug called Baclofen, a GABA-B receptor agonist that is delivered either systemically or spinally to patients. However, according to Marsala, patients taking this drug often develop tolerance and need increased dosage to achieve the same effect.
"A new therapy to control spasticity is very important," said lead author Michael P. Hefferan, Ph.D., of UCSD's Department of Anesthesiology. "This AMPA receptor blockade offers a novel means of reducing the spasticity and rigidity in muscles because it works through a totally different receptor system than current drugs being used."
Spinal spasticity is the result of increased spinal neuronal excitability. The NGX424 compound -- which is delivered via intrathecal catheters that inject the drug into the fluid surrounding the spinal cord -- suppresses the AMPA-mediated neuronal excitation, relieving otherwise increased muscle tone.
The authors also demonstrated that intrathecal delivery of GluR1 antisense (a treatment that blocks expression of one of the subunits in the AMPA receptor complex) provides a similar antispasticity effect. This further demonstrates a role for AMPA receptors in spasticity and rigidity, and indicates that blockade of this subunit by NGX424 likely plays a key role in the observed antispasticity effect.
Marsala added that additional large animal safety testing will be required before the researchers can consider clinical trials in humans. However, the rat data from this study indicates no toxicity using infused NGX424. Subcutaneous delivery of the drug is currently being evaluated for treating migraines.
Additional researchers include Karolina Kucharova, Kiyohiko Kinjo, Osamu Kakinohana, Tony L. Yaksh, UCSD Department of Anesthesiology; Gabriella Sekerkova, Feinberg School of Medicine, Northwestern University; Seiya Nakamura and Tatsuya Fuchigami, UCSD Department of Anesthesiology and University of the Ryukyus, Okinawa, Japan; Zoltan Tomori, Institute of Experimental Physics, Slovak Academy of Scineces; and Neil Kurtz, TorreyPines Therapeutics, Inc., La Jolla.
Funding for the research was provided by the National Institutes of Health, an American Heart Association post-doctoral fellowship and TorreyPines Therapeutics Inc.
Source: Debra Kain
University of California - San Diego
четверг, 18 августа 2011 г.
Short And Long-Term Efficacy Of Spinal Stabilisation System Investigated In Patients With Lower Back Pain
A new study announced today by Medtronic will investigate the short and long-term benefits of adding a spinal stabilisation system to a standard herniectomy procedure in patients with spinal disc herniation. The study is the first randomised control trial to assess the clinical benefit and patient perception of the relief of lower back pain in patients with spinal disc herniation, comparing a standard herniectomy versus a herniectomy supplemented with the DIAMпїЅ Spinal Stabilisation System.
"This new study is crucial to determine whether a spinal stabilisation system can help offer faster recovery time and reduce postoperative pain to patients with lower back pain undertaking a herniectomy and hence prevent or delay the need for spinal fusion," stated Dr. Ferdinand Krappel, an orthopaedic surgeon with Medizinisches Zentrum Kreis Hospital in Aachen, Germany, and a leading investigator of the DIAM study. "Compared to spinal fusion, this procedure is minimally invasive and it maintains the surgical site for future procedures if and when required."
It is estimated that more than 22 million people age 20 and older suffer from chronic back pain in Western Europe. One-third of these adults show evidence of herniated disc. Spinal disc herniation is also known as a slipped, ruptured or torn disc, and consists in a rupture of the spinal disc often occurring as a result of aging.
This multi-centre study expects to enroll 268 patients at 20 centres in six countries, including Belgium, Germany, Italy, Spain, Switzerland, and the United Kingdom. The study is the third of three planned randomised control trials investigating the benefits of the DIAM Spinal Stabilisation System in more than 1,000 patients in the United States and in Europe. The European trial endpoints include back pain relief at six months and reduction of disability at 12 months.
