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Study: Women With Dense Breast Tissue May Benefit From Regular MRIs

Breast cancer. Coloured sagittal magnetic resonance imaging (MRI) scans of a breast of a 39- year-old woman with breast cancer. The cancer (orange) has been highlighted by the injection of a gadolinium contrast medium, a contrast medium suitable for use in MRI scans. The front of the breast is at left in each scan, in these views from the side. The cancer is a ductal carcinoma, a carcinoma of the ducts that channel milk to the nipple. Ductal carcinoma is a common form of breast cancer. Breast cancer, the most common cancer in women, can be treated by surgical removal of the affected breast, often combined with radiotherapy and chemotherapy.

While there has been some controversy over when women should start getting mammograms, all experts agree that screening is an important first step in detecting breast cancers and treating them early. But for some women, that’s not enough. For the approximately 40% of women with dense breast tissue, and especially the 10% with extremely dense tissue, cancer cells are harder to detect, since the denser tissue can mask small growths. In addition, dense breast tissue itself is also a risk factor for developing cancer.

There’s been debate among experts over whether these women should have additional screening, on top of mammograms. A new study published in the New England Journal of Medicine provides the strongest data yet to support adding MRI screening to mammograms for women with extremely dense breast tissue.

Previous studies have compared rates of breast cancer in women getting mammograms alone to rates in those getting mammograms and MRI, but it hasn’t been clear that the “cancers” identified in these data sets were actually cancer. That’s because some breast cancers are what experts consider a pre-cancerous stage, known as ductal carcinoma in situ, meaning they may not grow or progress into disease.

That’s led some doctors to worry over potential over-diagnosis of breast cancer, which can lead to over-treatment of lesions that may never develop into tumors. The U.S. Preventive Services Task Force, which attempts to find answers to controversial health questions, has concluded that there is not enough evidence to advise women about the benefits or harms of adding other breast-cancer testing on top of mammograms.

In the new study, Carla van Gils, professor of clinical epidemiology of cancer at the University Medical Center Utrecht, attempted to address this concern by focusing on how many actual cancers the combination of mammogram and MRI can help to detect in women with dense breast tissue. Taking advantage of the fact that the Netherlands has a national cancer registry that includes about 99% of all diagnoses in the country, she and her team studied more than 40,000 women with extremely dense breast tissue, who were randomly assigned to screening with mammography alone or both mammography and MRI.

Each woman in the study was screened once in the two year study period (following the Netherlands’ screening guidelines that call for mammograms every other year for women over 50). Van Gils and her team analyzed how many invasive cancers were detected in between screenings, which serves as a measure for how effective the MRI was in detecting what the researchers call interval cancers—those diagnosed after a negative mammogram, and before the next mammogram was scheduled.

“If we can prevent those, we know at least we are preventing clinically relevant tumors,” says van Gils, “and not just over diagnosing.” They found that the rate of such cancers in women getting both types of imaging was 2.5 per 1,000 screenings, compared to 5 in 1,000 for women just getting mammograms.

The idea is that supplementing mammograms with MRI in the initial screening led to earlier detection of tumors that the mammograms missed which in turn contributed to lower cancer rates during a second screening, because presumably the women are seeing their doctors when suspicious growths are found and getting them treated.

The data do not confirm that combining mammograms and MRIs can lead to fewer deaths from breast cancer; that’s something van Gils will study in coming years. But documenting the reduction in cancer detected in between screenings is an important first step in showing the value of supplemental MRI for women with extremely dense breast tissue.

It also supports the reasoning behind a law passed earlier this year in the U.S. requiring that mammogram reports include an assessment of the density of women’s breast tissue, along with an explanation for why that might make mammogram results more difficult to interpret.

Van Gils notes that the results of her study aren’t robust enough yet to recommend that all women with dense breast tissue (even those with extremely dense breast tissue) should get MRIs on top of their regular mammogram screenings. For one, lowering the rates of false positives for MRIs is still a challenge; training radiologists to become more adept are reading images of dense breast tissue could help, as could applying machine learning technology to pick up subtle changes that even the best-trained human eyes cannot.

