Universit?¤tsmedizin Berlin and Universit?¤tsklinik Freiburg succeeded in documenting how the immune system can counteract the advancement of Alzheimer’s disease. Within the scope of their neuroscience paper they showed that certain scavenger cells in the immune system, so-called macrophages, play a key role in this context. Furthermore, they were able to demonstrate how special cell-signaling proteins, so-called chemokines, mediate the defense process. The results of the study have now been published in the renowned Journal of Neuroscience.

Prof. Josef Priller, Director of Neuropsychiatry at Campus Charit?© Mitte, is head of the research team. The paper was sponsored by the German Federal Ministry of Education and Research (‘BMBF’) and the German Research Foundation (‘DFG’). For ten years now the scientists have been investigating the exact role of macrophages in neurodegenerative diseases. “Macrophages can reduce harmful deposits in the brain that are the cause of Alzheimer’s disease,” Prof. Priller explains.

In an animal model the research team was now able to show which certain subset of macrophages is responsible for reduction of the deposits. Contrary to earlier academic opinion, this defense reaction cannot be handled by the immune cells of the brain, the microglia, because they themselves are damaged by the pathological process. Instead, specialized bone marrow-derived macrophages are activated and directed into the brain to remove the toxic deposits. The carrier cells receive the command to specialize and infiltrate the brain in the form of certain cell-signaling proteins. The researchers managed to identify a specific chemokine for the first time.

This results in a completely new treatment approach for Alzheimer’s disease. “In future we hope to be able to systematically introduce specialized scavenger cells to the brain and thus speed up the reduction of Alzheimer’s disease deposits,” says Prof. Priller. The researchers are confident that they have found the approach for a cell-based therapy with relatively few side effects.

Sources: Universit?¤tsmedizin Berlin, AlphaGalileo Foundation. Continue reading →

Many heavy meat eaters believe they eat a lot of meat because of the taste. But according to groundbreaking new research in the Journal of Consumer Research, the reason that a beef burger tastes better than a veggie burger to some people has more to do with values than actual taste.

Authors Michael W. Allen (University of Sydney), Richa Gupta (University of Nashville), and Arnaud Monnier (National Engineer School for Food Industries and Management, France) conducted a series of studies that examined the symbolic meaning of foods and beverages. They found that when it came to tasting meat or soft drinks, what influenced participants was what they thought they had eaten rather than what they actually ate.

The authors note that meat has an association with social power, and people who scored high in the authors’ Social Power Value Endorsement measure believed that a meat-containing item tasted better than a vegetarian alternative, even when both products were actually identical (one was mis-represented). Similarly, participants who supported the values symbolized by Pepsi (Exciting Life, Social Power, and Recognition) gave a more favorable rating to the product they thought was Pepsi – even though they were drinking the low-price Woolworth cola.

Participants were told that they would taste either a beef sausage roll or a vegetarian alternative roll, and that they would drink either a Pepsi or a Woolworth Homebrand cola. Some received the item they were told they would receive and some were given the similar-tasting item. Then they filled out a questionnaire about values and taste, along with their current food and soft drink consumption.

“Our present findings may have implications for efforts to promote better eating habits,” write the authors. “Heavy meat eaters claim that they eat meat because it tastes better than other foods, such as meat substitutes. Our results challenge that claim. Participants who ate the vegetarian alternative did not rate the taste and aroma less favorably than those who ate the beef product. Instead, what influenced taste evaluation was what they thought they had eaten and whether that food symbolized values that they personally supported ??¦ strategies that might persuade heavy meat eaters to change their diet include changing the cultural associations of fruits and vegetables to encompass values that meat eaters endorse (e.g., power and strength), or challenging heavy meat eaters’ assumptions about what tastes good by using in-store (blind) taste tests or showing them results of studies such as this one.”

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Michael W. Allen, Richa Gupta, and Arnaud Monnier. “The Interactive Effect of Cultural Symbols and Human Values on Taste Evaluation” Journal of Consumer Research: August 2008

Founded in 1974, the Journal of Consumer Research publishes scholarly research that describes and explains consumer behavior. Empirical, theoretical, and methodological articles spanning fields such as psychology, marketing, sociology, economics, and anthropology are featured in this interdisciplinary journal. The primary thrust of JCR is academic, rather than managerial, with topics ranging from micro-level processes (e.g., brand choice) to more macro-level issues (e.g., the development of materialistic values).

