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Feb 28
World-Renowned Plastic Surgeons Share Knowledge And Experience
For the first time, thought and opinion leaders from two of the world's leading centers of aesthetic surgery, Brazil and the United States, will be meeting to share scientific updates, procedural knowledge and clinical information at the inaugural American-Brazilian Aesthetic Meeting.

Faculty for the meeting includes some of the most recognized names in organized plastic surgery from two continents, including:

- Ricardo Riberio, MD, Brazil, Meeting Co-Chair
Plastic Surgeon from Rio de Janiero, Brazil
- Renato Saltz, MD, Meeting Co-Chair and President-Elect, American Society for Aesthetic Plastic Surgery -- Plastic Surgeon from Park City, UT
- Jose Carlos Sampaio Goes, MD, Past-President, International Society of Aesthetic Plastic Surgery
Plastic Surgeon from Sao Paulo, Brazil
- Alan Gold, MD, President, the American Society for Aesthetic Plastic Surgery
Plastic Surgeon from Great Neck, NY
- Foad Nahai, MD, President, International Society of Aesthetic Plastic Surgery and Past-President, the American Society for Aesthetic Plastic Surgery -- Plastic Surgeon from Atlanta, GA
- Mark Jewell, MD, Past-President, the American Society for Aesthetic Plastic Surgery
Plastic Surgeon from Eugene, OR

The attendees for the meeting includes residents, fellows, nurses, aestheticians and physicians from the US, South America, Europe and Asia. The topics include aesthetic surgery, cosmetic medicine, patient safety (a full morning), breast and skin cancer reconstruction -- all related to aesthetic plastic surgery. The meeting is endorsed/sponsored by the American Society for Aesthetic Plastic Surgery (http://www.asaps.org) and the International Society of Aesthetic Plastic Surgery (http://www.isaps.org).

Feb 28
Endovascular Repair Results In Decrease Of Total Aneurysm Deaths
Elective repair for abdominal aortic aneurysms (AAA) is on the rise, yet total AAA- related deaths continue to decline since the introduction of endovascular repair (EVAR), according to an ongoing, long-term research report from Beth Israel Deaconess Medical Center in Boston.

This study has been updated with the most recent AAA data Nationwide Inpatient Sample database using ICD-9 diagnosis and procedure codes thorough 2005. It evaluates the overall annual number of aneurysm repairs, AAA-related deaths and mortality rates for both elective and rupture repair, rupture diagnoses without repair, and the effect of EVAR on the annual volume of aneurysm repair and its impact on rupture occurrence. Complete details of the research have been published in the March 2009 issue of the Journal of Vascular SurgeryŽ.

"We have found that use of EVAR, which was approved by the Food and Drug Administration in 1999, has increased steadily and in 2005 accounted for 56 percent of repairs, yet only 27 percent of the deaths for intact repairs," said senior author Marc L. Schermerhorn, assistant professor of surgery, Harvard Medical School and section chief of endovascular surgery at the center's department of vascular surgery.

The overall number of AAA-related deaths (intact repair, ruptured repair, unrepaired ruptures) from 1993 to 2005 was 79,955 and the number of annual deaths decreased by 38 percent. The updated study showed that by 2005, the mean annual number of intact repairs increased from 36,122 in the pre-EVAR era (1993-1998) to 38,901 in the post-EVAR era (2001-2005). Despite the increase in repairs, the mean annual number of deaths related to intact AAA repair decreased from 1,693 pre-EVAR to 1,207 post-EVAR. Mortality for all intact AAA repair had decreased from 4.0 percent to 3.1 percent pre- and post-EVAR yet open repair mortality remained unchanged.

The overall mean annual number of ruptured AAA diagnoses dropped from 9,979 to 7,773 and overall mean annual deaths from a ruptured AAA decreased from 5,338 to 3,901 post-EVAR. From 1993 forward, admissions for ruptured AAA diagnosis decreased 30 percent and deaths after total repairs for ruptured AAA decreased from 2,702 in 1993 to 1,605 in 2005. Also in 2005, EVAR was performed in 17 percent of ruptured AAA repairs and mortality was decreased from 42.9 in 2001 to 30.3 percent in 2005.

