Thursday, May 28, 2015

New technology could save the lives of more transplant patients, new research suggests

New technology could save the lives of more transplant patients, new research suggests

New technology could 'significantly' improve stem cell transplant outcomes, new research by the blood cancer charity Anthony Nolan has revealed.
The promising technology has the potential to 'revolutionise' the field of tissue (or HLA) typing, according to the researchers.
It allows Anthony Nolan's scientists to obtain very high quality and 'unparalleled' information about a patient and donor's tissue types which enables them to make the best possible matches.

This, they say, 'could ultimately result in considerable improvement in survival rates post-transplant'.  ...

Can Uganda end its Aids epidemic?

Can Uganda end its Aids epidemic?
HIV testing
Uganda's government is aiming to launch an ambitious campaign of HIV testing for its citizens.
According to the country's Minister of Health, the goal is that more than 90% of Ugandans will know their HIV status.
The Minister, Dr Elioda Tumwesigye, spoke of the plan on 'The Truth About AIDS' on the BBC World Service.
"We want to give an opportunity to every Ugandan at least one round to say yes or no to an HIV test," he said.
"We will go to every home, every village, and test."
Dr Tumwesigye claimed this door-to-door approach to testing counselling had worked well in the Western Ugandan district he represents as a member of parliament.
If the East African country can establish the HIV status of nine out of every ten people, it will have achieved the first of three targets of a new grand initiative led by UNAids (the Joint United Nations programme on HIV/Aids).

Tuesday, May 19, 2015

Livers donated after cardiac death are safe to use in liver cancer patients

Livers donated after cardiac death are safe to use in liver cancer patients

JACKSONVILLE, Fla. -- Patients with liver cancer can be cured with a liver transplant. But because of the shortage of donated organs, these patients often die waiting for a liver. That's because most transplant centers predominantly use livers from donors who die from brain death.
But in the largest study of its kind, transplant physicians at Mayo Clinic in Florida have found that liver cancer patients have the same beneficial outcomes using organs donated by patients who died of cardiac death. The study was recently published online in the American Journal of Transplantation.
"Our program has one of the largest experiences in the world with liver transplants using donations after cardiac death," says the study's lead investigator, transplant surgeon Kristopher P. Croome, M.D. "We now know that these organs effectively offer new life for patients with liver cancer."
"I believe this study firmly and finally answers the question as to whether liver donations after cardiac death are as viable for patients with liver cancer as livers from donors who die from brain death," he says. "They are."

Using organs after cardiac death for liver transplants could increase the number of transplants performed by 10 percent to 15 percent nationwide, Dr. Croome says. "One reason why the wait time for liver transplant is short at Mayo Clinic in Florida is that we efficiently and successfully use both types of donated livers. But nationwide, over the last decade, the transplant list and the number of liver cancer patients are increasing."  ...

Many ER Patients with Chest Pain Can Be Sent Home, Study Finds

Many ER Patients with Chest Pain Can Be Sent Home, Study Finds

HealthDay news image MONDAY, May 18, 2015 (HealthDay News) -- While chest pain sends many people to the nearest hospital emergency department, most patients may not need a costly hospital stay as a result, a new study suggests.
According to a news release from Ohio State University, chest pain sends more than 7 million Americans to the ER every year and about half of them are then admitted for further observation, testing or treatment.
But is the cost and inconvenience of a hospital stay always warranted?
The study aimed to "assess whether this population of patients could safely go home and do further outpatient testing within a day or two," lead researcher Dr. Michael Weinstock, a professor of emergency medicine at the university's College of Medicine, said in the news release.
His team looked at data from more than 11,000 visits by patients experiencing chest pain to three hospitals in Columbus, Ohio between 2008 and 2013.
Only four people in the study group -- working out to just 0.06 percent of patients -- developed a life-threatening heart rhythm, suffered a heart attack or cardiac or respiratory arrest, or died, Weinstock's team found.  ... 

Side Effects of Stem Cell/Bone Marrow Transplantation …

Side Effects of Stem Cell/Bone Marrow Transplantation …

Although a stem cell transplant (sometimes called a bone marrow transplant) is an effective treatment for several types of cancer, it can cause a number of different side effects. The type and intensity of these side effects vary from person to person and depend on the kind of transplant performed, the person’s overall health, and other factors. Your health care team will work with you to prevent side effects or manage any that occur. This is called palliative or supportive care and is an important part of your overall treatment plan. Be sure to talk with your health care team about any side effects you experience, including new symptoms or a change in symptoms.
The two most serious side effects of stem cell transplantation are infection and graft-versus-host disease.
Infection
The chemotherapy and/or radiation therapy given before a stem cell transplant weakens a persons immune system, lowering the bodys defenses against bacteria, viruses, and fungi. That means stem cell recipients are especially vulnerable to infection during this early period of treatment.
Although most people think the greatest risk of infection is from visitors or food, most infections that occur during the first few weeks after a transplant are caused by organisms that are already in the patient’s lungs, sinuses, skin, and intestines. Fortunately, most of these infections are relatively easy to treat with antibiotics.
The reduced immunity of the early transplant period lasts about two weeks, after which the immune system is back to near full strength and can keep most common germs at bay without the help of medications. This is true for both autologous (AUTO) transplant recipients (who receive their own stem cells) and allogeneic (ALLO) transplant recipients (who receive stem cells from another person).
However, a risk of serious infection remains for ALLO transplant recipients because they are given anti-rejection drugs. These drugs suppress the immune system to prevent the body from rejecting the donors stem cells. However, this low immunity also leaves the body more at risk for infection. This risk increases when more anti-rejection drugs are needed. Your treatment team will work with you to prevent and manage infections.
Graft-versus-host disease
People who have an ALLO transplant are also at risk of developing a post-transplant illness called graft-versus-host disease (GVHD). It occurs when the transplanted stem cells recognize the patients body as foreign and attack it, causing inflammation. GVHD ranges from mild to life-threatening. AUTO transplant recipients do not face this risk because the transplanted stem cells come from their own bodies.


