January 6, 2009, 7:25 PM CT

3T MRI can detect wrist ligament tears

MRI of the wrist at 3T is an effective way to detect wrist ligament tears and in some cases can avoid unnecessary surgery, as per a research studyperformed at Neuroskeletal Imaging in Merritt Island, Florida.

The study included 49 patients who had both 3T MR and arthroscopy; 51 tears were found on arthroscopy. 41 of the 51 tears were also found using 3T MRI. "The resolution with 3T MRI is good. We are able to see the small ligaments a lot better and determine whether or not they are torn," said Thomas Magee, MD, main author of the study.

"3T MRI is beneficial to both the patient and the physician. If there is a problem, it provides a road map for the doctor to use during surgery and eliminates any type of surgery for those who have normal findings," said Dr. Magee. "We are able to see bone bruises, cysts and other things that appears to be pain generators instead of ligament tears," he said.

"Ligament tears are very common in people over the age of 40. Approximately 40% of all people over age 40 have some type of ligament tear," said Dr. Magee. "Trauma, wear and tear and degeneration can cause tearing of the ligaments," he said.

"If surgery is being contemplated, I advise people to have an MR scan to determine the cause of pain before arthroscopy," said Dr. Magee......... Posted by: Emily      Read more         Source

December 23, 2008, 10:28 PM CT

Clinical pharmacists can reduce drug costs

Clinical pharmacy services can significantly reduce the cost of prescription drugs and save money elsewhere in the health care system, as per a new study by scientists at the University of Illinois at Chicago.

For every dollar spent by hospitals or health systems to provide clinical pharmacy services, $4.81 was saved through lower drug costs, reductions in adverse drug events and medicine errors and other savings, says Glen Schumock, associate professor and director of UIC's Center for Pharmacoeconomic Research and senior researcher on the study.

Schumock and colleagues reviewed 93 studies published between 2001 and 2005 to uncover the impact of clinical pharmacy services, defined as services that involve direct patient care by a clinical pharmacist. Unlike traditional pharmacy services, in which a pharmacist dispenses medications, clinical pharmacists make recommendations to physicians regarding drug treatment or sometimes even help write the prescription.

Clinical pharmacy services in the studies examined were provided in hospitals, community pharmacies, nursing homes and other facilities. Such services have been available since the late 1970s but have only recently become common, Schumock said.

"The expansion of clinical pharmacy services is one potential mechanism that could be more greatly employed to curb the problem of prescription drug spending," he said......... Posted by: Emily      Read more         Source

December 22, 2008, 9:39 PM CT

Premature babies develop altered sensory responses

Premature infants who need intensive care or surgery are less sensitive to thermal (hot and cold) sensations during the later part of life, as per research conducted at UCL (University College London). The study, reported in the journal Pain, suggests that pain and injury correlation to major medical interventions in early development may alter how children respond to painful stimuli much during the later part of life.

In the study, 43 eleven-year-old children born at less than 26 weeks of gestation (14 weeks premature) who are being followed up by the EPICure study group, were tested for their responses to different sensations temperature and light touch using quantitative sensory testing. In comparison to a group of children who had been born at full term, the premature children were less sensitive to temperature (cool, cold, warm and hot) but not to light touch, and this was most marked in those who had also undergone a surgical operation as a baby. The scientists also found a more marked decrease in sensitivity to temperature and to touch close to scars relating to major chest surgery, again suggesting that the severity of injury in early life influences the degree of sensory change. A questionnaire survey showed that the children's everyday pain experiences were similar, but there were some minor differences between the two groups in the way children coped with pain......... Posted by: Emily      Read more         Source

December 22, 2008, 9:31 PM CT

Structure of New Botulism Nerve Toxin

All seven neurotoxin subtypes cause their deadly effects using a common mechanism, with each step being activated by a different portion, or domain, of the toxin protein. First the neurotoxin binds to a nerve cell; then it moves into the cell; and then it cleaves specific proteins that block the release of neurotransmitters, the chemicals nerve cells use to communicate with one another and with muscles. Without that communication, muscles, including those used to breathe, become paralyzed.

"Blocking any of these steps could thwart the toxins' deadly action," Swaminathan said. "But to do that, we need to understand the details of the proteins' structures".

