Patient Experience Of NHS Dentistry Must Be Included In Performance Measures, Urges The BDA, UK
The NHS dental contract should focus on patient experience - quality of treatment and oral health outcomes - and not on the one crude target that simply measures a dentist’s output. That’s the message the British Dental Association will be delivering at the Patients Association launch of a dental report in London.
The Chair of the BDA’s General Dental Practice Committee, which represents family and high street dentists, Lester Ellman will say:
“The new system focuses on targets, not patients. The new UDA [units of dental activity] system is flawed and has failed to encourage a greater quantity preventive approach to care.
“The BDA wants a stroll of completion indicators that looks at enduring experience - quality and oral health outcomes.”
In a review of developments since the bargain was implemented in April 2006, Dr Ellman will tell delegates that it has been a tough time for both dentists and patients and warned that the uncertainty would continue. He will explain that the new contract drives dentists to focus on output, and forces them to look at everything in terms of UDAs which makes the provision of overall care else difficult. He will also say that the target-driven contract has had a demoralising effect in succession the profession.
“The BDA wants to create an environment where working for the NHS is a choice that dentists can require, confident that they can provide care to patients based on quality and prevention. The UDA system does not support this approach.
“Care should be delivered because of a supportive system not despite a poor one.”
Dr Ellman will be speaking at the Patients Association launch of “The new dental shrink up: Full of holes and causing pain” 1 Great George Street, London.
1. Units of dental activity (UDAs) is the only performance mete out used to assess dentists output under the 2006 contract.
2. The British Dental Association (BDA) is the professional association for dentists in the UK. It represents over 20,000 dentists working in general practice, in common and hospital settings, in academia and research, and in the armed forces.
British Dental Association
The Seattle Biomedical Research Institute To Sign Up Volunteers To Be Exposed To Risk
FoxNews reports "Within the next 18 months, medical researchers bequeath be asking people in Seattle to volunteer to be exposed to the deadliest form of malaria to help them test the effectiveness of vaccine candidates.
The Seattle Biomedical Research Institute is collaborating with the PATH Malaria Vaccine Initiative to accelerate malaria vaccine research by opening a new vaccine testing center in Seattle’s south Lake Union neighbors.
Scientists at the center will use early testing of vaccines to weed out those that don’t work so they can speed up research on the ones that are effective. Malaria vaccine testing has even now begun at a second site in the United States, the Walter Reed Army Institute of Research in Maryland, and is also being conducted at labs in England and the Netherlands.
"We’re particularly excited by the center’s location in Seattle, a community where many people have an interest in global freedom from disease issues and, as a result, are willing to volunteer for such an important cause — to help save the lives of young children in some of the world’s poorest countries," said Dr. Christian Loucq, Malaria Vaccine Initiative director.
Malaria, which is spread by means of mosquitoes, kills else than a million people each year, most of them children. Deaths doubled in Africa over the accomplished 20 years exactly to resistance to existing drugs and insecticides.
Seattle volunteers will be paid an estimated $2,000 or more to hold a paper cup containing infected mosquitoes against their arm, waiting for the insects to bite. Symptoms usually develop within nine to 11 days, and volunteers will be treated for malaria when the first parasites show up in their blood. The treatments last three days.
In the related frame at Walter Reed, where hundreds of people have been exposed to the malaria virus, not one person has gotten seriously ill, said Dr. Patrick Duffy, head strong of the Seattle Biomedical Research Institute’s malaria research programs.
The compensation is for time and inconvenience and the amount must be approved by an independent panel before the study begins.
"It’s a sensitive issue. They want to make sure it’s fair … but not so much that somebody would say, ‘I can’t turn down this opportunity’," Duffy said.
Testing subjects will get not one sicker than someone with the flu and most won’t even go without a day of work after being exposed to malaria and then treated, he said. They will require to stay in a downtown hotel for a few days and receive daily medical tests, but can leave their room during the day for the cause that treatment for the virus would begin before it becomes contagious.
"The parasite has an incredibly complex lifecycle. It takes on many different forms during its different lifecycle stages. One form infects the mosquito. That form develops late. The form that makes people sick develops early. We’ll be treating this seasonably before the form that can be transmitted is developed," Duffy said.
After a story about the vaccine center ran in The Seattle Times on Wednesday, the project’s e-mail box was filled by hundreds of inquiries from people who wanted to participate in the vaccine trials, Duffy said.
He related people in Seattle have a strong sense of altruism.
"I don’t think most people would volunteer for this unless they felt like they were doing it for a larger purpose," Duffy said.
The Seattle vaccine testing center will be built this year and the first trial by just six volunteers is expected to be conducted in the summer of 2009, paid for with between $4 million and $5 million from the Malaria Vaccine Initiative, which was created with a grant of $50 million from the Bill & Melinda Gates Foundation.
Additional trials are expected to cost between $1 million and $2 million and each one would require about 26 volunteers.
The Seattle Biomedical Research Institute has been working on tropical diseases for about 30 years and is home to one of the largest malaria research programs in the United States.
Although the institute has been developing malaria vaccines of its own, the testing program will be open to vaccine candidates from around the world.
Duffy said the project at Walter Reed, where he worked before coming to the institute in Seattle, has helped one promising vaccine candidate get to the point where it is about 50 percent effective at preventing malaria.
He said that vaccine is an inspiration to everyone who is working to declare by verdict a way to save people from malaria.
"We have a unfairly effective vaccine now and there’s no reason for what cause we can’t get a fully effective vaccine," Duffy said.
Bill and Melinda Gates announced in October they would seek worldwide eradication of the disease rather than just control. Their foundation has committed $860 million to malaria programs and any other $650 million to support the Global Fund to Fight AIDS, Tuberculosis and Malaria."
1 commentNext Generation Microbicides Offer New Hope For Women’s Sexual Health, UK
On International Women’s Day, 8 March 2008 the National AIDS Trust calls on Government and pharmaceutical companies to support trials of a new class of microbicides that could offer the greatest hope for women’s sexual health in the 21st century. Existing methods of HIV prevention are failing millions of women, particularly in developing countries, where women often cannot negotiate condom use.
While trials of some at daybreak day microbicide candidates have ended without showing effectiveness, next generation microbicides offer new hope in 2008. These new compounds, currently in trials, differ from earlier options as they specifically target HIV, use different delivery methods (such as a gel, cream, or vaginal ring), can protect for longer periods, and - most importantly - are based on proven antiretroviral therapies commonly used to treat HIV.
Deborah Jack, Chief Executive of the National AIDS Trust, comments:
“Women are disproportionately affected by HIV globally, yet we soft do not have a widely accepted female controlled option for women to protect themselves against HIV. Next generation microbicides offer a real hope to empower women and reduce HIV as part of a comprehensive prevention package.
“Government and pharmaceutical companies must make HIV prevention a priority and ensure that each necessary resource is harnessed to give next breed microbicides the greatest uncertainty of result.”
Women and HIV
- There are 15.4 very great number women manner of life with HIV
- 61% of adults estate with HIV in sub-Saharan Africa are women
- Women are significantly more likely than men to contract HIV from a single act of unprotected vaginal intercourse
National AIDS Trust
The National AIDS Trust (NAT) is the UK’s leading independent policy and campaigning voice on HIV and AIDS. It aims to prevent the spread of HIV, animate early diagnosis, ensure people living with HIV have access to treatment and worry one’s self, and eradicate HIV-related stigma and discrimination.
National AIDS Trust
Ception Therapeutics Initiates Phase II/III Clinical Trial For Its Lead Product Reslizumab In Eosinophilic Esophagitis (EE) In Children
Ception Therapeutics, Inc. announced the initiation of a multi-center, Phase II/III clinical trial to evaluate reslizumab, a humanized monoclonal antibody (mAb) against interleukin-5 (IL-5), for the treatment of eosinophilic esophagitis (EE) in pediatric patients. EE is a chronic inflammatory disease characterized by exigency swallowing, vomiting, stomach or chest pain, and a failure to thrive. IL-5 is the major cytokine liable for the eosinophilic inflammation of the esophagus seen in this condition.
The U.S. Food and Drug Administration (FDA) has granted orphan drug station to reslizumab for the treatment of pediatric EE. This name is part of a well-established program designed to support the development of drugs for rare diseases which affect fewer than 200,000 people in the United States. Depending upon the study results, Ception expects to file a Biological License Application (BLA) with the FDA for reslizumab based on this study.
“The initiation of this study marks a major corporate milestone for Ception,” said Steve Tullman, co-founder, President and CEO of Ception Therapeutics, Inc. “Over the last decade, awareness of EE has dramatically increased, but currently, there is no approved treatment. Children with this disease may suffer significant morbidity and it can be a challenge for them to maintain proper nutrition.”
The study (Res-05-0002) is a randomized, double-blind trial of reslizumab versus placebo in the treatment of pediatric patients between 5 and 18 years of age with poorly-controlled EE. Subjects will be randomized to one of three active dose groups or placebo, administered at monthly intervals for four months. The co-primary endpoints of the search into are changes in clinical symptoms and esophageal eosinophil levels at the end of therapy. The clinical study is being conducted at multiple centers and direct enroll approximately 172 patients. For more information on this clinical trial, please visit http://www.clinicaltrials.gov [Identifier: NCT00538434].
