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How pancreatic tumors could help to fight diabetes

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A new study analyzes rare tumors in which insulin-producing beta cells are produced in excess in order to find a “genetic recipe” for regenerating these cells. And the findings might change the current therapeutic practices for treating diabetes.
Beta cells play a crucial role in the development of diabetes. These tiny cells found in our pancreas produce insulin, and a loss of beta cells is known to be a cause of type 1 diabetes.

Additionally, recent studies have shown that beta cells also play a crucial role in the development of type 2 diabetes. For instance, a study that Medical News Today reported on found that the release of pro-inflammatory proteins kills off insulin-producing beta cells in the early stages of type 2 diabetes.

But the “problem” with beta cells, medically speaking, is that they replicate in early childhood but cease to proliferate after that.

New research, however, carried out by scientists at the Icahn School of Medicine at Mount Sinai in New York City, NY, uncovers a “genomic recipe” for regenerating these key cells.

The study was led by Dr. Andrew Stewart, the director of the Diabetes, Obesity, and Metabolism Institute at the Icahn School of Medicine, and the findings were published in the journal Nature Communications.

Studying rare tumors to fight diabetes
For the new research, Dr. Stewart and team analyzed a very rare type of benign tumor called insulinomas. These are “pancreatic beta cell adenomas” that secrete too much of the hormone insulin.

The tumors are small and proliferate slowly. The researchers used whole-exome and RNA-sequencing analysis to examine the genetic makeup of 38 such tumors.

Speaking to Medical News Today about the rationale for choosing to study insulinomas, Dr. Stewart said, “In order to discover drugs that would make human pancreatic beta cells regenerate in people with diabetes, we wanted to understand how human beta cells normally replicate.”

“Unfortunately,” he added, “human beta cells only replicate in the first year of life, so obtaining beta cells from babies is difficult. On the other hand, insulinomas […] are a prefect model: they are rare, they are benign […] tumors of the human beta cell[s], and make large amount of insulin, so much [that] they cause low blood glucose (hypoglycemia).”


Source: https://www.medicalnewstoday.com/articles/319632.php

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Smart electronic bandage may heal chronic wounds

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A new smart bandage may change our wound caring practices.
Researchers have designed a “smart” bandage that is much more effective and faster-acting than regular healing patches. The same device can also be loaded with drugs, depending on the type and stage of the wound it is applied to.

The idea for the new device was born out of the need to find more efficient, expedient, and cost-effective treatments for chronic wounds.

Chronic wounds – including venous ulcers, diabetic ulcers, and pressure ulcers – are particularly challenging to treat due to the complex biological mechanism that characterizes them.

They do not heal after the standard 4 weeks of care, largely because the body does not release the compounds that are essential to healing in a timely fashion.

But the new device may change this. Being able to administer different drugs at different stages in the progression of the wound is known to help with chronic wounds, and the smart bandage allows medical professionals to do just that using one single device.

The smart healing patch was engineered by researchers from the University of Nebraska-Lincoln (UNL) in collaboration with scientists from Harvard Medical School in Boston, MA, and the Massachusetts Institute of Technology in Cambridge, MA.

In the new study – which is published in the journal Advanced Functional Materials – the team details a series of experiments that they ran in order to test the benefits of their innovation.

One of the corresponding authors of the study is Ali Tamayol, an assistant professor of mechanical and materials engineering at UNL. “The medical cost associated with [chronic] wounds is tremendous,” he says. “So there is a big need to find solutions for [them].”

How the smart bandage works

The smart healing patch is the size of a postage stamp, made up of electrically conductive fibers, and can be controlled remotely with a smartphone or another wireless or bluetooth device.

The fibers are coated with a water-based gel that can be loaded with various drugs, depending on the needs of the wound.
Antibiotics, so-called growth factors that help the tissue to regenerate, and painkillers could all be alternatively administered using the same “e-bandage,” all the while controlling remotely not only the substance, but also the dosage.

In one of the experiments detailed in the study, the researchers applied the e-bandage loaded with a tissue-growth factor to wounded mice, and a normal “dry” bandage to a control group of mice.

The experiment showed that the smart bandage helped the mice to regrow three times as much tissue than the control group did. Tissue regeneration is a key step in the healing process.

In another experiment, the team loaded the bandage with an antibiotic. The smart healing patch successfully fought off the infection.

“This is the first bandage that is capable of dose-dependent drug release […] You can release multiple drugs with different release profiles. That’s a big advantage in comparison with other systems.” Prof. Ali Tamayol
“What we did here,” he continues, “was come up with a strategy for building a bandage from the bottom up […] This is a platform that can be applied to many different areas of biomedical engineering and medicine.”