Read more:
Side Effects of Stem Cell/Bone Marrow Transplantation …

Friday, May 15, 2015

Abnormal Test Results in Hospital Signal Raised Kidney Injury Risk

Abnormal Test Results in Hospital Signal Raised Kidney Injury Risk

(HealthDay News) -- Common kidney function tests using blood or urine can help doctors identify hospitalized patients at risk for acute kidney injury, researchers say.
Acute kidney injury is a sudden loss of kidney function that can develop within a few hours or over a few days. As many as 10 percent of hospitalized patients and up to 22 percent of intensive care unit (ICU) patients worldwide experience acute kidney injury, according to the study authors.

For the study, the researchers reviewed information from more than 1.3 million hospital patients. Nearly 19,000 had acute kidney injury, the investigators found.  ...

Vitamin Supplement Linked to Reduction in Skin Cancer Risk

Vitamin Supplement Linked to Reduction in Skin Cancer Risk

(HealthDay News) -- A cheap and easily available vitamin supplement appears to reduce a person's risk of skin cancer, new research contends.
A form of vitamin B3 called nicotinamide is linked to a reduction of non-melanoma skin cancers by 23 percent when taken twice daily, according to Australian researchers.
"It's safe, it's almost obscenely inexpensive, and it's already widely commercially available," said senior author Dr. Diona Damian, a professor of dermatology at the University of Sydney.
Nicotinamide costs less than $10 for a month's supply and is available at pharmacies and health food stores, she said.
However, more study is needed before researchers can say whether everyone would benefit from the supplement. "It's not something we'd recommend at this stage for the general population," Damian said.
The study is slated for presentation May 30 at the upcoming annual meeting of the American Society of Clinical Oncology. Findings presented at meetings are generally considered preliminary until they've been published in a peer-reviewed journal. Funding for this study was provided by the National Health and Medical Research Council of Australia.
Skin cancer is the most common form of cancer in the United States, with about 5 million cases treated every year at a cost of about $4.8 billion, Damian said.
Common skin cancers tend to grow slowly and can be cured if found and treated early, according to the American Cancer Society (ACS). These types of skin cancer include basal and squamous cell carcinoma. A more dangerous type of skin cancer called melanoma accounts for just 73,000 cases a year, according to the ACS.
Ultraviolet rays from the sun cause most skin cancers by damaging the DNA of skin cells, Damian said.
UV radiation also hampers the body's ability to fight off cancer, depleting the energy that skin cells need to repair damaged DNA and profoundly suppressing the skin's immune system, she said.
Earlier studies indicated that nicotinamide can provide skin cells with an energy boost, enhancing DNA repair and strengthening the skin's immune system, Damian said.
To see whether this would help protect against skin cancer, researchers launched a clinical trial involving nearly 400 high-risk patients who'd had at least two non-melanoma skin cancers during the previous five years. Their average age was 66 and two-thirds were men. Many also had chronic health conditions, such as arthritis, high blood pressure, or heart or lung disease, according to the researchers.
Half of the group took nicotinamide twice daily for a year. The other half took a placebo. Dermatologists checked for skin cancer every three months.
The people taking nicotinamide showed immediate benefits. "This reduction in skin cancers seemed to start as early as the first three-month visit," Damian said.

By the end of the one-year study period, new non-melanoma skin cancer rates were down 23 percent in the nicotinamide group compared to the placebo group, the researchers found.  ...

Injectable hydrogel boosts stem cell therapy to restore vision, repair brain damage

Injectable hydrogel boosts stem cell therapy to restore vision, repair brain damage


A new study reveals how an injectable "hydrogel" boosted stem cell transplantation to aid brain recovery following stroke and helped partially reverse blindness in mice. Study leaders Molly Shoichet and Derek van der Kooy, of the University of Toronto in Canada, and colleagues publish their findings in the journal Stem Cell Reports.
Stem cell therapy has become a major focus in medical research - particularly tissue regeneration - primarily because stem cells have the ability to become any other cell type in the body.
In March, for example, Medical News Today reported on a study detailing how stem cells therapy could one day be used to treat osteoarthritis. The researchers of that study transformed human embryonic stem cells into cartilage cells, which successfully repaired damaged cartilage after being transplanted into the knee joints of rats.
However, the University of Toronto team note that when it comes to stem cell transplantation, there are some problems. They explain that while scientists can successfully grow stem cells in a lab dish, once left to their own devices after being transplanted into the body, stem cells often die or find it hard to fuse with surrounding tissue.
The researchers previously developed an injectable gel-like material, or "hydrogel," to tackle this issue. The hydrogel consists of two compounds: methylcellulose and hyaluronan. Methylcellulose forms a gel to hold the stem cells together during delivery to the transplant site, while hyaluronan works to ensure the stem cells survive.
"Through this physical blend of two materials we are getting the best of both worlds," says Shoichet.
For their study, the team set out to test how the hydrogel may benefit stem cell transplantation for nerve cell damage caused by disease or injury.
Firstly, the researchers grew photoreceptors - light-sensitive cells in the eye's retina that are responsible for vision - from stem cells, before encapsulating them in the hydrogel and injecting them into the eyes of blind mice.
The researchers found that injecting these mice with the hydrogel-encapsulated photoreceptors successfully restored around 15% of their pupillary response, meaning their vision was partially restored.
Next, the team enveloped neural stem and progenitor cells in the hydrogel and injected them into the brains of mice that had brain damage due to recent stroke.
Within weeks, the mice demonstrated improvements in motor coordination, according to the researchers.
They now plan to test how the hydrogel-encapsulated neural cells affect rats with stroke injury, noting that rats have larger brains that are more appropriate for behavioral tests.
Commenting on their findings, Schoichet says:
"This study goes one step further, showing that the hydrogels do more than just hold stem cells together; they directly promote stem cell survival and integration. This brings stem-cell based therapy closer to reality."
The team adds that because they have shown the hydrogel increases the effectiveness of stem cell transplantation in both the eyes and the brain - two separate parts of the nervous system - it has the potential to boost the effectiveness of such therapy across of wide range of body regions.
What is more, they say that once the hydrogel has delivered stem cells to the required destination, it dissolves and the body reabsorbs it within a matter of weeks.
Injectable hydrogels may not only be useful for stem cell therapy. In February, Medical News Today reported on a study published in Nature Communications, in which researchers revealed the creation of an injectable hydrogel made of polymer-containing nanoparticles and cellulose that can deliver multiple drugs over long time periods.
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Thursday, April 02, 2015

