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October 22, 2006, 8:12 PM CT

Heart Surgery For Atrial Fibrillation Simplified

Heart Surgery For Atrial Fibrillation Simplified
Heart surgeons at Washington University School of Medicine in St. Louis have helped usher in a new era in the surgical therapy of atrial fibrillation. Using radiofrequency devices - rather than a scalpel - they've greatly shortened the surgery and made it significantly easier to perform.

"Because of the devices, the procedure - called the Cox-Maze procedure - has gone from an operation that hardly anyone was doing to one that 80 to 90 percent of U.S. heart surgeons are now performing," says Ralph J. Damiano Jr., M.D., the John Shoenberg Professor of Surgery and chief of cardiac surgery at the School of Medicine and a cardiac surgeon at Barnes-Jewish Hospital.

Adults older than 40 have a 25 percent risk of eventually developing atrial fibrillation in which the upper chambers of the heart twitch rapidly instead of contracting fully and regularly. The condition can lead to stroke or heart failure.

For some patients, medications can control the abnormal heart rhythms and the risk of clotting linked to atrial fibrillation, but they do not cure the disorder. The Cox-Maze procedure has a greater than 90 percent cure rate.

Damiano and colleagues have played a vital role in the development and testing of radiofrequency devices for treating atrial fibrillation. The devices deliver high-energy radiofrequency waves to heart tissue and very quickly create scars or ablations, which replace most of the complex incisions mandatory by the Cox-Maze procedure. The ablations disrupt the atria's abnormal electrical activity and normalize heart rhythm.........

Posted by: Daniel      Permalink         Source


October 19, 2006, 9:51 PM CT

Malaria in the Middle East

Malaria in the Middle East
Malaria is not commonly thought of as a major disease in the Middle East, but a study from Yemen in this week's BMJ reveals worryingly high levels of severe malaria in children.

In fact, the figures show that as a number of as 4 out of 10 children attending hospital with severe illness could be affected during the peak season. This is comparable to a number of areas of Africa.

Scientists identified over 2,000 children aged 6 months to 10 years who were admitted to two public hospitals with suspected severe malaria. Malaria was confirmed in 1,332 children, 808 of whom had severe malaria.

The proportion of admissions varied as per the season, from 1% between July and September to 40% in February and March. Twenty six children died in hospital. Most deaths were in children with a neurological presentation, and more girls died than boys.

Severe malaria puts a high burden on health services in Yemen, say the authors. Malaria control should be a priority and lesson should be learnt from other areas of highly seasonal malaria.........

Posted by: Mark      Permalink         Source


October 19, 2006, 9:44 PM CT

Beliefs Could Have Adverse Effect On HIV Rates

Beliefs Could Have Adverse Effect On HIV Rates
A review of research on the prevalence of HIV in the Middle East and North Africa has observed that whilst cultural and religious practices may be behind a low prevalence of HIV in the region, they could potentially contribute to increasing the spread of HIV.

Research from the World Health Organisation, published in this week's BMJ, argues it is possible that some practices which are common among Muslim populations may contribute to decreasing the risk of HIV transmission. One is low alcohol consumption, which reduces 'risky' behaviours and another is potentially male circumcision which was shown in a recent clinical trial to have a protective effect but application of these results to other epidemiological, cultural and social settings still needs to be confirmed.

At the same time other population trends, beliefs and practices in the region may have an adverse effect. Most countries in the region have young populations with a rapidly increasing age at marriage, but young people may be ill-equipped to protect themselves against sexually transmitted infections. Traditional Muslim approaches have tended to be very conservative, and it is difficult to break the silence around issues of sexual behaviour particularly those which deviate from religious norms.

A detailed analysis of religious publications and doctrinal pronouncements revealed that strong moralising views were common HIV was seen as divine retribution and religion was presented as a protection. This can mean that those with HIV/AIDS are stigmatised.........

Posted by: Mark      Permalink         Source


October 19, 2006, 9:40 PM CT

Reducing Knee Pain And Reliance On Painkillers

Reducing Knee Pain And Reliance On Painkillers
Older people with knee pain who receive their main care from physiotherapists and pharmacists are more likely to experience improvements in pain levels and knee function, and are less likely to need NSAIDs (non-steroidal anti-inflammatory drugs, eg asprin and ibuprofen), as per a BMJ study.

Scientists from Keele University undertook a study involving over 300 people with knee pain. The participants (aged over 55), were split into three groups.