Feb 28
Alzheimer's Plaques Play Bigger Role
Researchers in the US studying mice with and without amyloid-beta plaques in their brains (the plaques that are characteristic of Alzheimer's disease) found that contrary to current thinking, the plaques don't just damage the neurons they are close to but may well affect signalling in other parts of the brain through their influence on extensive networks of astrocyte brain cells.

The study was the work of researchers from the MassGeneral Institute for Neurodegenerative Disease (MGH-MIND) at Massachusetts General Hospital in Charlestown, and is published in the 27 February online issue of Science.

Simply speaking, mammals have two main types of brain cell: neurons that send electrical and chemical signals and glia cells that support, control, and look after them. An astrocyte is a type of star-shaped glia cell that not only provides passive support to neurons, but as scientists discovered in the 1990s, they also send signals using calcium ions that move from cell to cell like waves, and these waves can travel a long way in the brain.

Astrocytes are found everywhere in the brain and they account for about half the volume of it.

Plaques are left over bits of cell that clump together and stick to neurons, disrupting their ability to send signals; they are more common in older brains and one of the hallmarks of Alzheimer's disease.

The authors explained in their background information that although we already know that senile plaques disrupt the neurons they stick to (focal disruption), we don't know much about how astrocytes behave in Alzheimer's disease. With this study they showed that senile plaques make astrocytes hyperactive; not just the ones nearby, but also others quite far away from the focal neuron site.

Lead author Kishore Kuchibhotla of MGH-MIND told the press:

"Our work suggests that amyloid plaques might have a more complex role in altering brain function than we had thought."

"Plaques develop rapidly and have been shown to cause relatively acute, localized neuro-toxicity," he added, explaining that their work shows astrocytes "could provide a network mechanism that may stretch the impact of plaques to more distant areas of the brain."

For this study Kuchibhotla and colleagues used a method called "multiphoton fluorescence lifetime imaging microscopy" to measure and trace the calcium waves travelling along astrocyte networks in the brains of gentically altered laboratory mice with and without some of the hallmarks of Alzheimer's disease, such as the amyloid-beta plaques. (Using a dye they "labelled" astrocytes so that when they were active they lit up and when they switched off they went dark).

They found that resting calcium levels were high throughout the astrocyte network in mice with plaques, not just where they happened to be near individual plaques.

Using time-lapsed images they found that changes in calcium waves in astrocytes were more frequent and synchronized across long distances and uncoupled from what was happening near the neurons.

The researchers also found some rare calcium waves travelling between cells: these were only present in mice with amyloid-beta plaques and the waves appeared to start near plaques and spread radially from them for at least 200 micrometers.

They concluded that:

"Although neurotoxicity is observed near amyloid-[beta] deposits, there exists a more general astrocyte-based network response to focal pathology."

Kuchibhotla said that:

"This is the first clear evidence in a live animal model that amyloid plaques perturb calcium signaling across the astrocyte network via a neuron-independent mechanism."

"It has been suggested that these intercellular calcium waves, which previously had been observed only in response to some sort of external stimulus, indicate the existence of or response to a traumatic insult," he added, explaining that while their results support this idea, what we still don't know is whether the calcium signals they observed actually protect or harm cells.

"We've only begun to scratch the surface of how plaque deposition impacts astrocyte function," said Kuchibhotla.

An important question for future research will be how the increased activity of astrocytes affects the ways neurons work, and another will be whether it increases or limits the formation of plaques.