About Reslizumab
Reslizumab is a humanized mAb opposite to IL-5. IL-5 plays a crucial role in the maturation, growth and chemotaxis of eosinophils, inflammatory cells implicated in a number of allergic diseases.
About Eosinophilic Esophagitis
Eosinophilic esophagitis (EE) is a disease that has become increasingly recognized in children and adults over the last decade.(1) It is characterized by an accumulation of eosinophils in the esophagus in association with symptoms that frequently mimic gastro-esophageal ebb. disease (GERD).(2) Specifically, patients typically report symptoms that include difficulty feeding and failure to thrive in younger children, as well as vomiting, epigastric or chest pain, dysphagia, and food impaction.(2) The diagnosis must be made on the basis of an esophageal biopsy demonstrating the presence of significant numbers of eosinophils, clinical symptoms, and the absence of acid reflux or failure to respond to acid reduction therapy.(1)
Allergic responses have been forcibly implicated in the etiology of EE.(1) The overexpression of the cytokine IL-5 by T ally type 2 cells is thought to play a major role in the pathogenesis of the disease.(1) Therapies currently utilized for EE include severely restricted diets, including an elemental formula diet typically administered by nasogastric or gastrostomy tube.(2) There are no approved pharmacologic therapies for EE, although corticosteroids are sometimes administered to patients.
About Ception Therapeutics, Inc.
Ception Therapeutics is a biopharmaceutical company focused without ceasing the discovery and evolution of novel products to address areas of unmet medical need. The Company’s pipeline includes reslizumab in clinical development for eosinophilic inflammatory conditions and an orally available small molecule anti-TNF program. Ception Therapeutics pursues new drug targets through a proprietary thermodynamics-based rational drug design platform. For further information, visit http://www.ceptiontx.com.
(1) Furuta, G., Liacouras, C., et al. Eosinophilic Esophagitis in Children and Adults: A Systemic Review and Consensus Recommendations for Diagnosis and Treatment. Gastroentergology 2007:133:1342-1363
(2) Blanchard, C., Wang, N., Rothenberg, M. Eosinophilic esophagitis: Pathogenesis, genetics, and therapy. J. Allergy Clin Immun. November 2006 (Vol. 118, Issue 5, Pages 1054-1059)
Ception Therapeutics, Inc.
http://www.ceptiontx.com
Bloody Diarrhea Can Indicate Ischemic Colitis
Bloody diarrhea is alarming because it be possible to signal any of several medical conditions — some very serious.
When it occurs in people age 60 and older, in that place’s a good possibility bloody diarrhea indicates ischemic (is-KEM-ik) colitis. Fortunately, by proper medical treatment, most people with ischemic colitis recover within a day or two, according to the March issue of Mayo Clinic Health Letter.
Ischemic colitis occurs when blood flow to part of the large intestine (colon) has been suddenly reduced or blocked. This can lead to areas of colon inflammation, and in rare circumstances, permanent colon damage. When the colon doesn’t get enough blood, tissues are damaged, causing it to leakage blood.
A number of factors can contribute to reduced blood flow to the colon, including congestive heart failure, dehydration, recent surgery, infections and even long distance running. in the greatest degree often with this condition, normal blood flow already has returned by the time symptoms appear. When a doctor is looking for the cause, it’s common that none can subsist found.
Usually there’s no reason to directly treat ischemic colitis because it resolves on its own. Still, people be possible to feel very ill. Patients many times require one to two days in the hospital to receive antibiotics to help quiet bacteria from spreading and fluids to preclude dehydration. If the underlying cause is found, the condition may require to be treated.
Colon damage from an at the head episode typically heals completely within two weeks. Most people in no degree have another episode.
Mayo Clinic
200 First St. SW
Rochester, MN 55902
United States
http://www.mayoclinic.com
Advaxis Scientists Publish Research Of Listeria Monocytogenes-Based Vaccine For Prostate Cancer In Latest Edition Of Cancer Immunology & Immunotherapy
Drs. Vafa Shahabi (Advaxis Inc. OTCBB: ADXS) and Yvonne Paterson (University of Pennsylvania) led a team (the “Team”) of six leading research microbiologists and published findings on the potential use of a Listeria monocytogenes-based vaccine for prostate cancer (”pCa”).
The Team developed and characterized a recombinant live attenuated Listeria monocytogenes/PSA (”Lm-LLO-PSA”) vaccine with potential use for the treatment of pCa. Results indicated that Lm-LLO-PSA is a likely solicitant for pCa immunotherapy.
“The Team’s findings support the opportunity for immunotherapy in treating prostate cancer,” said Thomas Moore chair and chief executive officer of Advaxis. “The results build immediately after Drs. Shahabi’s and Paterson’s vaccine work currently under development at Advaxis. We look forward to additional research in this circle at the same time that it can be instrumental in Advaxis’ patented Lm elocution platform.”
About Advaxis, Inc.
Based in North Brunswick, New Jersey, Advaxis is developing proprietary Listeria monocytogenes (”Lm”) cancer vaccines based on technology developed by Dr. Yvonne Paterson, professor of microbiology at the University of Pennsylvania and chairperson of Advaxis’ scientific advisory board. Advaxis is developing therapeutic cancer vaccines that enhance the immune system’s cancer-fighting abilities through its proprietary Lm based system, which utilizes multiple simultaneous immunological mechanisms to develop safer and more effective Lm based cancer vaccines. Advaxis is the exclusive licensee of a patented broadly enabling Lm platform technology that can elicit effective anti-tumor responses.
Advaxis’ lead Lm vaccine candidate - Lovaxin C - targets cervical and head strong and neck cancers. Current Lm vaccines in development target breast, ovarian and lung cancers. Advaxis has completed a Phase I/II clinical trial. The Lm platform will also have applications in the fields of infectious disease and autoimmune disorders.
About Lovaxin C Vaccine
Advaxis’ Listeria technology platform uses modified Listeria monocytogenes (”Lm”) to deliver a tumor-specific antigen fusion protein. Lm has the ability to generate a robust immune response and produce an unusually herculean and effective therapeutic immune response to existing cancers and other diseases affecting many akin immune mechanisms, simultaneously and in integrated fashion.
Advaxis’ Lm-based technology is mostly based on Dr. Yvonne Paterson’s decade worth of work in her laboratory at the University of Pennsylvania. This technology she developed generates an unusually profound cytotoxic immune response capable of killing cancer cells. The Company’s proprietary antigen fusion protein technology, also suppresses regulatory T cells that inhibit many vaccines in the creation of a local tumor environment, conducive to the therapeutic effects of the activated tumor-killing cells.
Lovaxin C was designed to treat women who receive already developed cervical cancer as a result of contracting the human papilloma virus (”HPV”), unlike current products on the market that are ineffective in treating HPV-infected women.
Forward-Looking Statements
Certain statements contained in this press release are forward-looking statements that contain risks and uncertainties. The statements contained herein that are not purely historical are forward looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended and Section 21E of the Securities Exchange Act of 1934, as amended. Forward-looking statements deal with the Company’s current plans, intentions, beliefs and expectations and statements of future economic performance. Forward-looking statements involve known and unknown risks and uncertainties that may ground the Company’s actual results in future periods to differ materially from what is currently anticipated. Factors that could cause or contribute to such differences include those discussed from time to time in reports filed by the Company by the Securities and Exchange Commission. The Company cannot guarantee its future results, levels of activity, performance or achievements.
http://www.advaxis.com
Type 2 Diabetes May Be Caused By Intestinal Dysfunction
Growing evidence shows that surgery may effectively cure Type 2 diabetes — an approach that not only may change the way the disease is treated, but that introduces a new way of thinking about diabetes.
A new article — published in a special supplement to the February issue of Diabetes Care by a leading expert in the emerging field of diabetes surgery — points to the small bowel as the possible site of critical mechanisms for the development of diabetes.
The study’s author, Dr. Francesco Rubino of NewYork-Presbyterian Hospital/Weill Cornell Medical Center, presents scientific proof on the mechanisms of diabetes control after surgery. Clinical studies hold shown that procedures that simply restrict the stomach’s size (i.e., gastric banding) employ advantageously diabetes only by inducing massive weight loss. By studying diabetes in animals, Dr. Rubino was the first to provide scientific evidence that gastrointestinal bypass operations involving rerouting the gastrointestinal tract (i.e., gastric bypass) can cause diabetes remission independently of any weight loss, and even in subjects that are not obese.
“By answering the question of how diabetes surgery works, we may be answering the question of how diabetes itself works,” says Dr. Rubino, who is a professor in the Department of Surgery at Weill Cornell Medical College and chief of gastrointestinal metabolic surgery at NewYork-Presbyterian/Weill Cornell.
Dr. Rubino’s prior research has shown that the primary mechanisms by which gastrointestinal bypass procedures control diabetes specifically rely on the bypass of the upper small intestine — the duodenum and jejunum. This is a key finding that may point to the origins of diabetes.
