The Biotechnology Study Center of NYU School of Medicine will hold its annual awards symposium on April 5, 2010, to honor three outstanding leaders in biomedical research. The Dart/NYU Biotechnology Achievement Awards recognize the role of pure science in the development of pharmaceuticals and honors those scientists whose work has led to major advances to improving care provided at the patient’s bedside.

Recipients of this year’s award include:

Martin Raff, MD, Emeritus Professor of Biology and Scientist in the MRC Laboratory for Molecular Cell Biology, University College London, for discovering how cell surface molecules govern life, death and memory in the nervous and immune systems.

Paul Greengard, PhD, Vincent Astor Professor, Laboratory of Molecular and Cellular Neuroscience, The Rockefeller University, for translating Nobel-prize winning discoveries of signal transduction in the nervous system from bench to bedside.

Leslie B. Vosshall, PhD, Investigator, Howard Hughes Medical Institute; Chemers Family Associate Professor; Head of the Laboratory of Neurogenetics and Behavior, The Rockefeller University, for discovering odor sensing pathways in insects that may lead to the design of 21st century insect repellants.

“We applaud the honorees of this year’s distinguished awards for their innovative research in biotechnology and molecular biology,” said Gerald Weissmann, MD, research professor of medicine in the division of rheumatology and director of the Biotechnology Study Center. “The discoveries of these extraordinary scientists have already had an impact on human health and promise even more for the future.” Dr. Weissmann will chair the awards symposium, co-sponsored by the NYU School of Medicine’s Honors Program and featuring presentations by each of the awardees.

This year marks the tenth anniversary of this awards symposium. Previous winners from both institutions include:
Barry Coller, MD, David Rockefeller Professor, Vice President for Medical Affairs and Physician-in-Chief, The Rockefeller University, recipient of the Dart/New York University School of Medicine 2003 Biotechnology Alumnus Award

Emil C. Gotschlich, MD, R. Gwin Follis-Chevron Professor, The Rockefeller University, recipient of the Dart/New York University School of Medicine 2008 Biotechnology Alumnus Award

Salvador Moncada, MD, PhD, Director, Wolfson Institute for Biomedical Research, University College London, recipient of the Dart/New York University School of Medicine 2007 Achievement Award in Applied Biotechnology

The Biotechnology Study Center is an academic center for the study of biotechnology with the end-goal of significantly impacting public health. The Dart/NYU Biotechnology Achievement Awards are supported by a generous grant from Dart Neuroscience LLC since 2004 and are awarded on behalf of the Fellows of the Center at The Biotechnology Center.

Source:
Lisa Greiner

NYU Langone Medical Center / New York University School of Medicine Continue reading →

A growing number of drug-resistant strains of HIV are a threat to the effectiveness of current treatments despite anti-HIV drug cocktails decreasing the number of HIV-related deaths and improving the quality of life for HIV patients. Existing methods of detecting drug-resistant forms of HIV are expensive, time consuming, and often fail to identify small populations of drug-resistant HIV. Now, researchers at the University of Pennsylvania School of Medicine have developed a drug resistance screening method that analyzes multiple HIV variants at the same time, while also saving time and money.

By combining two genetic tests, Frederic D. Bushman, PhD, Professor of Microbiology, and colleagues, rapidly obtained gene sequences from multiple drug-resistant HIV samples at once. The study appeared online in Nucleic Acids Research.

“There is considerable interest in identifying minor drug resistant variants prior to initiating new therapy, in order to allow treatment with the most effective drugs,” explains Bushman. “Treatment of HIV infection often fails because viruses mutate to resist drugs. Under the pressure of drug treatment, small populations of resistant viruses can quickly grow to become the majority, resulting in treatment failure due to drug resistance.”

According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), approximately 40 million people in the world are currently living with HIV/AIDS. Commonly prescribed antiretroviral cocktails work to slow the debilitating effects of HIV by disrupting the virus at various stages in its replication. While combinations of antiretroviral drugs have proven effective, quickly mutating forms of HIV can complicate treatment outcomes.

