Medical tourism is to go under the microscope in a major new study, led by an academic from the University of York, which aims to assess its potential advantages and disadvantages.
The study, which is funded by the National Institute for Health Research, will examine the motives people have for travelling across national boundaries to receive treatments such as dental services, elective surgery for hip or joint replacement, cosmetic surgery and fertility treatment.
Dr Neil Lunt, of the York Management School, will head a team of researchers that includes health economists, social scientists and clinicians who will research four aspects of medical tourism.
They will spend 18 months studying:
economic impact
consumerism and patient decision-making
quality, safety and risk
industry development.
Medical tourism is currently mainly privately funded and the researchers will seek to establish the amount people are paying for this healthcare and its economic impact. They will also examine the potential savings for the NHS that contracting out treatments to other countries might bring.
But this will be linked to a review of potentially negative impacts on the NHS, such as the need to ensure continuity of care for people who have been treated abroad and the cost of treating complications.
The research team will explore how patients make their decisions concerning treatments and destinations, what information they use - such as websites, friends, internet chat rooms - and how informed their choices are. Patients will also be asked about their experiences of treatment abroad.
Dr Lunt said: "We will advance knowledge of patient treatment experience and how consumers think about choice, and how risk and safety are managed at the consumer and organisational levels.
"Our work will contribute towards understanding quality, administrative and legal dimensions of medical tourism as well as unintended consequences. The study will be of interest to those working within and making decisions about the NHS, policy-makers, regulators, providers, clinicians and consumer organisations as well as patients."
The research team includes Professor Stephen T Green of Sheffield Teaching Hospitals Foundation NHS Trust; Dr Mark Exworthy of the School of Management at Royal Holloway, University of London; Professor Russell Mannion of the Health Services Management Centre at the University of Birmingham and Professor Richard Smith, of the Department of Global Health and Development, London School of Hygiene & Tropical Medicine.
Source:
David Garner
University of York
четверг, 29 сентября 2011 г.
понедельник, 26 сентября 2011 г.
A Sporting Chance For Active Total Knee Replacement Patients
Total knee arthroplasty (TKA) patients may be able to participate in high-impact sports without increasing risk of early implant failure, according to a new study presented at the 2010 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS). In addition, the authors observed better clinical scores in the group of patients who participated in activities discouraged by the Knee Society (KS) than those of the control group.
The Knee Society recommends TKA patients avoid activities that cause high stress loads on the implant and may increase the risk of early failure. Such activities include high-impact aerobics, football, soccer, baseball, basketball, jogging and power lifting, among others.
"Recent studies have shown that as many as one in six total knee replacement patients participate in non-recommended activities," said Sebastian Parratte, M.D., PhD, an orthopaedic surgeon from the Mayo Clinic in Rochester, MN and the Aix-Marseille University, Center for Arthritis Surgery, Hospital Sainte-Marguerite in Marseille, France. "This study offers some reassurance to those patients who choose to return to an active lifestyle after surgery."
Researchers evaluated outcomes of 218 patients between the ages of 18 and 90 who underwent primary knee arthroplasty at the Mayo Clinic and reported performing heavy manual labor or practicing a non-recommended sport following surgery. The "sport group" was matched by age, gender and BMI to a control group of 317 patients who underwent the same procedure using an identical implant and followed recommended activity guidelines.
Clinical and radiologic results were measured using Knee Society (KS) scores and implant survivorship was evaluated using multivariate analysis according to the Cox model.
At an average follow-up of seven-and-a-half years after surgery, the study found:
No significant radiological differences and no significant differences in implant durability could be demonstrated between the sport group and the control group;
The sport group showed slightly higher KS Knee and function scores compared to the control group;
The control group experienced a 20 percent higher revision rate for mechanical failure (loosening, wear or fracture) compared to the sport group;
After accounting for all variables, including co-morbidities, the sport group had a 10 percent higher risk of mechanical failure compared to the control group.
These results were quite surprising to Dr. Parratte and his team.
"We hypothesized that high-impact activities would not increase the risk of implant failure, but we did not foresee that such activities might actually improve clinical results," he said. "It is clear that more research is necessary to evaluate the short and long-term effect of high-impact activities on the durability and function of modern TKA implants."
He added that, although the industry is not ready or able at this point to revise its recommendations, that possibility may exist in the not-too-distant future. In the meantime, he noted that surgeons and patients should continue to follow all industry recommendations relating to recovery following joint replacement surgery.
About Joint Replacement
Joint replacement, also known as arthroplasty, is considered by many to be one of the most successful medical innovations of the 20th century. Total joint replacement is a surgical procedure in which the patient's natural joint is replaced with an artificial one, made of a combination of plastic, metal, and/or ceramic.
The most common reasons for this surgery are pain and stiffness that limits normal activities such as walking and bending and that cannot be satisfactorily treated with medications or other therapies. Therefore, joint replacement surgery often provides a significantly improved quality of life to patients who would otherwise have to live with severe pain.
In 2007, there were 550,161 total knee replacements performed in the United States, and that number is on the rise - particularly as the Baby Boomer population continues to age. Because of this trend, it is important to optimize patient outcomes.
Disclosure:
Dr. Parratte and his co-authors received no compensation for this study.
Source:
Lauren L. Pearson
American Academy of Orthopaedic Surgeons
The Knee Society recommends TKA patients avoid activities that cause high stress loads on the implant and may increase the risk of early failure. Such activities include high-impact aerobics, football, soccer, baseball, basketball, jogging and power lifting, among others.
"Recent studies have shown that as many as one in six total knee replacement patients participate in non-recommended activities," said Sebastian Parratte, M.D., PhD, an orthopaedic surgeon from the Mayo Clinic in Rochester, MN and the Aix-Marseille University, Center for Arthritis Surgery, Hospital Sainte-Marguerite in Marseille, France. "This study offers some reassurance to those patients who choose to return to an active lifestyle after surgery."