That said, if longer-term studies—enabling doctors to compare MRI readings over time to track the growth of lesions—also confirm that supplementing mammograms with MRI can lower death rates from breast cancer, it could push experts to change guidelines and give women firmer advice on how best to manage their cancer risk.

By Alice Park

November 27, 2019

Source: Study: Women With Dense Breast Tissue May Benefit From Regular MRIs | Time

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Dr. Amy Degnim, surgeon at Mayo Clinic, explains what dense breast tissue is and different types of imaging that may be recommended for breast cancer screening. To learn more about breast cancer screening, visit: https://mayocl.in/31AZAoC To request an appointment at Mayo Clinic, visit: https://mayocl.in/2QwVBoc Dense breast tissue makes breast cancer screening more difficult due to its appearance on a mammogram. Other imaging used for screening includes 3D mammogram, breast MRI, breast ultrasound and molecular breast imaging (MBI). More health and medical news on the Mayo Clinic News Network. https://newsnetwork.mayoclinic.org/

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More Blood Pressure Medication Recalls Due To Cancer Concerns

You may want an MBA. But you want to avoid NMBA.

NMBA stands for N-Methylnitrosobutyric acid, something that you don’t want in your blood pressure medications. But alas, this probable carcinogen continues to appear in various medications at higher than acceptable levels.

The latest news is that Torrent Pharmaceuticals Limited is further expanding its recall of Losartan Potassium Tablets USP and Losartan Potassium/hydrochlorothiazide tablets, USP, according to the U.S. Food and Drug Administration (FDA). The FDA announcement includes five more lots of these medications. The additional lots add to the lots of blood pressure medications that have been recalled in the past 14 months or so.

In 2018 and 2019, it seems like news about potential cancer-causing contaminants in medications has become as repetitive as the lyrics “My Name Is” in Eminem’s song “My Name Is.” I’ve written about such news for blood pressure medications in November of last year, January of this year, and again March of this year. Then, just last week I covered impurities found in a common heartburn medication, ranitidine. Then, on Thursday, I added an update that Novartis was halting its distribution of ranitidine, the generic form of Zantac, until further testing could be done.

Today In: Innovation

As they say when you soil your pants, one time may be an accident but more than three times is a trend. It is time to take a closer look at how drugs are being manufactured, stored, and distributed and how such processes are being monitored. As I have mentioned before, making medications is not the same as making handbags. You don’t, at least you shouldn’t, eat your handbags. While a poorly-made handbag could lead to social embarrassment, a poorly-made medication can have much greater and even life-threatening implications.

The FDA is the main agency to protect you against fraudulent and contaminated medications. But the FDA currently may not have the funding and the resources to carefully check everything that every drug manufacturer and distributor is doing, especially when some of these operations are rapidly changing or occurring overseas.

For now, if you are taking blood pressure medications, or any medications for that matter, pay attention to FDA warnings and recall news. The FDA maintains a searchable listing of active product warnings and recalls. As a precautionary measure, you may want to search for a medication before starting it. You can also check with your pharmacist to make sure that your medication is not on a recall or warning list. Of course, if you do find that your medication has a warning or is being recalled, don’t just stop taking it. That can be like trying to return a parachute while you are using it. Check with your doctor first to determine your course of action.

Follow me on Twitter or LinkedIn. Check out my website.

I am a writer, journalist, professor, systems modeler, computational and digital health expert, avocado-eater, and entrepreneur, not always in that order. Currently, I am a Professor of Health Policy and Management at the City University of New York (CUNY), Executive Director of PHICOR (@PHICORteam), and Associate Professor at the Johns Hopkins Carey Business School. My previous positions include serving as Executive Director of the Global Obesity Prevention Center (GOPC) at Johns Hopkins University, Associate Professor of International Health at the Johns Hopkins Bloomberg School of Public Health, Associate Professor of Medicine and Biomedical Informatics at the University of Pittsburgh, and Senior Manager at Quintiles Transnational, working in biotechnology equity research at Montgomery Securities, and co-founding a biotechnology/bioinformatics company. My work involves developing computational approaches, models, and tools to help health and healthcare decision makers in all continents (except for Antarctica) and has been supported by a wide variety of sponsors such as the Bill and Melinda Gates Foundation, the NIH, AHRQ, CDC, UNICEF, USAID and the Global Fund. I have authored over 200 scientific publications and three books. Follow me on Twitter (@bruce_y_lee) but don’t ask me if I know martial arts.