The herniectomy procedure takes approximately one hour and usually requires two to three days of hospitalisation. During the operation, the spinal stabilisation system is placed between the spinous processes (the visible ridges of the back) and is designed to act as a shock absorber that reduces loads on the surrounding vertebrae. The core of the DIAM System is made of silicone, while the outer mesh and tethers are made of medical-grade polyester. The flexible properties of the DIAM materials may also protect the integrity of the spinous process.
According to Lionel Hadjadjeba, vice president of the Spinal, Biologics and Navigation business at Medtronic, "Medtronic plays a leading role in the research on new device therapy for patients with chronic back pain, and learning more about the DIAM Spinal Stabilisation System will enable us to continue bringing therapies to market."
Back pain is one of the most common reasons for chronic disability and incapacity in the Western world.
About the Spinal Business at Medtronic
Medtronic's spinal business, based in Memphis, Tenn., is the global leader in today's spine market and is committed to advancing the treatment of spinal conditions. The spinal business collaborates with world-renowned surgeons, researchers and innovative partners to offer state-of-the-art products and technologies for neurological, orthopedic and spinal conditions. Medtronic is committed to developing affordable, minimally invasive procedures that provide lifestyle friendly surgical therapies. More information about the company and its spinal treatments can be found at medtronicspinal and its patient-education Web sites, back, iscoliosis, maturespine and necksurgery.
About Medtronic
Medtronic, Inc. (medtronic), headquartered in Minneapolis, is the global leader in medical technology - alleviating pain, restoring health, and extending life for millions of people around the world.
Medtronic
medtronic
"This new study is crucial to determine whether a spinal stabilisation system can help offer faster recovery time and reduce postoperative pain to patients with lower back pain undertaking a herniectomy and hence prevent or delay the need for spinal fusion," stated Dr. Ferdinand Krappel, an orthopaedic surgeon with Medizinisches Zentrum Kreis Hospital in Aachen, Germany, and a leading investigator of the DIAM study. "Compared to spinal fusion, this procedure is minimally invasive and it maintains the surgical site for future procedures if and when required."
It is estimated that more than 22 million people age 20 and older suffer from chronic back pain in Western Europe. One-third of these adults show evidence of herniated disc. Spinal disc herniation is also known as a slipped, ruptured or torn disc, and consists in a rupture of the spinal disc often occurring as a result of aging.
This multi-centre study expects to enroll 268 patients at 20 centres in six countries, including Belgium, Germany, Italy, Spain, Switzerland, and the United Kingdom. The study is the third of three planned randomised control trials investigating the benefits of the DIAM Spinal Stabilisation System in more than 1,000 patients in the United States and in Europe. The European trial endpoints include back pain relief at six months and reduction of disability at 12 months.
The herniectomy procedure takes approximately one hour and usually requires two to three days of hospitalisation. During the operation, the spinal stabilisation system is placed between the spinous processes (the visible ridges of the back) and is designed to act as a shock absorber that reduces loads on the surrounding vertebrae. The core of the DIAM System is made of silicone, while the outer mesh and tethers are made of medical-grade polyester. The flexible properties of the DIAM materials may also protect the integrity of the spinous process.
According to Lionel Hadjadjeba, vice president of the Spinal, Biologics and Navigation business at Medtronic, "Medtronic plays a leading role in the research on new device therapy for patients with chronic back pain, and learning more about the DIAM Spinal Stabilisation System will enable us to continue bringing therapies to market."
Back pain is one of the most common reasons for chronic disability and incapacity in the Western world.
About the Spinal Business at Medtronic
Medtronic's spinal business, based in Memphis, Tenn., is the global leader in today's spine market and is committed to advancing the treatment of spinal conditions. The spinal business collaborates with world-renowned surgeons, researchers and innovative partners to offer state-of-the-art products and technologies for neurological, orthopedic and spinal conditions. Medtronic is committed to developing affordable, minimally invasive procedures that provide lifestyle friendly surgical therapies. More information about the company and its spinal treatments can be found at medtronicspinal and its patient-education Web sites, back, iscoliosis, maturespine and necksurgery.
About Medtronic
Medtronic, Inc. (medtronic), headquartered in Minneapolis, is the global leader in medical technology - alleviating pain, restoring health, and extending life for millions of people around the world.