Researchers evaluated outcomes of 218 patients between the ages of 18 and 90 who underwent primary knee arthroplasty at the Mayo Clinic and reported performing heavy manual labor or practicing a non-recommended sport following surgery. The "sport group" was matched by age, gender and BMI to a control group of 317 patients who underwent the same procedure using an identical implant and followed recommended activity guidelines.
Clinical and radiologic results were measured using Knee Society (KS) scores and implant survivorship was evaluated using multivariate analysis according to the Cox model.
At an average follow-up of seven-and-a-half years after surgery, the study found:
No significant radiological differences and no significant differences in implant durability could be demonstrated between the sport group and the control group;
The sport group showed slightly higher KS Knee and function scores compared to the control group;
The control group experienced a 20 percent higher revision rate for mechanical failure (loosening, wear or fracture) compared to the sport group;
After accounting for all variables, including co-morbidities, the sport group had a 10 percent higher risk of mechanical failure compared to the control group.
These results were quite surprising to Dr. Parratte and his team.
"We hypothesized that high-impact activities would not increase the risk of implant failure, but we did not foresee that such activities might actually improve clinical results," he said. "It is clear that more research is necessary to evaluate the short and long-term effect of high-impact activities on the durability and function of modern TKA implants."
He added that, although the industry is not ready or able at this point to revise its recommendations, that possibility may exist in the not-too-distant future. In the meantime, he noted that surgeons and patients should continue to follow all industry recommendations relating to recovery following joint replacement surgery.
About Joint Replacement
Joint replacement, also known as arthroplasty, is considered by many to be one of the most successful medical innovations of the 20th century. Total joint replacement is a surgical procedure in which the patient's natural joint is replaced with an artificial one, made of a combination of plastic, metal, and/or ceramic.
The most common reasons for this surgery are pain and stiffness that limits normal activities such as walking and bending and that cannot be satisfactorily treated with medications or other therapies. Therefore, joint replacement surgery often provides a significantly improved quality of life to patients who would otherwise have to live with severe pain.
In 2007, there were 550,161 total knee replacements performed in the United States, and that number is on the rise - particularly as the Baby Boomer population continues to age. Because of this trend, it is important to optimize patient outcomes.
Disclosure:
Dr. Parratte and his co-authors received no compensation for this study.
Source:
Lauren L. Pearson
American Academy of Orthopaedic Surgeons
пятница, 23 сентября 2011 г.
Early ACL Surgery In Kids Would Save $30 Million & Prevent Thousands Of Secondary Injuries
Nearly $30 million a year would be saved in hospital charges if early rather than delayed ACL (anterior cruciate ligament) reconstruction surgery was performed on pediatric patients, according to a study presented at the American Orthopaedic Society for Sports Medicine's (AOSSM) Annual Meeting in Providence, Rhode Island. Additionally, more than 7,300 tears to the meniscus and 7,800 cartilage tears in children could be avoided each year in the U.S. by early ACL surgery.
"The timing of pediatric and adolescent ACL surgery has historically been controversial," said Theodore J. Ganley, MD, Director of Sports Medicine and Associate Professor at the Children's Hospital of Philadelphia. "The theoretical risks of growth disturbance in younger patients are balanced against the risk of further knee damage related to delaying treatment until closer to skeletal maturity."
The goal of ACL knee surgery is to stabilize the knee allowing patients get back to a healthy, active lifestyle. Long-term, the surgery aims to prevent instability and additional damage to the knee.
A 14-year review of ACL reconstructions presented by the authors at the 2009 AOSSM Annual Meeting revealed a 4 to 11-fold increase in meniscal and cartilage injuries with a greater than 12 week delay in ACL treatment.
In the current study, a model for pediatric ACL reconstruction was developed based on probabilities derived from the ACL review. Identical groups of 100,000 patients, representative of the U.S. population were simulated to undergo either early or delayed ACL reconstruction, with the secondary meniscal and cartilage damage and hospital charges compared between the two groups.
"The decision tree and statistical modeling approach for the study created by my co-author Suneel Bhat, is unique in that it incorporates variability, thereby generating a model simulation of a large scale prospective study, which provides a way to generalize implications," said Dr. Ganley. The simulation found that in females in the U.S., delaying ACL reconstruction beyond 12 weeks resulted in 1,560 medial meniscal tears and 2,100 cartilage tears relative to early surgery each year. In males, delayed surgery resulted in 3,300 medial meniscal tears and 5,720 cartilage tears relative to early surgery.
The study revealed that more than $29.4 million would be saved in hospital charges for pediatric patients each year in the U.S. by reconstructing ACL tears early rather than delaying treatment.
Source:
Lisa Weisenberger
American Orthopaedic Society for Sports Medicine
"The timing of pediatric and adolescent ACL surgery has historically been controversial," said Theodore J. Ganley, MD, Director of Sports Medicine and Associate Professor at the Children's Hospital of Philadelphia. "The theoretical risks of growth disturbance in younger patients are balanced against the risk of further knee damage related to delaying treatment until closer to skeletal maturity."
The goal of ACL knee surgery is to stabilize the knee allowing patients get back to a healthy, active lifestyle. Long-term, the surgery aims to prevent instability and additional damage to the knee.
A 14-year review of ACL reconstructions presented by the authors at the 2009 AOSSM Annual Meeting revealed a 4 to 11-fold increase in meniscal and cartilage injuries with a greater than 12 week delay in ACL treatment.
In the current study, a model for pediatric ACL reconstruction was developed based on probabilities derived from the ACL review. Identical groups of 100,000 patients, representative of the U.S. population were simulated to undergo either early or delayed ACL reconstruction, with the secondary meniscal and cartilage damage and hospital charges compared between the two groups.
