October 21, 2010, 8:07 AM CT

First implanted device to treat balance disorder

A University of Washington Medical Center patient on Thursday, Oct. 21, will be the world's first recipient of a device that aims to quell the disabling vertigo linked to Meniere's disease.

The UW Medicine clinicians who developed the implantable device hope that success in a 10-person surgical trial of Meniere's patients will lead to exploration of its usefulness against other common balance disorders that torment millions of people worldwide.

The device being tested a cochlear implant and processor with re-engineered software and electrode arrays represents four-plus years of work by Drs. Jay Rubinstein and James Phillips of UW's Department of Otolaryngology-Head and Neck Surgery. They worked with Drs. Steven Bierer, Albert Fuchs, Chris Kaneko, Leo Ling and Kaibao Nie, UW specialists in signal processing, brainstem physiology and vestibular neural coding.

"What we're proposing here is a potentially safer and more effective treatment than exists now," said Rubinstein, an ear surgeon and auditory scientist who has earned a doctoral degree in bioengineering and who holds multiple U.S. patents.

In the United States, Meniere's affects less than one percent of the population. The disease occurs mostly in people between ages 30 and 50, but can strike anyone. Patients more often experience the condition in one ear; about 30 percent of cases are bilateral......... Posted by: Sue      Read more         Source

October 21, 2010, 8:01 AM CT

Conventional, annual Pap smear cost-effective

A study of the options for reducing cancer incidence and mortality among women who have been treated for premalignant cervical lesions observed that an annual conventional Pap smear is a cost effective strategy.

Joy Melnikow, professor in the Department of Family and Community Medicine and his colleagues tested several follow-up screening strategies for the 500,000 American women diagnosed and treated for cervical intraepithelial neoplasia (CIN), abnormal cervical cell growth that can lead to cervical cancer. The first comprehensive study of its kind, "Surveillance After Treatment for Cervical Intraepithelial Neoplasia" would be reported in the recent issue of Obstetrics & Gynecology

"This is a large and growing pool of women who need follow-up after therapy," said Melnikow, who is also director of the UC Davis Center for Healthcare Policy and Research. "But we've had few studies on which to base recommendations for follow-up".

Detection and therapy of these pre-malignant lesions have led to large reductions in cervical cancer incidence and death in a number of countries where screening is routine. But current recommendations about follow-up over time vary widely, and the use of newer technologies had not been fully reviewed until now, Melnikow said......... Posted by: Emily      Read more         Source

October 21, 2010, 7:59 AM CT

Virtual colonoscopy and teleradiology in rural areas

Computed tomography colonography (CTC) otherwise known as virtual colonoscopy is feasible in remote health centers where optimal colonoscopy is limited, as per a research studyin the recent issue of the American Journal of Roentgenology (www.ajronline.org).

The study waccording toformed at Fort Defiance Indian Hospital in Fort Defiance, AZ, and Tuba City Regional Health Care Center in Tuba City, AZ, both of which are rural medical centers serving Native American, mainly Navajo, populations. After brief on-site instruction, including performing a CTC examination on a volunteer to train the CT technologists, both sites began performing CTC.

"A total of 321 studies were transferred to the University of Arizona Hospital for evaluation, with reports returned via a teleradiology information system. Overall image quality evaluation of stool, fluid and distention revealed that about 92 percent of patients had diagnostic quality examinations with respect to each image quality parameter," said Arnold C. Friedman, MD, main author of the study.

"Optical colonoscopy in a number of rural areas is limited. Availability of CTC permits access to a robust method of colorectal screening for rural patients," said Friedman.

"Our results show that CTC can be introduced with minimal effort to rural undeserved communities, adequately performed locally, and then interpreted remotely. However, important aspects of implementation should include technologist training, referring doctor education, careful attention to image transmission and clearly defined methods of communication with patients and referring providers," he said......... Posted by: Sue      Read more         Source

October 20, 2010, 7:45 AM CT

Osteoporosis drug builds bone

A drug marketed to grow bone in osteoporosis patients also works to heal bone wounds in gum disease patients, a University of Michigan study suggests.

"This new approach for the therapy of periodontal disease could allow us to rebuild some of the bone that is lost due to periodontal disease, which until this point has been very difficult to achieve," said Jill Bashutski, clinical assistant professor at the U-M School of Dentistry and first author on the study. "Current therapys to re-grow bone around teeth affected with gum disease have limited success rates".

