Contemplative Brain Network Less Complex In Children
A brain network linked to introspective tasks such since forming the self-image or understanding the motivations of others is smaller difficult and well-connected in children, scientists at Washington University School of Medicine in St. Louis have learned. They also showed that the network establishes firmer connections between various brain regions as an individual matures.
The scientists are working to establish a picture of how these connections and other brain networks normally develop and interact. They want to use that paint to conduct more detailed assessments of the furniture of aging, brain injuries and conditions such as autism on brain part.
“Having this information will not only help us understand what’s going wrong in these patients, it will also allow us to better assess whether and how future interventions are providing those patients with effective treatment,” says senior author Bradley L. Schlaggar, M.D., Ph.D., associate professor of pediatrics, radiology, neurology and anatomy and neurobiology.
The results appear online this week in The Proceedings of the National Academy of Sciences.
Neuroscientists including co-author Marcus E. Raichle, M.D., professor of radiology, of anatomy and neurobiology and of neurology first identified the network, which is called the default network, in 1996. Since then, scientists have linked it to a number of inward-looking activities, including the creation of the “autobiographical self,” a person’s internal narrative of their life story; and “mentalizing,” the ability to decompose the mental states of others and use those insights to trim the self’s behavior appropriately.
Schlaggar, Raichle and colleagues including Steve Petersen, Ph.D., the James McDonnell Professor of Cognitive Neuroscience and professor of neurology and psychology, have been using a new technique called resting-state functional connectivity MRI to identify brain networks and analyze their functions and development. Instead of analyzing mental activity when a volunteer works on a cognitive task, resting-state connectivity scans their brains hind they have been asked to place and not engage in any specific tasks. The scans reveal changes in the oxygen levels in blood flowing to different areas of the brain. Researchers interpret correlations in the rise and fall of blood oxygen to different brain areas as a sign that those areas likely work together. In neuroscientist’s terms, this means the regions have functional connectivity.
Damien A. Fair, a graduate bookish man in Schlaggar’s lab, led the new study, which compared functional connectivity in 13 brain regions linked to the default network in children ages seven to nine and adults ages 21 to 31.
“The difference between children and adults is profound,” Fair says. “In a graph depicting the strength of connections between the brain regions we studied, children’s minds have just a few connections between some regions, in which case the adult brains have a web-like mesh of many different interconnecting links involving all the regions.”
In papers published in recent years, the researchers have used the same techniques to identify two networks that they think control much of the brain activity behind behaviors directed toward “external” goals (see http://mednews.wustl.edu/news/serving-boy/normal/9639.html and http://mednews.wustl.edu/news/page/normal/9778.html), including observing and interacting with the environment.
Schlaggar and colleagues plan further study of how the brain networks interact for the period of development and in the mature brain. They also are looking at how network functions differ in patients through brain injuries and conditions such as autism.
“Autism spectrum disorder first manifests earlier than the time period we were studying,” Schlaggar notes. “But many of the functions it affects have been associated with the default network, so we’re eager to see if analysis of this network and its expansion can give us new insights into autism.”
Fair DA, Cohen AL, Dosenbach NUF, Church JA, Miezin FM, Barch DM, Raichle ME, Petersen SE, Schlaggar BL. The maturing architecture of the brain’s default network. Proceedings of the National Academy of Sciences, online edition, in print March 11.
Funding from the National Institutes of Health, the John Merck Scholars Fund, the Burroughs-Wellcome Fund, the Dana Foundation, the Ogle Family Fund, the Washington University Chancellor’s Graduate Fellowship, the United Negro College Fund and the Merck Graduate Science Research Dissertation Fellowship 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 of medicine 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
Digestive Health Experts Urge More Americans To Get Screened For Colorectal Cancer
Although novel evidence released by the American Cancer Society attributes early detection to the sharp decline in colorectal cancer deaths in the U.S., not enough Americans are getting screened for colorectal cancer, according to experts from the American College of Gastroenterology. Screening rates remain low, even though Medicare and many private plans pay for screening tests.
While there has been significant improvement in public awareness of colorectal cancer and screening, few people realize that there are a number of simple screening tests that can make up colorectal cancer one of the most preventable cancers. Early detection of colorectal cancer, then it is most treatable, directly results in improved survival, exceeding 90 percent when detected at the earliest stages.
Colonoscopy remains the preferred screening strategy for colorectal cancer screening, according to the American College of Gastroenterology. Unlike other screening modalities, such as flexible sigmoidoscopy and fecal occult blood test, colonoscopy is the only test that can detect and remove pre-cancerous polyps from the colon during the same examination.
The ACG recommends men and women at average risk for colorectal cancer to take the first step screening at age 50. African-Americans should begin colorectal cancer screening as early as 45. To learn more about the benefits of colorectal cancer screening and prevention, speak with your doctor or visit http://www.acg.gi.org.
Physician Experts Available for Interviews
Physician experts on colorectal cancer screening are available for media interviews for March Colon Cancer Awareness Month.
Our physicians can apply to:
— various colorectal cancer screening methods, including colonoscopy
— emergence of new screening technologies
— modern scientific developments in colorectal cancer prevention
— word on the lifesaving potential of colorectal cancer screening
— screening recommendations for average to high-risk individuals, particularly African-Americans.
About Colorectal Cancer
Colorectal cancer is the number two cancer killer in the United States, affecting men and women equally. The American Cancer Society, in their 2008 Cancer Facts & Figures publication, estimates 148, 810 Americans will be diagnosed with colorectal cancer this year, and nearly 50,000 will die from the disease. However, with screening and early detection, many of these deaths can be prevented. Most colorectal cancers perform the operations indicated in from polyps, that are abnormal growths in the colon. Left undetected and free to grow, some polyps may develop into cancer. Screening tests can find and remove precancerous polyps before they turn into cancer.
Colorectal Cancer Screening Recommendations
For normal risk individuals, the American College of Gastroenterology recommends screening beginning at age 50 (age 45 for African-Americans). The preferred screening test according to the American College of Gastroenterology is colonoscopy each 10 years. An alternative strategy for average risk individuals is an annual stool test in favor of blood and a lithe sigmoidoscopic exam every 5 years. Unlike colonoscopy, this approach does not allow identification and removal of polyps in the entire colon.
For those with a family history of colorectal cancer, testing should make a beginning at 40 years of age or 10 years younger than the mature years of the youngest insincere relation at the time of colon cancer diagnosis, whichever is earlier. For both average and high risk individuals, all potential precancerous polyps should be removed.
Earlier Screening Recommended for African-Americans: Begin at Age 45
African-Americans are diagnosed with colorectal cancer at a younger age than other ethnic groups, and African-Americans with colorectal cancer have decreased survival compared with other ethnic groups. Physician experts from the American College of Gastroenterology in 2005 issued new recommendations to healthcare providers to begin colorectal cancer screening in African-Americans at age 45 rather than 50. Colonoscopy is the preferred method of screening for colorectal cancer and data support the recommendation that African-Americans begin screening at a younger age because of the increased frequency of colorectal cancer and a greater superiority of proximal or right-sided polyps and cancerous lesions in this population. The recommendations were published in the March 2005 issue of The American Journal of Gastroenterology.