"The decision tree and statistical modeling approach for the study created by my co-author Suneel Bhat, is unique in that it incorporates variability, thereby generating a model simulation of a large scale prospective study, which provides a way to generalize implications," said Dr. Ganley. The simulation found that in females in the U.S., delaying ACL reconstruction beyond 12 weeks resulted in 1,560 medial meniscal tears and 2,100 cartilage tears relative to early surgery each year. In males, delayed surgery resulted in 3,300 medial meniscal tears and 5,720 cartilage tears relative to early surgery.
The study revealed that more than $29.4 million would be saved in hospital charges for pediatric patients each year in the U.S. by reconstructing ACL tears early rather than delaying treatment.
Source:
Lisa Weisenberger
American Orthopaedic Society for Sports Medicine
вторник, 20 сентября 2011 г.
Hip, Thigh Implants Can Raise Bone Fracture Risk In Children
Children with hip and thigh implants designed to help heal a broken bone or correct other bone conditions are at risk for subsequent fractures of the very bones that the implants were intended to treat, according to new research from Johns Hopkins Children's Center.
Findings of the Johns Hopkins study, based on an analysis of more than 7,500 pediatric bone implants performed at Hopkins over 15 years, will be presented Feb. 16 at the annual meeting of the American Academy of Orthopaedic Surgeons.
Although the absolute risk among the patients was relatively small - nine out of 1,000 hip and thigh implants were linked to hip and thigh fractures - it was 15 times higher than the risk for implant-related fractures in other bones, the researchers say. They urge orthopedic surgeons to carefully consider removing the implants a few years after surgery or once the bone has healed completely.
Implant related fractures are believed to stem from the pressure and stress that the implant exerts on the bone, especially in patients whose bones are still growing and in those with already weakened or brittle bones from preexisting conditions such as cerebral palsy and some rare skeletal syndromes. Indeed, most of the 25 implant-related fractures in the study occurred in children with such diagnoses.
The investigators note that hip and thigh bones experience the highest stress because their shape changes rapidly during growth, so removing these implants may be especially important for children.
"Removing the implant early and as soon as the bone heals is a wise consideration for all children with hip and thigh implants, but even more so for patients with already vulnerable bone structure," says senior investigator Paul Sponseller, M.D., M.B.A., director of orthopedic surgery at Hopkins Children's.
Thigh implants carried the highest risk - 20 of the 25 fractures observed in the study involved hip and/or thigh implants, or nine fractures per 1,000 such implants. The overall risk for fractures caused by implants in any bone was three per 1,000, while the risk of fracture was less than one per 1,000 in the hand, arm, forearm, leg, ankle and foot bones.
Low-risk implants in healthy children are best left in, the researchers add, because the surgical risks of removing them may outweigh the benefits.
"To remove or not remove an otherwise asymptomatic implant has been a long-standing question in orthopedic surgery, and we hope that our findings will help surgeons and patients make such decisions," Sponseller says.
The average time between implant insertion and fracture was 2.6 years.
Co-investigators on the research included Amit Jain, B.S., Arabella Leet, M.D., and Michael Ain, M.D., all of Hopkins, and Gurkan Erkula, M.D., formerly of Hopkins.
Source:
Johns Hopkins Medicine
Findings of the Johns Hopkins study, based on an analysis of more than 7,500 pediatric bone implants performed at Hopkins over 15 years, will be presented Feb. 16 at the annual meeting of the American Academy of Orthopaedic Surgeons.
Although the absolute risk among the patients was relatively small - nine out of 1,000 hip and thigh implants were linked to hip and thigh fractures - it was 15 times higher than the risk for implant-related fractures in other bones, the researchers say. They urge orthopedic surgeons to carefully consider removing the implants a few years after surgery or once the bone has healed completely.
Implant related fractures are believed to stem from the pressure and stress that the implant exerts on the bone, especially in patients whose bones are still growing and in those with already weakened or brittle bones from preexisting conditions such as cerebral palsy and some rare skeletal syndromes. Indeed, most of the 25 implant-related fractures in the study occurred in children with such diagnoses.
The investigators note that hip and thigh bones experience the highest stress because their shape changes rapidly during growth, so removing these implants may be especially important for children.
"Removing the implant early and as soon as the bone heals is a wise consideration for all children with hip and thigh implants, but even more so for patients with already vulnerable bone structure," says senior investigator Paul Sponseller, M.D., M.B.A., director of orthopedic surgery at Hopkins Children's.
Thigh implants carried the highest risk - 20 of the 25 fractures observed in the study involved hip and/or thigh implants, or nine fractures per 1,000 such implants. The overall risk for fractures caused by implants in any bone was three per 1,000, while the risk of fracture was less than one per 1,000 in the hand, arm, forearm, leg, ankle and foot bones.
Low-risk implants in healthy children are best left in, the researchers add, because the surgical risks of removing them may outweigh the benefits.
"To remove or not remove an otherwise asymptomatic implant has been a long-standing question in orthopedic surgery, and we hope that our findings will help surgeons and patients make such decisions," Sponseller says.
The average time between implant insertion and fracture was 2.6 years.
Co-investigators on the research included Amit Jain, B.S., Arabella Leet, M.D., and Michael Ain, M.D., all of Hopkins, and Gurkan Erkula, M.D., formerly of Hopkins.
Source:
Johns Hopkins Medicine
суббота, 17 сентября 2011 г.
Electronic Health Record-Based Programs Triples Osteoporosis Screening Rate, Study Finds
Use of the Electronic Health Record tripled the rate of osteoporosis screenings in women who are at risk for the disease, according to a study conducted recently by a team of Geisinger Health System researchers.
About half of those who were screened were considered high-risk for the disease, the study found.
An estimated 10 million Americans suffer from the disease and the nation collectively spends about $18 billion per year on bone fractures related to osteoporosis.
EHR-screening programs can help improve those numbers, make patients' everyday lives less painful and save doctors time and resources, said Dr. Eric Newman, Geisinger's Director of Rheumatology.
The EHR was used to identify women who had not had bone density screens for osteoporosis in the last two years. Those women were sent letters and received telephone calls if their records were flagged.