“When we bypass the duodenum and jejunum, we are bypassing what may be the source of the moot point,” says Dr. Rubino, who is heading up NewYork-Presbyterian/Weill Cornell’s Diabetes Surgery Center.
In fact, it has become increasingly evident that the gastrointestinal tract plays an important role in energy regulation, and that many gut hormones are involved in the ordering of sugar metabolism. “It should not surprise anyone that surgically altering the bowel’s anatomy affects the mechanisms that regulate blood sugar levels, eventually influencing diabetes,” Dr. Rubino says.
While other gastrointestinal operations may cure diabetes as an effect of changes that improve blood sugar levels, Dr. Rubino’s research tools and materials in animals show that procedures based on a bypass of the upper intestine may work instead by reversing abnormalities of blood glucose regulation.
In certainty, bypass of the upper small intestine does not improve the ability of the body to regulate blood sugar levels. “When performed in subjects who are not diabetic, the bypass of the upper intestine may even impair the mechanisms that regulate blood levels of glucose,” says Dr. Rubino. In striking contrast, when nutrients’ passage is diverted from the upper internal of anti-diabetic patients, diabetes resolves.
This, he explains, implies that the upper intestine of diabetic patients may be the site where an abnormal signal is produced, causing, or at least favoring, the development of the disease.
in what state exactly the upper intestine is dysfunctional remains to be seen. Dr. Rubino proposes an original explanation known in the scientific community as the “anti-incretin theory.”
Incretins are gastrointestinal hormones, produced in response to the transit of nutrients, that boost insulin production. Because an excess of insulin can determine hypoglycemia (extremely low levels of blood flatter) — a life-threatening condition — Dr. Rubino speculates that the body has a counter-regulatory mechanism (or “anti-incretin” mechanism), activated by the same passage of nutrients through the upper intestine. The recent mechanism would act to decrease one as well as the other the secretion and the action of insulin.
“In healthy patients, a correct balance between incretin and anti-incretin factors maintains normal excursions of sugar levels in the bloodstream,” he explains. “In some individuals, the duodenum and jejunum may be producing too much of this anti-incretin, thereby reducing insulin secretion and blocking the exercise of insulin, ultimately resulting in Type 2 diabetes.”
Indeed, in Type 2 diabetes, cells are resistant to the action of insulin (”insulin resistance”), while the pancreas is unable to produce enough insulin to overcome the check.
After gastrointestinal bypass procedures, the exclusion of the upper inconsiderable intestine from the transit of nutrients may offset the abnormal production of anti-incretin, thereby resulting in remission of diabetes.
In order to better understand these mechanisms, and help make the potential benefits of diabetes surgery more widely available, Dr. Rubino calls for prioritizing research in diabetes surgery. “Further research on the exact molecular mechanisms of diabetes, surgical control of diabetes and the role played by the bowel in the disease may bring us closer to the lead to of diabetes.”
Today, most patients with diabetes are not offered a surgical option, and bariatric surgery is recommended no other than instead of those with severe obesity (a body mass index, or BMI, of greater than 35kg).
“It has become clear, however, that BMI cut-offs can no longer be used to determine who is an ideal candidate for surgical treatment of diabetes,” says Dr. Rubino.
“There is, in fact, growing evidence that diabetes surgery can be effective even for patients who are alone slightly obese or just overweight. Clinical trials in this field are therefore a priority because they allow us to compare diabetes surgery to other method of treating options in the attempt to understand when the benefits of surgery outweigh its risks. Clinical guidelines for diabetes surgery will certainly have being different from those for bariatric surgery, and should not be based only on BMI levels,” he notes.
“The exercise we have erudite with diabetes surgery is that diabetes is not unceasingly a chronic and relentless disease, where the only possible treatment goal is just the control of hyperglycemia and minimization of the risk of complications. Gastrointestinal surgery offers the possibility of complete disease remission. This is a major shift in the way we consider treatment goals for diabetes. It is unprecedented in the history of the disease,” adds Dr. Rubino.
Type 2 diabetes, which accounts for 90 to 95 percent of total cases of diabetes, is a growing epidemic that afflicts more than 200 million people worldwide.
At a time when diabetes is growing epidemically worldwide, Dr. Rubino says that finding new treatment strategies is a race in countervail to time. “At this point, missing the opportunity that surgery offers is not an option.”
In addition to having performed landmark studies in the field of diabetes surgery, Dr. Rubino was the most considerable organizer of an influential Diabetes Surgery Summit, held in Rome in March 2007. This international consensus conference helped establish the field, making international recommendations for the use of surgery and creating an International Diabetes Surgery Task Force. Dr. Rubino serves as a founding member.
NewYork-Presbyterian Hospital/Weill Cornell Medical Center
NewYork-Presbyterian Hospital/Weill Cornell Medical Center, located in New York City, is one of the leading academic medical centers in the world, comprising the teaching hospital NewYork-Presbyterian and Weill Cornell Medical College, the medical school of Cornell University. NewYork-Presbyterian/Weill Cornell provides state-of-the-art inpatient, ambulatory and deterrent care in all areas of healing art, and is committed to valuable point in patient care, education, research and community service. Weill Cornell physician-scientists have been responsible for many medical advances — from the development of the Pap test for cervical cancer to the synthesis of penicillin, the first successful embryo-biopsy pregnancy and birth in the U.S., the first clinical trial for gene therapy for Parkinson’s disease, the first indication of bone marrow’s critical role in tumor growth, and, most recently, the earth’s first successful use of deep brain stimulation to treat a minimally-conscious brain-injured patient. NewYork-Presbyterian, which is ranked sixth on the U.S.News & World Report list of top hospitals, also comprises NewYork-Presbyterian Hospital/Columbia University Medical Center, Morgan Stanley Children’s Hospital of NewYork-Presbyterian, NewYork-Presbyterian Hospital/Westchester Division and NewYork-Presbyterian Hospital/The Allen Pavilion. Weill Cornell Medical College is the foremost U.S. medical college to offer a medical degree overseas and maintains a strong global presence-chamber in Austria, Brazil, Haiti, Tanzania, Turkey and Qatar. For more information, visit http://www.nyp.org and http://www.med.cornell.edu.
NewYork Presbyterian Hospital
425 East 61st St., Fl. 7
New York, NY 10021
United States
http://www.nyp.org
Health Protection Agency Announces Consultation On Its Advice On Solid Radioactive Waste Disposal, UK
The Chairman of the Health Protection Agency, Sir William Stewart, announced that the Agency’s Board is consulting stakeholders on its proposals to update advice on solid radioactive decrement disposal.*
Sir William said: “The Health Protection Agency has a remit across the UK toward public health protection from potential radiation hazards. This is an important consultative document, prepared by means of the Agency’s Radiation Protection Division, at a time of increasing interest in nuclear dominion and in the good disposal of its radioactive waste.”
There are two power reasons for going out for consultation on this topic now. First, the current guidelines were published in 1992 by the National Radiological Protection Board (which joined the Health Protection Agency in April 2005). They were based on recommendations from the International Commission in succession Radiological Protection (ICRP) which have recently been updated. Second, there have been a number of recent policy reviews by the UK Government and others looking at the options for radioactive waste disposal.
The advice is intended for use by planners in the detailed risk assessment of solid radioactive waste disposal facilities. Given the long half-life of some radioactive waste, an important principle underpinning the proposed advice is that people in the future should have the same point of protection as we have today.
The key proposals for consultation embody:
- Criteria and methods for assessing the radiation risks resulting from natural processes and events (such as earthquake or landslide) that could affect the waste disposal facility in the future;
- Criteria for assessing the radiation risks to people intruding into the facility. Two types of obtrusion are considered: the intentional intrusion by people who are fully aware that it is a radioactive waste disposal facility, and inadvertent intrusion by those who are inattentive of the nature of the facility;
- The various measures used to assign one’s share to future impacts, which combine the likelihood of an event happening with the radiation dose and risk that could result from it.
Reference
* HPA Advice on Radiological Protection Objectives for the Land-Based management of Solid Radioactive Waste. The Consultation paper is available here.
Notes
1. A summary of the advice from NRPB in 1992 can be found here.
2. The Recommendations of the International Commission on Radiological Protection, updated in 2007, are available from: http://www.icrp.org/index.asp.
3. The Health Protection Agency is an independent organisation dedicated to protecting people’s health in the United Kingdom . It does this by providing impartial advice and authoritative information on health protection issues to the public, to professionals and to government. The Agency combines public health, biological, chemical and radiological expertise, research and emergency planning in one organisation. It works at international, national, regional and local levels and has links with many other organisations around the world. This means it can respond quickly and effectively to new and existing national and global threats to health.
Health Protection Agency
AANA Condemns Unsafe Injection Practices
In a decisive response to recent incidents in Nevada and New York in what one. patients were infected with hepatitis C allegedly from one side the reuse of needles and syringes, the American Association of Nurse Anesthetists (AANA) called on healthcare professionals across the population to exercise the extreme care and vigilance when performing or observing injections on patients.
