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Past News Items - Oct 2013

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In the News

New Paradigm In Joint Tissue Health

New Web-Based Trainings for Psychiatrists

A Protein Safeguards Against Cataracts

NeuroAiDTM, a Treatment for Post-Stroke Recovery, Reduced Early Cardiovascular Events and Deaths by Half After Stroke

Clear Link Between Liver Disease and Risk for Cardiovascular Disease, Finds Saint Luke’s Study

Cleveland Clinic Names Top 10 Medical Innovations For 2014

Just What the Doctor Ordered: Help for Kids Who Stutter Sent to 53,727 Pediatricians

Peripheral Nerve Stimulation: Promising Long-Term Treatment For Chronic Headache Sufferers

Chronic Pain Treatment Cools Hot Flashes In Menopausal Women

Decontaminating The Sanitizer Dispenser, Giving Health Care Workers Their Own Hand Gel Reduces Operating Room Contamination Significantly

Exclusive Medical Marijuana Outreach Program for the Medical Community

New Global Research on Fundamental Causes of Lupus


Better Identification of Prostate Cancer

World-first Trial for Tendon Repair Using Tendon Stem Cells Published in the Prestigious American Journal of Sports Medicine

Cardiac Biomarker ST2 Proves Far Superior To Galectin-3 In A Head-to-Head Study

Improving Outcomes in the Treatment and Management of Metastatic Colorectal Cancer

Released: 10/31/13

New Paradigm In Joint Tissue Health

Orlando-based nutraceutical company XYMOGEN announced today the launch of SynovX, the latest in the business's lineup of professional dietary supplements.

The SynovX line introduces three formulas—SynovX Performance, SynovX Tendon & Ligament and SynovX Metabolic—which are designed to support metabolism and the definitive needs of joint support associated with exercise. Each supplement contains specific ingredients to address discomfort while stimulating muscle function. These new formulas reflect the latest research and developments in the area of joint health.

"XYMOGEN has had the SynovX line in development for some time now," said CEO Brian Blackburn, "After years of research, we have finally achieved the optimal formulas to address the needs of patients and healthcare practitioners. Each of the SynovX supplements upholds the company's high standards of quality in our product offerings."

XYMOGEN is renowned for its commitment to innovation in the healthcare industry. The company attributes its reputation to a "People First" culture, which offers employees unprecedented opportunities for discovery, growth and fulfillment. The business has earned numerous accolades and was recently named for a sixth time to INC Magazine's list of the nation's fastest growing private companies.


Released: 10/31/13

New Web-Based Trainings for Psychiatrists

Community Care Behavioral Health Organization (Community Care) is offering a series of 12 Web-based trainings for psychiatrists focusing on strategies that psychiatrists can use to help individuals improve their health.

The 30-minute presentations each come with free Continuing Medical Education (CME) credits. The training sessions focus on strategies that psychiatrists can use to help patients improve their health – such as quitting smoking and losing weight, and by coordinating their medical care with their primary care practitioners. The trainings can be accessed here.

Community Care recognizes that wellness and physical health are important components of an individual's recovery and that psychiatrists and other behavioral health professionals can play a significant role in helping individuals achieve their goals.

"These presentations are designed to support psychiatrists as they assume a more prominent role in helping individuals address concurrent medical issues," said James Schuster, MD, MBA, Chief Medical Officer of Community Care. "They are one of many Community Care efforts designed to improve the health and wellness of its members."

The webcast trainings are as follows:

      Role of the Psychiatrist (in Physical Health Care for individuals with SMI)
      Monitoring, Screening & Preventive Care in the Psychiatrist's Office
      Nicotine Dependence in Individuals with SMI
      Behavioral and Pharmacological Treatments for Smoking Cessation
      Clinical Epidemiology of the Metabolic Syndrome in SMI
      Lifestyle and Behavioral Approaches to Management of Metabolic Syndrome in SMI
      Hypertension in the Psychiatrist's Office
      Dyslipidemia in the Psychiatrist's Office
      Diabetes in the Psychiatrist's Office
      COPD and Other Respiratory Problems in the Psychiatrist's Office
      Psychosocial Stress and Physical Illness in the Psychiatrist's Office
      Hepatitis C and HIV in the Psychiatrist's Office

The presentations feature Lyndra Bills, MD, Community Care medical director focused on health and wellness; and Jaspreet Brar, MD, PhD, who has extensive experience helping individuals with serious mental illness address wellness concerns.

Free CME credit or contact hours are available to those who create an account, view the entire webcast, complete and submit the evaluation form, and complete and submit the accompanying post-test. Participants receive 0.5 hour CMEs per topic.

The training is targeted for physicians, physician assistants, nurse practitioners, RNs, and social workers. Participants gain an in-depth knowledge and the skills needed to implement treatment and services for individuals with severe mental illness.


Released: 10/23/13

A Protein Safeguards Against Cataracts

Activation mechanism of a protective protein in the ocular lens resolved

The refractive power of the human eye lens relies on a densely packed mixture of proteins. Special protective proteins ensure that these proteins do not clump together as time passes. When this protective mechanism fails, the ocular lens becomes clouded—the patient develops a cataract. Scientists at the Technische Universitaet Muenchen (TUM) have now resolved the activation mechanism of one of these protective proteins, laying the foundation for the development of new therapeutic alternatives.

The lens of the human eye is made up of a highly concentrated protein solution that imparts the eye its high refractive power. Yet, despite this high protein content the ocular lens must remain clear and transparent. To this end ocular lens cells have developed a remarkable strategy: They have thrown overboard the complex machinery present in all other cells of the human body for building up and breaking down proteins. Instead, lens proteins are created only once in a lifetime, during embryonic development. They are as old as the organism itself. To make them last a lifetime, the proteins are kept permanently in a dissolved state. If they clump together, the lens clouds over and the patient gets cataracts.