"This is pretty significant," said Dr. William Ayoub of Geisinger Medical Group-Scenery Park, State College, one of the study's authors. "The EHR is streamlining the screening process and letting people know about a potential health concern before it becomes a major problem."
The EHR screening program was started in two Geisinger family practice clinics near State College, Pa. It was so successful that there are now plans to implement the program at other sites throughout the Geisinger system, Newman said.
Geisinger Health System is widely recognized as a leader in EHR implementation and development. Osteoporosis screening is one of the specific areas in which Geisinger has used its fully implemented $70 million Electronic Health Record, Newman said.
"We are clearly out there trying to prevent fractures from occurring," Newman said. "We proactively want to identify women who are at a great risk for osteoporosis."
The study was presented at the American College of Rheumatology's annual meeting in Washington D.C. in November. Just one in 10 papers were accepted for oral presentation at the meeting.
About Geisinger Health System
Geisinger Health System is one of the nation's leading fully integrated healthcare providers. Founded in 1915, Geisinger serves more than two million residents throughout central and northeastern Pennsylvania. The physician-led organization is at the forefront of the country's rapidly emerging electronic health records movement. Geisinger includes three major regional medical centers, a 650-member group practice, a not-for-profit health insurance company, and the Geisinger Center for Health Research-dedicated to creating innovative new models for patient care, satisfaction and clinical outcomes.
Contact: Justin Walden
Geisinger Health System
About half of those who were screened were considered high-risk for the disease, the study found.
An estimated 10 million Americans suffer from the disease and the nation collectively spends about $18 billion per year on bone fractures related to osteoporosis.
EHR-screening programs can help improve those numbers, make patients' everyday lives less painful and save doctors time and resources, said Dr. Eric Newman, Geisinger's Director of Rheumatology.
The EHR was used to identify women who had not had bone density screens for osteoporosis in the last two years. Those women were sent letters and received telephone calls if their records were flagged.
"This is pretty significant," said Dr. William Ayoub of Geisinger Medical Group-Scenery Park, State College, one of the study's authors. "The EHR is streamlining the screening process and letting people know about a potential health concern before it becomes a major problem."
The EHR screening program was started in two Geisinger family practice clinics near State College, Pa. It was so successful that there are now plans to implement the program at other sites throughout the Geisinger system, Newman said.
Geisinger Health System is widely recognized as a leader in EHR implementation and development. Osteoporosis screening is one of the specific areas in which Geisinger has used its fully implemented $70 million Electronic Health Record, Newman said.
"We are clearly out there trying to prevent fractures from occurring," Newman said. "We proactively want to identify women who are at a great risk for osteoporosis."
The study was presented at the American College of Rheumatology's annual meeting in Washington D.C. in November. Just one in 10 papers were accepted for oral presentation at the meeting.
About Geisinger Health System
Geisinger Health System is one of the nation's leading fully integrated healthcare providers. Founded in 1915, Geisinger serves more than two million residents throughout central and northeastern Pennsylvania. The physician-led organization is at the forefront of the country's rapidly emerging electronic health records movement. Geisinger includes three major regional medical centers, a 650-member group practice, a not-for-profit health insurance company, and the Geisinger Center for Health Research-dedicated to creating innovative new models for patient care, satisfaction and clinical outcomes.
Contact: Justin Walden
Geisinger Health System
среда, 14 сентября 2011 г.
DeCODE Discovers Common Genetic Variations Contributing To Low Bone Mineral Density And Risk Of Osteoporosis
Scientists from deCODE genetics (Nasdaq: DCGN) and colleagues from Australia and Denmark report the discovery of common single-letter variations (SNPs) in the human genome linked to low bone mineral density (BMD), the clinical measurement used to diagnose osteoporosis. deCODE had previously identified five sites in the genome harboring SNPs with influence on BMD, and today's study has added four more. They were identified through the correlation of BMD measurements with more than 300,000 SNPs across the genomes of 7,000 study participants in Iceland. The findings were then followed up and replicated in more than 5,000 participants from Denmark and Australia. The paper, "New sequence variants associated with bone mineral density," is published in the online edition of Nature Genetics at nature/ng, and will appear in an upcoming print edition of the journal.
The new variants reported today are located on chromosomes 17q21, 14q32, 12q13 and 18q21. Like the variants previously discovered by deCODE, certain of those reported today are known to be involved in bone and skeletal development. The SNPs on chromosome 17 are adjacent to the SOST gene, which encodes sclerostin, a protein involved in the formation of bone. And the SNP on chromosome 18 lies close to the TNFRSF11A gene that has been implicated in Paget's disease, a disorder causing localized bone deformities and weakness.
"This study expands our understanding of the genetic factors contributing to low bone mineral density, propensity to fractures, and osteoporosis. And the genetics is clearly pointing us toward valuable novel drug targets. The next steps in this work are to analyze how these variants contribute to low BMD and related disorders, and to identify additional common as well as rare variants with a high impact on bone density. Once we do, we may well bring together genetic risk factors accounting for a sufficient proportion of risk of osteoporosis to develop a clinically useful DNA-based risk assessment test. This could be a valuable tool, since peak bone density is achieved by early adulthood. Those at high risk of osteoporosis could therefore take concrete measures including appropriate diet and exercise regimes, to maximize their bone mass in youth and lower their risk of the disease later in life," said Kari Stefansson, CEO of deCODE.
deCODE would like to thank the Icelandic participants, as well as the participants and scientists from the Danish Prospective Epidemiological risk Factor (PERF) study and the Australian Dubbo Osteoporosis Epidemiological Study (DOES), for making this study possible.