About the American College of Gastroenterology
Founded in 1932, the American College of Gastroenterology (ACG) is an making with an international membership of more than 10,000 individuals from 80 countries. The College is committed to serving the clinically oriented digestive disease specialist though its emphasis steady scholarly practice, teaching and research. The deputation of the College is to serve the evolving needs of physicians in the delivery of high quality, scientifically blameless, humanistic, ethical, and cost-effective health care to gastroenterology patients.
American College of Gastroenterology (ACG)
6400 Goldsboro Rd., Ste 450
Bethesda, MD 20817
United States
http://www.acg.gi.org
First Step To Create Cystic Fibrosis Model Using Pigs
Cystic fibrosis is the most common genetic disease in Caucasians. The median lifespan for those with the disease is 36 years, and lung disease is the major mainspring of mortality. For years, scientists have studied cystic fibrosis using mice in which the cystic fibrosis gene was altered. However, mice chouse not develop lung disease like humans with cystic fibrosis. Now, researchers at the University of Missouri and the University of Iowa have taken the leading rundle in developing a pertaining to swine cystic fibrosis model that may more faithfully mimic the ailment in humans. The investigation will be published in the upcoming edition of the Journal of Clinical Investigation.
“When you make the same genetic mutations in mice that people have, mice don’t get the lung disease that’s associated with cystic fibrosis, for a like reason no model currently exists to research lung disease caused by cystic fibrosis,” said Randy Prather, distinguished professor of reproductive biotechnology in the MU College of Agriculture, Food and Natural Resources. “Compared to mice, pigs may be a good model for human genetic diseases because their anatomy, biochemistry, physiology, size and genetics are more similar to those of humans.”
Prather collaborated with Michael Welsh from the Howard Hughes Medical Institute at the University of Iowa. To create the genetic defect in pigs, a team led by Welsh made genetic modifications in pig cells. Prather’s group for this reason generated the genetically modified pigs from the cells using a method called nuclear transfer. With the genetic modifications, the researchers hope they will be able to mimic the lung disease that afflicts humans who consider cystic fibrosis.
However, the pigs that were generated only carried one original of the mutated gene. Since these pigs do not have both copies of the mutant gene, they do not show signs of cystic fibrosis. So Prather bred the pigs naturally and the researchers are expecting animals in Spring 2008 that should have both copies of the affected gene. Both researchers said they will have to wait to see if the pigs that carry both copies of the deficient gene display symptoms related to those associated with cystic fibrosis in people.
“The gene that is mutated in individuals with cystic fibrosis was discovered in 1989; yet, we still do not understand many aspects of this disease and our treatments remain inadequate,” Welsh said. “Although scientists and physicians have learned much from studying cystic fibrosis mice, to form progress and improve treatments, we need an animal that at least partially mimics the lung disease of humans. We also are moving with other University of Iowa researchers who are doing similar moil with ferrets. We hope that these first steps will ultimately provide scientists with the means to better probe cystic fibrosis and aid those who suffer its ravages. We acquire our fingers crossed that these animal models will help.”
The production of these pigs could provide researchers with opportunities to conduct studies investigating treatments and therapies for cystic fibrosis that were not previously possible. Scientists have used mice when studying a variety of other diseases that affect humans. However, there are many diseases where mice fail to replicate the human symptoms. For example, more than 11 mice models have been developed to study cystic fibrosis; yet, none of them developed the spontaneous lung disease.
“We believe that this discovery could lead to additional uses of the pig when studying other diseases,” Prather said. “The pig is very much like humans in many respects and may be a key to finding cures, treatments and therapies for many diseases that affect the world.”
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Article adapted by Medical News Today from original press release.
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The study was funded by grants from the National Institutes of Health, the Howard Hughes Medical Institute and the Cystic Fibrosis Foundation.
Source: Christian Basi
University of Missouri-Columbia
JACC Identifies DEFER With 5 Year Outcomes As Landmark Trial
The Journal of the American College of Cardiology has recognized the five year follow up results of the DEFER (Deferral Versus Performance of PTCA in Patients Without Documented Ischemia) as one of the studies that had the greatest impact on cardiology in 2007, according to an article entitled “Highlights of the Year in JACC” by Anthony N. DeMaria, MD, et al. (JACC Vol. 51, No. 4, 2008 January 29, 2008:490-512)
Initially published in the May 29, 2007, issue of the peer-reviewed journal, DEFER concluded that patients treated based on broken flow reserve (FFR) results had achieved long-term outcomes equal, or superior, to patients who underwent stenting solely based on angiographic evidence. The study’s investigators measured FFR using PressureWire(R), a diagnostic utensil developed by the agency of Radi Medical Systems AB.
Dr. Nico Pijls, the study’s principal investigator, said, “From the DEFER study and other recent publications, it has become clear that the key issue in deciding which lesions should be stented is knowledge about whether a stenosis is responsible for ischemia. We are glad that JACC has recognized this study that demonstrates the weight of FFR and its role in interventional cardiology.”
FFR expresses maximum achievable blood flow in a coronary artery with abnormal stenosis as a fraction of maximum blood flow in the absence of a stenosis. FFR is 100% specific in identifying what one. lesions are actually causing the flow restriction and may be treated.
“The DEFER data was, and continues to be, any important topic of discussion among cardiologists,” said Jim Archetto, Chief Operating Officer of Radi Medical Systems, Inc. “There is a lot of uncertainty in interventional cardiology when it comes to determining whether or not a stent is necessary. Measuring FFR is the only way physicians can determine with precision that a suspect lesion requires treatment.”
As an adjunct to DEFER, authors gain designed a new 1000 patient study, Fractional Flow Reserve Versus Angiography for Multivessel Evaluation (FAME) (American Heart Journal Volume 154, Number 4). The objective of this groundbreaking, multicenter, randomized clinical trial is to compare angiographic guidance versus fractional flow reserve (FFR) to determine which coronary lesions to stent in patients with multivessel coronary disease.
The primary end point of the study is a composite of major adverse cardiac events, including death, myocardial infarction, and repeat coronary revascularization, at 1 year.
About Radi Medical Systems AB
Radi Medical Systems AB (Radi) develops, manufactures and sells medical devices designed to improve patient care. The company’s pioneering work in the field of interventional cardiology has resulted in market-leading intravascular sensors and hemostasis management and radiology devices. Radi works closely with medical practitioners to develop solutions that discourse clinical needs, as well as provide clinical education support. Founded in 1988, Radi employs in addition than 350 people globally and has representation in more than 40 countries. The company is based in Uppsala, Sweden, and maintains a U.S. headquarters in Wilmington, Mass. For more information, visit http://www.radi.se.
Radi Medical Systems AB
http://www.radi.se
People With Albinism Wanted For Survey, Australia
A University of Queensland researcher is seeking volunteers with albinism to without fault a survey that will provide the first snapshot of the disease in Australia.
Helene Johanson, a PhD student at UQ’s Institute for Molecular Bioscience, hopes to clarify the levels of albinism in Australia, for which there are no published statistics.
“Researchers are currently using statistics collected in the United States approximately a decade ago,” Ms Johanson said.
“The United States has a very different population demographic when compared to Australia and the South Pacific.