The first group took part in an 'enhanced pharmacy review' with up to 6 appointments with an experienced community pharmacist to monitor the appropriateness and effectiveness of medication. A second group received up to 6 sessions with a physiotherapist, which included general aerobic exercise and specific muscle strengthening and stretching exercises. A final 'control' group received an information and advice leaflet which was also issued to the other two groups plus a telephone call to reinforce the information in the leaflet and address any specific concerns about putting the advice into practice.

When compared with the control group, those in the physiotherapy group reported a significant improvement in pain levels and in knee function after three months of therapy. Participants in the pharmacy group also reported improvements in pain levels.........

Posted by: Mark      Permalink         Source


October 19, 2006, 9:35 PM CT

Immune System And Fight Against TB

Immune System And  Fight Against TB
A key aspect of how the body kicks the immune system into action against tuberculosis is revealed in research published recently. The authors, writing in Science, hope that their research could aid the development of novel vaccines and immunotherapies to combat TB, which is responsible for two million deaths each year.

The cause of TB is a slow-growing bacterium known as Mycobacterium tuberculosis. Researchers have known for some time that when host cells are invaded by this bacterium, the host cells are able to call up additional immune cells such as lymphocytes to fight them and try to limit the damage which the bacteria can cause.

The new research, by researchers from Imperial College London, the Universities of Cambridge and Oxford, and other international institutions, identifies a receptor on the host cells which triggers the immune cells' response to tuberculosis. The researchers demonstrated that without this receptor, known as CCR5, mycobacteria were able to thrive inside host cells, as the immune cells did not receive the signal from CCR5 to attack them.

The researchers hope that their findings could enable a novel vaccine or immunotherapy to be developed which could artificially kick the immune cells into action in the same way as CCR5. This could boost the immune response to TB.........

Posted by: Mark      Permalink         Source


October 19, 2006, 9:29 PM CT

How Pathogens Spread In Human Body

How Pathogens Spread In Human Body
Scientists at the University of Cambridge have discovered a new, more accurate, method of mapping how bacteria spread within the body, a breakthrough that could lead to more effective therapys and prevention of certain bacterial infections.

Dr. Pietro Mastroeni, Professor Duncan Maskell at the Centre for Veterinary Science, and their teams have pioneered the integration of mathematical models with observational data to predict the spread of individual bacteria within the human body. Their findings are published in the recent issue of PLoS Biology.

The work analyses the spread and distribution of Salmonella in the body, which is a bacterium that causes typhoid fever and food borne gastroenteritis in humans and animals, with severe medical and veterinary consequences and threats for the food industry. The work is of broad significance as these novel research approaches are applicable to a multitude of pathogenic microorganisms.

These studies indicate that individual bacteria and their progenies cleverly escape from host cells and distribute to new sites of the body, continuously staying one step ahead of the immune response. The type of spread varies between different bacteria, thus posing challenges for the rational therapy or prevention of these infections.........

Posted by: Mark      Permalink         Source


October 19, 2006, 8:53 PM CT

Labor Induction Increases Risk Of Amniotic-fluid Embollism

Labor Induction Increases Risk Of Amniotic-fluid Embollism
A Canadian population-based cohort study has revealed that medical induction of labour increases the risk of amniotic-fluid embolism. The study was led by Dr. Michael Kramer, Canadian Institutes of Health Research (CIHR) Senior Investigator from McGill University, and would be reported in the October 21st issue of The Lancet.

Amniotic-fluid embolism (AFE) is a rare, but serious and even fatal maternal complication of delivery. While its cause is unknown, it is one of the leading causes of maternal mortality in developed countries, accounting for seven of 44 direct maternal deaths in Canada in the period 1997-2000.

This population-based study examined the association of AFE and medical induction of labour in a cohort of three million hospital births in Canada, for the twelve fiscal years 1991-2002.

"AFE remains a rare occurrence," said Dr. Michael Kramer, principal investigator of the study and Scientific Director of CIHR's Institute of Human Development, Child and Youth Health. "Of the 180 cases of AFE we found, 24 or 13% were fatal. AFE arose almost twice as frequently in women who had medical induction of labour as in those who did not; fatal cases arose 3 times more frequently".

"Dr. Kramer's research has resulted in a discovery that will benefit physicians who look after pregnant women as they will now be aware of this potential complication should they induce labour", said Dr. Joseph Shuster, Interim Scientific Director of the MUHC. "This is an example of how academic university teaching hospitals improve the quality of patient care".........