Source: More Blood Pressure Medication Recalls Due To Cancer Concerns

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Dr. Luke Laffin, staff cardiologist in Preventive Cardiology and Clinical Specialist in Hypertension at Cleveland Clinic answers questions that patients often ask about taking high blood pressure medicines: types of medications, side effects, when to call the doctor, role of self-blood pressure monitoring (including how often), the best time to take blood pressure medications, and if there is a chance that patients can come off medications. He ends the program with three important points for patients with high blood pressure.

Promising Blood Test Could Help to Predict Breast Cancer Recurrence

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Doctors have gotten much better at detecting and treating breast cancer early. Drug and chemotherapy regimens to control tumors have gotten so effective, in fact, that in some cases, surgery is no longer necessary. In up to 30% of cases of early-stage breast cancer treated before surgery, doctors can’t find evidence of cancer cells in postoperative biopsies. The problem, however, is that there is currently no reliable way to tell which cancers have been pushed into remission and which ones have not.

That’s where an easy identifier, like a blood test, could transform the way early stage breast cancer is treated. In a paper published in Science Translational Medicine, researchers led by a team at the Translational Genomics Institute (TGen), an Arizona-based nonprofit, report encouraging results on just such a liquid biopsy. Its test, called Targeted Digital Sequencing (or TARDIS), was up to 100 times more sensitive than other similar liquid-biopsy tests in picking up DNA shed by breast cancer cells into the blood.

Currently available ways of tracking breast cancer cells in the blood are most useful in people with advanced cancer. In those conditions, cancer cells litter the blood with fragments of their DNA as they circulate throughout the body to seed new tumors in other tissues like the bone, liver and brain. But in early-stage breast cancer, these cells are, by definition, scarcer.

To address the problem, the research team, which included scientists at Arizona State University, the City of Hope, Mayo Clinic, and the Cancer Research UK Cambridge Institute, developed a new way to pick up elusive cancer DNA. They genetically sequenced tumor biopsy tissue from 33 women with stage 1, 2, or 3 breast cancer, most of whom received drug or chemotherapy treatment prior to getting surgery to remove their tumors. By comparing the tumor sequence to the sequence from the patients’ normal cells, the scientists isolated potential mutations that distinguished the cancer cells and identified those that were most likely to be so-called “founder mutations”—genetic aberrations present in the original cancer cells and carried into the resulting tumor.

On average, each patient harbored about 66 such founder mutations. For each patient, the scientists combined the founder mutations to form a personalized assay, which could then be used to pick up signs of breast cancer DNA in blood samples. Combining a number of mutations together turned out to be a more sensitive way to detect tumor DNA than trying to pick up a single or a small number of mutations in an already small number of tumor DNA fragments present in the blood.

They combined this approach with a new strategy for amplifying the scarce tumor DNA found in a blood sample by preserving the size of these snippets and attaching unique molecular identifiers to them to make them more easily detectable.

At the start of the study, TARDIS was able to find tumor DNA in the blood samples of all the patients; other liquid biopsies for breast cancer currently in development have reported picking up 50% to 75% of the cancer cases.

After the pre-surgery treatment TARDIS detected circulating tumor DNA in the blood in concentrations as low as 0.003%, or 100-fold more sensitive than other tests being developed.

“This is an important advance,” says Dr. Debu Tripathy, professor and chair of the breast medical oncology department at the University of Texas MD Anderson Cancer Center, who was not involved in the study. “This test can help identify those with early stage breast cancer who may still have residual cancer in their body that may not be detectable with standard scans.”

