As the weather becomes warmer, people start preparing their homes and yards for the spring and summer seasons. Projects such as yard work, cleaning and painting become priorities on the to-do list. However, thousands of orthopaedic injuries occur each year as a result of mishaps around the house. That is why the American Academy of Orthopaedic Surgeons urges people to take the proper safety precautions to reduce the number of spring cleaning-related accidents.
More than 530,000 ladder injuries, nearly 72,000 garden tool-related injuries and approximately 239,000 lawn mowing injuries were treated in hospital emergency rooms, doctors' offices and clinics in 2005, according to the U.S. Consumer Product Safety Commission.
"Many spring cleaning injuries occur when people rush or do not follow the proper safety precautions," explained Stephen Hurst, MD, orthopaedic surgeon and Fellow of the Academy. "Because most injuries are preventable, it is important to use the appropriate equipment for each project and take your time to minimize spring cleaning-related accidents."
Because orthopaedic surgeons not only treat, but try to prevent injuries of the bones, joints and muscles, the AAOS recommends the following guidelines for spring cleaning projects.
Proper techniques for lifting, carrying and bending should be part of any spring cleaning project:
-- Separate your feet, shoulder-width apart, keep your back upright and bend at the knees while tightening the stomach muscles.
-- Lift with your leg muscles as you stand up; don't try to lift any object by yourself if it is too heavy or an awkward shape.
-- Use a step stool instead of furniture - such as a couch or dining room chair - when dusting hard to reach areas.
-- Ladders used for chores - such as washing windows, painting, cleaning gutters and trimming trees - should be placed on a firm, level surface. Never place a ladder on ground or flooring that is uneven, soft or wet.
-- Over-reaching or leaning too far to one side when working on a ladder can also make you lose your balance and fall. Your bellybutton should not go beyond the sides of the ladder.
-- When gardening, avoid prolonged repetitive motions during activities such as digging, planting trimming and pruning. It is also important to wear gloves to reduce blistering and protect the skin.
-- Read product labels for proper use and wear protective clothing and gloves when using chemicals for gardening or cleaning. Store all chemicals - at the appropriate temperature, which is usually indicated on the package - in a place that is out of reach of both children and pets.
-- Take frequent breaks and replenish fluids to prevent dehydration. If you experience chest pain, shortness of breath or other signs of a heart attack, seek emergency care, such as by calling 9-1-1.
-- More information about the AAOS
-- For additional spring cleaning related injury prevention tips
www6.aaos
вторник, 30 августа 2011 г.
суббота, 27 августа 2011 г.
Aclasta Receives European Approval As First Once Yearly Treatment For Postmenopausal Osteoporosis
Aclasta (zoledronic acid 5 mg) has received European Union approval as the first once yearly treatment for women with postmenopausal osteoporosis.
The announcement closely follows the recent approval in the US, where the Food and Drug Administration (FDA) approved Aclasta under the brand name Reclast in August 2007. The European Commission decision applies to all 27 member states, Norway and Iceland.
"We are very pleased to receive EU approval, especially as it comes so soon after a similar decision in the US," said James Shannon, MD, Global Head of Development at Novartis Pharma AG. "This demonstrates widespread confidence in Aclasta, which provides physicians and patients with a completely new way to manage osteoporosis. The unique once yearly dosing of this medicine has the potential for significant compliance benefits and improved quality of life for women with osteoporosis."
Unlike oral bisphosphonate therapies taken daily, weekly or monthly, Aclasta is given as a once-yearly 15-minute intravenous (IV) infusion. This means with a single treatment, a patient can receive a full year's protection against the effects of osteoporosis. Data show that more than 70% of patients prefer a once-yearly infusion of Aclasta to a weekly tablet[4,5].
Osteoporosis is a long-term bone disease that causes bones to break more easily. The need for more effective treatments is based on estimates that about 200 million people worldwide suffer from this disease[6] and that one of two women over age 50 will suffer an osteoporotic fracture in their lifetime[3].
Aclasta is the only treatment approved in the EU and US to reduce the risk of fractures in areas of the body typically affected by osteoporosis, including the hip, spine and non-spine (e.g. wrist and rib)[1].
"Aclasta is highly effective at reducing fractures and can be given once-yearly which is a significant benefit to patients and clinicians," said Steven Boonen, Professor of Medicine at the Centre for Metabolic Bone Diseases & Division of Geriatric Medicine at the Leuven University in Belgium. "The convenience of a once-yearly dose should improve compliance and bone protection among patients while reducing fracture-related hospitalization and healthcare costs."
Results of the first-ever clinical study in patients with osteoporosis who had suffered a hip fracture, published in September in the The New England Journal of Medicine, show a once-yearly infusion of Aclasta reduced the risk of any type of subsequent osteoporotic fracture by 35% compared to patients treated with placebo. The Recurrent Fracture Trial involving more than 2,100 men and women also found the risk of death was significantly reduced by 28% in the Aclasta patient group compared to the placebo group (101 vs. 141 deaths)[2].
The regulatory approvals were based on efficacy and safety data from another study, the three-year Pivotal Fracture Trial involving more than 7,700 women. In this study, Aclasta was shown to increase bone strength and reduce the risk of spine fractures by 70% and hip fractures by 41%. The reduction in spine fractures was sustained over three years, and bone mineral density increased significantly in the spine by 6.7% and in the hip by 6% in women on Aclasta compared to placebo[1].
Osteoporotic fracture risk is often under-diagnosed and under-treated, resulting in sub-optimal outcomes and costs to healthcare systems[7]. Fractures can lead to reduced quality of life and loss of independence; someone with osteoporosis may also become partially disabled or immobilized, thereby requiring long-term care.
In women over age 45, osteoporosis accounts for more days spent in hospital than many other diseases, including diabetes, myocardial infarction (or heart attack) and breast cancer[8]. In 2000, the total direct costs related to osteoporotic fractures were estimated at 31.7 billion; these are forecast to increase to 76.7 billion in 2050 based on the expected changes in the demography of Europe[9].
Aclasta is now approved in more than 30 countries for the treatment of post-menopausal osteoporosis and in more than 60 countries including the US, Canada and the EU for the treatment of Paget's disease, the second most common metabolic bone disorder. Additional studies are ongoing to examine treatment of corticosteroid-induced osteoporosis, male osteoporosis, and prevention of bone loss in osteopenic patients.
The active ingredient in Aclasta is zoledronic acid, which is also available in a different dosage under the brand name Zometa (zoledronic acid 4 mg) Injection for use in certain oncology indications.
Aclasta was found to be generally safe and well tolerated in clinical trials. The most common adverse events associated with Aclasta were transient post-dose symptoms such as fever and muscle pain. Most of these symptoms occurred within the first three days following Aclasta administration and resolved within three days. The incidence of post-dose symptoms can be reduced with the administration of paracetamol or ibuprofen shortly following Aclasta infusion.
In the Pivotal Fracture Trial an increased number of cases of atrial fibrillation serious adverse events were observed in women given Aclasta compared to those on placebo (1.3% vs. 0.6% respectively). However, this finding has not been observed in other clinical studies or in post-marketing experience with over 1.5 million patients treated with zoledronic acid for oncology indications. In the Recurrent Fracture Trial, atrial fibrillation serious adverse events occurred in 1.1% of Aclasta-treated patients compared to 1.3% of placebo-treated patients. No spontaneous reports of osteonecrosis of the jaw (ONJ) - a rare occurrence in the osteoporosis population treated with bisphosphonates were seen in either the Pivotal Fracture Trial or Recurrent Fracture Trial.
