Medifit Instruments Limited, the world leading company in the measurement of Cardiac Vagal Tone and non-invasive Brainstem Assessment, announces the successful installation of a second Neuroscope(TM) for gastroenterology research at Hope Hospital, Salford, UK.
The Neuroscope is being successfully used in studies leading to the identification of mechanisms for the future management of pain.
Professor Qasim Aziz and clinical research fellow Dr. Peter Paine were so impressed with the results obtained from the first NeuroScope that a second was soon commissioned. In commenting, Dr. Peter Paine described the information derived from the use of the Neuroscope as being of the highest quality and extremely beneficial and cost effective to our research. He added, It is simply "essential to our work - we are so convinced as to the benefits of the Neuroscope that we are ordering a third device".
Medifit Instruments Limited, based in London at Enfield, UK, manufactures and Markets the Neuroscope(TM), which is the only diagnostic device capable of assessing Cardiac Vagal Tone, non-invasively and in real time. As part of the Central Medical Processor - as a tele-medicine vital signs platform - it is a world leader in the integration and management of patient vital signs and the assessment of brainstem function.
In clinical settings the Central Medical Processor enables the physician to view the patient as a virtual bulletin board of vital signs; the actions and reactions of the brainstem in real time are displayed on a beat by beat (heart beat) basis to provide an instant assessment of how the brain is reacting to any given circumstance.
More information from the company - telephone 079 399 36419 (+44 79 339 36419 if calling from outside the UK)
Empowering Medical Practitioners through improved Diagnostics
Medifit Instruments Limited
Innova Business Centre
Electric Avenue
Enfield
EN3 7XU
ENGLAND
Registered in England, number 3895663
VAT: GB749 4057 07
Phone: +44 (0) 20 8344 8545
Fax: +44 (0) 20 8350 1351
info@medifitinstruments.com
www.medifitinstruments.com
April 15, 2007
Aspirin Saves Lives Of Cancer Patients Suffering Heart Attacks, Despite Fears Of Bleeding
Many cancer patients who have heart attacks often are not treated with life saving aspirin given the belief in the medical community that they could experience lethal bleeding. Researchers at The University of Texas M. D. Anderson Cancer Center, however, say that notion is now proven wrong and that without aspirin, the majority of these patients will die.
Researchers say that their study, to be published in the February 1, 2007 issue of the journal Cancer and now available online, turns common medical assumptions upside down and will likely change medical practice for cancer patients. Because aspirin can thin blood and cancer patients experience low platelet counts and abnormal clotting, physicians view aspirin as a relative contraindication. Given that blood platelets are responsible for the clotting process, physicians do not eagerly prescribe aspirin as a standard treatment.
In this study, however, the investigators found that 9 of 10 cancer patients with thrombocytopenia (low platelet count) who were experiencing a heart attack and who did not receive aspirin died, whereas only one patient died in a group of 17 similar cancer patients who received aspirin. They also found aspirin helps cancer patients with normal platelet count survive heart attacks, just as it does for people without cancer.
"The notion that heart attacks in patients with low platelets should be treated with clot-dissolving aspirin defies logic, that is unless you suspect that the cancer is interfering with platelet function," says the study's senior investigator and author, Jean-Bernard Durand, M.D., assistant professor in the Department of Cardiology at M. D. Anderson Cancer Center.
"We believe tumors may be releasing chemicals that allow the cancer to form new blood supplies which makes blood more susceptible to forming clots." Durand, a heart failure specialist, says. "There appears to be a platelet paradox suggesting that cancer may affect the mechanism of the way that blood clots, and from this analysis, we have found that the single most important predictor of survival in these patients is whether or not they received aspirin." Durand says more research is needed to better understand this contraindication.
According to the World Health Organization there are approximately 10 million cancer patients worldwide, of which 1.5 million may develop blood clots during their cancer treatment and, as such, are at a much higher risk of dying from heart disease if not treated properly. "Now that we have this study, it would be a travesty if you survive treatment for cancer only to die of a heart attack soon thereafter," Durand says.
According to Durand, no guidelines currently exist for treatment of heart attacks in patients with cancer. He says that physicians are especially perplexed about what to do for cancer patients with thrombosis (blood clots), a condition that affects about 15 percent of all cancer patients and can be due to the use of chemotherapy or the presence of cancer.
Durand came to M. D. Anderson in 2000 to start the Cardiomyopathy Services, which is believed to be the only program in the world specifically designed to look at cardiovascular complications caused by chemotherapy treatment. He is also the co-founder of CONQUER (Cardiology Oncology International Quest to Educate and Research Heart Failure in Cancer), a newly created organization with goals of increasing the success of chemotherapy by reducing cardiovascular disease as a barrier and long term risk.
He and anesthesiologist Mona Sarkiss, M.D., Ph.D., made the observation that patients with thrombocytopenia who suffered a heart attack and were being treated in the intensive care unit at M. D. Anderson tended to die more often when they were not given aspirin. However, they noted that some of the patients given aspirin and/or beta-blockers had "great" clinical outcomes. "Because no practice guidelines exist, physicians were treating their patients with great variability and the disparity was obvious," Durand says.
Sarkiss, who is the study's lead author, Durand, and a team of researchers which included investigators from Baylor College of Medicine and Duke University Medical Center, conducted a retrospective analysis of cancer patients treated for heart attacks at M. D. Anderson Cancer Center in 2001. These 70 patients were divided into two groups based on their platelet counts, and data was collected on the use of aspirin, bleeding complications, and survival.
They found that heart attack patients with low platelets who did not receive aspirin had a seven-day survival rate of 6 percent, compared with 90 percent survival in those who received aspirin. Dr. Durand notes that there were no severe bleeding complications in patients who used aspirin. Conversely, patients with low platelet counts who formed a blood clot and were not exposed to aspirin died.
The beneficial effect of aspirin also was seen in patients with normal platelet counts. Seven-day survival was 88 percent in aspirin-treated patients as compared to 45 percent in patients who did not receive aspirin, the researchers found.
Durand observed that these deaths rates are abnormally high. "In the non-cancer patient with acute coronary syndrome anywhere in the United States, an expected seven-day mortality is less than 1 percent," he says.
There were parallel findings for those patients in either group who were treated with beta-blockers, which block the heart's use of adrenalin. The protective effect was not as strong as seen with aspirin, but was still life saving.
In those patients with a normal platelet count, 91 percent survived seven days when treated with beta-blockers, whereas 36 percent survived if they were not treated with the agent. In the thrombocytopenic group, 73 percent survived seven days when treated with beta-blockers, whereas only 13 percent survived if they were not treated.
###
Investigators working with Durand and Sarkiss were: Andrew Shaw, M.D., from Duke; Nasser Lakkis, M.D. from Baylor; and S. Wamique Yusuf, M.D., Carla Warneke, M.D., Gregory Botz, M.D., Cheryl Hirsch-Ginsburg, M.D., J. Chris Champion, M.D., Joseph Swafford, M.D., and Daniel Lenihan, M.D., from M. D. Anderson.