Researchers estimate that up to 50 percent of individuals being treated for HIV in the US carry drug-resistant forms of HIV, caused by mutations in the virus in response to drug treatment or by being infected with a resistant form of HIV. The increased availability of antiretroviral drugs to meet the HIV/AIDS needs of developing countries in recent years will likely contribute to a global rise in drug-resistant strains of HIV.

“To overcome drug resistance, patients must be treated with drugs to which the HIV virus is still susceptible,” says Bushman.

To tailor the most effective anti-HIV treatment for a patient, antiretroviral resistance screenings are conducted before a patient begins or changes drug therapy. In developing countries where HIV/AIDS is most prevalent, resistance testing is rare due to the high costs of screening. In cases where resistance testing is available, most screening techniques are not sensitive enough to analyze small populations of drug-resistant strains of HIV. While small populations of drug-resistant HIV may go undetected by current screening methods, Bushman says that minor mutant forms of HIV often impair a patient’s response to future drug therapy.

To increase the sensitivity of HIV screening techniques and decrease the time and cost of each test, Bushman and others examined seven samples of mutated strains of HIV, including three HIV samples from patients who had experienced antiretroviral multi-drug resistance. DNA bar coding, in which different DNA molecules are indexed using DNA sequence tags, allowed Bushman and others to map multiple sequences of HIV mutants simultaneously. Drug-resistant mutations were identified using a new DNA sequencing technique called pyrosequencing, which allows researchers to determine millions of bases of a DNA sequence in a single one-day experiment. By combining the two methods, researchers were able to quantify and characterize hundreds of thousands of HIV variants for drug resistance in a single test.

Not only did the parallel analysis help researchers to cut time, the new screening technique also uncovered four rare, minor drug-resistant mutations in the patient samples of HIV that had gone undetected by standard screening measures. These small drug-resistant populations of HIV may explain why some patients do not respond to antiretroviral treatment, because the minor alleles can rapidly grow out, generating new populations of drug-resistant viruses.

Bushman’s new screening technique may open up opportunities for improved drug-resistance screening in the United States and around the world. By rapidly gathering sequencing information about drug-resistant HIV, decoding resistance in HIV and other viruses can potentially be done at a fraction of current costs and time.

In the future, Bushman plans to apply his new method to optimize drug-resistance testing in the US and the developing world.

“Thanks to DNA bar coding and pyrosequencing, clinicians should be able to optimize treatment for their patients with much more relevant information in front of them,” says Bushman.

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Penn co-authors are Christian Hoffmann, Nana Minkah, Jeremy Leipzig, and Pablo Tebas.

PENN Medicine is a $2.9 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System.

Penn’s School of Medicine is ranked #2 in the nation for receipt of NIH research funds; and ranked #3 in the nation in U.S. News & World Report’s most recent ranking of top research-oriented medical schools. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System includes three hospitals, all of which have received numerous national patient-care honors [Hospital of the University of Pennsylvania; Pennsylvania Hospital, the nation's first hospital; and Penn Presbyterian Medical Center]; a faculty practice; a primary-care provider network; two multispecialty satellite facilities; and home care and hospice.

Contact: Karen Kreeger

University of Pennsylvania School of Medicine Continue reading →

A key statistic that consumer groups and the media often use when compiling hospital report cards and national rankings can be misleading, researchers report in a new study.

The statistic is called the mortality index. A number above 1.0 indicates a hospital had more deaths than expected within a given specialty. Lower than 1.0 means there were fewer than the expected number of deaths.

The study by Loyola University Health System researchers in the Journal of Neurosurgery illustrates how the mortality index can be misleading in at least two major specialties — neurology and neurosurgery. The index fails to take into account such factors as whether a hospital treats complex cases transferred from other hospitals or whether a hospital treats lower-risk elective cases or higher-risk non-elective cases.

“A hospital with a lower mortality index may not be a better hospital for patient care, but rather a place where the patient mix has been refined or limited,” said senior author Dr. Thomas Origitano, chairman of the Department of Neurological Surgery, Loyola University Stritch School of Medicine.

