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Mutations In Father’s Sperm Can Predict Children’s Autism

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There’s no question that autism can be traced to a combination of genetic and environmental factors. One genetic contributor in particular has in recent years intrigued scientists studying autism: DNA mutations originating in fathers’ sperm.

Studies have linked autism risk to de novo mutations, or changes in DNA that arise spontaneously in sperm as the germline cell develops, or in the embryo after fertilization. Researchers estimate that such mutations might be involved in anywhere from 10% to 30% of autism cases, and that the older a father is at the time of conception, the higher the chance his sperm will result in de novo mutations that can contribute to autism spectrum disorder. In fact, with every decade of life, the number of de novo mutations in sperm doubles.

In a new study published in Nature Medicine, researchers led by a team at the University of California, San Diego (UCSD) set out to determine if they could match specific disease-causing genetic mutations in the DNA of children with autism to the same mutations in their fathers’ sperm.

The team analyzed DNA from eight sets of fathers and children. In the children, they looked for a phenomenon called mosaicism, which are genetic differences even among cells from the same person. Each time a cell divides, the process can generate mutations, or genetic mistakes—some can be harmful (for example, some can lead to cancer), but most are not because they occur outside of important genes in what are known as “DNA deserts.”

The researchers then matched these changes found in the children to those found in their fathers’ sperm. That confirmed that the de novo mutations were indeed playing some role in contributing to autism.

The researchers also determined what percentage of sperm produced by the father contained these de novo mutations. This knowledge, say the study authors, could potentially lead to a test that can help fathers of children with autism to know how likely they are to have another child affected by the condition.

Eventually, the genetic test could also tell parents-to-be if they are at increased risk of having a child with autism. The DNA sequencing technology used is basically the same as used for whole genome sequencing, and the price for that continues to drop, so this wouldn’t be an especially expensive tool.

Inhibitor CocktailsCurrently around 165 genetic mutations have been linked to autism, and conducting a deep analysis of a potential father’s sperm for some of these aberrations could let him know if he is at higher or lower risk of fathering a child who might be affected by autism. (The list of implicated genes continues to grow at a rapid pace, and at the time of the study, the scientists worked with a smaller number of culprit genetic variants).

In some of the eight fathers in the study, up to 10% of their sperm carried mutations; if these men decided to have more children, they would have the option of choosing whether they wanted to take measures to reduce the risk their children would be affected. Some, for example, might use IVF so they could screen their embryos for the mutations.

By Alice Park December 23, 2019

you wouldn't settle for one star products. why settle for a 1 star bank?

Source: Mutations In Father’s Sperm Can Predict Children’s Autism

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Part of the joy and challenge of being a parent is making sacrifices so your children can hit traditional milestones: a high school graduation, going off to college, starting a life of their own. But for some parents – like Barbara Rivera, a mother of three with two autistic children – the sacrifices are far greater and the milestones far different than what she expected. (Caregiving; Season 2, Episode 8. Original Air Date: Saturday, December 20, 2014.)

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Robotic Prostatectomy Surgery

Also known as robotic prostatectomy, this minimally invasive procedure is performed with the assistance of advanced surgical technology and an experienced laparoscopic surgery team.

Robotic-assisted radical laparoscopic prostatectomy is accomplished using the da Vinci® Surgical System, a sophisticated robotic surgery system that allows surgeons to operate on the prostate with enhanced vision, control and precision.

Using the advanced surgical system, miniaturized robotic instruments are passed through several small keyhole incisions in the patient’s abdomen to allow the surgeon to remove the prostate and nearby tissues with great precision. This is much less invasive than a conventional radical retropubic prostatectomy, which involves an abdominal incision that extends from the belly button to the pubic bone.

During robotic-assisted radical prostatectomy, a three-dimensional endoscope and image processing equipment are used to provide a magnified view of delicate structures surrounding the prostate gland (e.g., nerves, blood vessels and muscles), allowing optimal preservation of these vital structures. The prostate is eventually removed through one of the keyhole incisions.

For most of the surgery, the surgeon is seated at a computer console and manipulates tiny wristed instruments that offer a range of motion far greater than the human wrist. The surgery is performed without the surgeon’s hands entering the patient’s body cavity.

Benefits of Robotic Surgery

Compared with traditional open surgery, patients who undergo robotic-assisted radical prostatectomy experience:

  • Less blood loss
  • Less pain
  • Shorter hospital stays
  • Faster recovery times (although catheter needs to remain in bladder for same amount of time after robotic or open procedure).