Medtronic
medtronic
понедельник, 15 августа 2011 г.
N Spine Receives 510(k) Clearance Of Its NFix II Dynamic Stabilization System For The Lumbar Spine
N Spine, Inc., a privately held San
Diego spinal implant company, today announced that it has received FDA
clearance of its NFix(TM) II dynamic pedicle screw and rod system for
stabilization of the lumbar spine as an adjunct to fusion. NFix(TM) II is
now commercially available in the United States.
"Interest from US surgeons in the NFix(TM) II Dynamic Stabilization
System has been extremely strong," said Sean Na, president and chief
executive officer of N Spine. "This enthusiasm reflects the appeal of our
unique design as well as the growing market adoption of dynamic rod
systems."
Outside of the US, early clinical results with the company's NFlex(TM)
Controlled Motion System have been very favorable. NFlex(TM) is the first
product to market that controls shear motion, while allowing a more
physiologic level of flexion, extension and lateral bending. NFlex(TM) is
CE marked for non-fusion indications, and is the subject of an N Spine
sponsored prospective randomized trial comparing it to the Zimmer
Dynesys(R) device.
"I'm very pleased with the results of the three-month motion x-rays on
the first NFlex(TM) patients," stated Hansen Yuan, MD, who is a member of
the N Spine, Inc. Scientific Advisory Board. "It's clear that motion is
maintained."
With clearance of the NFix(TM) II Dynamic Stabilization System for
fusion surgery, and NFlex(TM) as a stand alone motion preservation device
for non-fusion outside the US, the company is well positioned to leverage
its proprietary designs in the $5 billion spinal implant market. "There are
a significant number of patients who will benefit from motion preserving
technologies," stated Na.
Recently, N Spine closed on $2.75 million debt financing by Silicon
Valley Bank and has raised a total of $7.1 million in equity and
non-dilutive financing.
About N Spine, Inc
N Spine, Inc. is a privately held San Diego spine company that designs
and develops devices for dynamic stabilization and motion preservation of
the lumbar spine via minimally invasive surgery (MIS). The company is
positioned to become the market leader in this emerging field.
N Spine has developed a superior platform technology that will serve a
broad set of indications, successfully recruited executives with extensive
spine industry experience, and created an internationally renowned
Scientific Advisory Board.
N Spine, Inc.
n-spine/
Diego spinal implant company, today announced that it has received FDA
clearance of its NFix(TM) II dynamic pedicle screw and rod system for
stabilization of the lumbar spine as an adjunct to fusion. NFix(TM) II is
now commercially available in the United States.
"Interest from US surgeons in the NFix(TM) II Dynamic Stabilization
System has been extremely strong," said Sean Na, president and chief
executive officer of N Spine. "This enthusiasm reflects the appeal of our
unique design as well as the growing market adoption of dynamic rod
systems."
Outside of the US, early clinical results with the company's NFlex(TM)
Controlled Motion System have been very favorable. NFlex(TM) is the first
product to market that controls shear motion, while allowing a more
physiologic level of flexion, extension and lateral bending. NFlex(TM) is
CE marked for non-fusion indications, and is the subject of an N Spine
sponsored prospective randomized trial comparing it to the Zimmer
Dynesys(R) device.
"I'm very pleased with the results of the three-month motion x-rays on
the first NFlex(TM) patients," stated Hansen Yuan, MD, who is a member of
the N Spine, Inc. Scientific Advisory Board. "It's clear that motion is
maintained."
With clearance of the NFix(TM) II Dynamic Stabilization System for
fusion surgery, and NFlex(TM) as a stand alone motion preservation device
for non-fusion outside the US, the company is well positioned to leverage
its proprietary designs in the $5 billion spinal implant market. "There are
a significant number of patients who will benefit from motion preserving
technologies," stated Na.
Recently, N Spine closed on $2.75 million debt financing by Silicon
Valley Bank and has raised a total of $7.1 million in equity and
non-dilutive financing.