There is no “definitive or reliable source for rating the quality of overall neurosurgical care,” Origitano and colleagues wrote in the Journal of Neurosurgery, published by the American Association of Neurological Surgeons.

Researchers examined neurosurgical mortality data from 103 academic medical centers in the University HealthSystem Consortium. Hospitals with the worst mortality index tended to be Level 1 trauma centers with busy emergency rooms and a high percentage of Medicaid patients.

A Level 1 trauma center with a busy ER is more likely to treat severe and complex cases such as head and spinal injuries from car accidents, injuries from falls or gunshot wounds. And the reason a high percentage of Medicaid patients is associated with a high mortality index is likely because Medicaid patients are more likely to have “poor access to medical care, are poorly educated in health and hygiene, are uninsured and present only once their symptoms have become severe,” researchers wrote.

The study also found that in hospitals with the lowest mortality index, at least 87 percent of the neurosurgical cases were elective in nature. Elective surgery includes cases such as back surgery or decompression of a pinched nerve. Patients deemed to be at too high a risk do not undergo the surgery.

By contrast, non-elective surgery for such conditions as head injuries and spine infections generally has to be done even when the risks are high.

Researchers cited several other problems with rating systems. For example, report cards typically lump neurology and neurosurgery into one category, neurosciences. “Although both services treat many of the same pathological processes, their performance at any given institution is by no means shared,” researchers wrote. “This can be misleading if the neurology aspects of the rating system misrepresent the neurosurgical service or vice versa.”

Another common practice is using reputation as one of the main ranking criteria. This practice “is at best subjective,” researchers wrote.

Researchers wrote that misleading information in report cards and rakings “may falsely direct patients and their families to hospitals providing a lower level of neurosurgical care, or direct them away from hospitals providing a high level of neurosurgical care.”

In addition to Origitano, authors of the study are first author Dr. Ronald Hammers, a neurosurgery resident; James Sinacore, Ph.D., associate professor of Preventive Medicine and Epidemiology and Susan Anzalone, a Stritch medical student.

Source:
Jim Ritter

Loyola University Health System Continue reading →

The new family of chaperones, called TriC for short, supports another family of chaperones which Dr. Hartl had discovered a few years ago and which belongs to the family of heat shock proteins (Hsp-70). Both families ensure that proteins fold correctly and that they neither aggregate, nor kill nerve cells.

Proteins, the building material and the machines of life, can only become active when they fold and take on a three-dimensional structure. Scientists assume that insoluble protein aggregations
(plaques) in nerve cells trigger Chorea Huntington, an inherited disease.

The disease is characterized by jerky, uncontrolled movements of the body and face and, therefore, is called Chorea (Old Greek for “dance”) Huntington. Its scientific name goes back to the New York physician George Huntington who was the first to describe the deadly disease in 1872.

There is no cure for the disease and it can neither be stopped nor reversed. Researchers estimate that 1 in 10,000 persons is effected. So far 30,000 cases are known in the United States, 10, 000 in Canada, and 8,000 in Germany.

In 1993, researchers discovered the gene which produces the mutant protein huntingtin. This protein is considered to be the cause of Chorea Huntington. It is deposited in the nucleus of the nerve cells.

In 1997, Dr. Erich Wanker, then at the Max-Planck-Institute for molecular Genetics, Berlin, now at the Max Delbr?ck Center for Molecular Medicine (MDC), Berlin-Buch, was able to show that these aggregations consist of falsely folded huntingtin molecules.

The protein production units in nerve cells add too many glutamin building blocks to the amino acid sequence of the huntingtin protein, resulting in polyglutamin chains that are siginificantly longer than normal ones. As a result, the protein loses its normal structure and can no longer be degraded. Scientists assume that these protein aggregations are toxic for nerve cells.