Feb 28
Merck Foundation Launches Nationwide Diabetes Effort Targeting Minority Communities
The Merck Foundation on Wednesday launched an initiative to target diabetes among minorities in five cities nationwide, the Dallas Morning News reports (Isensee, Dallas Morning News, 2/26). The foundation has committed $15 million for the initiative -- "The Alliance to Reduce Disparities in Diabetes" -- that will support programs that aim to improve the quality, access, prevention and management of diabetes among minorities. Merck is supporting programs in Camden, N.J.; Chicago; Dallas; Fort Washakie, Wyo.; and Memphis, Tenn. Adult Hispanics, blacks and American Indians are most at risk for the disease (Merck Foundation release, 2/25).

Dallas Program
In Texas, black and Hispanic residents are more than twice as likely as white residents to die from diabetes. Minorities are also more likely to have an increased risk for disparities in care, which can lead to complications, according to the Morning News.

The Dallas effort, called the Diabetes Equity Project, builds upon an existing pilot program by Baylor Healthcare System. The Central Dallas Ministries' East Dallas clinic manages the program.

The new program will target health care workers and is designed to reach 1,000 people with diabetes within the first year. The program will give health workers access to a new electronic diabetes registry to improve case management. The program also will offer cross-cultural competency workshops to educate physicians about health-related lifestyle trends in minority communities, such as access to healthy foods, how different groups cope with disease and family involvement (Dallas Morning News, 2/26).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

Feb 28
Over 3,000 Health Care Professionals Go On-line To Benefit From Parkinson's Awareness Training
An on-line training module for GP's and healthcare professionals to increase awareness of Parkinson's disease, has attracted over 3,000 participants from as far away as New Zealand.

Parkinsons' Disease Society's (PDS) 2007 membership survey showed that 50% of people with Parkinson's believed there was a lack of understanding from GP's and professionals about how to spot and treat the condition.

As a result the PDS commissioned BMJ Learning to produce an on-line module to help users increase their knowledge and skills in how to care for patients, and how to increase knowledge and skills to assess and refer people with suspected Parkinson's Disease.

Daiga Heisters, PDS National Education Adviser, comments:

"We were delighted with the response to the training. The target of 400 participants to complete the module in the first 6 months was exceeded with over 3,000 completing in the first 5 months. This reflects the interest health care professionals have in increasing their knowledge on the management of Parkinson's and the effectiveness of BMJ Learning's marketing campaign".

Alveena Igbal, from Derby City PCT who took the course, said:

"As our elderly population increases so does the challenge to deal with chronic disabling conditions like Parkinsonism. In this context I have found the BMJ Learning module very useful."

Dr Amal Paul from Pudsey, Leeds, adds:

'' As a G.P. I have to look after a few patients with Parkinson's disease, and the need for further care management was more imperative for me when someone close to me was diagnosed. The module was very interesting, designed for adult learning, interactive, and educational. My knowledge and skills have definitely improved and the module was a big impetus for further study''.

This module complements the work of the PDS Education Training Officers currently working with GPs and other healthcare professionals throughout the UK at a local level.

Due to the success of the pilot, a second learning module is being launched, focusing on non- motor symptoms of Parkinson's such as depression and sleep disorders.

Feb 28
Women May Be Protected From Parkinson's Disease By Naturally Produced Estrogen
Women who have more years of fertility (the time from first menstruation to menopause) have a lower risk of developing Parkinson's disease than women with fewer years, according to a large, new study by researchers at Albert Einstein College of Medicine of Yeshiva University.

"These findings, involving nearly 74,000 women, suggest that longer exposure to the body's own, or endogenous, hormones, including estrogen, may help protect the brain cells that are affected by Parkinson's disease," says lead author Rachel Saunders-Pullman, M.D., M.P.H., M.S., assistant professor of neurology at Einstein and attending physician in neurology at Beth Israel Medical Center, an affiliate of Einstein's in Manhattan.

An abstract of the study was released by the American Academy of Neurology (AAN). Further study details will be presented at AAN's 61st Annual Meeting in Seattle, April 25 - May 2, 2009.