Source: Rudy Faust

University of Chicago Press Journals Continue reading →

Mild Alzheimer’s disease patients with higher physical fitness had larger brains compared to mild Alzheimer’s patients with lower physical fitness, according to a study published in the July 15, 2008, issue of Neurology®, the medical journal of the American Academy of Neurology.

For the study, 121 people age 60 and older underwent fitness tests using a treadmill as well as brain scans to measure the white matter, gray matter and total volume of their brains. Of the group, 57 were in the early stages of Alzheimer’s disease while the rest of the group did not have dementia.

“People with early Alzheimer’s disease who were less physically fit had four times more brain shrinkage when compared to normal older adults than those who were more physically fit, suggesting less brain shrinkage related to the Alzheimer’s disease process in those with higher fitness levels,” said study author Jeffrey M. Burns, MD, of the University of Kansas School of Medicine in Kansas City and member of the American Academy of Neurology.

The results remained the same regardless of age, gender, severity of dementia, physical activity and frailty. There was no relationship between higher fitness levels and brain changes in the group of people without dementia.

“People with early Alzheimer’s disease may be able to preserve their brain function for a longer period of time by exercising regularly and potentially reducing the amount of brain volume lost. Evidence shows decreasing brain volume is tied to poorer cognitive performance, so preserving more brain volume may translate into better cognitive performance,” Burns said.

“This is one of the first studies to explore the relationship between cardiorespiratory fitness and Alzheimer’s disease,” said Burns.

Burns says people should be cautious when interpreting the study results because scientists only observed the standard measure of fitness at one point in time.

The study was supported by the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, the University of Kansas Endowment Association, the Fraternal Order of Eagles and the Oppenheimer Foundation.

The American Academy of Neurology, an association of more than 21,000 neurologists and neuroscience professionals, is dedicated to improving patient care through education and research. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as epilepsy, dystonia, migraine, Huntington’s disease, and dementia. For more information about the American Academy of Neurology, visit aan.

American Academy of Neurology (AAN)
1080 Montreal Ave.
St. Paul, MN 55116
United States
neurology Continue reading →

Dendreon Corporation (Nasdaq: DNDN) announced the upcoming presentation of data from integrated analyses of three Phase 3 PROVENGE® (sipuleucel-T) clinical trials of an autologous cellular immunotherapy in advanced prostate cancer, to be presented at the annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago on Monday, June 7 at 8:00 a.m. CT.

“With the recent FDA approval of PROVENGE for asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer, patients now have a new treatment option available that prolongs survival,” said Daniel P. Petrylak, M.D., program director of the Genitourinary Oncology Section in the Division of Hematology/Oncology at Columbia University. “Cancer immunotherapy represents an entirely new era in medicine and patient care.”

The exploratory analyses include data from three Phase 3 trials in patients with metastatic castrate resistant prostate cancer (Studies D9901, D9902A, and IMPACT) that were integrated to examine the treatment effect in a larger group of patients, the use of docetaxel before and after randomization, and relationships between certain product parameters and clinical outcome. These include:

– A poster presentation by Dr. Celestia Higano, professor of oncology and urology at the University of Washington, titled, “Predictors of outcome and subgroup results from the integrated analysis of sipuleucel-T trials in metastatic castration resistant prostate cancer (abstract #4550).”

– A poster presentation by Dr. Petrylak titled, “Immunotherapy survival effect persists independent of post-randomization docetaxel use in Phase 3 studies of sipuleucel-T (abstract #4551).”

– A poster presentation by Dr. Frances P. Stewart, senior biostatician at Dendreon, titled, “Correlation between product parameters and overall survival in 3 trials of sipuleucel-T, an autologous active cellular immunotherapy for the treatment of prostate cancer (abstract #4552).”

PROVENGE is the first autologous cellular immunotherapy to be approved by the U.S. Food and Drug Administration for the treatment of asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer.

PROVENGE Safety

PROVENGE is intended solely for autologous use and is not routinely tested for transmissible infectious diseases.

The safety evaluation of PROVENGE was based on 601 prostate cancer patients in four randomized clinical trials who underwent at least one leukapheresis procedure. The most common adverse events (incidence greater than or equal to 15%) are chills, fatigue, fever, back pain, nausea, joint ache, and headache. Serious adverse events reported in the PROVENGE group include acute infusion reactions (occurring within 1 day of infusion) and cerebrovascular events. In controlled clinical trials, severe (Grade 3) acute infusion reactions were reported in 3.5% of patients in the PROVENGE group. Reactions included chills, fever, fatigue, asthenia, dyspnea, hypoxia, bronchospasm, dizziness, headache, hypertension, muscle ache, nausea, and vomiting. No Grade 4 or 5 acute infusion reactions were reported in patients in the PROVENGE group.