Risks of Robotic-Assisted Laparoscopic Radical Prostatectomy

The potential risks of robotic-assisted laparoscopic radical prostatectomy include the following:

  • Bleeding
  • Infection at the surgical site
  • Adjacent tissue/organ damage

Side Effects of Robotic-Assisted Laparoscopic Radical Prostatectomy

The rates of major side effects from robotic-assisted laparoscopic radical prostatectomy are about the same as open surgical approaches. The most common side effects include the following:

  • Urinary incontinence (inability to control urine): Similar to open surgery, urinary incontinence can occur following a robotic prostatectomy. However, this side effect often improves over time.
  • Erectile dysfunction (impotence): The return of erectile function following prostatectomy is based on the patient’s age, degree of preoperative sexual function and whether the nerves were spared during surgery. Unless cancer is suspected in the nerve tissue, surgeons will use nerve-sparing techniques during robotic prostatectomy to minimize the surgical impact on sexual function.

Prostate Cancer: When to Treat Versus When to Watch

Because certain prostate cancers grow very slowly, your doctor might determine that it’s not likely to present a significant threat to you. This is particularly true if a prostate cancer is localized, meaning it hasn’t spread beyond the prostate.

If that’s the case, you and your doctor can discuss getting regularly tested instead of undergoing treatment right away. Doctors call this approach active surveillance. By not rushing into treatment for a cancer that may not cause you any harm, this approach helps many men avoid treatment-related side effects.

Active surveillance , or active monitoring, means your doctor will monitor you closely, watching to see how the cancer progresses, if at all. This is primarily for cancers that doctors classify as:

  • Slow-growing
  • Very low risk for causing symptoms

To monitor a low-risk prostate cancer, someone on active surveillance could undergo:

  • Rectal exam : Every six months
  • PSA test : Twice a year. This blood test, commonly used to screen for prostate cancer, measures how much prostate-specific antigen (PSA) is in your blood.
  • Biopsy : Once a year (until and unless your doctor determines a less frequent biopsy is warranted)
  • MRI scan : Necessary in some cases to show more details of a cancer if your doctor has any questions or concerns from your test results

Prostate Cancer Treatment: When Watching May Be Enough

Your doctor will consider many factors before deciding whether this approach is right for you. This includes:

  • Gleason score : This scoring system grades how aggressive a prostate cancer is. It also gives doctors hints as to how likely a cancer is to spread. Gleason scores less than 7 are considered lower risk and might be appropriate for active surveillance.
  • Biopsy results : A prostate biopsy (removing tissue samples from the prostate) is the only definitive way to diagnose prostate cancer today. After a prostate biopsy, your doctor will count how many of the samples contain cancer. For biopsies that show three or fewer samples (or cores) with cancer, your doctor might recommend watching you before starting treatment.
  • PSA results : A PSA test is the standard way doctors assess prostate cancer risk. Doctors use PSA test results along with information about your prostate size to measure your PSA density. If PSA density is less than 0.15, you might not need treatment right away.
  • Physical characteristics : Another way your doctor will assess prostate cancer is through a rectal exam. If he or she can’t feel a cancer (via a hard nodule, for example), that’s another sign that could point to active surveillance as a possible treatment approach.

Source: Robotic Prostatectomy | Johns Hopkins Medicine

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This 3d medical animation provides an overview about the anatomy of the male urogenital system, with the main focus on the prostate. Prostate cancer is shown developing in the tubular ducts of the prostate. All of the general steps are then demonstrated in the animation to show how the cancerous prostate will be robotically removed during a minimally invasive procedure.

CBD Oil for Parkinson’s Disease

Every year in the United States, approximately 60,000 individuals are newly diagnosed with Parkinson’s disease according to the Parkinson’s Foundation (PF).[1]

The PF adds that, by the year 2020, the number of people living with this medical condition is expected to near one million in total, making it more prevalent than multiple sclerosis, muscular dystrophy, and Lou Gehrig’s disease combined.

What is Parkinson’s disease?

The American Parkinson Disease Association (APDA) defines Parkinson’s as “a type of movement disorder that can affect the ability to perform common, daily activities.”[2]

Unlike other movement disorders, Parkinson’s disease is characterized by a loss of brain cells, specifically those in the substantia nigra region. This lowers dopamine levels which causes issues related to movement regulation, thus impacting the patients’ quality of life.

Parkinson’s disease is both chronic and progressive, making this movement disorder one that is long-lasting, while also worsening as time progresses.

