Posts Tagged Journal Reference

Standard radiation therapy dose provides pain relief for painful heel spurs (plantar fasciitis)


ScienceDaily (July 26, 2012) — Patients with plantar fasciitis (painful bone heel spur) experience significantly less pain and improved quality of life following a standard dose of external beam radiation therapy, a common cancer treatment similar to receiving an X-ray, according to a randomized, cooperative group study that was published online July 25, 2012, in the International Journal of Radiation Oncology • Biology • Physics (Red Journal), the official scientific journal of the American Society for Radiation Oncology (ASTRO).

Approximately 8-10 percent of the population has severe bone heel spurs, with the most common treatments for alleviating the pain being ice, heat, and various anti-inflammatory agents. Steroids and local anesthetics can be injected, and oral analgesic medications may be prescribed, but most of these methods have only provided short-term pain relief. The results of this study demonstrated that up to 80 percent of standard dose patients experienced complete pain relief, and pain relief remained constant or even improved for up to 64 percent of the study participants during the follow-up period of 48 weeks post-treatment.

“Severe plantar fasciitis is a chronic health issue, and it can be extremely painful — many of these men and women cannot walk or stand for a long time,” said Marcus Niewald, MD, PhD, a radiation oncologist at Saarland University Medical Center in Homburg/Saar, Germany, and one of the study’s authors. “Radiation therapy has been used for its anti-inflammatory effect for more than 60 years. We are extremely encouraged by the results of our research because evidence of improved quality of life for patients is clearly evident with the standard dose regimen.”

This study was a prospective, randomized trial of a total of 66 patients, with evaluation every six weeks until 12-months post treatment. Four patients were secondarily excluded after the trial began; 29 patients received a standard dose regimen, and the remaining 33 patients received a low dose of radiation therapy. The standard dose patients were treated with a total dose of 6.0 Gy, applied in 6 single fractions of 1.0 Gy twice weekly on non-consecutive days. The low dose arm received 0.6 Gy, applied in 6 single fractions of 0.1 Gy twice weekly on non-consecutive days.

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The above story is reprinted from materials provided by American Society for Radiation Oncology.

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Journal Reference:

  1. Marcus Niewald, M. Heinrich Seegenschmiedt, Oliver Micke, Stefan Graeber, Ralf Muecke, Vera Schaefer, Christine Scheid, Jochen Fleckenstein, Norbert Licht, Christian Ruebe. Randomized, Multicenter Trial on the Effect of Radiation Therapy on Plantar Fasciitis (Painful Heel Spur) Comparing a Standard Dose With a Very Low Dose: Mature Results After 12 Months’ Follow-Up. International Journal of Radiation Oncology*Biology*Physics, 2012; DOI: 10.1016/j.ijrobp.2012.06.022

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Lucid dreamers help scientists locate the seat of meta-consciousness in the brain


ScienceDaily (July 27, 2012) — Studies of lucid dreamers show which centers of the brain become active when we become aware of ourselves in dreams.

Which areas of the brain help us to perceive our world in a self-reflective manner is difficult to measure. During wakefulness, we are always conscious of ourselves. In sleep, however, we are not. But there are people, known as lucid dreamers, who can become aware of dreaming during sleep. Studies employing magnetic resonance tomography (MRT) have now been able to demonstrate that a specific cortical network consisting of the right dorsolateral prefrontal cortex, the frontopolar regions and the precuneus is activated when this lucid consciousness is attained. All of these regions are associated with self-reflective functions. This research into lucid dreaming gives the authors of the latest study insight into the neural basis of human consciousness.

The human capacity of self-perception, self-reflection and consciousness development are among the unsolved mysteries of neuroscience. Despite modern imaging techniques, it is still impossible to fully visualize what goes on in the brain when people move to consciousness from an unconscious state. The problem lies in the fact that it is difficult to watch our brain during this transitional change. Although this process is the same, every time a person awakens from sleep, the basic activity of our brain is usually greatly reduced during deep sleep. This makes it impossible to clearly delineate the specific brain activity underlying the regained self-perception and consciousness during the transition to wakefulness from the global changes in brain activity that takes place at the same time.

