Engineers at the University of California at San Diego have come up with a way to help accelerate bone growth through the use of nanotubes and stem cells. This new finding could lead to quicker and better recovery, for example, for patients who undergo orthopedic surgery.
In recent years, stem cells have become a hot topic of investigation with studies suggesting revolutionary medical benefits due to their ability to be converted into selected types of newly generated cells. During their research, the group of UC San Diego bioengineers and material science experts used a nano-bio technology method of placing mesenchymal stem cells on top of very thin titanium oxide nanotubes in order to control the conversion paths, called differentiation, into osteoblasts or bone building cells. Mesenchymal stem cells, which are different from embryonic stem cells, can be extracted and directly supplied from a patient's own bone marrow.
The researchers described their lab findings in a paper published this week in the Proceedings of the National Academy of Sciences (PNAS), "Stem Cell Fate Dictated Solely by Altered Nanotube Dimension."
"If you break your knee or leg from skiing, for example, an orthopedic surgeon will implant a titanium rod, and you will be on crutches for about three months," said Sungho Jin, co-author of the PNAS paper and a materials science professor at the Jacobs School of Engineering. "But what we anticipate through our research is that if the surgeon uses titanium oxide nanotubes with stem cells, the bone healing could be accelerated and a patient may be able to walk in one month instead of being on crunches for three months.
"Our in-vitro and in-vivo data indicate that such advantages can occur by using the titanium oxide nanotube treated implants, which can reduce the loosening of bones, one of the major orthopedic problems that necessitate re-surgery operations for hip and other implants for patients," Jin added. "Such a major re-surgery, especially for older people, is a health risk and significant inconvenience, and is also undesirable from the cost point of view."
This is the first study of its kind using stem cells attached to titanium oxide nanotube implants. Jin and his research team - which include Jacobs School bioengineering professors Shu Chien and Adam Engler, as well as post doctoral researcher Seunghan Oh and other graduate students and researchers - report that the precise change in nanotube diameter can be controlled to induce selective differentiation of stem cells into osteoblast (bone-forming) cells. Karla Brammer, a Jacobs School materials science graduate student, will also present these findings in a poster session during the Jacobs School of Engineering's Research Expo on February 19.
According to this breakthrough research, nanotubes with a larger diameter cause cells growing on their surface to elongate much more than those with a small diameter. The larger diameter nanotube promotes quicker and stronger bone growth. "The use of nano topography to induce preferred differentiation was reported in recent years by other groups, but such studies were done mostly on polymer surfaces, which are not desirable orthopedic implant materials," Jin said.
It is common for physicians and surgeons to use chemicals for stem cell implants in order to control cell differentiation, a conversion into a certain desired type of cells, for example, to neural cells, heart cells, and bone cells. However, introducing chemicals into the human body can sometimes have undesirable side effects. "What we have accomplished here is a way to introduce desirable guided differentiation using only nanostructures instead of resorting to chemicals," said Seunghan (Brian) Oh, who is the lead author of the PNAS article.
The next step for engineers will be to work with orthopedic surgeons and other colleagues at the UC San Diego School of Medicine to study ways to translate this breakthrough research to clinical application, said Shu Chien, a UC San Diego bioengineering professor and director of the university's new Institute of Engineering in Medicine (IEM). Chien said this effort will be fostered by the IEM, whose goal is to bring together scientists, engineers and medical experts to come up with novel approaches to medicine.
"Our research in this area has pointed to a novel way by which we can modulate the stem cell differentiation, which is very important in regenerative medicine," Chien said. "This will lead to a truly interdisciplinary approach between engineering and medicine to getting novel treatments to the clinic to benefit the patients."
Source: Andrea Siedsma
University of California - San Diego
вторник, 30 августа 2011 г.
суббота, 27 августа 2011 г.
After Hip Replacement Surgery, Rivaroxaban Better Than Enoxaparin For Preventing VTE
Patients who had complete hip replacement surgery, or total hip
arthroplasty (THA), had better success at preventing venous
thromboembolism if they used extended duration rivaroxaban instead of
short-term enoxaparin plus placebo. The results of the full study by
Professor Ajay Kakkar (Barts and the London School of Medicine and
Dentistry and the Thrombosis Research Institute, London, UK) and
colleagues are published in The Lancet.
Venous thromboembolism (VTE) is a potentially fatal blood clot, and its
risk of occurrence is greater after THA. Standard preventative
treatment includes heparin-based thromboprophylaxis (with enoxaparin)
for about 10 to 35 days after surgery, but this clot-preventing
treatment is rarely used after the patient has left the hospital. For
example, one registry reported that less than 50% of patients received
thromboprophylaxis for at least 28 days. To investigate the efficacy of
a new orally active antithrombotic drug, Kakkar and colleagues
conducted the RECORD2 study.
For patients undergoing THA, the randomized, controlled trial compared
31 to 39 days of the oral antithrombotic drug rivaroxaban with 10 to 14
days of enoxaparin followed by placebo in patients undergoing THA.
Specifically, of 2,509 patients scheduled for THA 1,252 were randomly
assigned to receive oral rivaroxaban 10mg once daily for 31 to 39 days
followed by placebo injection for 10 to 14 days, and 1,257 were
randomly assigned to receive enoxaparin 40mg once daily subcutaneously
for 10 to 14 days followed by placebo tablet for 31 to 39 days. The
researchers focused on deep-vein thrombosis (DVT) measurements as well
as non-fatal pulmonary embolism (NFPE) and death from any cause through
days 30 to 42.
Complete data were obtained for 864 patients in the rivaroxaban group
and 869 in the enoxaparin group. Of key interest were the rates of DVT
for each group: 17 patients (2.0%) in the rivaroxaban group and 81
patients (9.3%) in the enoxaparin group. This translates to an absolute
risk reduction of 7.3% for those patients in the rivaroxaban group, or
a four times greater likelihood that patients in the enoxaparin group
suffer DVT, NFPE, or die. There were no significant differences noted,
however, in bleeding events during treatment.
"Extended thromboprophylaxis with rivaroxaban was significantly more
effective than short-term enoxaparin plus placebo for the prevention of
venous thromboembolism, including symptomatic events, in patients
undergoing total hip arthroplasty," conclude the authors.
An accompanying Comment, written by Dr John Eikelboom and Professor
Jeffrey Weitz (McMaster University, Hamilton, ON, Canada), maintains
that, "With superior efficacy, no compromise in safety, and a
convenient once daily regimen, rivaroxaban seems an obvious choice for
simplified thromboprophylaxis after hip or knee arthroplasty."
Extended duration rivaroxaban versus short-term enoxaparin for
the prevention of venous thromboembolism after total hip arthroplasty:
a double-blind, randomised controlled trial
Ajay K Kakkar, Benjamin Brenner, Ola E Dahl, Bengt I Eriksson, Patrick
Mouret, Jim Muntz, Andrea G Soglian, ГЃkos F Pap, Frank Misselwitz,
Sylvia Haas, for the RECORD2 Investigators
The Lancet (2008).
DOI:10.1016/S0140-6736(08)60880-6
Click
Here to View Journal Website
Written by: Peter M Crosta
arthroplasty (THA), had better success at preventing venous
thromboembolism if they used extended duration rivaroxaban instead of
short-term enoxaparin plus placebo. The results of the full study by
Professor Ajay Kakkar (Barts and the London School of Medicine and
Dentistry and the Thrombosis Research Institute, London, UK) and
colleagues are published in The Lancet.