Alternative to surgery

To date, this condition could only be treated surgically by replacing the clouded lens with an artificial one. However, if the precise mechanism by which lens proteins are kept in a dissolved state were understood, it would open up new avenues for treatment. So, how does the cell manage to keep the proteins soluble for so long? The magic lies in two proteins, aA-crystallin and its relative, aB-crystallin. They are the best-known representatives of the class of so-called small heat shock proteins. They play an important role in all human cells, since they prevent other proteins from turning into useless clumps when subjected to strong heat or cell stress.

What exactly these protective proteins look like and how they act remained shrouded in mystery for a long time, in spite of intensive research. “The great challenge in the analysis of these two crystallin types lies in their inordinate variety,” explains Johannes Buchner, professor for biotechnology at the Technische Universitaet Muenchen. “These proteins exist as a mixture of very different forms, each comprising a variable number of subunits. This makes it very difficult to distinguish the individual structures from one another.”

Molecular switch

In 2009, in very close collaboration with Sevil Weinkauf, professor for electron microscopy at the Technische Universitaet Muenchen, the first part of the aB-crystallin puzzle fell into place. The team successfully deciphered the molecular structure of the most important form of this versatile protein—a molecule comprising 24 subunits. Under normal conditions, i.e. when the cell is not exposed to stress, this complex is the most common variant. However, it is merely an idle form that contributes little to the prevention of clumping in other proteins. It was clear that there must be another molecular switch that triggers the protective protein.

It is this trigger mechanism that the team headed by Buchner and Weinkauf uncovered now. When a cell is exposed to stress—when subjected to heat, for instance—phosphate groups are attached to a specific region of the protein. The negative charges of these phosphates break the links between the subunits and the large complexes consequently disintegrate into numerous smaller ones of only six or 12 subunits each. As a result of this breakup, the regions at the ends of the complexes become more flexible allowing the molecules to dock up with different partners, thereby preventing them from clumping—the protective protein is now active.

Interdisciplinary cooperation

The success of the scientists can be traced back above all to the interdisciplinary combination of biochemical and electron-microscopic methodologies. Aligning the information from the two-dimensional protein disintegration images with the manifold three-dimensional structures of aB-crystallin proved particularly difficult. “Imagine you only have a few pictures of a coffee cup’s shadow cast and want to infer the shape of the cup from that,” Weinkauf explains to illustrate the problem. “Now, if you think that sounds difficult, try to imagine you have not just a single cup, but a cupboard full of china that you want to deduce from the shadow casts. It is precisely this daunting challenge that we met for aB-crystallin.”

The newly acquired insights into the aB-crystallin mode of action form a solid footing for new therapeutic approaches. For instance, medication to treat cataracts could be developed: it would trigger the aB-crystallin activation mechanism to clear up clouded ocular lenses. But aB-crystallin also plays a role in other tissue cells. In cancer cells, for example, it is overly active and interferes with the so-called programmed cell death. In this case new medication would aim at inhibiting the protein.

The work has been funded by German Research Foundation (Cluster of Excellence Center for Integrated Protein Science Munich (CIPSM) and SFB 1035).


Released: 10/22/13

NeuroAiDTM, a Treatment for Post-Stroke Recovery, Reduced Early Cardiovascular Events and Deaths by Half After Stroke

  • Early vascular events are an important cause of morbidity and mortality in the first three months after a stroke.
  • The CHIMES Study is a placebo-controlled trial of NeuroAiD™, having included 1,099 patients with ischemic stroke and receiving appropriate secondary prevention treatments.
  • The frequency of early cardiovascular events and deaths during the three-month follow-up was significantly halved in the NeuroAiD™, group (p=0.025) without an increase in bleeding rate and non-vascular deaths.

NeuroAiD™, a treatment of post-stroke recovery containing natural extracts, reduces early cardiovascular events and deaths by nearly 50% on top of antiplatelet agents within three months after stroke onset. There is also no increase in bleeding rate and non-vascular deaths according to research published online in the journal Stroke.

The CHIMES study is an academic international double-blind, placebo-controlled clinical trial in 1,099 patients having suffered an ischemic stroke of intermediate severity within 72 hours, treated by NeuroAiD™ or placebo and monitored for 3 months.

Considering the positive effects of NeuroAiD™ on cerebral blood flow and a potential role in “ischemic preconditioning,” CHIMES researchers hypothesized that NeuroAiD™ may have an effect on preventing the occurrence of early vascular events after stroke onset. They analyzed a composite outcome consisting of vascular events and vascular deaths, all events being blindly adjudicated. NeuroAiD™ was given on top of secondary prevention therapies like antiplatelet drugs, statins, and antihypertensive and antidiabetics treatments.

As a result the vascular outcome occurred in 16 patients (2.9%) of the NeuroAiD™ group, as opposed to 31 patients (5.6%) in the placebo group (p=0.025). This represents half the rate of early cardiovascular events and deaths, which corresponds to about 27 fewer patients suffering a recurrent vascular event or death per 1,000 patients treated over three months.

On the safety side, there was no increase in bleeding and nonvascular deaths, confirming the compound's excellent safety profile, with patients on NeuroAiD™ having fewer adverse events than those in the placebo group.

Prof Marie-Germaine Bousser, former head of the neurology department in Hopital Lariboisiere in Paris and co-author of the publication, said this study revealed a potentially important effect of NeuroAiD™ in reducing morbidity and mortality after ischemic stroke. “Only a limited number of treatments have been shown to reduce early recurrent vascular events and deaths after acute stroke, mainly using antiplatelet agents and their combinations. NeuroAiD™ having no effect on platelet aggregation or coagulation could be added to these drugs without increasing bleeding risk.”