Disclaimer
The foregoing press release contains forward-looking statements that can be identified by the use of forward-looking terminology such as "can", "potential", "expected", "will", "should", similar expressions or express or implied discussions regarding potential future regulatory submissions or approvals with respect to, or future sales of, of Aclasta, Reclast or Zometa. Such forward-looking statements reflect the current views of Novartis and involve known and unknown risks, uncertainties and other factors that may cause actual results to be materially different from any future results, performance or achievements expressed or implied by such statements. There can be no guarantee that Aclasta,Reclast or Zometa will be approved for any additional indications in the EU, US or any additional markets or that Aclasta, Reclast or Zometa will reach any particular level of sales. In particular, management's expectations regarding Aclasta, Reclast and Zometa could be affected by, among other things, unexpected regulatory actions or delays or government regulation generally; unexpected clinical trial results, including unexpected additional analysis of existing clinical data, and unexpected new clinical data; competition in general; government, industry, and general public pricing pressures; the company's ability to obtain or maintain patent or other proprietary intellectual property protection; as well as the additional factors discussed in Novartis AG's Form 20-F filed with the US Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those described herein as anticipated, believed, estimated or expected. Novartis is providing this information as of this date and does not undertake any obligation to update any forward-looking statements contained in this document as a result of new information, future events or otherwise.
About Novartis
Novartis AG (NYSE: NVS) is a world leader in offering medicines to protect health, cure disease and improve well-being. Our goal is to discover, develop and successfully market innovative products to treat patients, ease suffering and enhance the quality of life. We are strengthening our medicine-based portfolio, which is focused on strategic growth platforms in innovation-driven pharmaceuticals, high-quality and low-cost generics, human vaccines and leading self-medication OTC brands. Novartis is the only company with leadership positions in these areas. In 2006, the Group's businesses achieved net sales of USD 37.0 billion and net income of USD 7.2 billion. Approximately USD 5.4 billion was invested in R&D. Headquartered in Basel, Switzerland, Novartis Group companies employ more than 100,000 associates and operate in over 140 countries around the world. For more information, please visit novartis.
References
[1] Black D, Delmas S, Eastell R et al for the HORIZON Pivotal Fracture Trial. Once-Yearly Zoledronic Acid for Treatment of Postmenopausal Osteoporosis. NEJM 2007; 356(18): 1809-22.
[2] Lyles KW, Colon-Emeric CS, Magaziner JS et al for the HORIZON Recurrent Fracture Trial. Zoledronic Acid and Clinical Fractures and Mortality after Hip Fracture. NEJM 2007;357:10.1056/NEJMoa074941, published online Sept 17 2007.
[3] National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. Osteoporosis Overview. Department of Health and Human Services.
[4] Saag K, Lindsay R, Kriegman A et al. A single zoledronic acid 5mg infusion is preferred over weekly 70 mg oral alendronate in a clinical trial of postmenopausal women with osteoporosis/osteopenia. Osteo Int 2006; 17(1):S1-124.
[5] Omizo M, McClung M, Minkoff J et al. A single infusion is preferred to oral weekly treatment in post-menopausal women with low bone mineral density previously treated with alendronate. Presented at 28th Annual meeting of the American Society for Bone and Mineral Research (ASBMR), 15-19 September 2006, Philadelphia, USA. Forthcoming 2007.
[6] Cooper C. Epidemiology of osteoporosis. Osteoporosis Int 1999;9 (Suppl2):S2-8 Available at iofbonehealth/health-professionals/about osteoporosis/epidemiology.html. Accessed on September 1, 2007.
[7] Siris E, Miller P, Barrett-Connor E et al. Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 2001; 286:2815-22.
[8] Kanis JA, Delmas P, Burckhardt P et al. Guidelines for diagnosis and management of osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporos Int 1997; 7:390-406
[9] Kanis JA and Johnell O. Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 2005; 16:229.
View drug information on Reclast; Zometa.
The announcement closely follows the recent approval in the US, where the Food and Drug Administration (FDA) approved Aclasta under the brand name Reclast in August 2007. The European Commission decision applies to all 27 member states, Norway and Iceland.
"We are very pleased to receive EU approval, especially as it comes so soon after a similar decision in the US," said James Shannon, MD, Global Head of Development at Novartis Pharma AG. "This demonstrates widespread confidence in Aclasta, which provides physicians and patients with a completely new way to manage osteoporosis. The unique once yearly dosing of this medicine has the potential for significant compliance benefits and improved quality of life for women with osteoporosis."
Unlike oral bisphosphonate therapies taken daily, weekly or monthly, Aclasta is given as a once-yearly 15-minute intravenous (IV) infusion. This means with a single treatment, a patient can receive a full year's protection against the effects of osteoporosis. Data show that more than 70% of patients prefer a once-yearly infusion of Aclasta to a weekly tablet[4,5].
Osteoporosis is a long-term bone disease that causes bones to break more easily. The need for more effective treatments is based on estimates that about 200 million people worldwide suffer from this disease[6] and that one of two women over age 50 will suffer an osteoporotic fracture in their lifetime[3].
Aclasta is the only treatment approved in the EU and US to reduce the risk of fractures in areas of the body typically affected by osteoporosis, including the hip, spine and non-spine (e.g. wrist and rib)[1].
"Aclasta is highly effective at reducing fractures and can be given once-yearly which is a significant benefit to patients and clinicians," said Steven Boonen, Professor of Medicine at the Centre for Metabolic Bone Diseases & Division of Geriatric Medicine at the Leuven University in Belgium. "The convenience of a once-yearly dose should improve compliance and bone protection among patients while reducing fracture-related hospitalization and healthcare costs."
Results of the first-ever clinical study in patients with osteoporosis who had suffered a hip fracture, published in September in the The New England Journal of Medicine, show a once-yearly infusion of Aclasta reduced the risk of any type of subsequent osteoporotic fracture by 35% compared to patients treated with placebo. The Recurrent Fracture Trial involving more than 2,100 men and women also found the risk of death was significantly reduced by 28% in the Aclasta patient group compared to the placebo group (101 vs. 141 deaths)[2].
The regulatory approvals were based on efficacy and safety data from another study, the three-year Pivotal Fracture Trial involving more than 7,700 women. In this study, Aclasta was shown to increase bone strength and reduce the risk of spine fractures by 70% and hip fractures by 41%. The reduction in spine fractures was sustained over three years, and bone mineral density increased significantly in the spine by 6.7% and in the hip by 6% in women on Aclasta compared to placebo[1].
Osteoporotic fracture risk is often under-diagnosed and under-treated, resulting in sub-optimal outcomes and costs to healthcare systems[7]. Fractures can lead to reduced quality of life and loss of independence; someone with osteoporosis may also become partially disabled or immobilized, thereby requiring long-term care.
In women over age 45, osteoporosis accounts for more days spent in hospital than many other diseases, including diabetes, myocardial infarction (or heart attack) and breast cancer[8]. In 2000, the total direct costs related to osteoporotic fractures were estimated at 31.7 billion; these are forecast to increase to 76.7 billion in 2050 based on the expected changes in the demography of Europe[9].
Aclasta is now approved in more than 30 countries for the treatment of post-menopausal osteoporosis and in more than 60 countries including the US, Canada and the EU for the treatment of Paget's disease, the second most common metabolic bone disorder. Additional studies are ongoing to examine treatment of corticosteroid-induced osteoporosis, male osteoporosis, and prevention of bone loss in osteopenic patients.
The active ingredient in Aclasta is zoledronic acid, which is also available in a different dosage under the brand name Zometa (zoledronic acid 4 mg) Injection for use in certain oncology indications.
Aclasta was found to be generally safe and well tolerated in clinical trials. The most common adverse events associated with Aclasta were transient post-dose symptoms such as fever and muscle pain. Most of these symptoms occurred within the first three days following Aclasta administration and resolved within three days. The incidence of post-dose symptoms can be reduced with the administration of paracetamol or ibuprofen shortly following Aclasta infusion.
