March 15, 2011, 11:12 PM CT

Unusual treatment of colonic perforation

Colonoscopy is considered a safe procedure, eventhough complications can occur. The most dreaded of these is iatrogenic perforation. The literature reports perforation rates of 0.03%-0.8% for diagnostic procedures, and a rate of 0.15%-3% for therapeutic procedures. Mechanisms of perforation are the result of either mechanical disruption of the colonic wall (e.g. thermal injury, forced push into a diverticulum, or stretching of the bowel with loops or the slide-by technique) or excessive air insufflation. After perforation, prompt abdominal surgery is often recommended, especially in the last few years, following the introduction of laparoscopic approaches in clinical practice. Nevertheless, conservative therapy is a feasible and effective option for patients who are clinically stable and without peritonism or life threatening signs.

A research article published on February 28, 2011 in the World Journal of Gastroenterology addresses this question. The authors reported a case of a 63-year-old male who experienced an iatrogenic sigmoid perforation repaired combining three endoscopic techniques.

The lesion was large and irregular with three discrete perforations, therefore, the authors decided to close it by placing one clip per perforation, and then connecting all the clips with two endoloops. Finally they chose to use a fibrin glue injection to obtain a complete sealing. Four days after the colonoscopy the patient underwent a laparoscopic right hemicolectomy due to evidence of a large polyp of the caecum with high grade dysplasia and focal carcinoma in situ. Inspection of the sigma showed complete repair of the perforation......... Posted by: Sue      Read more         Source

March 15, 2011, 11:09 PM CT

Managing post-stroke depression

Stroke patients who are not successfully treated for depression are at higher risk of losing some of their capability to function normally, as per a research studyin the March 15, 2011 issue of the journal Neurology

Eventhough as a number of as a third of those who experience a stroke develop depression, a newly released study by scientists from the Regenstrief Institute, the schools of health and rehabilitation sciences and of medicine at Indiana University-Purdue University Indianapolis and the Richard L. Roudebush VA Medical Center is the first to look whether managing post-stroke depression improves physical functioning.

They scientists report that individuals who remain depressed three months after a stroke are more likely to have decreased functional capabilities than those whose depression was successfully treated. Functional capabilities include getting dressed, feeding oneself, and accomplishing other tasks. These capabilities increased significantly in those people who were treated for depression.

Post-stroke depression may be associated with chemical changes in the brain, clinical evidence indicates.

"The relationship between post-stroke depression and recovery of function after a stroke has not been well understood. Prior scientists have looked at both depression and function after stroke but they did not investigate whether identifying and managing depression improved ability to accomplish tasks of daily living and other function related issues," said study first author Arlene A. Schmid, Ph.D., a Regenstrief Institute investigator, an assistant professor of occupational treatment at the IU School of Health and Rehabilitation Sciences and a VA Center of Excellence on Implementing Evidence Based Practice investigator......... Posted by: Daniel      Read more         Source

March 15, 2011, 10:57 PM CT

Extended Parental Support as a Safety Net

A newly released study from the Journal of Marriage and Family shows that contrary to popular anxieties about slacker young adults who refuse to grow up, or indulgent parents who stifle their adult children's development by continuing to support them, there is evidence that parental assistance in early adulthood promotes progress toward autonomy and self-reliance.

Study author Teresa Swartz, "The fact that young people depend so heavily upon their parents well beyond the age when most people from earlier generations had already started families and had dependable jobs has triggered a great deal of public anxiety over whether these trends signal young adult immaturity and stunted development. The larger social trends in delaying family formation appears to be one reason for the extended dependence upon parents. Today, the road to adulthood is much longer and more arduous than it was thirty years ago".

The scientists collected longitudinal data to examine the conditions under which young adults are more likely to receive financial support for living expenses, or to live in the parental home. Eventhough almost half of the respondents received either money for living expenses or lived with their parents (or both) in their mid-twenties, only 10-15% received financial or housing help when in their early 30s. The likelihood of receiving financial help decreased 15% each year, and the likelihood of living with parents decreased by 18% each year. Swartz, "These results indicate that young people do eventually become independent of parents as they grow older"......... Posted by: Janet      Read more         Source

March 15, 2011, 10:52 PM CT

Better Images of Bacteria

It's a cloak that surpasses all others: a microscopic carbon cloak made of graphene that could change the way bacteria and other cells are imaged.

