New data in the June 2011 issue of the Journal of Vascular Surgery®, the official publication of the Society for Vascular Surgery®, reveals that carotid endarterectomy (CEA) may be the preferred treatment for women who require intervention for cerebrovascular disease. The study notes that the results of cartoid angioplasty and stenting (CAS) have not been extensively analyzed in female patients.

According to Caron B. Rockman, MD, lead author and Associate Professor of surgery at New York University Medical Center in New York City, a total of 54,658 cases were reviewed from the Nationwide Inpatient Sample between 2004 and 2005. “A total of 94.2 percent of the patients had CEA while 5.8 percent had CAS,” said Dr. Rockman. “Women comprised 42.3 percent of the analyzed cases and were significantly less likely to undergo CAS than men (5.4 percent vs. 6.1 percent).”

Despite concerns from early randomized trials that women might have higher rates of complications than men after undergoing CEA, in the current study, researchers noted that women and men had equivalent rates of perioperative stroke when undergoing CEA (1.0 percent vs. 1.0 percent) and CAS (2.7 percent vs. 2.0 percent).

Overall, women and men were equally likely to be symptomatic with a previous TIA (transient ischemic attack) or stroke before undergoing their carotid artery procedure (5.3 percent vs. 5.3 percent). It was noted that symptomatic women had a significantly higher overall rate of perioperative stroke than symptomatic men (3.8 vs. 2.3 percent). Dr. Rockman added that although women had a slightly higher complication rate, it was still well within the acceptable range for symptomatic patients undergoing cerebrovascular intervention.

More importantly, asymptomatic women had a significantly lower perioperative stroke rate after CEA than after CAS (0.9 percent vs. 2.1 percent). Rates of perioperative stroke additionally showed a trend favoring CEA as opposed to CAS among symptomatic women (3.4 percent vs. 6.2 percent) as well.

Researchers noted that the benefit of CEA in female patients has been questioned by various randomized, prospective trials particularly in asymptomatic cases; several have noted an increase in perioperative stroke among women after CEA. However, they added that the outcome of carotid angioplasty and stenting had not been extensively examined in women.

“An unexpected finding from our current analysis was that there appears to be a sex-based selection bias with regard to the type of carotid intervention performed,” said Dr. Rockman. “Men were more likely to undergo CAS than women (6.1 percent vs. 5.4 percent) and
asymptomatic men were more likely to undergo CAS than asymptomatic women (5.8 percent vs.4.8 percent). In contrast to these findings, symptomatic male patients were less likely to undergo CAS than symptomatic
female patients (11.9 percent vs. 13.5 percent).” The precise reasons for these potential biases remain unclear at this time.

“Our analysis reveals that the concern regarding an increased perioperative stroke rate after CEA among asymptomatic women appears to be unfounded,” added Dr. Rockman. “Overall, regardless of symptomatic status or the procedure performed, female patients undergoing carotid intervention had a nearly equivalent outcome compared with their male counterparts. Our findings suggest that women do not have an increased rate of perioperative complications as compared to men after intervention for carotid occlusive disease and that the indications for carotid intervention should not be influenced by their sex.” Furthermore, CEA may be the preferred treatment in women who warrant intervention for cerebrovascular disease unless compelling reasons exist to perform CAS.

Source:

Society for Vascular Surgery

Analyzing prostate-specific antigen (PSA) velocity and its rate of increase over time may help physicians better assess which patients require biopsy and active treatment and could, according to researchers from Innsbruck, Austria, result in significant healthcare savings. These data were presented during the 105th Annual Meeting of the American Urological Association (AUA). The session was moderated by William J. Catalona, MD, an expert in prostate cancer and PSA.

“We have made exciting discoveries since the abstract was submitted,” said Jasmin Bektic, MD, who presented the data. “The growth rate in PSA from cancer based on PSA velocity is a strong predictor of the risk of high Gleason cancer. High sensitivity to high-risk cancer along with good specificity to no cancer can be achieved using growth rate and PSA variation around trend.”

Using data from participants in the Tyrol project, researchers analyzed PSA velocity, or the rate of PSA change, in 426 prostatectomy patients with four years of periodic PSA tests. These patients were categorized into four groups: those with recurrence following radical prostatectomy; those with Gleason grade 8-10 tumors without recurrence; those with Gleason grade 5-6; and those with stage T1-T2a tumors without recurrence and with negative surgical margins.

