December 6, 2007, 7:42 PM CT

Study of African traditional medicine

Described as a hotspot of botanical diversity, there are more than 20,000 indigenous plant species in South Africa. Several thousand of them are used by traditional healers every day in that country for treating a range of problems from the common cold to serious diseases such as AIDS. How safe and effective these therapys are will be the focus of The International Center for Indigenous Phytotherapy Studies (TICIPS), a collaborative research effort between the University of Missouri-Columbia and the University of the Western Cape, South Africa. The center will be funded by a $4.4 million, 4-year grant from the National Center for Complementary and Alternative Medicines (NCCAM), a division of the National Institutes of Health.

The American and South African citzens have strong interests in complementary and alternative medicine practices, but little is known of their safety and effectiveness, said Bill Folk, senior associate dean for research in the School of Medicine, principal investigator of the grant and co-director of TICIPS.

Folk and U.S. research teams from MU, University of Missouri-Kansas City (UMKC), Missouri Botanical Garden, University of Texas and Georgetown University will partner with Quinton Johnson, director of the South African Herbal Science and Medicine Institute and co-director of TICIPS at the University of the Western Cape, University of Cape Town, University of Kwazulu-Natal (UKZ-N) in South Africa, and South African traditional healers. Together, they will study the medicinal properties, safety and effectiveness of several African plants in use today by traditional healers. South Africa is home to more than 200,000 traditional healers who care for more than 27 million people......... Posted by: Emily      Read more         Source

December 6, 2007, 7:23 PM CT

Discussions can help domestic violence victims speak up

Scientists at University of Pennsylvania School of Medicine and other sites have observed that doctors and other health care providers can better their chances of identifying and helping victims of domestic violence by changing the way they ask patients questions.

In a large study recently reported in the Annals of Internal Medicine, scientists found many communication pitfalls when emergency care providers discussed domestic violence with patients. Some examples: Providers often stumbled over their words, failed to acknowledge a disclosure of abuse or abruptly changed the subject. Occasionally, they screened for abuse in the presence of the womans partner.

The study also revealed several best practices for communications. Follow-up questions and open-ended queries, for instance, were found to be helpful in prompting patients to disclose abuse. Patients also tended to open up to providers who showed empathy and concern or those who followed up on non-medical clues raised by patients, such when the patient talked about stress.

We observed that probing asking even one more question was linked to almost three times the rate of patient disclosure of experiences with abuse, says lead author Karin V. Rhodes, MD, MS, Director of the Division of Health Policy Research in Penns Department of Emergency Medicine......... Posted by: Emily      Read more         Source

December 6, 2007, 3:51 PM CT

Making Emergency Artery Repair Safer

Catheters outfitted with balloons, lasers, and miniature drills have made the therapy of blocked arteries virtually routine. These devices are used to clear plaque from a number of vessels including coronary, femoral, renal, and carotid arteries. Until recently, a misstep in the delicate procedure commonly mandatory risky emergency surgery. Now physicians are using the same technology used to open clogged arteries to repair ruptures and perforations with less risk. In an article in the Journal of Interventional Cardiology, scientists from the University of California, Davis Medical Center review state-of-the-art therapy for vessel punctures.

"Rupture or perforation of a blood vessel during angioplasty can result in life-threatening bleeding," said lead author John Laird, M.D. "This review provides doctors with a summary of equipment and techniques that will enhance their ability to treat such complications."

An estimated 0.1% of patients undergoing balloon angioplasty, which uses an inflatable balloon to widen arteries, suffer a perforation during the procedure. Patients treated with a rotablator drill have a 1.3% risk of perforation, while those treated with the excimer laser face a 1.9% risk. Balloon, drill, and laser are all attached to a catheter inserted through a small incision in the arm or groin and snaked through an artery to the blockage......... Posted by: Emily      Read more         Source

December 6, 2007, 3:37 PM CT

Every Baby Has a Story

An aspiring director of feature films and commercials captured the hearts of the public with an inspiring video that has won top prize in the March of Dimes "Every Baby Has a Story'' public service ad contest.

"This was a great way for people to see my work unfiltered," David Pestka, 32, of Stamford, CT, said this week. Pestka said he learned a lot, not only about filmmaking, but also about the health of mothers and babies. "This couldn't be better timing. My wife and I are starting to plan our own family.''.