To fulfill a post marketing requirement and as a part of the company’s ongoing commitment to patients, Dendreon will conduct a registry of approximately 1,500 patients to further evaluate a small potential safety signal of cerebrovascular events. In four randomized clinical trials of PROVENGE in prostate cancer patients, cerebrovascular events were observed in 3.5% of patients in the PROVENGE group compared with 2.6% of patients in the control group.

About Active Cellular Immunotherapy

PROVENGE is classified by the FDA as an autologous cellular immunotherapy. It is designed to be an active cellular immunotherapy. Active cellular immunotherapy is designed to stimulate a T-cell response to cancer cells. An immune response is started by a specialized class of immune system cells called antigen-presenting cells (APCs). APCs take up antigen from their surroundings and process the antigen into fragments that are then displayed on the APC surface. Once displayed, these antigens can be recognized by specific classes of immune cells called T lymphocytes (T-cells), which are activated as a result of their engagement with APCs and combat disease by seeking antigen-bearing cells directly. PROVENGE is designed to target the prostate cancer antigen prostatic acid phosphatase (PAP), an antigen that is expressed in more than 95 percent of all prostate cancers.

About Dendreon

Dendreon Corporation is a biotechnology company targeting cancer and transforming lives through the discovery, development, commercialization and manufacturing of novel therapeutics. The Company applies its expertise in antigen identification, engineering and cell processing to produce active cellular immunotherapy product candidates designed to stimulate an immune response in a variety of tumor types. Dendreon’s first autologous cellular immunotherapy product, PROVENGE® (sipuleucel-T), was approved by the FDA in April 2010 for the treatment of asymptomatic or minimally symptomatic metastatic castrate resistant (hormone refractory) prostate cancer. Dendreon also is developing an orally-available small molecule that targets TRPM8 that could be applicable to multiple types of cancer. The Company is headquartered in Seattle, Washington and is traded on the Nasdaq Global Market under the symbol DNDN.

This news release contains forward-looking statements that are subject to risks and uncertainties. Factors that could affect these forward-looking statements include, but are not limited to, developments affecting Dendreon’s business and prospects, including commercialization of PROVENGE. Information on the factors and risks that could affect Dendreon’s business, financial condition and results of operations are contained in Dendreon’s public disclosure filings with the U.S. Securities and Exchange Commission, which are available at sec. Dendreon cautions investors not to place undue reliance on the forward-looking statements contained in this press release. All forward-looking statements are based on information currently available to Dendreon on the date hereof, and Dendreon undertakes no obligation to revise or update these forward-looking statements to reflect events or circumstances after the date of this press release, except as required by law.

Source: Dendreon Corporation

View drug information on Provenge. Continue reading →

Of the five senses, taste is one of the least understood, but now researchers at the University of Pennsylvania School of Medicine have come one step closer to understanding how the sense of taste develops. They have pinpointed a molecular pathway that regulates the development of taste buds. Using genetically engineered mice, they discovered that a signaling pathway activated by small proteins called Wnts is required for initiating taste-bud formation. They have also determined that Wnt proteins are required for hooking up the wiring of taste signals to the brain.

Senior author Sarah E. Millar, PhD, Associate Professor in the Departments of Dermatology and Cell and Developmental Biology, Penn postdoctoral fellow Fei Liu, PhD, and colleagues report their findings in the most recent online issue of Nature Genetics. “The developmental biology of taste is underexplored,” says Millar of her team’s impetus for the study.

The researchers demonstrated that blocking the action of Wnt proteins in surface cells of the developing tongue prevents taste-bud formation, while stimulating Wnt activity causes the formation of excessive numbers of enlarged taste papillae that are able to attract taste-related nerve fibers. This study represents the first genetic analysis of taste-organ initiation in mammals. While these studies were performed in mice, the researchers believe that their findings will also hold true for understanding the basis of taste-bud development in humans.

Taste buds are the sensory organs that transmit chemical stimuli from food and other sources to nerve cells, which convey these signals to the taste centers in the brain. Taste buds sit in the small bumps in the surface and sides of the tongue called papillae.

