A new finding reveals that African-American patients with breast, ovarian, and prostate cancer tend to die earlier than patients of other races with these cancers, even when they receive identical medical treatment and when socioeconomic factors are controlled for. The finding, an analysis of almost 20,000 patient records from 35 clinical trials, points to biological or genetic factors as the potential source of the survival gap. Dawn Hershman, M.D, M.S., a Columbia University Medical Center oncologist whose research is dedicated to examining racial and ethnic disparities in cancer outcome and in cancer survivorship, was the senior author of the research published online by the Journal of the National Cancer Institute (JNCI).

The study analyzed patient records from clinical trials – going back as far as 1974 – conducted by the Southwest Oncology Group (SWOG). The investigators conducted an analysis that controlled for comparable treatment, disparities in tumor prognosis, demographics, and socioeconomic status, and found no statistically significant difference in survival based on race for a number of cancers – including lung, colon, lymphoma, leukemia and multiple myeloma. However, African-American patients with breast, ovarian, or prostate cancers – the gender specific tumors – were found to face a significantly higher risk of death than did other patients, ranging from 21 percent higher for those with prostate cancer to 61 percent higher for ovarian cancer patients.

The poorer outcome for African-American cancer patients was supported by separate data published last month in the Journal of Clinical Oncology (JCO), which found that disparities in breast cancer survival based on race persisted even after adjusting for differences in treatment. That analysis of data from 634 breast cancer patients who participated in two SWOG-conducted trials was led by first author Dr. Hershman. Findings revealed that African-American women received similar dose intensity and cumulative dose as the Caucasian breast cancer patients, but were more likely to discontinue treatment early or experience treatment delay. In addition, African-American women had lower white blood counts, but no increase in infections complications. While Dr. Hershman and her team adjusted for these specific treatment related factors and other known predictors of outcome, such as age, hormone receptor status, stage, and treatment, African-American women still faced a lower rate of survival.

“The findings from these two studies are important as they suggest a possible role for biologic factors such as genetics, hormonal factors, comorbid conditions and tumor biology in cancer disparities. A better understanding of all the factors that contribute are critical, so that continued progress can be made toward reducing cancer mortality for patients of all races and ethnicities,” says Dr. Hershman, assistant professor of medicine and epidemiology at Columbia University Medical Center and co-director of the breast cancer program at the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian Hospital/Columbia University Medical Center. “There may be differences in genetic factors by race that alter the metabolism of chemotherapy drugs or that make cancers more resistant or more aggressive. We are now starting research to determine the role of these factors in this disparity.”

“When you look at the dialogue about the issue of race and cancer survival that has gone on over the years, it always seems to come down to general conclusions that African-Americans in part have poorer access to quality treatment, may be diagnosed in later stages and may not have the same standard of care delivered as Caucasian patients, leading to a disparity in survival,” says Kathy Albain, M.D., of Loyola University’s Cardinal Bernardin Cancer Center, lead, and senior author of the JNCI and JCO papers, respectively. “The good news is that for most common cancers, your survival is the same regardless of race. But this is not the case for breast, ovarian, and prostate cancers.”

“The need to address the racial disparities in cancer survival outcomes – both sociological and biological – has never been more urgent,” says Dr. Hershman. “With the incidence of cancer among minorities predicted to double in the next two decades – while comparable incidence among whites is only expected to rise 31 percent – this is a crucially important public health issue to understand all the factors that alter survival outcomes.”

Source:
Elizabeth Streich

Columbia University Medical Center Continue reading →

An alarming number of adolescents already battling eating disorders are also intentionally cutting themselves, and health-care providers may be failing to diagnose many instances of such self-injury, according to a new study from Stanford University School of Medicine and Lucile Packard Children’s Hospital.

The researchers found that 40.8 percent of patients with eating disorders in their study had documented incidents of intentionally harming themselves, most often by cutting and burning. What’s more, the study suggests that inadequate clinical screening might mean the count should be much higher.