Heart Groups Issue Updated Blood Pressure Guidelines

Heart Groups Issue Updated Blood Pressure Guidelines


News Picture: Heart Groups Issue Updated Blood Pressure GuidelinesBy Steven Reinberg
HealthDay Reporter Three leading groups of heart experts have issued updated guidelines that set blood pressure goals for people with heart disease. Specifically, the guidelines reinforce a target blood pressure of less than 140/90 mm Hg for those at risk for heart attack and stroke. The guidelines also set a goal of 130/80 mm Hg for those with heart disease who have already had a heart attack, stroke or a ministroke, or who have had a narrowing of their leg arteries or an abdominal aortic aneurysm.
However, the new guidelines are intended to be more flexible than ones crafted in 2007, said Dr. Clive Rosendorff, chairman of the committee that wrote the updated guidelines. Ultimately, the blood pressure goal any individual patient tries to achieve should be left to the discretion of the doctor and the patient.
For example, the lower goal may not be appropriate for older, frail patients who might experience dizziness if their blood pressure drops too much.
"Guidelines are simply that, guidelines, they are not inflexible rules," Rosendorff said.
The updated guidelines, from the American Heart Association, the American College of Cardiology and the American Society of Hypertension, were published March 31 in the journal Hypertension.
"In patients with heart disease, untreated high blood pressure is a major risk for heart attack and stroke," said Rosendorff, who is also a professor of medicine at the Icahn School of Medicine at Mount Sinai Medical Center in New York City.
Rosendorff said these guidelines are for patients with heart disease. New blood pressure guidelines for people who have high blood pressure but do not have heart disease are in the works, but those won't be released for some time, he said.
High blood pressure has become a growing problem in the United States during the past decade, according to a recent report from the U.S. Centers for Disease Control and Prevention. The overall death rate from high blood pressure has increased 23 percent since 2000, even as the death rate from all other causes has dropped 21 percent. That spike was seen in both genders and was most marked among those aged 45 to 64 and those over 85.
According to Rosendorff, one change in the updated guidelines is a concise statement about which drugs should be used to lower blood pressure in patients with heart disease.
"There are three drugs which have been shown to improve outcomes," he said. These include beta-blockers that slow the heart rate and reduce the force of cardiac contraction and also increase blood flow to the heart, Rosendorff said.
The guidelines also recommend angiotensin II receptor blockers (ARBs) and angiotensin-converting-enzyme inhibitors (ACE inhibitors), which increase the size of blood vessels, thus lowering blood pressure, and diuretics that lower blood pressure by reducing the amount of fluid in the body.  ...


Wednesday, April 01, 2015

Penn Medicine Surgeons Perform First Ex Vivo Lung Perfusion Transplantation in the Philadelphia Region

Penn Medicine Surgeons Perform First Ex Vivo Lung Perfusion Transplantation in the Philadelphia Region

PHILADELPHIA — Transplant surgeons at the Perelman School of Medicine at the University of Pennsylvania have successfully used a new technique that repairs damaged donated lungs that would have been unusable, allowing for successful transplantation of the reconditioned lungs into a patient. The patient, a 66-year-old man from the Philadelphia suburbs, was transplanted at the Hospital of the University of Pennsylvania (HUP) and is the first in the region to receive donated lungs using this new procedure.
“ Known as ex vivo lung perfusion (EVLP), the new technique is applied to donor lungs outside of the body before transplantation with the goal of improving recovery practices and expanding the pool of organs available for patients in need of lung transplantation.
Chronic lung disease affects 35 million Americans, results in 400,000 deaths, and causes a public health burden exceeding $150 billion each year. Lung transplantation is the only life-saving therapy for patients with end-stage lung disease, however, the procedure has limited availability because not all donor lungs are safe for transplantation. This shortage of donor lungs results in the death of 20 percent of lung transplant candidates awaiting transplant.

"In the U.S., only 15-20 percent of potential donors have viable lungs for transplantation," said Edward Cantu, MD, assistant professor of Surgery, Division of Cardiovascular Surgery, at Penn. "Donor lungs are susceptible to injuries from excess fluid accumulation, bacteria, or damage from intensive care unit-related complications, rendering them medically unsuitable for transplantation. EVLP is a new method that allows the transplant team time to accurately assess and optimize function of these injured donor lungs that would otherwise not be used. With this new technique, we could potentially double the number of usable lungs for patients awaiting transplantation." . ...

What to do with kidneys from older deceased donors?

What to do with kidneys from older deceased donors?