The findings are significant because gum disease is the leading cause of tooth loss in adults and is linked to a host of other health problems. Periodontal disease results in loss of teeth and can be devastating because it compromises speaking as well as eating, which can in turn contribute to poor nutrition.

The generic name of the drug is teriparatide and it is marketed by Eli Lilly and Co. under the trade name Forteo. It's a type of parathyroid hormone and the only anabolic (meaning it grows bone) osteoporosis drug approved on the market in the United States. Typically, osteoporosis drugs work by preventing bone loss.

The study, "Teriparatide and Osseous Regeneration in the Oral Cavity" appears online in the New England Journal (NEJM) Oct. 16 and in the print edition Oct. 28. The study was presented Oct. 16 in Toronto at the annual meeting of the American Society for Bone and Mineral Research......... Posted by: Sue      Read more         Source

October 20, 2010, 7:40 AM CT

Vitamin D in preventing esophageal cancer

In a first-of-its-kind clinical trial, physicians at University Hospitals (UH) Case Medical Center who are Case Western Reserve University School of Medicine scientists are exploring the role of Vitamin D in preventing esophageal cancer. Principal Investigator Linda Cummings, MD, along with Amitabh Chak, MD, and Gregory Cooper, MD, from the UH Digestive Health Institute, is recruiting patients with Barrett's esophagus to measure the effects of Vitamin D on protein levels that may influence the risk of developing esophageal cancer.

"Vitamin D is being studied for its role in possibly reducing the risk of developing several types of cancer, such as colon, breast and prostate," says Dr. Cummings, a gastroenterologist with the UH Digestive Health Institute and Assistant Professor at Case Western Reserve University School of Medicine. "This novel study is the first-of-its-kind looking at Vitamin D's potential role in helping to prevent esophageal cancer." As per co-investigator Sanford Markowitz, MD, Ingalls Professor of Cancer Genetics at Case Western Reserve University School of Medicine and oncologist with UH Case Medical Center, the study "has the potential to make a highly important contribution to the medical management of Barrett's esophagus, which is becoming an ever increasing challenge"......... Posted by: Sue      Read more         Source

October 20, 2010, 7:12 AM CT

World's first completely robotic surgery

In a world first, a completely robotic surgery and anesthesia has been performed at the McGill University Health Centre (MUHC). The DaVinci surgical robot, which lets surgeons work from remote locations, was put to work this summer, whereas the anesthesia robot, nicknamed McSleepy, has been providing automated anesthesia since 2008. The two combined to perform the first all-robotic surgery on a prostatectomy patient at the Montreal General Hospital.

"Collaboration between DaVinci, a surgical robot, and anesthetic robot McSleepy, seemed an obvious fit; robots in medicine can provide health care of higher safety and precision, thus ultimately improving outcomes," said Dr. TM Hemmerling of McGill University and MUHC's Department of Anesthesia, who is also a neuroscience researcher at the Research Institute (RI) of the MUHC.

"The DaVinci allows us to work from a workstation operating surgical instruments with delicate movements of our fingers with a precision that cannot be provided by humans alone," said Dr. A. Aprikian, MUHC urologist in chief and Director of the MUHC Cancer Care Mission, and also a researcher in the Cancer Axis at the RI MUHC. He and his team of surgeons operate the robotic arms from a dedicated workstation via video control with unsurpassed 3D HD image quality......... Posted by: Sue      Read more         Source

October 20, 2010, 7:08 AM CT

Link between obesity and memory

Because of impairments in their insulin sensitivity, obese individuals demonstrate different brain responses than their normal-weight peers while completing a challenging cognitive task, as per new research by psychology experts at The University of Texas at Austin.

The results provide further evidence that a healthy lifestyle at midlife could lead to a higher quality of life later on, particularly as new drugs and therapys allow people to live longer.

"The good thing about insulin sensitivity is that it's very modifiable through diet and exercise," says psychology graduate student Mitzi Gonzales, who co-authored the paper reported in the journal Obesity with Assistant Professor Andreana Haley and other colleagues.

To better understand why midlife obesity is associated with higher risk of cognitive decline and dementia in old age, the scientists had middle-aged adults between 40 and 60 years of age complete a challenging cognitive task while undergoing functional magnetic resonance imaging (fMRI).