The signaling pathway activated by Wnt proteins is critical to the development of many organ systems, and its inappropriate activation causes human diseases including colon cancer. In previous studies, Millar and colleagues have shown that this pathway is essential for initiating the formation of hair follicles and mammary glands in mice.

The sites of Wnt signaling are easily visualized in specially engineered transgenic mice, using an enzymatic assay. “We noticed in the tongue that there was this beautiful pattern of blue spots that correspond to the developing taste papillae,” says Millar. “This connected the Wnt pathway to their development.”

In the present study, the researchers found that in mice in which the actions of Wnt proteins were blocked, taste papilla buds completely failed to develop. Conversely, in mice in which Wnt signaling was over activated, their tongues were covered with many and large papillae and taste buds.

“Unlike most surface epithelial cells, taste buds have characteristics of neurons as well as skin. Like other types of epithelial cells they turn over and regenerate, but they also express chemoreceptors and make synapses with neurons,” explains Millar. The group studied how developing taste buds become wired into the nervous system. In early tongue development, neurons enter the tongue epithelium and make synapses with taste bud cells. This study confirmed that taste buds produce signals that attract nerve fibers to them. When taste-bud development was prevented by blocking Wnt signaling, the nerve fibers did not enter the tongue epithelium.

“They don’t know where to go on their own,” she says.

Millar also mentions that by now understanding the basis for the initiation of taste-papilla formation, the evolution and difference between species in the numbers and patterns of taste buds can be more fully explored. All animals that taste have taste buds, but there are differences, for example humans have more (around 200) taste papillae than mice, and they are arranged in a different pattern.

Future research directions will include determining whether Wnt signaling is also important for the periodic regeneration of taste buds from taste-bud stem cells that occurs throughout life in adult animals. Taste-bud regeneration can be affected by chemotherapy, so understanding this process will have important implications for patient care.

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The research was supported by the National Institutes of Health. In addition to Millar and Liu, co-authors on the paper are: Natalie Gallant, Seshamma T. Reddy, and Thomas Andl, from Penn; Shoba Thirumangalathu and Linda Barlow from the University of Colorado Health Sciences Center; Steven Yang and Andrzej A. Dlugosz from the University of Michigan; Cristi L. Stoick-Cooper and Randall T. Moon from the Howard Hughes Medical Institute and University of Washington; and Makoto M. Taketo from Kyoto University.

PENN Medicine is a $2.9 billion enterprise dedicated to the related missions of medical education, biomedical research, and high-quality patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System.

Penn’s School of Medicine is ranked #2 in the nation for receipt of NIH research funds; and ranked #3 in the nation in U.S. News & World Report’s most recent ranking of top research-oriented medical schools. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.

The University of Pennsylvania Health System includes three hospitals, all of which have received numerous national patient-care honors (Hospital of the University of Pennsylvania; Pennsylvania Hospital, the nation’s first hospital; and Penn Presbyterian Medical Center); a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home care and hospice.

Contact: Karen Kreeger

University of Pennsylvania School of Medicine Continue reading →

1. Children could be the key to halting the obesity epidemic

Attempts to treat established obesity in adulthood may be too late to have important impacts on disease prevention or health improvements as there is evidence that obesity in children and adolescents has already resulted in long-lasting metabolic and vascular abnormalities, write Dr Debbie Lawlor (Bristol University) and Dr Nish Chaturvedi (Imperial College, London) .

They argue that targeting the prevention of obesity during key periods of a child’s development could be the way to reduce subsequent risks of adult obesity and associated chronic disease.

The perinatal period and puberty/adolescence could be two critical periods during which interventions might have long-term effects.

There is increasing evidence that intrauterine over-nutrition predicts life-long obesity. High maternal glucose, free fatty acid and amino acid plasma concentrations result in over-nutrition of the foetus which, through permanent changes in appetite control, neuroendocrine functioning or energy metabolism in the developing foetus, leads to obesity in later life. Strict glycaemic control during pregnancy could held to prevent this.

Adolescence may also offer a unique opportunity to modify the risk of future obesity, perhaps via short-term interventions as behaviours such as dietary patterns and levels of physical activity are largely formed in adolescence and persist into adulthood.

Dr Lawlor said: “New behavioural, environmental and pharmacological approaches for the prevention and treatment of obesity in children are needed. However, the epidemic of childhood obesity is unlikely to be resolved without concerted political action.”