Venous thromboembolism (VTE) is a potentially fatal blood clot, and its
risk of occurrence is greater after THA. Standard preventative
treatment includes heparin-based thromboprophylaxis (with enoxaparin)
for about 10 to 35 days after surgery, but this clot-preventing
treatment is rarely used after the patient has left the hospital. For
example, one registry reported that less than 50% of patients received
thromboprophylaxis for at least 28 days. To investigate the efficacy of
a new orally active antithrombotic drug, Kakkar and colleagues
conducted the RECORD2 study.
For patients undergoing THA, the randomized, controlled trial compared
31 to 39 days of the oral antithrombotic drug rivaroxaban with 10 to 14
days of enoxaparin followed by placebo in patients undergoing THA.
Specifically, of 2,509 patients scheduled for THA 1,252 were randomly
assigned to receive oral rivaroxaban 10mg once daily for 31 to 39 days
followed by placebo injection for 10 to 14 days, and 1,257 were
randomly assigned to receive enoxaparin 40mg once daily subcutaneously
for 10 to 14 days followed by placebo tablet for 31 to 39 days. The
researchers focused on deep-vein thrombosis (DVT) measurements as well
as non-fatal pulmonary embolism (NFPE) and death from any cause through
days 30 to 42.
Complete data were obtained for 864 patients in the rivaroxaban group
and 869 in the enoxaparin group. Of key interest were the rates of DVT
for each group: 17 patients (2.0%) in the rivaroxaban group and 81
patients (9.3%) in the enoxaparin group. This translates to an absolute
risk reduction of 7.3% for those patients in the rivaroxaban group, or
a four times greater likelihood that patients in the enoxaparin group
suffer DVT, NFPE, or die. There were no significant differences noted,
however, in bleeding events during treatment.
"Extended thromboprophylaxis with rivaroxaban was significantly more
effective than short-term enoxaparin plus placebo for the prevention of
venous thromboembolism, including symptomatic events, in patients
undergoing total hip arthroplasty," conclude the authors.
An accompanying Comment, written by Dr John Eikelboom and Professor
Jeffrey Weitz (McMaster University, Hamilton, ON, Canada), maintains
that, "With superior efficacy, no compromise in safety, and a
convenient once daily regimen, rivaroxaban seems an obvious choice for
simplified thromboprophylaxis after hip or knee arthroplasty."
Extended duration rivaroxaban versus short-term enoxaparin for
the prevention of venous thromboembolism after total hip arthroplasty:
a double-blind, randomised controlled trial
Ajay K Kakkar, Benjamin Brenner, Ola E Dahl, Bengt I Eriksson, Patrick
Mouret, Jim Muntz, Andrea G Soglian, ГЃkos F Pap, Frank Misselwitz,
Sylvia Haas, for the RECORD2 Investigators
The Lancet (2008).
DOI:10.1016/S0140-6736(08)60880-6
Click
Here to View Journal Website
Written by: Peter M Crosta
среда, 24 августа 2011 г.
Young Child With Devastating Bone Disease Walks For First Time After Innovative Operation
An innovative operation using "telescoping rods" performed at Hospital for Special Surgery in Manhattan enabled a young Long Island boy to walk for the first time, and the child and his mother are going to Washington, D.C., to tell their story.
Patricia Vega and her son, Ismael, who turns six this month, have been invited to join Dr. Daniel Green, their orthopedic surgeon, to meet with U.S. Senators and Representatives to personally advocate for the future of musculoskeletal care and continued federal funding for research. The American Academy of Orthopaedic Surgeons is sponsoring the event, and Dr. Green and little Ismael are representing the Pediatric Orthopaedic Society of North America.
Dr. Green, a pediatric orthopedic surgeon at Hospital for Special Surgery, implanted the metal rods into the leg bones of little Ismael, who was born with osteogenesis imperfecta, or OI, which caused his bones to be brittle and weak. An innovation in OI surgery, the telescoping rods get longer as the child grows, avoiding the need for repeated operations.
Before the surgery, Ismael was carried around by his parents or used a stroller. His bones were so fragile that by the time he was three, he had suffered 12 broken bones and more than 100 microfractures. Doctors on Long Island told his mother little could be done. They said Ismael would probably never be able to walk and would spend most of his life in a wheelchair.
But Patricia Vega, who is from Hampton Bays, refused to give up hope. One day, a nurse who was assisting Mrs. Vega in caring for Ismael told her the highly specialized pediatric orthopedic surgeons at Hospital for Special Surgery might be able to help him.
Mrs. Vega went to see Dr. Green, who explained that a newer type of surgery using "telescoping" rods could straighten his bones and enable Ismael to walk. The special rods, implanted in his thigh bones, would extend, in essence, growing along with her child. The surgery, in combination with newer bone-building medicines called bisphosphonates, would give her child his best chance to lead a more normal life.
Mrs. Vega agreed to the operation. Until his surgery at age three, life was tough for little Ismael. As a baby, when he instinctively tried to stand up, his fragile bones could not support his small body, and a bone in his leg would break.
Multiple fractures had caused Ismael's thigh bones to be severely bent. "The x-rays showed that his femur bone, which was supposed to be straight, was bent at 90 degrees," Dr. Green recalled. "His bones were so weak they were having microscopic fractures over and over again, and this led his femur bone to develop these massive deformities or curves. His other thigh bone was bent at 45 degrees."
The surgery entailed placing metal rods in Ismael's bones to make them straight, prevent future fractures and enable him to walk. "Placing rods in the long bones of the legs is one of the most common surgeries performed in patients with OI," Dr. Green said. "The advantage these days is the telescoping rods they're a great advance. In recent years, we've seen excellent results in many cases."
The special rod, which self-elongates as the child grows, eliminates the need for repeated surgeries to change rods as the child gains height. Dr. Green says Special Surgery is one of the few hospitals in the region using the telescoping rod system, and doctors are following patients to see how well it's working.
Ismael's operation was a success. He needed to wear casts from his toes to his hips for five weeks and then had months of intensive physical therapy. But the end result was worth it, Mrs. Vega says. "I have no words to explain how happy I was when Ismael walked for the first time. We feel that Dr. Green was sent from heaven. Without him, Ismael would not be walking."
"There have been tremendous advances in the treatment of OI in the past decade, and Ismael's case is a very positive illustration of what can be done," Dr. Green says. "It's a combination of surgery and medication that has improved the opportunities for children with this disease. I've seen patients in their 40s with OI who, unfortunately, did not have these treatments available when they were children. They have the same type of OI as Ismael, but have spent most of their lives in a wheelchair."
Hospital for Special Surgery (HSS) has one of the largest osteogenesis imperfecta centers in the region and uses a team approach, including orthopedic surgeons, radiologists, nurses and physical therapists. "The team at HSS seeks to educate parents about the disease. We believe education is the key to empowerment," Dr. Green says. "We're very impressed by Mrs. Vega. She's a strong advocate for her child."
Mrs. Vega now speaks to other parents of children with OI to let them know that treatments are available. She's extremely grateful for the care her son received at HSS. "Dr. Green is not just a doctor, he's a person with heart. He treated my son as more than a patient, he treated him as if he were part of his family."