“Imagine that you have a variable patch that has antidotes or drugs targeted toward specific hazards in the environment,” Tamayol adds.

The researchers also hope that the first application of their device will be to heal the chronic ulcers that result from diabetes.

The majority of the bandage’s components have already been approved by the Food and Drug Administration (FDA), the researchers say. But before bringing the device to market, the bandage will still have to be tested in animals and then in human trials.

Until then, the team is hard at work trying to make the bandage capable of administering the appropriate treatments autonomously.

Source: https://www.medicalnewstoday.com/articles/319678.php

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A newly discovered cardiovascular repair process could reverse heart failure

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Scientists may have discovered a way of reversing heart failure by getting heart muscle to regenerate itself.They found that silencing a signaling pathway in mice that had developed heart failure following a heart attack activated a previously unrecognized self-healing process.

In a paper recently published in the journal Nature, the researchers, led by a team from Baylor College of Medicine in Houston, TX, report their findings about the signaling pathway, which is known as Hippo.

Heart failure is a serious condition that affects around 5.7 million adults in the United States. It develops when the heart cannot pump enough blood to meet the body’s needs.

Heart failure does not mean that the heart has stopped pumping, but it does mean that vital organs do not get the oxygen and nutrients they need to function properly. Around half of patients with heart failure do not live more than 5 years after diagnosis.

“Heart failure remains the leading cause of mortality from heart disease,” explains corresponding author James F. Martin, a professor who specializes in regenerative medicine at Baylor College of Medicine and who is also director of the Cardiomyocyte Renewal Lab at the Texas Heart Institute, also in Houston.

Injured hearts favor scarring to regeneration

At present, the best treatment for heart failure is a heart transplant. However, the number of heart failure patients far exceeds the number of hearts available for transplant. Having a ventricular assist device implanted is also an option, but it is a much less favorable one.

One of the curious things about heart muscle is that it does not regenerate when it dies after being starved of oxygen, such as after a heart attack.

Instead of generating new beating muscle cells, or cardiomyocytes, the heart replaces the dead tissue with scar tissue made from fibroblast cells.
Unlike cardiomyocytes, fibroblasts have no pumping ability, so the heart gradually gets weaker and weaker, with the result that the majority of severe heart attack patients develop heart failure.
Prof. Martin says that he and his laboratory team are studying biological pathways that are active during heart development and regeneration in order to find ways to heal heart muscle.

Biological pathways are series of molecular events inside cells that lead to changes in the cell or result in particular products. For example, they can turn genes on and off and they can trigger cells to make fats, proteins, hormones, and other molecules. They can also carry signals and cause cells to move.

Silencing the Hippo pathway

“In this study, we investigated the Hippo pathway, which is known from my lab’s previous studies to prevent adult heart muscle cell proliferation and regeneration,” Prof. Martin notes.

In their study paper, he and his colleagues explain that the Hippo pathway – “a kinase cascade that prevents adult cardiomyocyte proliferation and regeneration” – is more active in patients with heart failure.

“This,” says first author John Leach, a graduate student of molecular physiology and biophysics in Prof. Martin’s group, “led us to think that if we could turn Hippo off, then we might be able to induce improvement in heart function.”

So, the team silenced the Hippo pathway in a mouse model that mimics the type of advanced heart failure that occurs in humans after a heart attack. They compared the results with those of a group of healthy mice (the controls).

“After 6 weeks we observed that the injured hearts had recovered their pumping function to the level of the control, healthy hearts,” says Leach.

The researchers believe that silencing Hippo not only renews heart muscle cells – as investigated extensively in their study – but it also changes the process of fibrosis, or scarring. They call for further studies to investigate the effects on fibrosis.

“Our findings indicate that the failing heart has a previously unrecognized reparative capacity involving more than cardiomyocyte renewal.”

Source: https://www.medicalnewstoday.com/articles/319649.php

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Government curbs random use of stem cells for therapeutic purposes

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For adults, stem cells can be used for therapeutic purposes in cases of leukemia and lymphomas, solid tumours such as germ cell and some non-cancerous diseases of the blood.
In order to curb the misuse of stem cell treatments, the Indian Council for Medical Research (ICMR) and the Department of Biotechnology (DBT) released updated national guidelines on Wednesday that restrict the use of stem cell therapy.

For adults, stem cells can be used for therapeutic purposes in different cases of leukemia (cancer of the blood) and lymphomas (cancer of the lymphatic system), solid tumours such as germ cell, and non-cancerous diseases of the blood such as severe aplastic anaemia, sickle cell disease, among others.