Debbie A Lawlor and Nish Chaturved: Commentary: Treatment and prevention of obesity – are there critical periods for intervention? Int J Epidemiol., doi: 10.1093/ije/dyi309

2. Smoking during pregnancy increases risk of overweight offspring

Maternal smoking during pregnancy increases the risk of overweight in children before the age of eight years, according to a new study by Dr Aimin Chen and colleagues at the US National Institutes of Health.

Using data for 34,866 children enrolled in the US Collaborative Perinatal Project, the researchers examined maternal pregnancy smoking in relation to weight, height and body mass index (BMI) in offspring at ages one, three, four, seven and eight years.

Although children of mothers who smoked during pregnancy were found to weigh less at birth, their weight quickly equalled or exceeded that of other children. In the period up to eight years old, the children of smokers were more likely to be overweight, particularly the girls. Maternal smoking in the third trimester of pregnancy was more strongly associated with child overweight than maternal smoking in the first trimester.

Dr Chen said: “Lower birth weight among infants of prenatal smokers results in greater post-natal catch-up growth which is associated with increased risk of diabetes, hypertension, and cardiovascular diseases.

“In addition, maternal smoking during pregnancy may be associated with poor appetite control in offspring. Just as adults who stop smoking can experience weight gain, babies who experience withdrawal from in utero smoking exposure after birth may also be susceptible to increased weight gain.”

Aimin Chen, Michael L Pennell, Mark A Klebanoff, Walter J Rogan and Matthew P Longnecker: Maternal smoking during pregnancy in relation to child overweight: follow-up to age 8 years Int J Epidemiol., doi: 10.1093/ije/dyi218

3. Tackling obesity in the developing world

Obesity will continue to spread in the developing world where governments and health services have few effective public health levers with which to arrest the trend, writes Andrew Prentice of the London School of Hygiene and Tropical Medicine.

Profound alterations in the structure and composition of diets across the globe, coupled with very rapidly changing patterns in physical activity have resulted in a macro-environment that is highly conducive to obesity.

The recent World Health Organisation (WHO) report on Diet, Nutrition and the Prevention of Chronic Diseases placed obesity at the top of the public health agenda. Its argument for action is based partly on the economic consequences of inaction, for example heart disease, stroke and diabetes could cost China $4556 billion in the period 2005-15.

Dr Prentice said: “Major new initiatives by governments worldwide are needed to combat the external factors that contribute to the obesity pandemic such as the low cost of highly refined oils and carbohydrates, the encouragement towards motorized transport and the growth of sedentary forms of employment. These aspects of globalisation are infiltrating traditional lifestyles even in the poorest of developing countries.

“However, the prospects of halting the obesity pandemic within the foreseeable future appear remote as most countries will not be able to afford any measures to tackle the problem beyond public education campaigns warning of the health consequences of very high levels of body fat.”

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Andrew M Prentice: The emerging epidemic of obesity in developing countries Int J Epidemiol., doi: 10.1093/ije/dyi272

Notes to Editors
This issue of the IJE was overseen by associate editors, Dr Debbie Lawlor (Bristol University) and Dr Nish Chaturvedi (Imperial College, London).

For copies of the papers, please contact barbaraatesworthbristol.ac

Contact details for Dr Debbie Lawlor: 0117 928 7267, d.a.lawlorbristol.ac

The International Journal of Epidemiology is a key journal in the field of epidemiology and public health, published six times per year by Oxford University Press. It is edited at the Department of Social Medicine, University of Bristol, which is a leading centre for epidemiology, health services research and public health in the UK and was one of only three to be awarded the top 5* grade in the 2001 Research Assessment Exercise.

Issued by the Public Relations Office, Communications & Marketing Services, University of Bristol, tel (0117) 928-8896, mobile 077-7040-8757.

Contact: Hannah Johnson
hannah.johnsonbristol.ac
University of Bristol Continue reading →

People who significantly cut back on the amount of salt in their diet could reduce their chances of developing cardiovascular disease by a quarter, according to a report on bmj today.

Researchers in Boston also found a reduction in salt intake could lower the risk of death from cardiovascular disease by up to a fifth.

Cardiovascular disease refers to the group of diseases linked to the heart or arteries, for example a stroke or heart disease. While there is already a substantial body of evidence showing that cutting back on salt lowers blood pressure, studies showing subsequent levels of cardiovascular disease in the population have been limited and inconclusive.