Using a mathematical construct, investigators calculated the rate of PSA increase. Patients whose cancer ultimately recurred had PSA velocity readings of at least 0.25 ng/ml/yr (median 1.01), with only 7 percent having a velocity under 0.4 ng/ml/yr. Twenty-one percent of the Gleason 8-10 cancers that did not recur had a velocity of less than 0.4 ng/ml/yr. The least aggressive cancers had a median PSA velocity of 0.36 ng/ml/yr, with 53 percent below 0.4 and 36 percent below 0.25 ng/ml. These data suggest that indolent tumors can be identified not only by Gleason score, but also by PSA velocity.

“Monitoring PSA velocity over time gives us valuable information that can help us better assess which tumors are slow-growing and which ones may kill,” said William J. Catalona, MD, the briefing moderator. “Further analysis of these changes improves the specificity of the PSA test and can help us better decide when biopsy and active treatment might be necessary. It helps make PSA a smarter test.”

“The PSA test is a very effective marker when interpreted appropriately.”

Source
American Urological Association

The Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) is intensifying the international training of doctoral researchers. At its autumn meeting in Bonn the Grants Committee responsible for Research Training agreed to the establishment of 13 additional Research Training Groups, 7 of which are International Research Training Groups. These enable doctoral researchers to cooperate closely with foreign universities. “We are particularly pleased about the first International Research Training Group involving an Indian university. This means that our young researchers will come into even closer contact with this fast devel-oping scientific country,” said DFG President Professor Matthias Kleiner. Apart from this milestone, there are other new International Research Training Groups that build upon existing cooperation arrangements with the USA, Japan, Russia, Spain and South Korea within this funding programme.

The new Research Training Groups offer large numbers of doctoral researchers the opportunity to obtain a doctorate in a structured research and qualification programme at a technically advanced level. They will therefore play a crucial role, especially in view of the current debate about the quality of doctorates awarded at German universities. The 13 newly ap-proved Research Training Groups will each receive project funding of between approximately 344,000 euros to 1,123,000 euros annually. They involve such topics as novel connections between quantum and gravitational field theories, new ideas for the bionic implementation of concepts derived from nature in modern technology, and work on better treatments for ischemic heart disease. Other topics deal with changes in the clerically based social system in the wake of European unification and the development of a self-organised mobile communication system in disaster scenarios.

In the Grants Committee meeting it became clear that the DFG’s increased commitment to promoting equal opportunities in science has already been put into practice. All those involved – from the applicants and the reviewers to the members of the Grants Committee – are increasingly aware of this issue and consider it important to implement concrete measures. “It is pleasing to see how many convincing strategies, in some cases based on the DFG’s new research-oriented standards on gender equality, already exist,” underlined DFG President Kleiner.

In addition to the 13 new institutions, which will initially be funded for four and a half years, the Grants Committee also approved the renewal of 17 Research Training Groups for a further period. This brings the number of Research Training Groups currently funded by the DFG to a total of 247, 64 of which are International Research Training Groups.

The new Research Training Groups in detail:

(listed in alphabetical order by host university)
Using mountains as drinking water reservoirs is the subject of the International Research Training Group “Complex Terrain and Ecological Heterogeneity” at the University of Bayreuth and the Kangwon National University, Korea. The German and Korean scientists are researching various parameters of the mountain landscapes that supply drinking water for more than half of humanity. With the models resulting from this work, they want to better understand the interaction of socio-economic and ecological aspects in the protection of drinking water distribution and land usage. (Host university: University of Bayreuth; Spokes-person: Professor Dr. John Tenhunen; Collaboration partner: Kangwon National University, Korea)

The aim of the Research Training Group “Mass, Spectrum, Symmetry: Particle Physics in the Era of the Large Hadron Collider,” established at the Humboldt University of Berlin and Dresden University of Technology, is to create closer links among the broad theoretical and experimental expertise in the various research fields of elementary particle physics and to clearly point out the collaborative character of their research area for the doctoral researchers. The experimental basis of this comes from the participation in the ATLAS experiment of the Large Hadron Collider (LHC) at CERN and the search for new physics taking place there, along with collaboration in international neutrino experiments. From a theoretical point of view, a broad spectrum of research on quantum field theory is also being studied, while at the same time building a bridge between astroparticle physics and particle physics in accelerators. (Host universities: Humboldt University of Berlin, Dresden University of Technology; Spokesperson: Professor Dr. Jan Plefka)