A new study highlights the best way to use kidneys from older deceased donors, providing the most benefits to patients and addressing the worsening organ shortage. The study's findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), could lead to changes in current transplant allocation policies.
The number of patients waiting for a kidney transplant in the United States recently eclipsed 100,000, yet most kidneys recovered from deceased donors aged 65 years or older are discarded.  ...

Black bear may hold secret to cure for kidney disease

Black bear may hold secret to cure for kidney disease

BAR HARBOR, Maine — One of Maine’s iconic forest dwellers may just harbor clues that could lead to better treatment and ultimately a cure for human kidney disease.
Researchers at The Jackson Laboratory in Bar Harbor are studying black bear kidneys in an effort to determine how the animals are able to regenerate the organ every year after spending the winter in near kidney failure.
“During hibernation [the bear] kidney is damaged, and the kidney function decreases to a level comparable to that of a human dialysis patient,” said Dr. Ron Korstanje, Jackson Laboratory assistant professor and lead researcher on the bear kidney project. “We know that in humans, a dialysis patient does not recover unless they receive a kidney transplant.”
But bears, somehow, are able to regain full kidney function after coming out of hibernation.
“We do not know how they are able to do that,” Korstanje said. “We are trying to understand what processes are going on in the bear kidneys, allowing them to recover and have perfectly working kidneys again.”
Gaining that understanding, Korstanje said, could help with the discovery of new treatments for human kidney disease.
More than 43 million Americans have chronic kidney disease, costing more than $42 billion a year, nearly a quarter of the country’s Medicare budget.
“Kidney disease is a really big issue in humans,” said Dr. Deborah Eustis-Grandy, chair of the science department at the Maine School of Science and Mathematics in Limestone but who is on sabbatical at The Jackson Lab. “If scientists can figure out how bears regenerate their kidneys, this could lead to avenues for treating kidney disease.”
While at Jackson, Eustis-Grandy is studying digitized slides of bear kidney tissue and measuring key cellular structures.
At first glance, a bear kidney and a human kidney have little resemblance to each other, Eustis-Grandy said.
A human kidney is smooth, uniform and full of capillaries and structures that filter impurities out of the blood as it passes through the organ.
A bear kidney, on the other hand, comprises numerous lobes that each look and act like a miniature human kidney, Eustis-Grandy said.
“The main thing the body is trying to get rid of is a type of waste called urea,” she said. “If it is not removed from the blood, it can build up and become toxic. When people with kidney failure are on dialysis, the main purpose is to remove urea from the blood.”
In the case of hibernating bears, that urea is retained in the bloodstream and serves as a source for protein synthesis as the bears metabolize and live off their fatty stores.
“There is a lot of speculation on what is going on with this,” Eustis-Grandy said. “We do know there is a reduction of blood flow in the [bear] kidneys in the winter, but we don’t know of any documented specific structural [kidney] abnormalities and [documenting] that is one of the things I am trying to do.  ...

1000-year-old recipe kills MRSA superbug

1000-year-old recipe kills MRSA superbug

The 10th-century "eyesalve" remedy was discovered at the British Library in a leather-bound volume of Bald's Leechbook, widely considered to be one of the earliest known medical textbooks.
Christina Lee, an expert on Anglo-Saxon society from the School of English at the University of Nottingham, translated the ancient manuscript despite some ambiguities in the text.
"We chose this recipe in Bald's Leechbook because it contains ingredients such as garlic that are currently investigated by other researchers on their potential antibiotic effectiveness," Lee said in a video posted on the university's website.
"And so we looked at a recipe that is fairly straightforward. It's also a recipe where we are told it's the 'best of leechdoms' -- how could you not test that? So we were curious."
Lee enlisted the help of the university's microbiologists to see if the remedy actually worked.
The recipe calls for two species of Allium (garlic and onion or leek), wine and oxgall (bile from a cow's stomach) to be brewed in a brass vessel.
"We recreated the recipe as faithfully as we could. The Bald gives very precise instructions for the ratio of different ingredients and for the way they should be combined before use, so we tried to follow that as closely as possible," said microbiologist Freya Harrison, who led the work in the lab at the School of Life Sciences.
The book included an instruction for the recipe to be left to stand for nine days before being strained through a cloth. Efforts to replicate the recipe exactly included finding wine from a vineyard known to have existed in the ninth century, according to Steve Diggle, an associate professor of sociomicrobiology, who also worked on the project.
The researchers then tested their recipe on cultures of MRSA, methicillin-resistant Staphylococcus aureus, a type of staph bacterium that does not respond to commonly used antibiotic treatments.

The scientists weren't holding out much hope that it would work -- but they were astonished by the lab results.  ...

Tuesday, September 30, 2014

40 States, District of Columbia Reporting Respiratory Virus That Targets Kids

40 States, District of Columbia Reporting Respiratory Virus That Targets Kids

Health officials also investigating whether germ is tied to cases of muscle weakness in 9 Colorado children
HealthDay news image MONDAY, Sept. 29, 2014 (HealthDay News) -- Forty states and the District of Columbia now have a total of 277 confirmed cases of Enterovirus D68, the severe respiratory illness that typically targets children, U.S. health officials are reporting.
Officials said the 40 states are Alabama, Arkansas, California, Colorado, Connecticut, Delaware, Georgia, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.
So far, all the cases have involved children, except for one adult, according to the federal Centers for Disease Control and Prevention.
Enterovirus D68 is part of the family of viruses that includes the common cold. It can sometimes require hospitalization, especially for children with asthma.   ,,,read more        