Contact: Laura Sussman
University of Texas M. D. Anderson Cancer Center
Researchers say that their study, to be published in the February 1, 2007 issue of the journal Cancer and now available online, turns common medical assumptions upside down and will likely change medical practice for cancer patients. Because aspirin can thin blood and cancer patients experience low platelet counts and abnormal clotting, physicians view aspirin as a relative contraindication. Given that blood platelets are responsible for the clotting process, physicians do not eagerly prescribe aspirin as a standard treatment.
In this study, however, the investigators found that 9 of 10 cancer patients with thrombocytopenia (low platelet count) who were experiencing a heart attack and who did not receive aspirin died, whereas only one patient died in a group of 17 similar cancer patients who received aspirin. They also found aspirin helps cancer patients with normal platelet count survive heart attacks, just as it does for people without cancer.
"The notion that heart attacks in patients with low platelets should be treated with clot-dissolving aspirin defies logic, that is unless you suspect that the cancer is interfering with platelet function," says the study's senior investigator and author, Jean-Bernard Durand, M.D., assistant professor in the Department of Cardiology at M. D. Anderson Cancer Center.
"We believe tumors may be releasing chemicals that allow the cancer to form new blood supplies which makes blood more susceptible to forming clots." Durand, a heart failure specialist, says. "There appears to be a platelet paradox suggesting that cancer may affect the mechanism of the way that blood clots, and from this analysis, we have found that the single most important predictor of survival in these patients is whether or not they received aspirin." Durand says more research is needed to better understand this contraindication.
According to the World Health Organization there are approximately 10 million cancer patients worldwide, of which 1.5 million may develop blood clots during their cancer treatment and, as such, are at a much higher risk of dying from heart disease if not treated properly. "Now that we have this study, it would be a travesty if you survive treatment for cancer only to die of a heart attack soon thereafter," Durand says.
According to Durand, no guidelines currently exist for treatment of heart attacks in patients with cancer. He says that physicians are especially perplexed about what to do for cancer patients with thrombosis (blood clots), a condition that affects about 15 percent of all cancer patients and can be due to the use of chemotherapy or the presence of cancer.
Durand came to M. D. Anderson in 2000 to start the Cardiomyopathy Services, which is believed to be the only program in the world specifically designed to look at cardiovascular complications caused by chemotherapy treatment. He is also the co-founder of CONQUER (Cardiology Oncology International Quest to Educate and Research Heart Failure in Cancer), a newly created organization with goals of increasing the success of chemotherapy by reducing cardiovascular disease as a barrier and long term risk.
He and anesthesiologist Mona Sarkiss, M.D., Ph.D., made the observation that patients with thrombocytopenia who suffered a heart attack and were being treated in the intensive care unit at M. D. Anderson tended to die more often when they were not given aspirin. However, they noted that some of the patients given aspirin and/or beta-blockers had "great" clinical outcomes. "Because no practice guidelines exist, physicians were treating their patients with great variability and the disparity was obvious," Durand says.
Sarkiss, who is the study's lead author, Durand, and a team of researchers which included investigators from Baylor College of Medicine and Duke University Medical Center, conducted a retrospective analysis of cancer patients treated for heart attacks at M. D. Anderson Cancer Center in 2001. These 70 patients were divided into two groups based on their platelet counts, and data was collected on the use of aspirin, bleeding complications, and survival.
They found that heart attack patients with low platelets who did not receive aspirin had a seven-day survival rate of 6 percent, compared with 90 percent survival in those who received aspirin. Dr. Durand notes that there were no severe bleeding complications in patients who used aspirin. Conversely, patients with low platelet counts who formed a blood clot and were not exposed to aspirin died.
The beneficial effect of aspirin also was seen in patients with normal platelet counts. Seven-day survival was 88 percent in aspirin-treated patients as compared to 45 percent in patients who did not receive aspirin, the researchers found.
Durand observed that these deaths rates are abnormally high. "In the non-cancer patient with acute coronary syndrome anywhere in the United States, an expected seven-day mortality is less than 1 percent," he says.
There were parallel findings for those patients in either group who were treated with beta-blockers, which block the heart's use of adrenalin. The protective effect was not as strong as seen with aspirin, but was still life saving.
In those patients with a normal platelet count, 91 percent survived seven days when treated with beta-blockers, whereas 36 percent survived if they were not treated with the agent. In the thrombocytopenic group, 73 percent survived seven days when treated with beta-blockers, whereas only 13 percent survived if they were not treated.
###
Investigators working with Durand and Sarkiss were: Andrew Shaw, M.D., from Duke; Nasser Lakkis, M.D. from Baylor; and S. Wamique Yusuf, M.D., Carla Warneke, M.D., Gregory Botz, M.D., Cheryl Hirsch-Ginsburg, M.D., J. Chris Champion, M.D., Joseph Swafford, M.D., and Daniel Lenihan, M.D., from M. D. Anderson.
Contact: Laura Sussman
University of Texas M. D. Anderson Cancer Center
Potential New Pain Therapy Target Revealed By Scripps Research Study
The study was published January 21, 2007 in an advanced online edition of the journal Nature.
The researchers found that TRPA1, a protein that helps transmit pain signals, is a direct sensor of reactive chemicals. "While many noxious and pungent compounds were known to activate this pain receptor, we discovered that they do so by directly and irreversibly binding to the cysteine amino acids of this protein," said Ardem Patapoutian, a Scripps Research scientist whose laboratory conducted the study. "Our study shows that TRPA1 activation is directly linked to chemical insult."
"Cysteines, one of the twenty building blocks of all proteins, are known to undergo oxidation/reduction reactions," Patapoutian continued. "Somehow the TRPA1 protein is tuned to sense cysteine modifications. In fact, any cysteine reactive agent seems to activate TRPA1, although we don't know exactly how cysteine binding translates into ion channel activation."
But this activation mechanism comes with an interesting property.
"Generally, compounds that activate ion channels bind in a lock-and-key mechanism that is readily reversible," said Lindsey Macpherson, another author of the study and a Ph.D. candidate in the Scripps Research Kellogg School of Science and Technology. "The mechanism by which noxious compounds activate TRPA1 is unique. For example, compounds that activate an ion channels through a lock-and-key mechanism have structural similarity. TRPA1 activators have no structural similarity; instead, they share a common potential for chemical reactivity, and their binding is long-lasting."
TRPA1 is not unique among proteins to be activated by cysteine modifying agents, the study noted. Another signaling protein known as Kelch-like ECH-associated protein 1 (KEAP1) is activated by many of the same compounds that activate TRPA1; KEAP1 is a sensor for oxidative damage from free radicals and upregulates expression of antioxidant enzymes. Apparently, reactive compounds can activate at least two pathways through cysteine modification as a warning against cell damage, the study concluded.
"Our findings, which are the result of a successful collaboration with the Ben Cravatt and Peter Schultz labs at Scripps Research, show that modification of reactive cysteines within TRPA1 can cause channel activation," Macpherson said. "Our research efforts are now aimed at further understanding how binding of these compounds activate the channel, and identifying the physiological role of TRPA1 in sensing oxidative stress." The protein is currently being investigated by several pharmaceutical companies as a potential target for chronic pain, Patapoutian noted.