This research provides some of the strongest objective evidence to date that lowering the amount of salt in the diet reduces the long term risk of future cardiovascular disease, say the authors of the report.

Researchers followed up participants from two trials completed in the nineties which had been conducted to analyse the effect that reducing salt in the diet had on blood pressure.

All the participants had high-normal blood pressure (pre-hypertension). They were therefore at greater risk of developing cardiovascular disease. 744 people took part in the first Trial of Hypertension Prevention which was completed in 1990, 2382 in the second, which ended in 1995. In both trials participants reduced their sodium intake by approximately 25% – 35% alongside a control group who didn’t cut back on their salt intake.

Detailed information about cardiovascular and other health problems was sought from participants in the earlier trials. As part of this researchers found that participants who had cut back on salt during the trials tended to stick to a lower salt diet compared to those who had been in the control group. In total the researchers obtained information from 2415 (77.3%) participants, 200 of whom had reported some sort of cardiovascular problem.

The reduction in the risk of developing cardiovascular problems as a result of the sodium reduction intervention was substantial. The results showed these pre-hypertensive individuals were 25% less likely to develop cardiovascular problems over the course of the 10-15 years post-trial. There was also a 20% lower mortality rate. This risk reduction was evident in each trial.

To the authors knowledge this study is the first and only study of sufficient size and duration to assess the effects of a low salt diet on cardiovascular problems based on randomised trial data. It provides unique evidence that lowering salt in the diet might prevent cardiovascular disease.

“Long term effects of dietary sodium reduction on cardiovascular disease outcomes: observational follow-up of the trials of hypertension prevention (TOHP)
BMJ Online First

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Surgeons at Rush University Medical Center are going through the nose, a technique that has been very successful at removing pituitary tumors, to reach tumors inside the brain. Compared to traditional open surgery, which requires peeling back the skin from the face and cutting large holes in the skull, the minimally invasive transnasal approach offers no scars, a shorter hospital stay, and potentially fewer complications.

While common for pituitary tumors, surgical access through the nose is rare for tumors inside the brain because surgeons must go through the dura mater, the tough membrane that covers the brain and contains the cerebrospinal fluid. Leakage of cerebrospinal fluid can lead to serious complications, such as severe headaches, infection, and meningitis. The confluence of several advanced technologies: miniature surgical instruments, improved endoscopic visualization, computer guided surgical navigation, and a membrane sealant has made it possible to safely access tumors beyond the dura.

Guided by a computerized mapping system and an endoscope, a rigid tube that carries a light source and a mini-camera, surgeons drill small holes in a bone at the back of the nose and through the dura. With the camera images magnified on a screen, the surgeon can see exactly where he is threading tiny surgical instruments. The tumor is completely removed through the nostril.

To complete the surgery, the hole in the dura must be completely sealed to prevent leaking of cerebrospinal fluid. Surgeons use material made from cadaver skin to create a tough scaffold. Several layers of the material along with fat harvested from the patient are placed over the hole. The material expands to form a tight seal.

“This is an exciting surgery. Instead of going from the outside in, we are going from the inside out,” said Dr. Guy Petruzzelli, co-director of the Rush Skull Base Surgery Program. “We have the same ability to remove the tumor, but without scars and with fewer complications.”

Dr. Richard Byrne, chairman of neurosurgery at Rush, calls this new approach to removing skull base tumors revolutionary. “With an open surgery, we have to move the brain to gain access to the tumor. With the transnasal approach, it is amazing to see the brain beautifully undisturbed. We remove the tumor with the same borders as open surgery without manipulating the brain.”

The transnasal approach is not appropriate for all brain tumors. According to Petruzzelli it can be used for most skull base tumors, or tumors at the junction of the cranial skeleton and the nose or spine. The procedures require close cooperation between an experienced neurosurgeon and head and neck surgeon.

“Both surgeons must work as an integrated unit, moving away from the idea of ‘my part’ or ‘your part’ of the operation. The entire procedure becomes a combined effort focused on the patient and their recovery,” said Petruzzelli. “Minimally invasive skull base surgery should only be attempted at medical centers with high levels of expertise in neurosurgery, head and neck surgery, radiology and anesthesia.”