“These are very high numbers, but they’re still conservative estimates,” said the study’s lead author, Rebecka Peebles, MD, who was an instructor in pediatrics at Stanford when the research was conducted and is joining the faculty at Children’s Hospital of Philadelphia.

Peebles noted that clinicians aren’t routinely asking about this activity. “We ask 97 percent of children 12 years and up if they smoke cigarettes; we need to get that good with screening for self-injurious behavior,” she said.

The study is to be published online in the Journal of Adolescent Health. Its senior author is James Lock, MD, PhD, professor of psychiatry and behavioral sciences and of pediatrics. He is also psychiatric director of the Comprehensive Eating Disorders Program at Packard Children’s Hospital.

To conduct the study, the researchers examined the intake evaluation records of 1,432 patients, ages 10-21, who were admitted to the hospital’s eating disorders program from January 1997 through April 2008. Just over 90 percent of all the patients were female, three-quarters of them white, with a mean age of 15. Among the 40.8 percent identified to be physically harming themselves, the mean age was 16. Many of these patients had a history of binging and purging, and 85.2 percent of the self-injurers were cutting themselves.

The researchers also discovered that slightly fewer than half the charts showed that health-care providers had asked patients if they intentionally injured themselves. If patients aren’t asked, they are unlikely to volunteer such information, said Peebles.

Those who were questioned tended to fit previously published profiles of a self-injurer: older, white, female, suffering from bulimia nervosa, or with a history of substance abuse. “The question is, ‘Are we missing other kids who are not meeting this profile?’” Peebles said. “This is part of why we wanted to look at this. If you see an innocent-looking 12-year-old boy, you don’t even think of asking about self-injurious behavior. We need to get much better about universal screening.”

Peebles noted that the profile itself might be flawed. If health-care workers only ask a certain type of patient about a behavior, the profile that emerges will necessarily reflect that bias, she said.

The study did not examine the reasons behind such acts but Peebles said her clinical experience suggested patients “are trying to feel pain.”

“Patients describe a feeling of release that comes when they cut or burn themselves,” she said. “They’ll cut with a razor or a scissor blade. Sometimes we’ve even had kids who will take the tip of a paper clip and gouge holes. To burn themselves, they’ll heat up a metal object and press it to their skin, or they’ll use cigarettes.”

Physicians and other health-care providers at Packard’s Comprehensive Eating Disorders Program now question all new patients about self-injurious behavior. Studies have shown that between 13 and 40 percent of all adolescents engage in some form of self-injury, which is also associated with a higher risk of suicide.

“In clinical practice, kids are fairly open when you engage with them,” Peebles said. “They’ll come in wearing long sleeves, or hiding the marks on their inner thighs. But then when you ask them, they are usually willing to discuss the behavior.”

The study’s other author is Jenny Wilson, MD, who was a resident in pediatrics when the study was conducted.

The study was funded in part by the Stanford Child Health Research Program. The Departments of Pediatrics and of Psychiatry and Behavioral Sciences also helped to support this study.

Source:
Erin Digitale
Stanford University Medical Center Continue reading →

Long-term survivors of testicular cancer who were treated with cisplatin-based chemotherapy had more severe side effects, including neurological side effects and Raynaud-like phenomena, than men who were not treated with chemotherapy, according to a new study published online November 25 in the Journal of the National Cancer Institute.

Marianne Bryd??y, M.D., of the Department of Oncology, Haukeland University Hospital, in Bergen, Norway, and colleagues conducted a cross-sectional study to assess the prevalence of these known side effects among long-term testicular cancer survivors in Norway according to the treatment they had received. Side effects include sensory neuropathy, tinnitus, hearing impairment, and Raynaud-like phenomena (discoloration of the hands or feet on exposure to cold).

Researchers invited 1,814 men who were treated for unilateral testicular cancer during 1980-1994 to participate in a national multicenter follow-up survey conducted during 1998-2002. A total of 1,409 participants, who were allocated to three groups based on cisplatin administration, were assessable in this study.