In the Pivotal Fracture Trial an increased number of cases of atrial fibrillation serious adverse events were observed in women given Aclasta compared to those on placebo (1.3% vs. 0.6% respectively). However, this finding has not been observed in other clinical studies or in post-marketing experience with over 1.5 million patients treated with zoledronic acid for oncology indications. In the Recurrent Fracture Trial, atrial fibrillation serious adverse events occurred in 1.1% of Aclasta-treated patients compared to 1.3% of placebo-treated patients. No spontaneous reports of osteonecrosis of the jaw (ONJ) - a rare occurrence in the osteoporosis population treated with bisphosphonates were seen in either the Pivotal Fracture Trial or Recurrent Fracture Trial.
Disclaimer
The foregoing press release contains forward-looking statements that can be identified by the use of forward-looking terminology such as "can", "potential", "expected", "will", "should", similar expressions or express or implied discussions regarding potential future regulatory submissions or approvals with respect to, or future sales of, of Aclasta, Reclast or Zometa. Such forward-looking statements reflect the current views of Novartis and involve known and unknown risks, uncertainties and other factors that may cause actual results to be materially different from any future results, performance or achievements expressed or implied by such statements. There can be no guarantee that Aclasta,Reclast or Zometa will be approved for any additional indications in the EU, US or any additional markets or that Aclasta, Reclast or Zometa will reach any particular level of sales. In particular, management's expectations regarding Aclasta, Reclast and Zometa could be affected by, among other things, unexpected regulatory actions or delays or government regulation generally; unexpected clinical trial results, including unexpected additional analysis of existing clinical data, and unexpected new clinical data; competition in general; government, industry, and general public pricing pressures; the company's ability to obtain or maintain patent or other proprietary intellectual property protection; as well as the additional factors discussed in Novartis AG's Form 20-F filed with the US Securities and Exchange Commission. Should one or more of these risks or uncertainties materialize, or should underlying assumptions prove incorrect, actual results may vary materially from those described herein as anticipated, believed, estimated or expected. Novartis is providing this information as of this date and does not undertake any obligation to update any forward-looking statements contained in this document as a result of new information, future events or otherwise.
About Novartis
Novartis AG (NYSE: NVS) is a world leader in offering medicines to protect health, cure disease and improve well-being. Our goal is to discover, develop and successfully market innovative products to treat patients, ease suffering and enhance the quality of life. We are strengthening our medicine-based portfolio, which is focused on strategic growth platforms in innovation-driven pharmaceuticals, high-quality and low-cost generics, human vaccines and leading self-medication OTC brands. Novartis is the only company with leadership positions in these areas. In 2006, the Group's businesses achieved net sales of USD 37.0 billion and net income of USD 7.2 billion. Approximately USD 5.4 billion was invested in R&D. Headquartered in Basel, Switzerland, Novartis Group companies employ more than 100,000 associates and operate in over 140 countries around the world. For more information, please visit novartis.
References
[1] Black D, Delmas S, Eastell R et al for the HORIZON Pivotal Fracture Trial. Once-Yearly Zoledronic Acid for Treatment of Postmenopausal Osteoporosis. NEJM 2007; 356(18): 1809-22.
[2] Lyles KW, Colon-Emeric CS, Magaziner JS et al for the HORIZON Recurrent Fracture Trial. Zoledronic Acid and Clinical Fractures and Mortality after Hip Fracture. NEJM 2007;357:10.1056/NEJMoa074941, published online Sept 17 2007.
[3] National Institutes of Health Osteoporosis and Related Bone Diseases National Resource Center. Osteoporosis Overview. Department of Health and Human Services.
[4] Saag K, Lindsay R, Kriegman A et al. A single zoledronic acid 5mg infusion is preferred over weekly 70 mg oral alendronate in a clinical trial of postmenopausal women with osteoporosis/osteopenia. Osteo Int 2006; 17(1):S1-124.
[5] Omizo M, McClung M, Minkoff J et al. A single infusion is preferred to oral weekly treatment in post-menopausal women with low bone mineral density previously treated with alendronate. Presented at 28th Annual meeting of the American Society for Bone and Mineral Research (ASBMR), 15-19 September 2006, Philadelphia, USA. Forthcoming 2007.
[6] Cooper C. Epidemiology of osteoporosis. Osteoporosis Int 1999;9 (Suppl2):S2-8 Available at iofbonehealth/health-professionals/about osteoporosis/epidemiology.html. Accessed on September 1, 2007.
[7] Siris E, Miller P, Barrett-Connor E et al. Identification and fracture outcomes of undiagnosed low bone mineral density in postmenopausal women: results from the National Osteoporosis Risk Assessment. JAMA 2001; 286:2815-22.
[8] Kanis JA, Delmas P, Burckhardt P et al. Guidelines for diagnosis and management of osteoporosis. The European Foundation for Osteoporosis and Bone Disease. Osteoporos Int 1997; 7:390-406
[9] Kanis JA and Johnell O. Requirements for DXA for the management of osteoporosis in Europe. Osteoporos Int 2005; 16:229.
View drug information on Reclast; Zometa.
среда, 24 августа 2011 г.
Treating Femoral Fractures With Limited Resources
An article published in The Journal of Bone and Joint Surgery, British Volume demonstrates that in cases where resources are limited and there is a delay from injury to treatment, femoral fractures can heal successfully without stabilisation by external or internal fixation.
The research was based on treatment of patients at a Red Cross Hospital in Kenya where injuries consisted of bullet wounds caused during the current conflict in neighbouring Sudan and therefore there was over 24 hours between injury and treatment owing to the long distances involved and lack of available transport. In current practice it is believed that these wounds must be treated without delay, despite the fact that recent reports have shown that delays up to 24 hours do not affect the outcome.
While the authors do not advocate delaying treatment, of the 52 patients treated for ballistic fractures of the femur three required amputation for persisting infection. 48 of the fractures healed, with 15 patients mobilised early requiring only plaster protection acting as a simple form of functional brace.
With the advances in fractures techniques, methods such as traction and plaster have come to be seen as inadequate, however, the study shows that femoral fractures can heal in times when resources are limited, such as in less developed countries.
Click here to Read the full text article.
Notes
- The Journal of Bone and Joint Surgery - British Volume is a world leading orthopaedics journal with an Impact Factor of 1.868
- JBJS-Br publishes twelve issues a year of high-quality, peer-reviewed research, overseen by an international editorial board led by Editor James Scott
- The Journal was first published in 1948 by The British Editorial Society of Bone and Joint Surgery, a registered charity (No. 209299), with the object of the advancement and improvement of education in orthopaedic surgery and allied branches of surgery and the diffusion of knowledge of new and improved methods of teaching and practicing orthopaedic surgery in all its branches
- You can find out more about The Journal at jbjs.uk
Source
Becky Hall
The Journal of Bone and Joint Surgery - British Volume
The research was based on treatment of patients at a Red Cross Hospital in Kenya where injuries consisted of bullet wounds caused during the current conflict in neighbouring Sudan and therefore there was over 24 hours between injury and treatment owing to the long distances involved and lack of available transport. In current practice it is believed that these wounds must be treated without delay, despite the fact that recent reports have shown that delays up to 24 hours do not affect the outcome.
While the authors do not advocate delaying treatment, of the 52 patients treated for ballistic fractures of the femur three required amputation for persisting infection. 48 of the fractures healed, with 15 patients mobilised early requiring only plaster protection acting as a simple form of functional brace.
With the advances in fractures techniques, methods such as traction and plaster have come to be seen as inadequate, however, the study shows that femoral fractures can heal in times when resources are limited, such as in less developed countries.
Click here to Read the full text article.