Posted by: Emily      Permalink         Source


October 19, 2006, 8:47 PM CT

Targeted Tumor Therapy

Targeted Tumor Therapy
Targeted tumor treatment lobs toxic payloads directly into tumors to destroy cancer cells while leaving normal cells unharmed. In the case of radiotherapy, these missiles, which should unerringly home in on the target and make it implode, consist of radioactive bullets guided by small molecules--known as agonists--that recognize and then activate specific receptors over-expressed on the surface of tumor cells.

But a team including scientists at the Salk Institute for Biological Studies and collaborators in Switzerland now shows that it may be better to exploit small molecules that antagonize rather than activate receptors. Those findings are published in this week's Early Online Edition of the Proceedings of the National Academy of Sciences.

"Our findings mark a paradigm shift," says Jean Rivier, a professor in the Clayton Foundation Laboratories for Peptide Biology at the Salk. "In the past, radiolabeled antagonists were never considered for targeted cancer treatment since they don't trigger the internalization of the receptor/ligand complex, which was believed to be the critical step towards accumulation of the payload. But we observed that antagonists have other properties that may considerably improve the sensitivity of diagnostic procedures and improve the efficacy of receptor-mediated radiotherapy," he adds.........

Posted by: Janet      Permalink         Source


October 19, 2006, 8:42 PM CT

In Early Embryos, Cilia Get The Message

In Early Embryos, Cilia Get The Message
Having your heart in the right place commonly means having it located on the left side of your body. But just how a perfectly symmetrical embryo settles on what's right and what's left has fascinated developmental biologists for a long time. The turning point came when the rotational beating of cilia, hair-like structures found on most cells, was identified as essential to the process.

Now, researchers at the Salk Institute for Biological Studies take a step back and illuminate the molecular process that regulates formation of cilia in early fish embryos. As per a research findings published in a forthcoming issue of Nature Genetics, the Salk team, led by Juan Carlos Izpisa Belmonte, Ph.D., a professor in the Gene Expression Laboratory, identified a novel factor that links early developmental signals with the function of cilia and their role in controlling left-right specification in zebrafish.

"When we altered the function of the gene duboraya, we saw problems with cilia formation, eventhough the gene product itself is not a part of the structure. This opens up a new area of research," says Belmonte.

Cilia have been known to cell biologists for over a hundred years. Belmonte is convinced that these humble structures, which have until recently been ignored by physiologists and molecular biologists alike, are poised to take center stage in the field of biology. Explains Belmonte: "When you impair the function of cilia or the flow of cilia, you create substantial problems throughout the body."........

Posted by: Emily      Permalink         Source


October 18, 2006, 10:49 PM CT

Newspaper Articles Skew Coverage Of Comas

Newspaper Articles Skew Coverage Of Comas
Newspaper articles skew coverage of comas by focusing heavily on patients who are more likely to awaken and recover, thus possibly leading the public to think that coma patients have better odds than they truly do.

These findings of a Mayo Clinic study on how U.S. newspapers cover comas are reported in the recent issue of Mayo Clinic Proceedings. This study is the first of its kind and follows a study published earlier this year in Neurology on how comas are represented in film. The lead author of both articles is Eelco F.M. Wijdicks, M.D., a neurointensivist at Mayo Clinic in Rochester.

Dr. Wijdicks traces the public's interest in coma patients to the Terri Schiavo case, which created intense interest in how coma patients are treated. Schiavo's situation illustrates the need for the public to be well informed about comas, Dr. Wijdicks says. The number of newspaper stories about coma increased in Florida after the Schiavo case.

For the Mayo Clinic study published in Proceedings, Dr. Wijdicks and his daughter, Marilou Wijdicks, identified 340 newspaper articles in 50 leading newspapers, one in each state, over five years to ascertain how well newspapers cover comas. California and Florida had the highest number of newspaper articles concerning coma. Few articles had misrepresentations or inaccuracies, but newspaper editors and reporters struggled with a few key issues.........

Posted by: Daniel      Permalink         Source



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Did you know?
Studies in monkeys and women suggest that unlike traditional estrogen therapy, a diet high in the natural plant estrogens found in soy does not increase the risk of uterine cancer in postmenopausal women, according to Mark Cline, D.V.M., Ph.D., an associate professor of comparative medicine at Wake Forest University Baptist Medical Center.

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