“This survey should allow us to identify how frequent adults and children in Australia are affected by this disease, with the tools and materials aiding public health planners, researchers and managers.
“The survey is completely dependent on volunteers, and we would be very grateful for the help in generating accurate statistics.”
The survey is part of Ms Johanson’s wider PhD project, which focuses on identifying the genetic cause of albinism in individuals from Australia and the South Pacific region.
Albinism is a rare genetic condition where individuals cannot produce the pigment melanin, or can merely produce it at very low levels.
Melanin is the pigment responsible for eye, hair and skin colour, so those with the condition often have very light colouring in these features.
They also suffer from eye problems, including poor vision, a condition called nystagmus what one. produces rapid involuntary movements of the eye, and strabismus, which occurs when sufferers cannot align their eyes simultaneously.
To access the take a view of, please visit http://research.imb.uq.edu.au/albinism/ by April 30, 2008.
The survey should not take more than five - 10 minutes to complete, and preliminary findings behest be presented at the Albinism Fellowship of Australia Conference in Adelaide in April.
Information collected during the inspection will be completely confidential. The survey has been cleared by the Human Ethics Committee of The University of Queensland in accordance with National Health and Medical Research Council guidelines.
The University of Queensland, Brisbane Australia
Facing Loss Of Beloved Hospital, St. Luke’s RNs Overwhelmingly Vote To Authorize 10-Day Strike Against Sutter, California
Just weeks after the neonatal intensive care unit at St. Luke’s Hospital was closed by Sutter Health, RNs from the facility voted overwhelmingly to authorize their bargaining teams to strike the hospital chain for up to ten days over a pattern of medical redlining, as justly serious issues of patient safety and healthcare for nurses, the California Nurses Association/National Nurses Organizing Committee reports today.
Nurses from St. Luke’s have joined together with community members in a campaign to save the hospital, which has operated for nearly 140 years with a mission to serve the underserved. Sutter Health has been attempting to close the facility in order to concentrate its medical services in wealthier parts of town-a medical redlining strategy similar to that which they are employing at San Leandro Hospital and Sutter Santa Rosa. St. Luke’s is the only private hospital in the southern half of San Francisco.
With the strike vote, St. Luke’s nurses join colleagues from California Pacific Medical Center, Sutter Solano, Alta Bates-Summit Medical Center, Mills-Peninsula Health Services and San Leandro Hospital in authorizing the strike.
Nurses from two other facilities vote today, and RNs from Fremont-Rideout Health Group in Marysville and Yuba City and Contra Costa Regional Medical Center in Martinez, two non-Sutter facilities, will hold strike votes on Friday.
Jane Sandoval, an RN at St. Luke’s Hospital said: “We will save St. Luke’s because we must. Our patients depend on this hospital, our community depends on this hospital, and the entire city depends on this hospital. Sutter is closing this hospital unit by one, and RNs will strike rather than allow them to continue.”
In the North Bay, votes at Marin General, Sutter Santa Rosa, and Novato Community Hospital have been postponed due to the hospitalization of CNA’s regional representative with cardiac trouble. The votes will be rescheduled for a later date.
5,000 RNs have walked out of 11 Sutter facilities twice already. The key reason for the walkouts is the pattern of patient safety risks caused by dint of. Sutter’s refusal to schedule RNs to care for patients when nurses are on legally-mandated meal or rest breaks. Such scheduling gaps leave patients unattended and at risk for sentinel events.
Nurses are also concerned extremely Sutter’s exercise of ‘medical redlining’ by closing three hospitals in medically-underserved areas (St. Luke’s Hospital in San Francisco, San Leandro Hospital, and Sutter Santa Rosa Medical Center), and their refusal to agree to fair settlements on issues of healthcare and retiree healthcare and pensions.
“At St. Luke’s and other facilities, Sutter should by trying to make sure its patients are guaranteed safe nursing care at all times. Instead, they are digging in their heels, looking to fight nurses tooth and nail, and at my facility are even embarking on retaliation campaigns against nurses,” said Jan Rodolfo, some RN at Alta Bates Summit Medical Center and the elected secretary of the CNA board.
Patient Care Problems Key to Dispute
The key area of dispute is patient care protections. Sutter has rejected the nurses’ proposal for a dedicated meal-and-break relief RN as well as for trained lift teams available 24 hours a day to protect patients from falls and nurses from back injuries. Another important concern is a proposal that all patients are assigned directly to an RN.
Sutter RNs are also incensed by the chain’s attempt at most facilities to cut back healthcare benefits and attempt to shift cost, premiums and fees onto the nurses, both those currently working and retirees. Sutter RNs note that other hospitals, such as Kaiser Permanente, in a very based on competition market during a nursing shortage, offer much better retirement medical benefits and as a result find it easier to recruit and retain nurses.
Hospitals Affected
Sutter hospitals affected are St. Luke’s Hospital and California Pacific Medical Center in San Francisco, San Leandro Hospital, Alta Bates-Summit curative Center in Berkeley and Oakland, Mills-Peninsula Health Services in Burlingame and San Mateo, Eden Medical Center in Castro Valley, Sutter Delta in Antioch, and Sutter Solano in Vallejo.
California Nurses Association
Did Reckitt Manipulate Gaviscon’s Monopoly After It Came Off Patent? UK
According to information which reached BBC’s Newsnight, Gaviscon, a heartburn drug, continued monopolizing the UK market for much longer than it should esteem done, and cost the National Health Service (NHS) approximately £40 million unusual ($78m) because of this.
Internal documents seemed to reveal that executives at Reckitt Benckiser deliberately placed obstacles to prevent generic copies of the drug from being produced and marketed. Newsnight reported that an ex-Reckitt senior executive had cheated the NHS out of millions of pounds. Gaviscon continued being sold to the NHS at three times the price of the generic cost.
Newsnight reported that Reckitt executives bragged about influencing regulatory authorities to slow down the approval for a generic name for Gaviscon. A generic name should have been introduced in 2000.
The generic distinction should have been published in 2000 but Reckitt opposed this. This plan to introduce a generic name and then face a Reckitt objection happened again and again till 2006. According to Reckitt, the objections were related to health and safety. However, according to secret internal documents, the process should be “drag(ged) out as long as possible” as millions of pounds of business was at stake.
The secret internal documents, that should have been shredded excepting weren’t, paint a picture of executives deliberately placing obstacles to trip up or slow in a descending course the introduction of generic competitors by manipulating regulatory authorities.
John Schmidt, a competition lawyer, told Newsnight there is now concern as to whether Reckitt had broken contest law. As the obstacles slowed down the introduction of generic competition, Reckitt worked on doctors to use another Gaviscon formulation whose patent life had not yet expired.
In fact, according to a 2005 PDF document “Reckitt Benckiser and Britannia Pharmaceuticals have been found to have breached the ABPI Code of Ethics in relation to their promotion of Gaviscon Advance. Specifically their representative(s) had said, or otherwise implied, to five practices in Glasgow that the Medicines Management Team supported switching patients from Gaviscon to Gaviscon Advance and that was untrue. The companies were found to be in breach of clause 7.2 (information and claims must not mislead, both promptly or by implication) and clause 15.2 (reps must maintain a high standard of ethical conduct).”