Notes
- The Journal of Bone and Joint Surgery - British Volume is a world leading orthopaedics journal with an Impact Factor of 1.868
- JBJS-Br publishes twelve issues a year of high-quality, peer-reviewed research, overseen by an international editorial board led by Editor James Scott
- The Journal was first published in 1948 by The British Editorial Society of Bone and Joint Surgery, a registered charity (No. 209299), with the object of the advancement and improvement of education in orthopaedic surgery and allied branches of surgery and the diffusion of knowledge of new and improved methods of teaching and practicing orthopaedic surgery in all its branches
- You can find out more about The Journal at jbjs.uk
Source
Becky Hall
The Journal of Bone and Joint Surgery - British Volume
воскресенье, 21 августа 2011 г.
Perceptions Of Risk Aggravating Stress Epidemic
Britain is facing a stress epidemic as more than 77% of people surveyed by the British College of Osteopathic Medicine (BCOM) claim that the current risk of economic uncertainty has increased theirs or their partner's stress levels.
A staggering 79% of those same respondents claimed to have lost their job or become aware that they are at risk of losing it within the past 3-6 months, even though, when pushed, only 29% of those respondents could say with any certainty that they or their partner had already lost their job or that they were liable to lose it, highlighting the gap between actual reality and anticipation of what could happen. Asked whether the media portrayal of the economic situation was creating more stress for them almost 79% claimed that it was.
In addition, 72% said that the stress experienced by themselves or their partner was also manifesting itself physically. Asked for the way in which their stress was presenting itself the majority (45%) said they felt depressed, followed by 20% citing insomnia and 9% with 'chronic pain' such as back pain and RSI. Stress-induced headaches and migraine were cited by 8%, and 6% with psoriasis or eczema.
Asked how significant an impact the stress was having on close relationships with family friends 14% said it was 'very significant', followed by 44% claiming it was 'fairly significant'. However, when asked what steps they were taking in order to combat the stress 55% claimed to be focussed more on exercise and healthy diet, followed by 34% who simply said they were 'doing nothing'; 13% said they were using prescribed medication, compared with almost 7% on alternative medication. In terms of physical therapies, massage fared well with almost 13% claiming to use it to manage, and 2% using osteopathy specifically.
When asked what would encourage them to take up a physical therapy to treat their stress 57% said the cost, 44% said better information, 33% said easier access to facilities and 22% said more widely publicised scientific results.
Dr. Ian Drysdale, College Principal, said, "This survey shows not only how the obvious factors of economic uncertainty affect our stress levels, but that the cost of then taking up activities or treatments that could combat the stress is an equally important factor. We hear of so many different treatments out there that all claim to alleviate stress but many of them are still inaccessible to far too many. It also highlights the importance of clearer communication of the benefits of alternative and physical therapies as well as more evidence-based benefits of such therapies"
About BCOM
The British College of Osteopathic Medicine (BCOM) was founded in 1936 by Stanley Lief, the eminent naturopathic osteopath. It is a statutory regulated and accredited training facility, educational charity and centre of excellence in Osteopathic education, regulated by the Osteopaths act of 1993 and accredited by the General Osteopathic Council.
BCOM clinics provide high quality, low-cost treatment based on holistic, or naturopathic, osteopathy. This is a uniquely integrated approach, centring on the treatment and education of our patients not only in terms of their particular problem, but also in the wider context of their lifestyle and its effect on them.
Men, women and children of all ages come to BCOM Clinics for treatment of a wide variety of conditions. Patients are assured of the highest standards of care, with all treatments carried out by clinical students under strict supervision of qualified and experienced osteopaths.
Since its formation in 1936, the British College of Osteopathic Medicine has achieved an international reputation for the professional excellence of its teaching and qualifications. In 2008, BCOM launched its undergraduate Masters in Osteopathy, providing public funding to eligible students.
Source
British College of Osteopathic Medicine
A staggering 79% of those same respondents claimed to have lost their job or become aware that they are at risk of losing it within the past 3-6 months, even though, when pushed, only 29% of those respondents could say with any certainty that they or their partner had already lost their job or that they were liable to lose it, highlighting the gap between actual reality and anticipation of what could happen. Asked whether the media portrayal of the economic situation was creating more stress for them almost 79% claimed that it was.
In addition, 72% said that the stress experienced by themselves or their partner was also manifesting itself physically. Asked for the way in which their stress was presenting itself the majority (45%) said they felt depressed, followed by 20% citing insomnia and 9% with 'chronic pain' such as back pain and RSI. Stress-induced headaches and migraine were cited by 8%, and 6% with psoriasis or eczema.
Asked how significant an impact the stress was having on close relationships with family friends 14% said it was 'very significant', followed by 44% claiming it was 'fairly significant'. However, when asked what steps they were taking in order to combat the stress 55% claimed to be focussed more on exercise and healthy diet, followed by 34% who simply said they were 'doing nothing'; 13% said they were using prescribed medication, compared with almost 7% on alternative medication. In terms of physical therapies, massage fared well with almost 13% claiming to use it to manage, and 2% using osteopathy specifically.
When asked what would encourage them to take up a physical therapy to treat their stress 57% said the cost, 44% said better information, 33% said easier access to facilities and 22% said more widely publicised scientific results.
Dr. Ian Drysdale, College Principal, said, "This survey shows not only how the obvious factors of economic uncertainty affect our stress levels, but that the cost of then taking up activities or treatments that could combat the stress is an equally important factor. We hear of so many different treatments out there that all claim to alleviate stress but many of them are still inaccessible to far too many. It also highlights the importance of clearer communication of the benefits of alternative and physical therapies as well as more evidence-based benefits of such therapies"
About BCOM
The British College of Osteopathic Medicine (BCOM) was founded in 1936 by Stanley Lief, the eminent naturopathic osteopath. It is a statutory regulated and accredited training facility, educational charity and centre of excellence in Osteopathic education, regulated by the Osteopaths act of 1993 and accredited by the General Osteopathic Council.
BCOM clinics provide high quality, low-cost treatment based on holistic, or naturopathic, osteopathy. This is a uniquely integrated approach, centring on the treatment and education of our patients not only in terms of their particular problem, but also in the wider context of their lifestyle and its effect on them.
Men, women and children of all ages come to BCOM Clinics for treatment of a wide variety of conditions. Patients are assured of the highest standards of care, with all treatments carried out by clinical students under strict supervision of qualified and experienced osteopaths.
Since its formation in 1936, the British College of Osteopathic Medicine has achieved an international reputation for the professional excellence of its teaching and qualifications. In 2008, BCOM launched its undergraduate Masters in Osteopathy, providing public funding to eligible students.
Source
British College of Osteopathic Medicine
четверг, 18 августа 2011 г.
Value Of Calcium And Vitamin D Supplements For Older Women
What benefits are there for older women if they take Calcium and Vitamin D supplements? A new study found that a woman's risk of having a hip fracture goes down, but her risk of other types of fractures remain the same. Researchers also found that the supplements did not alter a post-menopausal woman's risk of developing colorectal cancer.
The research was carried out by the Women's Health Initiative, USA.
The study, of 36,000 menopausal women, found a 1% improvement in bone density as a result of taking Calcium and Vitamin D supplements for 7 years. Hip fractures went down 29% (for women over 60 it was 29%).
The study found the benefits were only there for women who took their supplements regularly, at least four days out of every five.
Written by:
The research was carried out by the Women's Health Initiative, USA.
The study, of 36,000 menopausal women, found a 1% improvement in bone density as a result of taking Calcium and Vitamin D supplements for 7 years. Hip fractures went down 29% (for women over 60 it was 29%).
The study found the benefits were only there for women who took their supplements regularly, at least four days out of every five.
Written by:
понедельник, 15 августа 2011 г.
