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Stem cells and macular degeneration

December 7, 2010 Leave a comment

http://www.nytimes.com/2010/11/22/health/policy/22retina.html?ref=health

Elderly people losing their vision from age-related macular degeneration might one day have a treatment option that requires fewer injections into the eye than the standard drug now used…Advanced Cell Technology is expected to announce Monday that it has won regulatory approval to test a therapy derived from human embryonic stem cells in people with Stargardt’s macular dystrophy…only the second trial of a therapy derived from human embryonic stem cells to be cleared…Lucentis can restore a person’s ability to drive and read, in some cases…drug works best when given every four weeks, which can be inconvenient for patients and doctors…Regeneron’s drug, which is called VEGF Trap-Eye, “gives us the opportunity to not have to see them monthly,”… After a year, roughly 95 percent of the patients in all the arms of the trial maintained their vision, meaning their ability to read an eye chart declined by no more than 15 letters, or three lines…VEGF Trap-Eye was also “noninferior” to Lucentis in terms of the average change in vision after one year. Lucentis recipients had a mean gain of 8.1 letters and 9.4 letters in the two trials. Those getting Regeneron’s drug every eight weeks had gains of 7.9 letters and 8.9 letters…Both VEGF Trap-Eye and Lucentis block a protein called vascular endothelial growth factor that causes blood vessels to grow and leak into the eye…When used in the eye, Avastin costs about $50 a dose, compared with about $2,000 for Lucentis. Still, even with such low-priced competition, Lucentis has sales exceeding $2 billion globally…Human embryonic stem cells are controversial because their creation usually entails the destruction of human embryos…

 

Beyond understanding

December 7, 2010 Leave a comment

http://opinionator.blogs.nytimes.com/2010/11/21/beyond-understanding/?emc=eta1

 

Autism is often the subject of contentious and emotional debate, certainly because it manifests in the most vulnerable of humans — children.. also hard to pin down; as a “spectrum disorder” it can take extreme and disheartening forms and incur a devastating toll on families…Simon Baron-Cohen, for example, in his book “Mindblindness,” argues that the whole raison d’être of consciousness is to be able to read other people’s minds…we might have to concede that, given the way humans interact with one another, there is always a potential mystery concealed within the most elementary statement…And it is harder than you think it is going to be to eliminate, entirely, the residue of obscurity, the possibility of misunderstanding lurking at the core of every sentence…Consider, for example, Sartre’s classic one-liner, “Hell is other people.” Wouldn’t autism, with its inherent poverty of affective contact, go some way towards accounting for that? The fear of faces and the “gaze of the other” that Sartre analyzes are classic symptoms…Perhaps language can be seen as a car, a vehicle of some kind, designed to get you from A to B, carrying a certain amount of information, but apt to get stuck in jams or break down or crash; and which will therefore need fixing…This car mechanic conception of language is just the sort of thing high-functioning autistic types would come up with, my psychologist friend might say, because they understand “systems” better than they understand people. They are “(hyper-)systemizers” not “empathizers.” The point I am not exactly “driving” at but rather skidding into, and cannot seem to avoid, is this: indisputably, most car mechanics are men…

 

fMRI for feedback

December 7, 2010 Leave a comment

http://www.technologyreview.com/biomedicine/26768/?p1=A1

 

new way to create and interpret real-time brain scans could help addicts control their cravings…scientists used a combination of brain-scanning and feedback techniques to train subjects to move a cursor up and down with their thoughts. The subjects could perform this task after just five minutes of training…scientists hope to use this information to help addicts learn to control their own brain states and, consequently, their cravings…reviously shown that people can learn to consciously control their brain activity if they’re shown their brain activity data in real time—a technique called real-time functional magnetic resonance imaging (fMRI)… efforts have been difficult to put into practice. Part of the problem is that scientists have had to choose which part of the brain to focus on, based on existing knowledge of neuroscience…focusing on a limited region adds extra noise to the system…whole-brain information cancels out a lot of the noise…researchers found that both addicts and healthy people could control their state of mind equally well…Addicts’ cognitive control issues are not linked to more general thinking, but instead limited to more emotionally charged thoughts, like cravings…

 

Home Health telepresence robots

December 6, 2010 Leave a comment

http://www.technologyreview.com/blog/editors/26072/?p1=A4

 

predicted robots will have a crucial role to play in the future of healthcare. Angle said that assistive robots will enable old or sick people to live independently for longer…pointed to figures showing that the elderly often have chronic health issues that require expensive assisted living programs or nursing homes. “The numbers of seniors are going up and our ability to care for them is going down,”… challenges of developing such a robot are substantial. It would encounter a variety of unexpected and unpredictable situations, so it would need to be flexible and adaptable—able to move around in a messy room, pick up unfamiliar objects, or open doors. Some research robots have demonstrated a few such skills, but there is nothing that can do them all…home-help robot could also deliver remote medical care, Angle noted. A robot equipped with a blood pressure detector, stethoscope, a camera, and other low-cost equipment could allow doctors to perform routine check-ups remotely…would guess that iRobot plans to release a telepresence robot that can perform some of these functions in the next few years…