The International Research Training Group “Self-Assembled Soft-Matter Nanostructures at Interfaces” is working at the interface of chemistry and physics. German and American scientists are working together to study the fundamental principles of self-organisation in microscopic structures of organic and biomolecular material at interfaces, so-called nanostructures. Under the leadership of the Berlin Institute of Technology, a joint research project with the Max Planck Institute of Colloids and Interfaces and the Humboldt University will build on the already existing successful collaboration with North Carolina State University and the Uni-versity of Pennsylvania. (Host university: Berlin Institute of Technology; Spokesperson: Pro-fessor Dr. Martin Schoen; Collaboration partners: North Carolina State University, University of Pennsylvania)

The Research Training Group “Bionics – Interactions Across Boundaries to the Environment” at the University of Bonn is dealing with the transfer of biological phenomena into technical areas. The participants in the Group, from biology and computer science, are focusing on bio-logical interactions across boundaries such as those of the skin and sensory organs with their environment. Whether it be adhesion properties, infrared vision or optical orientation: exam-ples from nature will be studied and implemented in technical systems. In this project the re-searchers from Bonn are cooperating with engineers from the Research Centre JГјlich and the RWTH Aachen as well as external industrial partners. (Host university: Rheinische Friedrich Wilhelms University, Bonn; Spokesperson: Professor Dr. Gerhard von der Emde)

A better understanding of mathematical structures of equations in different applications of fluid mechanics is the goal of the International Research Training Group “Mathematical Fluid Dynamics”, in which Darmstadt University of Technology is collaborating closely with the Japanese University of Tokyo and Waseda University. The researchers in this Group, who come from various disciplines, intend to link together various branches of mathematics and engineering in a productive way. (Host university: Darmstadt University of Technology; Spokesperson: Professor Dr. Matthias Hieber; Collaboration partners: University of Tokyo, Waseda University)

“The Dynamic Response of Plants to A Changing Environment” is the title of the Interna-tional Research Training Group in plant science at the University of DГјsseldorf. In close co-operation with Michigan State University in the USA, the complex adaptation processes of plants to non-constant temperature and light conditions are to be investigated. The interdisciplinary research ranges from genomics and population ecology to bioinformatics and cell biology and biochemistry. (Host university : Heinrich-Heine University, DГјsseldorf; Spokes-person: Professor Dr. Andreas P. M. Weber; Collaboration partner: Michigan State Univer-sity)

In its International Research Training Group with Spanish scientists in the field of medicine, the University of Giessen is working on the topic of vascular diseases. Its focus is on ischemic heart disease, which is the most common cause of death in industrialised countries. Under the title “Protecting the Heart from Ischemia” the interdisciplinary project is concerned with the causes and effects of the disease and also with possible therapeutic approaches. (Host university : Justus-Liebig University, Giessen; Spokesperson: Professor Dr. Hans Michael Piper; Collaboration partner: Universitat AutГІnoma de Barcelona)

The European “Expert Cultures of the 12th to 16th Centuries” are the topic of a Research Training Group at the University of GГ¶ttingen. In this project, doctoral researchers from the fields of history, theology and philosophy will investigate the ambivalent relationship that arose in the late Middle Ages between experts and society, in which the non-experts devel-oped a very diverse set of attitudes, ranging from trust in experts to criticism of them. (Host university: Georg-August University, GГ¶ttingen; Spokesperson: Professor Dr. Frank Rexroth)

The Research Training Group “Self-organised Mobile Communication Systems for Disaster Scenarios” aims to overcome the restrictions of existing, highly static communication sys-tems. The young team of researchers from the Technical University of Ilmenau is developing more flexible types of communication technology to this end. At the forefront of this is the creation of improved organisational networks. As a specific objective, the scientists want to create mechanisms for the dynamic self-organising coordination of future means of communi-cation. (Host university: Technical University of Ilmenau; Spokesperson: Professor Dr.-Ing. Andreas Mitschele-Thiel)