About deCODE
deCODE is a bio-pharmaceutical company developing drugs and DNA-based tests to improve the treatment, diagnosis and prevention of common diseases. Its lead therapeutic programs, which leverage the company's expertise in chemistry and structural biology, include DG041, an antiplatelet compound being developed for the prevention of arterial thrombosis; DG051 and DG031, compounds targeting the leukotriene pathway for the prevention of heart attack; and DG071 and a platform for other PDE4 modulators with therapeutic applications in Alzheimer's disease and other conditions. deCODE is a global leader in human genetics, and has identified key variations in the genome (SNPs) conferring increased risk of major public health challenges from cardiovascular disease to cancer. Based upon these discoveries deCODE has brought to market a growing range of DNA-based tests for gauging risk and empowering prevention of common diseases. Through its CLIA-registered laboratory, deCODE is offers deCODE T2(TM) for type 2 diabetes; deCODE AF(TM) for atrial fibrillation and stroke; deCODE MI(TM) for heart attack; deCODE ProstateCancer(TM) for prostate cancer; deCODE Glaucoma(TM) for a major type of glaucoma; and deCODE BreastCancer(TM), for the common forms of breast cancer. deCODE is delivering on the promise of the new genetics.SM Visit us on the web at decode; on our diagnostics site at decodediagnostics; for our pioneering personal genome analysis service, integrating the genetic variants included in these tests and those linked to another twenty common diseases, at decodeme; and on our blog at decodeyou.
Any statements contained in this presentation that relate to future plans, events or performance are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements are subject to a number of risks and uncertainties that could cause actual results, and the timing of events, to differ materially from those described in the forward-looking statements. These risks and uncertainties include, among others, those relating to our ability to obtain financing and to form collaborative relationships, the effect of a potential delisting of our common stock from The Nasdaq Global Market, uncertainty regarding potential future deterioration in the market for auction rate securities which could negatively affect our cash position and result in additional permanent impairment charges, our ability to develop and market diagnostic products, the level of third party reimbursement for our products, risks related to preclinical and clinical development of pharmaceutical products, including the identification of compounds and the completion of clinical trials, the effect of government regulation and the regulatory approval processes, market acceptance, our ability to obtain and protect intellectual property rights for our products, dependence on collaborative relationships, the effect of competitive products, industry trends and other risks identified in deCODE's filings with the Securities and Exchange Commission, including, without limitation, the risk factors identified in our most recent Annual Report on Form 10-K and any updates to those risk factors filed from time to time in our Quarterly Reports on Form 10-Q or Current Reports on Form 8-K. deCODE undertakes no obligation to update or alter these forward-looking statements as a result of new information, future events or otherwise.
deCODE genetics Inc
decode
The new variants reported today are located on chromosomes 17q21, 14q32, 12q13 and 18q21. Like the variants previously discovered by deCODE, certain of those reported today are known to be involved in bone and skeletal development. The SNPs on chromosome 17 are adjacent to the SOST gene, which encodes sclerostin, a protein involved in the formation of bone. And the SNP on chromosome 18 lies close to the TNFRSF11A gene that has been implicated in Paget's disease, a disorder causing localized bone deformities and weakness.
"This study expands our understanding of the genetic factors contributing to low bone mineral density, propensity to fractures, and osteoporosis. And the genetics is clearly pointing us toward valuable novel drug targets. The next steps in this work are to analyze how these variants contribute to low BMD and related disorders, and to identify additional common as well as rare variants with a high impact on bone density. Once we do, we may well bring together genetic risk factors accounting for a sufficient proportion of risk of osteoporosis to develop a clinically useful DNA-based risk assessment test. This could be a valuable tool, since peak bone density is achieved by early adulthood. Those at high risk of osteoporosis could therefore take concrete measures including appropriate diet and exercise regimes, to maximize their bone mass in youth and lower their risk of the disease later in life," said Kari Stefansson, CEO of deCODE.
deCODE would like to thank the Icelandic participants, as well as the participants and scientists from the Danish Prospective Epidemiological risk Factor (PERF) study and the Australian Dubbo Osteoporosis Epidemiological Study (DOES), for making this study possible.
About deCODE
deCODE is a bio-pharmaceutical company developing drugs and DNA-based tests to improve the treatment, diagnosis and prevention of common diseases. Its lead therapeutic programs, which leverage the company's expertise in chemistry and structural biology, include DG041, an antiplatelet compound being developed for the prevention of arterial thrombosis; DG051 and DG031, compounds targeting the leukotriene pathway for the prevention of heart attack; and DG071 and a platform for other PDE4 modulators with therapeutic applications in Alzheimer's disease and other conditions. deCODE is a global leader in human genetics, and has identified key variations in the genome (SNPs) conferring increased risk of major public health challenges from cardiovascular disease to cancer. Based upon these discoveries deCODE has brought to market a growing range of DNA-based tests for gauging risk and empowering prevention of common diseases. Through its CLIA-registered laboratory, deCODE is offers deCODE T2(TM) for type 2 diabetes; deCODE AF(TM) for atrial fibrillation and stroke; deCODE MI(TM) for heart attack; deCODE ProstateCancer(TM) for prostate cancer; deCODE Glaucoma(TM) for a major type of glaucoma; and deCODE BreastCancer(TM), for the common forms of breast cancer. deCODE is delivering on the promise of the new genetics.SM Visit us on the web at decode; on our diagnostics site at decodediagnostics; for our pioneering personal genome analysis service, integrating the genetic variants included in these tests and those linked to another twenty common diseases, at decodeme; and on our blog at decodeyou.
Any statements contained in this presentation that relate to future plans, events or performance are forward-looking statements within the meaning of the Private Securities Litigation Reform Act of 1995. These forward-looking statements are subject to a number of risks and uncertainties that could cause actual results, and the timing of events, to differ materially from those described in the forward-looking statements. These risks and uncertainties include, among others, those relating to our ability to obtain financing and to form collaborative relationships, the effect of a potential delisting of our common stock from The Nasdaq Global Market, uncertainty regarding potential future deterioration in the market for auction rate securities which could negatively affect our cash position and result in additional permanent impairment charges, our ability to develop and market diagnostic products, the level of third party reimbursement for our products, risks related to preclinical and clinical development of pharmaceutical products, including the identification of compounds and the completion of clinical trials, the effect of government regulation and the regulatory approval processes, market acceptance, our ability to obtain and protect intellectual property rights for our products, dependence on collaborative relationships, the effect of competitive products, industry trends and other risks identified in deCODE's filings with the Securities and Exchange Commission, including, without limitation, the risk factors identified in our most recent Annual Report on Form 10-K and any updates to those risk factors filed from time to time in our Quarterly Reports on Form 10-Q or Current Reports on Form 8-K. deCODE undertakes no obligation to update or alter these forward-looking statements as a result of new information, future events or otherwise.
deCODE genetics Inc
decode
воскресенье, 11 сентября 2011 г.
