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© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

“Recovery of regenerative cells located in the stromal vascular fraction of a patient’s own subcutaneous tissue is relatively simple and can be used for self-healing,” said Christopher Alt, Ph.D., a researcher involved in the work from the Department of Molecular Pathology at the University of Texas in Houston. “A patient’s quality of life can be improved by application of those recovered regenerative cells to the heart, as well as to bone, tendons, non-healing wounds and joints.”

Using newborn rats, scientists studied the combination of rat heart muscle cells (cardiomyocytes) and human adipose (fat) stem cells derived from human subcutaneous adipose tissue. They found that the two fused and formed new heart muscle cells with several nuclei. When kept in a culture environment, these cells beat. These new cells exhibited an ability to compensate for a loss of cardiomyocytes as following a myocardial infarction, via fusion with cardiomyocytes. Furthermore, this study shows that contrary to previous findings suggesting that genetic modification of certain embryonic genes in adult stem cells is required as a prerequisite for turning into heart cells, the human stem cells used in this study were not genetically modified.

“Much work is still ahead before this method can be applied to humans, but the hope is that this technique might eventually make heart transplants unnecessary,” said Gerald Weissmann, M.D., Editor-in-Chief of The FASEB Journal. “This study not only shows the power of stem cell fusion technology, but also that cardiac regeneration is on the horizon.”

Notes:

Details:
Roxana Metzele, Christopher Alt, Xiaowen Bai, Yasheng Yan, Zhi Zhang, Zhizhong Pan, Michael Coleman, Jody Vykoukal, Yao-Hua Song, and Eckhard Alt

Human adipose tissue-derived stem cells exhibit proliferation potential and spontaneous rhythmic contraction after fusion with neonatal rat cardiomyocytes
FASEB J March 2011 25:830-839; doi:10.1096/fj.09-153221.

Source:
Cody Mooneyhan
Federation of American Societies for Experimental Biology

The study included nearly 6,900 type 1 diabetics undergoing SPK transplantation. When SPK transplant was successful with both organs functional at one year, the long-term survival rate was 89 percent, compared to 80 percent for patients receiving a kidney from a living donor and 65 percent for those receiving a kidney (but not pancreas) from a deceased donor (All SPK transplants came from deceased donors). However, SPK recipients were about two percent more likely to die during the first year after transplantation. There was also a ten to fifteen percent chance that the transplanted pancreas would fail during the first year. When this happened, the long-term survival rate dropped to 74 percent.

Patients with type 1 diabetes and advanced kidney disease face a difficult decision, according to Wiseman: “Should they try to get on the waiting list for SPK and assume the greater surgical risk, or should they accept a kidney from a living donor and live with continued diabetes?” If they opt for kidney transplant alone, they then must decide whether to undergo a separate pancreas transplant later on. In Wiseman’s study, even this option did not lead to better survival than successful SPK transplantation.

The new findings help to guide this decision by comparing the benefits and risks of the various transplant options. “Overall, the chances for better long-term success favor the SPK option, particularly if the waiting time for an SPK is not long this varies with regions of the United States.”

The study is limited by a lack of information on why the SPK recipients lived longer one theory is that improved diabetes control helped avoid cardiovascular disease. In addition, although the study provides important new evidence that survival rate is higher after successful SPK transplantation, it does not help in predicting which patients will have a successful SPK transplant.

The authors reported no financial disclosures.

Source: American Society of Nephrology (ASN)

Criticism
Robert Hayes, director of the Medicare Rights Center, called the application “badly flawed,” adding, “We and other consumer groups gave Social Security a good deal of comments on how to simplify the applications, and these comments were largely ignored.” He said that several questions on the application are long and confusing, which could prompt Medicare beneficiaries not to complete the application. Hayes also criticized a warning on the application that says Medicare beneficiaries who provide false information “may be sent to prison or may face other penalties, or both.” He said, “These are very poor people getting these letters. They are older and sicker than the average person on Medicare and least able to dig through the lengthy application” (Jaffe, Cleveland Plain Dealer, 3/21).