Scientists from the Max Planck Institutes of Psychiatry in Munich and for Human Cognitive and Brain Sciences in Leipzig and from Charité in Berlin have now studied people who are aware that they are dreaming while being in a dream state, and are also able to deliberately control their dreams. Those so-called lucid dreamers have access to their memories during lucid dreaming, can perform actions and are aware of themselves – although remaining unmistakably in a dream state and not waking up. As author Martin Dresler explains, “In a normal dream, we have a very basal consciousness, we experience perceptions and emotions but we are not aware that we are only dreaming. It’s only in a lucid dream that the dreamer gets a meta-insight into his or her state.”

By comparing the activity of the brain during one of these lucid periods with the activity measured immediately before in a normal dream, the scientists were able to identify the characteristic brain activities of lucid awareness.

“The general basic activity of the brain is similar in a normal dream and in a lucid dream,” says Michael Czisch, head of a research group at the Max Planck Institute of Psychiatry. “In a lucid state, however, the activity in certain areas of the cerebral cortex increases markedly within seconds. The involved areas of the cerebral cortex are the right dorsolateral prefrontal cortex, to which commonly the function of self-assessment is attributed, and the frontopolar regions, which are responsible for evaluating our own thoughts and feelings. The precuneus is also especially active, a part of the brain that has long been linked with self-perception.” The findings confirm earlier studies and have made the neural networks of a conscious mental state visible for the first time.

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The above story is reprinted from materials provided by Max-Planck-Gesellschaft.

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Journal Reference:

  1. Martin Dresler, Renate Wehrle, Victor I. Spoormaker, Stefan P. Koch, Florian Holsboer, Axel Steiger, Hellmuth Obrig, Philipp G. Sämann, Michael Czisch. Neural Correlates of Dream Lucidity Obtained from Contrasting Lucid versus Non-Lucid REM Sleep: A Combined EEG/fMRI Case Study. Sleep, 2012;35(7):1017-1020

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Shift work linked to increased risk of heart attack and stroke


ScienceDaily (July 26, 2012) — Shift work is associated with an increased risk of major vascular problems, such as heart attacks and strokes, concludes a study published on the website of the British Medical Journal.

This is the largest analysis of shift work and vascular risk to date and has implications for public policy and occupational medicine, say the authors.

Shift work has long been known to disrupt the body clock (circadian rhythm) and is associated with an increased risk of high blood pressure, high cholesterol and diabetes, but its association with vascular disease is controversial.

So a team of international researchers analyzed the results of 34 studies involving over two million individuals to investigate the association between shift work and major vascular events. Shift work was defined as evening shifts, irregular or unspecified shifts, mixed schedules, night shifts and rotating shifts. Control groups were non-shift (day) workers or the general population.

Differences in study design and quality were taken into account to minimize bias.

Among the 2,011,935 people in the studies more than 17,359 had some kind of coronary event, 6,598 had myocardial infarctions (heart attacks), and 1,854 had ischemic strokes caused by lack of blood to the brain. These events were more common among shift workers than other people: shift work was associated with an increased risk of heart attack (23%), coronary events (24%) and stroke (5%). These risks remained consistent even after adjusting for factors such as study quality, socioeconomic status and unhealthy behaviors in shift workers.

Night shifts were associated with the steepest increase in risk for coronary events (41%). However, shift work was not associated with increased death rates from any cause.

Although the relative risks were modest, the authors point out that the frequency of shift work in the general population mean that the overall risks are high. For Canada — where some of the study’s authors are based and where 32.8% of workers were on shifts during 2008-9 — 7.0% of myocardial infarctions, 7.3% of all coronary events, and 1.6% of ischemic strokes could be attributed to shift work.

The authors say their findings have several implications. For example, they suggest screening programs could help identify and treat risk factors, such as high blood pressure and cholesterol levels. Shift workers could also be educated about symptoms that could indicate early heart problems.

Finally, they say more work is needed to identify the most vulnerable groups of shift workers and the effects of modifying shift patterns on overall vascular health.

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The above story is reprinted from materials provided by BMJ-British Medical Journal.

Note: Materials may be edited for content and length. For further information, please contact the source cited above.


Journal Reference:

  1. M. V. Vyas, A. X. Garg, A. V. Iansavichus, J. Costella, A. Donner, L. E. Laugsand, I. Janszky, M. Mrkobrada, G. Parraga, D. G. Hackam. Shift work and vascular events: systematic review and meta-analysis. BMJ, 2012; 345 (jul26 1): e4800 DOI: 10.1136/bmj.e4800

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MRSA cases in academic hospitals double in five years


ScienceDaily (July 26, 2012) — Infections caused by methicillin-resistant Staphylococcus aureus (MRSA) doubled at academic medical centers in the U.S. between 2003 and 2008, according to a report published in the August issue of Infection Control and Hospital Epidemiology, the journal of the Society for Healthcare Epidemiology of America.