Dr. Green says Ismael has an excellent prognosis. The Vegas have taken him to Disney World since the operation. "I broke down in tears when I saw him walking and going on rides in Orlando, I was so happy," Mrs. Vega said. During their first trip, Ismael experienced Disney World in a stroller and in the arms of his parents. "Before the surgery, I never thought I'd see him walk," she said.
Always an advocate for her child, Mrs. Vega also wants to help others and is very happy to be able to share her son's story with lawmakers during her upcoming trip. "My hope for the future is to discover a cure and to let people know there's a lot of hope for kids with OI."
Source: Hospital for Special Surgery
Patricia Vega and her son, Ismael, who turns six this month, have been invited to join Dr. Daniel Green, their orthopedic surgeon, to meet with U.S. Senators and Representatives to personally advocate for the future of musculoskeletal care and continued federal funding for research. The American Academy of Orthopaedic Surgeons is sponsoring the event, and Dr. Green and little Ismael are representing the Pediatric Orthopaedic Society of North America.
Dr. Green, a pediatric orthopedic surgeon at Hospital for Special Surgery, implanted the metal rods into the leg bones of little Ismael, who was born with osteogenesis imperfecta, or OI, which caused his bones to be brittle and weak. An innovation in OI surgery, the telescoping rods get longer as the child grows, avoiding the need for repeated operations.
Before the surgery, Ismael was carried around by his parents or used a stroller. His bones were so fragile that by the time he was three, he had suffered 12 broken bones and more than 100 microfractures. Doctors on Long Island told his mother little could be done. They said Ismael would probably never be able to walk and would spend most of his life in a wheelchair.
But Patricia Vega, who is from Hampton Bays, refused to give up hope. One day, a nurse who was assisting Mrs. Vega in caring for Ismael told her the highly specialized pediatric orthopedic surgeons at Hospital for Special Surgery might be able to help him.
Mrs. Vega went to see Dr. Green, who explained that a newer type of surgery using "telescoping" rods could straighten his bones and enable Ismael to walk. The special rods, implanted in his thigh bones, would extend, in essence, growing along with her child. The surgery, in combination with newer bone-building medicines called bisphosphonates, would give her child his best chance to lead a more normal life.
Mrs. Vega agreed to the operation. Until his surgery at age three, life was tough for little Ismael. As a baby, when he instinctively tried to stand up, his fragile bones could not support his small body, and a bone in his leg would break.
Multiple fractures had caused Ismael's thigh bones to be severely bent. "The x-rays showed that his femur bone, which was supposed to be straight, was bent at 90 degrees," Dr. Green recalled. "His bones were so weak they were having microscopic fractures over and over again, and this led his femur bone to develop these massive deformities or curves. His other thigh bone was bent at 45 degrees."
The surgery entailed placing metal rods in Ismael's bones to make them straight, prevent future fractures and enable him to walk. "Placing rods in the long bones of the legs is one of the most common surgeries performed in patients with OI," Dr. Green said. "The advantage these days is the telescoping rods they're a great advance. In recent years, we've seen excellent results in many cases."
The special rod, which self-elongates as the child grows, eliminates the need for repeated surgeries to change rods as the child gains height. Dr. Green says Special Surgery is one of the few hospitals in the region using the telescoping rod system, and doctors are following patients to see how well it's working.
Ismael's operation was a success. He needed to wear casts from his toes to his hips for five weeks and then had months of intensive physical therapy. But the end result was worth it, Mrs. Vega says. "I have no words to explain how happy I was when Ismael walked for the first time. We feel that Dr. Green was sent from heaven. Without him, Ismael would not be walking."
"There have been tremendous advances in the treatment of OI in the past decade, and Ismael's case is a very positive illustration of what can be done," Dr. Green says. "It's a combination of surgery and medication that has improved the opportunities for children with this disease. I've seen patients in their 40s with OI who, unfortunately, did not have these treatments available when they were children. They have the same type of OI as Ismael, but have spent most of their lives in a wheelchair."
Hospital for Special Surgery (HSS) has one of the largest osteogenesis imperfecta centers in the region and uses a team approach, including orthopedic surgeons, radiologists, nurses and physical therapists. "The team at HSS seeks to educate parents about the disease. We believe education is the key to empowerment," Dr. Green says. "We're very impressed by Mrs. Vega. She's a strong advocate for her child."
Mrs. Vega now speaks to other parents of children with OI to let them know that treatments are available. She's extremely grateful for the care her son received at HSS. "Dr. Green is not just a doctor, he's a person with heart. He treated my son as more than a patient, he treated him as if he were part of his family."
Dr. Green says Ismael has an excellent prognosis. The Vegas have taken him to Disney World since the operation. "I broke down in tears when I saw him walking and going on rides in Orlando, I was so happy," Mrs. Vega said. During their first trip, Ismael experienced Disney World in a stroller and in the arms of his parents. "Before the surgery, I never thought I'd see him walk," she said.
Always an advocate for her child, Mrs. Vega also wants to help others and is very happy to be able to share her son's story with lawmakers during her upcoming trip. "My hope for the future is to discover a cure and to let people know there's a lot of hope for kids with OI."
Source: Hospital for Special Surgery
воскресенье, 21 августа 2011 г.
Playing With Pain Can Ruin Your Tennis Game
Foot pain began affecting Donna's tennis game, and she was determined not to let it keep her from the sport she loved.
The 47-year-old avid tennis player from Arizona tried to play through the pain and rest her feet between matches. But when the pain became too much, and even started affecting her everyday activities, she made an appointment with a foot and ankle surgeon. His diagnosis: Donna was suffering from plantar fasciitis and a neuroma.
According to Donna's doctor, Kris DiNucci, DPM, FACFAS, a Fellow of the American College of Foot and Ankle Surgeons, the conditions plaguing her are common among court-playing athletes. "Because playing tennis requires quick, repetitive foot movements and continuous forefoot pressure, neuromas, (a thickening of the nerve tissue in the foot from compression) are common," DiNucci says. "In addition, those same movements can cause athletes to develop plantar fasciitis, an inflammation of the strong ligament that extends from the heel to the toes," he added. "If treated early, both conditions can be resolved non-operatively. But as the condition progresses, surgical methods may be required to help patients get back to their sport and their everyday activities."
Donna's treatment regimen included stretching exercises, icing, a cortisone injection, an adjustment to her shoes and custom orthotics. "Within four months the heel pain from the plantar fasciitis had improved tremendously. But the pain in the ball of my foot from the neuroma was still bad and Dr. DiNucci recommended surgery," Donna said.
"While surgery is not always needed to treat neuromas, in Donna's case it was necessary because she wasn't responding to non-surgical treatments," DiNucci said.
Four weeks after surgery, Donna was back on the tennis courts and eight-weeks post-op, she was back to her normal three-to-four day a week tennis game.
Court-playing athletes, such as tennis and basketball players, are also susceptible to Achilles tendonitis, sesamoiditis, stress fractures, ankle sprains and posterior tibial tendonitis, which all can be brought on from the high-impact movements of playing on hard surfaces. "Players with existing foot maladies or structural abnormalities of the lower extremity also need to be extra cautious while playing since their conditions can put them at a higher risk for overuse injury," says Dr. DiNucci.