That could help guide treatment, by, for example, determining which patients require closer monitoring for recurrent growths. Because the sequencing identifies the genetic mutations contributing to the tumor, the test could also help doctors to decide which targeted drug therapies, which are designed to address specific cancer mutations, to prescribe for their patients.

Most importantly, the test could help women whose tumors are effectively eliminated by their pre-surgery treatment to avoid an operation altogether since the blood test would reassure her and her doctor that no residual tumor DNA remained.

“If we could really know with a more accurate degree of certainty that you don’t have residual disease, it would be help in saying that you don’t need any more therapy [including surgery],” says Dorraya El-Ashry, chief scientific officer of the Breast Cancer Research Foundation. ”Conversely, if you still had residual disease, if there is information from the test that can pinpoint the next therapy, that would also be better.”

Muhammed Murtaza, co-director of the center for non-invasive diagnostics at TGen, says TARDIS needs to be tested in a larger group of breast cancer patients before it can be rolled out to doctors’ offices. His team is planning to study the test’s efficacy in about 200 breast cancer patients, in order to clarify exactly what levels of tumor DNA found in the blood are most likely to lead to recurrence. They are also exploring how modified versions of TARDIS could be applied to other cancers, like esophageal, colorectal, pancreatic and prostate.

There’s even encouraging precedent for this sort of a liquid biopsy. Doctors routinely rely on a blood test for chronic myeloid leukemia, for example, to track patients’ response to targeted drugs that treat specific mutations driving the cancer. “Applying this same technology to more common solid cancers like breast cancer is the new frontier,” says Tripathy.

By Alice Park

Source: https://time.com

 

How Will The Failure Of Biogen’s Alzheimer’s Drug, Aducanumab, Impact R&D?

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Photographer: Scott Eisen/Bloomberg

© 2016 Bloomberg Finance LP

The landscape of experimental Alzheimer’s disease (AD) drugs is strewn with failures, so much so that it has been referred to as “an unrelenting disaster zone”. Recognizing the greatly increasing number of patients with this disease, many biopharma companies have invested a lot of resources in attacking this problem, only to be turned away in late stage studies as happened to Merck with its BACE inhibitor, verubecestat, and Lilly with its beta-amyloid antibody, solanezumab.

Now add Biogen to the list of companies that have failed in this arena. Its drug, aducanumab, partnered with Eisai, was believed to be better in removing beta-amyloid from the brain than any agent previously tested. Many have hypothesized that beta-amyloid causes the formation of damaging clumps of debris in the brain leading to AD. Unfortunately, Biogen halted a major clinical trial with aducanumab due to a futility analysis showing that the drug doesn’t work.

This is a terrible result for Alzheimer’s patients who had hoped that this was the drug that would finally succeed in treating AD. But the demise of aducanumab is also disastrous for Biogen which had expended an enormous amount of resources into this program, likely at the expense of other opportunities. It was a risky bet and one for which Wall Street has delivered a punishing blow. Biogen’s stock dropped by nearly 30% shortly after announcing the disappointing aducanumab results.

How is Biogen going to respond? As John Carroll has reported, many industry analysts believe that there aren’t many gems in the Biogen pipeline that can make up for the loss of this potential blockbuster. In predicting Biogen’s next steps, perhaps there are some learnings from another such pipeline failure – that of Pfizer’s torcetrapib.

Torcetrapib was the first of a class of compounds known as CETP inhibitors, drugs that both raised HDL-cholesterol and lowered LDL-cholesterol. A CETP inhibitor had the potential to remodel a heart patient’s lipid profile thereby greatly reducing his risk of a heart attack or stroke. There was tremendous excitement generated in this potential breakthrough treatment, not just in Pfizer but also among cardiologists and heart patients. In fact, internal commercial analyses predicted annual sales in excess of $15 billion. However, as happened with aducanumab, on December 4th, 2006, Pfizer announced that torcetrapib failed its long-term clinical study. The drug was dead. The Wall Street reaction was swift, albeit not as dramatic as Biogen’s experience. Pfizer stock dropped 10% as a result of this news.