Vikas Berry, assistant professor of chemical engineering at Kansas State University, and his research team are wrapping bacteria with graphene to address current challenges with imaging bacteria under electron microscopes. Berry's method creates a carbon cloak that protects the bacteria, allowing them to be imaged at their natural size and increasing the image's resolution.

Graphene is a form of carbon that is only one atom thick, giving it several important properties: it's impermeable, it's the strongest nanomaterial, it's optically transparent and it has high thermal conductance.

"Graphene is the next-generation material," Berry said. "Eventhough only an atom thick, graphene does not allow even the smallest of molecules to pass through. Furthermore, it's strong and highly flexible so it can conform to any shape".

Berry's team has been researching graphene for three years, and Berry recently saw a correlation between graphene and cell imaging research. Because graphene is impermeable, he decided to use the material to preserve the size of bacterial cells imaged under high-vacuum electron microscopes......... Posted by: Mark      Read more         Source

March 15, 2011, 10:24 PM CT

Chasing the pot of gold

Approximately two million adults in the United States meet criteria for pathological gambling, and another four to six million are considered problem gamblers, as per the National Council on Problem Gambling. A study by scientists at Wayne State University reveals that gambling addiction therapy is not one-size-fits-all, but it is difficult to predict which style of therapy is best for the various forms of gambling addiction.

As per David M. Ledgerwood, Ph.D., assistant professor of psychiatry and behavioral neurosciences at Wayne State University, there appears to be up to three different subtypes of people with serious gambling problems. One group, emotionally vulnerable (EV) gamblers, had higher psychiatric and gambling severity and were more likely to have a parent with psychiatric problems as in comparison to another subtype, behaviorally conditioned (BC) gamblers. BC gamblers are thought to start gambling because they get caught up in elements of reward linked to the game, rather than to soothe emotional problems.

"In addition, we observed that antisocial impulsive (AI) gamblers also had elevated gambling and psychiatric severity when in comparison to BC gamblers," said Ledgerwood. "This group was most likely to have antisocial personality disorders, a history of substance abuse therapy, and a parent with substance abuse or gambling problems"......... Posted by: JoAnn      Read more         Source

March 15, 2011, 10:22 PM CT

Malaria drug for pancreatic cancer?

Researchers report they have shrunk or slowed the growth of notoriously resistant pancreatic tumors in mice, using a drug routinely prescribed for malaria and rheumatoid arthritis.

The pre-clinical results, which will appear in the recent issue of the journal Genes & Development and is currently published on its web site, have already prompted the opening of a small clinical trial in patients with advanced pancreas cancer, one of the deadliest and hardest-to-treat forms of cancer, said the investigators, led by Alec Kimmelman, MD, PhD, a radiation oncologist at Dana-Farber.

"We are seeing robust and impressive responses in pancreas cancer mouse models," said Kimmelman, whose laboratory specializes in studies of pancreas cancer, the fourth-leading cause of cancer death in the United States. The oral drug, hydroxychloroquine, is inexpensive, widely available, and causes relatively mild side effects, he said. A second, planned clinical trial will combine the drug with radiation.

"While these findings are indeed exciting and a cause for optimism, one needs to be mindful that so far the effects, while impressive, have only been shown in mice," said Ronald DePinho, MD, director of the Belfer Institute for Applied Cancer Science at Dana-Farber. "I eagerly await to see how the human studies will progress"......... Posted by: Sue      Read more         Source

March 15, 2011, 7:57 AM CT

Focus on Prion Diseases

New research by Chongsuk Ryou, researcher at the UK Sanders-Brown Center on Aging and professor of microbiology, immunology and molecular genetics in the UK College of Medicine, may shed light on possible therapys for prion diseases.

Prion diseases, which include Creutzfeldt-Jakob disease in humans and bovine spongiform encephalopathy ("mad cow" disease) in cattle, are caused by prions - unconventional pathogens composed of infectious protein particles and resistant to conventional sterilization procedures. Presently there is no known agent or procedure that can halt or reverse damage caused by prion disease.