Mr. Pestka's video, "Story Inside,'' won 36 percent of the nearly 3,500 votes cast by the public among the three finalist videos posted on the March of Dimes Web site in November. The other two videos, "My Story, Eleni'' and "Daddy's Lullaby'' garnered 34 and 30 percent respectively.

"David's video was very moving and compelling,'' said Dr. Jennifer L. Howse, president of the March of Dimes. "It showed just how much a baby's health means to families across the country.''.

"The idea for 'Story Inside' came from the March of Dimes 'Every Baby Has A Story' theme,'' said Pestka of his video, which is in a catchy rhyme. The video also touches on health insurance, advocacy and research and prematurity. One memorable line is, "Some of our babies are not getting old - some of their stories are not being told. The March of Dimes fights so our babies survive.''......... Posted by: Emily      Read more         Source

December 5, 2007, 8:38 PM CT

Physician style and HMO affiliation

Apart from a more complicated medical case, what makes different physicians spend different amounts of time with their patients" Scientists at UC Davis have identified several key doctor- and practice-specific characteristics that affect the length of a patients medical appointment, and ultimately with a patients satisfaction with the doctors visit.

In a new study, "Primary Care Visit Length, Quality, and Satisfaction for Standardized Patients with Depression" in the December 2007 issue of the Journal of General Internal Medicine, Estella Geraghty and her colleagues found several key determinants for visit length, ranging from individual style and practice volume to whether a doctor practiced within a health maintenance organization (HMO) or whether the doctor had any nonprofessional experience with depression.

Identifying the key predictors that drive the length of doctor visits has long remained elusive, despite much effort by researchers. Using what are called "standardized patients" -- actors who have been carefully coached to simulate specific patient ailments -- Geraghty and her team were able to control patient presentations and more accurately gauge doctor practices.

Scientists observed that visit length for patients with similar conditions varied more than 10-fold among primary care physicians, with much of the variation attributed to individual doctor styles. Doctors working in HMOs and those with the busiest schedules, for example, spent significantly less time with patients. Physicians with personal or vicarious experience with depression, however, spent more time with their patients. They spent as much as 11 percent more time with depressed patients than doctors who did not have that connection with the ailment......... Posted by: Emily      Read more         Source

December 5, 2007, 8:27 PM CT

Transfusion-free medicine for Jehovah's Witnesses

Jehovahs Witness patients no longer have to die for want of blood, says Patricia Ford, MD, a hematologist/oncologist and Medical Director of the Center for Bloodless Medicine and Surgery at Pennsylvania Hospital, part of the PENN Medicine hospital network. Dr. Ford is one of the pioneers of bloodless surgery and has been teaching its technique to doctors around the world.

One technique a bloodless surgery can employ is called cell salvage in which blood lost during surgery is siphoned from the body, passed through a filter for cleaning and returned to the body. It can also be used by the doctor during surgery to limit blood loss and to avoid the need for transfusion of blood from sources other than the patient.

Jehovahs Witness patients think that accepting blood from a source other then themselves defies the scriptural teachings that their religion holds steadfast. Originally developed to meet the needs of the Jehovahs Witness community, bloodless surgery is transfusion-free and is acceptable to Jehovah Witness followers because they are being reinfused with their own blood. Bloodless surgery and medicine is a viable and life-saving option for these patients and those wary of the safety of the blood supply, and it is safe for a growing number of surgical and medical conditions, except for acute leukemia and traumatic injury......... Posted by: Emily      Read more         Source

December 4, 2007, 10:22 PM CT

HIV-infected infants respond poorly to childhood vaccination

It is known that HIV-infected children who do not receive appropriate antiretroviral drugs experience immune depression, and may become susceptible to infectious diseases that would otherwise be prevented by childhood immunization. It is therefore important to find out to what extent HIV-infected children are able to generate adequate levels of antibodies following routine childhood immunizations.

A paper published online this week in PLoS ONE describes the results of a cross-sectional study carried out amongst 18-36 month-old children born to HIV-infected mothers and living in Central Africa. The study suggested that immuno-suppressed HIV-infected children have a low persistence of antibodies to the vaccines of the Expanded Program on Immunization (EPI, WHO).

The study was conducted in Cameroon and the Central African Republic by pediatricians, epidemiologists, bacteriologists and virologists, and coordinated by the Institut Pasteur (Paris, France) through its International Network, especially the institutes based at the Pasteur Center in Yaound and at the Institut Pasteur in Bangui.