Internally, the Pfizer reaction was intense. Torcetrapib was supposed to be the blockbuster that would drive growth into the next decade. Its loss created an enormous hole. Pfizer CEO Jeff Kindler responded in a couple of ways. First, he decided to “right size” R&D in relation to lower expected future revenues. In effect, hundreds of millions of dollars needed to be cut from R&D. Pfizer’s R&D budget had already undergone major portfolio adjustments and reorganizations over the previous five years due to the acquisition of Warner-Lambert Parke-Davis in 2000 followed by the acquisition of Pharmacia in 2004. Meeting the new R&D budget targets weren’t going to be achieved by simple cuts; rather, major research sites had to be closed and jobs had to be eliminated. Gone were R&D sites around the world including those in France, Japan and, most significantly, the iconic laboratory in Ann Arbor, Michigan.

But budget cuts weren’t going to be enough for Pfizer to meet its desired goals. The company began assessing major M&A opportunities and in 2009 it acquired Wyeth for $68 billion leading to yet another round of reorganizations and portfolio reshuffling. The ripple effect of the torcetrapib demise was felt by the entire company and lasted for a number of years.

So, how will Biogen respond? Undoubtedly, there will be budget cuts. In addition, perhaps Biogen will look at its R&D portfolio and give a higher priority to those programs that have the potential to deliver revenues in the short term. There might also be a push to drop programs deemed to be very risky or where the proof-of-concept requires long, expensive clinical trials. Finally, it wouldn’t be surprising to see Biogen become aggressive in their M&A activities. But make no mistake. The death of an important drug like aducanumab will have both a short and a long term effect on Biogen as a company and especially on R&D.

I was the president of Pfizer Global Research and Development in 2007 where I managed more than 13,000 scientists and professionals in the United States, Europe, and Asi…

Source: How Will The Failure Of Biogen’s Alzheimer’s Drug, Aducanumab, Impact R&D?

Open Innovation In Japan Breaks New Ground In The Operating Room

Yoshihiro Muragaki (left) and Jun Okamoto (right) of Tokyo Women's University's Institute of Advanced Biomedical Engineering and Science

Yoshihiro Muragaki (left) and Jun Okamoto (right) of Tokyo Women’s Medical University’s Institute of Advanced Biomedical Engineering and Science pose in a version of the Smart Cyber Operating Theater (SCOT).JAPAN BRANDVOICE

Imagine undergoing surgery on a robotic bed that can automatically help perform a magnetic resonance imaging (MRI) scan while an artificial intelligence (AI) system actively supports surgeons by suggesting various procedures. It sounds like a scenario from a Hollywood movie, but it’s reality in Japan.

Doctors at the Tokyo Women’s Medical University – Waseda University Joint Institution for Advanced Biomedical Sciences (TWIns) recently performed a groundbreaking brain surgery to treat essential tremor, a neurological disorder. It was the first clinical use of the latest version of the institution’s Smart Cyber Operating Theater (SCOT). Hyper SCOT, as it’s known, brings robotics and AI into the operating theater so that patients can have better post-surgical outcomes. It’s an impressive example of the many forms of open collaboration driving innovation in Japan.

A new frontier in surgery

Walking into the Hyper SCOT operating room at Tokyo Women’s Medical University, one gets the feeling of entering Sick Bay aboard the starship Enterprise from Star Trek. Silver doors slide open to reveal a sleek white room illuminated by variable-color lights. In the center are a pair of robots: an operating bed that swivels to position a patient under a large MRI scanner nearby, and a dual-armed industrial-style robot that can support a surgeon’s arms while operating. On the wall are high-resolution images of a patient’s brain. Surgeons can gesture to zoom in or change the images’ orientation, a feature inspired by the Tom Cruise film Minority Report.

As a next-generation operating room, SCOT can reduce risks and increase benefits for patients, says Muragaki.