However, it remains unclear as to how and by what mechanism(s) these aggregations effect the
nerve cells which lose their their normal function and eventually die. “There are mainly two
hypotheses”, said Dr. Hartl. “In one model, neurotoxicity results from the ability of polyglutaminexpanded proteins to recruit other important cellular proteins with short polyglutamin stretches into Foundation under Public Law Directors: Prof. Walter Birchmeier, PhD., Dr. jur. Stefan Schwartze Member of the Hermann von Helmholtz Association of National Research Centres the aggregates.” In the other model, aggregating polyglutamin proteins cause a partial inhibition of the garbage disposal of the cells, the ubiquitin-proteasome system.

The heat shock proteins are able to prevent protein aggregation, making them less toxic for the
nerve cells, said Dr. Hartl. The TriC-families act together with the heat shock proteins. Both
families help the proteins stay in a soluble state and, thus, they do not aggregate. It remains to be seen if these findings can be utilized to develop therapies against neurodegenerative diseases. The four-day conference, which started on September 6, is organized by the Max Delbr?ck Center for Molecular Medicine (MDC), the Charit? Universit?tsmedizin Berlin, and the University of Bonn (all in Germany). 200 clinicians and researchers from Canada, Europe, Japan, and the USA discuss their latest findings there.

Max Delbrek Center For Molecular Medicine Berlin-Buch
mdc Continue reading →

Doctors at the University of Virginia Health System have shown for the first time that getting rid of poisonous RNA (ribonucleic acid) in muscle cells can reverse myotonic dystrophy, the most common type of muscular dystrophy in adults.

About 40,000 people in the United States have myotonic muscular dystrophy (MMD). The disease can cause a slow, progressive wasting of the muscles, irregular heartbeat, cataracts and insulin resistance. Many people don’t know they have MMD until their teens or twenties.

To prove the theory that toxic RNA is involved in myotonic muscular dystrophy, a research team led by Dr. Mani Mahadevan, a UVa pathologist, duplicated the disease in mice. “We showed in our mouse model that when you make this poisonous RNA the mice get various aspects of myotonic dystrophy,” Mahadevan said. “Then, when you take away the toxic RNA, the mice get back to normal.”

Mahadevan hopes the research might lead to new therapies for MMD in the next few years. “If we develop a therapy to silence the expression of the toxic RNA molecule, that would be a viable approach to treat people with myotonic muscular dystrophy,” he said. Mahadevan’s research in published in the September 2006 issue of Nature Genetics and can be found online at: nature/ng/index.html

Making RNA is the second step in the conversion of DNA into proteins that determine the function of the body’s cells. Myotonic muscular dystrophy is the first example of a disease caused by toxic RNA.

In 1992, Mahadevan discovered the gene mutation that causes myotonic muscular dystrophy (type 1) as part of a research group in Canada. The mutation is an increased number of CTG repeats in a gene called DMPK. Everyone with myotonic muscular dystrophy has that mutation on chromosome 19, which is now part of a genetic, diagnostic test for myotonic dystrophy.

In their latest research, Mahadevan and colleagues created a new type of mouse model with many extra copies of the CTG repeats, each attached to DNA for a protein that glows green under a microscope. They also integrated an “on switch” for MMD in the mice, activated by giving them doxycycline, an antibiotic, in their drinking water.

When mice began to produce many copies of RNA with CTG repeats, they developed the hallmarks of type 1 MMD within a few weeks, including an inability to relax muscles and heart rhythm abnormalities. When doxycycline was stopped, mice stopped producing toxic RNA and returned to normal, except in cases when the heart was severely damaged.

So far, however, Mahadevan and other scientists can’t explain exactly what happens inside the cell to cause someone to get myotonic dystrophy. “The prevailing theory is that the RNA remains in the nucleus, rather than moving out of it, and proteins get stuck to the RNA and aren’t able to do their job,” Mahadevan said.

This toxic RNA in not found in every cell of the body, Mahadevan said. Rather, it is produced in higher levels in muscle cells, in the heart and brain, in the lining of the intestines and in the lens and muscles of the eyes.

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Contact: Megan Rowe

University of Virginia Health System Continue reading →

A key component of health care reform involves the improvement of quality, access and value when delivering health services, particularly for patients admitted to a hospital. To help meet these needs, the University of California established the Center for Health Quality and Innovation, which provides financial support for health quality initiatives across the UC health system.