Friday, September 19, 2014

Reining in PTSD with Equestrian Therapy

Reining in PTSD with Equestrian Therapy

A Veteran pats a horse in a stable
Army Veteran Larry Opitz spends some time with his favorite horse, Kris, at Strongwater Farm in Tewksbury, Mass. Photo by Bob Whitaker, Lowell Sun. Used with permission.
by Tom Cramer, VA Staff Writer
Thursday, September 18, 2014
A horse is a horse, of course, of course … except, perhaps, when he’s also your therapist.
“Interaction with an animal just makes you feel more relaxed,” said Joe Grimard, a recreational therapist at the Edith Nourse Rogers Memorial Veterans Hospital in Bedford, Mass. “You’re connecting with an animal, a living thing and that’s all you’re focused on. You’re no longer focusing on yourself, or your problems.”
Each week, Grimard drives four to six Veterans out to nearby Strongwater Farm, where they get to ride horses for free. Family members of Veterans are also welcome.
“These guys are in the 90-day treatment program at our domiciliary,” said Grimard, a Navy Veteran. “So it’s good for them to get away from the hospital now and then and do something different.
“It’s my job to get these guys back out into the community, doing healthy things,” he added. “They need to know they have alternatives to the lifestyles that landed them in trouble before.”

Just Relax

Grimard said the whole idea is to provide Veterans with relaxing, positive experiences.
“A lot of these guys have anxiety,” he said. “They have traumatic memories, so we want them creating new, pleasant memories to replace the not-so-pleasant ones. This is a peaceful place. When I bring them out here, I don’t tell them I’m taking them to therapy. I just tell them, ‘I’m bringing you out here so you can enjoy life a little.’
“Once they get around a horse, they start to loosen up,” he continued. “You can see them begin to relax. You can see their self-esteem and their confidence building. Gradually you can see them becoming the person they were before all that stuff happened to them.”
Grimard said he’s now seeing an increasing number of younger Veterans — those who served in Iraq and Afghanistan — expressing an interest in visiting the horse farm.
“They’re very physical, very enthusiastic,” he said. “They just jump right on the horse without a second thought. It doesn’t matter whether you’re dealing with posttraumatic stress, addiction or family problems, coming out here is just a fun, cool thing to do.
 I feel like I have a friendship with the staff here at the Bedford VA. Without them, I would have been dead years ago. 
— Larry Opitz... read more...

Thursday, September 18, 2014

FDA approves Trulicity to treat type 2 diabetes

FDA approves Trulicity to treat type 2 diabetes

3:50 PM

The U.S. Food and Drug Administration today approved Trulicity (dulaglutide), a once-weekly subcutaneous injection to improve glycemic control (blood sugar levels), along with diet and exercise, in adults with type 2 diabetes.
Type 2 diabetes affects about 26 million people and accounts for more than 90 percent of diabetes cases diagnosed in the United States. Over time, high blood sugar levels can increase the risk for serious complications, including heart disease, blindness, and nerve and kidney damage.
"Type 2 diabetes is a serious chronic condition that causes blood glucose levels to rise higher than normal,” said Mary Parks, M.D., deputy director of the Office of Drug Evaluation II in the FDA’s Center for Drug Evaluation and Research. “Trulicity is a new treatment option, which can be used alone or added to existing treatment regimens to control blood sugar levels in the overall management of type 2 diabetes.”
Trulicity is a glucagon-like peptide-1 (GLP-1) receptor agonist, a hormone that helps normalize blood sugar levels. The drug’s safety and effectiveness were evaluated in six clinical trials in which 3,342 patients with type 2 diabetes received Trulicity. Patients receiving Trulicity had an improvement in their blood sugar control as observed with reductions in HbA1c level (hemoglobin A1c is a measure of blood sugar control)...  read more 

Wednesday, September 17, 2014

Most Treatments for Blood Clots Appear Safe, Effective

Most Treatments for Blood Clots Appear Safe, Effective

HealthDay news image2014 (HealthDay News) -- Almost all the various treatment options for blood clots that form in veins are equally safe and effective, new research shows.
In exploring the safety and effectiveness of treatments for such blood clots as deep vein thrombosis or pulmonary embolism (blood clot in a lung), Canadian researchers analyzed outcomes associated with eight blood-thinning options, including unfractionated heparin, low-molecular-weight heparin (LMWH) and fondaparinux in combination with vitamin K antagonists.

The investigators also examined LMWH with dabigatran (Pradaxa), edoxaban, rivaroxaban (Xarelto), apixaban (Eliquis), as well as LMWH alone...

Sunday, September 07, 2014

Woman describes how she underwent a kidney transplant and then also required a life saving liver transplant.

Woman describes how she underwent a kidney transplant and then also required a life saving liver transplant.
This online report is the story of a Florida woman -Helen Schwarz - (pictured) who has recovered from both a kidney and then subsequently a liver transplant.

Helen who works as an administrative manager for the Tallahassee Democrat newsroom in the United States, was born with the  genetic disorder known as polycystic kidney disease (PCKD).

Initially when Helens own kidneys were no longer functioning adequately, Helen underwent a live donor kidney transplant. Subsequently Helen's liver became markedly enlarged due to there also being multiple cysts within it. This was related to her underlying genetic condition and was contributing to a further deterioration in Helen's physical health. This led to Helen undergoing a life saving liver transplant from which she has now recovered.

Deborah Verran's insight:
Most patients with polycystic kidney disease will only require a kidney transplant when their own kidneys fail. However there are a small number of patients with this condition in whom the liver is also involved and at times liver transplantation may also be required.



Heart Attack Symptoms in Women – Are they Different?