After Alzheimer's disease, Parkinson's disease is the most common neurodegenerative disease. About 1.5 million Americans currently have Parkinson's, characterized by symptoms that can include tremor (shaking), slowness of movement, rigidity (stiffness), and difficulty with balance. The condition typically develops after the age of 60, although 15 percent of those diagnosed are under 50. There is no cure for Parkinson's, although medications or surgery can ease symptoms of the disease.

Parkinson's disease is almost twice as common in men as in women, and researchers have long hypothesized that sex hormones might play a role in the disease.

In the current study, researchers analyzed the records of the Women's Health Initiative (WHI) Observational Study and focused on those women who developed Parkinson's disease. The study involved about 73,973 women who underwent natural menopause.

The study found that women who had a fertile lifespan of more than 39 years had about a 25 percent lower risk of developing Parkinson's compared with women who had a fertile lifespan shorter than 33 years.

In addition, the data showed that women who had four or more pregnancies were about 20 percent more likely to develop Parkinson's disease than were women who had three or fewer pregnancies. "One explanation for this finding is that the post-partum period, which is typically one with lower levels of estrogen, subtracts from a woman's total fertile lifespan," says co-author Sylvia Wassertheil-Smoller, Ph.D., professor of epidemiology and population health and the principal investigator of the WHI study at Einstein.

"Overall, our findings might lead one to assume that hormone therapy would make sense as a neuroprotective agent," says Dr. Saunders-Pullman. "However, we also found that women who were taking hormone therapy did not have a lower risk for Parkinson's. Thus, our data does not support a role for treatment with exogenous hormones, that is, hormones that originate outside the body, to prevent Parkinson's."

In fact, hormone therapy can have harmful neurological effects. "Earlier studies in the Women's Health Initiative demonstrated that hormone therapy increases one's risk for both stroke and dementia," says Dr. Wassertheil-Smoller. "Clearly, we need to conduct more research into estrogen's effects on the brain."

Feb 28
Yeast Gives Clues To Parkinson's
Scientists from the US and Australia are using cells from yeast and mammals to learn about how environment and genes affect whether a person gets Parkinson's disease or not.

Many aspects of the way yeast cells work are the same in animal and human cells, and since it is only possible to get hold of cells diseased with Parkinson's after a person is dead, having a similar more easily accessible cell to work with helps scientists study the early development of the disease and scan and test the thousands of genes that might be involved.

One such example is the subject of a study published this week in Nature Genetics, where Antony Cooper from Sydney's Garvan Institute of Medical Research in Australia and colleagues have for the first time found a way to connect three pieces of the Parkinson's disease jigsaw: sensitivity to manganese, and the behaviour of two genes, alpha-synuclein and PARK9 (also known as ATP13A2).

Alpha-synuclein and PARK9 have already been separately associated with forms of Parkinson's, and manganese poisoning can cause Parkinson-like symptoms in miners and welders exposed to high levels of the metal.

Parkinson's disease is where neurons that produce the neurotransmitter dopamine degenerate, and scientists have also known for some time that this is associated with an overexpression of the protein alpha-synuclein which autopsies have found in abundance in affected regions of the brain.

A European team also previously found that PARK9, already known to be involved in a hereditary form of Parkinson's, was in much greater abundance in the brains of people who had died of sporadic (ie not inherited) forms of the disease compared to the same parts of the brain in people who did not have the disease.

Cooper suspects that PARK9 was actually protecting the neurons and may explain why many of them surrounded by PARK9 survived.

What Cooper and colleagues found was that PARK9 appears also to diminish the toxic effects of alpha-synuclein, and it may also act as a manganese pump that is potentially capable of removing excess amounts of the metal from cells.

Cooper and colleagues were able to study the effect of PARK9 in yeast because it contains an equivalent gene.

An important and puzzling question in Parkinson's research is whether there is a single or cluster of genetic factors that cause the degeneration of neurons that produce dopamine.

As Cooper explained:

"We would love to be able to link all the genes that we know have something to do with Parkinson's disease."