“It is astounding that in this day and age there are nurse anesthetists, anesthesiologists, and other healthcare professionals who still risk using needles and syringes on more than one patient, or know of such activities and don’t report them,” said Wanda Wilson, CRNA, PhD, president of the 37,000 member AANA. “Published standards and guidelines dictate that single-use and disposal of these products is the with most propriety way to ensure patient safety. Patient safeness is our primary focus — not cost savings, time savings, or any other factor.”
Wilson added that while the AANA believes the vast majority of Certified Registered Nurse Anesthetists (CRNAs), anesthesiologists, and other healthcare professionals who give injections practice in a safe manner according to established drug-handling and administration guidelines, recent hepatitis C outbreaks at an endoscopy center in Las Vegas, Nev., and a uneasiness management facility in Long Island, N.Y., leave no doubt that unsafe practices are still occurring and can cause great harm to patients.
“My heart goes out to the patients in Las Vegas and Long Island who contracted hepatitis, and I fervently hope that testing doesn’t reveal additional patients who might have been infected at these facilities,” Wilson said.
“These types of incidents are completely unacceptable, and the AANA is determined to help uncover the root cause and correct the problem,” Wilson said. “We invite other national healthcare organizations, as well as governmental entities and drug manufacturers, to work with us to restore public trust and achieve this goal of ensuring and enhancing patient safety when it comes to the use of needles, syringes, and single-use medication vials. Only by working together will we be able to develop and implement universally accepted techniques and guidelines, and share in the responsibility of their use and enforcement without hesitation.”
On February 29, health officials in Nevada closed the Endoscopy Center of Southern Nevada in Las Vegas after six patients were diagnosed with hepatitis C. The row was traced back to nurse anesthetists reusing syringes to draw up drug from single-use vials for multiple patients. According to the investigation report of the Southern Nevada Health District, “common practices” were identified that “would allow disease to be transmitted in this manner.” Officials are notifying more than 40,000 patients that they should be tested for hepatitis and HIV. (View the investigation report at http://health.nv.gov)
In November 2007, reports surfaced in the media that anesthesiologist Harvey Finkelstein, MD, a Long Island pain management specialist, was under investigation by the New York State Department of Health for reusing syringes to draw up physic from multi-dose vials and exposing thousands of patients to blood borne pathogen infection. On December 14, 2007, the Department of Health contacted approximately 8,500 patients who had been treated by Finkelstein prior to January 15, 2005, urging them to be tested for hepatitis and HIV if they had received an injection from the doctor. (View the investigation report at http://www.health.state.ny.us) Finkelstein’s record in the nine years prior to the reuse investigation included 10 malpractice settlements.
“Anesthesia practiced according to professional guidelines is safe,” Wilson said. “We intend to use these incidents to reinforce the importance of adhering to established guidelines and to gain a better understanding of common practices related to the use of needles, syringes, and single-use medication vials by nurse anesthetists and other healthcare professionals.
“What is clearly not the answer to the problem is during the term of any group of providers — physician or other — to insist that ‘it couldn’t happen to us,’ because that’s certainly not in our patients’ best interests,” said Wilson. “Every clinician and professional society lives in a glass house when it comes to a critical issue such as infection prevention. If the hepatitis C outbreaks in New York and Nevada demonstrated anything, it was that such incidents occur regardless of a provider’s degree, credential, or title. For any group to suggest otherwise is to put its collective head strong in the sand — it is irresponsible, thoughtless, and a sure invitation for yet not the same Nevada or New York situation to occur.”
The AANA refused to put its head in the sand at the time that, in 2002, a hepatitis outbreak in Norman, Okla., was traced back to a succor anesthetist supervised by an anesthesiologist at a hospital outpatient clinic. More than 100 patients who were treated at the hospital were diagnosed with hepatitis B or C (although it was impossible to determine precisely in what plight many patients were infected prior to treatment or during treatment at the facility).
In response to the situation in Norman, the AANA took immediate action. CRNAs across the country were mailed a copy of the AANA Infection Control Guide along with a letter reinforcing the importance of strict compliance to ensure patient safety. Press releases were disseminated to educate, inform, and reassure the public about safe injection practices. The AANA also hired a research compressed to conduct a random telephone survey of CRNAs, anesthesiologists, and other clinicians to learn more about practices and attitudes on needle and syringe reuse.
The results of the survey were eye-opening, and confirmed the AANA’s suspicions that the problem is more widespread than believed.
Among the different categories of freedom from disease professionals surveyed, 3 percent of anesthesiologists who responded indicated they reuse needles and/or syringes on multiple patients. CRNAs, other physicians, nurses and spoken surgeons reported reuse at 1 percent or less. Extrapolating from the survey’s findings, 3 percent of anesthesiologists plus 1 percent of CRNAs equated in 2002 to approximately 1,000 anesthesia professionals who might have been exposing more than a million patients to risks of contaminated needles and syringes.
The AANA distributed this information widely among public and professional communities, including to the Centers despite Disease Control. Despite these alarming results, the AANA was unable to generate interest in a summit meeting of healthcare organizations to address the issue. “Perhaps if the issue had been given more attention at the time, we wouldn’t be revisiting it anew today,” Wilson said.
“The most important action we at the AANA feel we can take from this point forward,” Wilson added, “is to do absolutely everything in our power to study and correct the infection control outlet related to drug handling and administration, and make whatever changes are necessary to ensure the safety of future anesthesia patients.”
About the American Association of Nurse Anesthetists (AANA)
Founded in 1931 and located in Park Ridge, Ill., the AANA is the professional organization for more than 90 percent of the nation’s CRNAs. As advanced practice nurses, CRNAs administer approximately 27 million anesthetics in the United States each year. CRNAs practice in every setting where anesthesia is available and are the sole anesthesia providers in more than two-thirds of the whole of rural hospitals. Additional knowledge about the AANA is available on the Internet at http://www.aana.com.
American Association of Nurse Anesthetists
http://www.aana.com
How Hunger Works In The Brain
What makes you suddenly dart into the bakery when you spy chocolate- frosted donuts in the window, though you certainly hadn’t planned on indulging? As you lick the frosting off your fingers, don’t blame a lack of self-control.
New research from Northwestern University’s Feinberg School of Medicine reveals how be hungry works in the brain and the way neurons pull your strings to lunge for the sweet fried dough.
Krispy Kremes, in perhaps their first starring role in neurological research, helped lead to the discovery.
In the study, subjects were tested twice — once after gorging on up to eight Krispy Kreme donuts until they couldn’t eat anymore, and on another day on the model of fasting despite eight hours.
In both sessions, people were shown pictures of donuts and screwdrivers, while researchers examined their brains in fMRI’s.
When the subjects saw pictures of donuts after the eating binge, their brains didn’t register much weal. But after the fast, two areas of the brain leaped into action upon seeing the donuts. foremost, the limbic brain — an ancestral part of the brain present in all animals from snakes to frogs to humans — lit up like fireworks.
“That part of the brain is able to detect what is motivationally significant. It says, not only am I hungry, but in the present life is food,” said higher author Marsel Mesulam, M.D., the Ruth and Evelyn Dunbar Distinguished Professor of Psychiatry and Behavioral Sciences at the Feinberg School and a neurologist at Northwestern Memorial Hospital.
Next, the brain’s spatial attention network shifted the hungry subject’s focus toward the new object of aspiration — in this case the Krispy Kremes.
“If we didn’t take this part of the brain, every time you passed by a bakery you would have no control over your erosive,” explained Mesulam, who also is director of the Cognitive Neurology and Alzheimer’s Disease Center at the Feinberg School. “If your nerve cells fired every time you smelled something edible, then you’d wear away all the time, not just when you’re hungry.”
“There’s a very complex system in the brain that helps to direct our watchfulness to items in our environment that are relevant to our needs, for example, food when we are unfertile but not when we are full,” said Aprajita Mohanty, lead author of the paper and a post-doctoral fellow at the Feinberg School. The study was published on-line last week in the journal Cerebral Cortex.
Mesulam noted the research demonstrates how our brain decides what to pay attention to in a nature full of stimuli — not just sweets. “If you are in a wood and you hear rustling, the context urges you to pay full attention since this could be a sign of danger,” he said. “If you are in your office, the context makes the identical sound less relevant. A greater job of the brain is to match response to words immediately preceding.”
The study helped Mesulam understand his own behavior. “Now I know why I can’t resist walking into the bakery some days when I have an odor fresh scones,” he said.
—————————-
Article adapted by Medical News Today from original press release.
—————————-
Source: Marla Paul
Northwestern University
Nurses And Physicians Must Collaborate To Improve Medical-Surgical Patient Care
As nurses continue to leave the profession, studies have found that interfere with physicians is single stressor in the work environment. When conflict resolution and collaborative environments exist, recruitment and retention are likely to increase and patient outcomes improve. A study in the February 2008 issue of MEDSURG Nursing moderated nurses’ and physicians’ perceptions of their collaborative port. on medical-surgical units.
Gina Aya Nelson and co-authors found nurses feel they lack the assertiveness to impart their opinions and contributions when interacting with physicians, and the authors say that until these issues are resolved, nurses may not enjoy the collaborative relationships they would like with physicians. According to the authors, physicians perceive they value and use input from nurses and are comfortable with the physician-nurse team. The two groups differ on this point, say the authors, as nurses did not share this perception.