Prof Christopher Chen, neurologist at the National University of Singapore and the principal investigator of the CHIMES study, considers that pharmacological effects of NeuroAiD™ could explain the cardiovascular benefits observed in CHIMES trial. “NeuroAiD™ has been shown to increase cerebral blood flow velocity and to activate ATP-dependent potassium channels which play an important role in preconditioning, helping to improve tolerance of cerebral and myocardial tissues to ischemia. Further elucidate of other mechanisms of action of NeuroAiD™ in preventing vascular events would be very interesting.”

This analysis was conducted by the CHIMES investigators, an international partnership of leaders in neurology, having carried out this large-scale trial to investigate the use of a product from natural substances in reducing disability and cardiovascular events after an acute stroke in a rigorous manner.

Occurring every two seconds, stroke is one of the leading causes of mortality and morbidity worldwide. Each year, 20 million people suffer from the devastating disease. There is an increasing need for multi-modal therapies to help more patients recover quickly and effectively from stroke, and to prevent recurrent cardiovascular events.


Released: 10/17/13

Clear Link Between Liver Disease and Risk for Cardiovascular Disease, Finds Saint Luke’s Study

Assessment of 377 asymptomatic patients reveals non-alcoholic fatty liver disease (NAFLD) proves to be a stronger indicator than age, smoking, gender, or other traditional risk factors

Non-alcoholic fatty liver disease (NAFLD) is the most common liver disease in the United States and other Western countries, affecting up to a third of the general population, and in most cases causing no signs or symptoms. NAFLD is the most common cause for cirrhosis and a common cause for primary liver cancer. Most affected individuals are completely unaware of their liver disease.

Now Saint Luke’s liver specialists and cardiologists have discovered a compelling association between NAFLD and a high risk for cardiovascular disease. The link between the two was stronger than other more traditional risk factors for coronary artery disease such as smoking, hypertension, male gender, diabetes, high cholesterol, or metabolic syndrome. The research findings are published in an online article in the Mayo Clinic Proceedingsposted Oct. 16, 2013.

The research study was a collaborative partnership between Saint Luke’s Liver Disease Management Center gastroenterologists Rajiv Chhabra, MD, and John Helzberg, MD, and Saint Luke’s Mid America Heart Institute cardiologists James O’Keefe, MD, and Randall Thompson, MD.

The study assessed upper abdominal CT images from 377 non-symptomatic patients undergoing non-contrast CT scans to determine coronary calcium scores. Using expanded imaging “windows” to include the liver and spleen, researchers found that patients with fatty liver disease were more likely to also have coronary artery disease. The research is compelling enough that cardiologists at Saint Luke’s are considering changing their practices to include liver and spleen images in CT scans as a screening indicator of coronary artery disease risk.

Non-alcoholic fatty liver disease is the accumulation of fat in the liver in people who drink little to no alcohol. The fat can cause inflammation and scarring in the liver. Its most serious form can progress to cirrhosis, liver failure, or liver cancer. It is the most common liver disorder in Western countries and one of the fastest growing concerns among clinicians due to an escalating patient population with obesity and diabetes.

“If current trends continue, the prevalence of NAFLD is expected to increase to 40 percent of the population by 2020,” said Dr. Helzberg. “This discovery is important in identifying potential cardiovascular disease in NAFLD patients. Hopefully future research will yield better treatment options and disease management.” Treatments now primarily include lifestyle changes such as diet, exercise, and increased monitoring.

While more research is needed to explore the relationship between the two conditions, the growing number of patients with NAFLD suggests a potential role for increased screening among the medical community. “These findings suggest that patients with coronary artery disease should possibly be screened for liver disease. Likewise, NAFLD patients should be evaluated for coronary artery disease,” said Dr. Chhabra.

Funding was provided through a research grant to Dr. Helzberg from the Saint Luke’s Foundation and the Mid America Heart Institute Foundation.

“This study is another example of what can arise from cross-disciplinary collaboration that is increasingly common at Saint Luke’s. By pooling our knowledge and insights, we are able to identify promising areas for research that may have a powerful impact on our ability to practice medicine and to improve the lives of our patients,” said David J. Cohen, MD, MSc, director of Cardiovascular Research at Saint Luke’s Hospital.


Released: 10/17/13

Cleveland Clinic Names Top 10 Medical Innovations For 2014

Bionic eye for restoring sight in patients with inherited retina disease ranks No. 1 on the annual list

Cleveland Clinic today announced its eighth annual list of Top 10 Medical Innovations that will have a major impact on improving patient care within the next year. The list includes a bionic eye, a neurostimulator for epilepsy, and fecal transplantation.

The list of breakthrough devices and therapies was selected by a panel of Cleveland Clinic physicians and scientists and announced during Cleveland Clinic’s 2013 Medical Innovation Summit.

The Top 10 Medical Innovations for 2014 are:

After two decades of development and testing and more than $200 million in funding, the Food and Drug Administration approved an early-stage bionic eye for severe retinitis pigmentosa (RP) in 2013 that combined a surgically implanted 60-electrode retinal prosthesis, video-camera-enabled glasses, and a video processing unit.

A variety of genomic-based cancer tests are now available that, without surgery, can analyze the genes in a person’s cancer tumor and predict both the biology and aggressiveness of the cancer.

An implanted neurological device that can significantly reduce the frequency of epileptic seizures gained the unanimous backing of an FDA neurological device advisory panel in 2013. Surgically implanted under the scalp, the device delivers short electrical pulses to interrupt the triggers before seizure symptoms can occur.

Sofosbuvir, the first all-oral hepatitis C treatment, is moving through the final stages of FDA approval. This medication would be the first of a new generation of hepatitis C drugs called direct-acting antivirals, which can improve treatment response rates to 90 percent or higher.