Novel Model Of Osteosarcoma
In the June 15th issue of G&D, Dr. Stuart Orkin (HHMI, Dana-Farber Cancer Institute, Children's Hospital Boston) and colleagues present a new mouse model of osteosarcoma.
Osteosarcoma is the most common type of malignant bone cancer, and one of the most lethal: The 5-year survival rate is only about 60%, and this statistic drops steeply once the cancer spreads. Osteosarcoma results from the dysregulated growth of osteoblasts (the cells that form the bone matrix). It primarily develops near the ends of the femur, tibia or humerus, and is usually diagnosed during adolescence, when the long bones of the body are undergoing rapid growth.
While the precise causes of osteosarcoma are unknown, it is evident that two tumor suppressor genes - p53 and Rb - are involved, as children with familial mutation syndromes affecting either of these genes have higher incidences of osteosarcoma.
Dr. Orkin's team has developed a novel experimental system to model the genetics of human osteosarcoma. The researchers generated a strain of transgenic mice lacking specifically the p53 and Rb genes in an early osteoblast progenitor cell population. All mutant animals rapidly developed osteosarcomas, with clinical, histo-cytological and molecular features closely recapitulating the human disease.
The scientists concluded that p53 loss is essential for the development of osteosarcoma, and that while Rb gene mutation acts synergistically with p53 loss to facilitate carcinogenesis, loss of Rb, alone, is not sufficient to induce osteosarcomagenesis.
Ultimately, this high-fidelity animal model will further elucidate the genetic contributions to osteosarcoma, and enable researchers to rationally design and test new therapies. Dr. Orkin is hopeful that "our work will stimulate translational efforts to develop novel therapies for this devastating bone tumor".
Source: Heather Cosel-Pieper
Cold Spring Harbor Laboratory
Osteosarcoma is the most common type of malignant bone cancer, and one of the most lethal: The 5-year survival rate is only about 60%, and this statistic drops steeply once the cancer spreads. Osteosarcoma results from the dysregulated growth of osteoblasts (the cells that form the bone matrix). It primarily develops near the ends of the femur, tibia or humerus, and is usually diagnosed during adolescence, when the long bones of the body are undergoing rapid growth.
While the precise causes of osteosarcoma are unknown, it is evident that two tumor suppressor genes - p53 and Rb - are involved, as children with familial mutation syndromes affecting either of these genes have higher incidences of osteosarcoma.
Dr. Orkin's team has developed a novel experimental system to model the genetics of human osteosarcoma. The researchers generated a strain of transgenic mice lacking specifically the p53 and Rb genes in an early osteoblast progenitor cell population. All mutant animals rapidly developed osteosarcomas, with clinical, histo-cytological and molecular features closely recapitulating the human disease.
The scientists concluded that p53 loss is essential for the development of osteosarcoma, and that while Rb gene mutation acts synergistically with p53 loss to facilitate carcinogenesis, loss of Rb, alone, is not sufficient to induce osteosarcomagenesis.
Ultimately, this high-fidelity animal model will further elucidate the genetic contributions to osteosarcoma, and enable researchers to rationally design and test new therapies. Dr. Orkin is hopeful that "our work will stimulate translational efforts to develop novel therapies for this devastating bone tumor".
Source: Heather Cosel-Pieper
Cold Spring Harbor Laboratory
четверг, 8 сентября 2011 г.
Cost Effective Relief From Low Back Pain With Acupuncture
Acupuncture has a small but significant benefit for patients with low back pain, and appears to be cost-effective in the longer term, find two studies published on bmj today.
In the UK, an estimated 16% of the adult population consult their general practitioner for help with back pain in a 12-month period. The annual cost of lower back pain to the NHS has been estimated at 480 pounds million (пїЅ703million; $901million) and the burden of lower back pain is estimated at over пїЅ10 billion per year in terms of lost productivity and sickness benefits.
Acupuncture is used by an estimated 2% of adults each year for a range of conditions, including back pain. But the evidence is largely inconclusive and the best way to manage low back pain remains unclear.
So, researchers identified 241 adults aged 18 to 65 with persistent non-specific low back pain. The people were provided by members of the British Acupuncture Council. Patients were randomly assigned to either usual NHS care or up to 10 acupuncture treatment sessions. All patients remained under GP care.
Pain levels were measured at intervals during the two-year study period. Satisfaction with treatment and use of pain medication were also recorded.
At 12 months, patients in the acupuncture group showed a small benefit in pain scores compared to patients receiving usual care. Stronger evidence was observed for an increased benefit at 24 months.
At three months, patients in the acupuncture group were significantly more likely to be 'very satisfied' with their treatment compared with usual care, and with their overall care, but showed no such difference in satisfaction with information received.
At 24 months, the acupuncture group were more likely to report reduced worry about their back pain, less likely to report current use of pain medication for their back, and more likely to report no pain for the past 12 months.
Although the differences in pain scores between groups were small, they represent a clinically worthwhile benefit and can be viewed as a 'moderate' effect, say the authors.
Further research is needed to investigate the optimum timing for such an acupuncture treatment package, and to assess the value of repeated courses of acupuncture for patients experiencing recurrent episodes of low back pain, they conclude.