The center has now awarded nine grants totaling $3.4 million to six UC institutions for projects aimed at better understanding and alleviating common obstacles to health quality, including frequent falls, excess radiation from scans, hospital-acquired conditions and issues of care coordination among multiple health professionals. Of the nine studies, six include UCLA health care experts as participants.

Rising above hospital falls

Between 2 percent and 15 percent of hospital patients in the U.S. experience falls. Nearly a third of these result in injuries, and sometimes even death. At Ronald Reagan UCLA Medical Center, however, falls declined by 30 percent when the hospital instituted a program called “5Ps.” In many hospitals across the country, nurses on rounds use an hourly process called “4Ps” to assess patients’ pain, personal needs, positioning in a bed or chair, and the placement of items they might need. At UCLA, nurse Catherine Walsh, the accreditation manager for in-patient nursing and interventional areas for the UCLA Department of Nursing and a member of the department’s falls prevention committee, created the “5Ps” program by adding “preventing falls” to the hourly rounding process. During each nursing visit, factors that could result in falls are identified and mitigated, reducing risk on an ongoing basis during hospitalization. Walsh and Dr. Teryl Nuckols, a UCLA associate professor of general internal medicine and health services research, who are co-leaders of the project, and their team received a grant of $375,000 to develop educational programs for health professionals and to expand the use of the “5Ps” program to other UCLA hospitals and UC medical centers.

Getting patients back on their feet

Stroke patients spend a long time in the hospital. At UCLA, the average patient stays for 18 days, from onset through rehabilitation. Other patients recovering from critical illnesses may stay even longer. All these extended stays result in dramatic muscle weakening a loss of about 1 percent of muscle mass each day while on bed rest underscoring the need to boost exercise programs to help patients recover. But many patients, due to lack of motivation, don’t benefit from exercise programs, and when they do exercise, it’s often not enough. A team headed by Dr. Bruce Dobkin, a UCLA professor of clinical neurology, received a $50,000 grant to create a program that involves the use a network of wireless sensors and a special exercise bike that can fit in a bed or on the floor. The program will allow health professionals to monitor activity in the hospital and at home, provide instant feedback to patients, and gather information to design more effective rehabilitative exercise programs. The sensors include accelerometers, developed by faculty at UCLA’s Wireless Health Institute, that a patient can wear comfortably, and mathematical algorithms are used to interpret the type, quantity and quality of daily activities.

Improving care following hospital discharge

The transition between hospital and outpatient settings is a particularly vulnerable time for patients, as their condition is at risk of deteriorating shortly after they exit the hospital doors. In fact, about one-fifth of Medicare patients are readmitted to the hospital within 30 days, with half of those readmissions considered preventable. By bringing together teams from different clinical sites to improve processes and learn from each other, patient care can be enhanced, particularly when patients transition from the hospital to a primary care provider. Such quality improvement programs assess patients for readmission risks when they enter the hospital, help patients and caregivers understand these risks, and follow up with both patients and physicians shortly after discharge. Dr. Nasim Afsarmanesh, an assistant clinical professor and director of quality and safety at Ronald Reagan UCLA Medical Center, and her colleagues from other centers were granted $750,000 to create a quality improvement network that will collaborate to design and implement interventions to improve these important transitions of care.

Standardizing CT scan protocols

A computerized tomography (CT) scan can yield a tremendous amount of diagnostic information, but it is also important to assess the amount of radiation a patient receives from these scans. In order to reduce the total amount of radiation, and to meet the terms of a new California law requiring the reporting of radiation exposure, health practitioners need to set standards that allow for high-quality diagnostic CT scans with a minimum amount of radiation. To create necessary exposure standards, a team including UCLA radiology researchers Dr. Michael McNitt-Gray and Dr. Christopher Cagnon was given a grant of $750,000 to create standard protocols for CT scans of all types which will balance radiation exposure and image quality. The team will also establish educational programs for all UC medical centers to create practice standards that could be used nationwide.