 

Drug Resistant Cancers

December 6, 2010 Leave a comment

http://www.technologyreview.com/biomedicine/26789/?p1=A2

tumors can evolve resistance to powerful new cancer drugs. But scientists are now learning why, giving hints at how to stop it…Massachusetts General Hospital published a study that gave hope to patients with metastatic melanoma. But the good news was tempered by a serious caveat: in most patients, the drug eventually stopped working after anywhere from months to years… issue of drug resistance has plagued the new generation of so-called targeted cancer therapies, designed to block the effects of genetic mutations that drive the growth of cancer…uncovered how some melanoma tumors fight back against these drugs…“If we can understand and anticipate the full spectrum of ways cancers can get around these drugs, we can come up with formulas for combinations of drugs that could have lasting control,”… collaborators analyzed the effects of 600 different protein kinases, which are types of enzymes, on melanoma tumor cells growing in a dish. They found that overactivity among nine of the protein kinases made the cells resistant the type of drug that was so promising in Flaherty’s melanoma study. One enzyme had never previously been implicated in cancer. The researchers confirmed the findings by analyzing tissue samples from melanoma patients who evolved resistance to the drug…not yet clear how common this particular mechanism of drug resistance is…”It’s not chaos that creates resistance, it’s the same rational cell and molecular biology that led to the development of these therapies in first place,”… results will help scientists figure out more effective drug combinations. He likened the approach to those used to eradicate stubborn viruses. “A cocktail would be designed to cut off any possible escape route,” he says. However, “it’s more daunting to cover all grounds for a cancer cell,” because such cells tend to be very “plastic,” or capable of change…also cautions that researchers have studied relatively few patients, so it’s not yet clear how broadly these findings will apply to larger numbers of patients. (One problem is that it’s hard to come by tissue samples—researchers need tissue from the same patient both before and after treatment.)…

Radiation Risk in breast screening

August 27, 2010 Leave a comment

http://www.nytimes.com/2010/08/24/science/24breast.html?_r=1&ref=health

When Dr. Deborah Rhodes orders a diagnostic test that involves radiation, she consults a chart in her office that lists the amount of radiation exposure from each test. She considers the patient’s total past exposure, and then carefully weighs the risks and benefits of each test and any alternative approaches she can take…more physicians should take this approach. One study found that certain nuclear-based breast imaging exams that involve injecting radioactive material into patients expose women to far higher doses of radiation than regular mammography, increasing their risk of cancer in vulnerable organs beyond the breast, like the kidneys, bladder or ovaries….point of the paper was to say that not all the breast imaging procedures have comparable risks and doses.”… consultant to G.E. Healthcare regarding digital breast tomosynthesis, another breast imaging technique,… nuclear technologies breast-specific gamma imaging (B.S.G.I.) and positron emission mammography (P.E.M.) are meant to be used as complements or adjuncts to mammography and ultrasound, once there is concern about a cancerous lesion, and not for routine screening. These technologies are also more useful in women who have very dense breast tissue, when mammography often does not provide clear images…single breast-specific gamma imaging or positron emission mammography exam exposes patients to a risk of radiation-induced cancer that is comparable to the risk from an entire lifetime of yearly mammograms starting at 40,… While digital mammography has an average lifetime risk of inducing 1.3 fatal breast cancers per 100,000 women aged 40 at exposure, a single B.S.G.I. exam was estimated to involve a lifetime risk 20 to 30 times greater in women aged 40, and the lifetime risk of a single P.E.M. was 23 times greater….mammography only increases a woman’s risk for breast cancer while B.S.G.I. and P.E.M. increase the risk of cancer in other organs, such as the intestines, kidneys, bladder, gallbladder, uterus, ovaries and colon…

Acupuncture

August 27, 2010 Leave a comment

http://well.blogs.nytimes.com/2010/08/23/studying-acupuncture-one-needle-prick-at-a-time/?ref=health

little dispute that people feel better after receiving the treatment, in which thin needles are inserted deeply into the skin at specific points on the body. But are they benefiting from acupuncture itself, or just getting a placebo effect?… Researchers from MD Anderson Cancer Center in Houston found that among 455 patients with painful knee arthritis, acupuncture delivered no more relief than a sham treatment….Actually, patients got significant pain relief from both treatments — an average reduction of one point on a scale of 1 to 7…patients in both groups received treatment with needles and electrical stimulation; the main difference was that in the sham group, the needles were not inserted as deeply and the stimulation was far shorter in duration….a trained acupuncturist would customize the treatment to a patient’s specific symptoms. But in this study, the patients in the “real” acupuncture group all received needles inserted in the same way….Rather than proving that acupuncture does not work, in other words, the study may suggest that it works even when administered poorly…MD Anderson research and other recent acupuncture studies have fueled speculation that the prick of a needle, whether from real acupuncture or a sham version, can influence the way the body processes and transmits pain signals…