About N Spine, Inc
N Spine, Inc. is a privately held San Diego spine company that designs
and develops devices for dynamic stabilization and motion preservation of
the lumbar spine via minimally invasive surgery (MIS). The company is
positioned to become the market leader in this emerging field.
N Spine has developed a superior platform technology that will serve a
broad set of indications, successfully recruited executives with extensive
spine industry experience, and created an internationally renowned
Scientific Advisory Board.
N Spine, Inc.
n-spine/
пятница, 12 августа 2011 г.
Once-Monthly Bonviva(R), An Important Advance In The Treatment Of Postmenopausal Osteoporosis
Data presented this week at the 33rd European Symposium on Calcified Tissues (ECTS) adds to the growing body of evidence that the only once-monthly bisphosphonate, Bonviva(R) (ibandronic acid), is proving to be an important step forwards in the treatment of osteoporosis. The data being presented at the ECTS meeting supports existing evidence in showing that Bonviva:
-- is highly effective1
-- is well-tolerated2
-- has a convenient once monthly dosing schedule that is preferred by women, which may therefore help them to stay on therapy3
Bonviva's benefit of less frequent dosing (compared to weekly bisphosphonates) has the potential to play a significant role to play in helping women with postmenopausal osteoporosis stay on their treatment. This is of particular importance as adherence to treatment is a major problem in the management of osteoporosis, with more than 50% of patients on a once-weekly bisphosphonate stopping treatment within a year.4,5 'Real life' efficacy can only be truly achieved if postmenopausal patients continue to take an effective treatment for a long period of time.
The Growing Body of Evidence
Bonviva, efficacy in osteoporosis with only one tablet once a month
Bonviva, a highly effective bisphosphonate, has been shown to reduce spinal fractures by 62% in patients with postmenopausal osteoporosis.6 New analyses from the MOBILE 2-year (Monthly Oral iBandronate In LadiEs) study, presented at the 33rd European Symposium on Calcified Tissues (ECTS), confirm once-monthly Bonviva is highly effective at increasing lumbar spine and hip bone mineral density (BMD), an accepted surrogate for fracture risk reduction.1
Bonviva - a well-tolerated treatment option
Associated side effects are one of the main reasons patients stop taking their osteoporosis treatment.7 MOBILE showed that two years treatment with Bonviva once monthly was not associated with an increased incidence of upper gastrointestinal (GI) adverse events versus the daily dose. In addition, data showed there was no evidence that treatment led to an increased withdrawal due to upper GI adverse events compared to the 2.5mg daily regimen over two-years.2
Patient preference for once monthly dosing
Patient preference is becoming increasingly recognised as an important factor in ensuring treatment is taken for the long term as prescribed. Also presented at ECTS, the results of the BALTO II (Bonviva ALendronate Trial in Osteoporosis) multi-centre clinical study suggest that once-monthly bisphosphonate dosing has the potential to improve adherence, with over 70% of postmenopausal women with osteoporosis* preferring a once-monthly bisphosphonate, finding it more convenient than a once-weekly option.3
BALTO II examined the treatment preferences of 321 women with postmenopausal osteoporosis in centres across the US and Europe and of the 93% who expressed a preference, * 70.6% preferred treatment with Bonviva taken once a month and 76.6% found it more convenient than weekly alendronate. 3 In the study, the most common reason women gave for their preference was that one tablet a month is easier to follow for a long time.3
Helping women to stay on therapy
Also at ECTS, the study design for PERSIST (PERsistence Study of Ibandronate verSus alendronaTe) was presented for the first time. This is a six-month prospective, randomised, open label, multicentre study of over 1,000 women with postmenopausal osteoporosis.8 PERSIST uses a study design that is as close to 'real life' as possible, with patients given prescriptions by their GP and required to visit the local pharmacist to receive the medication, as happens in normal practice.8 The results from the PERSIST trial will show whether patients on a monthly treatment programme stay on treatment longer than those taking a weekly option.