Also, though it typically appears after the age of 50, roughly one in ten Parkinson’s disease patients are diagnosed at a younger age. This is called Early Onset Parkinson’s.

Symptoms of Parkinson’s tend to vary from person to person and fall into one of two categories: motor symptoms and non-motor symptoms.

The APDA shares that it is the motor symptoms of Parkinson’s that typically make these typical daily movements more difficult, some of which include experiencing tremors, having stiff or rigid muscles, walking difficulties, slowness of movement (also known as bradykinesia), and postural instability.

Another motor symptom Parkinson’s disease patients tend to notice is a change in their voice. Changes in volume are common in the early stages, whereas speaking fast, crowding words, and stuttering are more prevalent in advanced stages of this disease.

Parkinson’s symptoms that don’t involve movement and are therefore sometimes missed, include:

  • Reduced sensitivity to smells
  • Trouble staying asleep
  • Increased depression and anxiety
  • Psychotic symptoms such as hallucinations and delusions
  • Fatigue
  • Weight loss
  • Excessive sweating
  • Difficulty multi-tasking
  • Harder time with organization
  • Constipation
  • Increase in urinary frequency and urgency
  • Lightheadedness
  • Reduced libido
  • Slower blinking and dry eyes

Currently, there is no cure for Parkinson’s. However, patients do have a few treatment options that can help manage this particular medical condition.

One is taking a medication to help better manage motor function. Two well-known options include Levodopa and Carbidopa, both of which can be prescribed in varying strengths and formulations.

Another common Parkinson’s treatment is therapy. For instance, physical therapy may be pursued to aid in walking and occupational therapy can help enhance fine motor skills. Speech therapy may also be required to assist with vocal issues.

Deep brain stimulation is an option as well. Approved by the U.S. Food and Drug Administration (FDA) several years ago, this treatment method is a form of surgical therapy in which an electrode is implanted in the brain, then stimulated via a device that is placed in the chest area under the skin.

The APDA further indicates that complementary medicine such as yoga and massage can also provide relief from symptoms of PD as well. Research is also finding that CBD oil can potentially help too.

CBD is short for cannabidiol, a chemical compound found within the cannabis plant that binds to cannabinoid receptors located in the body’s endocannabinoid system.[3]

CBD is different than other cannabinoids found in the marijuana plant that are known for producing the high commonly associated with medical marijuana use. This includes tetrahydrocannabinol (THC) and a similar cannabinoid, tetrahydrocannabivarin (THCV). Both THC and THCV can produce this high effect, whereas CBD does not.[4]

Additionally, our bodies do produce some cannabinoids on its own. These are called endogenous cannabinoids because they are so similar to cannabis plant compounds. CBD works by mimicking and augmenting these natural cannabinoids, providing a more therapeutic effect.

Admittedly, information in this field is still emerging, primarily because the endocannabinoid system is a relatively new finding due to the first endocannabinoid not being discovered until 1992.[5]

After the second one was identified three years later, researchers began to realize that the human body has an entire endocannabinoid system that offers positive effects related to bone density and diabetes prevention.

Since that time, research has also connected CBD with providing benefits for Parkinson’s disease.

For instance, one 2018 study published by Frontiers in Pharmacology shares that CBD helps by increasing levels of the endocannabinoid anandamide, an agonist of cannabinoid receptors.[6] It is also thought to aid in other processes found helpful for Parkinson’s patients, such as those related to serotonin receptors like 5-HT1A, peroxisome proliferator-activated receptors, and more.

Other studies shared by the National Institute of Health (NIH) have found similar results. Specifically, they indicate that the study of CBD in relation to Parkinson’s disease is especially interesting because of the direct relationship between endocannabinoids, cannabinoid receptors, and the neurons associated with this neurodegenerative disease that impacts the central nervous system.[7]

Another piece of research, this one published in the journal Cannabis and Cannabinoid Research, indicates that many clinical trials have been conducted in this area. [8] Though some have been inconclusive or controversial, others have found that CBD has positive effects on some of Parkinson’s motor symptoms.

One such study looked at 22 patients who engaged in the medical use of cannabis, which contains CBD.[9] In this case, improvements were noted in regard to tremor, rigidity, and bradykinesia 30 minutes after using medical marijuana.