###
Other authors of the study, Noxious Compounds Activate TRPA1 Ion Channels Through Covalent Modification Of Cysteines, are Adrienne E. Dubin, Michael J. Evans, Felix Marr, and Benjamin F. Cravatt of The Scripps Research Institute; and Peter G. Schultz of The Scripps Research Institute and Genomics Institute of the Novartis Research Foundation.
The study was supported by the National Institutes of Health and the Novartis Research Foundation.
About The Scripps Research Institute
The Scripps Research Institute is one of the world's largest independent, non-profit biomedical research organizations, at the forefront of basic biomedical science that seeks to comprehend the most fundamental processes of life. Scripps Research is internationally recognized for its discoveries in immunology, molecular and cellular biology, chemistry, neurosciences, autoimmune, cardiovascular, and infectious diseases, and synthetic vaccine development. Established in its current configuration in 1961, it employs approximately 3,000 scientists, postdoctoral fellows, scientific and other technicians, doctoral degree graduate students, and administrative and technical support personnel. Scripps Research is headquartered in La Jolla, California. It also includes Scripps Florida, whose researchers focus on basic biomedical science, drug discovery, and technology development. Currently operating from temporary facilities in Jupiter, Scripps Florida will move to its permanent campus in 2009.
Contact: Keith McKeown
Scripps Research Institute
The researchers found that TRPA1, a protein that helps transmit pain signals, is a direct sensor of reactive chemicals. "While many noxious and pungent compounds were known to activate this pain receptor, we discovered that they do so by directly and irreversibly binding to the cysteine amino acids of this protein," said Ardem Patapoutian, a Scripps Research scientist whose laboratory conducted the study. "Our study shows that TRPA1 activation is directly linked to chemical insult."
"Cysteines, one of the twenty building blocks of all proteins, are known to undergo oxidation/reduction reactions," Patapoutian continued. "Somehow the TRPA1 protein is tuned to sense cysteine modifications. In fact, any cysteine reactive agent seems to activate TRPA1, although we don't know exactly how cysteine binding translates into ion channel activation."
But this activation mechanism comes with an interesting property.
"Generally, compounds that activate ion channels bind in a lock-and-key mechanism that is readily reversible," said Lindsey Macpherson, another author of the study and a Ph.D. candidate in the Scripps Research Kellogg School of Science and Technology. "The mechanism by which noxious compounds activate TRPA1 is unique. For example, compounds that activate an ion channels through a lock-and-key mechanism have structural similarity. TRPA1 activators have no structural similarity; instead, they share a common potential for chemical reactivity, and their binding is long-lasting."
TRPA1 is not unique among proteins to be activated by cysteine modifying agents, the study noted. Another signaling protein known as Kelch-like ECH-associated protein 1 (KEAP1) is activated by many of the same compounds that activate TRPA1; KEAP1 is a sensor for oxidative damage from free radicals and upregulates expression of antioxidant enzymes. Apparently, reactive compounds can activate at least two pathways through cysteine modification as a warning against cell damage, the study concluded.
"Our findings, which are the result of a successful collaboration with the Ben Cravatt and Peter Schultz labs at Scripps Research, show that modification of reactive cysteines within TRPA1 can cause channel activation," Macpherson said. "Our research efforts are now aimed at further understanding how binding of these compounds activate the channel, and identifying the physiological role of TRPA1 in sensing oxidative stress." The protein is currently being investigated by several pharmaceutical companies as a potential target for chronic pain, Patapoutian noted.
###
Other authors of the study, Noxious Compounds Activate TRPA1 Ion Channels Through Covalent Modification Of Cysteines, are Adrienne E. Dubin, Michael J. Evans, Felix Marr, and Benjamin F. Cravatt of The Scripps Research Institute; and Peter G. Schultz of The Scripps Research Institute and Genomics Institute of the Novartis Research Foundation.
The study was supported by the National Institutes of Health and the Novartis Research Foundation.
About The Scripps Research Institute
The Scripps Research Institute is one of the world's largest independent, non-profit biomedical research organizations, at the forefront of basic biomedical science that seeks to comprehend the most fundamental processes of life. Scripps Research is internationally recognized for its discoveries in immunology, molecular and cellular biology, chemistry, neurosciences, autoimmune, cardiovascular, and infectious diseases, and synthetic vaccine development. Established in its current configuration in 1961, it employs approximately 3,000 scientists, postdoctoral fellows, scientific and other technicians, doctoral degree graduate students, and administrative and technical support personnel. Scripps Research is headquartered in La Jolla, California. It also includes Scripps Florida, whose researchers focus on basic biomedical science, drug discovery, and technology development. Currently operating from temporary facilities in Jupiter, Scripps Florida will move to its permanent campus in 2009.
Contact: Keith McKeown
Scripps Research Institute
AAGBI Response To The BMJ Medical Milestones Poll Results
The Association of Anaesthetists of Great Britain and Ireland is pleased to note the results of the British Medical Journal Medical Milestones Poll to find the most important medical advance since the BMJ started in 1840.


The most important advance was Sanitation, [clean water and sewage disposal] followed by Antibiotics, and then Anaesthesia in third position, within two percentage points of the winner.


Congratulations to Sanitation, in which John Snow (an anesthetist) was also involved, and the important advance of Antibiotics.


Dr David Whitaker, President of the Association comments, "for Anaesthesia to be ranked in the top three out of an original list of 70 is significant recognition for the importance of the work Anaesthetists do caring for patients through our particular specialty".


Such acknowledgement of Anaesthesia also provides a pleasing start to the Association of Anaesthetists of Great Britain and Ireland's 75th Anniversary Year.


The AAGBI was originally set up in 1932, "to develop Anaesthesia" into what has successfully become the very important specialty further recognized today.


Association of Anaesthetists Anniversary strapline is "75 years, advancing patient safety", which underlines the improvements in patient care and mortality that have continued since the original milestone.
Association of Anaesthetists of Great Britain and Ireland


The most important advance was Sanitation, [clean water and sewage disposal] followed by Antibiotics, and then Anaesthesia in third position, within two percentage points of the winner.


Congratulations to Sanitation, in which John Snow (an anesthetist) was also involved, and the important advance of Antibiotics.


Dr David Whitaker, President of the Association comments, "for Anaesthesia to be ranked in the top three out of an original list of 70 is significant recognition for the importance of the work Anaesthetists do caring for patients through our particular specialty".


Such acknowledgement of Anaesthesia also provides a pleasing start to the Association of Anaesthetists of Great Britain and Ireland's 75th Anniversary Year.


The AAGBI was originally set up in 1932, "to develop Anaesthesia" into what has successfully become the very important specialty further recognized today.


Association of Anaesthetists Anniversary strapline is "75 years, advancing patient safety", which underlines the improvements in patient care and mortality that have continued since the original milestone.
Association of Anaesthetists of Great Britain and Ireland
Scientific, Medical Luminaries Gather At New York Symposium To Discuss The Science Of Electroceuticals
An impressive lineup of medical researchers and clinicians, including Nobel Laureate Louis Ignarro, PhD, gathered at a December 19 symposium in New York City to discuss the new and important scientific discipline of Electroceuticals. В В The next frontier in pulsed electromagnetic field (PEMF) therapy and electrotherapeutics, Electroceuticals are highly-refined electromagnetic fields that are now being used to non-invasively "jumpstart" the body's natural anti-inflammatory response to treat pain successfully and help soft tissue wounds heal faster.В
В Speakers discussed how advances in physics, biology and engineering have all begun to allow medical clinicians to directly affect the electrochemical processes that control all biological processes.В The complete proceedings, which are summarized below, can be accessed at http://www.ivivitechnologies.com.