The researchers found that at 4-21 years after the initiation of treatment for testicular cancer, men who had received any chemotherapy had statistically significantly higher odds for increasing severity of all assessed symptoms compared with men not treated with chemotherapy. Treated men also had more hearing impairment, as measured by audiometry, particularly those who had received dose-intensive chemotherapy.

“A major aim in the treatment of testicular cancer is to minimize toxic effects without compromising the high cure rate,” the authors write. “Our data favor the use of chemotherapy regimens that contain 20 mg/m2 cisplatin per day to limit ototoxicity.”

Source: Steve Graff

Journal of the National Cancer Institute Continue reading →

When medication fails to control seizures in children with tuberous sclerosis complex (TSC), a rare genetic disorder that affects multiple organ systems and frequently causes epilepsy, surgery to remove part of the brain is often necessary. But pre-surgical testing, which involves the implanting of electrodes into a child’s head, can lead to longer hospital stays and greater risks from surgery.

Now, a study by researchers with UCLA’s Pediatric Epilepsy Surgery Program has found that an alternative, non-invasive approach to pre-surgical testing, along with earlier consideration for surgery, is associated with the best seizure-free surgical outcome in patients with TSC.

“Surgery to remove the portion of the brain causing the epilepsy is the most successful treatment for children with TSC and intractable epilepsy, but mapping which parts to take out can be challenging in a disease with multiple tubers in the brain and therefore multiple potential seizure-generating regions,” said lead study author Dr. Joyce Wu, an associate professor of pediatric neurology at Mattel Children’s Hospital at UCLA.

“The standard test of implanting electrodes into the patient’s head is uncomfortable, leads to a prolonged hospital stay with increased costs, and potentially increases the risks from surgery,” she said. “Our study looked at the effectiveness of our non-invasive, diagnostic imaging approach, which appeared to work just as well.”

The study is the first to examine UCLA’s non-invasive approach, which uses a combination of magnetic resonance imaging (MRI), fluoro-deoxyglucose positron emission tomography (FDG-PET) and magnetic source imaging (MSI) to identify the area of brain to be removed. The results showed that approximately two-thirds of TSC patients became seizure-free after surgery. The non-invasive results were similar to the traditional surgical testing method of implanting electrodes into the patient’s head for several days of monitoring.

Researchers also unexpectedly found that shorter seizure duration before surgery was associated with the best chance of children with TSC becoming seizure-free following surgery. Therefore, they said, it is important to consider surgery early, when medications fail to control seizures.

The study findings appear in the Feb. 2 issue of Neurology, the medical journal of the American Academy of Neurology.

Up to 90 percent of patients with TSC have epilepsy, with a significant portion suffering from medication-resistant, or intractable, epilepsy. For these patients, surgical removal of the tuber and surrounding cerebral cortex may offer seizure freedom.

The study included 28 TSC patients with intractable epilepsy referred to UCLA between 2000 and 2007. In addition to the standard pre-surgical evaluation, these patients had MSI and FDG-PET/MRI co-registration. None had the invasive intracranial test. Of these patients, 18 (64 percent) underwent surgical resection, and of those, 12 (67 percent) were seizure-free postoperatively with an average follow up of 4.1 years.

The study also confirmed that a younger age at surgery and shorter seizure duration were associated with post-operative freedom of seizures. Since epilepsy in children can be severely debilitating, early diagnosis and treatment are critical in helping a child reach full cognitive potential.

Anya, now two-and-a-half years old, underwent the surgery at UCLA when she was 16 months old. After suffering up to 30 seizures a day and her medications not working as effectively, Dr. Wu and her team suggested that Anya be evaluated for surgery to remove the offending tubers.

She then underwent the non-invasive testing and was found to be a good candidate for surgery. It has been more than a year since her seven-hour operation, and she is still seizure-free.

“TSC is a pretty devastating disease,” said Anya’s mother, Anita Smith, who wrote an article about her daughter’s condition for a parenting website. “It’s important for parents to know that they do not have to put their child through so many invasive tests and that surgery can be more successful if it’s done earlier.”

The next stage of research will focus on applying this approach to non-TSC patients, encouraging earlier considerations for surgery, reporting seizure outcomes after longer postoperative follow-ups, and assessing long-term developmental outcomes.