Now, nearly a decade in the pattern of the patent life for Gaviscon had expired, it still represents 88% of the NHS alginic acid compounds market. A generic name has not yet been introduced.
Reckitt Benckiser, in a press release wrote “We are shocked through the allegations made as Reckitt Benckiser is a responsible company in the way it conducts its business.”
Related Article
— Statement In Response To Media Reports About Gaviscon - Reckitt Benckiser Healthcare UK
Written by - Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today
New Findings About The Brain Lead To Treatment For Eating Disturbances
The discovery of the brain’s so called melanocortin system and its central role in controlling liking has paved the way for entirely new possibilities for treating obesity and anorexia. In the latest issue of the prestigious journal Nature Reviews Drug Discovery, Uppsala University researcher Jarl Wikberg and one of his associates present a review of pioneering research in this field that he and other scientists have conducted over nearly two decades.
The mapping of the melanocortin hypothesis was made possible through the cloning of genes for five different melanocortin receptors, which was performed by Jarl Wikberg in collaboration with other researchers in the early 1990s.
“The melanocortin system monitors the energy balance and regulates for what reason much we eat and how much energy the body uses. The result of quite of this is that we maintain our body weight,” says Jarl Wikberg.
But things can go wrong. It is a highly complex system, and even tiny imbalances can settle inalienably major changes. For instance, the melanocortin system is exposed to great genetic variations, and many mutations lead to utmost obesity in early ages. Such mutations are found in 3 6 percent of children who have these problems.
“There are also mutations that affect the system in the opposite direction, and these may be an explanation for anorexia.”
These discoveries have prompted chiefly major drug companies to develop drugs that target melanocortin receptors, for the treatment of eating disorders. Interestingly, the same system has also been shown to be involved in the regulation of sexual behavior, and this has resulted in the creation of drugs for treating diminished sex drive as well.
“In men such usage has become accepted, but it is uniformly controversial to bargain women. It will be interesting to see how an effective treatment for diminished sex drive will be received in the future,” says Jarl Wikberg.
UPPSALA UNIVERSITET
P.O. Box 256
SE-751 05 Uppsala
http://www.uu.se
Statement In Response To Media Reports About Gaviscon - Reckitt Benckiser Healthcare UK
We are shocked by the allegations made as Reckitt Benckiser is a amenable company in the plan of conduct it conducts its business.
Nevertheless, we are profoundly concerned by the inappropriate sentiment expressed in some of the historic internal correspondence reported. We take this very solemnly and have instigated an close internal investigation, and will take action. We also refute much of which has been reported which implies a power and influence we simply do not possess.
The company has never objected to a monograph driven generic name being published. The timetable of which is not, and never has been, within our control - a monograph/generic name could have been published at any time by the regulators without reference to somewhat third part party.
The company made appropriate challenges where it felt it was justified in sequence to render certain patients are prescribed the not oblique treatment. These were within the law and relevant regulations. We stress that the regulators only take a annotate into account which time it is substantial.
Gaviscon is a very small part of the £350m the NHS spends on drugs to treat illnesses such as heartburn and dyspepsia - less than 6%. Patients with heartburn can be treated with many different but equally effective treatments including Proton Pump Inhibitors (PPIs), H2 receptor blockers, and other cheaper alginate equivalents to Gaviscon. These treatments are in the main interchangeable. Ultimately only doctors have sole and absolute choice on which of these to prescribe.
Regarding the specific reference to alleged pressure from sales reps to GPs, we have had one case only regarding this issue relating to 1 single rep (out of 86) working conducive to us in the NHS salesforce. RB accepted the resolution of the ABPI panel in August 2005. This was an unfortunate, one-off incident, not endorsed by the company, the representative was reprimanded, and we directly took all possible steps to avoid any other similar breaches of the code. Since then we have not one evidence or record that any sales reps have breached the Code of Practice.
Gaviscon Original and Gaviscon Advance have been available in the NHS since 1971 and 1997 respectively and both remain available for doctors to prescribe today. Gaviscon Advance is a sixtieth part of a minute generation alginate product - the result of considerable investment in R&D - with proven stronger, longer lasting effect and lower sodium salt content. Given its improved properties, drench for disagreeable lot Gaviscon Advance still costs exactly the same as Gaviscon Original - providing doctors and patients with a better crops, at no additional cost.
http://www.reckittbenckiser.com
Related Article
— Did Reckitt Manipulate Gaviscon’s Monopoly After It Came Off Patent? UK
Written by - Christian Nordqvist
Higher Antioxidant Properties In Torrefacto-Roasted Coffee
Torrefacto-roasted coffee has higher antioxidant properties than natural roast, according to the dissertation defended by a biologist of the University of Navarra, Isabel López Galilea. She has emphasized in her study that the etc. of sugar during the roasting process increases the development of compounds with high antioxidant activity.
The researcher of Department of Food Sciences, Physiology and Toxicology of the University of Navarra analyzed eleven varieties of commercial coffee for her study, which was entitled “The Influence of Torrefacto Roasting on the Principal Components of Coffee and its Antioxidant and Pro-oxidant Capacity.”
As this scientist of the School of Sciences emphasized, numerous studies have shown the benefits of this drink. In particular, it is considered to be one of the best sources for antioxidants in the diet; these substances help to protect us against free radicals, which are a cause of premature aging and certain diseases. Coffee has an antioxidant capacity which is ten times higher than other drinks, such as red wine and tea.
The antioxidant capacity varies according to the preparation method
In order to bear up out this study, Isabel López analyzed the coffee consumption habits of the inhabitants of Navarra, via 300 surveys. The results showed that Navarrans consume an average of 125 ml of coffee per day, with consumption slightly higher among women. In addition, they in a primary manner consume ground coffee resulting from a mixture of natural roast and torrefacto-roast coffees, and the coffee is generally prepared with Italian or mocha coffee makers, followed by the filter, espresso and pump methods.
After confirming the increased antioxidant capacity of ground coffees roasted using the torrefacto process, she showed how these properties were present in the brewed coffee, which is the typical form of coffee consumption. In regard to the different preparation methods, she discovered that espresso machines produce a drink with the highest antioxidant dimensions, more than coffee produced by the Italian, filter and pump methods. These properties may be due to the greater content of ‘brown compounds’ [compuestos pardos] developed during the roasting management, as well as to polyphenic compounds and caffeine.
In addition, she demonstrated that both the compounds contained in coffee as well as its aroma are affected by the type of roast and the system of extraction; nevertheless, this is a topic that will require further meditate in order to identify results while burdened with varying conditions. In her study, Dr. López identified 34 volatile compounds with high aromatic impact on coffee drinks, and new aromatic compounds were detected, such as octanol, which produces an strained orange aroma.
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Article adapted by Medical News Today from original press release.
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This release is available in Spanish.
Source: Garazi Andonegi
Elhuyar Fundazioa
Newly Defined Signaling Pathway Could Mean Better Biofuel Sources
A newly defined biochemical pathway in plants may provide the scientific tools to design plants that will yield larger quantities of alternative transportation fuels than currently can be produced, according to Purdue University researchers.