В В "The science of Electroceuticals is so rich; it is always thrilling to bring such incredible minds together to discuss this exciting field," said Andre DiMino, founder and Co-CEO of Ivivi Technologies, Inc., a company dedicated to the field of electrotherapeutics and sponsor of the symposium.
В DiMino introduced the symposium line-up.В Some key presenters and panelists included:
В Arthur Pilla, PhD., the original developer of bone growth stimulation technology and a leading authority on bioelectromagnetic responses in therapeutic medical applications provided a "state of the science" and discussed the creation and identification of electrotherapeutic signals.В
В Pilla, a professor of biomedical engineering at Columbia University, said that applications for which Electroceuticals are already known to be effective include the healing of recalcitrant bone fractures, increasing the success rate of spinal fusion from 50% to 85%, healing chronic and acute soft tissue wounds, suppressing the body's inflammatory response, increasing local blood circulation, and perhaps most exciting, encouraging angiogenesis.
В Pilla also discussed the practical effects of electrotheraputic technologies вЂ" namely reducing costs of healthcare by reducing surgery and morbidity.В In 1980, bone growth stimulators reduced the cost of health care for delayed union fractures by tenfold. In fact, recent studies have shown Electroceuticals' tremendous promise to significantly reduce healing time, including 59% on surgical wounds, 69% on tendons and 70% on chronic wounds, such as diabetic foot ulcers. В
В Pilla then took attendees across the evolution of the technology to today's Electroceuticals which activate the Calcium(Ca)-Calmodulin(CaM)-Nitric Oxide(NO) pathways that are at the core of the body's healing cascade.
В Louis Ignarro, PhD., who received the 1998 Nobel Prize in Medicine and Physiology for his seminal work on the biological importance of nitric oxide, gave a presentation on the link between Nitric Oxide (NO) and the biological cascade stimulated by the application of Electroceuticals.
В Ignarro, a professor of pharmacology at UCLA, began by discussing the discovery of biological importance of NO, its pharmacological uses, and his discovery that arteries produce NO that maintains the health of the vasculature.В One well-known outcome is the discovery that NO was the neurotransmitter that stimulated male erections, leading to the development of Viagra.В
В Ignarro's research has discovered that NO has a multitude of functions in the body, helping to regulate processes that include angiogenesis, blood pressure control, digestion, respiration and promotion of learning and memory.В NO, found naturally in the human body, is potentially analgesic, anti-oxidant and anti-inflammatory, depending on the biological circumstances.
В Dr. Ignarro described how Ca/CaM activates the enzymes responsible for healthy NO production, the precise binding mechanism triggered by Electroceuticals.В
В Diana Casper, PhD., is a neurobiologist at the Albert Einstein School of Medicine, specializing in neurodegeneration.В She runs the neurosurgery lab at the Montefiore Medical Center. В В
В Casper gave a short history of Parkinson's disease, including pathology and treatments.В She highlighted a 2003 study that determined Parkinson's may be related to inflammation of brain cells, which lasts until death.В Having learned about the effects of pulsed electromagnetic fields, Casper became interested in the possibility that PEMF may help increase neuronal survival in response to inflammation.
В While Casper's research is ongoing, she showed preliminary data which demonstrated the promise of PEMF on neurodegenerative diseases.В Cultures treated with PEMF demonstrated improved neuronal survival.В She also presented data demonstrating decreases in acute inflammation after brain trauma, potentially promising work for problems of inflammation associate with brain trauma.В In a third study, Casper's lab demonstrated that PEMF increases NO levels, which, in turn, has neuroprotective properties.В
В Casper proposed next steps involve animal studies using models of neurodegenerative diseases.В Among the possible neuronal applications for PEMF treatments are Parkinson's, Alzheimer's, Huntington's disease.
В In addition to the keynote speakers, attendees and panelists included several practicing clinicians who described their successful experiences using Electroceuticals to treat patients.В One clinician described his ongoing study of the effect of Electroceuticals on heart disease, based on the known effects of Electroceuticals in improving angiogenesis.
В To access the complete Symposium proceedings please log on to http://www.ivivitechnolgies.com.
В About Ivivi Technologies:
Ivivi Technologies, Inc. (AMEX: II) is a medical technology company focusing on designing, developing and commercializing its proprietary electrotherapeutic technology platform.В Ivivi's research and development activities are focused specifically on pulsed electromagnetic field, or PEMF, technology, which, by creating a therapeutic electrical current in injured soft tissue, stimulates biochemical and physiological healing processes to help repair the injured tissue and reduce related pain and inflammation.В Since the mid-1990's, the Company's Electroceuticals™ have been used for a wide array of conditions, including chronic wounds, pain and edema following plastic and reconstructive surgery and chronic inflammatory disorders.
В Forward-Looking Statements:
This press release contains "forward looking statements" that are subject to risk and uncertainties, including, but not limited to, the Company's limited operating history, history of significant and continued operating losses and substantial accumulated earnings deficit, difficulties with its financial accounting controls, the failure of the market for the Company's products to continue to develop, the inability for customers to receive third party reimbursement, the inability to obtain additional capital, the inability to protect the Company's intellectual property, the loss of any executive officers or key personnel or consultants, competition, changes in the regulatory landscape or the imposition of regulations that affect the Company's products and other risks detailed from time to time in the Company's filings with the Securities and Exchange Commission, including the Company's registration statement on Form SB-2.В These risks could cause actual results to differ materially from those expressed in any forward looking statements made by, or on behalf of, the Company.В The Company assumes no obligation to update the information contained in this press release.
В Speakers discussed how advances in physics, biology and engineering have all begun to allow medical clinicians to directly affect the electrochemical processes that control all biological processes.В The complete proceedings, which are summarized below, can be accessed at http://www.ivivitechnologies.com.
В В "The science of Electroceuticals is so rich; it is always thrilling to bring such incredible minds together to discuss this exciting field," said Andre DiMino, founder and Co-CEO of Ivivi Technologies, Inc., a company dedicated to the field of electrotherapeutics and sponsor of the symposium.
В DiMino introduced the symposium line-up.В Some key presenters and panelists included:
В Arthur Pilla, PhD., the original developer of bone growth stimulation technology and a leading authority on bioelectromagnetic responses in therapeutic medical applications provided a "state of the science" and discussed the creation and identification of electrotherapeutic signals.В
В Pilla, a professor of biomedical engineering at Columbia University, said that applications for which Electroceuticals are already known to be effective include the healing of recalcitrant bone fractures, increasing the success rate of spinal fusion from 50% to 85%, healing chronic and acute soft tissue wounds, suppressing the body's inflammatory response, increasing local blood circulation, and perhaps most exciting, encouraging angiogenesis.