Nelson and co-authors suggest nurses take in assertiveness training to improve their assertiveness skills and self-esteem. They recommend further studies to determine if their results can be generalized.
“Nurse-Physician Collaboration on Medical-Surgical Units”
Gina Aya Nelson, MSN, RN; Major L. King, PhD, RN, CNS; Stephanie Brodine, MD
MEDSURG Nursing - February 2008; http://www.medsurgnursing.net
MEDSURG Nursing, The Journal of Adult Health, is the magistrate journal of the Academy of Medical-Surgical Nurses (AMSN). The journal provides its readers with the multidisciplinary information they need to provide clinically admirable patient solicitude and to enhance their nursing practice. MEDSURG Nursing supports adult health/medical-surgical nurses as they strive for excellence in patient care, private practice, and outpatient health care settings in urban, suburban, and rural locations. Each peer-reviewed issue of MEDSURG Nursing features a comprehensive discussion and description of today’s clinical issues in adult health/medical-surgical nursing. MEDSURG Nursing and AMSN are committed to the advancement of adult freedom from disease/medical-surgical nursing practice. The journal is published six times a year.
http://www.medsurgnursing.net
European Congress Of Radiology 2008: Overview Of The Siemens Highlights
At the European Congress of Radiology 2008 (ECR 2008) Siemens Healthcare presents its comprehensive portfolio for radiology and introduces numerous new solutions and products for the improvement of workflows in this special medical field. On the occasion of the Women’s Health Days organized by the European Society of Radiology in Vienna, Siemens also places special focus on the topic of “Breast Care”. The company therefore shows its Breast Care products and solutions not only at the trade pomp booth but also in a special trailer that is accessible to the public.
The innovations presented at the ECR 2008 in Vienna include the new system for digital radiography, Ysio from Siemens. By selecting modules from a program, users have power to create their own Ysio X-ray system customized to their needs.
Encouraged by the outstanding marketing success of the worldwide first dual-source CT system Somatom Definition with two X-ray tubes that simultaneously generate different energies, Siemens Healthcare has already developed six specific dual-energy applications. At the ECR 2008, Siemens presents four new applications that simplify the diagnosis of diseases of the heart, brain, lungs and extremity joints.
The new Acuson S2000 platform is the first utrasound system of the new S product line presented by Siemens Healthcare. The latest technologies integrated in the platform are intended to optimize the workflow and considerably simplify the physician’s work. The scheme is in addition well equipped for future applications: It enables the implementation of innovative ARFI (Acoustic Radiation Forced Impulse) imaging and is prepared for integration of the latest silicon ultrasound technology, that is almost ready for the market.
The new role-based portals syngo Portal Radiologist, syngo Portal Referring Physician and syngo Portal Executive, support radiologists and hospital personnel with intelligent access to and management of patient images, data or reports. All portals contribute at various levels not excepting that to optimization of workflows, but furnish users with innovative applications from within their avow work context. This is supplemented by new applications with regard to computer aided diagnostics (CAD) such as the software syngo TrueD.
In addition, Siemens presents a whole series of different highlights from its radiology portfolio at the ECR 2008:
Magnetic resonance imaging (MRI)
Siemens is pushing the boundaries again
Siemens has proven again its technology leadership in MRI with the introduction of two new magnetic resonance systems based on Tim (Total imaging matrix) technology - namely the MAGNETOM ESSENZA and the MAGNETOM Verio. MAGNETOM ESSENZA meets customer requirements for a cost-effective, yet qualitatively high magnetic resonance system. MAGNETOM Verio is the world’s first MRI system to combine 3-tesla technology with a 70 centimeters Open Bore plus Tim technology. The enlarged opening accommodates patients who could not be examined with earlier 3-tesla systems, such as claustrophobic and obese persons and patients who require special positioning. The unique Tim technology was developed by Siemens. Since its introduction in 2004, it has been installed more than 3000 times. Tim enables superior image quality, higher patient comfort as well as optimal workflow. It has been demonstrated that customers with Siemens MR systems equipped with Tim technology have shown patient throughput increases up to 50 percent. In some cases examination times have been cut in half- a whole-body examination requires less than 10 minutes, for example. One of the main goals of Siemens is improving the workflow by the automation of single steps. From the work at the scanner to post-processing and evaluation, syngo, the highly intuitive Siemens cross-modality user interface enables to operate the scanner quickly and easy. The Inline technology automates daily post-processing activities. Clinical results can be evaluated immediately. In the cardiology sector, fully automatic detection of heart contours and their motions are performed during image acquisition. The physician is talented to evaluate heart functions directly following the examination. Previously, the image data had to be transferred to a post-processing computer, and contours had to be frequently post-processed by hand.
Even getting a second opinions and answers to clinical questions while a patient is being scanned, is possible. Using syngo Expert-i, physicians and experts can remotely access the MR suite from anywhere in the network.
Computed tomography
One for all: Somatom Definition AS
With the Somatom Definition AS (Adaptive Scanner), Siemens introduces a new way to use single source CT. This is the first time that a scanner adapts to virtually any patient and any clinical need, making it an expert in any clinical field and allowing comprehensive examination even of most different patient groups like children and portly or trauma patients. An innovation to minimize disagreeable lot is the Adaptive prescribed portion Shield. With this technique patients benefit from dose saving by up to 25% in all spiral CT examinations. Moreover, the Somatom Definition AS is the first CT scanner to provide 3D image guidance for interventions to facilitate not solitary routine biopsies but also complex interventions such as radio frequency (RF) ablations and minimal invasive procedures. Another outstanding feature is the new Adaptive 4D-Spiral scan mode. The continuous movement of the patient table permits whole organ perfusion and dynamic studies up to 27 cm. In a stroke situation, for example, the entire brain perfusion can be evaluated. With foregoing systems, only a portion of the affected organ could be imaged. The extraordinary adaptability of the Somatom Definition AS to most diverse clinical needs and patients makes a decisive contribution to workflow optimization and facilitates integration of CT imaging in medical procedures. The new Siemens scanner can be used, for example, for stroke diagnosis, can function as a non-invasive catheter laboratory or as a tool for therapy management with cancer patients or even as an intervention suite - all according to the need of the individual patient.
Angiography
Artis zeego - Robot technology for medicine
The new Artis zeego angiography system of Siemens Healthcare introduces unprecedented flexibility in catheter labs and operating rooms. The industrial robot technology integrated in Artis zeego allows the physician to move the C-arm to almost any position around the patient. This makes it easier than ever before to visualize internal organs from various sides, if - for example - tumors or vessel diseases have to be diagnosed. The University Clinic in Munich will be the first hospital worldwide to use the new Siemens angiography system for patient care. Artis zeego supports innovative 3D procedures such as tomograms with syngo DynaCT from Siemens. The new Large Volume syngo DynaCT software enables the physician to visualize large volumes such as the entire abdomen or the liver, for example during chemoembolization or biopsies. Artis zeego is superior to conventional angiography systems also during neuro interventions because it can provide larger views of the skull, neck and spine.
Radiation therapy
Low-impact and efficient: Artiste linear accelerator for adaptive radiation therapy
The Artiste linear accelerator from Siemens provides various imaging modes and numerous treatment protocols and thus offers all prerequisites towards adaptive radiation therapy. The objective of this handling way is to focus maximum radiation intensity on the tumor while preserving the surrounding healthy tissue. Before the treatment is started, a CT scan is performed or - what is particularly time-saving - the treatment beam is directly used to check whether the tumor is located exactly at the position calculated in the treatment planning. The Adaptive Targeting concept of Artiste enables the oncologist to detect and correct changes in the anatomy and shifts in the patient position at the delivery of the treatment and maximize the dose exactly in the tumor. All clinical decision makers can view the image and patient information on the monitor of user-specific syngo Suite for Oncology workplaces. Artiste uses the 160 high-speed blades of its MLC (Multi-Leaf-Collimator) to adapt the treatment beam to the tumor shape at highest accuracy and optimize homogeneous dose distribution.
Molecular Imaging
PET-CT: High-Definition PET from Siemens sets new standards for image sharpness
Siemens has set new standards for the quality of molecular imaging by introducing the high-resolution positron emission tomography (High-Definition PET, HD•PET) for PET computed tomography systems (PET-CT). The worldwide unique 2-millimeter resolution technology enables more sharpness and clearness of the images in the entire field of view. Thus, the physician is able to define small lesions more precisely - even inside lymph nodes, in the abdomen, in the head strong and neck region and in the brain. Moreover, the improved signal-to-noise ratio provides sharper images on which the physician can differentiate more easily between healthy and possibly diseased tissue. This allows the initiation of selective treatment earlier than before. HD•PET is based on the Siemens TruePoint technology, a unique combination of technical features and workflow solutions for PET-CT imaging that optimize patient diagnosis, treatment and care. HD•PET is available for all biograph TruePoint systems and can - as an extension - be integrated in already operating TruePoint systems.