Heart Attack Symptoms in Women – Are they Different?Chest pain is still the most common sign of a heart attack for most women, although studies have shown that women are more likely than men to have symptoms other than chest pain or discomfort when experiencing a heart attack or other form of acute coronary syndrome (ACS), according to an article "Symptom Presentation of Women With Acute Coronary Syndromes – Myth vs. Reality" published online Dec. 10 in the Archives of Internal Medicine. The study was funded by the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.
Researchers examined 35 years of research that yielded 69 studies 69 studies and found that, depending on the size of the study (which ranged from large trials to single centers and interviews), between 30 percent and 37 percent of women did not have chest discomfort during a heart attack. In contrast, 17 percent to 27 percent of men did not experience chest discomfort. Overall, the majority of women – and men -- in the reviewed studies had chest discomfort with heart attack (two-thirds to three-quarters, depending on study size...


Friday, September 05, 2014

Researchers Develop Innovative Imaging System to Study Sudden Cardiac Arrest

Researchers Develop Innovative Imaging System to Study Sudden Cardiac Arrest

A research team at Vanderbilt University has developed an innovative optical system to simultaneously image electrical activity and metabolic properties in the same region of a heart, to study the complex mechanisms that lead to sudden cardiac arrest. Tested in animal models, the system could dramatically advance scientists' understanding of the relationship between metabolic disorders and heart rhythm disturbances in humans that can lead to cardiac arrest and death, and provide a platform for testing new treatments to prevent or stop potentially fatal irregular heartbeats, known as arrhythmias.
The research is supported in part by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health.

The design and use of the dual camera system is described in the Nov.1 issue of Experimental Biology and Medicine. Additional support for the project has also been provided by the Vanderbilt Institute for Integrative Biosystems Research and Education (VIIBRE), the American Heart Association, and the Simons Center for Systems Biology at the Institute for Advanced Study...

Potassium-rich Foods and Stroke Risk

Potassium-rich Foods and Stroke Risk

Atomato a day may help keep the doctor away - Or how about a sweet potato a day? Both of these foods are rich in potassium and a new study suggests that postmenopausal women who eat foods higher in this dietary mineral are at lower risk of having a stroke.
The researchers studied more than 90,000 women ages 50 to 79 for an average of 11 years. The team looked at how much potassium they consumed, as well as if they had strokes or passed away during the study period. The results showed that those who ate the most potassium were 12 percent less likely to suffer stroke in general and 16 percent less likely to suffer an ischemic stroke, the most common kind. .. read more


Thursday, September 04, 2014

Creatinine 1.29 is It Serious in Chronic Kidney Disease

Creatinine 1.29 is It Serious in Chronic Kidney Disease

Creatinine 1.29 is It Serious in Chronic Kidney Disease As we all know the normal creatinine level is different from male(0.5-1.5) and female(0.7-1.2), so if your creatinine level is higher than it, you should make further diagnosis in time so as to avoid big disease. Compared to the normal level, creatinine 1.29 is not very high, even this you can not sure whether your kidneys are damaged or not. You need to do some tests to make more accurate diagnosis. If you want to know more details directly, you can chat with our online doctor.
First you need to make sure whether you have ate much foods with high protein in a short time, or got an infection or cold or fever recently, all of them may increase your creatinine level in a while. If you have experience the above things, you need to take the test one weeks later to make further diagnosis...

Monday, September 01, 2014

What is the Difference Between Kidney Cysts and Polycystic Kidney Disease

What is the Difference Between Kidney Cysts and Polycystic Kidney Disease


In a study of dialysis patients, those who reported that they had discussed the option of transplantation with clinicians were more likely to be put on the transplant waiting list; however, clinician-reported discussions of transplantation did not increase patients' likelihood of being waitlisted. The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), indicate that better ways of informing patients about kidney transplantation may be needed.
One of the key principles of informed consent is describing alternative treatments. So when starting someone on hemodialysis, it is imperative to discuss the alternatives to hemodialysis, for example peritoneal dialysis and kidney transplantation. The Centers for Medicare & Medicaid Services (CMS) believe the discussion of kidney transplantation is so important that they mandate it. Unfortunately, though, there is no guidance as to what kind of discussion is required.

Dorry Segev, MD, PhD (Johns Hopkins University School of Public Health) and his colleagues asked 388 patients if providers (kidney specialists or dialysis staff) had discussed transplantation with them, and then they looked to see whether the providers reported to CMS that they had discussed transplantation with those patients.

Discordance between patient and provider in discussions about kidney transplantation

Discordance between patient and provider in discussions about kidney transplantation

In a study of dialysis patients, those who reported that they had discussed the option of transplantation with clinicians were more likely to be put on the transplant waiting list; however, clinician-reported discussions of transplantation did not increase patients' likelihood of being waitlisted. The findings, which appear in an upcoming issue of the Journal of the American Society of Nephrology (JASN), indicate that better ways of informing patients about kidney transplantation may be needed.
One of the key principles of informed consent is describing alternative treatments. So when starting someone on hemodialysis, it is imperative to discuss the alternatives to hemodialysis, for example peritoneal dialysis and kidney transplantation. The Centers for Medicare & Medicaid Services (CMS) believe the discussion of kidney transplantation is so important that they mandate it. Unfortunately, though, there is no guidance as to what kind of discussion is required.

Dorry Segev, MD, PhD (Johns Hopkins University School of Public Health) and his colleagues asked 388 patients if providers (kidney specialists or dialysis staff) had discussed transplantation with them, and then they looked to see whether the providers reported to CMS that they had discussed transplantation with those patients... read more ...