In children, the therapy is also permitted in different types of blood cancers, solid tumours of brain, bones, etc, and non-cancerous diseases such as thalassemia major, juvenile rheumatoid arthritis, and osteopetrosis, among others.

At the moment, certain medical practitioners offer stem cell therapy for conditions even outside their speciality and for conditions where there has been no proven cure through this treatment.

“The 2017 guidelines reiterate that any stem cell use in patients, other than that … for approved indications, is investigational at present… every use of stem cells in patients outside an approved clinical trial is unethical and shall be considered as malpractice,” says the report.

An expert, on condition of anonymity, said, “Even clinical trials in stem cell treatments should only be done by domain experts. However, these days you would find stem cell clinics almost everywhere. It is an expensive treatment modality and you can’t fool people.”

The guidelines elaborately mention categories where stem cell use “permissible, restrictive or prohibited”.

The use of stem cells has been strictly prohibited in human germ line gene therapy, wherein changes are made to the DNA that will be passed on to the next generation, and human cloning; use of gene modified human embryos; breeding of animals in which any type of human stem cells have been introduced at any stage of development, etc.

“India has a large unmet medical need, which requires facilitation of safe and regulated translational and clinical stem cell research,” says the report.

Dr Soumya Swaminathan, director general, ICMR, said, “These are the updated guidelines keeping in mind the advances that have happened in the field. It is a fast-paced area and needs constant upgradation.”

Source: http://www.hindustantimes.com/health/government-curbs-random-use-of-stem-cells-for-therapeutic-purposes/story-EWjiXbW5YqUxLLKG16IqJK.html

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DNA study provides insight into how to live longer – BBC

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The researchers say a person loses two months for every kilogram overweight they are – and seven years for smoking a packet of cigarettes a day.
Unusually, the Edinburgh university team found their answers by analysing differences in people’s genetic code or DNA.
Ultimately they think it will reveal new ways of helping us to live longer.
The group used the genetic code of more than 600,000 people who are taking part in a natural, yet massive, experiment.
Clearer picture
If someone smokes, drinks, dropped out of school and is overweight, it can be difficult to identify the impact of one specific unhealthy behaviour.
Instead, the researchers turned to the natural experiment.
Some people carry mutations in their DNA that increase appetite or make them more likely to put on weight, so researchers were able to compare those programmed to eat more with those who were not – irrespective of their wider lifestyles.
Dr Peter Joshi, from the university’s Usher Institute, said: “It doesn’t mess up the analysis. You can look directly at the effect of weight, in isolation, on lifespan.”
Similar sets of mutations have been linked to how long people spend in education and the enjoyment they get from smoking or drinking.
The research team also found specific mutations in human DNA that alter lifespan, reported in the journal Nature Communications.
Mutations in a gene (a set of instructions in DNA) that is involved in running the immune system could add seven months of life on average
People with a mutation that increased levels of bad cholesterol knocked eight months off life expectancy
A rare mutation in a gene – APOE – linked to dementia reduced lifespans by 11 months
And one that made smoking more appealing cut lives by five months
Dr Joshi says these genetic variants are the “tip of the iceberg”. He says around 20% of the variation in lifespans may be inherited, but only 1% of such mutations have yet been found.
However, he said that while genetics does influence lifespan, “you’ve got even more influence” through the choices you make.
Dr Joshi told the BBC: “We hope to discover novel genes affecting lifespan to give us new information about ageing and construct therapeutic interventions for ageing.”
There are also some disease mutations that clearly affect life expectancy, and to devastating effect, such as the Huntington’s gene. People with Huntington’s often die in their 20s.
However, in order to follow people until the end of their lives, many of the people studied were born before 1940.
Prof David Melzer, from the University of Exeter Medical School, said: “An extra year of education then may have been much more important than it is now.”

Source: http://www.bbc.com/news/health-41588613

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Two in one? New pill may curb type 2 diabetes and aid weight loss

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The study was conducted by a team from Leicester Diabetes Centre. Patients who were taking Metformin were given the pill.

Diabetes is considered to be a silent killer by medical professionals across the world. Even a single symptom reflecting the onset of the disease is a cause for concern.

It is a disease that could be hereditary and can also develop due to an unhealthy lifestyle.

Semaglutide is reportedly the first pill to help incite weight loss, according to a report by the Daily Mail. 71% of the 632 patients in the study were able to loose weight test results revealed.

The study was conducted by a team from Leicester Diabetes Centre. Patients who were taking Metformin were given the pill.

There are many medically prescribed ways and means to ensure prevention from developing the potentially lethal disease and those who are at immediate risk, are often advised diet control.