Intraoperative imaging
The Arcadis C-arm race: Efficient workflow and excellent image quality in the OR
Siemens introduces the newest procreation of the company’s Arcadis C-arm product family at the German Congress despite Orthopedics and Trauma Surgery in Berlin, Germany. With this generation, surgical workflows have been optimized through numerous improvements. These include, for example, the new ergonomic monitor trolley and the easy user interface. Also an intelligent algorithm automatically adjusts and optimizes the image quality. quite systems are suitable for broad clinical applications: in orthopedics, trauma and neurosurgery as well as gastroenterology, vascular and cardiac surgery or in urology. The new generation of the Arcadis C-arm family includes such systems as Varic, Avantic and Orbic (Orbic 3D) that have been successfully used in their initial version in hospitals around the world. These mobile C-arms of Siemens are based on syngo, an by intuition operated Siemens software platform that facilitates clinical workflows in many ways.
Customer Services
Customer Care. Life - Customer Care program with comprehensive services
The Customer Care. Life care concept offers training courses for almost all modalities as presence events or as e-learning in German and English. Customer Care. Life also includes services for customers who want to utilize today’s investments throughout the system life cycle and realize a maximum return on their investments.
The Customer Care program offers a multitude of innovative proactive services that enable the detection of potential faults in medical systems before malfunctions occur. This minimizes downtimes at the customer and decisively improves planning ease and workflows in hospitals and medical practices. The Siemens Guardian Program, for example, allows the real-time, proactive online monitoring of medical systems. System errors and potential deviations from the current standard values can be with haste detected and remedied so that reliability and availability of the system are considerably increased. This is enabled by means of the Siemens Remote avail (SRS) platform to which Siemens can connect the systems of its customers worldwide. Today, up to 50 percent of all system malfunctions can be remedied by SRS via remote access.
Consulting
Consulting for service providers in the healthcare sector
With its consulting services, Siemens Healthcare assists service providers in the healthcare sector in successfully positioning themselves on the market today and in the future. Interdisciplinary consulting teams concatenate the fields of strategy, clinical and administrative process optimization, technology and infrastructure planning. They devise action plans in due account of economic aspects and individual customer requirements. For example: Siemens consultants assist the Diakonessenhuis Uttrecht, Netherlands, in optimizing its workflow. As a result, the number of proceeding steps for varicose vein treatment has been reduced there by half.
Refurbished Systems
Environmental Siemens concepts for medical engineering systems
To reuse pre-owned systems as much as feasible is an important component of the company’s philosophy. Resources are conserved by extending the period of life cycle of a product. For example, computed and magnetic resonance tomographs, ultrasound, emission of rays therapy and radiography systems are accepted back by Med and reconditioned by the Refurbished Systems division. For this purpose, an extensive five-level quality process was developed (system selection, qualified disassembly, refurbishing process, installation, liability for material defects) that matches the same high quality standards for new systems. Through this integrated approach, a yearly discharge of 10000 tons of CO2 is eliminated. These energy savings correspond to the yearly electrical energy demands of 3,000 3 person households.
Siemens Healthcare is one of the world’s largest suppliers to the healthcare industry. The social meeting is a renowned medical solutions provider with core competence and innovative strength in diagnostic and therapeutic technologies as well as in knowledge engineering, including information technology and system integration. With its laboratory diagnostics acquisitions, Siemens Healthcare is the first fully integrated diagnostics group, bringing together imaging and lab diagnostics, therapy, and healthcare information technology solutions, supplemented by consulting and support services. Siemens Healthcare delivers solutions across the entire continuum of care - from prevention and forward discovery, to diagnosis, therapy and care. The company employs more than 49,000 people worldwide and operates in 130 countries. In the fiscal year 2007 (Sept. 30), Siemens Healthcare reported sales of €9.85 billion, orders of €10.27 billion, and group profit of €1.32 billion. Further information can be found by visiting http://www.siemens.com/healthcare.
Siemens Healthcare
Nurse Support Can Help Identify Patients With Sleep Apnea, Improve Treatment Compliance
Gasping for breath in the middle of the night is a frightening experience and a intimate friend one for those suffering from sleep apnea. According to Debra Berry in the February 2008 issue of MEDSURG Nursing, the most common cause of apnea sufferers’ respiration troubles is an obstructed airway.
The condition, known as obstructive sleep apnea (OSA), is the most common-place form of sleep apnea and affects millions of Americans. In her article, Berry notes that 80%-90% of cases go undiagnosed, and she explores the jeopardy factors and treatments, as properly as the important role nurses play in caring for OSA patients.
According to Berry, continuous positive airway pressure (CPAP) is the primary treatment towards OSA. Patients wear a mask that keeps their airway open by applying positive air hurry. The downside to this effective treatment, Berry says, is that patients often don’t stick with it, complaining of nasal dryness, congestion, excessive noise from the mask and facial abrasions. Berry notes several randomized studies that indicate nursing support and intensive diligent education improved CPAP compliance.
Berry recommends nurses become more knowledgeable of the symptoms and risk factors of OSA as they are in a unique position to identify patients with be thoughtless apnea, educate them without ceasing OSA risks and provide support in establishing treatment. Taking these extra steps may help prevent adverse patient events.
“Case Study: Obstructive repose Apnea”
Debra Berry, MSN, APRN, ACNP-BC, CCNS, CCRN
MEDSURG Nursing - February 2008; http://www.medsurgnursing.net
MEDSURG Nursing, The Journal of Adult Health, is the official journal of the Academy of Medical-Surgical Nurses (AMSN). The diary provides its readers with the multidisciplinary information they need to provide clinically of the best quality patient care and to enhance their nursing practice. MEDSURG Nursing supports adult health/medical-surgical nurses as they strive for excellence in patient care, private practice, and outpatient health care settings in urban, suburban, and rural locations. Each peer-reviewed issue of MEDSURG Nursing features a comprehensive discussion and description of today’s clinical issues in adult health/medical-surgical nursing. MEDSURG Nursing and AMSN are committed to the advancement of adult health/medical-surgical nursing practice. The journal is published six times a year.
http://www.medsurgnursing.snare
Low Maternal Education Linked To Intellectual Disabilities In Offspring By Epidemiologic Study
By applying a public health approach, researchers at three universities have discovered a key indicator for increased risk of mental retardation in the general population. The study assessed population-level risk factors by linking birth records of 12-14-year-old children in Florida with their respective public school records, over the course of a school year. The results appear in the March 2008 end of the American Journal of Mental Retardation (”Public Health Approach to the Study of Mental Retardation,” by Derek A. Chapman, Keith G. Scott, and Tina L. Stanton-Chapman).
Using the rationale that high-prevalence risk factors can have a substantial impact at the population level, even allowing that the risk to the individual is low, Derek Chapman, Assistant Professor of Epidemiology & Community Health at Virginia Commonwealth University, Keith Scott, Professor of Psychology, at the University of Miami, and Tina L. Stanton-Chapman, Assistant Professor of Curriculum Instruction and Special Education, at the University of Virginia, found that low maternal education resulted in the highest risk of intellectual disability to offspring compared with other factors such as maternal illness, delivery complications, gestational age at birth, and level very low birth weight.
Extremely low being weight infants (<1000 grams or 2.2 lbs) were 9.1 times more likely to have a mild intellectual disability compared to normal birth weight infants (2500+g or 5.5 lbs), yet were only associated with 2.1% of cases in the population. Women with an education below the high school level were 8.9 times more likely to have a child with mild intellectual disability compared with women who had more than 12 years of education, but were associated with 50.9% of cases. Significant socioeconomic effects were found across all levels of pertaining disabilities, with higher income and education dramatically attenuating risk associated with biologic factors such as low birth weight, indicating a range of opportunities for population-based prevention and early intervention services.
The study’s corresponding author, Derek Chapman, explained, “This approach to the study of disabilities is critical because an exclusive focus on prevention via medical interventions ignores the tremendous impact we can have by addressing social factors for which low education is a marker. If infants born to women with a high school education or less had the same risk as those born to college-educated women, there would be a 75% reduction in mild intellectual disabilities. Although genetic and biologic factors clearly play a role, their risk can be attenuated and there is a greater potential impact by addressing social factors such as maternal stress, birth spacing, preconception care, the child-rearing environment, and access to early and comprehensive intervention for at-risk infants and children.”
The authors speculate that in addition to direct genetic effects, prenatally, maternal education may impact cognitive development through awareness and avoidance by the mother of certain risk behaviors and access to early and comprehensive prenatal care. Likewise, the authors theorize that, postnatally, low maternal education can influence mental development of the child through poor nutrition choices by the mother, less cognitive stimulation in the home environment, less knowledge of and access to early intervention services, and increases in childhood injuries.
—————————-
Article adapted by means of Medical News Today from original press release.
—————————-
Click here for free full text of this article.
The American Journal on Mental Retardation (AJMR) is the leader in reporting ground-breaking research in the biological, behavioral, and educational sciences. Since 1886, AJMR has been an essential reference for institutions, libraries, professionals, and students seeking to stay up-to-date in the fields of biology, health sciences, human services, psychology, mental retardation, and/or education.