Reducing radiation from unnecessary CT scans

Many hospitals will automatically order a CT scan of any patient admitted with blunt chest injuries. Yet many of these scans, while exposing patients to ionizing radiation, may not provide any benefit. One reason so many patients receive these scans is that information that could help health professionals decide whether such scans are necessary is scarce. Dr. William Mower, a UCLA professor of emergency medicine, and his colleagues received $375,000 to create a decision-making process that will help practitioners analyze key signs, allowing them to differentiate patients who could likely have injuries requiring a CT scan from those with no risk of those types of injuries. The grant will allow the researchers to identify the key clinical signs that a patient has internal chest injuries in order to make the selection process practicable in emergency and hospital settings.

Preventing pulmonary embolism and deep vein thrombosis

Blood clots in the lung and the rest of the body afflict hundreds of thousands of Americans each year and rank among the most common preventable causes of death in hospital patients. Treatments to prevent these clots are available but are used only 30 to 50 percent of the time with eligible patients. Dr. Nasim Afsarmanesh, an assistant clinical professor and director of quality and safety at Ronald Reagan UCLA Medical Center, and her colleagues received $750,000 to find ways to reduce the occurrence of these clots in hospitalized patients. The group will create teams at each UC medical center to collect data and create tools to enhance performance and prevention rates.

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

Patients who develop multiple sclerosis before age 18 appear to experience more relapses of symptoms than those diagnosed with the disease as adults, according to a report in the January issue of Archives of Neurology, one of the JAMA/Archives journals.

“Although the clinical onset of multiple sclerosis (MS) typically occurs between ages 20 and 40 years, 2.7 percent to 10.5 percent of patients have been reported to develop their first symptoms before their 18th birthday,” the authors write as background information in the article. Previous reports suggest the progression of MS-an inflammatory disease in which myelin, the protective coating covering nerve cells, degenerates-is slower in patients who are diagnosed in childhood.

Mark P. Gorman, M.D., of Brigham and Women’s Hospital and Massachusetts General Hospital, Boston, and colleagues studied 110 patients diagnosed with relapsing-remitting MS in adulthood (average age at diagnosis, 34.4) and 21 with pediatric-onset MS (average age at diagnosis, 15.4). Relapsing-remitting is the most common type of MS, in which patients experience periods of symptoms followed by periods of symptom-free remission. Study participants developed their first symptoms in July 2001 or later, were monitored with semi-annual neurological examinations and were followed for 12 months or longer (an average of 3.67 years for pediatric-onset patients and 3.98 years for adult-onset).

Patients who developed the disease in childhood had, on average, a higher yearly rate of relapses than those who were diagnosed as adults (1.13 vs. 0.4 relapses per year). “These findings persisted in multivariate regression models when controlling for sex, race and proportion of disease spent undergoing disease-modifying treatment and when age at onset was treated as a continuous variable,” the authors write.

“In general, the disease course of MS has been divided into a relapsing-remitting phase, during which inflammatory mechanisms predominate, and a secondary progressive phase, during which neurodegenerative mechanisms predominate,” they continue. “Acute relapses are the clinical hallmark of the inflammatory phase of MS. The higher relapse rate in the pediatric-onset group in our study may therefore suggest that patients with pediatric-onset MS are coming to medical attention closer to the true biological onset of their disorder than patients with adult onset during a more inflammatory phase, as has been previously suggested.”

If patients with pediatric-onset diseases do indeed have more relapses despite their disease progressing more slowly, “this discrepancy may suggest greater plasticity, less neurodegeneration and potentially more repair and remyelination in the younger nervous system. Further study of the biological basis for this discrepancy may yield insight into the apparent disconnect between relapses and long-term disability progression.”

Arch Neurol. 2009;66[1]:54-59.

This study was supported by the Pediatric Multiple Sclerosis Centers of Excellence Grant from the National Multiple Sclerosis Society. Dr. Gorman is supported by a National Multiple Sclerosis Society Clinical Fellowship.