A new anesthesia management system that combines the latest in computer technology and microelectronics is now available to meet the demands of modern surgery and improve the standard of care.

Many gastroenterologists are now employing fecal microbiota transplantation—the use of human stool transplants—to battle C. diff in those patients who do not respond to standard drug therapy.

A synthetic version of the naturally occurring hormone, human relaxin-2, which is widely associated with pregnancy, has proven that it can improve acute heart failure symptoms after being infused over a 48-hour period in the hospital following a heart failure episode or a heart attack.

A new sedation system is a first-of-a-kind device in the world that allows non-anesthesia professionals to administer the drug propofol during colonoscopy and esophagogastroduodenoscopy (EGD) procedures.

Scientists have discovered what may be an important new biomarker for heart disease that serves as an accurate screening tool for predicting future risks of heart attack, stroke, and death in persons not otherwise identified by traditional risk factors and blood tests. The novel biomarker is called TMAO, or trimethylamine N-oxide, and it’s a microbial byproduct of intestinal bacteria.

For treatment of low-grade B-cell lymphomas and leukemias, there are now B-cell receptor pathway inhibitors that interfere with cancer cell division by focusing on proteins involved in signaling pathways. By effectively blocking signals that tell cancer cells to grow and divide uncontrollably, these targeted cancer therapies can help stop cancer progression while preserving normal, healthy cells.


Released: 10/16/13

Just What the Doctor Ordered: Help for Kids Who Stutter Sent to 53,727 Pediatricians

7 Tips for Talking with the Child Who Stutters

“This is one of the most helpful pieces that I have been sent in my 27 years of private practice,” wrote a doctor from Washington state.

Pediatricians from across the country are praising the book and new video, 7 Tips for Talking with the Child Who Stutters, from the Stuttering Foundation. “I just received the pediatrician’s guide for stuttering and had a chance to review it. What wonderful and helpful information you and your group provided,” he added.

Another pediatrician from Maryland wrote: “I’m so pleased to be able to offer better support and guidance to concerned parents. I’m impressed with the scope of your outreach program and applaud the Foundation for doing such excellent work!”

The Stuttering Foundation sent a copy of the new video and accompanying book, The Child Who Stutters: To the Pediatrician, to 53,727 pediatricians this week.

“Through our website, StutteringHelp.org, we have made the leading voices on preschool stuttering available for free to parents to answer their tough questions about stuttering, offer practical strategies, and build confidence,” said Jane Fraser, president of the Stuttering Foundation. “It is our hope that parents who seek advice about stuttering from their trusted pediatrician will find the help they need.”


Released: 10/15/13

Peripheral Nerve Stimulation: Promising Long-Term Treatment For Chronic Headache Sufferers

For the more than 45 million Americans who suffer from chronic headaches, relief may be on the way in the form of an electric pulse, according to a study presented at the ANESTHESIOLOGY™ 2013 annual meeting. Electric stimulation of the peripheral nerve reduced average headache intensity by more than 70 percent.

With electric stimulation of the peripheral nerve, a thin insulated wire is implanted in the back of the head (occipital nerve) or in the forehead above the eyebrow (supraorbital nerve) and delivers electric pulses to block pain. The study looked into the safety and long-term usefulness of this treatment.

“Despite advances in headache treatment over the past two decades, many people do not get adequate pain relief from current treatments, or they cannot tolerate the side effects of the medications,” said Billy K. Huh, MD, PhD, professor and medical director of the Department of Pain Medicine at The University of Texas MD Anderson Cancer Center, Houston, and adjunct professor of the Department of Anesthesiology at Duke University Medical Center, Durham, NC. “This treatment offers hope to those patients and a chance for a major improvement in quality of life.”

The study monitored 46 patients who received peripheral nerve stimulation between 2005 and 2012. Follow-up phone interviews were conducted to determine subsequent headache intensity, frequency of headaches per month, complications. and overall satisfaction with the treatment.

The study found that both headache intensity and frequency decreased significantly. The average headache intensity was reduced by more than 70 percent. The average number of “headache days” decreased from 28 to 14 per month. Ninety percent of patients were satisfied with the treatment, with one reporting more than eight years of reduced headache intensity and frequency.

A drawback of the treatment is its relatively high level of complications, which include electrode migration, equipment problems, and infection. The study authors state that as physicians gain experience with implantation techniques, complications will decrease.

“This is a real breakthrough for chronic headache sufferers,” explained Dr. Huh. “For patients with no other options to relieve their pain and suffering, this treatment is a way for them to get their life back.”


Released: 10/15/13

Chronic Pain Treatment Cools Hot Flashes In Menopausal Women

Menopausal women suffer from half as many hot flashes after receiving a non-hormonal chronic pain treatment, according to a study presented at the ANESTHESIOLOGY™ 2013 annual meeting. The nerve block treatment interrupts the area of the brain that regulates body temperature, reducing moderate-to-severe hot flashes and alleviating depression in menopausal women, breast cancer patients, and women in surgical menopause.

“Hot flashes affect more than 80 percent of menopausal women,” said David R. Walega, MD, chief of the Division of Pain Medicine, and program director of the Multidisciplinary Pain Medicine Fellowship, Department of Anesthesiology at Northwestern University Feinberg School of Medicine, Chicago.

“This is the first effective, non-hormonal treatment for hot flashes, which for many women have a serious negative effect on their lives. This treatment will also help breast cancer patients who suffer from hot flashes as a side effect of their treatments or medication. Some breast cancer patients stop taking their medication (tamoxifen) because of hot flashes.”

Hot flashes are a sudden feeling of heat or warmth starting in the face and extending to the neck and chest area. Some women also experience profuse sweating and a “reddening” or flush to their skin. Hot flashes can last anywhere from one to 10 minutes and vary in strength and frequency.