Rush University Medical Center is an academic medical center that encompasses the more than 600 staffed-bed hospital (including Rush Children’s Hospital), the Johnston R. Bowman Health Center and Rush University. Rush University, with more than 1,270 students, is home to one of the first medical schools in the Midwest, and one of the nation’s top-ranked nursing colleges. Rush University also offers graduate programs in allied health and the basic sciences. Rush is noted for bringing together clinical care and research to address major health problems, including arthritis and orthopedic disorders, cancer, heart disease, mental illness, neurological disorders and diseases associated with aging.

rush.edu Continue reading →

HHS Secretary Mike Leavitt on Monday met with several House Republicans who are in discussions with a bipartisan group of Senate lawmakers to craft a third version of legislation that would reauthorize and expand SCHIP, CQ Today reports (Armstrong, CQ Today, 11/5). Leavitt said the White House is not directly involved in congressional negotiations, adding that the administration is “providing technical assistance.” According to Leavitt, President Bush will veto the latest version of SCHIP legislation, as well as any version of the measure that includes a tobacco tax increase. “The president has been very clear that he does not intend, is not willing, to raise taxes and doesn’t think it’s necessary,” Leavitt said (Johnson, CongressDaily, 11/6).

However, CQ Today reports that “[a]ny compromise bill that moves forward will almost certainly include such a tax,” and even House Republican leaders “have said the proposed tobacco tax is not an issue for them.” Leavitt also took issue with the “express lane” provision of the bill, which would allow applicants who qualify for programs with similar eligibility requirements, such as school lunch subsidies, to enroll in SCHIP. “This whole thing is designed in a way to make qualification almost automatic, to make the ability to monitor it almost impossible, and penalties nonexistent,” Leavitt said (CQ Today, 11/5).

Leavitt declined to say whether that level is sufficient, adding that the administration “just want[s] a rigorous standard.” Leavitt said that the bill’s sponsors want to “blow the doors off eligibility in very clever and hard-to-see ways.” The SCHIP bill “is about creating a system where the federal government insures everybody,” Leavitt said, adding, “It’s wrapped in the cloak of children, but this is a very serious policy debate that’s unfolding” (CongressDaily, 11/6). SCHIP negotiators plan to meet again on Tuesday (CQ Today, 11/5).

DCCC Polling
Democratic Congressional Campaign Committee Chair Rep. Chris Van Hollen (D-Md.) on Monday in a letter circulated to the House Democratic Caucus said that internal DCCC polling shows Democratic challengers are gaining an electoral advantage because of the SCHIP debate, Roll Call reports. Van Hollen said that Republicans who voted against the SCHIP proposal might lose votes to their Democratic challengers.

“Last week we saw the latest evidence that our fight to provide health coverage to 10 million children through SCHIP is continuing to resonate with the American people — especially in key congressional districts,” Van Hollen wrote, adding, “As (DCCC poll) findings confirm, vulnerable Republicans who continue to vote in lock step with George Bush against SCHIP will be held accountable by their constituents.”

The National Republican Congressional Committee said that Van Hollen’s claims are baseless and misleading, and noted that the polls show Democrats only are interested in using SCHIP reauthorization as a political weapon (Drucker, Roll Call, 11/6).

Adult Coverage
Dow Jones on Monday examined how although Bush “has complained about adults receiving” SCHIP coverage, it was the Bush administration that “granted the majority of current waivers that enable states to enroll parents” in the program, and “it has approved every one of the waivers that enable the enrollment of childless adults.” Eleven states currently provide SCHIP benefits to adults, eight of which were approved during Bush’s term. In 2006, about 700,000 SCHIP beneficiaries were adults; 500,000 of those beneficiaries were parents of children enrolled in the program and the rest were childless adults. Childless adults were able to enroll in the program beginning in 2001, after the Bush administration implemented the Health Insurance Flexibility and Accountability initiative.

In July 2006, then-CMS Administrator Mark McClellan said, “Extending coverage to parents and caretaker relatives not only serves to cover additional uninsured individuals, but it may also increase the likelihood that they will take the steps necessary to enroll their children.” However, White House spokesperson Tony Fratto said that the administration was “always cautious” about allowing adults to enroll in SCHIP. Fratto said that the administration “listened to the request from states for greater flexibility in administering their state plans for SCHIP,” adding, “They argued that adding adults would result in more children being added. This experiment obviously failed and should not be extended” (Mantell, Dow Jones, 11/5).

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved. Continue reading →

‘There’s a real need to define the difference between a low GI diet and a low GI food,’ say Sydney University’s Prof Jennie Brand-Miller and Diabetes Australia’s Alan Barclay in the June issue of GI News.