While obese, overweight and normal-weight participants performed equally well on the task, obese individuals displayed lower functional brain response in one brain region, the inferior parietal lobe.

Obese participants also had lower insulin sensitivity than their normal weight and overweight peers, meaning that their bodies break down glucose less efficiently. Poor insulin sensitivity may ultimately lead to diabetes mellitus if the pancreas is unable to secrete enough insulin to compensate for reduced glucose use......... Posted by: JoAnn      Read more         Source

October 19, 2010, 8:51 AM CT

Cataract surgery saves lives

CHICAGOCataract surgery not only improves vision and quality of life for older people, but is also apparently a way to reduce the number of car crashes. The research will be presented today's at the Scientific Program of the 2010 American Academy of Ophthalmology (AAO) Middle East-Africa Council of Ophthalmology (MEACO) Joint Meeting. Cataract surgery not only improves vision and quality of life for older people, but is also apparently a way to reduce the number of car crashes. The research will be presented today's at the Scientific Program of the 2010 American Academy of Ophthalmology (AAO) Middle East-Africa Council of Ophthalmology (MEACO) Joint Meeting. It is the largest, most comprehensive ophthalmic education conference in the world.

There's no question that good vision is essential to avoiding auto crashes. But what's the actual impact of a common, vision-improving therapy like cataract removal on crash rates? And is it significant enough that health systems should make sure people don't wait months between cataract diagnosis and surgery? To answer these questions researcher Jonathon Ng, MD, studied accident rates for Western Australian residents before and after cataract surgery on the first eye. (Commonly a time interval is built in between surgery in the first and second eyes.)........ Posted by: Mike      Read more         Source

October 19, 2010, 8:50 AM CT

Bioelectrical signals turn cells cancerous

Biologists at Tufts University School of Arts and Sciences have discovered that a change in membrane voltage in newly identified "instructor cells" can cause stem cells' descendants to trigger melanoma-like growth in pigment cells. The Tufts team also observed that this metastatic transformation is due to changes in serotonin transport. The discovery could aid in the prevention and therapy of diseases like cancer and vitiligo as well as birth defects.

The research is published in the October 19, 2010, issue of Disease Models and Mechanisms

"Discovering this novel bioelectric signal and new cell type could be very important in efforts to understand the mechanisms that coordinate stem cell function within the host organism and prevent tumor growth. Ultimately it could enable us to guide cell behaviors toward regenerative medicine applications," said research leader and senior author Michael Levin, Ph.D., professor of biology and director of the Center for Regenerative and Developmental Biology at Tufts.

Co-authors on the paper were Tufts Postdoctoral Associate Douglas Blackiston, Research Associate Professor Dany S. Adams, Research Associate Joan M. Lemire and doctoral student Maria Lobikin.

Misregulation of stem cells is a known factor in cancers and birth defects. Recent studies have shown that stem cells exhibit unique electrophysiological profiles and that ionic currents controlled by ion channel proteins play important roles during stem cell differentiation. However, while a number of genetic and biochemical signaling pathways play a part in regulating the interplay between cells and the host organism, the role of bioelectric signals remains poorly understood, especially when looking beyond artificial cultures to entire living organisms......... Posted by: Janet      Read more         Source

October 18, 2010, 7:59 AM CT

Nonprofit weight loss program beats obesity

In the battle against obesity, new research has observed that it may not be necessary to spend a lot on a weight loss program when cheaper, nonprofit alternatives may work just as well.

Scientists at the University of Colorado Anschutz Medical Campus found those who spent three years in the nonprofit Take Off Pounds Sensibly (TOPS) program lost five to seven percent of their body weight and kept it off.

"This is the first time a study of this size and duration has ever been done on a weight loss program," said Nia Mitchell, MD, MPH, and a primary care doctor who worked on the study. "The natural history of weight loss is weight regain and we were happy to see that people were able to keep off the weight".

The three-year study, published last month in the research journal, Obesity, followed thousands of people enrolled in TOPS. The program provided access to their database, but no funding for the research. Milwaukee-based TOPS helps members lose weight through group support and education. They are encouraged to get a weight goal from their doctors and make it their target. At the same time, they attend weekly meetings and weigh-ins. Members receive a booklet with a six week lesson plan, a one-year subscription to TOPS News and membership in the local chapter......... Posted by: JoAnn      Read more         Source