A unique and highly complex connection between various research fields in physics is the aim of the Research Training Group “Quantum and Gravitational Fields” at the University of Jena. In close collaboration between physicists and mathematicians the Group is making use of the interface between field theory and differential geometry. The aim is therefore to exploit the innovative cross-fertilisation of physics and mathematics to search for completely new discoveries in physics. The results of fundamental interactions of elementary particle physics are essential for the construction of theories beyond the standard model, and also have practical importance for other fields such as micro and nano-technology. (Host university: Friedrich-Schiller-University, Jena; Spokesperson: Professor Dr. Andreas Wipf)

“The Christian Churches and the Challenge of Europe” – this is the title of a Research Train-ing Group at the University of Mainz researching the changes in the Christian dominated social model together with the churches in European countries with regard to the notion of European unification and the actual process of “Europeanisation”. The researchers, from the disciplines of religious studies, politics, history and law, will be concentrating on the period from the Wilhelminian era to the present day. (Host university: Johannes Gutenberg Univer-sity, Mainz; Spokesperson: Professor Dr. Heinz Duchhardt)

The International Research Training Group “Regulation and Evolution of Cellular Systems” aims to work in a way that promotes dialogue. The intention is not only to increase German-Russian dialogue between the two Munich universities and the Lomonosov Moscow State University – but also to improve the level of communication between theoretical bioinformat-ics and practical life sciences as a foundation for the future. German and Russian research groups from specialist disciplines such as bioinformatics, computer science, proteomics, biol-ogy and biochemistry will therefore be working in close knit teams. (Host universities: Ludwig-Maximilians University, Munich, Technical University of Munich; Spokesperson: Professor Dr. Dmitrij Frishman, Professor Dr. Ralf Zimmer; Collaboration partner: Lo-monosov Moscow State University)

In the first ever German-Indian International Research Training Group, scientists from the University of MГјnster and the University of Hyderabad are carrying out joint research in the field of glyco-science. Under the title “Molecular and Cellular Glyco-Sciences” the international group composed of biologists, chemists and medical researchers is studying the carbo-hydrate-containing bio-molecules. These are increasingly being recognised as information-bearing molecules which perform important signalling and regulatory functions within and between cells and organisms. The important interaction of carbohydrates and proteins is to be studied in the cell for its molecular and biochemical aspects. (Host university: Westphalian Wilhelms University, MГјnster; Spokesperson: Professor Dr. Bruno Moerschbacher, Collabo-ration partner: University of Hyderabad)

###

Further information on the DFG’s Research Training Groups can be found at: dfg.de/gk

Source: Dr. Eva-Maria Streier

dfg.de/
Deutsche Forschungsgemeinschaft

A new study conducted by SANE Australia finds almost half of all Australians still have a very limited understanding of schizophrenia and the everyday reality of living with the illness.

The study (conducted in conjunction with Virtual Medical Centre), surveyed nearly 900 people with 49 per cent admitting to having a poor understanding of schizophrenia and its impact.

‘The findings are disappointing but not surprising,’ says SANE Australia’s Executive Director Barbara Hocking. ‘A lot of education is still needed about the realities of schizophrenia – the fact is, with treatment, the majority of those affected lead full lives and participate in the community.

‘Unfortunately there is still a lot of stigma and discrimination towards those with schizophrenia, which is not helped by persistent myths about the illness. The most common myth confuses schizophrenia with so-called ‘split personality’, which is not the case.

‘Another myth is that people affected by schizophrenia are violent, when in fact research shows that they are more likely to be victims of violence than to commit violent acts themselves.’

One in a hundred people will develop schizophrenia during their lives. More males than females are affected and 75% develop the illness between 16 and 25 years.

Schizophrenia is an illness which influences the normal functioning of the brain, affecting its ability to interpret information and make sense of the world. Symptoms can include confused thinking, delusions, hallucinations, difficulty expressing emotions and withdrawal from others. There is no cure for schizophrenia but treatment, which includes medication, psychological therapy and community support and accommodation programs, can do much to reduce and even eliminate the symptoms.

‘Through events such as Schizophrenia Awareness Week we can hope to break down the stigma surrounding the illness by encouraging conversation and help-seeking behaviour,’ says Ms Hocking.