Rx Drug Card Program
In related news, the Orlando Sentinel on Monday examined how many low-income Medicare beneficiaries who qualify for a $600 subsidy under the Medicare prescription drug discount card program remain unaware of the available financial assistance. According to the federal government, an estimated seven million Medicare beneficiaries qualify for the $600 subsidy for 2005, but only 1.73 million of those had enrolled as of Feb. 28. Eligible Medicare beneficiaries who enroll before March 31 will receive the full $600 subsidy, and those who enroll after that date will receive a $150 to $450 subsidy for the remainder of the year based on the date of enrollment. Medicare is working to educate beneficiaries about the subsidy before the March 31 deadline. However, according to Tricia Neuman, a Kaiser Family Foundation vice president and director of its Medicare Policy Project, “This is just a hard population to reach.” She added, “A key obstacle is that anytime you offer a new benefit, there’s a huge learning curve until a large number of people really know about it and then go through the process of applying for it” (Shelton, Orlando Sentinel, 3/21).

“Reprinted with permission from kaisernetwork 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 . © 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

Some of the factors involved in Peyronie’s disease can be: the existence of an infection, genetic predisposition, vascular problems, consumption of specific medicines, diabetes, hypertension, etc.
The plaque itself is benign, or noncancerous. However, if not treated, the disease may lead to serious erectile dysfunction.

At first, the line of treatment for Peyronie’s disease was to “watch and wait” to see whether the penile curvature resolved itself or worsened. When the latter occurred, the patient was given vitamin E treatment, even though its positive outcome is not scientifically proved.

Researchers also have injected chemical agents into the plaques, a procedure that also lacks scientific studies that confirm its effectiveness.

A more effective way of curing Peyronie’s disease is surgery, a last resort procedure which raises the patient’s risk of experiencing complete loss of erectile function, rigidity and shortening of the penis.

Fortunately, surgery is not the only option to treat Peyronie’s diseases. Andromedical, a Spanish medical company, markets the andropenis®, a medical device using the principle of traction to straighten the penis with no side effect, as long as it is used on a penis in flaccidity. The first outcome should appear within three weeks of treatment and after 6 to 7 months, the patient will notice full results: a correction of up to 70 per cent curvature. Thanks to its efficiency, the andropenis® is recognized by famous doctors worldwide, such as Wendy Hurn, Urology Specialist Practitioner, Bristol Royal Infirmary, UK.

Several scientific studies have confirmed the effectiveness of the andropenis® for patients with Peyronie’s disease. Apart from rectifying penile curvatures, the andropenis® can also be used as a penile postoperative treatment in order to avoid scar retraction and especially to achieve a penis enlargement of 3 to 4 centimetres (1.2 to 1.6 inches) in length as well as a girth increase of 1,5 centimetre (0.6 inch) with a 97.5 percent rate of efficiency as demonstrated by independent scientific research around the globe.

www.andromedical

Don Monteith, Senior Research Fellow at the UCL Environmental Change Research Centre, says: “A huge amount of carbon is stored in the form of organic deposits in soils, and particularly in the peatlands that surround many of our remote surface waters. In the past two decades an increasing amount of this carbon has been dissolving into our rivers and lakes, turning the water brown.

“There have been numerous attempts to explain what’s happening, with everything from global warming to changing land-use cited as the cause. Some studies have suggested that we’re seeing an unprecedented phenomenon as soils destabilise with unpredictable consequences for the global carbon cycle.”

John Stoddard of the EPA says: “By analysing water chemistry records from over 500 sites across the northern hemisphere we’ve found that the dominant factor in the whole process is not global warming. The most important driver has actually been the major reduction in acid rain since the 1970s. As acidity and pollutant concentrations in the soil fall, carbon becomes more soluble, which means more of it moves into our lakes and rivers and more can be exported to the oceans.

“In some ways we’re seeing waters returning to their natural, pre-industrial state. However, more research is needed into the implications for freshwaters. The environmental pathways of heavy metals like aluminium and mercury, for example, are closely tied to dissolved organic carbon, and it’s too early to know how increasing organic matter will affect these toxic compounds.