This prospective, randomized, controlled study included 40 patients between 30 and 65 years old who experienced at least 25 hot flashes per week. Half of the participants received a stellate ganglion blockade (SGB) injection with a local anesthetic. A SGB blockade was injected in the neck about two inches to the right of the voice box. The other 20 patients received an injection of sterile saline. The patients recorded the daily number of hot flashes in a journal and were followed for six months. The study participants were also objectively assessed by a core temperature monitor, which measures changes in a person’s skin conductants.

Moderate to severe hot flashes decreased 50 percent for women who received the SGB injection. Dr. Walega also observed a 30 percent decrease in depression and a 10 percent improvement in verbal learning. These findings were important as loss of memory and cognition are another frequent concern of women in menopause who have hot flashes.

“This is a fast, relatively painless, long-lasting and cost-effective treatment for hot flashes,” continued Dr. Walega. “It has tremendous potential to help not only menopausal women, but also breast cancer patients and women in surgical menopause (whose ovaries have been removed), who have had to put up with ineffective treatments or simply ‘grin and bear it.’”


Released: 10/15/13

Decontaminating The Sanitizer Dispenser, Giving Health Care Workers Their Own Hand Gel Reduces Operating Room Contamination Significantly

Simple remedies—from keeping the antibacterial gel dispenser clean to giving healthcare workers their own hand sanitizer—can help keep patients safe by decreasing contamination in operating and recovery rooms, suggest two studies presented at the ANESTHESIOLOGY™ 2013 annual meeting.

Keeping hand sanitizers clean decreases their bacterial contamination by 75 percent, while healthcare workers with personal gel bottles attached to their belts were nearly 30 percent more likely to use the hand sanitizer, the studies found.

The studies investigated operating room contamination, resulting in common sense remedies to increase sanitization. The first study looked at bacterial counts on such high-touch surfaces as the hand sanitizer dispenser and the electronic medical record keyboard. The second study followed the compliance of a hand hygiene policy before and after personal sanitation gel devices were worn on the belts of medical personnel.

“Perioperative infection and contamination is a serious threat to patient safety,” said Devon C. Cole, MD, Department of Anesthesiology, University of Florida, Gainesville. “The hand sanitizer is touched to sanitize a presumably unsanitary hand and is therefore uniquely vulnerable to contamination. It just made sense to measure the bacteria on the dispenser handles of these containers.”

Bacteria on sanitizer dispensers were sampled at four-hour intervals at two hospitals during the workday and also at 5:00 a.m. and 8:00 p.m. At the first hospital, all the hand sanitizer dispensers were cleaned with a germicidal disposable wipe after each patient was discharged. At the second hospital, no disinfection of the dispensers was done.

Hand sanitizer dispensers accumulated a rising number of bacteria throughout the day at both hospitals. However the number of bacterial colony-forming units at the second hospital was significantly higher. At 5:00 a.m. and 8:00 p.m., there was an average of one bacterial unit. At the end of the day, an average of 93 bacterial units had accumulated on the dispensers. At the first hospital, the number of bacterial units rose from one at 5:00 a.m. to 23 at 6:00 p.m., significantly less than hospital number two.

“Often the last object touched by the anesthesia provider before the patient’s IV is the hand sanitizer dispenser,” explained Dr. Cole. “Too small a volume of sanitizer, inadequate coverage of fingertips, and a short drying time will all enable bacteria to persist on the providers’ hands. Routine cleansing of the dispensers will reduce this reservoir of bacteria. Decontamination of the dispenser should be an important part of anesthesia workstation cleaning.”

In the second study, attending physicians, fellows, residents, and nurses were observed for compliance with the hand hygiene policy before and after they were given a personal sanitation gel dispensing device to be worn on their belts. Next, compliance rates with and without the personal sanitation gel dispenser were compared.

“Despite the availability of wall-mounted hand sanitation dispensers, compliance was less than ideal,” said Colby L. Parks, MD, of the Department of Anesthesia at the University of Wisconsin, Madison. “This study shows that a simple intervention in which a personal antibacterial hand gel dispenser is readily available, works better for a busy healthcare provider’s workflow pattern, presumably leading to decreased patient and surrounding-care-area contamination.”

The study found that the overall compliance with the hand hygiene protocol after the implementation of personal gel dispensers increased 29 percent. More than 307 encounters were observed. In the 146 encounters prior to the implementation of the personal gel dispensers, compliance for pre- and post-patient contact hand hygiene was 23 percent and 43 percent, respectively. For the 161 encounters after the individual gel dispensers were provided, the compliance for pre- and post-patient contact was 53 percent and 72 percent, respectively.


Released: 10/10/13

Exclusive Medical Marijuana Outreach Program for the Medical Community

MediJean announced it has developed a multi-faceted program to help Health Care Practitioners better understand the use of medical marijuana. The new program includes a Continuing Medical Education (CME) course, private cannabis medical communities, and a Health Care Practitioner engagement plan.

"Based on the discussions we are having with professionals in the health care sector and the research we have conducted, it is clear that Health Care Practitioners want more information on this innovative medicine," said Anton Mattadeen, Chief Strategy Officer at MediJean. “We have a plan to help them."

The global perspective on medical marijuana is experiencing a transformation, as more people understand the health benefits of cannabis medicine. CNN's Chief Medical Correspondent, Dr. Sanjay Gupta, illustrated this in his August 8th, article "Why I Changed My Mind on Weed." In this publication, Dr. Gupta said, "there are very legitimate medical applications [for marijuana]. In fact, sometimes marijuana is the only thing that works."

MediJean recognizes that the medical community requires a wide body of accessible knowledge on medical marijuana in order to make more informed decisions prior to prescribing its use.