The scientists observed that antibody levels to measles vaccine was especially low amongst children who were HIV infected, and that antibody levels to vaccine amongst HIV-uninfected children born to HIV-infected mothers were lower than expected. This latter finding raises the possibility that HIV exposure during pregnancy might influence the response to EPI vaccines in the first weeks of life. These results suggest that children living with HIV may need an adapted EPI vaccine schedule......... Posted by: Emily      Read more         Source

December 4, 2007, 9:51 PM CT

Bone marrow cell transplants help nerve regeneration

A study carried out by scientists at the Kyoto University School of Medicine and reported in the current issue of CELL TRANSPLANTATION (Vol.16 No. 8) has shown that when transplanted bone marrow cells (BMCs) containing adult stem cells are protected by a 15mm silicon tube and nourished with bio-engineered materials, they successfully help regenerate damaged nerves. The research may provide an important step in developing artificial nerves.

We focused on the vascular and neurochemical environment within the tube, said Tomoyuki Yamakawa, MD, the studys lead author. We thought that BMCs containing adult stem cells, with the potential to differentiate into bone, cartilage, fat, muscle, or neuronal cells, could survive by obtaining oxygen and nutrients, with the result that rates of cell differentiation and regeneration would improve.

Nourished with bioengineered additives, such as growth factors and cell adhesion molecules, the BMCs after 24 weeks differentiated into cells with characteristics of Schwann cells a variety of neural cell that provides the insulating myelin around the axons of peripheral nerve cells. The new cells successfully regenerated axons and extended their growth farther across nerve cell gaps toward damaged nerve stumps, with healthier vascularity......... Posted by: Emily      Read more

December 3, 2007, 10:35 PM CT

New marker to identify cancer stem cells

Scientists at the University of Michigan Comprehensive Cancer Center have found a marker that can be used to identify stem cells in breast tumors, suggesting a potential simple test that could help determine the best therapy for breast cancer.

The finding also provides strong support for the hypothesis that a small number of cells, called cancer stem cells, are responsible for fueling a tumors growth.

U-M scientists were the first to discover stem cells in a solid tumor, finding them first in breast cancer. Generally, stem cells make up fewer than 5 percent of all the cells in a tumor, but they may be the key cells in cancer progression. The process of looking at the cell surface to identify stem cells, however, is too complex to apply to patient care.

In the new study, reported in the recent issue of Cell Stem Cell, the scientists observed that cells from normal and malignant breast tissue that had high levels of the enzyme aldehyde dehydrogenase activity, or ALDH, acted like breast stem cells. Further, of 577 human breast cancer tissue samples studied, those that expressed the specific form ALDH1 had the worst outcomes, suggesting this easily detected marker could be used to assess prognosis.

This study is a big step because it provides a marker thats easy to use in both normal and cancer cells. Clinical applications were really not possible with the previously described markers. The fact that ALDH1 was identified in stem/progenitor cells from both normal and cancer tissue lends support to the idea that those cells are the primary target of transformation to malignancy. We believe it is only a very small population of cells that really are capable of unlimited growth and therefore drive cancer recurrence and metastasis, says senior study author Gabriela Dontu, M.D., Ph.D., research assistant professor of internal medicine at the U-M Medical School......... Posted by: Emily      Read more         Source

December 3, 2007, 10:33 PM CT

Kids of depressed moms

Young children whose mothers are depressed are more prone to behavioural problems and injury, suggests US research published in Injury Prevention.

The scientists looked at the impact of maternal depression on childrens behaviour and injury rates among 1106 mother and child pairs between 1992 and 1994.

The mothers and their children were all taking part in the National Longitudinal Study of Youth, which has been tracking the health of young mothers and their children from birth since 1986.

In total, 94 children, all of whom were under the age of 6, had sustained injuries, sufficient to require medical attention during the study period. Two thirds of these injuries had happened at home.

Validated scales were used to assess problem behaviour among the children and depressive symptoms among the mothers.

Children whose mothers scored persistently high marks on the depression scales were more than twice as likely to have been injured as those whose mothers had a low rating.

And children whose mothers had a high rating were significantly more likely to have behavioural problems and to act out. Boys were more at risk of this than girls.

When analysed in more depth, the findings showed that for every 1 point increase on the depression score, the risk of injury rose by 4% and the risk of behavioural problems increased by 6%......... Posted by: Emily      Read more         Source