В Pilla also discussed the practical effects of electrotheraputic technologies вЂ" namely reducing costs of healthcare by reducing surgery and morbidity.В In 1980, bone growth stimulators reduced the cost of health care for delayed union fractures by tenfold. In fact, recent studies have shown Electroceuticals' tremendous promise to significantly reduce healing time, including 59% on surgical wounds, 69% on tendons and 70% on chronic wounds, such as diabetic foot ulcers. В
В Pilla then took attendees across the evolution of the technology to today's Electroceuticals which activate the Calcium(Ca)-Calmodulin(CaM)-Nitric Oxide(NO) pathways that are at the core of the body's healing cascade.
В Louis Ignarro, PhD., who received the 1998 Nobel Prize in Medicine and Physiology for his seminal work on the biological importance of nitric oxide, gave a presentation on the link between Nitric Oxide (NO) and the biological cascade stimulated by the application of Electroceuticals.
В Ignarro, a professor of pharmacology at UCLA, began by discussing the discovery of biological importance of NO, its pharmacological uses, and his discovery that arteries produce NO that maintains the health of the vasculature.В One well-known outcome is the discovery that NO was the neurotransmitter that stimulated male erections, leading to the development of Viagra.В
В Ignarro's research has discovered that NO has a multitude of functions in the body, helping to regulate processes that include angiogenesis, blood pressure control, digestion, respiration and promotion of learning and memory.В NO, found naturally in the human body, is potentially analgesic, anti-oxidant and anti-inflammatory, depending on the biological circumstances.
В Dr. Ignarro described how Ca/CaM activates the enzymes responsible for healthy NO production, the precise binding mechanism triggered by Electroceuticals.В
В Diana Casper, PhD., is a neurobiologist at the Albert Einstein School of Medicine, specializing in neurodegeneration.В She runs the neurosurgery lab at the Montefiore Medical Center. В В
В Casper gave a short history of Parkinson's disease, including pathology and treatments.В She highlighted a 2003 study that determined Parkinson's may be related to inflammation of brain cells, which lasts until death.В Having learned about the effects of pulsed electromagnetic fields, Casper became interested in the possibility that PEMF may help increase neuronal survival in response to inflammation.
В While Casper's research is ongoing, she showed preliminary data which demonstrated the promise of PEMF on neurodegenerative diseases.В Cultures treated with PEMF demonstrated improved neuronal survival.В She also presented data demonstrating decreases in acute inflammation after brain trauma, potentially promising work for problems of inflammation associate with brain trauma.В In a third study, Casper's lab demonstrated that PEMF increases NO levels, which, in turn, has neuroprotective properties.В
В Casper proposed next steps involve animal studies using models of neurodegenerative diseases.В Among the possible neuronal applications for PEMF treatments are Parkinson's, Alzheimer's, Huntington's disease.
В In addition to the keynote speakers, attendees and panelists included several practicing clinicians who described their successful experiences using Electroceuticals to treat patients.В One clinician described his ongoing study of the effect of Electroceuticals on heart disease, based on the known effects of Electroceuticals in improving angiogenesis.
В To access the complete Symposium proceedings please log on to http://www.ivivitechnolgies.com.
В About Ivivi Technologies:
Ivivi Technologies, Inc. (AMEX: II) is a medical technology company focusing on designing, developing and commercializing its proprietary electrotherapeutic technology platform.В Ivivi's research and development activities are focused specifically on pulsed electromagnetic field, or PEMF, technology, which, by creating a therapeutic electrical current in injured soft tissue, stimulates biochemical and physiological healing processes to help repair the injured tissue and reduce related pain and inflammation.В Since the mid-1990's, the Company's Electroceuticals™ have been used for a wide array of conditions, including chronic wounds, pain and edema following plastic and reconstructive surgery and chronic inflammatory disorders.
В Forward-Looking Statements:
This press release contains "forward looking statements" that are subject to risk and uncertainties, including, but not limited to, the Company's limited operating history, history of significant and continued operating losses and substantial accumulated earnings deficit, difficulties with its financial accounting controls, the failure of the market for the Company's products to continue to develop, the inability for customers to receive third party reimbursement, the inability to obtain additional capital, the inability to protect the Company's intellectual property, the loss of any executive officers or key personnel or consultants, competition, changes in the regulatory landscape or the imposition of regulations that affect the Company's products and other risks detailed from time to time in the Company's filings with the Securities and Exchange Commission, including the Company's registration statement on Form SB-2.В These risks could cause actual results to differ materially from those expressed in any forward looking statements made by, or on behalf of, the Company.В The Company assumes no obligation to update the information contained in this press release.
Dental Researchers Test No-Needle Anesthesia, No-Drilling Cavity Care
Imagine having a decayed tooth repaired, painlessly, without drilling or shots of anesthesia to numb the area.
Wishful thinking? Not if two studies being conducted at the University at Buffalo's School of Dental Medicine show positive results.
In one study, funded by a $100,000 grant by Apollonia, LLC, researchers in the school's Center for Dental Studies are testing a nasal spray that numbs the upper teeth.
"If this study is successful," said Sebastian Ciancio, D.D.S., principal investigator on the study, "it may mean the end of dental injections when dentists are performing procedures on the upper arch."
The second study, set to begin in coming months, will test the use of ozone to kill bacteria in a decayed tooth and its potential to eliminate the need for the dreaded drill, at least to repair simple cavities. Researchers at UB and two other U.S. dental schools will conduct the research, which is funded by a $1.5 million grant from Curozone, Inc. and Kavo Dental Manufacturing Co. UB's portion is $400,000.
Ciancio, who also is the UB principal investigator on this study, said the ozone delivery device currently is being used in Europe. "If the U.S. studies are successful, it should be available in this country in about two years," he said.
The nasal spray study is testing the effectiveness in dental procedures of a topical anesthetic normally used by ear, nose and throat physicians when they operate on the nose. Patients who received this anesthetic for that purpose reported it also numbed their upper teeth, sparking interest in using it for dental procedures.
"We currently are testing to determine what the optimal dose is for this spray when used as an anesthetic agent for the maxillary (upper) teeth," said Ciancio. "The current study includes 85 patients and should be completed by the end of January and will be followed by a second study in March. Once we know the results, we'll then test it in a broader population."
Co-investigators, all from the UB dental school, are Eugene Pantera, D.D.S., Sandra Shostad, D.D.S., and Joseph Bonavilla, D.D.S.
The ozone study will evaluate the effectiveness of the ozone delivery device, which fits over a tooth and forms an airtight seal, in arresting tooth decay. The study will enroll 125 participants and will last 18 months.
"Following application of the ozone, patients will use a remineralizing solution, which strengthens the weakened tooth structure and, in many cases, eliminates the need for any dental drilling," said Ciancio.
Additional investigators on this study are Othman Shibly, D.D.S., Jude Fabiano, D.D.S., Benita Sobieroj, D.D.S., Maureen Donley, D.D.S., and Nina Kim, D.D.S., all from the UB dental school faculty.
Contact: Lois Baker
University at Buffalo
Wishful thinking? Not if two studies being conducted at the University at Buffalo's School of Dental Medicine show positive results.
In one study, funded by a $100,000 grant by Apollonia, LLC, researchers in the school's Center for Dental Studies are testing a nasal spray that numbs the upper teeth.