The pathway moves materials that determine cell shape and size through a system of signaling proteins, reported Dan Szymanski, a plant geneticist and cellular biologist. By learning more about the growth and development process, it may be possible to engineer plants with improved properties such as cell walls that are additional massive or are more easily fermented in the biofuel process.
“We expect that cell wall material will to be a major source of biomass from plants designated for biofuel production,” Szymanski said. “We need to learn more about how plant cells control the quality and amount of cell wall material.”
He and his research team investigated plant growth and cell wall development from several scientific approaches in determining the cascade of events that leads to changes in the cell wall. They discovered that a protein called “SPIKE1″ directs the protein signaling course of life. They report their findings in “Early Edition,” the online publication of the journal Proceedings of the National Academy of Sciences. The study also will be published in the journal’s March 11 print issue.
“Plant cells grow by expansion, which is cell wall synthesis coupled through an increase in cell size,” Szymanski said. “The key questions we need to answer in trying to create plants more valuable for biofuel production center on understanding how plants integrate metabolism, cell growth and biomass production.”
To answer those questions and be able to engineer plants for improved growth of biomass for alternative fuels, Szymanski and other scientists must investigate molecular function.
“Our research is focused on understanding signaling mechanisms,” he said. “to what degree does a cell interpret multiple types of information and then translate that information to a signal that says, ‘Grow here, or shape or reinforce the cell wall here.’ Or to the kind of extent does a cell know to make new cytoskeleton filaments at a certain time and place to define regions of growth that determine the cell’s shape and size?”
Actin filaments comprise the cytoskeleton, which is the roadway for delivery and recycling of materials that drive plant growth and determine the cell shape and size. Actin is an abundant protein in organisms that have multiple cells with nuclei.
SPIKE1 is a master regulator of many growth control pathways, including the protein signaling pathway that produces the cytoskeleton. Szymanski and his colleagues were able to demonstrate that one of SPIKE1’s functions is to control product of actin filament, which defines localized cell regions since delivery and recycling of growth materials.
“Wall construction in plants, just as in a road stand out, is a coordinated effort,” Szymanski said. “The provision and demand of the materials needed during growth must be coordinated. The question is, how do cells regulate this?”
The signaling pathway, headed by SPIKE1, is responsible for organizing activities during construction - delivering materials and recycling materials that are used during growth, he said. After SPIKE1 initiates communication among proteins along the pathway, actin filaments are produced and changes in cell shape and size occur.
Cells also must coordinate with the activities of surrounding cells that have different shapes and functions.
“Cell expansion occurs in a crowded, but accommodating environment,” Szymanski said. “As neighboring cells expand, this growth intrudes upon a neighbor. SPIKE1 generates signals so that cells can coordinate through neighboring cells’ activities to promote organized cell expansion and proper cell-to-cell adhesion.”
Szymanski and his colleagues used an altered version of the mustard family laboratory set in the ground Arabidopsis to study SPIKE1’s function and declare by verdict the proteins that it activates and to which it binds.
They found that when they created mutant plants by switching off the SPIKE1 gene so that the function is lost, one result was improper growth that manifested as holes in the leaf epidermis.
By studying the results of turning off various other protein complexes in the pathway, Szymanski’s team was quick to follow the sequence of events that occur during signaling.
They also found that plants in which the function of one of the pathway’s signaling proteins was altered resulted in mutants that all looked alike, Szymanski said. This suggested that the three major protein complexes the scientists investigated all function in a common pathway. The Purdue research team confirmed this by making returning upon one’s track mutants - plants in which couple of the proteins had been switched off. One of the pathway’s protein complexes, called “WAVE,” functions the corresponding; of like kind way in both humans and Arabidopsis, and the SPIKE1 signaling pathway is likely to function in other plants including rice and corn.
However, in other organisms with SPIKE1-like genes, switching off the gene kills the organism. This lethality has made it difficult for scientists to understand the function of SPIKE1 and comparable genes in other organisms, including humans. Since Arabidopsis survives when SPIKE1 is disrupted, the Purdue team was able to determine the signaling pathway.
The scientists hypothesize that SPIKE1 may both generate and organize protein complex signaling, Szymanski said. They also need to discover what activates SPIKE1. When the researchers understand enough about the processes involved in plant small cavity growth and development, then they may exist able to design plants that are bigger with more cell wall that can exist processed into biofuel.
“Learning more relative to SPIKE1 likely will help us gain a better understanding of the mechanics and regulation involved with the pathways that control cell architecture and exhibition in plants, and also may be relevant to animal and human expansion and development,” Szymanski said.
The other researchers involved with this study were graduate student Dipanwita Basu, postdoctoral students Jie Le and Taya Zakharova, and research technician Eileen Mallery. the whole of are in the Purdue Department of Agronomy.
The National Science Foundation and the Purdue Agricultural Research Program funded this project.
http://www.purdue.edu
News From Molecular And Cellular Proteomics
Tracking a Deteriorating Heart
Researchers have conducted a detailed molecular survey of how heart muscle proteins change over time in diseased tissue, revealing clues that may lead to earlier diagnosis of heart disease.
Despite great progress in reducing mortality, cardiomyopathies (diseases affecting heart muscle) remain one of the leading killers in the developed world. A big contributor to this mortality is that many patients only finish diagnosed at later distemper stages, limiting therapeutic options.
Tony Gramolini, Andrew Emili and their colleagues sought to obtain more insight into cardiomyopathy progression, so they performed a large-scale protein survey of mouse cardiac cells affected through a alteration that weakens the muscle. They compared protein profiles at 8, 16, and 24 weeks of both diseased and health-giving animals.
The researchers noticed time-dependent changes in 593 proteins, around 40 of which were particularly strong. While the altered proteins affect a variety of biological pathways, an inability to maintain the proper calcium balance, leading to increased cell inclemency, was heavily affected. Restoring this balance might be a key to treating these heart conditions early on.
Corresponding authors:
Andrew Emili, Donnelly Centre for Cellular and Biomedical Research, University of Toronto, Ontario
Anthony O. Gramolini, Charles H. Best Institute, University of Toronto, Ontario
Understanding Our Saliva
Researchers have developed a novel technique to separate and analyze all the proteins found in human saliva, not just the soluble ones, providing every approach that may reveal protein markers for oral cancer and other disorders in the oral cavity.
Saliva contains an abundance of proteins that could be used to screen for diseases, particularly oral diseases. Until now, nevertheless, studies be under the necessity only focused on the small subset of free-floating saliva proteins. Far more proteins are present inside of oral cells, and Timothy Griffin, Nelson Rhodus and colleagues developed a method, called three-step peptide fractionation, to look at those understudied proteins.
They analyzed saliva samples from four oral cancer patients and identified over 1000 human proteins, including many known cancer associated proteins. In addition, they separated out proteins from over 30 different bacteria, people of which have not been previously found in saliva, and several of which may also have possible cancer links.
The researchers note that the actual death of numbers rate for oral cancer has hardly declined extremely the past 30 years; their technique, providing the first description of using whole cells to identify the vast array of human and bacterial proteins in saliva, may help become identical new markers for verbal cancer progression.