‘Because a low GI food is defined as 55 or less, people have made the reasonable assumption that a whole diet that averages less than 55 is low enough. In fact the average Australian and American diet already has a GI of 56 to 58 because we all eat low GI fruits and dairy products and of course sugar (GI 60). So to reduce the risk of chronic disease, it is clear that a low GI eating pattern/diet must have a much lower number.

‘What we now know from numerous observational cohort studies around the world is that the average GI of the diet of people in the lowest quintile (20% of the population) is about 40-50. Similarly, in a recent meta-analysis of 15 experimental studies investigating the role of low GI diets in managing diabetes, the average GI was 45. Since this average GI has been proven to have significant health benefits in people with existing diabetes and in reducing the risk of chronic diseases like heart disease and diabetes, and importantly, people can and do achieve it in real life, we believe a GI of 45 or less is a reasonable definition of a low GI diet or meal.

‘How do you achieve this? Substitute low for high GI foods in your everyday meals and snacks, especially the breads you choose. Breakfast in particular is your opportunity to go for low GI ‘Gold’ by selecting a low GI breakfast cereal. Don’t assume that adding milk to crispy flakes makes it a low GI meal.’ If you don’t eat breakfast cereal, make sure you choose a low GI bread for your toast, and of course low GI breads are a must for those sandwiches at lunch.’

10 tips for reducing the GI of your diet

1. Fruit and vegetables play a central role in low GI eating. Aim to eat at least two serves of fruit and five serves of vegetables every day, preferably of three or more different colours. Fill half your dinner plate with veggies.

2. If you are a big potato eater, either have one or two Nicola or tiny chat potatoes with a small cob of corn or make a cannellini bean and potato mash replacing half the potato with cannellini beans.

3. Swap your bread. Instead of high GI packaged white and wholemeal breads, choose a really grainy bread, granary bread, stoneground wholemeal bread, sourdough bread, soy and linseed bread, pumpernickel, fruit loaf, low GI white bread (yes there are some) or breads made from chickpea or other legume-based flours.

4. Replace those high GI crunchy breakfast flakes that spike blood glucose and insulin levels with low GI carbs like natural muesli, traditional porridge oats or one of the lower GI processed breakfast cereals.

5. Make your starchy staples the low GI ones. Look for lower GI rices such as basmati, Doongara Clever Rice or Moolgiri medium grain rice and choose less processed foods or low GI wholegrains such as rolled oats or quinoa for porridge or pearl barley, buckwheat, bulgur, whole kernel rye, or whole wheat kernels.

6. Learn to love legumes and eat them often – home cooked or canned. Try adding chickpeas to a stir-fry, red kidney beans to a chilli made with mince, a 4-bean salad with barbecue, lentils in soup and borlotti beans in a casserole.

7. Include at least one low GI carb with every meal. You’ll find them in four of the food groups: fruit and vegetables; bread and cereals; legumes including soybeans, chickpeas and lentils; low fat dairy foods and soy alternatives.

8. Choose low GI snacks such as fresh fruit, a dried fruit and nut mix, low fat milk or yoghurt (or soy alternatives), or a sandwich made with a low GI bread.

9. Add a little acid to your meal – vinaigrette with salad, yoghurt with cereal, lemon juice on vegetables, sourdough bread. All these foods contain acids, which slow stomach emptying and lower your blood glucose response to the carbohydrate with which they are eaten.

10. Limit refined flour products whether home baked or from the supermarket such as cookies, cakes, pastries, pies, crumpets, crackers, biscuits, irrespective of their fat and sugar content.

Two extra tips to reduce blood glucose spikes

– Incorporate a lean protein source with every meal – lean meat, skinless chicken, eggs, fish or seafood, or low fat dairy, legumes or tofu if you are vegetarian.

– Remember portion caution with carb rich foods such as pasta, noodles and low GI rices. It’s all too easy to over-eat them. While they may be low GI choices themselves, eating lots will have a marked effect on your blood glucose. A cup of cooked noodles or al dente pasta with lots of mixed vegetables can turn into 3 cups of a noodle based or pasta meal and fit into any adult’s daily diet.

GI News: www.ginews.blogspot

For more information
GI Database: www.glycemicindex
GI Symbol Program: www.gisymbol.au
GI Shopper’s Guide: Shopper’s Guide to GI Values 2007

University of Sydney GI Group
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