Chris Evans, from the UK Centre for Ecology and Hydrology, adds: “The suggestion that waters are returning to more natural conditions may be of little consolation to water supply companies as they are faced with the increasingly difficult — and expensive — task of removing the colour from drinking water using treatment facilities that were designed to deal with the lower concentrations experienced in previous years.”

Data for this study was drawn from nationally funded monitoring programs in the UK, USA, Canada, Norway, Sweden and Finland. Trends in dissolved organic carbon, air temperatures and a suite of other chemical variables were assessed using data from 1990-2004. The study is the largest of its kind and the data represents the main source of high quality, long-term information about the condition of our headwater systems. Ironically many of the study sites, including those in the UK, are under threat of imminent closure or scaling back due to cuts in government funding. This comes despite increasing recognition of the urgent need to monitor the response of natural environments to climate change and other man-made pressures, and the obvious value of these records for increasing our understanding of environmental processes.

###

About UCL:

Founded in 1826, UCL was the first English university established after Oxford and Cambridge, the first to admit students regardless of race, class, religion or gender, and the first to provide systematic teaching of law, architecture and medicine. In the government’s most recent Research Assessment Exercise, 59 UCL departments achieved top ratings of 5* and 5, indicating research quality of international excellence.

UCL is in the top ten world universities in the 2007 THES-QS World University Rankings, and the fourth-ranked UK university in the 2007 league table of the top 500 world universities produced by the Shanghai Jiao Tong University. UCL alumni include Marie Stopes, Jonathan Dimbleby, Lord Woolf, Alexander Graham Bell, and members of the band Coldplay.

About the UCL Environmental Change Research Centre

The ECRC is one of UCL’s major interdisciplinary research centres. It is based in the Department of Geography and conducts research on the effects of climate change and pollution on aquatic ecosystems (ecrc.ucl.ac/)

About the US Environmental Protection Agency

The U.S. EPA is the regulatory agency responsible for protecting the quality of the air and waters of the U.S. As part of its responsibilities, the EPA conducts extensive research on the effects of environmental pollutants on ecological and human well-being.

Source: Dave Weston

University College London

“The typical influenza vaccine does not provide immunity to swine flu,” said Executive Vice President Thomas B. Casale, MD, FAAAAI. “As with other influenza viruses, this virus typically attacks the respiratory tract. So if you have a chronic respiratory condition like asthma, it can take a turn for the worse, exacerbating your asthma.”

While people with asthma or other chronic lung conditions are at a higher risk for developing complications from influenza, it is important to be attentive to the presence of symptoms but not to panic. Catching the symptoms early is key because the antiviral drugs used to combat swine flu are most effective if started as soon as possible, and might not work if administered more than 48 hours after becoming ill.

The symptoms of swine flu include fever, tiredness, lack of appetite and coughing. Some people with the virus have also reported a runny nose, sore throat, nausea, vomiting and diarrhea.

“Any individual exhibiting signs of swine flu should call his or her physician to discuss those symptoms. A doctor is best prepared to advise whether or not an in-person visit should be made,” noted Casale. Also, patients should avoid contact with other individuals as much as possible and practice good hygiene, especially hand washing.

The American Academy of Allergy, Asthma & Immunology represents allergists, asthma specialists, clinical immunologists, allied health professionals and others with a special interest in the research and treatment of allergic disease. Established in 1943, the AAAAI has nearly 6,500 members in the United States, Canada and 60 other countries.

For useful tips to help reduce flu transmission, visit aaaai.

Locate an allergist/immunologist online at aaaai/physref.

Source
American Academy of Allergy, Asthma & ImmunologyFurther information on Swine Flu

See a Map Of H1N1 Outbreaks
See our Mexico Swine Flu Blog

“People with high levels of albumin in their urine were at markedly higher risk of mortality than people with low levels of albumin in the urine,” said Kunihiro Matsushita, MD, PhD, lead author of the study and a postdoctoral fellow with the Johns Hopkins Bloomberg School of Public Health’s Department of Epidemiology.