“UCLA is one of the few centers with the ability and experience to treat kids with this rare disorder,” said senior author Dr. Gary Mathern, professor of neurosurgery at UCLA. “By developing improved technologies to help these young patients, we hope to make a difference in their lives.”

Additional authors included Dr. Noriko Salamon, Dr. Raman Sankar and Dr. W. Donald Shields, of UCLA; Dr. Heidi E. Kirsch, Mary M. Mantle and Dr. Srinivasan S. Nagarajan, of UC San Francisco; and Lacey Kurelowech and Dr. Maung H. Aung, of the Scripps Clinic.

This study was supported by the National Institue of Neurological Disorders and Stroke of the National Institutes of Health. The authors have no financial ties to disclose.

Mattel Children’s Hospital UCLA, one of the highest-rated children’s hospitals in California, is a vital component of the Ronald Reagan UCLA Medical Center, ranked by U.S. News & World Report as the third best hospital in nation and best in the Western United States. Mattel Children’s Hospital offers a full spectrum of primary and specialized medical care for infants, children and adolescents. The hospital’s mission is to provide state of-the-art treatment for children in a compassionate atmosphere, as well as to improve the understanding and treatment of pediatric diseases.

Source: University of California, Los Angeles (UCLA) Continue reading →

Southeast Community Care, provided by Arcadian Health Plan, Inc., is recognized as the number one plan in the Roanoke-Roanoke City County area for excellent value among Medicare Advantage plans as the recipient of the 2011 Senior Choice Gold Award. The award is given out by HealthMetrix Research Inc., a national independent managed care research firm that has provided independent information to a national audience of managed care organizations and consumers since 1996. Award recipients were selected from over 200 Medicare managed care plans that demonstrate cost-sharing effectiveness and value in the design of their 2011 medical and Part D prescription drug benefits for Medicare beneficiaries.

“Finding an affordable, quality Medicare Advantage plan is particularly important to Medicare eligibles given the current economic climate and the important decisions they’re facing surrounding their health care right now,” said Dan Dyer, Vice President, Southeast Community Care. “We are honored to receive this award, as it speaks directly to our ongoing mission to bring high-quality, affordable care to Medicare beneficiaries in the Roanoke area.”

In announcing the 2011 Senior Choice Gold Award recipients, HealthMetrix Research and MedicareNewsWatch president Alan Mittermaier pointed out the importance of the award for Medicare beneficiaries:

“This award responds to the concerns and uncertainties that beneficiaries have with the out-of-pocket costs incurred when they enroll in a Medicare Advantage plan. Southeast Community Care has demonstrated a commitment to delivering maximum value in the design of their plan benefits, copayments, deductibles, and premiums. We believe that informed beneficiaries can rely on this award as an indication of excellence just as they rely on other awards and consumer ratings that recognize excellence in quality of care, health outcomes and member satisfaction.”

The Senior Choice Gold Award is based on the 2011 Medicare CostShare report produced by HealthMetrix Research Inc., the most independent analysis of Medicare plan cost-sharing available.

Source: Southeast Community Care Continue reading →

Gaining body fat may be a good thing, at least for people with type 1 diabetes, say researchers at the University of Pittsburgh Graduate School of Public Health. Their study, being presented at the 68th Scientific Sessions of the American Diabetes Association in San Francisco, followed 655 patients with type 1 diabetes for 20 years and found that patients who gained weight over time were less likely to die.

The findings are based on participants in the Pittsburgh Epidemiology of Diabetes Complications Study, a long-term prospective study of childhood onset type 1 diabetes, which began in 1986. Participants in the study, an average age of 28 when entering the study and 44 at its completion, were diagnosed with type 1 diabetes between 1950 and 1980. Researchers measured patients’ body mass index (BMI) and waist circumference and assessed BMI every two years during the study period. Over the course of the study, 147 deaths occurred.

Results showed that patients whose BMI increased the most during the study (2 to 11 points or about 10 to 55 pounds) were one-third less likely to die than those who had smaller increases in BMI, indicating that weight gain may protect people with type 1 diabetes from premature death.