SANE produces a number of education resources about schizophrenia to help people understand and make sense of the illness, as a first step to coping with its effects. SANE also operates a StigmaWatch program, which works with the community to monitor media portrayals of mental illness and suicide, advocating for an end to misrepresentations of schizophrenia.

Schizophrenia Awareness Week runs from May 17 – 23 2009.

Source
SANE Australia

Doctors who take a few minutes to talk with patients about their smoking maybe passing along a leaflet or a sample of nicotine gum make a difference when it comes to helping them quit successfully, according to a recent review of studies.

“Assuming an unassisted quit rate of 2 to 3 percent, a brief advice intervention can increase quitting by a further 1 to 3 percent,” write reviewers led by Lindsay Stead, of the University of Oxford in England.

Stead and his team looked at of 41 studies of more than 31,000 smokers.

“To a non-clinician, these results may seem underwhelming, but [they] are really quite significant when you consider how many people who smoke see a physician every year about 80 percent and how many more of them would quit if all doctors advised them to do so at every visit,” said Abigail Halperin, M.D.

Halperin, a physician-researcher specializing in prevention and treatment of tobacco-related diseases at the University of Washington, is not affiliated with the review.

The review appears in the latest issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates medical research. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing medical trials on a topic.

The reviewers looked at studies conducted between 1972 and 2007. When they pooled data from 17 trials of brief advice compared to no advice, they found significant increases in quit rate among the group that got some kind of counsel from a physician.

Efforts did not have to be lengthy or complicated: The researchers found no statistical difference between intensive and minimal endeavors. However, the studies did not select study participants based on motivation to quit smoking, which might have affected the findings on intensive interventions.

“Cessation interventions are typically highly cost-effective, so even a very small improvement in effect from intensifying the intervention could well be cost-effective,” said Stead, a review group coordinator at Oxford’s Department of Primary Health Care.

Halperin said that there are still some 45 million smokers in the United States and about 70 percent of them say they want to quit. “Of these, about half try to quit and less than 5 percent are successful. If we assume that half of these patients are advised by their M.D. to quit smoking now a generous estimate and that 2 percent more would quit if they were all advised to, then we could see an additional 720,000 smokers become nonsmokers each year.”

“This would have a huge impact on public health, since tobacco related diseases are by far the nation’s largest contributor to disability and premature death not to mention health care costs,” Halperin said.

The majority of smokers require not one, but several quit attempts, to stop smoking for good.

Stead says once a doctor identifies a patient as a smoker and discovers that he or she is willing to make a quit attempt, then follow-up and referral in addition to a brief intervention can help ensure success.

Only a small percentage of people who quit remain nonsmokers beyond six months to one year without additional help, according to Halperin. “In the two programs where I work, we assist patients in developing a quit plan, provide practical counseling, and prescribe nicotine replacement therapy or other medication to ameliorate withdrawal symptoms, and are seeing 25- to 35-percent quit rates,” she said.

“These steps can be accomplished by any physician or other health care provider, or by referring the patient to a telephone quit line or other program that provides this kind of evidence-based support,” she added.

“I suspect the barrier to providing intensive interventions to all comers including smokers who were initially resistant to the idea of a quit attempt would be that physicians would be hard to persuade it was effective,” Stead said.

Stead LF, Bergson G, Lancaster T. Physician advice for smoking cessation (Review). Cochrane Database of Systematic Reviews 2008, Issue 2.

The Cochrane Collaboration is an international non-profit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit cochrane for more information.

Health Behavior News Service
Center for the Advancement of Health 2000 Florida Ave. NW, Ste 210
Washington, DC 20009
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For people who carry common gene variants, cigarette smoking greatly increases the risk that a blood vessel in the brain will weaken and balloon out – called an aneurysm – which could be life-threatening if it ruptures, according to research presented at the American Stroke Association’s International Stroke Conference 2010.

Researchers reported on two new studies from the Familial Intracranial Aneurysm (FIA) project, a multinational collaboration funded by the National Institutes of Neurological Disorders and Stroke to study genetic and other risk factors in families with at least two members affected by intracranial aneurysm.

In one study (Broderick, abstract 156), researchers found that the chance of an intracranial aneurysm increased between 37 percent and 48 percent for people who carried one copy of an identified risky gene variation. However, when the gene variant was combined with smoking the equivalent of one pack a day for 20 years, the risk increased more than five-fold. People with two copies of the gene variant were at even higher risk.