Corresponding Authors:
Timothy Griffin, Department of Biochemistry, Molecular Biology, and Biophysics, University of Minnesota, Minneapolis
Nelson Rhodus, Division of parole Medicine, School of Dentistry, University of Minnesota, Minneapolis
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Article adapted by Medical News Today from original press release.
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The American Society for Biochemistry and Molecular Biology is a nonprofit scientific and educational organization through over 11,900 members in the United States and internationally. Most members teach and conduct research at colleges and universities. Others conduct research in various government laboratories, nonprofit scrutiny institutions and industry. The Society’s student members attend undergraduate or graduate institutions.
Founded in 1906, the Society is based in Bethesda, Maryland, on the campus of the Federation of American Societies on the side of Experimental Biology. The Society’s purpose is to advance the science of biochemistry and molecular biology through publication of the Journal of Biological Chemistry, the Journal of Lipid Research, and Molecular and Cellular Proteomics, organization of scientific meetings, advocacy for funding of basic research and education, support of science education at all levels, and promoting the diversity of individuals entering the scientific work force.
For more information about ASBMB, see the Society’s Web site at http://www.asbmb.org/.
Source: Nick Zagorski
American Society for Biochemistry and Molecular Biology
New Development In Computed Tomography: Dual Energy
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.
Research in computed tomography is currently focused on using dual energy (DE) to distinguish between different tissues on CT images. While other manufacturers are trying to generate different energies with a single X-ray tube, Siemens launched the Somatom Definition already four years ago - a Dual Source CT scanner with two X-ray tubes that simultaneously work with two different radiation energies. A great variety of information about the type and composition of the tissue and the perfusion of an organ can be derived from a data record acquired with a single scan for which several test steps or procedures had been necessary in the past. The dual energy procedure spares the patient several scans, accelerates clinical workflows and opens up new clinical fields of application for computed tomography.
One of the new dual energy applications for the Somatom Definition from Siemens is syngo DE Heart PBV (Perfusion Blood Volume), which provides color-marking of non-perfused parts of the myocardium during cardiological examinations. Moreover, a specific application enables the solitary display of the heart, for example without thorax structures. The heart perfusion is examined primarily after an infarction to determine damaged areas of the organ. DECT for the first time allows to detect a stenosis and the stenosis degree as well as the location and extent of the resulting reduced perfusion in the myocardium in a single scan.
Deposits of uric acid crystals in the joints of gout patients may damage the cartilaginous and bony substance, particularly if the disease has been chronical for diverse years. With syngo DE Gout, computed tomography can for the first time be used also for gout detection. The of recent origin DE application assists the physician in clearly identifying uric acid crystals in the extremities and monitoring changes in the crystals in the course of treatment.
Syngo DE Lung Vessels provides a whole series of new applications to assist the physician in CT examinations of patients with suspected pulmonary embolism - a sudden occlusion of blood vessels in the lungs. The new applications enable the detection of non-perfused blood vessels and tissue of the lungs through color-marking. The application “Lung Isolation” isolates the entire organ to allow the assessment of the perfusion situation without obstructing neighboring organs.
Syngo DE Brain Hemorrhage assists in the distinction between new and old hemorrhages in the event of cerebral bleeding. The two force levels of the X-ray tubes are used to fade out the contrast medium (CM). In the past, this had required two scans. The CM subtraction offers two advantages: A non-CM enhanced examination is not necessary and the patient is spared the dose of a second scan.
The four new DE applications presented by Siemens at the ECR 2008 supplement the six already existing CT applications with dual energy features:
- syngo DE Direct Angio for the distinction of bone and vessel structures, particularly if the vessels are located immediately next to the bone
- syngo DE Lung PBV for perfusion assessment of the lung tissue
- syngo DE Muskuloskeletal for the display of ligaments and tendons
- syngo DE Calculi Characterization for the automatic note of the biochemical composition of renal calculi, e.g. uric acid or calcium oxalate
- syngo DE Hardplaque for the display of calcification in the body and determination of the vessel status
- syngo DE Virtual Unenhanced for the subtraction of contrast medium in abdominal scans
About Somatom Definition
With the Somatom Definition, Siemens has developed the first Dual Source computed tomography system worldwide. The system is equipped with two X-ray tubes and pair detectors, allowing clinical scans at unprecedented speed. The Somatom Definition aquires images of outstanding quality and detail even of hearts with a high heart rate or irrgular heartbeat - at only half the dose of previous systems. The two X-ray tubes provide the plan with features previously not existing in diagnostic imaging. This incluces the possibility of simultaneously operating the X-ray tubes at different voltage levels (dual energy) in a single scan so that two data records with different patient information are generated, thereby allowing to display tissue and fluids and facilitating the distinction of vessels, bones and soft tissue.
Siemens Healthcare is one of the world’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 fully integrated diagnostics fellowship, bringing together imaging and lab diagnostics, therapy, and healthcare information technology solutions, supplemented by consulting and aid services. Siemens Healthcare delivers solutions across the entire continuum of care - from prevention and early detection, 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 benefit of €1.32 billion. Further information can be found by visiting http://www.siemens.com/healthcare.
Siemens Healthcare
After Radical Retropubic Prostatectomy ‘Insignificant’ Prostate Cancer Has A Risk Of Progression Similar To Low Risk ‘Significant’ Cancer
UroToday.com- In a report in the January, 2008 issue of the British Journal of Urology International, Dr. Sengupta and associates from the Mayo Clinic assess the risk of progression and death among patients with pathologically insignificant tumors after radical prostatectomy (RP) for prostate cancer (CaP). Insignificant CaP was defined as a pre-surgical PSA <10ng/ml, a cancer volume of <0.5ml, a pathologic Gleason score <7, and pathological stage
A total of 6,496 patients eligible for the study were identified in the Mayo Clinic Prostatectomy Registry. Preoperative clinical variables were reviewed to include PSA doubling time (PSADT) when available. Cancer volume was obtained by 3-dimensional measurement of the largest tumor nodule. Endpoints included biochemical progression-free survival (bPFS) as defined by a PSA level >0.4ng/ml, systemic PFS (sPFS) defined as a positive bone scan or biopsies of other sites of CaP, cancer-specific survival (CSS), and overall survival (OS). Insignificant CaP was found in 354 (5.5%) patients and the pathological features of these tumors were more favorable than those with “significant” tumors. These men were younger, less likely to have palpable disease, or Gleason scores of >7. PSADT was evaluable in only 159 men with insignificant CaP and 1,950 men with significant CaP. A PSADT of <1 year was present in a similar proportion of both groups. However, among men with insignificant tumors, a PSADT of 1-10 years was less frequent and a PSADT of >10 years more frequent. Significant univariate predictors of insignificant pathology at RP included age, clinical stage, biopsy Gleason score, and PSADT. It was not possible to assess extent of CaP on biopsy, as most were performed at other institutions. On multivariate analysis, all these factors remained significant except age. Clinical stage had the strongest association. At a median follow-up of 9.2 years, only one man with insignificant CaP developed metastasis and none had died from CaP. The 10 year bPFS (87% vs. 66%), sPFS (100% vs. 94%), OS (91% vs. 85%), and CSS (100% vs. 97%) were each significantly better for men with insignificant vs. significant CaP, respectively. The investigators further defined 1,287 patients with low-risk CaP in the significant CaP group. The bPFS, sPFS, OS, and CSS were similar among the low-risk men and those with insignificant CaP. Thus, the 10 year risk of metastatic lapse and death is close to non-existent among patients with insignificant CaP, but the risk of biochemical recurrence is 13%. Whether the differences in the definitions of insignificant and low-risk CaP need reassessment is a question raised by this study. Sengupta S, Blute ML, Bagniewski SM, Inman B, Leibovich BC, Slezak JM, Myers RP and Zincke H UroToday - the only urology website with original content written by global urology key opinion leaders actively engaged in clinical practice. To access the latest urology news releases from UroToday, go to: www.urotoday.com Copyright © 2008 - UroToday
Innovations Help Improve Radiology Processes And Research
Developing networks, improving communication, simplifying work - the term “workflow” includes all of this and is playing an increasingly important role in modern healthcare. At the ECR (European Congress of Radiology) in Vienna, Austria, Siemens Healthcare is presenting a whole array of IT services in spite of radiology and its communication within hospitals and with physicians’ practices. The new role-based portals syngo Portal Radiologist, syngo Portal Referring Physician and syngo Portal Executive (the latter still in development), support radiologists and hospital personnel with intelligent access to and management of uncomplaining images, data or reports. All portals contribute at various levels not only to optimization of workflows, but also furnish supplies users with innovative applications pertinent to the context of their business. This is supplemented by new applications for computer-aided detection (CAD).