No matter the sport, athletes must take preventive methods to protect their feet to keep themselves in the game. Supportive shoes tailored to the sport are vital, along with proper training and stretching before and after play. If athletes are injured or experience pain or discomfort in their feet or ankles, it's best to be examined by a foot and ankle surgeon. Early intervention is the key to proper healing.
As for Donna, she's back on her feet and has made modifications to her game, such as stretching before and after a match and wearing more supportive shoes with her orthotics.
Source: American College of Foot and Ankle Surgeons
The 47-year-old avid tennis player from Arizona tried to play through the pain and rest her feet between matches. But when the pain became too much, and even started affecting her everyday activities, she made an appointment with a foot and ankle surgeon. His diagnosis: Donna was suffering from plantar fasciitis and a neuroma.
According to Donna's doctor, Kris DiNucci, DPM, FACFAS, a Fellow of the American College of Foot and Ankle Surgeons, the conditions plaguing her are common among court-playing athletes. "Because playing tennis requires quick, repetitive foot movements and continuous forefoot pressure, neuromas, (a thickening of the nerve tissue in the foot from compression) are common," DiNucci says. "In addition, those same movements can cause athletes to develop plantar fasciitis, an inflammation of the strong ligament that extends from the heel to the toes," he added. "If treated early, both conditions can be resolved non-operatively. But as the condition progresses, surgical methods may be required to help patients get back to their sport and their everyday activities."
Donna's treatment regimen included stretching exercises, icing, a cortisone injection, an adjustment to her shoes and custom orthotics. "Within four months the heel pain from the plantar fasciitis had improved tremendously. But the pain in the ball of my foot from the neuroma was still bad and Dr. DiNucci recommended surgery," Donna said.
"While surgery is not always needed to treat neuromas, in Donna's case it was necessary because she wasn't responding to non-surgical treatments," DiNucci said.
Four weeks after surgery, Donna was back on the tennis courts and eight-weeks post-op, she was back to her normal three-to-four day a week tennis game.
Court-playing athletes, such as tennis and basketball players, are also susceptible to Achilles tendonitis, sesamoiditis, stress fractures, ankle sprains and posterior tibial tendonitis, which all can be brought on from the high-impact movements of playing on hard surfaces. "Players with existing foot maladies or structural abnormalities of the lower extremity also need to be extra cautious while playing since their conditions can put them at a higher risk for overuse injury," says Dr. DiNucci.
No matter the sport, athletes must take preventive methods to protect their feet to keep themselves in the game. Supportive shoes tailored to the sport are vital, along with proper training and stretching before and after play. If athletes are injured or experience pain or discomfort in their feet or ankles, it's best to be examined by a foot and ankle surgeon. Early intervention is the key to proper healing.
As for Donna, she's back on her feet and has made modifications to her game, such as stretching before and after a match and wearing more supportive shoes with her orthotics.
Source: American College of Foot and Ankle Surgeons
четверг, 18 августа 2011 г.
First Gene Linked To Scoliosis Identified By Scientists
Physicians have recognized scoliosis, the abnormal curvature of the spine, since the time of Hippocrates, but its causes have remained a mystery -- until now. For the first time, researchers have discovered a gene that underlies the condition, which affects about 3 percent of all children.
The new finding lays the groundwork for determining how a defect in the gene -- known as CHD7 -- leads to the C- and S-shaped curves that characterize scoliosis. The gene's link to scoliosis was identified by scientists at Washington University School of Medicine in St. Louis, working in collaboration with investigators at the University of Texas Southwestern Medical Center and Texas Scottish Rite Hospital for Children, both in Dallas, Rutgers State University of New Jersey and the University of Iowa. The group published its results in May in the American Journal of Human Genetics.
"Hopefully, we can now begin to understand the steps by which the gene affects spinal development," says Anne Bowcock, Ph.D., professor of genetics, of medicine and of pediatrics. "If we understand the genetic basis of the condition, we can theoretically predict who is going to develop scoliosis and develop treatments to intervene before the deformity sets in. It may take many years to accomplish these goals, but I think it will eventually happen."
The researchers have traced a defect in CHD7 to idiopathic scoliosis, the form of the condition for which there is no apparent cause. It is the most common type of scoliosis, occurs in otherwise healthy children and is typically detected during the growth spurt that accompanies adolescence.
Although scientists have known for years that scoliosis runs in families, its pattern of inheritance has remained unclear. That's because the condition is likely caused by several different genes that work in concert with one another -- and the environment -- to cause scoliosis. Bowcock predicts that scientists will soon find other genes involved in the disease.
The CHD7 gene is thought to play a critical role in many basic functions in the cell. The researchers zeroed in on the gene after finding that it is missing or profoundly disrupted in a rare syndrome called CHARGE. Babies born with the syndrome often die in infancy. Those that survive have heart defects, mental retardation, genital and urinary problems, ear abnormalities and deafness, among other problems. They also develop late-onset scoliosis.
"This led us to consider that milder variations of CHD7 may be involved in other types of scoliosis," Bowcock said.
The researchers, led by Carol Wise, Ph.D., at Scottish Rite Hospital, collected data on 52 families with a history of scoliosis in at least two members -- the one who sought treatment and another from earlier generation. The patients had an average spinal curvature of 40 degrees and did not have any illnesses, such as Marfan syndrome or cerebral palsy, which can also involve scoliosis. The researchers performed genome-wide scans that spelled out the 6 billion letters of genetic code in the affected family members and analyzed the data.
They found that patients with scoliosis very often had a defect in the gene's non-coding region, meaning that the error did not disrupt production of the CHD7 protein. The researchers speculate that this particular mutation alters the binding of a molecule that controls whether the gene is turned on. In this case, they think the gene is turned off more often than it should be, which reduces the amount of CHD7 protein produced.
"The change in the amount of the protein produced is subtle, which correlates with the onset of scoliosis, which typically happens very gradually," explains Michael Lovett, Ph.D., professor of genetics and pediatrics. "This particular defect was so highly associated with scoliosis that it is either the real McCoy or is very closely linked to the defect that causes the condition."
The researchers will continue to look for genetic variations involved in scoliosis by studying additional families with the condition.
Severe scoliosis is typically treated by surgery or by wearing an orthopedic brace, which straightens the curvature over time. Most minor spinal curves can be monitored by a doctor and do not progress to the point where treatment is necessary.
Gao X, Gordon D, Zhang D, Browne R, Helms C, Gillum J, Weber S, Devroy S, Swaney S, Dobbs M, Morcuende J, Sheffield V, Lovett M, Bowcock A, Herrine J and Wise C. CHD7 Gene polymorphisms are associated with susceptibility to idiopathic scoliosis. American Journal of Human Genetics, vol. 80, p. 957-965. May 2007.
Washington University School of Medicine's full-time 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.
Contact: Caroline Arbanas
Washington University School of Medicine
The new finding lays the groundwork for determining how a defect in the gene -- known as CHD7 -- leads to the C- and S-shaped curves that characterize scoliosis. The gene's link to scoliosis was identified by scientists at Washington University School of Medicine in St. Louis, working in collaboration with investigators at the University of Texas Southwestern Medical Center and Texas Scottish Rite Hospital for Children, both in Dallas, Rutgers State University of New Jersey and the University of Iowa. The group published its results in May in the American Journal of Human Genetics.