*who had tried both monthly and weekly treatments and who had expressed a preference
About Bonviva
-- Bonviva, a potent and highly effective bisphosphonate, has been studied to date in clinical trials involving over 13,000 patients.
-- Once-monthly Bonviva is indicated for the treatment of osteoporosis in postmenopausal women. It works by reducing elevated bone turnover, increasing bone mineral density and reducing the incidence of vertebral fractures.
-- Bonviva is the only nitrogen containing bisphosphonate that has demonstrated a reduction in vertebral fracture risk using a drug-free interval of more than one day.6
-- Bonviva, like other bisphosphonates administered orally, may cause upper gastrointestinal disorders such as dysphagia, oesophagitis and oesophageal or gastric ulcer.
-- Once-monthly oral Bonviva received European Union approval in September 2005 and Swiss medic approval in August 2005. Once monthly Boniva (the brand name in the US) received FDA approval in March 2005.
Roche/GSK Collaboration
In December 2001, F Hoffmann-La Roche (Roche) and GlaxoSmithKline (GSK) announced their plans to co-develop and co-promote Bonviva for the treatment and prevention of postmenopausal osteoporosis in a number of major markets, excluding Japan. The Roche/GSK collaboration provides expertise and commitment to bringing new osteoporosis therapies to market as quickly as possible.
About Roche
Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of disease, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is a world leader in diagnostics, the leading supplier of medicines for cancer and transplantation and a market leader in virology. In 2005 sales by the Pharmaceuticals Division totalled 27.3 billion Swiss francs, and the Diagnostics Division posted sales of 8.2 billion Swiss francs. Roche employs roughly 70,000 people in 150 countries and has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai. Additional information about the Roche Group is available on the Internet (roche).
About GSK
GSK, one of the world's leading research-based pharmaceutical and healthcare
companies, is committed to improving the quality of human life by enabling people to do more, feel better and live longer.
All trademarks used or mentioned in this release are legally protected.
Roche Healthkiosk, Osteoporosis:
health-kiosk.ch/start_osteo.htm
GSK website:
gsk
References
1. Stone M, Henson J, Stakkesatd JA, Hughes C, Mairon N, et al. Once-monthly ibandronate dosing is more effective than daily dosing for improving bone mineral density: MOBILE 2-year analysis. Abstract presented at 33rd European Symposium of Calcified Tissue, Prague, Czech Republic 10-14 May 2006.
2. Delmas PD, Stone M, Stakkestad JA, Leigh C, Hiltbrunner V et al. Upper gastrointestinal safety and tolerability profile of once-monthly oral ibandronate: MOBILE 2-year analysis. Abstract presented at 33rd European Symposium of Calcified Tissue, Prague, Czech Republic 10-14 May 2006.
3. Benhamou C-L, Licata AA, Devas V, Masanauskaite D, Hadji P. Patient preference for once-monthly oral ibandronate and weekly oral alendronate in postmenopausal osteoporosis: the BALTO study. Abstract presented at 33rd European Symposium of Calcified Tissue, Prague, Czech Republic 10-14 May 2006.
4. Cowell W, Fulford-Smith A, Poultney S. Adherence with bisphosphonate treatment for osteoporosis in UK patients. Poster presented the second joint meeting of the European Calcified Tissue Society and the International Bone Mineral Society, Geneva, 25-29 June 2005.
5. Cramer J, Amonkar MM, Hebborn A and Suppapanya N. Does dosing regimen impact persistence with bisphosphonate therapy among postmenopausal osteoporotic women? Journal Bone Mineral Research 2004; 19 Suppl 1: S448
6. Chesnut CH, Skag A, Christiansen C, Recker R, Stakkestad JA et al. Effects of Oral Ibandronate Administered Daily or Intermittently on Fracture Risk in Postmenopausal Osteoporosis. Journal of Bone & Mineral Research 2004;19(8):1241-49.