“The risk of mortality was elevated by nearly 50 percent at 30 mg/g albumin to creatinine ratio, which is the threshold for defining chronic kidney disease. In addition, mortality risk increased more than four-fold at high levels of albuminuria compared to an optimal level of 5 mg/g. The data presented in this analysis confirm that the current thresholds are indicative of increased all-cause and cardiovascular mortality risk with both kidney filtration function and urine protein contributing to risk.”

The new findings are part of a comprehensive effort by the Chronic Kidney Disease Prognosis Consortium to use data to refine the definition and staging of chronic kidney disease. Staging is a method used to categorize the severity of an illness to help establish the best course of treatment. Current guidelines from the National Kidney Foundation’s Kidney Disease Outcomes Quality Initiative (KDOQI) define chronic kidney disease based on the presence for greater than three months of either: estimated kidney filtration function below 60 ml or kidney damage most commonly detected by protein in the urine.

“This study conclusively confirms earlier suggestions for including both of these kidney measures in risk evaluation and provides a quantitative basis for chronic kidney disease definition and staging,” said co-author, Josef Coresh, MD, PhD, MHS, professor with the Bloomberg School’s Department of Epidemiology and director of the George W. Comstock Center for Public Health Research and Prevention. “With more than 1.2 million study participants from 14 countries, the paper has significant implications globally. The overwhelmingly positive response by the community of researchers studying kidney disease for the call to assemble the best possible data to define kidney disease prognosis and improve its definition and staging was impressive.”

Chronic kidney disease is increasingly recognized as a major global public health problem. The disease affects 10-16% of the adult population in Asia, Australia, Europe, and the US, and it increases the risk of all-cause mortality, cardiovascular disease, and progression to kidney failure, even after accounting for traditional risk factors such as hypertension and diabetes. There are more than 500,000 patients with kidney failure in the United States.

About the Chronic Kidney Disease Prognosis Consortium

The Consortium is led by Josef Coresh at Johns Hopkins University in the US, Paul de Jong and Ron Gansevoort at the University of Groningen in The Netherlands, and Andrew Levey at Tufts University in the US. It was initiated for a KDIGO’s October 2009 Controversies Conference where leading investigators from 45 studies contributed data to examine kidney disease outcomes across the globe. This report focuses on mortality outcomes from 14 countries including 21 leading population based studies. Other meta-analyses will focus on high risk and kidney disease cohort and end-points beyond mortality. The lead author was Kunihiro Matsushita from Johns Hopkins Bloomberg School of Public Health.

Chronic Kidney Disease Prognosis Consortium Participating Investigators/Collaborators:
AKDN Marcello Tonelli, Brenda Hemmelgarn; ARIC Josef Coresh, Brad C Astor, Kunihiro Matsushita, Yaping Wang; AusDiab Robert C Atkins, Kevan R Polkinghorne, Steven J Chadban; Beaver Dam Anoop Shankar, Ronald Klein, Barbara E K Klein; Beijing HaiYan Wang, Fang Wang, Luxia Zhang, Lisheng Liu; CHS Michael Shlipak, Mark J Sarnak, Ronit Katz, Linda P Fried; COBRA Tazeen Jafar, Muhammad Islam, Juanita Hatcher, Neil Poulter, Nish Chaturvedi; ESTHER Dietrich Rothenbacher, Hermann Brenner, Elke Raum, Wolfgang Koenig; Framingham Caroline S Fox, Shih-Jen Hwang, James B Meigs; Gubbio Massimo Cirillo; HUNT Stein Hallan, Stian Lydersen, Jostein Holmen; MESA Michael Shlipak, Mark J Sarnak, Ronit Katz, Linda P Fried; MRC Older People Paul Roderick, Dorothea Nitsch, Astrid Fletcher, Christopher Bulpitt; NHANES III Brad Astor, Josef Coresh; Ohasama Takayoshi Ohkubo, Hirohito Metoki, Masaaki Nakayama, Masahiro Kikuya, Yutaka Imai; PREVEND Ron T Gansevoort, Paul E de Jong, Marije van der Velde; Rancho Bernardo Simerjot Kaur Jassal, Elizabeth Barrett-Connor, Jaclyn Bergstrom; REGARDS David G Warnock, Paul Muntner, Suzanne Judd, William M McClellan, Mary Cushman, George Howard, Leslie A McClure; Severance Sun Ha Jee, Heejin Kimm, Ji Eun Yun; Taiwan Chi-Pang Wen, Sung-Feng Wen, Chwen-Keng Tsao, Min-Kuang Tsai; ULSAM Johan Ärnlöv.