AJMR is published by the American Association on Intellectual and Developmental Disabilities (http://www.aaidd.org/). AAIDD promotes progressive policies, sound research, effective practices and universal human rights for people with intellectual and developmental disabilities.
Source: Derek Chapman
American Association on Intellectual and Developmental Disabilities
Scientists Successfully Treat New Mouse Model Of Inflammatory Bowel Disease
Researchers trying to improve cancer immune therapy have made an unexpected fall in with: They’ve produced the most accurate mouse model to date of inflammatory bowel infirmity (IBD), a cluster of conditions that afflict approximately 1.4 million Americans with abdominal trouble, constipation and diarrhea.
The two most common forms of IBD are Crohn’s disease and ulcerative colitis (UC); in extreme cases, they can be fatal. The mouse model closely resembles the most serious configuration of human UC and is uniformly fatal. But scientists successfully treated the mice with a pair of broad spectrum antibiotics, easing gut inflammation and increasing survival. The results, reported this week in Public Library of Science Medicine, have researchers eager to follow up both in the clinic and the lab.
“The antibiotics we gave the mice were used individually in unsuccessful clinical trials as ulcerative colitis treatments, but now we obtain colleagues who are thinking of giving combined therapy an informal try,” says co-senior author Thaddeus S. Stappenbeck, M.D., Ph.D., assistant professor of pathology and immunology and of developmental biology. “The antibiotics to all appearance won’t be a cure by themselves, but they may provide us with a potent new approach to combine with other therapies.”
The mice may also allow scientists to learn which species of gut microorganisms are becoming embroiled in battles with host immune systems, triggering the symptoms of UC. That information could allow the development of stronger and more specific treatments.
Silvia Kang, a former graduate student in the laboratory of co-senior author Paul Allen, Ph.D., the Robert L. Kroc Professor of Pathology and Immunology, created the mouse model by crossbreeding two mouse lines they had developed for cancer immune therapy research. Each mouse line had one protein knocked out that restrained immune T cells from shifting into attack mode.
“The idea was to see if we could create super killer T cells we could use to attack tumors,” says Allen. “But wholly the mice became sick early on, started to lose weight and we by and by realized that they all had serious gastrointestinal issues.”
Allen decided to consult with Stappenbeck, an expert in IBD.
“I’ve looked at quite a few proposed mouse models of IBD, and I recognized upright away that this had the in posse to be outstanding,” says Stappenbeck. “The colons of the mice were incredible. They were filled with inflammatory T cells. We found the mice almost exactly replicated the most acute types of ulcerative colitis.”
Unlike prior models of IBD, the mice consistently expand gastrointestinal problems within a short time period and at a predictable point in their lifespan. When researchers treated the mice at three weeks with the antibiotics ciprofloxacin and metronidazole, colon inflammation was reduced and the mice were able to gain weight and survive longer.
Scientists believe IBD results from the host immune system damaging the tissues of the gut while erroneously attacking food and gut microorganisms that aid food classifying. There are an estimated 500 different species of microbes living in the gut, so sorting out which species are being attacked by means of the immune system has been an imposing challenge.
The new model may significantly ease that challenge. Although the dual antibiotics used to treat the mice are broad-spectrum, they didn’t sterilize the guts of the mice, suggesting that the treatment happened to eliminate the microorganisms causing IBD.
“We’d like to treat the mice and then reintroduce candidate microorganisms into their guts to see if this restarts the fiery reaction,” says Stappenbeck.
Stappenbeck and Allen plan continued collaborative study of the model.
Kang SS, Bloom SM, Norian LA, Geske MJ, Flaveli RA, Stappenbeck TS, Allen PM. each antibiotic-responsive mouse model of fulminant ulcerative colitis. Public Library of Science Medicine, March 3, 2008.
Funding from the National Institutes of Health and the Cancer careful search Institute supported this research.
Washington University School of Medicine’s 2,100 employed and volunteer faculty physicians also are the medical staff of Barnes Jewish and St. Louis Children’s hospitals. The School of Medicine is one of the leading medical research, teaching and patient care institutions in the nation, currently ranked fourth in the nation by U.S. News & World Report. Through its affiliations with Barnes Jewish and St. Louis Children’s hospitals, the School of Medicine is linked to BJC HealthCare.
Washington University in St. Louis
One Brookings Dr., Campus Box 1070
St. Louis, MO 63130
United States
http://www.wustl.edu
CSL Behring Submits BLA Requesting Approval Of C1-Esterase Inhibitor For The Treatment Of Hereditary Angioedema
CSL Behring has submitted a biologics license application (BLA) to the U.S. Food and Drug Administration (FDA) requesting approval to market its C1-esterase inhibitor concentrate in the United States because the treatment of hereditary angioedema (HAE), a rare and serious genetic disorder. The submission is based without interruption the recently completed phase II/III prospective, double-blind placebo-controlled International Multi- center Prospective Angioedema C1-Inhibitor Trial (I.M.P.A.C.T.), the largest HAE trial ever, that studied the efficacy of pasteurized C1-INH concentrate.
The proposed indication is for the treatment of acute attacks in patients with HAE. Currently, there are no specifically-approved therapies for HAE in North America.
“Submission of the BLA for C1-INH brings CSL Behring one step closer to providing therapy for hereditary angioedema,” said Val Romberg, Senior Vice President of Research and Development at CSL Behring. “We are confident that our expertise in developing and manufacturing plasma-derived protein therapies will be advantageous in our pursuit of regulatory approval in the United States.”
HAE is a genetic disorder caused by a deficiency of C1-INH which is inherited in an autosomal dominant manner. Symptoms include episodes of edema or swelling in the hands and feet, the face, the abdomen, and/or the larynx. Patients who have abdominal attacks can experience episodes of severe pain, diarrhea, nausea, and vomiting caused by swelling of the of the intestines wall. Attacks that involve the face and larynx can result in airway closure, asphyxiation, and, if untreated, death. Diagnosis of HAE requires a blood test to settle low or abnormal levels of C1-INH. There are estimates of 6,000 to 10,000 or more people with HAE in the United States.
The submission is based on a study of 124 HAE patients with acute, moderate, or severe abdominal or facial attacks. C1-INH concentrate was administered at two different doses and compared to placebo. The main study endpoints were: time to onset of symptom relief from HAE attacks, proportion of subjects by worsening clinical HAE symptoms, and safety.
CSL Behring manufactures and sells C1-INH concentrate in Germany, Austria, Switzerland, and several other countries under the interchange name Berinert(R) P.
About CSL Behring
CSL Behring is a global leader in the plasma protein biotherapeutics industry. Passionate about improving the quality of patients’ lives, CSL Behring manufactures and markets a range of safe and effective plasma-derived and recombinant products and related services. The company’s therapies are used in the treatment of immune deficiency disorders, hemophilia, von Willebrand disease, other bleeding disorders and inherited emphysema. Other products are used for the prevention of hemolytic diseases in the newborn, in cardiac surgery, organ transplantation and in the treatment of burns. The company also operates one of the world’s largest plasma collection networks, ZLB Plasma. CSL Behring is a subsidiary of CSL Limited, a biopharmaceutical company with headquarters in Melbourne, Australia. For more information, visit http://www.cslbehring.com.
CSL Behring
http://www.cslbehring.com
Warnex Offers New Prostate Cancer Screening Service
Warnex Inc. (TSX:WNX) announced that its Medical Laboratories division has launched a new screening service for prostate cancer, the PCA3 assay. The Warnex PCA3 screening service for prostate cancer uses advanced PCR technology to detect mRNA from the prostate cancer gene 3 (PCA3). Warnex is the first laboratory to offer this service in Canada.
“We are pleased to offer this new prostate cancer screening assay, which is highly specific and more precise than all other available screening tests for the detection of prostate cancer,” said Mark Busgang, President and CEO of Warnex. “The addition of this service to Warnex Medical Laboratories’ service offering is part of our strategy to focus on specialized medical testing for the healthcare industry using advanced technologies.”
The PCA3 test is a molecular biology assay that measures the expression of PCA3 mRNA in urine samples. PCA3 is specified to the prostate and is significantly up-regulated (60-100 fold) in prostate cancer. The experiment quantitatively measures PCA3 mRNA as well as PSA mRNA and determines their ratio. High ratios bear been shown to be indicative of prostate cancer. PCA3 screening may help reduce the number of unnecessary biopsies. In addition, the test is non-invasive, eliminating pain and discomfort associated by biopsies.
Prostate cancer is the most common cancer in Canadian men. According to Canadian Cancer Society, one in 8 men power of determination develop prostate cancer during his lifetime and one in 27 will die of it. Prostate cancer usually grows slowly and can often be cured or managed successfully.
About Warnex
Warnex is a life sciences company devoted to protecting public health by providing laboratory services to the pharmaceutical and healthcare sectors. Warnex’s analytical services division provides pharmaceutical and biotechnology companies with a variety of quality control services, including traditive chemistry, chromatography, microbiology, method development and validation, and stability studies. Warnex’s bioanalytical services division specializes in bioequivalence and bioavailability studies for clinical trials. Warnex’s medical laboratories division focuses on genetic and biochemical testing for the healthcare industry and has extensive expertise in genetic testing for full of heart identification, molecular diagnostics, and pharmacogenetics.