Researchers are hoping the new pill can control the common condition as some of the treatment currently available provokes weight gain and worsens type 2 diabetes. The pills also stopped patients from needing insulin.

The pill could offer a relief for those who struggle with injecting themselves. “For some patients injectable therapies are a problem, so having something available orally makes it more accessible to some patients,” lead author Professor Melanie Davies told the Daily Mail.

Type 2 diabetes is deadly as it can cause heart failure, blindness and leg amputations. “Type 2 diabetes is a serious condition with potentially devastating complications which is posing a major challenge to health services across the world because of the increasing numbers of people developing it,” Professor Davies told the Daily Mail.

Many experts are enthusiastic about the findings. “These latest results are hugely encouraging and will be welcomed across the diabetes community,” Oliver Jelley, editor of The Diabetes Times told the Daily Mail.

The findings were published in the JAMA.

Source: http://zeenews.india.com/health/two-in-one-new-pill-may-curb-type-2-diabetes-and-aid-weight-loss-2050837

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Finally a cure ? New vaccine raises hope of reducing pneumonia deaths

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An experimental vaccine that targets dozens of strains of the bacterium that causes pneumonia has the potential to significantly bring down the number of deaths due to the disease, a new study says.

The vaccine provoked an immune response to 72 forms of Streptococcus pneumoniae in laboratory tests on animals, according to the study published in the journal, ‘Science Advances’.

“We’ve made tremendous progress fighting the spread of pneumonia, especially among children. But if we’re ever going to rid ourselves of the disease, we need to create smarter and more cost-effective vaccines,” said the study’s co-lead author Blaine Pfeifer, Associate Professor at University at Buffalo in New York.

In 2004, pneumonia killed more than two million children worldwide, according to the World Health Organization (WHO). By 2015, the number was less than one million.

Better access to antibiotics and improved nutrition account for part of the decline. But scientists say it’s mostly due to vaccines introduced in the early 2000s that target up to 23 of the most deadly forms of the bacterium that causes pneumonia — Streptococcus pneumoniae.

As the new vaccine under development targets additional strains of S. pneumoniae — including the 23 mentioned above – it could, the researchers beleive, deal another blow to the disease.

Source: http://www.newindianexpress.com/lifestyle/health/2017/oct/21/new-vaccine-raises-hope-of-reducing-pneumonia-deaths-study-1679138.html

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MRI Predicts Potential Recovery from Cardiac Arrest Related Brain Damage

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MRI, which measures functional connections in the brain may be used to predict long-term recovery in patients who suffer neurological disability after cardiac arrest, says study. The Findings are published in the journal Radiology.

Cardiac arrest, or abrupt loss of heart function, is a common and often deadly occurrence that affects hundreds of thousands of people every year in the United States alone, according to the American Heart Association. Many patients who survive end up with severe neurological disabilities, as the temporary loss of oxygenated blood flow to the brain can result in widespread neuronal cell death.

The researchers assessed the brain’s functional connectivity in 46 patients who were in a coma following cardiac arrest. The imaging, performed within two weeks of cardiac arrest, included studies of brain structure and function. Functional imaging focused on four well-characterized networks in the brain, including the default mode network, which is active when a person is not engaged in a specific task, and the salience network, a collection of brain regions that select which stimuli are deserving of our attention.

One year after the patients’ cardiac arrests, the researchers assessed the patients with the Cerebral Performance Category Scale, a commonly used measure of neurological function following cardiac arrest. Eleven patients had favorable outcomes. Functional connectivity was stronger in those who achieved higher levels of independence at one year compared with those who were heavily dependent. The changes in functional connectivity between networks predicted outcomes with greater accuracy than any of the MRI structural measures tested.

“This is game-changing information about what happens in the brains of people who suffer cardiac arrest,” Dr. Stevens said. “We realize that network architectures can be selectively disrupted in this setting.”

A key predictor of outcomes was the interaction between the brain’s default mode and salience networks. These two networks are normally anti-correlated, meaning that as the default mode network becomes more active, activity is reduced in the salience network, and vice versa. When researchers compared the brain imaging results of patients who had favorable outcomes with those who did not, they noticed a stark difference.

“Anti-correlation was preserved in patients who recovered and abolished in those who did not,” Dr. Stevens said. “Relative preservation of this anti-correlation was the most robust signal of a favorable outcome.”

The results indicate that connectivity measures could be early markers of long-term recovery potential in patients with cardiac arrest-related brain damage, the researchers said.

While researchers don’t expect connectome analysis with MRI to be the single “magic bullet” solution to predicting outcomes, it could increase the confidence that clinicians have in communicating with patients’ families in the wake of cardiac arrest. Additionally, fMRI could aid in the development of therapeutic interventions for neurologically disabled patients.