"If this study is successful," said Sebastian Ciancio, D.D.S., principal investigator on the study, "it may mean the end of dental injections when dentists are performing procedures on the upper arch."
The second study, set to begin in coming months, will test the use of ozone to kill bacteria in a decayed tooth and its potential to eliminate the need for the dreaded drill, at least to repair simple cavities. Researchers at UB and two other U.S. dental schools will conduct the research, which is funded by a $1.5 million grant from Curozone, Inc. and Kavo Dental Manufacturing Co. UB's portion is $400,000.
Ciancio, who also is the UB principal investigator on this study, said the ozone delivery device currently is being used in Europe. "If the U.S. studies are successful, it should be available in this country in about two years," he said.
The nasal spray study is testing the effectiveness in dental procedures of a topical anesthetic normally used by ear, nose and throat physicians when they operate on the nose. Patients who received this anesthetic for that purpose reported it also numbed their upper teeth, sparking interest in using it for dental procedures.
"We currently are testing to determine what the optimal dose is for this spray when used as an anesthetic agent for the maxillary (upper) teeth," said Ciancio. "The current study includes 85 patients and should be completed by the end of January and will be followed by a second study in March. Once we know the results, we'll then test it in a broader population."
Co-investigators, all from the UB dental school, are Eugene Pantera, D.D.S., Sandra Shostad, D.D.S., and Joseph Bonavilla, D.D.S.
The ozone study will evaluate the effectiveness of the ozone delivery device, which fits over a tooth and forms an airtight seal, in arresting tooth decay. The study will enroll 125 participants and will last 18 months.
"Following application of the ozone, patients will use a remineralizing solution, which strengthens the weakened tooth structure and, in many cases, eliminates the need for any dental drilling," said Ciancio.
Additional investigators on this study are Othman Shibly, D.D.S., Jude Fabiano, D.D.S., Benita Sobieroj, D.D.S., Maureen Donley, D.D.S., and Nina Kim, D.D.S., all from the UB dental school faculty.
Contact: Lois Baker
University at Buffalo
Low-Dose Steroids Reduce Joint Damage From Rheumatoid Arthritis
Low doses of steroids can inhibit joint damage when used in the early phase of rheumatoid arthritis, according to a new review of evidence.
High-quality evidence supports combining the pills with standard medications in the first two years after diagnosis. "Such treatment should be made readily available to patients," say review authors led by John Kirwan of Liverpool Women's Hospital in England.
Concern exists about the side effects of steroid therapy, however. High doses can contribute to heart disease, osteoporosis and other complications. Questions remain about whether smaller doses lead to similar problems.
Rheumatoid arthritis is a chronic disease in which the body's immune system attacks and destroys healthy joint tissue. The hands and feet are frequently affected, and as the disease progresses it can cause pain, swelling, deformity and disability.
The steroids studied in the review are known as glucocorticoids and include the well-known anti-inflammatory prednisone. This medication is often prescribed in the first few months after diagnosis to relieve the discomfort of RA until slower-acting drugs begin protecting the joints.
Until now, concerns about side effects caused most rheumatologists to "put people on the lowest possible dose of steroids and get them off it as soon as possible," said Scott Zashin, M.D., of the University of Texas Southwestern Medical Center. "Now, we have to give steroids a little more respect."
The review appears in the most recent 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 systematic review is based on 15 studies including 1,414 patients. In most of the studies, patients received low doses of glucocorticoid pills along with so-called disease-modifying drugs for one to two years. Periodic X-rays revealed the extent of joint erosion and other signs of damage.
All studies except one showed reduced progression of joint damage in patients taking glucocorticoids. When reviewers used statistical methods to focus on only the highest-quality data, the benefits remained statistically significant.
"Even in the most conservative estimate, the evidence that glucocorticoids given in addition to standard therapy can substantially reduce the rate of erosion progression in rheumatoid arthritis is convincing," they say.
The authors say, however, that minimization of joint damage seen on X-rays may not equate to noticeable improvements for patients: "It does not necessarily follow that patients will gain long-term functional benefit." However, two related studies, including one by Kirwan, suggest "an important link" between the two.
Because of the known health risks associated with intensive steroid use, concern persists regarding long-term use at any level. The authors cite a 2006 systematic review covering the adverse effects of low-dose glucocorticoids, which concluded that "few of the commonly held beliefs about their incidence, prevalence and impact are supported by clear scientific evidence."
Moreover, safety data from recent randomized controlled clinical trials of low-dose steroids for RA suggest that negative side effects are "modest" and similar to those of sham treatments, say Kirwan and colleagues. Additionally, the most immediate concern -- reduced bone mineral density -- can now be readily treated.
Nevertheless, potential adverse reactions to glucocorticoid therapy merit further research, say the authors, as does usefulness of steroid treatment for patients who have had rheumatoid arthritis for 3 years or more.
Zashin urges patients recently diagnosed with rheumatoid arthritis to see a rheumatologist without delay. Early and aggressive treatment can prevent severe joint damage and disability for most people, he says.
###
Kirwan JR, et al. Effects of glucocorticoids on radiological progression in rheumatoid arthritis (Review). Cochrane Database of Systematic Reviews 2007, Issue 1.
The Cochrane Collaboration is an international nonprofit, 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 http://www.cochrane.org/ for more information.
Contact: Lisa Esposito
Center for the Advancement of Health
High-quality evidence supports combining the pills with standard medications in the first two years after diagnosis. "Such treatment should be made readily available to patients," say review authors led by John Kirwan of Liverpool Women's Hospital in England.
Concern exists about the side effects of steroid therapy, however. High doses can contribute to heart disease, osteoporosis and other complications. Questions remain about whether smaller doses lead to similar problems.
Rheumatoid arthritis is a chronic disease in which the body's immune system attacks and destroys healthy joint tissue. The hands and feet are frequently affected, and as the disease progresses it can cause pain, swelling, deformity and disability.
The steroids studied in the review are known as glucocorticoids and include the well-known anti-inflammatory prednisone. This medication is often prescribed in the first few months after diagnosis to relieve the discomfort of RA until slower-acting drugs begin protecting the joints.
Until now, concerns about side effects caused most rheumatologists to "put people on the lowest possible dose of steroids and get them off it as soon as possible," said Scott Zashin, M.D., of the University of Texas Southwestern Medical Center. "Now, we have to give steroids a little more respect."
The review appears in the most recent 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 systematic review is based on 15 studies including 1,414 patients. In most of the studies, patients received low doses of glucocorticoid pills along with so-called disease-modifying drugs for one to two years. Periodic X-rays revealed the extent of joint erosion and other signs of damage.
All studies except one showed reduced progression of joint damage in patients taking glucocorticoids. When reviewers used statistical methods to focus on only the highest-quality data, the benefits remained statistically significant.
"Even in the most conservative estimate, the evidence that glucocorticoids given in addition to standard therapy can substantially reduce the rate of erosion progression in rheumatoid arthritis is convincing," they say.
The authors say, however, that minimization of joint damage seen on X-rays may not equate to noticeable improvements for patients: "It does not necessarily follow that patients will gain long-term functional benefit." However, two related studies, including one by Kirwan, suggest "an important link" between the two.