Blue Cross And Blue Shield Companies To Reimburse SBi's Star™ Total Ankle Replacement
Small Bone Innovations, Inc. (SBi) announced today that 38 of the 39 independent member companies of the BlueCross and BlueShield Association will cover SBi's STAR™ Total Ankle Replacement system to benefit an estimated 98.5 million insured in 49 states.
SBi is an orthopedics company focused exclusively on serving patients and their physicians with technologies and treatments for joint replacement (arthroplasty) and post-traumatic reconstruction of the small bones & joints of the thumb, fingers, hand, wrist, elbow, toes, foot and ankle.
According to SBi, more than 90 percent of the approximately 175 million members of commercial insurance plans in the U.S. now have access to the STAR ankle replacement surgery, when deemed clinically appropriate by experienced surgeons.
"The STAR ankle is the first and only total ankle replacement system to have performed successfully in the FDA's rigorous pre-market approval (PMA) process," said James A. Nunley II, MD1, Chief of Orthopaedic Surgery at Duke University Medical Center in Durham, NC. "The compelling clinical data from the prospective, multi-center U.S. Investigational Device Exemption (IDE) STAR Ankle clinical trial, initiated in 2000, has been instrumental in the current stream of favorable coverage decisions by insurers as well as independent non-profit health care institutions." Dr. Nunley is a clinical investigator in the STAR clinical trials who has assisted in SBi's effort to benefit patients by changes in reimbursement policies.
"The STAR ankle is the only total ankle replacement indicated for use as a 'non-cemented' implant to replace painful ankle joints affected by osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. In the IDE clinical trials, the STAR ankle was deemed superior in efficacy and comparable in safety when compared to fusion, for treating ankle arthritis." Dr. Nunley added.
1 Dr. Nunley is paid consultant to SBi - providing education services.
Source:
Small Bone Innovations, Inc.
SBi is an orthopedics company focused exclusively on serving patients and their physicians with technologies and treatments for joint replacement (arthroplasty) and post-traumatic reconstruction of the small bones & joints of the thumb, fingers, hand, wrist, elbow, toes, foot and ankle.
According to SBi, more than 90 percent of the approximately 175 million members of commercial insurance plans in the U.S. now have access to the STAR ankle replacement surgery, when deemed clinically appropriate by experienced surgeons.
"The STAR ankle is the first and only total ankle replacement system to have performed successfully in the FDA's rigorous pre-market approval (PMA) process," said James A. Nunley II, MD1, Chief of Orthopaedic Surgery at Duke University Medical Center in Durham, NC. "The compelling clinical data from the prospective, multi-center U.S. Investigational Device Exemption (IDE) STAR Ankle clinical trial, initiated in 2000, has been instrumental in the current stream of favorable coverage decisions by insurers as well as independent non-profit health care institutions." Dr. Nunley is a clinical investigator in the STAR clinical trials who has assisted in SBi's effort to benefit patients by changes in reimbursement policies.
"The STAR ankle is the only total ankle replacement indicated for use as a 'non-cemented' implant to replace painful ankle joints affected by osteoarthritis, rheumatoid arthritis, and post-traumatic arthritis. In the IDE clinical trials, the STAR ankle was deemed superior in efficacy and comparable in safety when compared to fusion, for treating ankle arthritis." Dr. Nunley added.
1 Dr. Nunley is paid consultant to SBi - providing education services.
Source:
Small Bone Innovations, Inc.
пятница, 12 августа 2011 г.
Kiadis Pharma Announces Positive Clinical Results For ATIR(TM) In Mismatched Bone Marrow Transplantations
Biopharmaceutical company Kiadis Pharma announces that it has successfully completed treatment of the last patient on its ATIR(TM) phase I/II clinical trial. ATIR(TM), a donor lymphocyte cell based product, is under development to prevent acute Graft versus Host Disease (GvHD) and allow early immune reconstitution following a mismatched bone marrow transplantation. Nineteen end stage blood cancer patients were treated with no cases of grade III/IV acute GvHD occurring within the first 100 days after ATIR(TM) infusion, showing the feasibility and tolerability of the addition of ATIR(TM) in combination with a mismatched transplant procedure.
Following scientific advice from the EMEA Kiadis Pharma is preparing to initiate a multi center multinational pivotal study starting recruitment early 2009. In this study the efficacy of ATIR(TM) will be investigated in patients diagnosed with AML, ALL or MDS eligible for an allogeneic bone marrow transplantation but for whom no matching donor is available.
"Bone marrow transplantations are often the only treatment option left for end-stage blood cancer patients. But too many patients simply do not find a suitable matched donor in time" says Dr. Denis-Claude Roy of the Maisonneuve-Rosemont Hospital in Montreal, the principal investigator on the study. "Our study shows a rapid immune reconstitution in transplanted patients provided with ATIR(TM) treated immune cells from mismatched donors. Without ATIR(TM) treatment this would not be possible because of the high risk of acute Graft versus Host Disease with mismatched donor immune cells. This is obviously a very hopeful development for a large patient group."
Dr. Manja Bouman, CEO of Kiadis Pharma, says "The results of this clinical trial are very encouraging and it is another important milestone in the development of ATIR(TM) as a novel approach which may enable a safe and potentially life-saving mismatched bone marrow transplantation as a treatment option for end-stage blood cancer patients."
For the complete press release please go to: kiadis/news
English release is provided by Kiadis Pharma. Equivalent translations are from a third party.
Kiadis Pharma
kiadis
Following scientific advice from the EMEA Kiadis Pharma is preparing to initiate a multi center multinational pivotal study starting recruitment early 2009. In this study the efficacy of ATIR(TM) will be investigated in patients diagnosed with AML, ALL or MDS eligible for an allogeneic bone marrow transplantation but for whom no matching donor is available.
"Bone marrow transplantations are often the only treatment option left for end-stage blood cancer patients. But too many patients simply do not find a suitable matched donor in time" says Dr. Denis-Claude Roy of the Maisonneuve-Rosemont Hospital in Montreal, the principal investigator on the study. "Our study shows a rapid immune reconstitution in transplanted patients provided with ATIR(TM) treated immune cells from mismatched donors. Without ATIR(TM) treatment this would not be possible because of the high risk of acute Graft versus Host Disease with mismatched donor immune cells. This is obviously a very hopeful development for a large patient group."
Dr. Manja Bouman, CEO of Kiadis Pharma, says "The results of this clinical trial are very encouraging and it is another important milestone in the development of ATIR(TM) as a novel approach which may enable a safe and potentially life-saving mismatched bone marrow transplantation as a treatment option for end-stage blood cancer patients."
For the complete press release please go to: kiadis/news
English release is provided by Kiadis Pharma. Equivalent translations are from a third party.
Kiadis Pharma
kiadis
вторник, 9 августа 2011 г.
Camping Injuries Can Be A Bear
Camping, hiking, and other similar activities are great ways to get fresh air, exercise and recreation all at the same time; however, they also offer the potential for serious injuries if campers do not take care. If you plan to head back to nature before summer's end or as the leaves change colors in the fall, the American Academy of Orthopaedic Surgeons (AAOS) has recommendations to help you stay safe while camping in the great outdoors.
According to the U.S. Consumer Products Safety Commission:
-- In 2007, more than 11,000 people were treated in hospital emergency rooms, doctors' offices, clinics and other medical settings for injuries sustained while camping.
-- These numbers do not include those injured while using cots, trailers, stoves, and other camping equipment.
Musculoskeletal injuries can include:
-- Sprains
-- Fractures of the ankle and wrist
-- Shoulder strains and lacerations
"You should always try to camp with at least one partner, so if someone gets hurt, the other person can help," says John D. Kelly, IV, MD, spokesperson for the AAOS and an orthopaedic surgeon in Philadelphia. "Also, before you leave for the camping trip, be sure to notify someone at home where you are going and when you expect to return."