In a separate paper, the same researchers looked at the cost effectiveness of acupuncture for lower back pain. Costs were measured from both an NHS and a societal perspective, and effectiveness was measured in terms of quality adjusted life years (QALYs) gained.
They found that total NHS costs during the two-year study period were higher on average for the acupuncture group (460 pounds; пїЅ673; $859) than for the usual care group (345 pounds; пїЅ506; $644).
However, the cost per QALY gained was 4,241 pounds (пїЅ6,223; $7,921). This is well below the lower threshold of 20,000 pounds used by the National Institute for Health and Clinical Excellence (NICE) to decide whether the NHS can afford to pay for a health technology.
A short course of traditional acupuncture for the treatment of lower back pain in primary care confers a modest health benefit measured in QALYs for a relatively minor extra NHS cost relative to usual care, say the authors. The use of acupuncture for the treatment of lower back pain therefore appears to be cost-effective in the longer term.
Contact: Emma Dickinson
BMJ-British Medical Journal
In the UK, an estimated 16% of the adult population consult their general practitioner for help with back pain in a 12-month period. The annual cost of lower back pain to the NHS has been estimated at 480 pounds million (пїЅ703million; $901million) and the burden of lower back pain is estimated at over пїЅ10 billion per year in terms of lost productivity and sickness benefits.
Acupuncture is used by an estimated 2% of adults each year for a range of conditions, including back pain. But the evidence is largely inconclusive and the best way to manage low back pain remains unclear.
So, researchers identified 241 adults aged 18 to 65 with persistent non-specific low back pain. The people were provided by members of the British Acupuncture Council. Patients were randomly assigned to either usual NHS care or up to 10 acupuncture treatment sessions. All patients remained under GP care.
Pain levels were measured at intervals during the two-year study period. Satisfaction with treatment and use of pain medication were also recorded.
At 12 months, patients in the acupuncture group showed a small benefit in pain scores compared to patients receiving usual care. Stronger evidence was observed for an increased benefit at 24 months.
At three months, patients in the acupuncture group were significantly more likely to be 'very satisfied' with their treatment compared with usual care, and with their overall care, but showed no such difference in satisfaction with information received.
At 24 months, the acupuncture group were more likely to report reduced worry about their back pain, less likely to report current use of pain medication for their back, and more likely to report no pain for the past 12 months.
Although the differences in pain scores between groups were small, they represent a clinically worthwhile benefit and can be viewed as a 'moderate' effect, say the authors.
Further research is needed to investigate the optimum timing for such an acupuncture treatment package, and to assess the value of repeated courses of acupuncture for patients experiencing recurrent episodes of low back pain, they conclude.
In a separate paper, the same researchers looked at the cost effectiveness of acupuncture for lower back pain. Costs were measured from both an NHS and a societal perspective, and effectiveness was measured in terms of quality adjusted life years (QALYs) gained.
They found that total NHS costs during the two-year study period were higher on average for the acupuncture group (460 pounds; пїЅ673; $859) than for the usual care group (345 pounds; пїЅ506; $644).
However, the cost per QALY gained was 4,241 pounds (пїЅ6,223; $7,921). This is well below the lower threshold of 20,000 pounds used by the National Institute for Health and Clinical Excellence (NICE) to decide whether the NHS can afford to pay for a health technology.
A short course of traditional acupuncture for the treatment of lower back pain in primary care confers a modest health benefit measured in QALYs for a relatively minor extra NHS cost relative to usual care, say the authors. The use of acupuncture for the treatment of lower back pain therefore appears to be cost-effective in the longer term.
Contact: Emma Dickinson
BMJ-British Medical Journal
понедельник, 5 сентября 2011 г.
Eating Broccoli Could Guard Against Arthritis
Scientists at the University of East Anglia (UEA) are launching a groundbreaking new project to investigate the benefits of broccoli in the fight against osteoarthritis.
Initial laboratory research at UEA has found that a compound in broccoli called sulforaphane blocks the enzymes that cause joint destruction in osteoarthritis the most common form of arthritis.
Broccoli has previously been associated with reduced cancer risk but this is the first major study into its effects on joint health.
With funding from both Arthritis Research UK and the Diet and Health Research Industry Club (DRINC), the ВЈ650,000 project will explore how sulforaphane may act to slow or prevent the development of osteoarthritis. It will prepare the way for the first patient trials and could lead to safe new ways of preventing and treating this painful disease.
Sulforaphane is a bioactive compound found in cruciferous vegetables, particularly broccoli. Eating broccoli leads to a high level of sulforaphane in the blood, but scientists don't yet know if the sulforaphane gets into joints in sufficient amounts to be effective. This is one of the things that the UEA team hopes to discover.
Osteoarthritis is the leading cause of disability in the UK where it affects around six million people. It is a degenerative joint disease which gradually destroys the cartilage in the joints, particularly in the hands, feet, spine, hips and knees of older people. There is currently no effective treatment other than pain relief or joint replacement.
Prof Ian Clark, of UEA's School of Biological Sciences, who is leading the research said: "The UK has an aging population and developing new strategies for combating age-related diseases such as osteoarthritis is vital to improve the quality of life for sufferers but also to reduce the economic burden on society."
As part of the three-year project, the UEA team will also investigate the effects of other dietary compounds on osteoarthritis, including diallyl disulphide which is found in high amounts in garlic and also appears to slow the destruction of cartilage in laboratory models.
Source: East Anglia University, AlphaGalileo Foundation.
Initial laboratory research at UEA has found that a compound in broccoli called sulforaphane blocks the enzymes that cause joint destruction in osteoarthritis the most common form of arthritis.
Broccoli has previously been associated with reduced cancer risk but this is the first major study into its effects on joint health.
With funding from both Arthritis Research UK and the Diet and Health Research Industry Club (DRINC), the ВЈ650,000 project will explore how sulforaphane may act to slow or prevent the development of osteoarthritis. It will prepare the way for the first patient trials and could lead to safe new ways of preventing and treating this painful disease.