Ryou and his colleagues, however, have demonstrated through recent work that polymers of amino acid lysine (polylysines) are able to block propagation of prions by targeting plasminogen - a substance that stimulates the multiplication of prions. In test tubes and cultured cells, polylysines halted the spread of prions.

Furthermore, in an animal model of prion disease, mice treated with polylysines displayed symptoms later, survived longer and showed lower levels of prions in their brains than did untreated mice.

"Our study suggests that polylysine is a potential anti-prion agent and validates plasminogen as a therapeutic target to combat prion disease," said Ryou......... Posted by: Mark      Read more         Source

March 15, 2011, 7:43 AM CT

Teens and young adults with cancer

Adolescents and young adults are neither children nor adults and those affected by cancer require targeted care that crosses the boundaries between pediatric and adult oncology, as per several pioneers in this still-developing field of adolescent and young adult oncology. An illuminating roundtable discussion by these experts would be reported in the premier issue of Journal of Adolescent and Young Adult Oncology, a multidisciplinary peer-evaluated publication of Mary Ann Liebert, Inc. (www.liebertpub.com). The Roundtable has been published ahead of the print issue and is available at www.liebertpub.com/JAYAO. The full issue will launch in April 2011.

"AYA cancer presents the medical community with several unique problems. First, it requires true collaboration between pediatric and medical oncologists as the age range crosses both disciplines. Next, our AYA cancer patients not only have cancer but are also often dealing with ongoing developmental and psychosocial issues at the same time; as such, we must be aware of how a cancer diagnosis interferes with their normal development. The Roundtable discussion helps put AYA cancer in perspective for those who have still not considered the 15-39 year old cancer patient as a distinct and relevant patient group," as per Editor-in-Chief Leonard S. Sender, MD, of the University of California, Irvine and CHOC Children's Hospital......... Posted by: Janet      Read more         Source

March 15, 2011, 7:32 AM CT

Parental monitoring of opposite-gender

Young adults whose parents monitor their social interactions appears to be less likely to display impulsive behavior traits and to have alcohol-related problems, a newly released study suggests. The level of monitoring is associated with parenting style, and the link is stronger with the parent of the opposite gender.

This study is one of the first to explore the link between parenting style and parental monitoring, as well as to explore the monitoring style of each parent individually, says Julie A. Patock-Peckham, Ph.D., Assistant Professor of Psychology & Neuroscience at Baylor University and one of the study authors.

"While there's a plethora of research showing that low parental monitoring contributes to risky behavior, very few scientists have examined the effects of parental monitoring separated out by mothers and fathers," she says. "It's normally measured just with the word 'parent.'".

The study involved 581 college students from the Missouri University of Science and Technology and San Diego State University. Participating students completed a questionnaire that addressed the parenting styles of both their mothers and fathers, perceptions of mothers' and fathers' knowledge of their friendships and social plans, and questions about their own impulsiveness and alcohol-related problems......... Posted by: JoAnn      Read more         Source

March 15, 2011, 7:28 AM CT

Nursing home boom in China

A nursing home industry is booming in China as a rapid increase in the proportion of its elderly population forces a nationwide shift from traditional family care to institutional care, as per new research by Brown University gerontologists.

The study, led by Zhanlian Feng, assistant professor of community health, and published online in the Journal of the American Geriatrics Society, is the first systematic documentation of the growth and operation of nursing homes in Chinese cities. The demographics driving the trend, however, are better known: Experts with the U.S. Census Bureau project that China's over-65 population will rise from 8.3 percent of the population today to 22.6 percent (or 329 million people) in 2040.

Under a National Institutes of Health grant to co-author Vincent Mor, professor of medical science, Feng and his colleagues at Brown, Georgia State, and Nanjing University observed that the number of nursing homes in Nanjing grew from only three in 1980 to more than 140 in 2009. In Tianjin, where there are 136 nursing homes, only 11 existed before 1990. More than half of the nursing homes in the capital Beijing opened after 2000.

"Institution-based long-term care has been very rare in the country in the past," said Feng. "Even now it is still rare, but we've seen explosive growth, which is quite a phenomenon in a country where for thousands of years people have relied almost exclusively on the family for old age support"......... Posted by: Janet      Read more         Source