Archives of Neurology Continue reading →

Colonoscopy: New developments in polyp detection, colonoscopy preparation and sedation techniques that will increase the effectiveness of colonoscopy and ease patient concerns about the procedure will be presented. Research advances in sedation include computer-assisted sedation systems and the new evidence supporting the administration of propofol by GI physicians.

Monday, May 19 at Noon Pacific Time
DDW Abstract Numbers: 237, 877, 878, 883, 794, W1420 and a late breaking abstract.

Pancreatic Cancer: New research detailing innovative methods to better understand the risk factors for and improve earlier detection of pancreatic cancer will be presented. Specifically, researchers will demonstrate that the development of new biomarkers, novel treatment targets, innovative approaches to screening and surveillance and improved understanding of risk factors can lead to diagnosis of pancreatic cancer at earlier more treatable stages.

Tuesday, May 20 at 8:00 a.m. Pacific Time
DDW Abstract Numbers: 762, M1431, w1401 and 644.

Imaging & Technology: A sophisticated new surgical technology holds promise for future painless and scarless surgery with shorter recovery times than laparoscopic surgery. New research supports the safety and efficacy of natural orifice translumenal endoscopic surgery (NOTES™ ) and details the outcomes associated with new tools and robotic applications.

Also, a new real-time microscopic technique could change the way gastrointestinal diseases are detected — confocal laser endomicroscopy (CLE) effectively and immediately identifies suspicious activity and precancerous cells and may eliminate the need in many cases for biopsy in diagnosing gastrointestinal conditions. This could lead to earlier diagnosis and treatment of conditions including reflux disease, colon cancer and irritable bowel disease.

Sunday, May 18 at 8:00 a.m. Pacific Time
DDW Abstract Numbers: 881, SP535, 876, 871, S1162, 673, M1989 and a late breaking abstract.

Liver Disease: Researchers have made great strides in identifying better treatments for liver-related diseases. Results from new investigations into the creation of liver cells from embryonic stem cells; a potential link between recurrent urinary tract infections and primary biliary cirrhosis (PBC); and identification of the most efficacious treatments for patients with hepatitis C will be presented.

Tuesday, May 20 at 11:00 a.m. Pacific Time
DDW Abstract Numbers: 688, W1846, 461 and 161

Obesity: Researchers will unveil new data outlining improved bariatric surgery options and studies that offer new insight into the related toll on the body created by obesity that can cause cancers of the esophagus and pancreas.

Tuesday, May 20 at 1:00 p.m. Pacific Time
DDW Abstract Numbers: 243, M1951, 343 and 484.

NSAIDs: Researchers have begun looking to NSAIDs as having a potential role in the prevention of colorectal cancer, esophageal cancer and pancreatitis. The three studies presented investigate the potentially beneficial role that NSAID medications can play in the treatment of GI-related cancer and in the prevention of surgery-related inflammation.

Sunday, May 18 at Noon Pacific Time
DDW Abstract Numbers: W1625, M1947 and a late breaking abstract.

Celiac Disease: For those suffering from celiac disease, there may be good news on the horizon. New research presented will discuss the latest advancements in the diagnosis and prevention of celiac disease.

Monday, May 19 at 8:00 a.m. Pacific Time
DDW Abstract numbers: 584, 585 and S1263.

Quality of Care and Disparities: Does the success of a procedure depend on how often it is performed at a hospital, or by a particular surgeon” Is a patient’s access to procedures such as liver transplantation influenced by patient characteristics such as socioeconomic factors, geographic location, insurance or referral source” These questions and other important quality of care and disparities issues will be discussed via three new research presentations.

Wednesday, May 21 8:00 a.m. Pacific Time
DDW Abstract Numbers: 1033, T1167 and 1874

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To access DDW research abstracts go to: ddw/press

Digestive Disease Week® 2008 (DDW®) is the largest international gathering of physicians, researchers and academics in the fields of gastroenterology, hepatology, endoscopy and gastrointestinal surgery. Jointly sponsored by the American Association for the Study of Liver Diseases (AASLD), the American

Gastroenterological Association (AGA) Institute, the American Society for Gastrointestinal Endoscopy (ASGE) and the Society for Surgery of the Alimentary Tract (SSAT), DDW takes place May 17-22, 2008 in San Diego, Calif. The meeting showcases more than 5,000 abstracts and hundreds of lectures on the latest advances in GI research, medicine and technology.