7. IPSOS Health, European Survey of Physicians and women with osteoporosis, January-April 2005. Sponsored by Roche/GSK.
8. Cooper, A.L (on behalf of the PERSIST Study Investigators). Rationale and design of the PERSIST study (PERsistence Study of Ibandronate verSus alendronaTe). Abstract presented at 33rd European Symposium of Calcified Tissue, Prague, Czech Republic 10-14 May 2006.
View drug information on Boniva.
-- is highly effective1
-- is well-tolerated2
-- has a convenient once monthly dosing schedule that is preferred by women, which may therefore help them to stay on therapy3
Bonviva's benefit of less frequent dosing (compared to weekly bisphosphonates) has the potential to play a significant role to play in helping women with postmenopausal osteoporosis stay on their treatment. This is of particular importance as adherence to treatment is a major problem in the management of osteoporosis, with more than 50% of patients on a once-weekly bisphosphonate stopping treatment within a year.4,5 'Real life' efficacy can only be truly achieved if postmenopausal patients continue to take an effective treatment for a long period of time.
The Growing Body of Evidence
Bonviva, efficacy in osteoporosis with only one tablet once a month
Bonviva, a highly effective bisphosphonate, has been shown to reduce spinal fractures by 62% in patients with postmenopausal osteoporosis.6 New analyses from the MOBILE 2-year (Monthly Oral iBandronate In LadiEs) study, presented at the 33rd European Symposium on Calcified Tissues (ECTS), confirm once-monthly Bonviva is highly effective at increasing lumbar spine and hip bone mineral density (BMD), an accepted surrogate for fracture risk reduction.1
Bonviva - a well-tolerated treatment option
Associated side effects are one of the main reasons patients stop taking their osteoporosis treatment.7 MOBILE showed that two years treatment with Bonviva once monthly was not associated with an increased incidence of upper gastrointestinal (GI) adverse events versus the daily dose. In addition, data showed there was no evidence that treatment led to an increased withdrawal due to upper GI adverse events compared to the 2.5mg daily regimen over two-years.2
Patient preference for once monthly dosing
Patient preference is becoming increasingly recognised as an important factor in ensuring treatment is taken for the long term as prescribed. Also presented at ECTS, the results of the BALTO II (Bonviva ALendronate Trial in Osteoporosis) multi-centre clinical study suggest that once-monthly bisphosphonate dosing has the potential to improve adherence, with over 70% of postmenopausal women with osteoporosis* preferring a once-monthly bisphosphonate, finding it more convenient than a once-weekly option.3
BALTO II examined the treatment preferences of 321 women with postmenopausal osteoporosis in centres across the US and Europe and of the 93% who expressed a preference, * 70.6% preferred treatment with Bonviva taken once a month and 76.6% found it more convenient than weekly alendronate. 3 In the study, the most common reason women gave for their preference was that one tablet a month is easier to follow for a long time.3
Helping women to stay on therapy
Also at ECTS, the study design for PERSIST (PERsistence Study of Ibandronate verSus alendronaTe) was presented for the first time. This is a six-month prospective, randomised, open label, multicentre study of over 1,000 women with postmenopausal osteoporosis.8 PERSIST uses a study design that is as close to 'real life' as possible, with patients given prescriptions by their GP and required to visit the local pharmacist to receive the medication, as happens in normal practice.8 The results from the PERSIST trial will show whether patients on a monthly treatment programme stay on treatment longer than those taking a weekly option.
*who had tried both monthly and weekly treatments and who had expressed a preference
About Bonviva
-- Bonviva, a potent and highly effective bisphosphonate, has been studied to date in clinical trials involving over 13,000 patients.
-- Once-monthly Bonviva is indicated for the treatment of osteoporosis in postmenopausal women. It works by reducing elevated bone turnover, increasing bone mineral density and reducing the incidence of vertebral fractures.
-- Bonviva is the only nitrogen containing bisphosphonate that has demonstrated a reduction in vertebral fracture risk using a drug-free interval of more than one day.6
-- Bonviva, like other bisphosphonates administered orally, may cause upper gastrointestinal disorders such as dysphagia, oesophagitis and oesophageal or gastric ulcer.