“Like putting a match to kindling, smoking greatly increases the likelihood of a ruptured aneurysm in people with a genetic susceptibility,” said Joseph P. Broderick, M.D., study author and professor and chair of the neurology department at the University of Cincinnati Neuroscience Institute.

Cigarette smoking is the leading environmental cause of intracranial aneurysm. An estimated 70 percent to 80 percent of people who experience aneurysms are current or former smokers, he said. In the study, 82.5 percent of participants were smokers at some point. Intracranial aneurysms also occur in multiple members of certain susceptible families.

A ruptured intracranial aneurysm can create a subarachnoid hemorrhage. When that occurs, 40 percent of patients die, and most others experience major disability from the brain injury caused by the rapid bleeding.

By comparing the frequency in 406 patients from the FIA families with that of 392 control subjects without aneurysm in the Cincinnati area, researchers confirmed that certain gene variants on chromosomes 8 and 9 raise the risk of intracranial aneurysm. Other variants on chromosome 2, suggested as genetic risks in a prior study on other populations, were not found to be risk factors in this study.

In the study about 22 percent of controls had a least one copy of the gene variant on chromosome 8 and 73 percent had at least one copy of the variant for chromosome 9. Broderick noted that this percentage is about what is expected in the general population – at least among whites in this region.

“These results tell us the approximate location of the risk-inducing gene on the chromosomes but does not identify the exact gene or how its functioning contributes to the risk of aneurysm,” said Broderick, principal investigator of the FIA project.

“This is a powerful message to family members of people who have had ruptured aneurysms. Even if you have the gene, you can dramatically affect your risk by not smoking. If you smoke, you are multiplying the effect of the gene,” he said.

Broderick noted that since it is too early to recommend genetic testing, all family members of people who have had an intracranial aneurysm should stop smoking.

In a second presentation from the FIA study, (Sauerbeck, abstract 156), researchers reported that the primary causes of death in FIA families are cancer and cardiac problems other than aneurysm. In an average 3.27 years follow-up of 1,073 people with a diagnosis of intracranial aneurysm and 1,721 family members undiagnosed with an intracranial aneurysm at enrollment in the study, none of those without aneurysm at study onset died from a ruptured intracranial aneurysm. In addition, most deaths in those with aneurysm were unrelated to their aneurysms.

“Especially for those diagnosed with an unruptured aneurysm, if the condition is treated or medically monitored to make sure it’s not growing, you can modify your risk factors – by not smoking and keeping blood pressure under control – and not worry as much about the risk of rupture,” said Laura R. Sauerbeck, R.N., M.S., C.C.R.C., lead author of the study and assistant professor of research at the University of Cincinnati.

Brodericks’s co-authors are Sauerbeck, Ranjan Deka, Ph.D., Daniel L. Koller, Ph.D.; Dongbing Lai, M.S.; Subba Rao Indugula, Ph.D.; Guangyun Sun, Ph.D.; Daniel Woo, M.D.; Charles J. Moomaw, Ph.D.; Richard Hurnung, D.P.H.; E. Sander Connolly, M.D.; Craig Anderson, M.D.; Guy Rouleau, M.D.; Irene Meissner, M.D.; Joan E. Bailey-Wilson, Ph.D.; John Huston III, M.D.; Robert D. Brown, M.D.; Dawn O. Kleindorfer, M.D.; Matthew L. Flaherty, M.D.; Carl Langefeld, Ph.D.; and Tatiana Foroud, Ph.D.

Sauerbeck’s co-authors include Broederick, Hornung, Woo, Moomaw, Anderson, Connolly, Rouleau, and Brown for the FIA Investigators. Author disclosures are on the abstract.

The National Institute of Neurological Disorders and Stroke funded the research.

Source:
Bridgette McNeill
American Heart Association

Stony Brook University Medical Center will unveil this Friday a one-of-a-kind neuroendovascular simulator that recreates vasculature in the brain, including scenarios of damaged vessels from acute stroke, brain aneurysms, and other cerebrovascular anomalies. Affectionately known in the lab as “Headley,” the simulator – co-invented by B. Barry Lieber, PhD, a nationally recognized biomedical engineer and one of the world’s foremost authorities on brain vasculature and Director of the Cerebrovascular Research Center at SBUMC – will profoundly impact research, teaching, diagnosis and treatment of neurovascular disease. Stroke is the number three cause of death behind heart attack and cancer in the U.S. Every 40 seconds, someone in the U.S. has a stroke and every four minutes, someone dies of one.