The Academy offers the following strategies to prevent injuries while camping:
-- Bring a first aid kit and understand how to use its contents.
Suggested items for a first kit include: clean dressings and adhesives, antibiotic ointment, sterile gauze, simple splinting materials two wooden sticks with an sports elastic bandage should be suffice, a smoke flare, a chemical ice pack, a small-utility knife, a charged cell phone or other communication device.
Camping and hiking often involve rough terrain, making slips and falls common.
o Be sure to wear the right footwear, especially hiking boots, which offer support and traction.
If a camper or hiker twists an ankle:
-- Apply compression in the form of a wrap
-- If available, apply ice and elevate the limb
-- Try to walk sparingly.
Should a severe cut or laceration occur:
-- Apply direct pressure to control bleeding and use tap water to rinse the wound thoroughly.
-- If dressings are available, apply to the wound otherwise a clean cloth will suffice.
If a camper or hiker sprains a muscle, it should be wrapped and iced.
Should a sprain to the wrist or a fracture occur, you should apply an ice pack and immobilize the area with a splint.
Other important camping tips:
-- Be aware of potentially harmful animals or plants in the area and know what to do if injured by one.
-- Stay well hydrated.
-- Drink plenty of water, even if the weather is not hot.
-- Learn to recognize the signs of dehydration.
-- Wear sunscreen and insect repellent.
-- Use tools only for their intended purpose, for example:
-- Using a knife to open a can or cut wood can result in a serious laceration.
Mountain biking, rafting and kayaking can be dangerous. Do not attempt activities or stunts that are beyond your ability. Be sure protective gear, such as helmets, gloves and shoes fit properly and are appropriate to the activity.
o Bring appropriate clothing for the climate, keeping in mind that weather can change drastically between day and night. Check weather forecasts before you go.
Finally, please keep in mind that these tips are especially important when camping with children, who are more likely to get lost and are more susceptible to dehydration and other common camping injuries.
Tips to prepare for an emergency or disaster (orthoinfo.aaos/topic.cfm?topic=A00059)
Orthoinfo (orthoinfo)
American Academy of Orthopaedic Surgeons (AAOS)
6300 N River Rd.
Rosemont, IL 60018
United States
aaos
According to the U.S. Consumer Products Safety Commission:
-- In 2007, more than 11,000 people were treated in hospital emergency rooms, doctors' offices, clinics and other medical settings for injuries sustained while camping.
-- These numbers do not include those injured while using cots, trailers, stoves, and other camping equipment.
Musculoskeletal injuries can include:
-- Sprains
-- Fractures of the ankle and wrist
-- Shoulder strains and lacerations
"You should always try to camp with at least one partner, so if someone gets hurt, the other person can help," says John D. Kelly, IV, MD, spokesperson for the AAOS and an orthopaedic surgeon in Philadelphia. "Also, before you leave for the camping trip, be sure to notify someone at home where you are going and when you expect to return."
The Academy offers the following strategies to prevent injuries while camping:
-- Bring a first aid kit and understand how to use its contents.
Suggested items for a first kit include: clean dressings and adhesives, antibiotic ointment, sterile gauze, simple splinting materials two wooden sticks with an sports elastic bandage should be suffice, a smoke flare, a chemical ice pack, a small-utility knife, a charged cell phone or other communication device.
Camping and hiking often involve rough terrain, making slips and falls common.
o Be sure to wear the right footwear, especially hiking boots, which offer support and traction.
If a camper or hiker twists an ankle:
-- Apply compression in the form of a wrap
-- If available, apply ice and elevate the limb
-- Try to walk sparingly.
Should a severe cut or laceration occur:
-- Apply direct pressure to control bleeding and use tap water to rinse the wound thoroughly.
-- If dressings are available, apply to the wound otherwise a clean cloth will suffice.
If a camper or hiker sprains a muscle, it should be wrapped and iced.
Should a sprain to the wrist or a fracture occur, you should apply an ice pack and immobilize the area with a splint.
Other important camping tips:
-- Be aware of potentially harmful animals or plants in the area and know what to do if injured by one.
-- Stay well hydrated.
-- Drink plenty of water, even if the weather is not hot.
-- Learn to recognize the signs of dehydration.
-- Wear sunscreen and insect repellent.
-- Use tools only for their intended purpose, for example:
-- Using a knife to open a can or cut wood can result in a serious laceration.
Mountain biking, rafting and kayaking can be dangerous. Do not attempt activities or stunts that are beyond your ability. Be sure protective gear, such as helmets, gloves and shoes fit properly and are appropriate to the activity.
o Bring appropriate clothing for the climate, keeping in mind that weather can change drastically between day and night. Check weather forecasts before you go.
Finally, please keep in mind that these tips are especially important when camping with children, who are more likely to get lost and are more susceptible to dehydration and other common camping injuries.
Tips to prepare for an emergency or disaster (orthoinfo.aaos/topic.cfm?topic=A00059)
Orthoinfo (orthoinfo)
American Academy of Orthopaedic Surgeons (AAOS)
6300 N River Rd.
Rosemont, IL 60018
United States
aaos
суббота, 6 августа 2011 г.
For Orthopedic Injuries, A Robot That Follows Patients As They Move
The MRI and CT scan may one day have a robotic cousin capable of following and peering into patients as they move around.
A University of Florida engineer has designed a robot to shadow and shoot X-ray video of sufferers of orthopedic injuries as they walk, climb stairs, stand up from a seated position or pursue other normal activities - and maybe even athletic ones like swinging a bat.
UF mechanical and aerospace engineer Scott Banks' goal is to augment static images of patients' bones, muscles and joints with an interior view of these and other parts in action during normal physical activity. By merging such full-motion X-rays with computerized representations, orthopedic surgeons will make better diagnoses, suggest more appropriate treatments and get a clearer idea of post-operative successes and failures, he said.
"Our goal is come up with a way to observe and measure how joints are moving when people are actually using them," Banks said. "We think this will be tremendously powerful, not only for research but also in the clinical setting as well."
Complaints about orthopedic injuries are among the most common reasons people visit the doctor, according to the American Academy of Orthopedic Surgeons. More than 8 million people were hospitalized in 2003 for musculoskeletal conditions or injuries, which are estimated to cost the United States at least $215 billion annually.
Orthopedic surgeons have long diagnosed patients by touch or with static X-rays, MRI and CT scans. They also may use X-ray video, but current technologies provide only a tight view of a very limited range of motion in a controlled laboratory setting.
While all of these techniques can be effective, they do not work well with injuries that manifest themselves when a joint is in motion, Banks said. These include, for example, injuries to the patella, or kneecap, and injuries of the shoulder. Surgeons sometimes have to operate to diagnose these and other injuries, which can lead to unnecessary surgeries.
After operations, surgeons have few tools beyond the patient's experience to tell them whether a procedure worked as intended and whether it will forestall additional joint damage.
Banks hopes his robot - actually, a system that uses two robots because one robot will be necessary to shoot the X-ray video and another to hold the image sensor -- will lead to a radical improvement.
He has one working robot currently. The robot, which has a one-meter mechanical arm, is a commercial product normally used in robotically assisted surgeries and silicon chip manufacturing that Banks and his graduate students have re-engineered. The robot can shadow a person's knee, shoulder or other joint with its hand as he or she moves.
In its completed form, the hand will hold lightweight equipment capable of shooting X-rays, while another robot will hold the sensor that captures images of the body as moving videos. Although the robots will be attached to a fixed base, there is room for a person to move around normally within their reach. And in the future, said Banks, "we could put these robots on wheels and they could follow you around."