"Hopefully, we can now begin to understand the steps by which the gene affects spinal development," says Anne Bowcock, Ph.D., professor of genetics, of medicine and of pediatrics. "If we understand the genetic basis of the condition, we can theoretically predict who is going to develop scoliosis and develop treatments to intervene before the deformity sets in. It may take many years to accomplish these goals, but I think it will eventually happen."
The researchers have traced a defect in CHD7 to idiopathic scoliosis, the form of the condition for which there is no apparent cause. It is the most common type of scoliosis, occurs in otherwise healthy children and is typically detected during the growth spurt that accompanies adolescence.
Although scientists have known for years that scoliosis runs in families, its pattern of inheritance has remained unclear. That's because the condition is likely caused by several different genes that work in concert with one another -- and the environment -- to cause scoliosis. Bowcock predicts that scientists will soon find other genes involved in the disease.
The CHD7 gene is thought to play a critical role in many basic functions in the cell. The researchers zeroed in on the gene after finding that it is missing or profoundly disrupted in a rare syndrome called CHARGE. Babies born with the syndrome often die in infancy. Those that survive have heart defects, mental retardation, genital and urinary problems, ear abnormalities and deafness, among other problems. They also develop late-onset scoliosis.
"This led us to consider that milder variations of CHD7 may be involved in other types of scoliosis," Bowcock said.
The researchers, led by Carol Wise, Ph.D., at Scottish Rite Hospital, collected data on 52 families with a history of scoliosis in at least two members -- the one who sought treatment and another from earlier generation. The patients had an average spinal curvature of 40 degrees and did not have any illnesses, such as Marfan syndrome or cerebral palsy, which can also involve scoliosis. The researchers performed genome-wide scans that spelled out the 6 billion letters of genetic code in the affected family members and analyzed the data.
They found that patients with scoliosis very often had a defect in the gene's non-coding region, meaning that the error did not disrupt production of the CHD7 protein. The researchers speculate that this particular mutation alters the binding of a molecule that controls whether the gene is turned on. In this case, they think the gene is turned off more often than it should be, which reduces the amount of CHD7 protein produced.
"The change in the amount of the protein produced is subtle, which correlates with the onset of scoliosis, which typically happens very gradually," explains Michael Lovett, Ph.D., professor of genetics and pediatrics. "This particular defect was so highly associated with scoliosis that it is either the real McCoy or is very closely linked to the defect that causes the condition."
The researchers will continue to look for genetic variations involved in scoliosis by studying additional families with the condition.
Severe scoliosis is typically treated by surgery or by wearing an orthopedic brace, which straightens the curvature over time. Most minor spinal curves can be monitored by a doctor and do not progress to the point where treatment is necessary.
Gao X, Gordon D, Zhang D, Browne R, Helms C, Gillum J, Weber S, Devroy S, Swaney S, Dobbs M, Morcuende J, Sheffield V, Lovett M, Bowcock A, Herrine J and Wise C. CHD7 Gene polymorphisms are associated with susceptibility to idiopathic scoliosis. American Journal of Human Genetics, vol. 80, p. 957-965. May 2007.
Washington University School of Medicine's full-time 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.
Contact: Caroline Arbanas
Washington University School of Medicine
понедельник, 15 августа 2011 г.
United States Bone And Joint Decade Announces Conference Program
The United States Bone and Joint Decade announced an unparalleled program for its 2009 Global Network Conference to be held in Washington, D.C., Wednesday, October 21-Saturday, October 24. The conference will bring together the official Bone and Joint Decade National Action Network representatives from 56 countries, members of the administration, government policy makers, health care providers, patients and patient advocates for a two-day Patient Advocacy Meeting on October 21-22 and the Global Network Conference on October 23-24.
The Global Network Conference is a two-day education and strategic planning meeting which will highlight the significant burden of disease posed by musculoskeletal conditions and why raising awareness and engaging in advocacy are important means to advance prevention and treatment. On October 22, there will be a focus on raising awareness of musculoskeletal conditions on Capitol Hill for U.S. delegates, patients and the leadership of USBJD participating organizations.
Program highlights include:
"Health Care: Opportunities and Challenges" panel featuring Susan Blumenthal, M.D., Former Assistant Surgeon General, and Director, Center for the Study of the Presidency and Congress, held on Thursday, October 22, 10:00 a.m., at the Capitol Hill Visitors Center, HVC-215;
"Experts in Arthritis" panel featuring panelists Congresswoman Anna Eshoo (D-Calif.), David Borenstein, MD, rheumatologist, and John H. Klippel, MD, president and CEO, Arthritis Foundation, in addition to moderator Amye Leong, president and CEO, Healthy Motivation, held on Thursday, October 22, 1:30 p.m., at Rayburn House Office Building, Gold Room 2168, on Capitol Hill;
"From the Battlefront to the Home Front" luncheon featuring the Deputy Surgeon General of the U.S. Navy Rear Admiral Thomas R. Cullison held on Friday, October 23, 12:15 p.m., at the JW Marriot Hotel;
"Advancing the Health Policy Agenda" James Weinstein, DO, MS, Director, the Dartmouth Institute for Health Policy and Clinical Practice; and,
"Spotlight on Women's Health Care" panel featuring Jill Zarin, celebrity and arthritis advocate, held on Friday, October 24, 12:30 p.m., at the JW Marriot Hotel.
Featured program participants include Sens. Chuck Grassley (R-Iowa) and John Barrasso (R-Wyo.), Congressmen Charles Rangel (D-N.Y.), Dave Camp (R-Mich.), Charlie Melancon (D-La.), and John Dingell (D-Mich.), and Colin Carrie, Parliamentary Secretary for Health of Canada.
The Bone and Joint Decade is an international collaborative movement sanctioned by the United Nations and World Health Organization. Its mission is to improve the quality of life for people with musculoskeletal conditions and to advance the understanding, prevention and treatment of these conditions. Musculoskeletal conditions include back pain, arthritis, traumatic injuries, osteoporosis and childhood conditions. Currently, 63 national governments and more than 750 patient advocacy and health professional organizations endorse the efforts of the USBJD, and the Arthritis Foundation is one of its leading founders. In addition, all 50 states in the US have endorsed the Decade. To further advance the goals of the Decade, more than 60 countries have formed National Action Networks. For more information, please visit usbjd/.
Source
Arthritis Foundation
The Global Network Conference is a two-day education and strategic planning meeting which will highlight the significant burden of disease posed by musculoskeletal conditions and why raising awareness and engaging in advocacy are important means to advance prevention and treatment. On October 22, there will be a focus on raising awareness of musculoskeletal conditions on Capitol Hill for U.S. delegates, patients and the leadership of USBJD participating organizations.
Program highlights include:
"Health Care: Opportunities and Challenges" panel featuring Susan Blumenthal, M.D., Former Assistant Surgeon General, and Director, Center for the Study of the Presidency and Congress, held on Thursday, October 22, 10:00 a.m., at the Capitol Hill Visitors Center, HVC-215;
"Experts in Arthritis" panel featuring panelists Congresswoman Anna Eshoo (D-Calif.), David Borenstein, MD, rheumatologist, and John H. Klippel, MD, president and CEO, Arthritis Foundation, in addition to moderator Amye Leong, president and CEO, Healthy Motivation, held on Thursday, October 22, 1:30 p.m., at Rayburn House Office Building, Gold Room 2168, on Capitol Hill;
"From the Battlefront to the Home Front" luncheon featuring the Deputy Surgeon General of the U.S. Navy Rear Admiral Thomas R. Cullison held on Friday, October 23, 12:15 p.m., at the JW Marriot Hotel;
"Advancing the Health Policy Agenda" James Weinstein, DO, MS, Director, the Dartmouth Institute for Health Policy and Clinical Practice; and,
"Spotlight on Women's Health Care" panel featuring Jill Zarin, celebrity and arthritis advocate, held on Friday, October 24, 12:30 p.m., at the JW Marriot Hotel.
