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
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