“Although weight gain in adulthood is typically associated with increased mortality, this may not be the case for those with type 1 diabetes,” said Trevor Orchard, M.D., professor of epidemiology at the University of Pittsburgh Graduate School of Public Health. “Gaining a reasonable amount of weight may be a sign patients are getting enough insulin and appropriately controlling their disease, which may partly explain why those who gained weight over time had lower mortality rates,” said Dr. Orchard, who also is professor of medicine and pediatrics at the University of Pittsburgh School of Medicine.

Dr. Orchard and colleagues also looked at BMI ranges and mortality and found no difference in mortality between those with a BMI in the overweight range (BMI 25 to 30) and the normal range (BMI 20 to 25). Conversely, they found that having a BMI in the underweight (BMI less than 20) or obese range (BMI 30 and greater) was a strong predictor of mortality. When researchers controlled for waist circumference, a commonly cited reason for general fat mortality, patients with a BMI in the underweight range were at greatest risk for death, while those with a BMI in the overweight or obese ranges had a decreased risk of mortality compared to patients with a normal BMI.

“These results are not a firm recommendation to people with type 1 diabetes to put on weight, but it does raise the possibility that weight recommendations in type 1 diabetes may be somewhat different than those for the general population, and emphasizes the complex relationship between body fat and mortality in diabetes,” added Baqiyyah Conway, M.P.H., lead author of the abstract.

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Previously known as juvenile diabetes, type 1 diabetes is usually diagnosed in children and young adults. In type 1 diabetes, the pancreas produces little or no insulin to properly control blood sugar levels. It is typically treated with insulin replacement therapy. As many as 3 million Americans have type 1 diabetes.

In addition to Dr. Orchard and Ms. Conway, other authors include Rachel G. Miller, M.S.; Tina Costacou, Ph.D.; Linda Fried, M.D.; Robert Evans, Ph.D.; and Sheryl Kelsey, Ph.D., all of the University of Pittsburgh. The study was funded by the National Institute of Diabetes and Digestive and Kidney Diseases at the National Institutes of Health.

Source: Clare Collins

University of Pittsburgh Schools of the Health Sciences Continue reading →

Florida Gov. Charlie Crist (R) last week signed into law legislation (SB 8A) that will place a 5% tax on nursing homes’ net revenues as a way to increase the matching federal funds they receive through Medicaid, Florida Health News reports. The tax is expected to draw down 55 cents in federal Medicaid funds for every 45 cents it generates. The tax assessment would generate an additional $3.79 a day paid to the nursing homes by Medicaid, Florida Health News reports.

Nursing homes will begin collecting the money on April 1 under the assumption that CMS will approve a Medicaid waiver that will allow the matching funds to be allocated. Thirty-two states use similar assessments on health care facilities to draw down federal money. According to the Florida Health Care Association, without the tax, nursing homes faced a scheduled 10.5% cut in Medicaid funding, or more than $231 million. FCA Senior Vice President and Chief Operating Officer Tony Marshall said that funding cuts that high also would have resulted in layoffs of 7,000 nursing home personnel. Marshall said, “Facilities would do everything in their power to avoid putting patient care at risk,” adding, “I don’t know of another way to have done it.”

According to Florida Health News, nursing homes — along with other Medicaid providers — experienced Medicaid payment cuts during the 2008 regular session as well as in two special sessions held that year for a total reduction in funding of $346 million since 2007. Marshall said that the new nursing home tax will repeal those reductions, adding, “This will protect Florida’s oldest, most vulnerable citizens” (Jordan Sexton, Florida Health News, 2/3).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

An ambitious five-year project will attempt to make eye-tracking technologies more affordable for people with disabilities and extend the potential use of the devices to enable users to live more independently.

The Communication by Gaze Interaction (COGAIN) project will examine current state-of-the-art technologies, develop new software standards to extend the available products and research new applications for the technology based on end-users’ real needs.