The three portals syngo Portal Radiologist, syngo Portal Referring Physician and syngo Portal Executive are vital part components of the workflow innovations. They offer role-based access to applications and information critical to the daily functions of radiologists and other caregivers.
Syngo Portal Radiologist is intended to help radiologists with their specific tasks: For example, they can use the Check Requests, Read Images, and Sign Reports functions which allow the radiologists to organize their work according to the workflow step. An “integrated” quick understanding provides the user with access to the next logical application according to the workflow step he or she is carrying out.
Syngo Portal Referring Physician is also a role-based solution and supports the referring physician in communication with the radiology department. The portal enables physicians to schedule appointments directly from the ward or referring physician’s office. Predefined demand forms provide the option of recording clinical information beforehand and thus allow radiologists the ability to easily identify contraindications such as metal implants in MR patients.
Syngo Portal Executive is designed especially for executives in hospitals and clinics. They can practice this, for example, to simplify the planning of resources in the radiology department, or measure turnaround times for reports. A special advantage: The user interface can be individually customized to spasm the requirements of the hospital or the radiology department. This enables proactive decision management and better strategic planning.
Innovation in radiology workflow with syngo Imaging
A revised version of the picture archiving and communication system (PACS) syngo Imaging will also be shown at the ECR. Syngo Imaging supports exclusive independent CAD applications, such as syngo Lung CAD for detecting pulmonary nodules in thorax CT studies and syngo Chest X-ray (CXR) CAD for detecting pulmonary nodules in digital thorax X-ray images. For the first time syngo TrueD, an innovative software application used to interpret multimodal imaging procedures in oncological diagnosis, is also available on the PACS system. These applications provide extensive support in the diagnosis of the examining radiologists, who can analyze and compare the images directly via the PACS.
Oncological diagnosis and follow-up with syngo TrueD “Read anything from anywhere,” states James Busch, M.D., chief executive officer, Specialty Networks L.L.C. and a radiologist with Diagnostic Radiology Consultants (DRC) in Tennessee. “Syngo TrueD is a powerful post-processing application focusing on fusion imaging. The user interface is intuitive which drastically simplifies PET•CT explanation and it’s available wherever the radiologist is interpreting images.”
The newest version of syngo TrueD supports the oncological workflow in diagnosis, staging, and assessment of cancer treatment response. The application have power to load and simultaneously display anatomical and functional images from three points in time, for copy, from the initial examination and two follow-up exams. This serves to considerably simplify examinations for the time of the course of an illness or treatment.
Siemens Healthcare is one of the world’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 fully integrated diagnostics company, 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 early detection, 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
Effects Of Pathologic Stage On The Learning Curve For Radical Prostatectomy
UroToday.com - In the online version of European Urology, a group from Memorial-Sloan Kettering Cancer Center, the Cleveland Clinic and Wayne State investigate how pathologic stage would affect the learning curve in radical prostatectomy (RP) for prostate cancer (CaP). Andrew Vickers is the lead author.
There is existing evidence that the outcomes of cancer surgery are associated with characteristics of the operating surgeon. Surgeons with higher annual case volume have lower mortality rates for numerous procedures. This study hypothesized that differences in the learning bend. between organ-confined and locally advanced CaP would be informative as to cancer biology. The study cohort analyzed 7,765 men who underwent RP by 1 of 72 surgeons at 4 institutions between 1987 and 2003. Cancer recurrence was defined as a serum PSA >0.4ng/ml with a second, higher subsequent PSA. Locally advanced CaP was defined as the presence of extracapsular extension, seminal vesical invasion, or lymph node involvement. A multivariable, parametric survival-time return. model was performed. The researches adjusted for differences in case mix and included clinical and pathologic variables. For eddish. patient surgeon experience was coded in the manner that the number of RPs performed by the surgeon prior to the patient’s operation. The question was whether more experienced surgeons have better results irrespective of pathologic stage, or whether the association between experience and outcome depends on pathologic stage in the RP specimen.
There were 5,342 patients with organ confined CaP and 2,423 patients with locally advanced CaP. A moderate, but statistically significant negative association between pathologic stage and surgeon actual feeling was found. This appeared due to stage migration, as no important association between surgeon experience and organ-confined rank when separation was restricted to patients treated after 1995. A total 1,256 recurrences were identified at a median follow-up time of 3.9 years. Surgeon experience was associated with outcome for both patients with organ-confined or locally advanced CaP. The learning curve for locally advanced CaP reached a plateau at a 30% probability of recurrence at 5 years, whereas for organ-confined CaP the learning curve continued to rise towards a 100% recurrence-free probability. Among patients with organ-confined CaP operated on through surgeons who performed at least 1,000 prior RPs, the median 5-year recurrence-free probability was 97%. The learning curve for advanced CaP was steeper, with the adjusted 5-year probability of recurrence for a surgeon with 250 prior cases was 22% after 1995 compared to 36% in the thorough series, but similar to the main separation this reached a plateau at approximately a 30% probability of recurrence at 5 years. Thus the learning curve for locally advanced disease flattens at approximately 70%, suggesting that about a third of these patients cannot be cured by surgery alone.
Eur Urol. 2008 Jan 14 [Epub ahead of print]
Vickers AJ, Fernando Biancob FJ, Gonena M, Cronina AM, Easthamb JA, Schraga D, Kleinc EA, Reutherc AM, Kattand MW, Pontese E, Scardinob PT
Reported by UroToday.com Contributing Editor Christopher P. Evans, MD
UroToday - the only urology website with source content written by global urology key opinion leaders actively engaged in clinical practice.