Swaminathan and his team had previously analyzed the molecular-level structures of various fragments of botulinum neurotoxin subtypes A to F, and that of the whole neurotoxin B, using x-ray crystallography at the National Synchrotron Light Source (NSLS) at Brookhaven Lab. In this technique, researchers beam high-intensity x-rays at a crystalline sample of the protein and measure how the x-rays scatter off the sample to locate the positions of individual atoms.

These studies revealed that in subtypes A and B, the three domains were arranged in the same way: with the binding and protein-cleaving domains "flanking" a longer central region known as the translocation domain, essential for moving the toxin into the cell......... Posted by: Emily      Read more         Source

December 19, 2008, 5:20 AM CT

Not Just for Depression Anymore

Prozac is regularly prescribed to ease the emotional pain of patients who are being treated for cancer. But can this common anti-depressant help to fight cancer itself?

Dr. Dan Peer of the Department of Cell Research and Immunology at Tel Aviv University is proving that it can. A study he and colleagues recently completed validates that Prozac (chemical name fluoxetine) dramatically enhances the effectiveness of a widely used anti-cancer drug.

"The good news is that the medical community won't have to wait - Prozac can be used for this purpose right away," says Dr. Peer, noting that doctors in the U.S. already prescribe it to treat depression in chemotherapy patients.

Fighting Drug Resistance in Colon Cancer Patients

"Prozac is a very interesting non-specific blocker of cancer resistance," says Dr. Peer, whose study focused on colon cancer and the anti-cancer drug doxorubicin.

In their laboratory experiments, the Tel Aviv University researchers led by graduate student Mirit Argov together with Prof. Rimona Margalit, observed that Prozac enhanced doxorubicin's efficacy more than 1,000%. Prozac, in effect, worked to block the cancer drug from leaving the interior of the cancer cell and poisoning the healthy non-malignant cells that surrounded it......... Posted by: Emily      Read more         Source

December 16, 2008, 9:57 PM CT

New targets for treating addiction

Rewarding and stressful signals don't seem to have much in common. But scientists studying diseases ranging from drug addiction to anxiety disorders are finding that the brain's reward and stress signaling circuits are intertwined in complex ways.

Vanderbilt University Medical Center researchers have now discovered a functional link between reward and stress. They observed that dopamine the brain's chief reward signal works through corticotrophin-releasing factor (CRF) the brain's main stress signal to increase the activity of a brain region involved in addiction relapse.

The findings, reported Dec. 17 in The Journal of Neuroscience, point to new potential targets for treating alcohol and drug abuse especially the problem of relapse.

It is widely accepted that stress is a key signal in prompting alcohol and drug abuse relapse.

"Even after long periods of abstinence, an individual is at risk for relapse, and stress is what's most frequently cited as initiating that relapse," said Danny Winder, Ph.D., associate professor of Molecular Physiology & Biophysics and an investigator in the Center for Molecular Neuroscience and the Vanderbilt Kennedy Center.

Studies in animal models had suggested that a brain region called the extended amygdala an area that extends anatomically between reward and stress centers and CRF within this region were involved in stress-induced reinstatement (relapse) behavior......... Posted by: Emily      Read more         Source

December 16, 2008, 9:37 PM CT

MRI scans can predict effects of MS flare-ups

St. Louis, Dec. 16, 2008 One of the most pernicious aspects of multiple sclerosis (MS) its sheer unpredictability may finally be starting to yield to advanced medical imaging techniques.

Scientists from Washington University School of Medicine in St. Louis report online in the journal Neurology that an approach known as magnetic resonance diffusion tensor imaging (DTI) allowed them to estimate three months in advance the chronic effects of inflammation of the optic nerve. The condition occurs most often as a result of MS, a neurodegenerative disorder that can present with an extremely broad variety of symptoms that range from vision loss and other sensory damage to muscle weakness, spasticity or paralysis to depression, sleep loss or incontinence. MS affects an estimated 500,000 Americans.

"We see this as part of a battery of tests we hope to give patients within the next decade to help our clinical assessment and tailor it to an optimal therapy," says lead author Robert T. Naismith, M.D., assistant professor of neurology and a staff doctor at Barnes-Jewish Hospital. "It may also help further refine our basic understanding of MS in terms of expanding our insights into where and how damage occurs and why it can affect patients differently." .