"If you discover there's a central pathway involved, it provides much better potential for finding a successful treatment," he added, explaining that so far they have linked PARK9, alpha-synuclein and manganese, and this is no coincidence.

"They're likely to be affecting a pathway and we suspect it's a central pathway. To confirm that would be very exciting indeed," said Cooper.

Cooper has been working for some years, with co-authors Dr Susan Lindquist, from the Whitehead Institute for Biomedical Research and Dr Aaron Gitler, from the University of Pennsylvania School of Medicine, to find how alpha-synuclein might cause cell damage.

They teamed up with associate professor Guy Caldwell, of the University of Alabama, and associate professor Jean-Christophe Rochet from the University of Purdue in Indiana, to check their results using other models of Parkinson's disease.

Feb 24
Vikram Juneja, UC San Diego Senior Named Churchill Scholar For Extraordinary Undergraduate Research
Vikram Juneja, a UC San Diego senior, has been named the first Churchill Scholar at the university and he will use the $50,000 award to complete a one-year graduate program at Cambridge University, where he will work on a master's thesis on cancer stem cell research.

Juneja, a mechanical engineering major, has maintained a near 4.0 GPA, earning A+ grades in almost half his courses. Last spring when he was about to graduate his academic interests expanded dramatically after completing one biology class. His passion lead him to stay at UC San Diego another year to complete the course work needed for graduate work in the life sciences.

Biology professor Laurie Smith, the UC San Diego representative for the Churchill Scholarship program, nominated Juneja because she was impressed with his achievements and potential. "UC San Diego has its share of truly outstanding students in the sciences and engineering," she said. "In 10 years as a faculty member at UC San Diego I have interacted with scores of extremely bright, accomplished undergraduates in my classes, in research settings and in my role as an academic advisor, but I can honestly say that I have never encountered a student like Juneja before."

Juneja is one of 14 Churchill Scholars selected this year from a pool of 99 applicants from 63 colleges and universities nationwide, the largest applicant pool since the competition began in 1963. Churchill Scholars are chosen for their exceptional academic achievements and demonstrated capacity to contribute to the advancement of knowledge in the sciences, engineering or mathematics by pursuing original, creative work at an advanced level. Eight of the 480 former Churchill Scholars have gone on to win Nobel Prizes.

Juneja said he would not have been able to win the scholarship if he hadn't attended UC San Diego, where he was given extraordinary research opportunities. During his fourth year Juneja immersed himself in research at the UC San Diego School of Medicine studying cancer stem cell biology, working 30 hours per week in the in the lab while having a full class schedule. "The work was fun, but I was able to do top notch work and get the one-on-one experience with faculty and doctors," he said.

During summer 2008, he worked full-time at the UC San Diego School of Medicine with the support of an Amylin Research Scholarship, which is funded through Amylin Pharmaceutical's support of the Chancellor's Challenge 5K Run/Walk for Scholars.

"Millions of people have been affected by cancer," Juneja said. "So it was easy to stay motivated because our research will help so many people. It was exciting to come to the lab every day and feel a part of something."

Prior to researching cancer stem cells, Juneja participated in research with the Instrument Development Group at the Scripps Institution of Oceanography, focusing on the autonomous underwater glider called Spray. His past work also includes working on a project with Constantine Pozrikidis, professor in the Department of Mechanical Aerospace Engineering, on the mechanics of hexagonal lattices and the underlying structure of carbon nanotubes.

"I had a gut feeling about coming to UC San Diego," Juneja said. "I am from the Bay Area and I looked at UC Berkeley, but knew UC San Diego was a hot up-and-coming research institution. I was able to get so much hands-on experience outside of the classroom."

While an undergraduate at UC San Diego, Juneja co-authored four publications, including one first-author publication. "They are unprecedented in my experience for an undergraduate," Smith said.