For now, the single robot holds a standard video camera.
To use it, a patient wears an LED-lit patch on the body part that is intended for targeting. The patch, several cameras placed around the room and a networked computer command the robots to hone in on and track the joint.
In a slightly spooky demonstration, using a graduate student instead of a patient, the camera-tipped hand followed the student's thigh as he walked and otherwise moved normally. While the hand appeared accurate to the untrained eye, Banks said the video image, which included shots of the student's jeans, showed that it couldn't yet track the small LED patch with the accuracy needed for video X-ray.
Improving the accuracy is one of several challenges that remain in the project, Banks said. He has applied for a $275,000 grant from the National Institutes of Health to continue the work. UF has also applied for a patent on the new imaging technique, and Banks said it's possible that it could become standard equipment in hospitals.
Mike Moser, a UF orthopedic surgeon working with Banks on the project, said he thinks the robot system would be very useful to surgeons.
"The biggest thing that this technology could offer in treating orthopedic injuries is that it has the ability to visualize joint motion dynamically, as it changes," he said. "I think this would be good for many different conditions of the shoulder, knee, elbow and ankle. And I think it could be extrapolated to pretty much any orthopedic injury or condition."
Scott Banks
banksufl
University of Florida
ufl
A University of Florida engineer has designed a robot to shadow and shoot X-ray video of sufferers of orthopedic injuries as they walk, climb stairs, stand up from a seated position or pursue other normal activities - and maybe even athletic ones like swinging a bat.
UF mechanical and aerospace engineer Scott Banks' goal is to augment static images of patients' bones, muscles and joints with an interior view of these and other parts in action during normal physical activity. By merging such full-motion X-rays with computerized representations, orthopedic surgeons will make better diagnoses, suggest more appropriate treatments and get a clearer idea of post-operative successes and failures, he said.
"Our goal is come up with a way to observe and measure how joints are moving when people are actually using them," Banks said. "We think this will be tremendously powerful, not only for research but also in the clinical setting as well."
Complaints about orthopedic injuries are among the most common reasons people visit the doctor, according to the American Academy of Orthopedic Surgeons. More than 8 million people were hospitalized in 2003 for musculoskeletal conditions or injuries, which are estimated to cost the United States at least $215 billion annually.
Orthopedic surgeons have long diagnosed patients by touch or with static X-rays, MRI and CT scans. They also may use X-ray video, but current technologies provide only a tight view of a very limited range of motion in a controlled laboratory setting.
While all of these techniques can be effective, they do not work well with injuries that manifest themselves when a joint is in motion, Banks said. These include, for example, injuries to the patella, or kneecap, and injuries of the shoulder. Surgeons sometimes have to operate to diagnose these and other injuries, which can lead to unnecessary surgeries.
After operations, surgeons have few tools beyond the patient's experience to tell them whether a procedure worked as intended and whether it will forestall additional joint damage.
Banks hopes his robot - actually, a system that uses two robots because one robot will be necessary to shoot the X-ray video and another to hold the image sensor -- will lead to a radical improvement.
He has one working robot currently. The robot, which has a one-meter mechanical arm, is a commercial product normally used in robotically assisted surgeries and silicon chip manufacturing that Banks and his graduate students have re-engineered. The robot can shadow a person's knee, shoulder or other joint with its hand as he or she moves.
In its completed form, the hand will hold lightweight equipment capable of shooting X-rays, while another robot will hold the sensor that captures images of the body as moving videos. Although the robots will be attached to a fixed base, there is room for a person to move around normally within their reach. And in the future, said Banks, "we could put these robots on wheels and they could follow you around."
For now, the single robot holds a standard video camera.
To use it, a patient wears an LED-lit patch on the body part that is intended for targeting. The patch, several cameras placed around the room and a networked computer command the robots to hone in on and track the joint.
In a slightly spooky demonstration, using a graduate student instead of a patient, the camera-tipped hand followed the student's thigh as he walked and otherwise moved normally. While the hand appeared accurate to the untrained eye, Banks said the video image, which included shots of the student's jeans, showed that it couldn't yet track the small LED patch with the accuracy needed for video X-ray.
Improving the accuracy is one of several challenges that remain in the project, Banks said. He has applied for a $275,000 grant from the National Institutes of Health to continue the work. UF has also applied for a patent on the new imaging technique, and Banks said it's possible that it could become standard equipment in hospitals.
Mike Moser, a UF orthopedic surgeon working with Banks on the project, said he thinks the robot system would be very useful to surgeons.
"The biggest thing that this technology could offer in treating orthopedic injuries is that it has the ability to visualize joint motion dynamically, as it changes," he said. "I think this would be good for many different conditions of the shoulder, knee, elbow and ankle. And I think it could be extrapolated to pretty much any orthopedic injury or condition."
Scott Banks
banksufl
University of Florida
ufl
среда, 3 августа 2011 г.
Discovery Of How Rheumatoid Arthritis Causes Bone Loss Holds Implications For Autoimmune Disease And Osteoporosis
Researchers have discovered key details of how rheumatoid arthritis (RA) destroys bone, according to a study published in the Aug. 22 edition of the Journal of Biological Chemistry. The findings are already guiding attempts to design new drugs to reverse RA-related bone loss and may also address more common forms of osteoporosis with a few adjustments.
Two million Americans suffer from rheumatoid arthritis (RA), which causes swelling, pain and deformity in joints and also lead to the thinning of bone. In autoimmune diseases like RA, the body's disease-fighting immune cells mistakenly identify parts of a person's body as foreign invaders, akin to bacteria, and produce chemicals to destroy them. Among the immune chemicals known to play a central in autoimmune disease is tumor necrosis factor alpha (TNF alpha), which ramps up the production of immune cells and chemicals as part of the body's response to disease. When overproduced in RA patients, TNF alpha signals for the destruction of cartilage and bone.
Beyond its control over immune cells, TNF alpha also influences bone mass. Human bone is continually regenerated to maintain strength. Under the control of signaling molecules which include TNF alpha, two cell types, balanced against each other, make bone recycling possible. Osteoclasts break down aging bone to make way for new bone, while osteoblasts build new bone at the sites where osteoclasts have removed it. Going into the study, the field understood that TNF alpha decreases the number of bone-building osteoblasts, but not how. The current study provides the first direct proof that the TNF alpha affects osteoblasts through an enzyme called Smad Ubiquitin Regulatory Factor 1 (Smurf1), which in turn shuts down two proteins that would otherwise drive bone-building.
While traditional RA drugs like NSAIDs and steroids treat symptoms, a newer class of best-selling drugs (e.g. Humira, Remicade and Enbrel) reverses the disease process by shutting down TNF alpha activity. While the new drugs are effective for many patients, others experience infections and even lymphoma in a few cases. The new drugs are based on bioengineered versions of proteins made by human immune cells called antibodies, and are very expensive to make. Thus, the field has been searching for smaller, simpler chemicals that would be effective, but with lower costs and fewer side effects.
"The significance of our study is that it identifies SMURF1 as the signaling partner through which TNF does damage in RA-related bone loss," said Lianping Xing, Ph.D., assistant professor of Pathology and Laboratory Medicine at the University of Rochester Medical Center. "That has enabled researchers to begin designing small molecule drugs to shut down the action of Smurf 1 and its relatives. Furthermore, since mice engineered to have less Smurf1 expression develop thicker bones, future drugs that shut down Smurf1 may be also useful against more common forms of osteoporosis simply by changing the dose. Of course, this is early-stage work with many obstacles ahead, but it is exciting nonetheless."
Study Details
In the late 1990s, Gerald H. Thomsen, Ph.D., at Stony Brook University in New York discovered that Smurf1 helps to attach a protein tag called ubiquitin to aging proteins in need of disposal. The tag then attracts the attention of cellular machines called proteosomes that degrade proteins.