Caution Regarding Forward-Looking Statements
Certain statements contained in this news release are forward-looking and are subject to numerous risks and uncertainties, known and unknown. For notice identifying known risks and uncertainties, relating to strategic options for the Company, financial resources and credit risk, laboratory facilities, suppliers, government regulations, key employees, key customers and business partners, foreign currency risk, volatility of share price, and other important factors that could cause actual results to differ materially from those anticipated in the forward-looking statements, please refer to the heading Risks and Uncertainties in the Management’s Discussion and Analysis for the third quarter ended September 30, 2007, which can be found at http://www.sedar.com. Consequently, actual results may differ materially from the anticipated results expressed in these forward-looking statements.
Warnex Inc.
Prostate Cancer Guidelines Welcomed, UK
The Prostate Brachytherapy Advisory Group welcomes the NICE Guidelines on the diagnosis and treatment of prostate cancer published 27 February , in particular, the emphasis on informed indefatigable choice and that patients should be supported to build treatment decisions which take into account their quality of life as well as survival.
States Professor Stephen Langley, Consultant Urologist at St Luke’s Cancer Centre, Guildford and Chair of the Prostate Brachytherapy Advisory Group, ” Low dose rate (LDR) brachytherapy, or pinhole surgery as it is known, is a suitable option for men with low and intermediate risk prostate cancer. Fifteen year data shows that it is to be compared to both surgery and radiotherapy with much less risk of impotence and incontinence.”
Brachytherapy is a proven1 treatment for early localised prostate cancer. It involves implanting tiny radioactive seeds directly into the prostate to destroy the cancer cells. The seeds are permanently implanted, but degrade naturally over time.2 Unlike traditional surgery, brachytherapy or pinhole surgery is minimally invasive and is normally carried out viewed like a day case procedure allowing men to go to work and normal daily activities sooner. It offers a lively side effect profile with less risk of incontinence and impotence than other treatment options.3
The Prostate Brachytherapy Advisory Group is dedicated to supporting universal access to high-quality, low dose rate (LDR) brachytherapy in the UK and comprises a group of medical and National Health Service (NHS) representatives with an busy interest in the commissioning of services and the provident measures of care.
References
1. Radical prostatectomy, external beam radiotherapy <72 Gy, external beam radiotherapy > or =72 Gy, invariable matured ovule implantation, or combined seeds/external beam radiotherapy for stage T1-T2 prostate cancer.
Kupelian PA, Potters L, Khuntia D et al.
International Journal of Radiation Oncology Biology Physics 2004; 58(1):25-33.
2. The American Brachytherapy Society
3. Prostate brachytherapy has come of old age: a review of the technique and results.
Langley SEM, Laing R.
BJU International 2002; 89:241-249.
The Prostate Brachytherapy Advisory Group is supported by one unrestricted educational grant from Oncura.
Prostate Brachytherapy Advisory Group
A New X-Ray System For All Of The Clinical Requirements In Radiography
At the European Congress on Radiology 2008 in Vienna Siemens Healthcare introduced the new system for digital radiography (DR), Ysio. The concept of Ysio is to offer one DR solution for virtually all clinical demands. By selecting modules from a program, users can originate their own Ysio X-ray system exactly customized to their needs. Regardless of whether medical practices and hospitals require one or brace detectors, whether they want a patient table or not, or whether they need fully automated or synchronized operation - Ysio can provide an X-ray system adaptable to virtually any clinical requirement.
Patient volume and profiles, workflows, budgets, local standards and regulations are different during every medical practice and hospital. That’s wherefore Siemens Healthcare now offers Ysio, an X-ray system that can be composed according to individual needs. A configurator (a software tool) aids in determining the right theory variant for a particular customer. Independent of the variant the customer opts for, you can always recognize an Ysio system by the large color “MaxTouch” touch screen in the ceiling-mounted support. With this newly developed touchpad the customer can control system functions such as examination and exposure parameters or the dose. If customers decide on the fully automated ceiling-mounted support, they can even choose from over 500 pre-programmable system positions. These positions make it possible to move the tube into the correct position for the desired exposure with the isolated tease of a button. If the X-ray beam was aligned vertically, it is now automatically moved into a horizontal alignment, for example, to make an X-ray resemblance of the lungs. As a result, there is less physical exertion for the radiological technician and the conduct in the X-ray lab is accelerated.
A highlight of Ysio is the wireless detector, wi-D. Detectors convert X-ray emission of rays to digital image information, and are usually firmly integrated in the examination table. The wi-D can have being removed from the table and placed directly underneath or next to the patient. Exposures that are difficult or impossible to require using a permanently integrated detector, e.g. lateral exposures of the hip, can now be taken without difficulty. Patients with restricted mobility can be X-rayed, for instance, without having to leave a wheelchair. In addition the image quality is also improved: Since the detector is situated very close to the patient, there are virtually no distortions. The wireless detector, which transmits image data to the diagnostic workstation via WLAN, can be used just as flexibly as a cassette in analog X-ray systems space of time at the same time offering all the advantages of digital X-ray imaging.
Siemens Healthcare is one of the earth’s largest suppliers to the healthcare industry. The company is a renowned medical solutions provider with core competence and innovative strength in diagnostic and therapeutic technologies as well as in knowledge engineering, including information technology and system integration. With its laboratory diagnostics acquisitions, Siemens Healthcare is the first full integrated diagnostics copartnership, bringing together imaging and lab diagnostics, therapy, and healthcare information technology solutions, supplemented by consulting and support services. Siemens Healthcare delivers solutions across the complete continuum of care - from hindrance and seasonable finding out, to diagnosis, therapy and care. The company employs more than 49,000 people worldwide and operates in 130 countries. In the fiscal year 2007 (Sept. 30), Siemens Healthcare reported sales of €9.85 billion, orders of €10.27 billion, and group profit of €1.32 billion. Further information can be found by visiting http://www.siemens.com/healthcare.
Siemens Healthcare
Independent Survey Names CyberKnife(R) System Most Widely Used Extracranial Radiosurgery Technology
Accuray Incorporated (Nasdaq: ARAY), a global leader in the department of radiosurgery, announced results of an independent survey, which concluded that the CyberKnife® Robotic Radiosurgery System is the only extracranial radiosurgery technology in widespread, routine clinical use.
The survey also showed that hospitals with all-purpose units - which combine radiotherapy and radiosurgery systems - rarely use the devices for extracranial radiosurgery treatments. In fact, on average, each all-purpose unit was used to treat only five patients per year with extracranial tumors, compared to approximately 91 extracranial patients treated with one and the other CyberKnife System.
In its second year, this survey charts the rapid growth of radiosurgery for treatment of extracranial tumors and reinforces findings from 2006, which also indicated the CyberKnife System was the most widely used device for extracranial radiosurgery.
Last year approximately 50 percent of the CyberKnife Systems were used half of the time or more for extracranial treatments. This year, survey data show that 74 percent of CyberKnife Systems are now used half of the time or more to treat extracranial tumors. In contrast, less than 1 percent of all-purpose units currently are used at this level. This low usage suggests that these devices have virtually no measurable impact on the rapidly expanding extracranial radiosurgery market. In contrast, 100 percent of CyberKnife Systems are being utilized for some type of extracranial procedure, with prostate, lung and spine treatments increasing principally dramatically over the past year.
“Many hospitals are discovering that they can address a wider variety of patients - particularly those who want an alternative to surgery or have been diagnosed with inoperable tumors - by offering radiosurgery treatments,” said Eric P. Lindquist, senior vice president and chief marketing officer at Accuray. “As a result, the market for extracranial radiosurgery is growing universally. This year’s survey once again offers clear evidence that, unlike BrainLAB’s Novalis, Elekta’s Synergy, TomoTherapy’s HiArt and Varian’s Trilogy, the CyberKnife System, as a dedicated radiosurgery system, is the only device that is truly making a significant contribution to that growth.”
Survey Methodology
Dominic & Irvine Research, an independent market research firm, surveyed 1,460 radiation oncology sites in the United States by telephone between June and December of 2007 to determine the nature of their radiation oncology program, the systems that were utilized at the site (linear accelerator, intensity-modulated emission of rays therapy, image-guided radiation therapy, stereotactic radiosurgery, etc.), and the pattern of equipment usage for both intracranial and extracranial treatments. All-purpose units, as referenced above, include Varian Medical Systems’ Trilogy™, Elekta’s Synergy®, BrainLAB’s Novalis® and TomoTherapy’s Hi-Art®. Interviews were conducted with the head strong or director of radiation oncology as well as radiation oncologists and physicists at some sites.
About the CyberKnife® Robotic Radiosurgery System
The CyberKnife Robotic Radiosurgery System is the world’s solely robotic radiosurgery system designed to treat tumors anywhere in the body non-invasively. Using continual image guidance technology and computer controlled robotic mobility, the CyberKnife System automatically tracks, detects and corrects for tumor and patient movement in real