"We have developed an intricate approach to ensuring that this information is provided and to creating strong partnerships with Health Care Practitioners to guarantee this level of service is delivered," said Mattadeen. "This strategy will see us deliver CME courses, offer a secure online community for Health Care Practitioners to engage their colleagues around the world on this issue, and provide a direct means for doctors and nurse practitioners to give us their immediate feedback and for them to receive the most relevant information in return."

MediJean's CME course begins in January 2014 and will cover: cannabis as a medicine, things to know about prescribing cannabis, a review of the pertinent research information available on cannabis, and an overview of cannabis regulations in Canada. The company encourages doctors and nurse practitioners to register at medijean.com to secure a spot and receive date, time and location information for this course along with information on future CME courses.


Released: 10/10/13

New Global Research on Fundamental Causes of Lupus

The Lupus Research Institute (LRI) announced recipients of its 2013 Distinguished Innovator Award, taking the organization across the globe to support highly innovative studies on two continents. Now the world's largest private grants in novel lupus research, the LRI Distinguished Innovator Award supports large-scale studies for up to $1 million that can advance the search for a cure by uncovering fundamental causes of lupus.

The 2013 award recipients are David Tarlinton, PhD at The Walter and Eliza Hall Institute of Medical Research, Australia and Kenneth Smith, MD, PhD of University of Cambridge, Great Britain. Dr. Tarlinton will explore new ways to kill the cells responsible for producing autoantibodies that damage tissue and organs in lupus. Dr. Smith is pursuing an approach to predicting lupus outcome that has potential to reveal new ways to stop lupus progression.

"With the Distinguished Innovator grants, these two outstanding investigators have the opportunity to pursue potential new areas in lupus research that may strike at the root causes of SLE," noted world-leading immunologist Dr. William Paul, LRI Scientific Advisory Board Chairman and National Academy of Sciences member. "Drs. Tarlinton and Smith bring exciting new concepts to the causes of lupus; the knowledge emerging from their work has the potential to accelerate the drive toward therapies that can stop and reverse the progression of the disease."

"The Lupus Research Institute's global effort confirms our commitment to support the best novel research wherever it originates," said Margaret Dowd, President and CEO. "In just its second year the Distinguished Innovator Award is gaining worldwide recognition for allowing scientists to pursue the big ideas that can get at the underlying origins of lupus. If we can understand what causes this prototypical autoimmune disease, we can find ways to stop it."

Getting at the Source of Autoantibodies

Dr. Tarlinton's project targets the cells that produce the disease-causing autoantibodies in lupus. The life span of these antibody secreting cells, which are called plasma cells, is normally controlled by a protein inside them called Lyn. In lupus, harmful plasma cells survive, possibly due to abnormally low levels of Lyn. Dr. Tarlinton will search for drug candidates that can remove these plasma cells by mimicking the effects of Lyn.  

Potential for Personalized Treatment

Dr. Smith's group has discovered that lupus patients who develop more severe disease have a distinctive pattern of genes turned on in their white blood cells. He and his group will investigate whether this gene pattern can be used as a practical test for long-term lupus prognosis. Such a predictive test would allow for safer and more effective personalized treatment. They will also explore what causes this gene pattern, in the search for new treatment strategies.


Released: 10/07/13


Washington, DC – October 7, 2103 – Today marks the beginning of Naturopathic Medicine Week, the occasion for helping Americans learn about the health benefits of naturopathic medicine. Naturopathic Medicine Week (October 7 – 13) was established following passage of a resolution by the U.S. Senate that recognized the ability of naturopathic physicians to provide “safe, effective, and affordable health care.”

Naturopathic medicine is a form of medicine that:

  • Considers the whole person
  • Focuses on the causes of illness, not just the symptoms
  • Emphasizes prevention and ongoing wellness
  • Uses natural treatments that are less invasive and less expensive than conventional drugs and surgery.

“Given the rising costs of health care, the anticipated shortage of primary care physicians, and the ever-expanding interest in holistic health and wellness, the public deserves to know more about naturopathic medicine,” said Michael Cronin, ND, president of the American Association of Naturopathic Physicians (AANP). “Our members will be holding a range of free events and activities expressly for people who may be curious about natural medicine and how it works compared to conventional medicine.”

Approximately 4,400 doctors in the US are licensed to practice naturopathic medicine, having graduated from accredited 4-year naturopathic medical schools. Naturopathic doctors are rigorously trained in approaches that facilitate the body's inherent self-healing ability. They treat a full range of illnesses and work closely with their patients, guiding and empowering them education and self-care.

“Naturopathic Medicine Week is taking place all across the country the second week of October,” said Jud Richland, CEO of the AANP. “From weight management and diabetes to allergies, digestion and bone health, patients of naturopathic physicians are able to realize improved health and optimal wellness through the principles and practices of naturopathic medicine.”

A press kit on naturopathic medicine and a link to S. Res. 221 is included on the web site of the American Association of Naturopathic Physicians.

The American Association of Naturopathic Physicians is the professional association that represents licensed naturopathic physicians. AANP strives to make naturopathic medicine available to every American, and to increase recognition of naturopathic physicians as the identified authorities on natural medicine. Learn more at www.naturopathic.org.


Released: 10/04/13

Better Identification of Prostate Cancer

Study finds noninvasive ultrasound scan more accurate than MRI and PSA

Prostate cancer can be detected simply and more accurately with a radiation-free, non-invasive screening test, according to findings announced today at an international physician conference.

The findings, reported at the International Contrast Ultrasound Society (ICUS) annual conference, found contrast-enhanced ultrasound imaging (CEUS) exams can provide more accurate results than either MRI, PSA, or conventional ultrasound imaging.