Because of the known health risks associated with intensive steroid use, concern persists regarding long-term use at any level. The authors cite a 2006 systematic review covering the adverse effects of low-dose glucocorticoids, which concluded that "few of the commonly held beliefs about their incidence, prevalence and impact are supported by clear scientific evidence."
Moreover, safety data from recent randomized controlled clinical trials of low-dose steroids for RA suggest that negative side effects are "modest" and similar to those of sham treatments, say Kirwan and colleagues. Additionally, the most immediate concern -- reduced bone mineral density -- can now be readily treated.
Nevertheless, potential adverse reactions to glucocorticoid therapy merit further research, say the authors, as does usefulness of steroid treatment for patients who have had rheumatoid arthritis for 3 years or more.
Zashin urges patients recently diagnosed with rheumatoid arthritis to see a rheumatologist without delay. Early and aggressive treatment can prevent severe joint damage and disability for most people, he says.
###
Kirwan JR, et al. Effects of glucocorticoids on radiological progression in rheumatoid arthritis (Review). Cochrane Database of Systematic Reviews 2007, Issue 1.
The Cochrane Collaboration is an international nonprofit, 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 http://www.cochrane.org/ for more information.
Contact: Lisa Esposito
Center for the Advancement of Health
2 Minutes Conversation prevents RX - Wrong-Site Surgery
A study of Johns Hopkins surgeons, anesthesiologists and nurses suggests that hospital policies requiring a brief preoperation "team meeting" to make sure surgery is performed on the right patient and the right part of the body could decrease errors.
In the study, which will appear in the February issue of the Journal of the American College of Surgeons, Hopkins OR personnel were "very positive" about the briefings, according to surgeon Martin Makary, M.D., M.P.H., director of the Johns Hopkins Center for Surgical Outcomes Research and lead author of the study.
"Although we lack systems for uniform reporting of wrong-site surgeries to understand the extent of the problem, we observed team meetings increase the awareness of OR personnel with regard to the site and procedure and their perceptions of operating rooms safety" says Makary. He stressed that wrong-site surgery is exceptionally rare but entirely preventable.
A study published last year in the Archives of Surgery that looked at 2.8 million operations in Massachusetts over a 20-year period suggests that the rate of "wrong-site" surgery anywhere other than the spine is 1 in every 112,994 operations. The study excluded the spine because researchers defined wrong-site surgeries as operations conducted on a different organ or body part than intended by the surgeon and patient. Since the spine is one body part, even though a surgeon may have operated on the wrong part of the spine, technically it is still the right part of the body.
The Joint Commission, which evaluates and accredits nearly 15,000 health care organizations and programs in the United States, requires hospitals to have a presurgical conversation in the OR before every surgery.
Although Makary says no national standard was set by the Joint Commission, he and others led efforts at Hopkins to enforce the mandate, developing a standardized OR briefing program that became Hopkins Hospital policy in June 2006. Since then, he has collaborated with Rochester University, Yale, Columbia and Cornell and the World Health Organization to broaden the use and reach of the Hopkins program.
The briefing consists of a two-minute meeting during which all members of the OR team state their name and role, and the lead surgeon identifies and verifies such critical components of the operation as the patient's identity, the surgical site and other patient safety concerns. The briefing is performed after anesthesia is administered and prior to incision.
A survey, among 147 surgeons, 59 anesthesiologists, 187 nurses and 29 other OR staff, was given twice - before implementing the policy and after it had been in effect for three-months.
After training, a 13.2 percent increase in those who believed the policy would be effective was recorded among the OR personnel. And more than 90 percent agreed that "a team discussion before a surgical procedure is important for patient safety."
"The Joint Commission identified communication breakdowns as the most common root cause of wrong-site surgeries," says Makary. "Our research indicates that OR personnel see presurgical briefings as a useful tool to help prevent such errors."
Before the new policy was implemented, Makary notes, many surgeons would walk into the OR and start working without a conversation of any kind and without even knowing the names of the nurses and other staff who were assisting them.
###
The survey is based on a similar questionnaire designed by the airline industry to assess programs designed to reduce safety errors.
Hopkins faculty members Peter J. Pronovost, M.D., Ph.D., and Bryan Sexton, Ph.D., also contributed to the article.
Contact: Eric Vohr
Johns Hopkins Medical Institutions
In the study, which will appear in the February issue of the Journal of the American College of Surgeons, Hopkins OR personnel were "very positive" about the briefings, according to surgeon Martin Makary, M.D., M.P.H., director of the Johns Hopkins Center for Surgical Outcomes Research and lead author of the study.
"Although we lack systems for uniform reporting of wrong-site surgeries to understand the extent of the problem, we observed team meetings increase the awareness of OR personnel with regard to the site and procedure and their perceptions of operating rooms safety" says Makary. He stressed that wrong-site surgery is exceptionally rare but entirely preventable.
A study published last year in the Archives of Surgery that looked at 2.8 million operations in Massachusetts over a 20-year period suggests that the rate of "wrong-site" surgery anywhere other than the spine is 1 in every 112,994 operations. The study excluded the spine because researchers defined wrong-site surgeries as operations conducted on a different organ or body part than intended by the surgeon and patient. Since the spine is one body part, even though a surgeon may have operated on the wrong part of the spine, technically it is still the right part of the body.
The Joint Commission, which evaluates and accredits nearly 15,000 health care organizations and programs in the United States, requires hospitals to have a presurgical conversation in the OR before every surgery.
Although Makary says no national standard was set by the Joint Commission, he and others led efforts at Hopkins to enforce the mandate, developing a standardized OR briefing program that became Hopkins Hospital policy in June 2006. Since then, he has collaborated with Rochester University, Yale, Columbia and Cornell and the World Health Organization to broaden the use and reach of the Hopkins program.
The briefing consists of a two-minute meeting during which all members of the OR team state their name and role, and the lead surgeon identifies and verifies such critical components of the operation as the patient's identity, the surgical site and other patient safety concerns. The briefing is performed after anesthesia is administered and prior to incision.
A survey, among 147 surgeons, 59 anesthesiologists, 187 nurses and 29 other OR staff, was given twice - before implementing the policy and after it had been in effect for three-months.
After training, a 13.2 percent increase in those who believed the policy would be effective was recorded among the OR personnel. And more than 90 percent agreed that "a team discussion before a surgical procedure is important for patient safety."
"The Joint Commission identified communication breakdowns as the most common root cause of wrong-site surgeries," says Makary. "Our research indicates that OR personnel see presurgical briefings as a useful tool to help prevent such errors."
Before the new policy was implemented, Makary notes, many surgeons would walk into the OR and start working without a conversation of any kind and without even knowing the names of the nurses and other staff who were assisting them.
###
The survey is based on a similar questionnaire designed by the airline industry to assess programs designed to reduce safety errors.
Hopkins faculty members Peter J. Pronovost, M.D., Ph.D., and Bryan Sexton, Ph.D., also contributed to the article.