Researchers from the University of Chicago Medicine and the University HealthSystem Consortium (UHC) estimate hospitalizations increased from about 21 out of every 1,000 patients hospitalized in 2003 to about 42 out of every 1,000 in 2008, or almost 1 in 20 inpatients. “The rapid increase means that the number of people hospitalized with recorded MRSA infections exceeded the number hospitalized with AIDS and influenza combined in each of the last three years of the survey: 2006, 2007, and 2008,” said Michael David, MD, PhD, an assistant professor of medicine at the University of Chicago and one of the study’s authors.

The findings run counter to a recent CDC study that found MRSA cases in hospitals were declining. The CDC study looked only at cases of invasive MRSA — infections found in the blood, spinal fluid, or deep tissue. It excluded infections of the skin, which the UHC study includes.

MRSA infections, which cannot be treated with antibiotics related to penicillin, have become common since the late 1990s. These infections can affect any part of the body, including the skin, blood stream, joints, bones, and lungs.

The researchers attribute much of the overall increase they detected to community-associated infections — those that were contracted outside the healthcare setting. When MRSA first emerged it was primarily contracted in hospitals or nursing homes. “Community-associated MRSA infections, first described in 1998, have increased in prevalence greatly in the U.S. in the last decade,” David said. “Meanwhile, healthcare-associated strains have generally been declining.”

The study utilized the UHC database, which includes data from 90 percent of all not-for-profit academic medical centers in the U.S. However, like many such databases, the UHC data are based on billing codes hospitals submit to insurance companies, which often underestimate MRSA cases. For example, hospitals might not report MRSA cases that do not affect insurance reimbursement for that particular patient. In other cases, hospitals might be limited in the number of billing codes they can submit for each patient, which can result in a MRSA code being left off the billing report if it was not among the primary diagnoses.

David and his team corrected for these errors by using detailed patient observations from the University of Chicago Medical Center and three other hospitals. They looked at patient records to find the actual number of MRSA cases in each hospital over a three-year period. The team then checked the insurance billing data to see how many of those cases were actually recorded. They found that the billing data missed one-third to one-half of actual MRSA cases at the four hospitals. They used that rate of error as a proxy to correct the billing data from other 420 hospitals in the UHC database and arrive at the final estimates.

“I think this is still an underestimate of actual cases,” David said. “But we can say with some assurance that this correction gives us a more accurate lower bound for how many cases [of MRSA] there actually are. What’s clear from our data is that cases were on the rise in academic hospitals in 2003 to 2008.”

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The above story is reprinted from materials provided by University of Chicago Press Journals, via EurekAlert!, a service of AAAS.

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Journal Reference:

  1. Michael Z. David, Sofia Medvedev, Samuel F. Hohmann, Bernard Ewigman, Robert S. Daum. Increasing Burden of Methicillin-Resistant Staphylococcus aureus Hospitalizations at US Academic Medical Centers, 2003? Infection Control and Hospital Epidemiology, August 2012 [link]

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Do ovaries continue to produce eggs during adulthood?


ScienceDaily (July 26, 2012) — A compelling new genetic study tracing the origins of immature egg cells, or ‘oocytes’, from the embryonic period throughout adulthood adds new information to a growing controversy. The notion of a “biological clock” in women arises from the fact that oocytes progressively decline in number as females get older, along with a decades-old dogmatic view that oocytes cannot be renewed in mammals after birth.

After careful assessment of data from a recent study published in PLoS Genetics, scientists from Massachusetts General Hospital and the University of Edinburgh argue that the findings support formation of new eggs during adult life; a topic that has been historically controversial and has sparked considerable debate in recent years.

Eggs are formed from progenitor germ cells that exit the mitotic cycle, thereby ending their ability to proliferate through cell division, and subsequently enter meiosis, a process unique to the formation of eggs and sperm which removes one half of the genetic material from each type of cell prior to fertilization.