Other pieces of Parkinson’s research have found that CBD can also help relieve non-motor symptoms. For instance, an open-label study—meaning that there is no placebo group, so the subjects know that they’re receiving active treatment—found that, after being taken for four weeks, CBD helped reduce psychotic symptoms.[10]

Another double-blind trial involved 119 Parkinson’s patients who were treated with either 75 mg of CBD per day, 300 mg CBD daily, or a placebo. Although researchers could not establish a statistically significant difference in motor and general symptoms scores, there were significantly different means in relation to their well-being and quality of life.[11]

The Michael J. Fox Foundation for Parkinson’s Research adds that research in this area is somewhat limited due to governmental regulations, with interpretation of results also impacted due to no standardization of CBD doses or use of products containing CBD and THC combined.[12] Therefore, it can be difficult to determine the specific effect CBD can provide to Parkinson’s patients.

Healthline reports that CBD oil has a number of scientifically-proven benefits that extend beyond those related to Parkinson’s.[13] Among them are:

One of the major concerns patients have with the use of CBD oil is whether or not it is legal. Psychology Today stresses that, while many people think that the passing of the 2018 Farm Bill legalized CBD federally, this isn’t exactly the case.[14]

Instead, the Farm Bill only legalized hemp, which is the fibrous stalk of the marijuana plant. Technically, all other parts of the plant are still illegal under the Controlled Substances Act.

What confuses the issue even more is that each state has set its own statutes regarding hemp, medical marijuana, and CBD. For instance, in New York, patients can smoke cannabis, but they aren’t banned from accessing it as a dried flower. However, if you live in Colorado, not only can individuals use medical cannabis, but children can even legally possess it on school campuses if they have status as a medical cannabis patient.[15]

Because of these variations, it is always recommended that Parkinson’s patients check the legality of cannabis use or CBD oil in their individual states before utilizing this option for treatment purposes.

[1] “Statistics.” Parkinson’s Foundation. https://parkinson.org/Understanding-Parkinsons/Statistics

[2] “What is Parkinson’s Disease?” American Parkinson Disease Association. https://www.apdaparkinson.org/what-is-parkinsons/

[3] “What is CBD?” Project CBD. https://www.projectcbd.org/about/what-is-cbd

[4] Rahn, B. “What is THCV and What Are the Benefits of This Cannabinoid?” Leafly. Feb 03, 2015. https://www.leafly.com/news/cannabis-101/what-is-thcv-and-what-are-the-benefits-of-this-cannabinoid

[5] “A History of Endocannabinoids and Cannabis.” UTT BioPharma. https://www.uttbio.com/a-history-of-endocannabinoids-and-cannabis/

[6] Peres, F.F. et al. “Cannabidiol as a Promising Strategy to Treat and Prevent Movement Disorders?” Frontiers in Pharmacology. May 2018; 9:482. Doi:10.3389/fphar.2018.00482. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5958190/

[7] Fernandez-Ruiz, J et al. “Endocannabinoids and Basal Ganglia Functionality.” Prostaglandins, Leukotrienes and Essential Fatty Acids. Feb-Mar 2002; 66(2-3):257-67. https://www.ncbi.nlm.nih.gov/pubmed/12052041

[8] Stampanoni Bassi, M et al. “Cannabinoids in Parkinson’s Disease.” Cannabis and Cannabinoid Research. Feb 2017; 2(1):21-29. Doi: 10.1089/can.2017.0002. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5436333/

[9] Lotan, I et al. “Cannabis (medical marijuana) treatment for motor and non-motor symptoms of Parkinson disease: an open-label observational study.” Clinical Neuropharmacology. Mar-Apr 2014; 37(2):41-4. Doi: 10.1097.WNF.0000000000000016. https://www.ncbi.nlm.nih.gov/pubmed/24614667

[10] Zuardi A.W. et al. “Cannabidiol for the Treatment of Psychosis in Parkinson’s Disease.” Journal of Psychopharmacology. Nov 2009; 23(8):979-83. Doi: 10.1177/0269881108096519. https://www.ncbi.nlm.nih.gov/pubmed/18801821

[11] Chagas M.H. et al. “Effects of Cannabidiol in the Treatment of Patients with Parkinson’s Disease: An Exploratory Double-Blind Trial.” Journal of Psychopharmacology. Nov 2014; 28(11):1088-98. Doi: 10.1177/0269881114550355. https://www.ncbi.nlm.nih.gov/pubmed/25237116

[12] Dolhun, R. “Ask the MD: Medical Marijuana and Parkinson’s Disease.” The Michael J. Fox Foundation for Parkinson’s Research. May 02, 2018. https://www.michaeljfox.org/foundation/news-detail.php?ask-the-md-medical-marijuana-and-parkinson-disease-a