Supported by the most sophisticated imaging technology and the only robotically powered multi-axis angiography imaging technology in the region dedicated solely to research known as the Artis zeego, “Headley” will be introduced to the public for the first time by Dr. Lieber along with Drs. Henry Woo and David Fiorella, Endovascular Neurosurgeons and co-Directors of Stony Brook’s Cerebrovascular Center, at an event commemorating the opening of the Cerebrovascular Center on December 17 at 12 noon in the Hospital lobby.

Another highlight planned for the December 17 ceremony are first hand life-and-death experiences as told by patients and family members who experienced severe neurological events, and how they were treated at the Cerebrovascular Center and now return to Stony Brook to share their stories.

Also making remarks at the event will be Dr. Ken Kaushansky, Sr. Vice President of the Health Sciences and Dean of the School of Medicine at Stony Brook University, Hospital CEO, Dr. Steven Strongwater, and Dr. Raphael Davis, Chairman of the Department of Neurological Surgery and Co-Director of the Institute for Advanced Neurosciences.

“We established the Cerebrovascular Center as a comprehensive clinical and research program for the diagnosis and treatment of acute stroke, brain aneurysms, atherosclerosis, arteriovenus malformations (AVMs), as a direct response to the growing health care needs of the Suffolk County population,” said Dr. Davis. “Patients can feel confident that they are receiving the highest level of care available from Drs. Woo and Fiorella and their support team.”

“Neuroendovascular and cerebrovascular surgery are rapidly expanding fields, and we offer Long Islanders the most advanced care and latest technology to treat cerebrovascular disease by way of surgical and neurointerventional procedures,” said Dr. Woo. “Our acquisition of top line imaging technology, 320-slice CT, and other capabilities means we are responding directly to a growing need for these services in Suffolk County and beyond.”

Dr. Woo explains that the new research arm of the program, the Cerebrovascular Research Center (CRC), is crucial to paving the way for future patient care by finding the best and most effective ways to treat cerebrovascular conditions. The CRC will set the foundation for the discovery, testing, and delivery of new endovascular therapies by integrating bioengineering approaches with clinical medical sciences.

Dr. Lieber points to the neuroendovascular simulator as one of several cutting-edge developments of the CRC. The simulator will serve as a teaching and research tool to be used in conjunction with the Artis zeego system which is powered by advanced robotic technology to provide virtually unrestricted capabilities for imaging neurological vasculature of stroke, brain aneurysms AVM, and other cerebrovascular abnormalities.

“Basic and translational research on hemodynamics (circulation of the blood) completed in the CRC will not only lead to new methods to treat cerebrovascular conditions but also further improve existing methods performed on patients at the Center,” said Dr. Lieber.

Dr. Woo and colleagues currently perform every FDA-approved minimally invasive stroke interventional technique in the United States. Among routine procedures include repairing aneurysms, opening and stenting of narrowed or blocked arteries of the brain and carotid arteries, obliteration of AVMs, mechanical thrombectomy for blocked brain arteries and intracranial bypass procedures.

Source:

Cerebrovascular Center at Stony Brook University Medical Center

UroToday – In this award winning manuscript, the authors review the incidence, cause, and diagnosis of vascular complications in more than a score of experience with percutaneous renal surgery in 4,695 patients.

The incidence of hemorrhagic complications was highest among patients undergoing percutaenous resection of an upper tract transitional cell cancer (3.8%); for percutaneous stone removal or percutaneous endopyelotomy, the incidence was only 1.2% and 0.8% respectively.

Among the most recent patients (2495), angiography was diagnostic in 98%. The most common diagnosis by a factor of two was pseudoaneurysm followed by artierovenous malformation. Overall angiographic embolization was successful in 95%; three patients (0.06%) required open exploration. Of note, 17.5% of patients had more than one angiographic finding.

In my mind, this represents the most comprehensive treatment of this topic to date.