Featured program participants include Sens. Chuck Grassley (R-Iowa) and John Barrasso (R-Wyo.), Congressmen Charles Rangel (D-N.Y.), Dave Camp (R-Mich.), Charlie Melancon (D-La.), and John Dingell (D-Mich.), and Colin Carrie, Parliamentary Secretary for Health of Canada.
The Bone and Joint Decade is an international collaborative movement sanctioned by the United Nations and World Health Organization. Its mission is to improve the quality of life for people with musculoskeletal conditions and to advance the understanding, prevention and treatment of these conditions. Musculoskeletal conditions include back pain, arthritis, traumatic injuries, osteoporosis and childhood conditions. Currently, 63 national governments and more than 750 patient advocacy and health professional organizations endorse the efforts of the USBJD, and the Arthritis Foundation is one of its leading founders. In addition, all 50 states in the US have endorsed the Decade. To further advance the goals of the Decade, more than 60 countries have formed National Action Networks. For more information, please visit usbjd/.
Source
Arthritis Foundation
пятница, 12 августа 2011 г.
Advances In The Treatment Of Hand And Wrist Injuries And Disorders
An injury or ailment involving your hand or wrist can severely limit your ability to perform daily activities, such as taking a shower, driving a car or using a computer, and requires an expert team of physicians, surgeons and physical and occupational therapists. The physicians of the Penn Hand Service, part of the Penn Orthopaedic Institute , provide comprehensive treatment for a wide range of issues, including arthritis, fractures, nerve problems and sports-related injuries.
As medical advances in arthroscopy and imaging techniques are used more frequently to evaluate the small bones and ligaments of the hand, the physicians of the Penn Hand Service are exploring how these advances can improve the diagnosis and treatment of hand and wrist injuries.
New Treatment Option for a Broken Wrist
A distal radius fracture, or a broken wrist, is the most common break in the arm, according to the American Academy of Orthopaedic Surgeons, and usually results from some type of trauma, such as a fall or an accident. Since older patients are prone to weak bones due to osteoporosis, this type of fracture is more difficult to repair in the older population.
The orthopaedic surgeons at the Penn Hand Service are developing new instruments and devices, such as a combination of stainless steel pins and plates, which will make it easier to repair more difficult fractures, particularly in the elderly.
"In the past, some surgeons may have used external fixation, which involves placing pins or screws into the bone on both sides of the fracture, and securing them outside the skin with clamps and rods. But we've found that internal fixation, using plates in particular, allows us to align the bones better, and patients are able to regain mobility faster," says David Steinberg, MD, associate professor of orthopaedic surgery at the University of Pennsylvania Health System.
Wrist Arthroscopy
With its small incisions, arthroscopy is increasingly being used in the treatment of the hand. Arthroscopy is a technique used to evaluate a joint for damage or disease and, if necessary, to perform surgery. Wrist arthroscopy, in particular, has proven to be extremely valuable both in diagnosis and therapy. "It is very helpful for arthritis, for example," says David Bozentka, MD, chief of the department of orthopaedic surgery at Penn Presbyterian Medical Center. "We can assess the ligaments of the wrist and examine the extent of injury, all without making any large incisions."
Penn surgeons are also using this arthroscopic technique to treat ligament injuries in the wrist and to evaluate small joints in the hand. "We've even treated some cases of basal joint arthritis (arthritis in the joint at the base of the thumb) with arthroscopy," says Dr. Steinberg.
Wrist arthroscopy is a minimally invasive surgery, which typically limits patient discomfort and allows for faster recovery. In general, the procedure is appropriate for patients with earlier stage arthritis or torn cartilage, which is better suited to this type of treatment.
"Advanced cases of arthritis, for example, require more cleaning out of bone and, in some cases, ligament reconstruction, which is better performed through open surgery," says Dr. Steinberg. Nevertheless, arthroscopy remains a good surgical option for a number of conditions, which at one time required a larger incision in the wrist.
The University of Pennsylvania Health System is dedicated to high-quality patient care and service, advancing medical science through research, and educating the next generation of leaders in medicine. pennhealth
As medical advances in arthroscopy and imaging techniques are used more frequently to evaluate the small bones and ligaments of the hand, the physicians of the Penn Hand Service are exploring how these advances can improve the diagnosis and treatment of hand and wrist injuries.
New Treatment Option for a Broken Wrist
A distal radius fracture, or a broken wrist, is the most common break in the arm, according to the American Academy of Orthopaedic Surgeons, and usually results from some type of trauma, such as a fall or an accident. Since older patients are prone to weak bones due to osteoporosis, this type of fracture is more difficult to repair in the older population.
The orthopaedic surgeons at the Penn Hand Service are developing new instruments and devices, such as a combination of stainless steel pins and plates, which will make it easier to repair more difficult fractures, particularly in the elderly.
"In the past, some surgeons may have used external fixation, which involves placing pins or screws into the bone on both sides of the fracture, and securing them outside the skin with clamps and rods. But we've found that internal fixation, using plates in particular, allows us to align the bones better, and patients are able to regain mobility faster," says David Steinberg, MD, associate professor of orthopaedic surgery at the University of Pennsylvania Health System.
Wrist Arthroscopy
With its small incisions, arthroscopy is increasingly being used in the treatment of the hand. Arthroscopy is a technique used to evaluate a joint for damage or disease and, if necessary, to perform surgery. Wrist arthroscopy, in particular, has proven to be extremely valuable both in diagnosis and therapy. "It is very helpful for arthritis, for example," says David Bozentka, MD, chief of the department of orthopaedic surgery at Penn Presbyterian Medical Center. "We can assess the ligaments of the wrist and examine the extent of injury, all without making any large incisions."
Penn surgeons are also using this arthroscopic technique to treat ligament injuries in the wrist and to evaluate small joints in the hand. "We've even treated some cases of basal joint arthritis (arthritis in the joint at the base of the thumb) with arthroscopy," says Dr. Steinberg.
Wrist arthroscopy is a minimally invasive surgery, which typically limits patient discomfort and allows for faster recovery. In general, the procedure is appropriate for patients with earlier stage arthritis or torn cartilage, which is better suited to this type of treatment.
"Advanced cases of arthritis, for example, require more cleaning out of bone and, in some cases, ligament reconstruction, which is better performed through open surgery," says Dr. Steinberg. Nevertheless, arthroscopy remains a good surgical option for a number of conditions, which at one time required a larger incision in the wrist.
The University of Pennsylvania Health System is dedicated to high-quality patient care and service, advancing medical science through research, and educating the next generation of leaders in medicine. pennhealth
вторник, 9 августа 2011 г.