Researchers believe MS results from misdirected immune system attacks against the nervous system. Symptoms occur in bouts that vary unpredictably in nature, severity, duration and frequency. Symptoms of optic nerve inflammation, known as optic neuritis, include loss of vision, blurring or fogginess and pain in the affected eye......... Posted by: Emily      Read more         Source

December 16, 2008, 8:29 PM CT

Old and young brains rely on different systems

Neuroresearchers from Duke University Medical Center have discovered that older people use their brains differently than younger people when it comes to storing memories, especially those linked to negative emotions.

The study, appearing online in the recent issue of Psychological Science, is a novel look at how brain connections change with age.

Elderly adults, average age 70, and younger adults, average age 24, were shown a series of 30 photographs while their brains were imaged in a functional MRI (fMRI) machine. Some of the photos were neutral in nature and others had strong negative content such as attacking snakes, mutilated bodies and violent acts. While in the fMRI machine, the subjects looked at the photos and ranked them on a pleasantness scale. Then they completed an unexpected recall task following the fMRI scan to determine whether the brain activity that occurred while looking at the pictures could predict later memory. The results were sorted as per the numbers of negative and neutral pictures that were remembered or missed by each group.

The researchers observed that elderly adults have less connectivity between an area of the brain that generates emotions and a region involved in memory and learning. But they also observed that the elderly adults have stronger connections with the frontal cortex, the higher thinking area of the brain that controls these lower-order parts of the brain......... Posted by: Emily      Read more         Source

December 16, 2008, 8:24 PM CT

Pigs and dogs can bridge gap between mice and humans

Human and veterinary medicine could receive a big boost through use of larger animals, particularly pigs and dogs, in research, with Europe at the forefront. There is the prospect of bringing drugs to the market more quickly at less cost, as well as accelerating progress in other forms of treatment, notably the use of stem cells in regenerative medicine. The potential in this new field was discussed at a recent workshop organised by the European Science Foundation (ESF), which called for a European pig clinic to facilitate generation and characterisation of models of human disease that would be funded within the EU's Seventh Framework programme, the main source of EU funding for research projects.

The immediate goal in the field is to establish a common standardised way of using animals with clearly defined characteristics (phenotypes), so that results can be compared across Europe. "The workshop showed that there is excellent expertise in individual labs, but the phenotypic tests need to be harmonised and standardised to facilitate comparison of results obtained in different labs," said Angelika Schnieke, one of the workshop's convenors, who holds the chair of Livestock Biotechnology at the Centre of Life Science in Weihenstephan, Gera number of.

Such standardisation has already been achieved for rodents, especially the mouse, which is the most widely used animal model at present for human disease research. The extension of such a framework to pigs and dogs will bring great rewards not just for human medicine, but also for therapy of animal diseases. "Large animals offer a link between the classical rodent models and application in the clinic," said Schnieke......... Posted by: Emily      Read more         Source

December 15, 2008, 9:14 PM CT

Hopkins-led team solves failed vaccine mystery

Research led by Johns Hopkins Children's Center researchers has figured out why a respiratory syncytial virus vaccine used in 1966 to inoculate children against the infection instead caused severe respiratory disease and effectively stopped efforts to make a better one. The findings, published online on Dec. 14 in Nature Medicine, could restart work on effective killed-virus vaccines not only for RSV but other respiratory viruses, scientists say. The new findings also debunk a popular theory that the 1966 vaccine was ineffective because the formalin used to inactivate the virus disrupted critical antigens, the substances that stimulate the production of protective antibodies.

Instead, scientists said, the problem occurred when the antibodies created by the vaccine failed to successfully bind to the real virus after exposure to it, thereby incapacitating it. Like vaccines against influenza and polio, the 1966 formalin-inactivated RSV vaccine produced antibodies, but these turned out to be defective ones with poor virus-binding ability.

"We have found the root cause of the problem, and in doing so we have uncovered clues that will help us design even safer and more effective vaccines in the future," says senior investigator Fernando Polack, M.D., an infectious disease specialist at Hopkins Children's......... Posted by: Emily      Read more         Source