“The accuracy of MRI in diagnosis is very limited and it misses a significant number of cancerous tumors,” according to Hessel Wijkstra, PhD, a professor at Eindhoven University of Technology and a research scientist at AMC University Hospital in Amsterdam in the Netherlands. “In addition, PSA testing is inaccurate and generates large numbers of false negatives and false positives,” he added.

Prostate cancer is the number one cancer in men, and the potential impact of this is huge for male patients, according to Wijkstra.

“CEUS is less expensive, more accurate, more accessible, and does not use radiation,” added Stephanie Wilson, a radiologist from the University of Calgary and co-president of ICUS.

Wijkstra said that the lack of accuracy in the localization of prostate cancer limits patients to radical treatment options, such as operations and the use of radiation. “These treatments can have serious side effects, including impotence, incontinence, and a debilitating effect on the patient's quality of life,” he said.

While the ultrasound contrast agents Definity (Lantheus Medical Imaging) and Optison (GE Healthcare) are only approved for use in the United States for cardiac imaging, they and other agents are used widely in Europe and elsewhere for imaging tumors and organ systems throughout the body. Additional applications of these ultrasound contrast agents are under review worldwide.


Released: 10/02/13

World-first Trial for Tendon Repair Using Tendon Stem Cells Published in the Prestigious American Journal of Sports Medicine

Regenerative medicine company, Orthocell Limited (Orthocell), today announced the results of its unprecedented and successful clinical trial for the treatment of tendon injuries using its patented stem cell technology. Tendon injuries are one of the most common causes of occupational and sporting disability and current clinical treatments are only moderately effective.

Orthocell's new technique is known as Autologous Tenocyte Implantation (Ortho-ATIT) and involves biopsy of the patient's own healthy tendon, isolation and cultivation of tendon stem cells from the biopsy in a special laboratory, and then injection of these cells back to the injured tendon. The process takes about 20 minutes and is less invasive than surgery.

The company has received international profiling and recognition in the prestigious American Journal of Sports Medicine (AJSM), with a peer-reviewed publication of the world's first study on Ortho-ATIT stem cell technology for regeneration of damaged human tendon.

The AJSM, which is ranked as the world's number one journal for orthopaedics and sports medicine, published outcomes of the clinical trial last week. The data demonstrates that Orthocell's novel technology for repairing tendons was a safe and effective procedure that enables a reduction in pain and repairs tendons in severe chronic resistant tendon injury, like tennis elbow. The patients treated in the study had failed at least one previous therapy including physiotherapy and corticosteroid injection. Patients achieved significant improvement in function and structural integrity of the tendon after the Ortho-ATIT tendon stem cell injection.

Orthocell Managing Director Paul Anderson said the clinical study indicates great potential for the Ortho-ATIT stem cell tendon repair.

“The AJSM paper is a benchmark study that validates the repair of tendon using tendon-derived stem cells. We are now focusing our efforts on offering this world class treatment more widely to patients throughout Australasia, and we are also investigating new potential markets overseas,” said Mr. Anderson.

The technique was the result of more than 10 years of development by Professor Ming Hao Zheng's group at the Centre for Translational Orthopaedic Research at the University of Western Australia, one of the top 100 universities in the world.

“This is a very exciting body of work, which is indicated for a large patient population. There are currently limited treatment options for people suffering from tendon injury and related disorders, as there are no targeted drug therapies and surgery often delivers unsatisfactory results. This published study of Ortho-ATIT strongly suggested that substitution of tendon stem cells enables regeneration of tendon,” said Professor Zheng.

Amanda Redwood, a 45-year-old mother of two who participated in the trial, said Orthocell's treatment relieved her of severe elbow pain within six months.

“I experienced debilitating symptoms of tennis elbow for more than 16 months before I had the procedure. Within six weeks of the injection the pain started to subside, and within six months it was gone,” said Ms Redwood.

“As a result of this condition I was unable to play tennis and netball with my two girls and I could barely lift anything without severe pain, not even a glass of water. It made even the most menial of tasks difficult, so I am delighted that I've been able to make a full recovery so quickly, without surgery.”

Ortho-ATIT has been approved by the Therapeutics Goods Administration (TGA) in Australia. The technology is currently available to patients in Australasia who have failed conservative treatment. More information about treatment options can be obtained by contacting Orthocell directly or visiting the company website.


Released: 10/01/13

Cardiac Biomarker ST2 Proves Far Superior To Galectin-3 In A Head-to-Head Study

Galectin-3 pales in comparison. ST2 provides the most accurate risk prediction for patients with heart failure, even improving discrimination when the two most popular cardiac biomarkers, natriuretic peptides and high-sensitive troponin, are included.

Critical Diagnostics announced today that the study, “Head-to-head comparison of two myocardial fibrosis biomarkers for long-term heart failure risk stratification: ST2 vs. Galectin-3,” recently published online in JACC (the Journal of the American College of Cardiology) comparing the company's novel cardiac biomarker ST2 to Galectin-3 (Gal-3), a biomarker from BG Medicine (NASDAQ: BGMD), found ST2 to be superior.

Study investigators followed 876 heart failure patients over a 5-year period, comparing ST2 and Gal-3's ability to predict all-cause death and cardiovascular mortality over conventional clinical assessment. They used 11 standard risk factors (age, sex, NYHA functional class, estimated glomerular filtration rate, left ventricular ejection fraction, diabetes mellitus, sodium, hemoglobin, ischemic etiology of HF, ACE inhibitor or ARB drug treatment, and beta-blocker treatment) plus NT-proBNP.

In a rigorous multivariate analysis, only ST2 remained independently associated with all-cause and cardiovascular mortality. The incremental predictive contribution of Gal-3 to existing clinical risk factors was, as the study authors pronounced, “trivial,” and when troponin was included, Gal-3 fell out of the model.

The same study also showed that ST2 adds considerable prognostic value even when the commonly used biomarkers for heart failure patient care, Roche Diagnostic's (OTC: RHHBY) NT-proBNP, as well as high-sensitive troponin are also considered.