Emisphere Announces Recruitment Phase III Study For Oral Osteoarthritis Treatment
Emisphere
Technologies, Inc. (Nasdaq: EMIS) announced that Novartis Pharma AG
and Nordic Bioscience have completed recruitment for a multi-center Phase
III study exploring the safety and efficacy of an oral formulation of
salmon calcitonin using Emisphere's proprietary Eligen Technology to treat
patients with osteoarthritis of the knee. This study, which will be used to
support the filing with health authorities worldwide, includes more than
1,100 patients between 51 and 80 years old with a medical history and
symptoms of knee osteoarthritis. The study will be conducted mainly in
Europe and is estimated to complete second half 2010.
Osteoarthritis ("OA") is a clinical syndrome in which low-grade
inflammation results in joint pain, caused by a wearing-away of cartilage
that cushions the joints and the destruction or decrease of synovial fluid
that lubricates those joints. As OA progresses, pain can result when the
patient bears weight upon the joints, including walking and standing. OA is
the most common form of arthritis, and affects nearly 21 million people in
the United States, accounting for 25% of visits to primary care physicians,
and half of all non-steroidal anti-inflammatory drug prescriptions. It is
estimated that 80% of the population will have radiographic evidence of OA
by age 65.
"The problems associated with osteoarthritis will escalate as the
population ages," said Michael V. Novinski, President and Chief Executive
Officer of Emisphere. "This Phase III study aims at demonstrating that oral
salmon calcitonin, in combination with our Eligen drug delivery technology,
may contribute to solving this problem, and also shows that Emisphere is a
valuable partner in drug development."
About Emisphere Technologies, Inc.
Emisphere is a biopharmaceutical company that focuses on a unique and
improved delivery of therapeutic molecules using its Eligen Technology.
These molecules and compounds could be currently available or in
development. Such molecules are usually delivered by injection; in many
cases, their benefits are limited due to poor bioavailability, slow on-set
of action or variable absorption. The Eligen Technology can be applied to
the oral route of administration as well other delivery pathways, such as
buccal, rectal, inhalation, intra-vaginal or transdermal. The website is:
emisphere.
Safe Harbor Statement Regarding Forward-looking Statements
The statements in this release and oral statements made by
representatives of Emisphere relating to matters that are not historical
facts (including without limitation those regarding the timing or potential
outcomes of research collaborations or clinical trials, any market that
might develop for any of Emisphere's product candidates and the sufficiency
of Emisphere's cash and other capital resources) are forward-looking
statements that involve risks and uncertainties, including, but not limited
to, the likelihood that future research will prove successful, the
likelihood that any product in the research pipeline will receive
regulatory approval in the United States or abroad, the ability of
Emisphere and/or its partners to develop, manufacture and commercialize
products using Emisphere's drug delivery technology, Emisphere's ability to
fund such efforts with or without partners, and other risks and
uncertainties detailed in Emisphere's filings with the Securities and
Exchange Commission, including those factors discussed under the caption
"Risk Factors" in Emisphere's Annual Report on Form 10-K (file no. 1-10615)
filed on March 13, 2008 and our Quarterly Report on Form 10-Q for the
quarter ended June 30, 2008, filed on August 11, 2008.
Emisphere Technologies, Inc
emisphere
Technologies, Inc. (Nasdaq: EMIS) announced that Novartis Pharma AG
and Nordic Bioscience have completed recruitment for a multi-center Phase
III study exploring the safety and efficacy of an oral formulation of
salmon calcitonin using Emisphere's proprietary Eligen Technology to treat
patients with osteoarthritis of the knee. This study, which will be used to
support the filing with health authorities worldwide, includes more than
1,100 patients between 51 and 80 years old with a medical history and
symptoms of knee osteoarthritis. The study will be conducted mainly in
Europe and is estimated to complete second half 2010.
Osteoarthritis ("OA") is a clinical syndrome in which low-grade
inflammation results in joint pain, caused by a wearing-away of cartilage
that cushions the joints and the destruction or decrease of synovial fluid
that lubricates those joints. As OA progresses, pain can result when the
patient bears weight upon the joints, including walking and standing. OA is
the most common form of arthritis, and affects nearly 21 million people in
the United States, accounting for 25% of visits to primary care physicians,
and half of all non-steroidal anti-inflammatory drug prescriptions. It is
estimated that 80% of the population will have radiographic evidence of OA
by age 65.
"The problems associated with osteoarthritis will escalate as the
population ages," said Michael V. Novinski, President and Chief Executive
Officer of Emisphere. "This Phase III study aims at demonstrating that oral
salmon calcitonin, in combination with our Eligen drug delivery technology,
may contribute to solving this problem, and also shows that Emisphere is a
valuable partner in drug development."
About Emisphere Technologies, Inc.
Emisphere is a biopharmaceutical company that focuses on a unique and
improved delivery of therapeutic molecules using its Eligen Technology.
These molecules and compounds could be currently available or in
development. Such molecules are usually delivered by injection; in many
cases, their benefits are limited due to poor bioavailability, slow on-set
of action or variable absorption. The Eligen Technology can be applied to
the oral route of administration as well other delivery pathways, such as
buccal, rectal, inhalation, intra-vaginal or transdermal. The website is:
emisphere.
Safe Harbor Statement Regarding Forward-looking Statements
The statements in this release and oral statements made by
representatives of Emisphere relating to matters that are not historical
facts (including without limitation those regarding the timing or potential
outcomes of research collaborations or clinical trials, any market that
might develop for any of Emisphere's product candidates and the sufficiency
of Emisphere's cash and other capital resources) are forward-looking
statements that involve risks and uncertainties, including, but not limited
to, the likelihood that future research will prove successful, the
likelihood that any product in the research pipeline will receive
regulatory approval in the United States or abroad, the ability of
Emisphere and/or its partners to develop, manufacture and commercialize
products using Emisphere's drug delivery technology, Emisphere's ability to
fund such efforts with or without partners, and other risks and
uncertainties detailed in Emisphere's filings with the Securities and
Exchange Commission, including those factors discussed under the caption
"Risk Factors" in Emisphere's Annual Report on Form 10-K (file no. 1-10615)
filed on March 13, 2008 and our Quarterly Report on Form 10-Q for the
quarter ended June 30, 2008, filed on August 11, 2008.
Emisphere Technologies, Inc
emisphere
суббота, 6 августа 2011 г.
Top Children's Surgeon Says 'Poverty' Bone Disease Has Returned In Southampton
A poverty-linked bone disease that disappeared over 80 years ago, but resurfaced in northern parts of the UK this year, is now being discovered in high numbers of young patients in Southampton.
Rickets, a condition that causes children's bones to become weak and bowed, was endemic in poor Victorian England, but was written off by many orthopaedic surgeons by 1928 following the discovery of vitamin D in 1922.
However, the disease is now making a comeback around the world due to low vitamin D levels caused predominantly by lack of exposure to sunlight and also poor diet - though it had not been uncovered in Southampton until now.
This vitamin, found in a small number of foods, is important in supporting growth and maintaining strong bones.
"The return of rickets in northern parts of the UK came as a surprise despite the colder climate and lower levels of sunshine in the north, but what has developed in Southampton is quite astonishing," said Professor Nicholas Clarke, consultant orthopaedic surgeon at Southampton General Hospital and professor of paediatric orthopaedic surgery at the University of Southampton.
He explains that despite being historically linked with poverty-stricken communities, rickets is now appearing in children from all backgrounds.
"In my 22 years at Southampton General Hospital, this is a completely new occurrence in the south that has evolved over the last 12 to 24 months and we are seeing cases across the board, from areas of deprivation up to the middle classes, so there is a real need to get national attention focused on the dangers this presents."