As a next-generation operating room, SCOT can reduce risks and increase benefits for patients, says Muragaki.JAPAN BRANDVOICE

Hyper SCOT is designed to transform surgery from an analog process, where standalone equipment is not connected, into a digital process where data are shared. It can support surgical teams by providing them with a rich stream of data from networked medical tools as well as AI-powered advice on surgical options. SCOT also aims to improve precision by helping brain surgeons accurately navigate to a tumor site. Although MRI had only been available to surgeons before an operation, Hyper SCOT would enable them to get scans during the procedure, which could dramatically improve outcomes.

“If we have many kinds of information, we need some kind of strategy desk, like Mission Control at NASA,” says SCOT project leader Yoshihiro Muragaki, a professor in Tokyo Women’s Medical University’s Institute of Advanced Biomedical Engineering and Science. “Our moonshot is to make new eyes, brains and hands for surgeons. With SCOT, we can perform precision-guided therapy.”

Okamoto demonstrates a SCOT brain imagery gestural interface inspired by the film Minority Report at Tokyo Women's Medical University.

Okamoto demonstrates a SCOT brain imagery gestural interface inspired by the film Minority Report at Tokyo Women’s Medical University. JAPAN BRANDVOICE

A neurosurgeon himself, Muragaki conceived of the SCOT project and has spearheaded it since its inception in 2000. Back then it was known as the Intelligent Operating Theater, a version now known as Classic SCOT. Supported by a grant from the Japan Agency for Medical Research and Development (AMED), the system began as an initiative to enhance interoperability among devices used in the medical theater, but the development team later added features such as multiple surgery cameras that can send imagery to remote consultants, usually senior surgeons. These advisors have a bird’s-eye view of the action as well as near-real time data streams of patients’ vital statistics. Since 2000, the technology has been used in some 1,900 cases, mostly brain surgeries. MRI has been key in detecting residual tumor tissue that escaped surgeons’ notice during operations.

“Even under a microscope, it’s very difficult to detect where brain tumor tissue ends and healthy tissue begins,” says Muragaki. “That’s why we need MRI during surgery. It’s a very powerful tool for removing tumors. But that also means we can only use MRI-compatible devices in the operating room and we must choose them carefully.”

Fruits of teamwork

With over 100 researchers, SCOT is the result of a complex collaboration between academia and the private and public sectors. Aside from the two universities in TWIns, Muragaki and colleagues are working with Hiroshima University and Shinshu University, where versions of SCOT are being evaluated in clinical settings. High-tech companies are also helping to develop SCOT, including Hitachi, Canon Medical, and Air Water. Another participant is Denso. It developed a medical-equipment middleware called OpeLiNK that is based on factory automation technology as well as ORiN, a platform created with the support of the New Energy and Industrial Technology Development Organization (NEDO), a leading Japanese state-backed research center. Orchestrating all these players was essential in creating SCOT.

Another major benefit of SCOT is the ability to obtain scans using an MRI machine (right) during surgery.

Another major benefit of SCOT is the ability to obtain scans using an MRI machine (right) during surgery. JAPAN BRANDVOICE

“If one company tried to do this alone, it would want to use its own technology and keep rivals out,” says Muragaki. “That company wouldn’t succeed in integrating all the various technologies. That’s why public institutions are vital for this kind of open innovation project. They act like the frame in a traditional sensu Japanese folding fan, keeping everything together as the project unfolds.”

The collaborations that gave birth to SCOT were recently recognized when it picked up the Minister of Health, Labour and Welfare Award as part of the first Japan Open Innovation Prize. Sponsored by the Japanese government, the accolade was set up to promote initiatives that can serve as future role models for open innovation. In Japan, companies traditionally kept R&D in-house, even in recent years. But the public and private sectors have been pushing open innovation as a vehicle for enhancing competitiveness. Collaborations between government labs, corporations and universities are now flourishing. Major telecom carrier KDDI, for instance, launched the first of a series of Open Innovation Funds in 2012, aimed at investing in IT startups in Japan and overseas.

“There’s a growing recognition that if a company categorizes itself as a camera company, for instance, it is limiting itself,” Keiichiro Koumura, an official with major real estate company Mitsui Fudosan, recently told attendees at an open innovation seminar at Mitsui Fudosan’s Base Q in Tokyo. “Because as technology changes, cameras have become smartphones. One way to address this is open innovation.”