-- Once-monthly oral Bonviva received European Union approval in September 2005 and Swiss medic approval in August 2005. Once monthly Boniva (the brand name in the US) received FDA approval in March 2005.
Roche/GSK Collaboration
In December 2001, F Hoffmann-La Roche (Roche) and GlaxoSmithKline (GSK) announced their plans to co-develop and co-promote Bonviva for the treatment and prevention of postmenopausal osteoporosis in a number of major markets, excluding Japan. The Roche/GSK collaboration provides expertise and commitment to bringing new osteoporosis therapies to market as quickly as possible.
About Roche
Headquartered in Basel, Switzerland, Roche is one of the world's leading research-focused healthcare groups in the fields of pharmaceuticals and diagnostics. As a supplier of innovative products and services for the early detection, prevention, diagnosis and treatment of disease, the Group contributes on a broad range of fronts to improving people's health and quality of life. Roche is a world leader in diagnostics, the leading supplier of medicines for cancer and transplantation and a market leader in virology. In 2005 sales by the Pharmaceuticals Division totalled 27.3 billion Swiss francs, and the Diagnostics Division posted sales of 8.2 billion Swiss francs. Roche employs roughly 70,000 people in 150 countries and has R&D agreements and strategic alliances with numerous partners, including majority ownership interests in Genentech and Chugai. Additional information about the Roche Group is available on the Internet (roche).
About GSK
GSK, one of the world's leading research-based pharmaceutical and healthcare
companies, is committed to improving the quality of human life by enabling people to do more, feel better and live longer.
All trademarks used or mentioned in this release are legally protected.
Roche Healthkiosk, Osteoporosis:
health-kiosk.ch/start_osteo.htm
GSK website:
gsk
References
1. Stone M, Henson J, Stakkesatd JA, Hughes C, Mairon N, et al. Once-monthly ibandronate dosing is more effective than daily dosing for improving bone mineral density: MOBILE 2-year analysis. Abstract presented at 33rd European Symposium of Calcified Tissue, Prague, Czech Republic 10-14 May 2006.
2. Delmas PD, Stone M, Stakkestad JA, Leigh C, Hiltbrunner V et al. Upper gastrointestinal safety and tolerability profile of once-monthly oral ibandronate: MOBILE 2-year analysis. Abstract presented at 33rd European Symposium of Calcified Tissue, Prague, Czech Republic 10-14 May 2006.
3. Benhamou C-L, Licata AA, Devas V, Masanauskaite D, Hadji P. Patient preference for once-monthly oral ibandronate and weekly oral alendronate in postmenopausal osteoporosis: the BALTO study. Abstract presented at 33rd European Symposium of Calcified Tissue, Prague, Czech Republic 10-14 May 2006.
4. Cowell W, Fulford-Smith A, Poultney S. Adherence with bisphosphonate treatment for osteoporosis in UK patients. Poster presented the second joint meeting of the European Calcified Tissue Society and the International Bone Mineral Society, Geneva, 25-29 June 2005.
5. Cramer J, Amonkar MM, Hebborn A and Suppapanya N. Does dosing regimen impact persistence with bisphosphonate therapy among postmenopausal osteoporotic women? Journal Bone Mineral Research 2004; 19 Suppl 1: S448
6. Chesnut CH, Skag A, Christiansen C, Recker R, Stakkestad JA et al. Effects of Oral Ibandronate Administered Daily or Intermittently on Fracture Risk in Postmenopausal Osteoporosis. Journal of Bone & Mineral Research 2004;19(8):1241-49.
7. IPSOS Health, European Survey of Physicians and women with osteoporosis, January-April 2005. Sponsored by Roche/GSK.
8. Cooper, A.L (on behalf of the PERSIST Study Investigators). Rationale and design of the PERSIST study (PERsistence Study of Ibandronate verSus alendronaTe). Abstract presented at 33rd European Symposium of Calcified Tissue, Prague, Czech Republic 10-14 May 2006.
View drug information on Boniva.
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