Professor Clarke says he and colleague Dr Justin Davies, a consultant paediatric endocrinologist, have checked over 200 children for bone problems and more than 20% of them have significant deficiencies.
"A lot of the children we've seen have got low vitamin D and require treatment," he said.
"This is almost certainly a combination of the modern lifestyle, which involves a lack of exposure to sunlight, but also covering up in sunshine, and we're seeing cases that are very reminiscent of 17th century England."
He added: "We are facing the daunting prospect of an area like Southampton, where it is high income, middle class and leafy in its surroundings, seeing increasing numbers of children with rickets, which would have been inconceivable only a year or so ago."
Professor Clarke says vitamin D supplements should be more widely adopted to halt the rise in cases.
Source:
Southampton University Hospitals NHS Trust
Rickets, a condition that causes children's bones to become weak and bowed, was endemic in poor Victorian England, but was written off by many orthopaedic surgeons by 1928 following the discovery of vitamin D in 1922.
However, the disease is now making a comeback around the world due to low vitamin D levels caused predominantly by lack of exposure to sunlight and also poor diet - though it had not been uncovered in Southampton until now.
This vitamin, found in a small number of foods, is important in supporting growth and maintaining strong bones.
"The return of rickets in northern parts of the UK came as a surprise despite the colder climate and lower levels of sunshine in the north, but what has developed in Southampton is quite astonishing," said Professor Nicholas Clarke, consultant orthopaedic surgeon at Southampton General Hospital and professor of paediatric orthopaedic surgery at the University of Southampton.
He explains that despite being historically linked with poverty-stricken communities, rickets is now appearing in children from all backgrounds.
"In my 22 years at Southampton General Hospital, this is a completely new occurrence in the south that has evolved over the last 12 to 24 months and we are seeing cases across the board, from areas of deprivation up to the middle classes, so there is a real need to get national attention focused on the dangers this presents."
Professor Clarke says he and colleague Dr Justin Davies, a consultant paediatric endocrinologist, have checked over 200 children for bone problems and more than 20% of them have significant deficiencies.
"A lot of the children we've seen have got low vitamin D and require treatment," he said.
"This is almost certainly a combination of the modern lifestyle, which involves a lack of exposure to sunlight, but also covering up in sunshine, and we're seeing cases that are very reminiscent of 17th century England."
He added: "We are facing the daunting prospect of an area like Southampton, where it is high income, middle class and leafy in its surroundings, seeing increasing numbers of children with rickets, which would have been inconceivable only a year or so ago."
Professor Clarke says vitamin D supplements should be more widely adopted to halt the rise in cases.
Source:
Southampton University Hospitals NHS Trust
среда, 3 августа 2011 г.
1-Stop Screening For Cancer And Osteoporosis
New research reveals that computed tomography (CT) colonography, also known as virtual colonoscopy, has the potential to screen for two diseases at once - colorectal cancer and osteoporosis, both of which commonly affect adults over age 50. Results of the study will be presented today at the annual meeting of the Radiological Society of North America (RSNA).
"With CT colonography, in addition to screening for colorectal cancer, we were able to identify patients with osteoporosis," said lead author Rizwan Aslam, M.B.Ch.B., assistant clinical professor of radiology at the University of California San Francisco.
CT colonography, an imaging study performed to detect pre-cancerous polyps in the large intestine, begins with an abdominal CT scan, which creates cross-sectional images of all structures in the abdomen including the spine. Computer software then arranges the CT images to create an interior or "fly-through" view of the colon.
Using the same CT images, another software application can create three-dimensional images of the spine, allowing bone mineral density to be measured. Low bone mineral density is usually associated with osteoporosis, a disease in which bones become fragile and more likely to break.
In the study conducted at the San Francisco Veterans Administration Hospital, the researchers evaluated the results of 35 patients who underwent CT colonography and bone mineral density testing with dual-energy x-ray absorptiometry (DEXA), a standard bone density screening tool. Patients included 30 males and five females ranging in age from 54 to 79.
The results of the study showed excellent agreement between the DEXA bone mineral density scores and the data generated through the CT colonography study.
"The bone density measurements obtained from CT colonography were comparable to the DEXA results," Dr. Aslam said. "Both tests identified osteoporotic bones."
Most physicians recommend that adults undergo CT colonography or conventional colonoscopy every seven to 10 years beginning at age 50.
"CT colonography isn't a replacement for DEXA testing, but it could be a way to screen more people for osteoporosis," Dr. Aslam said. "When an individual undergoes CT colonography, we can also obtain a bone density measurement with no additional radiation and at minimal cost."
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, 10 million Americans over age 50 have osteoporosis. Approximately 34 million Americans are at risk due to low bone mass. Detecting osteoporosis early provides for early intervention and treatment.
Co-authors are Judy Yee, M.D., Alexander Keedy, B.S., Timothy Joseph, M.D., and Alex Chau, B.S.
RSNA is an association of more than 42,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA)
For patient-friendly information on CT colonography and DEXA, visit RadiologyInfo.
Source: Linda Brooks
Radiological Society of North America
"With CT colonography, in addition to screening for colorectal cancer, we were able to identify patients with osteoporosis," said lead author Rizwan Aslam, M.B.Ch.B., assistant clinical professor of radiology at the University of California San Francisco.
CT colonography, an imaging study performed to detect pre-cancerous polyps in the large intestine, begins with an abdominal CT scan, which creates cross-sectional images of all structures in the abdomen including the spine. Computer software then arranges the CT images to create an interior or "fly-through" view of the colon.
Using the same CT images, another software application can create three-dimensional images of the spine, allowing bone mineral density to be measured. Low bone mineral density is usually associated with osteoporosis, a disease in which bones become fragile and more likely to break.
In the study conducted at the San Francisco Veterans Administration Hospital, the researchers evaluated the results of 35 patients who underwent CT colonography and bone mineral density testing with dual-energy x-ray absorptiometry (DEXA), a standard bone density screening tool. Patients included 30 males and five females ranging in age from 54 to 79.
The results of the study showed excellent agreement between the DEXA bone mineral density scores and the data generated through the CT colonography study.
"The bone density measurements obtained from CT colonography were comparable to the DEXA results," Dr. Aslam said. "Both tests identified osteoporotic bones."
Most physicians recommend that adults undergo CT colonography or conventional colonoscopy every seven to 10 years beginning at age 50.
"CT colonography isn't a replacement for DEXA testing, but it could be a way to screen more people for osteoporosis," Dr. Aslam said. "When an individual undergoes CT colonography, we can also obtain a bone density measurement with no additional radiation and at minimal cost."
According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, 10 million Americans over age 50 have osteoporosis. Approximately 34 million Americans are at risk due to low bone mass. Detecting osteoporosis early provides for early intervention and treatment.
Co-authors are Judy Yee, M.D., Alexander Keedy, B.S., Timothy Joseph, M.D., and Alex Chau, B.S.
RSNA is an association of more than 42,000 radiologists, radiation oncologists, medical physicists and related scientists committed to excellence in patient care through education and research. The Society is based in Oak Brook, Ill. (RSNA)
For patient-friendly information on CT colonography and DEXA, visit RadiologyInfo.
Source: Linda Brooks
Radiological Society of North America
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