Study Underlines Need for Improvement in Doctor-Patient Discussions About Transplantation

Study Underlines Need for Improvement in Doctor-Patient Discussions About Transplantation


Underlining the need for better ways through which patients can be informed about kidney transplantation; a new study reveals that dialysis patients who said that they had discussed the option of transplantation with their doctors were more likely to be put on the transplant waiting list though it did not increase their likelihood of being waitlisted.
 Study Underlines Need for Improvement in Doctor-Patient Discussions About Transplantation
One of the key principles of informed consent is describing alternative treatments. So when starting someone on hemodialysis, it is imperative to discuss the alternatives to hemodialysis, for example peritoneal dialysis and kidney transplantation. The Centers for Medicare & Medicaid Services (CMS) believe the discussion of kidney transplantation is so important that they mandate it. Unfortunately, though, there is no guidance as to what kind of discussion is required. Dorry Segev, MD, PhD (Johns Hopkins University School of Public Health) and his colleagues asked 388 patients if providers (kidney specialists or dialysis staff) had discussed transplantation with them, and then they looked to see whether the providers reported to CMS that they had discussed transplantation with those patients... read more

Wednesday, August 27, 2014

Gene therapy trial aims to find alternative to heart transplants

Gene therapy trial aims to find alternative to heart transplants

The first study of its kind will investigate the effectiveness of gene therapy for patients with a left ventricular assist device
British scientists have launched a pioneering trial to see whether gene therapy can potentially replace heart transplants.
Lee Adams, a 37-year-old carpenter from Hertfordshire, is the first of 24 patients with advanced heart failure to be recruited....read more


Tuesday, August 26, 2014

Treatment of renal artery stenosis

Treatment of renal artery stenosis
Renal artery stenting to open blockages in the kidney arteries may benefit patients who have historically been excluded from modern clinical trials, according to new recommendations for renal artery stenosis e-published in Catheterization and Cardiovascular Interventions by the Society for Cardiovascular Angiography and Interventions (SCAI).
University Hospitals Case Medical Center's Sahil Parikh, MD, Director, Interventional Cardiology Fellowship Program and Professor of Medicine, Case Western Reserve University School of Medicine was the lead author on the paper that details possible assessment and treatment guidelines for renal artery disease.
Blockages in the kidney (renal) arteries are often asymptomatic, but may lead to high blood pressure or worsening of high blood pressure control. If left untreated, the disease can cause kidney failure and heart failure. Optimal medical therapy remains the preferred first-line treatment. 


Thursday, August 14, 2014

Once Dialysis is Started in PKD Patient Can It Be Stopped ?

Once Dialysis is Started in PKD Patient Can It Be Stopped

2014-08-14 03:15
Once Dialysis is Started in PKD Patient Can It Be StoppedWe have got asked about this question, ‘Once dialysis is started in PKD patient, can it be stopped?’ To help people who have similar doubt, we offer analysis as below. For personalized advice, consult our online doctor for free and professional suggestions.
Polycystic Kidney Disease is a genetic condition characterized by the growth of cysts on the kidneys. There is currently no cure, and medicine treatment can only work to manage symptoms as well as reduce the risk of complications. Generally speaking, when patients’ kidney function declines below 15%, Dialysis is suggested to maintain alive.
While, once dialysis is started in PKD patient, can it be stopped?
Those people who have received dialysis for not long time with urine output have great chance to get off the therapy by taking effective treatment to protect and improve the remaining kidney function. Consult your kidney doctor for the most suitable choice of option...

Assessing the Efficacy of Kidney Paired Donation—Performance of an Integrated Three-Site Program

Assessing the Efficacy of Kidney Paired Donation—Performance of an Integrated Three-Site Program

Li, Han; Stegall, Mark D.; Dean, Patrick G.; Casey, Edward T.; Reddy, Kunam S.; Khamash, Hasan A.; Heilman, Raymond L.; Mai, Martin L.; Taner, C. Burcin; Kosberg, Catherine L.; Bakken, Lisa L.; Wozniak, Elmira J.; Giles, Kathleen L.; Veal, Lisa A.; Gandhi, Manish J.; Cosio, Fernando G.; Prieto, Mikel
imageBackgroundKidney paired donation (KPD) has emerged as a viable option for renal transplant candidates with incompatible living donors. The aim of this study was to assess the “performance” of a three-site KPD program that allowed screening of multiple donors per recipient. MethodsWe reviewed retrospectively the activity of our KPD program involving three centers under the same institutional umbrella. The primary goal was to achieve a transplant that was both ABO compatible and had a negative or low-positive flow cytometric crossmatch (+XM). ResultsDuring the 40-month study period, 114 kidney transplant candidates were enrolled—57% resulting from a +XM and 39% resulting from ABO incompatible (ABOi) donors. Important outcomes were as follows: (1) 81 (71%) candidates received a transplant and 33 (29%) were still waiting; (2) 368 donors were evaluated, including 10 nondirected donors; (3) 82% (37/45) of ABOi candidates underwent transplantation; (4) 56% (36/65) of +XM candidates underwent transplantation (however, all but four of these had a cPRA less than 95%); (5) at the end of the study period, 97% (28/29) of +XM candidates still waiting had a cPRA greater than 95%. ConclusionsThese data suggest evaluating large numbers of donors increases the chances of KPD. Patients with a cPRA greater than 95% are unlikely to receive a negative or low-positive +XM, suggesting the need for desensitization protocols in KPD....

Friday, August 08, 2014

Induced immunorejection may eliminate tumors post-cell transplantation

Induced immunorejection may eliminate tumors post-cell transplantation

Recent studies have shown that transplanting induced pluripotent stem cell-derived neural stem cells (iPS-NSCs) can promote functional recovery after spinal cord injury in rodents and non-human...