The study was funded by KDIGO and the US National Kidney Foundation.

Source
Johns Hopkins Bloomberg School of Public Health

“It’s a big step forward,” said Kang Zhang, MD, PhD, professor of ophthalmology and human genetics at Shiley Eye Center and director of the Institute for Genomic Medicine, both at UC San Diego. “It means we can generate stable, renewable neural stem cells or downstream products quickly, in great quantities and in a clinical grade millions in less than a week that can be used for clinical trials and, eventually, for clinical treatments. Until now, that has not been possible.”

Human embryonic stem cells hold great promise in regenerative medicine due to their ability to become any kind of cell needed to repair and restore damaged tissues. But the potential of hESCs has been constrained by a number of practical problems, not least among them the difficulty of growing sufficient quantities of stable, usable cells and the risk that some of these cells might form tumors.

To produce the neural stem cells, Zhang, with co-senior author Sheng Ding, PhD, a former professor of chemistry at The Scripps Research Institute and now at the Gladstone Institutes, and colleagues added small molecules in a chemically defined culture condition that induces hESCs to become primitive neural precursor cells, but then halts the further differentiation process.

“And because it doesn’t use any gene transfer technologies or exogenous cell products, there’s minimal risk of introducing mutations or outside contamination,” Zhang said. Assays of these neural precursor cells found no evidence of tumor formation when introduced into laboratory mice.

By adding other chemicals, the scientists are able to then direct the precursor cells to differentiate into different types of mature neurons, “which means you can explore potential clinical applications for a wide range of neurodegenerative diseases,” said Zhang. “You can generate neurons for specific conditions like amyotrophic lateral sclerosis (ALS or Lou Gehrig’s disease), Parkinson’s disease or, in the case of my particular research area, eye-specific neurons that are lost in macular degeneration, retinitis pigmentosa or glaucoma.”

The new process promises to have broad applications in stem cell research. The same method can be used to push induce pluripotent stem cells (stem cells artificially derived from adult, differentiated mature cells) to become neural stem cells, Zhang said. “And in principle, by altering the combination of small molecules, you may be able to create other types of stem cells capable of becoming heart, pancreas, or muscle cells, to name a few.”

The next step, according to Zhang, is to use these stem cells to treat different types of neurodegenerative diseases, such as macular degeneration or glaucoma in animal models.

Source: University of California

Sleep apnea, which affects more than 10 million American, with an estimated additional 10 million undiagnosed, is characterized by loud snoring interrupted by frequent episodes of totally obstructed breathing (obstructive sleep apnea). Serious episodes last more than ten seconds each and occur more than seven times per hour. Apnea patients may experience 30 to 300 such events per night. These episodes can reduce blood oxygen levels, causing the heart to pump harder.

The discussion will focus on understanding what treatments are best suited for different patient populations, while seeking to clarify whether non-surgical options are helping or hindering a patient’s treatment.

###

Title: Who Should (Not) Have Surgery for OSA?
Presenters: Eric J. Kezirian, MD, MPH (moderator); Allan I. Pack, MB, ChB, PhD; Edward M. Weaver, MD, MPH
Date: Tuesday, Septe

About the AAO-HNS

The American Academy of Otolaryngology – Head and Neck Surgery (entnet/), one of the oldest medical associations in the nation, represents more than 12,000 physicians and allied health professionals who specialize in the diagnosis and treatment of disorders of the ears, nose, throat, and related structures of the head and neck. The Academy serves its members by facilitating the advancement of the science and art of medicine related to otolaryngology and by representing the specialty in governmental and socioeconomic issues. The organization’s vision: “Empowering otolaryngologist-head and neck surgeons to deliver the best patient care.”

Source: Matt Daigle

American Academy of Otolaryngology — Head and Neck Surgery
mber 23