Richstone L, Reggio E, Ost MC, Seideman C, Fossett LK, Okeke Z, Rastinehad AR, Lobko I, Siegel DN, Smith AD.
J Endourol. 2008 Jun;22(6):1129-35.
doi:10.1089/end.2008.0061

UroToday Medical Editor Ralph V. Clayman, MD

UroToday – the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to:
www.urotoday

Copyright © 2008 – UroToday

Researchers led by Drs. James F. George and Anupam Agarwal at the University of Alabama at Birmingham have found that carbon monoxide (CO) can protect against arterial clotting. They report their data in the July 2009 issue of the American Journal of Pathology.

Carbon monoxide poisoning is extremely toxic; exposure prevents oxygen delivery to body tissues and is often fatal. However, inflamed or injured tissues upregulate heme oxygenase-1 (HO-1), a protein that both protects cells and produces CO, suggesting that low levels of CO may have protective effects.

To determine if HO-1 and CO can protect against arterial clotting, Chen et al examined clotting mechanisms in mice that received arterial transplants. Absence of HO-1 in these mice resulted in significant mortality due to arterial clotting; however, treatment with a CO-releasing molecule both decreased clotting and improved survival.

Drs. George, Agarwal, and colleagues conclude that HO-1/CO plays an “important role …[in] protection against vascular arterial thrombosis in murine aortic allotransplantation.”

Chen B, Guo L, Fan C, Bolisetty S, Joseph R, Wright MM, Agarwal A, George JF: Carbon Monoxide Rescues Heme Oxygenase-1-deficient Mice from Arterial Thrombosis in Allogeneic Aortic Transplantation. Am J Pathol 2009, 174: 2832-2839

Source:
Angela Colmone
American Journal of Pathology

A new iPhone application, created by researchers at Children’s Hospital Boston in collaboration with the MIT Media Lab, enables users to track and report outbreaks of infectious diseases, such as H1N1 (swine flu), on the ground in real time. The application, “Outbreaks Near Me,” builds upon the mission and proven capability of HealthMap, an online resource that collects, filters, maps and disseminates information about emerging infectious diseases, and provides a new, contextualized view of a user’s specific location – pinpointing outbreaks that have been reported in the vicinity of the user and offering the opportunity to search for additional outbreak information by location or disease.

Additional functionality of Outbreaks Near Me is the ability to set alerts that will notify a user on their device or by e-mail when new outbreaks are reported in their proximity, or if a user enters a new area of activity.

“We hope individuals will find the new app to be a useful source of outbreak information – locally, nationally, and globally,” says HealthMap co-founder John Brownstein, PhD, assistant professor in the Children’s Hospital Informatics Program (CHIP). “As people are equipped with more knowledge and awareness of infectious disease, the hope is that they will become more involved and proactive about public health.”

The new application also features an option for users to submit an outbreak report. This will enable individuals in cities and countries around the world to interact with the HealthMap team and participate in the public health surveillance process. Users may take photos – of situations and scenarios of, and/or leading to, disease – with their iPhone and submit them to the HealthMap system for review and eventual posting as an alert on the worldwide map.

“This is grassroots, participatory epidemiology,” says HealthMap co-founder Clark Freifeld, a PhD student at the MIT Media Lab and research software developer at CHIP. “In releasing this app we aim to empower citizens in the cause of public health, not only by providing ready access to real-time information, but also by encouraging them to contribute their own knowledge, expertise, and observations. In enabling participation in surveillance, we also expect to increase global coverage and identify outbreaks earlier.”

HealthMap was founded in 2006 and mines the Internet – searching disparate data sources such as news reports, curated personal accounts, official alerts, blogs and chat rooms – to track and map infectious disease outbreaks. While the data have been shown to provide early information on new outbreaks, users are encouraged to interpret the data appropriately as it is drawn from both official and unofficial sources.

The HealthMap Web site (healthmap) averages 10,000 unique visits a day, including regular users from the World Health Organization, the CDC, and the European Centre for Disease Prevention and Control. During the peak of H1N1 swine flu this spring, visits to the site rose substantially, with as many as 150,000 visitors coming to the Web site to search for information.

Outbreaks Near Me was developed with support from Google and is available at no cost for download in the iTunes App Store. For more information on Outbreaks Near Me, visit: healthmap/iphone.php.

Source:
Keri Stedman

Children’s Hospital Boston