To access the latest urology news releases from UroToday, go to: www.urotoday.com
Copyright © 2008 - UroToday
Beyond The Abstract: Anatomic Excision Of Anterior Prostatic Fat At Radical Prostatectomy: Implications For Pathologic Upstaging
UroToday.com - It is very exciting when you take an operation that has been around since 1905 and bare the head new information that was literally seemly in front of us all along. We found several interesting things. First, we found lymph nodes in the anterior prostatic fat (APF) in about 15% of men undergoing radical prostatectomy (RRP).This is really a new finding. A article by Kothari and Scardino in 2001 did describe lymph nodes around this area of the prostate, but did not specifically discuss the APF. Traditionally during RRP this stupid is discarded. This study suggests that perhaps we should be looking at this fat more carefully. Our second finding was the presence of metastases to these nodes in about 2% of patients, particularly in those that had anterior prostate cancers. Of note, one of the patients with a positive APF node had low risk disease (Gleason 3+3 with a PSA of 8.6 ng/mL). Surprisingly, in two other patients with positive APF nodes, their pelvic lymph node dissection was negative, which is of concern. Three of the 4 patients with positive nodes were upstaged as a result of APF node detection. Finally, we found that an anatomic dissection of the APF improved visualization and vascular control of the DVC as well as in greater numbers clearly identifying the apex. A fertile area of future study will be lymphatic mapping of the APF.
Written by David S. Finley, MD and Thomas E. Ahlering, MD as part of Beyond the Abstract on UroToday.com. This initiative offers a method of publishing for the professional urology community. Authors are given every opportunity to expand on the circumstances, limitations, etc., of their research by referencing the published abstract.
Link to original abstract
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A New Dimension Of Ultrasound: The European Debut Of The New System Acuson S2000 From Siemens
Siemens Healthcare is showing its Acuson S2000, the first ultrasound system of the new product series S, at the ECR (European Congress of Radiology) 2008 in Vienna. This system platform includes integration of the newest technologies to optimize workflows and once again considerably simplify the physician’s work. Thus the Acuson S2000 has been equipped with comprehensive software applications such as a new software for breast imaging. The system is also well equipped for future technologies: It enables the implementation of innovative ARFI (Acoustic Radiation Forced Impulse) imaging and is prepared for integration of new silicon ultrasound technology, which is almost ready for the market. The Acuson S2000 is suitable for internal medicine radiology imaging including vascular diagnosis and echocardiography in the same manner with well as gynecology and obstetrics.
One of the most innovative ultrasound applications of the new system is the so-called ARFI ultrasound. It compresses the tissue using acoustic strength and thus allows for qualitative and quantitative evaluation of the stiffness of deep tissue. Current investigation work indicates that this type of evaluation can be helpful in differentiating abnormalities such as liver tumors or quantifying the advancement of fibrosis (development of excess connective tissue). The Acuson S2000 has already been designed since integration of the future silicon ultrasound technology, the first groundbreaking development in probe technology in over 40 years. This technology uses the precise procedures of semiconductor production and realizes isotropic 3D and 4D ultrasound imaging for the first time, which allows for the same true-to-detail representation in every direction.
“We make no doubt of that the ARFI and silicon technologies will make some change in. ultrasound imaging as extensively as Doppler imaging did in its day”, says Klaus Hambüchen, Chief Executive Officer of the Ultrasound Business Unit. “The Acuson S2000 combines innovative technology, the most advanced clinical applications and a highly modern ergonomic design in a single system. It is our new premium platform, which will have a lasting stroke on the further development and significance of ultrasound.”
In addition to this, Siemens is preparing the Acuson S2000 for Automated Breast Scanning (ABS). This method provides automatically created, reproducible 3D ultrasound volumes of the breast. ABS is important for screening, early detection, diagnosis and aftercare for breast cancer and complements mammography, especially for women with dense breast tissue. As compared to manual breast ultrasound, ABS shortens the examination time and reduces user dependency. This makes ultrasound imaging more reproducible and provides more uniform results than before.
Innovative applications of the Acuson S2000 such as the so-called “SieClear Spatial Compounding” additionally increase the reliability of the doctor’s diagnosis. At the push of a button, this procedure allows with respect to highlighting of anatomical boundaries and improves tissue contrast as a whole. When using the Dynamic TCE technology at the same time, these innovations reduce speckle patterns and noise signals and ensure an excellent image rank, even in patients for whom it is otherwise hard to obtain good ultrasound images. For the first time the Acuson S2000 will use this 3D TCE with speckle reduction to acquire 3D images. The High Density (HD) probe technology also results in exceptionally defecate signal levels for excellent depth and contrast resolution.
In addition to this, the Acuson S2000 integrates knowledge-based applications, which make ultrasound examinations significantly more efficient than before. One example is the software solution syngo Auto OB, which creates semi-automatic biometric measurements of the fetus and saves the operator up to 75 percent of the operating steps in a routine examination. The system is equipped with Advanced-fourSight technology, which provides improved functionality on account of volumetric acquisition, data rendering and postprocessing. This software also includes Amnioscopic Rendering, which represents a unique method of surface rendering to show all but photorealistic and detailed views of the fetus. The additional imaging with Fetal Heart STIC (Spatio-Temporal Image Correlation) acquires data over the course of several cardiac cycles and creates a 3D volume of the fetal heart, which the physician can employment to view the heart in several layers.
The software syngo eSie Calcs is yet another special feature of this system. This software is intended for boundary detection and segments the scan areas of interest and automatically calculates all parameters that are important to the physician. The single-minded definition of a delimited area allows for tracing of lesions and calculating either their volumes in 3D or their surfaces in 2D.
The Acuson S2000 was completely redesigned with ergonomic aspects in mind: It is equipped with a simple, intuitive interface that users can adjust to their individual needs. The control panel and the 19-inch flat screen are adjustable and thus accommodate differing user needs. The Acuson S2000 is available for delivery starting in April 2008. You will find the rush images to accompany this press release at the following address: http://www.siemens.com/med-bilder/AcusonS2000.
Siemens Healthcare is one of the world’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 fully integrated diagnostics company, 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 early detection, 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
Elderly Drug Costs Rise
Drug costs have been increasing during 2007, especially those mainly prescribed to elderly.
Report by Association for the Advancement of Retired Persons (AARP) looked at 220 stigma name drugs and found that only 4 of them didn’t change in prices.
Most of increase was reported in drugs generally prescribed to elderly. Ambien by Sanofi-Aventis is the first in the list with 27.7%, blood thinning plavix by Bristol-Myers Squibb rose by means of 0.5%, cholesterol drug zocor by Merck didn’t make different in price.
Starting from January 1, 2006, when Medicare drug benefit started, wholesale drug prices were higher and started increasing, even exceeding inflation. In 2002 remedy prices increased by 5.3%, in 2006 by 6.6%, and in 2007 by 7.4%.
"Unfortunately, many manufacturers have taken the absence of an outcry as a green light to go ahead and raise prices even more," said John Rother, AARP’s policy director.
Pharmaceutical Research and Manufacturers of America, representing pharmaceutical companies, doesn’t agree with the report, saying that AARP didn’t mention drug prices are increasing slower than before, and that the report didn’t take into account generic drugs, which are 2/3 of all prescription drugs consumed.
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