Xing's team generated two lines of mice - one with high TNF alpha levels and with Smurf1 present, and a second group with high TNF alpha production but no Smurf1. Bone volume and strength of both groups of mice were then examined using a combination of imaging technologies and were compared. Experiments showed that increased TNF alpha levels dramatically decreased the levels of two key factors, Smad1 and Runx2. Both Smad1 and Runx2 signaled to increase the number of bone-building osteoblasts, but only if Smurf1 was present to pass on the signal from TNF alpha.
Genetically engineered mice with the Smurf1 gene removed no longer responded to TNF alpha because Smurf1 was not present to label Smad1 and Runx2 with the ubiquitin destruction tag. As expected, mice with increased TNF alpha had lesser bone mass than their counterparts, a result partially reversed in mice where Smurf1 had been removed.
Bolstering the importance of the current paper is the fact that TNF alpha promotes the destruction of some types of cancer cells. While toxic when administered systemically, it has found a niche in preventing the spread of skin cancer, where it can be injected directly into a tumor. Other drugs then became available that shut down the TNF signal by directly inhibiting the protein-eating proteosomes that receive the signal. There is an existing anti-myeloma drug on the market, bortezomib, which shuts down the proteosomes that Smurf1 partners with to destroy Smad 1 and Runx2.
Thus, Xing's team will be looking at the effect of bortezomib over the next year to see if shutting down proteosomes in bone cells does indeed increase bone mass in mice engineered to have high levels of TNF alpha. Bortezomib, is a general proteosome inhibitor, however, and does not specifically target Smurf 1, and future efforts will seek to identify Smurf1-specific drug candidates. In the meantime, the team is also seeking other groups of ligases that, like Smurf1, contribute to bone loss because experiments revealed that Smurf1 is not responsible for 100 percent of the bone loss under inflammatory conditions.
Along with Xing, the study was led by Ruolin Guo, Motozo Yamashita, Qian Zhang, Quan Zhou, Di Chen, David G. Reynolds, Hani Awad, Laura Yanoso, Lan Zhao, Edward Schwarz, Ying Zhang and Brendan Boyce within the Department of Pathology at University of Rochester. The article published in hard copy was first published online on June 19, 2008.
"Our over-all hypothesis is that in inflammatory diseases like RA, the function of a group of enzymes like Smurf1 gets turned on to cause proteasome degradation of key regulator proteins leading to bone loss," Xing said. "The real, future solution will involve a treatment that specifically addresses each of these."
Source: Greg Williams
University of Rochester Medical Center
View drug information on Enbrel; Humira; Remicade.
Two million Americans suffer from rheumatoid arthritis (RA), which causes swelling, pain and deformity in joints and also lead to the thinning of bone. In autoimmune diseases like RA, the body's disease-fighting immune cells mistakenly identify parts of a person's body as foreign invaders, akin to bacteria, and produce chemicals to destroy them. Among the immune chemicals known to play a central in autoimmune disease is tumor necrosis factor alpha (TNF alpha), which ramps up the production of immune cells and chemicals as part of the body's response to disease. When overproduced in RA patients, TNF alpha signals for the destruction of cartilage and bone.
Beyond its control over immune cells, TNF alpha also influences bone mass. Human bone is continually regenerated to maintain strength. Under the control of signaling molecules which include TNF alpha, two cell types, balanced against each other, make bone recycling possible. Osteoclasts break down aging bone to make way for new bone, while osteoblasts build new bone at the sites where osteoclasts have removed it. Going into the study, the field understood that TNF alpha decreases the number of bone-building osteoblasts, but not how. The current study provides the first direct proof that the TNF alpha affects osteoblasts through an enzyme called Smad Ubiquitin Regulatory Factor 1 (Smurf1), which in turn shuts down two proteins that would otherwise drive bone-building.
While traditional RA drugs like NSAIDs and steroids treat symptoms, a newer class of best-selling drugs (e.g. Humira, Remicade and Enbrel) reverses the disease process by shutting down TNF alpha activity. While the new drugs are effective for many patients, others experience infections and even lymphoma in a few cases. The new drugs are based on bioengineered versions of proteins made by human immune cells called antibodies, and are very expensive to make. Thus, the field has been searching for smaller, simpler chemicals that would be effective, but with lower costs and fewer side effects.
"The significance of our study is that it identifies SMURF1 as the signaling partner through which TNF does damage in RA-related bone loss," said Lianping Xing, Ph.D., assistant professor of Pathology and Laboratory Medicine at the University of Rochester Medical Center. "That has enabled researchers to begin designing small molecule drugs to shut down the action of Smurf 1 and its relatives. Furthermore, since mice engineered to have less Smurf1 expression develop thicker bones, future drugs that shut down Smurf1 may be also useful against more common forms of osteoporosis simply by changing the dose. Of course, this is early-stage work with many obstacles ahead, but it is exciting nonetheless."
Study Details
In the late 1990s, Gerald H. Thomsen, Ph.D., at Stony Brook University in New York discovered that Smurf1 helps to attach a protein tag called ubiquitin to aging proteins in need of disposal. The tag then attracts the attention of cellular machines called proteosomes that degrade proteins.
Xing's team generated two lines of mice - one with high TNF alpha levels and with Smurf1 present, and a second group with high TNF alpha production but no Smurf1. Bone volume and strength of both groups of mice were then examined using a combination of imaging technologies and were compared. Experiments showed that increased TNF alpha levels dramatically decreased the levels of two key factors, Smad1 and Runx2. Both Smad1 and Runx2 signaled to increase the number of bone-building osteoblasts, but only if Smurf1 was present to pass on the signal from TNF alpha.
Genetically engineered mice with the Smurf1 gene removed no longer responded to TNF alpha because Smurf1 was not present to label Smad1 and Runx2 with the ubiquitin destruction tag. As expected, mice with increased TNF alpha had lesser bone mass than their counterparts, a result partially reversed in mice where Smurf1 had been removed.
Bolstering the importance of the current paper is the fact that TNF alpha promotes the destruction of some types of cancer cells. While toxic when administered systemically, it has found a niche in preventing the spread of skin cancer, where it can be injected directly into a tumor. Other drugs then became available that shut down the TNF signal by directly inhibiting the protein-eating proteosomes that receive the signal. There is an existing anti-myeloma drug on the market, bortezomib, which shuts down the proteosomes that Smurf1 partners with to destroy Smad 1 and Runx2.
Thus, Xing's team will be looking at the effect of bortezomib over the next year to see if shutting down proteosomes in bone cells does indeed increase bone mass in mice engineered to have high levels of TNF alpha. Bortezomib, is a general proteosome inhibitor, however, and does not specifically target Smurf 1, and future efforts will seek to identify Smurf1-specific drug candidates. In the meantime, the team is also seeking other groups of ligases that, like Smurf1, contribute to bone loss because experiments revealed that Smurf1 is not responsible for 100 percent of the bone loss under inflammatory conditions.
Along with Xing, the study was led by Ruolin Guo, Motozo Yamashita, Qian Zhang, Quan Zhou, Di Chen, David G. Reynolds, Hani Awad, Laura Yanoso, Lan Zhao, Edward Schwarz, Ying Zhang and Brendan Boyce within the Department of Pathology at University of Rochester. The article published in hard copy was first published online on June 19, 2008.
"Our over-all hypothesis is that in inflammatory diseases like RA, the function of a group of enzymes like Smurf1 gets turned on to cause proteasome degradation of key regulator proteins leading to bone loss," Xing said. "The real, future solution will involve a treatment that specifically addresses each of these."
Source: Greg Williams
University of Rochester Medical Center
View drug information on Enbrel; Humira; Remicade.
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