Keiichiro Koumura of Mitsui Fudosan (center left) and Hideaki Nagano of Samurai Incubate (center right) discuss open innovation during a seminar at Base Q in Tokyo.

Keiichiro Koumura of Mitsui Fudosan (center left) and Hideaki Nagano of Samurai Incubate (center right) discuss open innovation during a seminar at Base Q in Tokyo.japan brandvoice

Looking to the future

As for SCOT, Muragaki hopes to spread the technology to other hospital facilities such as intensive care units, and apply it to other forms of surgery such as vascular operations. He also hopes to take the technology overseas.

“Most doctors are resistant to change. Before they try SCOT, surgeons don’t regard it as something that’s necessary but once they give it a go, their view changes,” says Muragaki. “After brain surgeries, we want to try the technology on bone tumors, and keep going. If you could do all surgeries with SCOT, it would decrease risks and increase benefits. That’s something we can work toward.”

To find out more about SCOT, visit the university’s website here.

For more on the Japanese Government’s innovations and technologies, please click here.

Japan is changing. The country is at the forefront of demographic change that is expected to affect countries around the world. Japan regards this not as an onus but as

Source: Open Innovation In Japan Breaks New Ground In The Operating Room

Blood Type: Microbiome and Diet — CFS Remission

One of my favorite sources for information on the microbiome is run by Dr. Peter J. D’Adamo. For many years he has advocated eating for your blood type. In this week’s issue of New Scientist. an article “Your gut bacteria may match your blood group – but we don’t know why“ The difference between many […]

via Blood Type: Microbiome and Diet — CFS Remission

HLA system in solid organ transplantation part 25 — MEDICINE FOR ALL

HLA mismatches and the production of alloantibodies HLA mismatches are not only the trigger for alloreactive T cells to destroy the transplant parenchyma, they also lead to the formation of alloreactive anti-HLA antibodies; and together they contribute to acute and chronic rejection, and the eventual immunologically-mediated transplant loss. But it is not the number […]

via HLA system in solid organ transplantation part 25 — MEDICINE FOR ALL

Researchers Find A Web Of Factors Behind Multiple Sclerosis

As the story goes, nearly 80 years ago on the Faroe Islands — a stark North Atlantic archipelago 200 miles off the coast of Scotland — a neurologic epidemic may have washed, or rather convoyed, ashore. Before 1940 the incidence of multiple sclerosis on the Faroes was near, if not actually, zero, according to the tantalizing lore I recall from medical school. Yet in the years following British occupation of the islands during World War II, the rate of MS rose dramatically, leading many researchers to assume the outbreak was caused by some unknown germ transmitted by the foreign soldiers……..

Source: Researchers Find A Web Of Factors Behind Multiple Sclerosis

Human Leukocyte Antigen (HLA) part 102 — MEDICINE FOR ALL

The discovery that foetal cells are devoid of the highly polymorphic HLA class Ia molecules, except for a low expression of HLA-C, is believed to play a dominant role for the induction of tolerance to the semi-allogenic foetus. Interestingly, the foetal-derived tissue in placenta does express the loss polymorphic HLA class Ib molecules, HLA-E, […]

via Human Leukocyte Antigen (HLA) part 102 — MEDICINE FOR ALL

Why Doctors Hate Their Computers – Atul Gawande

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On a sunny afternoon in May, 2015, I joined a dozen other surgeons at a downtown Boston office building to begin sixteen hours of mandatory computer training. We sat in three rows, each of us parked behind a desktop computer. In one month, our daily routines would come to depend upon mastery of Epic, the new medical software system on the screens in front of us. The upgrade from our home-built software would cost the hospital system where we worked, Partners HealthCare, a staggering $1.6 billion, but it aimed to keep us technologically up to date……..

Read more: https://www.newyorker.com/magazine/2018/11/12/why-doctors-hate-their-computers

 

 

 

 

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