[13] Kubala, J. “7 Benefits and Uses of CBD Oil (Plus Side Effects).” Healthline. Feb 26, 2018. https://www.healthline.com/nutrition/cbd-oil-benefits

[14] Pierre, J. “Now that Hemp is Legal, Is Cannabidiol (CBD) Legal Too?” Psychology Today. Jan 02, 2019. https://www.psychologytoday.com/us/blog/psych-unseen/201901/now-hemp-is-legal-is-cannabidiol-cbd-legal-too

[15] “Legal Information By State & Federal Law.” Americans for Safe Access. https://www.safeaccessnow.org/state_and_federal_law

Dr. Andrew Colucci

By: Dr. Andrew Colucci

Doctor of Medicine (M.D. cum laude) from Boston University School of Medicine in 2012 – Dr. Colucci is currently a radiologist in MA

Source: CBD Oil for Parkinson’s Disease

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Does medical marijuana help Parkinson’s symptoms? Rachel Dolhun, MD, movement disorder specialist and vice president of medical communications at The Michael J. Fox Foundation, answers this and other common questions about medical marijuana and Parkinson’s disease. The “Ask the MD” series is intended as an educational resource for people with Parkinson’s and their loved ones. Please consult with your personal healthcare provider to address individual medical questions. The Michael J. Fox Foundation for Parkinson’s Research is dedicated to finding a cure for Parkinson’s disease through an aggressively funded research agenda and to ensuring the development of improved therapies for those living with Parkinson’s today. https://www.michaeljfox.org We gratefully acknowledge the Steering Committee members of our Patient Disease Education Consortium in conjunction with The Albert B. Glickman Parkinson’s Disease Education Program and Charles B. Moss Jr. and family, whose sponsorship allows us to create and distribute materials, while preserving our track record of efficiency in stewarding donor-raised contributions for maximum impact on Parkinson’s drug development. Sponsorship support does not influence MJFF’s content perspective or panelist selection. Note: Tap cc in the lower right corner of the player to enable auto-generated captions for the video.

These Brands May Be to Blame for Vaping-Related Illnesses

Man smokes an electronic cigarette in town .

Dank Vapes seem to be associated with many cases of e-cigarette and vaping-product associated lung injury (EVALI) popping up across the country, the U.S. Centers for Disease Control and Prevention (CDC) announced Friday.

The CDC has already pointed to products containing the marijuana compound THC—particularly those tainted by the additive vitamin E acetate—as a likely cause of many of the nearly 2,300 EVALI cases and 48 deaths reported during the outbreak. Now, for the first time, the agency has released national data about specific brands used by individuals before they got sick.

More than half the 482 hospitalized EVALI patients who provided specific product information to the CDC reported using products from Dank Vapes, which the CDC calls “a class of largely counterfeit THC-containing products of unknown origin.” An Inverse investigation found that Dank Vapes is not a legitimate company, but rather a label often affixed to counterfeit products produced by unknown makers. “They act like a cannabis company, but they actually don’t exist. They’re in the packaging industry,” a cannabis industry entrepreneur told Inverse.

Health advocates are encouraging Donald Trump to move forward with a federal ban on thousands of flavors used in e-cigarettes. The CDC’s investigation points to the nebulous network’s reach. Patients in every region said they had used Dank Vapes products, though they were used a bit more often in the Midwest, Northeast and South than the West. The CDC has already reported evidence that Dank Vapes products were associated with illnesses in Illinois and Wisconsin.

Other vaping brands used by patients in the CDC’s report include TKO, Rove, Smart Cart, Kingpen and Cookie, many of which were used by more people in the West than anywhere else. TIME could not immediately reach any of the companies for comment.

Though the data helps advance the CDC’s investigation, there are still many unanswered questions. The nearly 500 patients included in the latest report said they had used 152 different products in all, making it difficult to nail down which ones are the possible sources of illnesses—especially since some patients use e-cigarettes from multiple brands.

It’s also not totally clear whether THC-containing products are to blame for all cases of EVALI. Eighty percent of the 1,782 hospitalized EVALI patients for whom the CDC has information about product use said they had vaped THC in the three months before symptoms (35% exclusively), but 54% also said they had used nicotine (13% exclusively). Smaller numbers also reported additionally or exclusively using products containing CBD, a non-psychoactive marijuana compound.

There was some good news in the report, however. The CDC says the number of EVALI diagnoses has declined each week since mid-September, suggesting that the outbreak may be approaching its end.

By : Jamie Ducharme

Source: These Brands May Be to Blame for Vaping-Related Illnesses

 

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/

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

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