Sulforaphane is a bioactive compound found in cruciferous vegetables, particularly broccoli. Eating broccoli leads to a high level of sulforaphane in the blood, but scientists don't yet know if the sulforaphane gets into joints in sufficient amounts to be effective. This is one of the things that the UEA team hopes to discover.
Osteoarthritis is the leading cause of disability in the UK where it affects around six million people. It is a degenerative joint disease which gradually destroys the cartilage in the joints, particularly in the hands, feet, spine, hips and knees of older people. There is currently no effective treatment other than pain relief or joint replacement.
Prof Ian Clark, of UEA's School of Biological Sciences, who is leading the research said: "The UK has an aging population and developing new strategies for combating age-related diseases such as osteoarthritis is vital to improve the quality of life for sufferers but also to reduce the economic burden on society."
As part of the three-year project, the UEA team will also investigate the effects of other dietary compounds on osteoarthritis, including diallyl disulphide which is found in high amounts in garlic and also appears to slow the destruction of cartilage in laboratory models.
Source: East Anglia University, AlphaGalileo Foundation.
пятница, 2 сентября 2011 г.
Foot Fashion Could Ease Arthritic Knees
The use of special mobility shoes can help ease knee pain and slow disease progression in people with osteoarthritis, according to research presented this week at the American College of Rheumatology Annual Scientific Meeting in Atlanta.
Osteoarthritis, or OA as it is commonly called, is the most common joint disease affecting middle-age and older people. It is characterized by progressive damage to the joint cartilage the cushioning material at the end of long bones and causes changes in the structures around the joint. These changes can include fluid accumulation, bony overgrowth, and loosening and weakness of muscles and tendons, all of which may limit movement and cause pain and swelling.
"Forces on the knee joint during walking have been shown to be related to pain, severity and progression of knee osteoarthritis," explains Najia Shakoor, MD; associate professor of medicine at Rush University in Chicago and lead investigator in the study. "Therefore, researchers currently investigate strategies to reduce these forces or loads on the knee joint in hopes of preventing progression of the disease." Dr. Shakoor's study recently tested these strategies, more specifically, by studying how the use of mobility shoes flat and flexible shoes, created specifically for this research, that allow natural foot mobility and provide sufficient support for the foot can affect knee OA.
At the beginning of the study, researchers used a special camera system and a force plate to determine gait (how a person walks) in 16 participants (who were all diagnosed with knee OA through X-rays and based on symptoms) while they walked in their own shoes, in mobility shoes, and barefoot. After this initial evaluation, participants were instructed to wear the mobility shoes a minimum of six hours per day, six days a week for six months. To determine the progression of each participant, researchers performed the same gait analysis that was performed at the beginning of the study at six, 12 and 24 weeks.
Overall, researchers determined that mobility shoes, in comparison to conventional shoes, led to significantly decreased knee loads in the participants. Additionally, they found that longer-term use of the mobility shoes led to even better outcomes in participants noting a reduction in knee load that increased from 3.7 percent at the beginning of the study to 9.4 percent after six weeks, and to 18 percent at six months. Finally, researchers found that after 24 weeks of wearing mobility shoes, participants experienced an adaptation in their gait (with a knee load reduction of 11 percent) even when wearing conventional shoes leading researchers to believe that the use of mobility shoes could create beneficial neuromuscular and behavioral changes in how people with OA walk.
"This study showed that specialized footwear was beneficial in reducing knee loads substantially over six months," says Dr. Shakoor. "It is also the first study to show that chronic use of a mechanical, knee-load reducing intervention could lead to favorable alterations in the way participants walk even once the intervention is removed. "
Source: American College of Rheumatology (ACR)
Osteoarthritis, or OA as it is commonly called, is the most common joint disease affecting middle-age and older people. It is characterized by progressive damage to the joint cartilage the cushioning material at the end of long bones and causes changes in the structures around the joint. These changes can include fluid accumulation, bony overgrowth, and loosening and weakness of muscles and tendons, all of which may limit movement and cause pain and swelling.
"Forces on the knee joint during walking have been shown to be related to pain, severity and progression of knee osteoarthritis," explains Najia Shakoor, MD; associate professor of medicine at Rush University in Chicago and lead investigator in the study. "Therefore, researchers currently investigate strategies to reduce these forces or loads on the knee joint in hopes of preventing progression of the disease." Dr. Shakoor's study recently tested these strategies, more specifically, by studying how the use of mobility shoes flat and flexible shoes, created specifically for this research, that allow natural foot mobility and provide sufficient support for the foot can affect knee OA.
At the beginning of the study, researchers used a special camera system and a force plate to determine gait (how a person walks) in 16 participants (who were all diagnosed with knee OA through X-rays and based on symptoms) while they walked in their own shoes, in mobility shoes, and barefoot. After this initial evaluation, participants were instructed to wear the mobility shoes a minimum of six hours per day, six days a week for six months. To determine the progression of each participant, researchers performed the same gait analysis that was performed at the beginning of the study at six, 12 and 24 weeks.
Overall, researchers determined that mobility shoes, in comparison to conventional shoes, led to significantly decreased knee loads in the participants. Additionally, they found that longer-term use of the mobility shoes led to even better outcomes in participants noting a reduction in knee load that increased from 3.7 percent at the beginning of the study to 9.4 percent after six weeks, and to 18 percent at six months. Finally, researchers found that after 24 weeks of wearing mobility shoes, participants experienced an adaptation in their gait (with a knee load reduction of 11 percent) even when wearing conventional shoes leading researchers to believe that the use of mobility shoes could create beneficial neuromuscular and behavioral changes in how people with OA walk.
"This study showed that specialized footwear was beneficial in reducing knee loads substantially over six months," says Dr. Shakoor. "It is also the first study to show that chronic use of a mechanical, knee-load reducing intervention could lead to favorable alterations in the way participants walk even once the intervention is removed. "
Source: American College of Rheumatology (ACR)
Подписаться на:
Сообщения (Atom)