“It’s a big project and it’s novel in that it brings together all the interested parties,” says Kari-Jouko R?ih?, Professor of Computer Science at the Finnish University of Tampere and IST-funded COGAIN project coordinator.

It’s also important. Eye tracking technologies could transform the lives of tens of thousands of people across Europe. The most extreme example of how this technology is used is its ability to give voice to people who are ‘locked-in’, people who can only move their eyes and only communicate with their gaze, says R?ih?. “But it also has applications for people with Amyotrophic Lateral Sclerosis [ALS], also known as Lou Gehrig’s disease, or Cerebral Palsy, or Multiple Sclerosis [MS].”

Currently state-of-the-art eye tracking equipment is very advanced, with an extremely high spatial and temporal resolution – it can detect tiny movements in millisecond intervals. “The problem is that this equipment is very expensive – about ?20,000 for a top-of-the-range system,” says R?ih?. COGAIN hopes to develop new equipment – in cooperation with manufacturers – that can provide sufficient resolution at a reasonable cost.

The basic eye-tracking system consists of a camera, a computer and software to provide an interface between the two. In an expensive system the camera uses an internal light source to create reflections on the eye. The camera tracks these reflections and uses them to move a cursor on the screen, for example.

COGAIN hopes to provide the same functionality, though at a lower performance, using an ordinary Web cam and ambient light.

But the project plans to do more. Currently eye-tracking systems are tied to proprietary software, which means that every new application must be written for a particular piece of controlling software. COGAIN wants to create standard control software so applications can be developed by anybody.

This is a key development. One of COGAIN’s aims is to develop new applications. This could include new types of text entry. “Currently most text entry is done using a ‘soft keyboard’. Essentially it’s a picture of a keyboard and users move the cursor along until they find the right letter,” says R?ih?.

But another system developed by one project partner, the University of Cambridge, uses a type of predictive text, where letters move across the screen and users fix their gaze on the letters they want. “It’s an unusual system, and it takes a little training to get used to it, but users can enter text at 20 words a minute once they become familiar with the system. That’s very fast,” says R?ih?.

He adds that the application is hard to imagine if you don’t see it in action. “But think of all the other potential applications for this technology that we just haven’t thought about, or imagined yet. The potential is enormous and COGAIN aims to develop that.”

The project’s partners already have some ideas. Software that could control heating and lighting through eye-tracking technology and a PC is one possible application. “We currently have a specialist group within the project looking at environmental controls,” says R?ih?. He adds that they are also examining the potential for controlling a wheelchair through eye-movements. This could change lives, for the better.

The project began in September 2004 and the team spent the first year establishing the current state of the market and creating links between all the different stakeholders. “So far we’ve held several meetings to build up networking between the various partners in the consortium,” says R?ih?. “We’ve also held our first COGAIN camp, which brought researchers and manufacturers into contact with end-users. It was a very interesting meeting and the researchers gained a new respect and understanding for the needs of people with disabilities.”

Article in IST RESULTS

Sarah and Mick demonstrating Quick Glance 2 by EyeTechDigital Systems. Copyright: COGAIN JPG 186.52k Continue reading →

Scientists report that adult stem cells isolated from humans with muscular dystrophy can be genetically corrected and used to induce functional improvement when transplanted into a mouse model of the disease. The research, published by Cell Press in the December issue of Cell Stem Cell, represents a significant advance toward the future development of a gene therapy that uses a patient’s own cells to treat this devastating muscle-wasting disease.

Duchenne muscular dystrophy (DMD) is a hereditary disease caused by a mutation in the gene that codes for a muscle protein called dystrophin. Dystrophin is a key structural protein that helps to keep muscle cells intact. DMD is characterized by a chronic degeneration of skeletal muscle cells that leads to progressive muscle weakness. Although intense research has focused on finding a way to replace the defective dystrophin protein, at this time there is no cure for DMD.

A research group led by Dr. Yvan Torrente from the University of Milan used a combination of cell- and gene-based therapy to isolate adult human stem cells from DMD patients and engineer a genetic modification to correct the dystrophin gene. “Use of the patient’s own cells would reduce the risk of implant rejection seen with transplantation of normal muscle-forming cells,” explains Dr. Torrente.