Next year while studying with Fiona Watt, a cancer researcher and deputy director of the Cambridge Research Institute, Juneja will continue to research the interaction of stem cells with their environment and how their basic processes are disturbed in cancer.

Juneja is excited to study in the United Kingdom and looks forward to traveling in Europe next year. He has been applying to Ph.D. programs in bioengineering this year and plans to go straight from Cambridge into a doctoral program. He is combining his passion for engineering with a deep fascination with biology, so bioengineering will allow him to combine both disciplines.

Feb 24
Roswell Park Examines 50 Years Of Cancer In An American Indian Population
In the most extensive review of cancer patterns among an American Indian tribal group, Roswell Park Cancer Institute (RPCI) researchers analyzed cancer patterns within the Seneca Nation of Indians for the period from 1955 through 2004. The study, led by Arthur Michalek, PhD, FACE, Senior Vice President for Educational Affairs, and Martin C. Mahoney, MD, PhD, Associate Professor of Oncology, Departments of Medicine and Health Behavior, RPCI, was published in a recent issue of the journal Cancer.

The retrospective study examined patterns of cancer incidence in 3,935 males and 4,193 females who were registered tribal members of the Seneca Nation of Indians. Cancer incidence rates were based on data collected through a computer match with the New York State Cancer Registry.

"Among the unique strengths of this study was the reliance on tribal roll books to identify enrolled tribal members and the ability to conduct a comprehensive study over 50 years, leading to the accrual of more than 120,000 person-years of observation. These parameters helped to overcome the issue of limited-sized populations, which has challenged studies among American Indian tribal groups in the past," said Dr. Michalek. "Additionally, the leaders of the Seneca Nation demonstrated their trust in Roswell Park researchers and a commitment to the health of their members by allowing researchers access to information required for this comprehensive analysis."

The study that found overall, no specific type of cancer was significantly elevated - and, in fact, both male and female tribal members demonstrated significantly reduced incidences for all cancers combined. Additionally, no specific age group showed significantly elevated incidence. A total of 233 primary cancers were diagnosed among Seneca males, with colorectal (20%) and prostate cancers (17%) the most common. Among female members, 256 cancers were diagnosed, with lung (20%) and breast cancer (16%) reported as the most common malignancies.

Dr. Mahoney continued, "Cancer remains a relatively rare diagnosis among tribal members, which places some limitation on the interpretation of these results. However, these unique cancer patterns are of extraordinary value to the Seneca Nation leaders as they determine health policy and cancer prevention strategies."

Feb 24
Health Of Mothers And Babies Must Remain Paramount, Says Australian Medical Association
The AMA has responded cautiously to the government's Maternity Services Review launched by Minister Roxon.

AMA President, Dr Rosanna Capolingua, said the medical profession's principal concern is the health and safety of mothers and babies.

"This is also the key concern of families. The health of mother and child must take precedence over all other considerations," Dr Capolingua said.

"This report holds no real surprises. It reinforces existing practice where midwives work in collaborative teams with obstetricians and GP obstetricians.

"It is encouraging that the report is measured and tentative in its deliberations, including acknowledging Australia's strong record of safety in maternity services and requiring that changes to maternity services be guided by evidence, including clear and consistent collection of data.

"The Minister's media release is much more gung ho, claiming the report brings better services for mother's and babies a step closer, a claim the report itself carefully avoids.

"The AMA supports improved access for indigenous and rural communities to the world class services most Australian women already enjoy."

Dr Capolingua said the real test of the report is not in the recommendations, but the policy it generates. "We will keep government accountable for any changes that lower the bar on the health of women and their babies," she said.

"It is not enough to run maternity services on the belief that birth is a natural process. When things go wrong, and they often do, women need immediate access to an obstetrician, an anaesthetist and a paediatrician. This access saves lives.

"I fear the introduction of a system where women are pressured into having a 'natural birth' that puts them and their baby at risk. Too often in other countries, including New Zealand, the midwife model means obstetricians are only called in when the 'natural birth' has become a medical emergency.