“Connectome studies have the potential to change not only outcome prediction, but to guide treatment as well,” Dr. Stevens said.

Source: http://www.medindia.net/news/mri-predicts-potential-recovery-from-cardiac-arrest-related-brain-damage-173880-1.htm

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Good News! Blood test can effectively rule out breast cancer, regardless of breast density

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With over a 99 percent negative predictive value, a liquid biopsy test can help clinicians manage difficult-to-diagnose dense breast patients

A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue. Nearly half of all women in the U.S. have dense breast tissue.

“Women who have dense breasts are at a double disadvantage. Not only are they at higher risk of developing breast cancer, but dense breast tissue can decrease the reliability of imaging and increase the chances of a false finding.” said Judith K. Wolf, MD, Chief Medical Officer of Provista Diagnostics, Inc. “This study shows that, with an over 99 percent negative predictive value (NPV), clinicians can confidently use Videssa Breast to detect cancer in women with dense breasts and better determine when biopsy is truly warranted to assess suspicious findings.”

The study, “Breast Density Does Not Impact the Ability of Videssa Breast to Detect Breast Cancer in Women Under Age 50” evaluated the performance of Videssa Breast among 545 women, ages 25 to 50, with abnormal or difficult-to-interpret imaging (BI-RADS 3 and 4). The sensitivity and specificity in the dense breast group was 88.9 percent and 81.2 percent respectively, and 92.3 percent and 86.6 percent in the non-dense group. The differences were not statistically significant. The NPV was 99.1 percent in women who had dense breasts and 99.3 in women with non-dense tissue, providing confirmation that when a woman receives a negative test result, she does not have breast cancer.

The challenges of diagnosing breast cancer in women with dense breasts has drawn national attention in recent years. Driven by patient advocacy groups such as Are You Dense Inc. and Are You Dense Advocacy, Inc., 32 states have enacted legislation to ensure women are informed of their breast density status and the associated diagnostic challenges.

A study published earlier this year in Clinical Breast Cancer proved the utility of Videssa Breast as a diagnostic complement to imaging for women with abnormal findings and demonstrated it could potentially reduce use of biopsy by up to 67 percent. “Using biomarkers for cancer detection is an important advance in managing women with dense breasts and navigating many diagnostic challenges. As a clinician, the ability to identify who will benefit most from further imaging and follow-up, and rule out breast cancer in women, when they receive suspicious findings, is tremendous,” says Elayne Arterbery, MD, radiation oncologist at St. Mary’s of Saginaw, who was a principal investigator on the Provista studies. “This study also validates the scientific promise and the growing role biomarkers have in addressing diagnostic challenges for women with dense breasts, and the merits of further research to help expand how we put that science to work to benefit women.”

Videssa Breast has been studied in two prospective, randomized, multi-center and blinded clinical trials, in more than 1,350 patients ages 25 to 75. The data featured in the current PLOS ONE publication is taken from the first study and cohort one of the second study. Videssa Breast is currently available for use by ordering healthcare providers for patients with abnormal imaging findings.

Source: https://www.sciencedaily.com/releases/2017/10/171025150623.htm

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Indian surgeons separate twins joined at the head

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Surgeons in the New Delhi, have separated twin boys who were conjoined at the tops of their heads.
Two-year-old Jaga and Kalia underwent 16 hours of surgery, and are now in the intensive care unit, doctors said.
A team of 30 doctors carried out the surgery – the first of its kind in India – at a state-run hospital.
The boys were born with shared blood vessels and brain tissues, a very rare condition that occurs once in about three million births.
The director of the All India Institute of Medical Sciences, Randeep Guleria, told the Press Trust of India that the “next 18 days would be extremely critical to ascertain the success of the surgery”.
The twins, hailing from a village in eastern Orissa state, were joined at the head – a condition known as craniopagus.
Even before the operation they had defeated the odds; craniopagus occurs in one in three million births, and 50% of those affected die within 24 hours, doctors say.
“Both the children have other health issues as well. While Jaga has heart issues, Kalia has kidney problems,” neurosurgeon A K Mahapatra said.
“Though initially Jaga was healthier, now his condition has deteriorated. Kalia is better,” he added.
Doctors said the most challenging job after the separation was to “provide a skin cover on both sides of the brain for the children as the surgery had left large holes on their heads”.
“If the twins make it, the next step will be reconstructing their skulls,” plastic surgeon Maneesh Singhal said.
The first surgery was performed on 28 August when the doctors created a bypass to separate the shared veins that return blood to the heart from the brain.

Source: http://www.bbc.com/news/world-asia-india-41772987

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