Muscle stem cells, identified by expression of the CD133 surface marker, were isolated from normal and dystrophic human blood and skeletal muscle. The isolated human muscle progenitors were implanted into the muscles of mice and were successfully recruited into muscle fibers. As expected, the CD133+ cells isolated from DMD patients expressed the mutated gene for dystrophin and gave rise to muscle cells that resembled muscle fibers in DMD patients.

The researchers then used a sophisticated genetic technique to repair the mutated dystrophin gene in the isolated DMD CD133+ cells so that dystrophin synthesis was restored. Importantly, intramuscular or intra-arterial delivery of the genetically corrected muscle cell progenitors resulted in significant recovery of muscle morphology, function, and dystrophin expression in a mouse model of muscular dystrophy.

“These data demonstrate that genetically engineered blood or muscle-derived CD133+ cells represent a possible tool for future stem cell-based autograft applications in humans with DMD,” says Dr. Torrente. The authors caution that significant additional work needs to be done prior to using this technology in humans. “Additional research will substantially enhance our understanding of the mechanisms underlying this effect and may lead to the improvement of gene and cell therapy strategies for DMD.”

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The researchers include Rachid Benchaouir, Mirella Meregalli, Andrea Farini, Marzia Belicchi, Maurizio Battistelli, and Nereo Bresolin, of the University of Milan, in Milan, Italy; Yvan Torrente of the University of Milan, in Milan, Italy, and UNISTEM, at University of Milan, in Milan, Italy; Giuseppe D’Antona and Roberto Bottinelli, of the Human Physiology Unit, University of Pavia, in Pavia, Italy; Aure?? lie Goyenvalle, of Genethon-CNRS, in Evry, France; and Luis Garcia, of Genethon-CNRS, in Evry, France.

Source: Cathleen Genova

Cell Press Continue reading →

For the second year in a row, Hospital for Special Surgery is the only hospital in New York State with an infection rate that is significantly lower than the state average for hip replacement or revision surgeries, according to the 2009 report on hospital infection rates released today by the State Department of Health.

“At Hospital for Special Surgery, we perform more joint replacement surgery than any other hospital in the country, and infection prevention is a critical component of our best practices,” said surgeon-in-chief Thomas P. Sculco, M.D. “We are vigilant about infection prevention at every level, from washing hands to maintaining a clean environment for our patients in the operating room and the entire hospital.”

Surgeons at Hospital for Special Surgery performed 15 percent of the nearly 26,000 hip replacement or revision procedures in New York State in 2009. Special Surgery was the only hospital of the 169 hospitals included in the report that had a statistically lower surgical site infection rate than the state average of 1.1 percent for that particular procedure. Hospitals that performed the highest number of hip replacement procedures had the lowest infection rates, according to the report.

“When patients select a hospital, a low infection rate should be one of the items at the top of their list,” said Louis A. Shapiro, president and CEO. “At Hospital for Special Surgery, we believe that infection prevention is everyone’s responsibility. Success can only be achieved with contributions from our entire staff, from surgeons and nurses to technicians and housekeepers.

Numerous best practices contribute to the low infection rate for hip replacement at Hospital for Special Surgery. All joint replacement procedures are performed quickly, in an average of one to two hours, and with regional anesthesia to reduce bleeding. The operating room teams remain consistent to speed surgical time, and an infection prevention specialist is dedicated to the operating room. During surgery, patients have minimal exposure to contaminants because they are isolated from the environment by a Plexiglas enclosure. After surgery, the operating rooms and instruments are meticulously cleaned, and the infection control department ensures that heightened standards are maintained.

New York State’s strict regulatory and surveillance systems require hospitals to report certain hospital-acquired infections to the State Department of Health. Today’s publication is the third annual report of hospital-acquired infections in New York State, but the second annual report to include hip replacement procedures. The report states that the data are made publically available each year to give people information about hospital performance that could help them make informed medical decisions.

Source: Hospital for Special Surgery Continue reading →