“This study emphasizes the clinical value of the emerging biomarkers of cardiac fibrosis for risk assessment in patients with ambulatory heart failure and establishes finally and unequivocally that ST2 is superior to Gal-3 for this clinical objective,” states James Snider, president of Critical Diagnostics. “As the study showed, every 10 ng/mL increase in ST2 increased a patient's risk by 20 percent. For example, a patient with an ST2 level of 85 ng/ml is at a two-fold higher risk than a patient with an ST2 level at the FDA cleared threshold of 35 ng/ml. At 135 ng/mL, that patient would be at a three-fold higher risk. That's pretty straightforward and offers physicians a simple metric to utilize ST2 in risk assessment of their patients for determination of the best course of treatment.”

Note the authors: “This study highlights the importance of assessing the true value of emerging cardiac fibrosis biomarkers above and beyond clinical risk factors and natriuretic peptides particularly in light of the newly obtained ST2...ACC/AHA class II recommendation for determination of prognosis in chronic HF. ST2 significantly refined discrimination and reclassification analysis while Gal-3 had negligible effects on performance metrics in risk prediction models.”

“In all studied cohorts with or without additional biomarkers, including natriuretic peptides, ST2 unambiguously emerged as a cardinal HF risk stratifier...these main findings suggest that the pathways identified by ST2 profoundly affect risk stratification in the context of chronic HF...The incorporation of ST2 into clinical practice for the prediction of all-cause and cardiovascular mortality should be readily contemplated by the practicing clinician.”

“As the body of evidence grows for ST2, Gal-3's limitations become more glaringly apparent,” remarks Snider. “For instance, not only is Gal-3 shown to be an inferior risk predictor, additionally, elevated Gal-3 levels tend to remain high, regardless of any change in a patient's condition.”

The authors point to a recent transplant study in which serum Gal-3 levels were measured before and after a heart transplant. Gal-3 levels stayed elevated even after patients received new hearts, leading the authors to conclude that Gal-3 is a systemic biomarker rather than being specific to heart disease. By comparison, ST2 has been shown to be directly involved in cardiac fibrosis, and ST2 levels change rapidly with changes in a patient's condition, which makes ST2 an excellent biomarker for assessing patient status with serial testing.

“We also know that Gal-3 levels are affected by common confounders, such as renal function, greatly compromising its clinical utility in heart failure patients,” notes Snider. “ST2 is not affected by renal function or, for that matter, many of the most common confounders such as age or body mass index. Another big differentiator is that ST2 has a single cutpoint. If a patient's ST2 level is above 35 nanograms per milliliter, they are considered at risk. Gal-3, on the other hand, has multiple cutpoints, so decision-making can become confused and problematic.

“As if all that were not enough, the performance of a biomarker is dependent, in part, on both its analytical and biological variability in clinical use. A biomarker's Reference Change Value (RCV) reflects both of these measurements, expressed as the change in the value needed to indicate clinically meaningful change in a patient's condition. Biomarkers with lower RCV values require less change to be significant. This is obviously important when serially monitoring patients. In a seminal study published this year (‘Biological variation of galectin-3 and soluble ST2 for chronic heart failure: Implication on interpretation of test results') by Alan H.B. Wu, PhD, professor of laboratory medicine at UCSF, and chief of the clinical chemistry laboratory at San Francisco General Hospital, ST2 was shown to have an RCV less than half that for galectin-3, making it doubly powerful.”

“It's easy to see why, given the overwhelming body of evidence from the scientific community, more and more clinicians are turning to ST2 to help assess risk and guide treatment of their heart failure patients,” says David Geliebter, CEO of Critical Diagnostics. “This study hopefully puts an end to any debate on that issue. In a fully adjusted model, Gal-3 added no value over the standard risk factors and current biomarkers. What's more, alarmingly, in this most recent study, Gal-3 wrongly reclassified patients into a lower risk category who eventually died.

“We are happy to say that the real winners in all this are the millions of people living with heart failure,” adds Geliebter, “because it means they will have a better chance to live happier, healthier, longer lives thanks to ST2.”


Released: 10/01/13

Improving Outcomes in the Treatment and Management of Metastatic Colorectal Cancer

The Angiogenesis Foundation released a white paper at the 2013 European Cancer Congress that addresses the needs, challenges, and proposed solutions for improving treatment of metastatic colorectal cancer (mCRC), the third most common cancer among men and the second most common among women worldwide. The white paper, "Improving Outcomes in the Treatment and Management of Metastatic Colorectal Cancer," is the result of the International Expert Summit for mCRC, convened by the Angiogenesis Foundation in Berlin, Germany, this past July, that gathered a global multidisciplinary group of leading experts on the field.

New targeted drugs that have been approved since 2004 have shifted oncologists' approach to treating mCRC, and the standard of care now involves treatments aimed at interfering with angiogenesis—new blood vessel growth—which supplies tumors with oxygen and nutrients. Antiangiogenic treatments have increased both the survival and quality of life for patients suffering from this disease.

"With the advent of antiangiogenic therapy, metastatic CRC can now be approached as a cancer with multiple treatment options over time— choices that can improve a patient's quality of life. However, the benefit of these treatments has yet to be maximized and optimal care needs to be more accessible to all patients," commented Dr. William Li, President and Medical Director of the Angiogenesis Foundation.

This white paper addresses the current state of the field, identifies future goals and the barriers to those goals, and makes recommendations for advocacy leaders, oncologists, and the cancer community at large for improving patient outcomes worldwide. The white paper is being distributed at the European Cancer Congress at the Angiogenesis Foundation's advocacy booth, and can be downloaded at scienceofcrc.org/mCRC-globalwhitepaper.


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