Source: Aimee Frank

Digestive Disease Week Continue reading →

In 2004-2005, people in Canada’s poorest neighbourhoods were 85% more likely to be hospitalized for depression than people living in better-off neighbourhoods, according to a new analysis from the Canadian Institute for Health Information (CIHI). The analysis examines the relationship between neighbourhood income and general hospital use for depression for persons aged 15 to 64 in 13 Canadian cities. The analysis examines hospitalization rates, lengths of stay and readmission rates. Depression is the most common cause of hospitalization for mental illness in Canada, with a rate of 100 per 100,000 population (2005-2006).

CIHI’s analysis found that, whereas poorer Canadians were more likely to be hospitalized for depression, there were no differences between income groups in the duration of hospital stays (average of 16 days). This suggests patients had similar hospital experiences regardless of their income.

Similarly, CIHI’s analysis found no differences between income groups in the likelihood of readmission. Just more than 7% of patients admitted to hospital because of depression were readmitted within 30 days of their initial discharge.

The Association Between Socio-Economic Status and Inpatient Hospital Service Use for Depression

About CIHI

The Canadian Institute for Health Information (CIHI) collects and analyzes information on health and health care in Canada and makes it publicly available. Canada’s federal, provincial and territorial governments created CIHI as a not-for-profit, independent organization dedicated to forging a common approach to Canadian health information. CIHI’s goal: to provide timely, accurate and comparable information. CIHI’s data and reports inform health policies, support the effective delivery of health services and raise awareness among Canadians of the factors that contribute to good health.

Canadian Institute for Health Information Continue reading →

Large amounts of money and resources would be saved if all frontline NHS staff had basic knowledge about the social and physical ill effects of alcohol misuse, say doctors in this week’s BMJ.

In 2004 in England 38% of men and 16% of women aged 16-64 had an alcohol use disorder (26% overall), equivalent to around 8.2 million people.

About 217 million pounds is currently spent on specialist alcohol treatment, compared with the 20 billion pounds estimated cost of alcohol misuse. The government recently announced that 3.2 million pounds was to be made available for new initiatives for people who may be damaging themselves with alcohol. But will this new money be used wisely, ask Robin Touquet and Alex Paton?

Most conurbations in England have one or more specialist alcohol units, which are usually run by psychiatrists and largely deal with complex problems. These are controlled by mental health trusts, which are separated administratively from acute hospital trusts, so services tend to be fragmented.

In many areas voluntary agencies also provide a local service for people with alcohol problems, funded from various sources such as the local authority, primary care trusts, and charitable foundations. NHS services now rely solely on funds from primary care trusts.

Funding by primary care trusts for alcohol services could be well used in hospital emergency departments, where nearly a third of overall attendances are alcohol related, and more than two thirds may be so after midnight.

Research carried out by the emergency department team at St Mary’s Hospital London has shown that routine clinical staff can be trained to detect potential alcohol problems and to offer brief advice, with support from an alcohol health worker in the hospital. This approach is cost effective.

Studies have also shown that alcohol problems are underdetected in general practice, and the authors suggest closer liaison between general practitioners and local voluntary alcohol agencies, wider availability of alcohol workers, and alcohol clinics in general practices.

They also suggest that all general hospitals should have a senior consultant with an interest in alcohol misuse. Yet a recent review found that only 21 acute hospital trusts in England had an alcohol health worker.

If all frontline staff had basic knowledge about the social and physical ill effects of and the detection of alcohol misuse, and the benefits of brief advice and liaison with alcohol health workers, problems would be tackled far earlier – often preventing the development of dependence – and large amounts of money would be saved, they write. The new two year foundation training for junior doctors offers an important opportunity to develop such knowledge.

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Contact: Emma Dickinson

BMJ-British Medical Journal Continue reading →