Diabetes drug could increase lifespan: study

Diabetes drug could increase lifespan: study

Diabetes drug could increase lifespan: studyA large-scale study conducted by researchers at Cardiff University says that type 2 diabetes patients live longer than people without the disease thanks to surprising benefits of their medication, metformin, which could be expanded for use in non-diabetics. Murmurs of metformin's attributes had been circulating within the scientific community, and the findings of the Cardiff study not only build on its benefits but are of particular interest due to the massive sample size of 180,000 participants. Researchers compared survival rates of type 2 diabetes patients taking metformin, a first-line therapy, with those of patients on a less-prescribed diabetes drug called sulphonylurea, known for undesirable side effects such as weight gain and hypoglycemia. "What we found was illuminating," said lead author Professor Craig Currie from Cardiff University's School of Medicine...

Could Chiropractic Manipulation of Your Neck Trigger a Stroke?

Could Chiropractic Manipulation of Your Neck Trigger a Stroke?

American Heart Association releases statement saying risk may be increased if artery wall is torn
HealthDay news image  (HealthDay News) -- Getting your neck adjusted by a chiropractor or osteopathic doctor may be associated with an increased risk of stroke, according to a scientific statement released Thursday by the American Heart Association.
The energetic thrusts and rotations sometimes used in neck manipulation may cause a small tear in the artery walls in the neck, a condition called cervical artery dissection, the statement noted.
A tear in the artery wall can result in a stroke if a blood clot forms at the site and later breaks free to block a blood vessel in the brain.
Such a tear "occurs with a sudden movement that can hyperextend or rotate the neck, such as one you may see with whiplash or sporting events, or even violent coughing or vomiting," said statement author Dr. Jose Biller, chair of neurology at Loyola University Chicago Stritch School of Medicine. "The techniques for cervical manipulation, even though they vary among health professionals, include a rotation of the neck and sometimes a forceful thrust." ...

Work-related stress a risk factor for type 2 diabetes

Work-related stress a risk factor for type 2 diabetes

Workplace stress can have a range of adverse effects on health with an increased risk of cardio-vascular diseases in the first line. However, to date, convincing evidence for a strong association between work stress and incident Type 2 diabetes mellitus is missing. Researchers have now discovered that individuals who are under a high level of pressure at work face an about 45 percent higher risk of developing type 2 diabetes than those who are subjected to less stress at their workplace...

Debate over compensating organ donors heats up

Debate over compensating organ donors heats up
Science Recorder
According to a recent San Francisco Gate article, more than 120,000 people in the U.S. need organ donations. Due to this large number, and due to the many people that never receive a transplant, in fact, the newsletter references the California ...


Thursday, August 07, 2014

Aggressive outreach increases organ donation among Hispanic Americans

Aggressive outreach increases organ donation among Hispanic Americans

An outreach campaign that included local media and culturally sensitive educational programs in targeted neighborhoods was associated with an increase in consent rates for organ donation among...

Overtreatment, undertreatment of patients with high blood pressure linked to kidney failure, death

Overtreatment, undertreatment of patients with high blood pressure linked to kidney failure, death

The mantra for treatment for high blood pressure has been 'the lower, the better,' but that goal can potentially put patients at risk of kidney failure or death, according to a study. The results of this study demonstrate a need to better understand the ideal target blood pressure ranges as well as the potential dangers of overtreating patients, according to the researchers...

Save a life through organ donation

Save a life through organ donation
The Harlan Daily Enterprise
“There are so many people who don't know they can join the registry and donate their organs when they die. For example, 99 percent of us will never be able to donate organs when we die — yes, 99 percent. So, joining the registry is simply saying, 'if ...

Organ donations on the rise among Latinos at County-USC Medical Center



Organ donations on the rise among Latinos at County-USC Medical Center
Los Angeles Times
But among Latino patients at County-USC who met the medical criteria for organ donation, the share who consented -- either through their families or in advance through the state organ donation registry -- climbed steadily from 56% in 2005 to 83% in 2011...

Monday, August 04, 2014

Caveats of Mesenchymal Stem Cell Therapy in Solid Organ Transplantation

Caveats of Mesenchymal Stem Cell Therapy in Solid Organ Transplantation
In the past decade, therapeutic use of mesenchymal stem cells (MSCs) has increased dramatically. The weight of existing evidence supports that the short-term application of MSCs is safe and feasible; however, concerns remain over the possibility of unwanted long-term effects. One fundamental difference between MSCs and pharmacotherapy is that, once applied, the effects of cell products cannot be easily reversed. Therefore, a carefully considered decision process is indispensable before cell infusion. In addition to unwanted interactions of MSCs with the host immune system, there are concerns that MSCs may promote tumor progression or even give rise to cancer themselves.
As animal models and first-in-man clinical studies have provided conflicting results, it is challenging to estimate the long-term risk for individual patients. In addition, most animal models, especially rodents, are ill-suited to adequately address questions over long-term side effects. Based on the available evidence, we address the potential pitfalls for the use of MSCs as a therapeutic agent to control alloimmune effects. The aim of this review is not to discourage investigators from clinical studies, but to raise awareness of the intrinsic risks of MSC therapy (read more)


FDA Approves Jardiance to Treat Type 2 Diabetes

FDA Approves Jardiance to Treat Type 2 Diabetes
The U.S. Food and Drug Administration today approved Jardiance (empagliflozin) tablets as an addition to diet and exercise to improve glycemic control in adults with type 2 diabetes.
Type 2 diabetes affects approximately 26 million people and accounts for more than 90 percent of diabetes cases diagnosed in the United States. Over time, high blood sugar levels can increase the risk for serious complications, including heart disease, blindness, and nerve and kidney damage.
"Jardiance provides an additional treatment option for the care of patients with type 2 diabetes," said Curtis J. Rosebraugh, M.D., M.P.H., director of the Office of Drug Evaluation II in the FDA’s Center for Drug Evaluation and Research. “It can be used alone or added to existing treatment regimens to control blood sugar levels in the overall management of diabetes.” ...