Contact: Eric Vohr
Johns Hopkins Medical Institutions
Back Pain: When To Opt For Surgery, From The Harvard Health Letter
Low back pain is an extremely common condition: 80% of Americans experience at least one bout of it some time during their lives. Usually, rest, some pain relievers, and perhaps some exercises help it go away. But for many millions, the pain lingers and may become severe and debilitating. How do you know when back pain warrants surgery? The February 2007 issue of the Harvard Health Letter investigates.
Deciding to have surgery is never simple, but it's especially difficult when the back is involved. Many studies of back surgery have been small. Popular procedures have been questioned, and new ones get introduced before we really know how well they'll work over the long haul. It's hard enough for doctors to figure out what to do about surgery for back pain. Patients are often even more confused.
Back surgery is an option for people with long-lasting pain due to herniated disks, spinal stenosis, or degenerative disease. Studies have shown good results from spinal stenosis surgery, with any lingering pain controlled with medication. On the other hand, doctors are beginning to question whether too many surgeries are performed to treat degenerative disease. As for herniated disks, a recent study found that surgical and nonsurgical treatments worked equally well. An editorial accompanying the study said toss-up results show that the decision whether to have surgery is a matter of patient preference more than anything else.
Ideally, your primary care physician can walk you through your options- surgical and non-to get you to an effective treatment.
Harvard Health Publications
http://www.health.harvard.edu/health
Deciding to have surgery is never simple, but it's especially difficult when the back is involved. Many studies of back surgery have been small. Popular procedures have been questioned, and new ones get introduced before we really know how well they'll work over the long haul. It's hard enough for doctors to figure out what to do about surgery for back pain. Patients are often even more confused.
Back surgery is an option for people with long-lasting pain due to herniated disks, spinal stenosis, or degenerative disease. Studies have shown good results from spinal stenosis surgery, with any lingering pain controlled with medication. On the other hand, doctors are beginning to question whether too many surgeries are performed to treat degenerative disease. As for herniated disks, a recent study found that surgical and nonsurgical treatments worked equally well. An editorial accompanying the study said toss-up results show that the decision whether to have surgery is a matter of patient preference more than anything else.
Ideally, your primary care physician can walk you through your options- surgical and non-to get you to an effective treatment.
Harvard Health Publications
http://www.health.harvard.edu/health
Surgical Trauma In Back Surgery Lowered By Pretreating Spinal Cord With Local Anesthetic
Texas researchers believe that they have discovered how to prevent many cases of the most common problem encountered by patients undergoing spine surgery: failed back surgery syndrome (FBSS).
FBSS occurs when surgery either fails to cure back pain or leads to additional chronic pain after a spinal operation.
In experiments using laboratory rats, neuroscientists at the University of Texas Medical Branch at Galveston (UTMB) applied the local anesthetic Lidocaine to the animals' exposed spinal cords before subjecting the rats to simulated spinal surgery. They found the procedure prevented both the release of chemicals associated with FBSS and behavior typical of animals experiencing FBSS-caused pain.
A paper describing their investigation is in press at the journal Experimental Neurology, and will be available January 26 at the journal's Web site in the "Articles in Press" section.
"Our hypothesis is that the unintentional stretching and compression that can occur in the spinal cord during surgery causes the release of large quantities of chemicals called excitatory amino acids, which produce a toxic environment in the spine and cause long-term hyperexcitability in spinal neurons, generating chronic neuropathic pain - pain produced in the nerves themselves," said UTMB neuroscience and cell biology professor Claire Hulsebosch, a senior author of the paper along with UTMB neuroscience and cell biology professor David J. McAdoo. "When we applied Lidocaine to the surface of the spinal cord before conducting our surgery," Hulsebosch continued, "we found that those releases were completely blocked."
In addition, Hulsebosch noted, rats whose spines had been pretreated with the local anesthetic showed less sensitivity and scored much lower than non-treated rats on a standard test for symptoms of neuropathic pain. In the test, steadily increasing pressure is applied to a rat's hind paws with fishing-line-like filaments. Rats experiencing the hypersensitivity associated with chronic pain tend to withdraw their paws at very low pressures, while those without chronic nerve pain react only to much higher pressures.
Researchers involved in the experiment cautioned that FBSS is a somewhat loose diagnosis, one with multiple causes that also may include pre-existing conditions that spinal surgery does not successfully address. "It also has to be said that the model we used, in which we cut the nerves in the dorsal root on the surface of the spinal cord, involved a severe injury," said UTMB neuroscience graduate student and first author Brian Rooney "But we think it's a good representation of the sort of injury that can be produced by surgery."
###
Neuroscience postdoctoral fellow E.D. Crown also co-authored the paper. The research was supported by grants from the John S. Dunn Research Foundation and the West Endowment, as well as the Frank A. Liddell, Jr. Fund of the Greater Houston Community Foundation, TIRR Foundation's Mission Connect program and the National Institutes of Health.
Contact: Jim Kelly
University of Texas Medical Branch at Galveston
FBSS occurs when surgery either fails to cure back pain or leads to additional chronic pain after a spinal operation.
In experiments using laboratory rats, neuroscientists at the University of Texas Medical Branch at Galveston (UTMB) applied the local anesthetic Lidocaine to the animals' exposed spinal cords before subjecting the rats to simulated spinal surgery. They found the procedure prevented both the release of chemicals associated with FBSS and behavior typical of animals experiencing FBSS-caused pain.
A paper describing their investigation is in press at the journal Experimental Neurology, and will be available January 26 at the journal's Web site in the "Articles in Press" section.
"Our hypothesis is that the unintentional stretching and compression that can occur in the spinal cord during surgery causes the release of large quantities of chemicals called excitatory amino acids, which produce a toxic environment in the spine and cause long-term hyperexcitability in spinal neurons, generating chronic neuropathic pain - pain produced in the nerves themselves," said UTMB neuroscience and cell biology professor Claire Hulsebosch, a senior author of the paper along with UTMB neuroscience and cell biology professor David J. McAdoo. "When we applied Lidocaine to the surface of the spinal cord before conducting our surgery," Hulsebosch continued, "we found that those releases were completely blocked."
In addition, Hulsebosch noted, rats whose spines had been pretreated with the local anesthetic showed less sensitivity and scored much lower than non-treated rats on a standard test for symptoms of neuropathic pain. In the test, steadily increasing pressure is applied to a rat's hind paws with fishing-line-like filaments. Rats experiencing the hypersensitivity associated with chronic pain tend to withdraw their paws at very low pressures, while those without chronic nerve pain react only to much higher pressures.
Researchers involved in the experiment cautioned that FBSS is a somewhat loose diagnosis, one with multiple causes that also may include pre-existing conditions that spinal surgery does not successfully address. "It also has to be said that the model we used, in which we cut the nerves in the dorsal root on the surface of the spinal cord, involved a severe injury," said UTMB neuroscience graduate student and first author Brian Rooney "But we think it's a good representation of the sort of injury that can be produced by surgery."
###
Neuroscience postdoctoral fellow E.D. Crown also co-authored the paper. The research was supported by grants from the John S. Dunn Research Foundation and the West Endowment, as well as the Frank A. Liddell, Jr. Fund of the Greater Houston Community Foundation, TIRR Foundation's Mission Connect program and the National Institutes of Health.
Contact: Jim Kelly
University of Texas Medical Branch at Galveston
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