While traditional thinking has held that female mammals are born with all of the eggs they will ever have, newer research has demonstrated that adult mouse and human ovaries contain a rare population of progenitor germ cells called oogonial stem cells capable of dividing and generating new oocytes. Using a powerful new genetic tool that traces the number of divisions a cell has undergone with age (its ‘depth’) Shapiro and colleagues counted the number of times progenitor germ cells divided before becoming oocytes; their study was published in PLoS Genetics in February this year.

If traditional thinking held true, all divisions would have occurred prior to birth, and thus all oocytes would exhibit the same depth regardless of age. However, the opposite was found — eggs showed a progressive increase in depth as the female mice grew older.

In their assessment of the work by Shapiro and colleagues — published recently in a PLoS Genetics Perspective article — reproductive biologists Dori Woods, Evelyn Telfer and Jonathan Tilly conclude that the most plausible explanation for these findings is that progenitor germ cells in ovaries continue to divide throughout reproductive life, resulting in production of new oocytes with greater depth as animals age.

Although these investigations were performed in mice, there is emerging evidence that oogonial stem cells are also present in the ovaries of reproductive-age women, and these cells possess the capacity, like their mouse counterparts, to generate new oocytes under certain experimental conditions. While more work is needed to settle the debate over the significance of oocyte renewal in adult mammals, Woods and colleagues emphasize that “the recent work of Shapiro and colleagues is one of the first reports to offer experimental data consistent with a role for postnatal oocyte renewal in contributing to the reserve of ovarian follicles available for use in adult females as they age.”

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The above story is reprinted from materials provided by Public Library of Science.

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Journal Reference:

  1. Woods DC, Telfer EE, Tilly JL. Oocyte Family Trees: Old Branches or New Stems? PLOS Genet, 2012 DOI: 10.1371/journal.pgen.1002848

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Modeling of new enzymes helps develop therapies for cocaine abuse


ScienceDaily (July 26, 2012) — Researchers from the University of Kentucky have designed and discovered a series of highly efficient enzymes that effectively metabolize cocaine. These high-activity cocaine-metabolizing enzymes could potentially prevent cocaine from producing physiological effects, and could aid in the treatment of drug dependency.

The results of this study by Chang-Guo Zhan et al are published in the journal PLOS Computational Biology.

The effectiveness of the enzymes’ work was evaluated through modeling cocaine pharmacokinetics, the study of the body’s action on administered external substances, such as cocaine, when the enzyme exists in the body. As there is no FDA-approved anti-cocaine medication, the medical and social consequences of cocaine abuse have made the development of anti-cocaine medication a high priority.

Administration of an enzyme to enhance cocaine metabolism has been recognized as a promising treatment strategy for overdose and abuse. A remarkable feature of the enzyme-based therapeutic approach is that one enzyme molecule can degrade many thousands of drug molecules per minute.

This pharmacokinetic modelling is a crucial step of enzyme-based therapy development for cocaine abuse. Furthermore, the general insights of the research should also be valuable for future development of an enzyme therapy for any addictive drug, as the general methodology of the modelling may be used to develop valuable models for evaluating the effectiveness of metabolic enzymes in detoxifying other drugs.

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Journal Reference:

  1. Zheng F, Zhan C-G. Modeling of Pharmacokinetics of Cocaine in Human Reveals the Feasibility for Development of Enzyme Therapies for Drugs of Abuse. PLoS Comput Biol, 2012 DOI: 10.1371/journal.pcbi.1002610

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Decoding the secrets of balance


ScienceDaily (July 26, 2012) — If you have ever looked over the edge of a cliff and felt dizzy, you understand the challenges faced by people who suffer from symptoms of vestibular dysfunction such as vertigo and dizziness. There are over 70 million of them in North America. For people with vestibular loss, performing basic daily living activities that we take for granted (e.g. dressing, eating, getting in and out of bed, getting around inside as well as outside the home) becomes difficult since even small head movements are accompanied by dizziness and the risk of falling.

We’ve known for a while that a sensory system in the inner ear (the vestibular system) is responsible for helping us keep our balance by giving us a stable visual field as we move around. And while researchers have already developed a basic understanding of how the brain constructs our perceptions of ourselves in motion, until now no one has understood the crucial step by which the neurons in the brain select the information needed to keep us in balance.

The way that the brain takes in and decodes information sent by neurons in the inner ear is complex. The peripheral vestibular sensory neurons in the inner ear take in the time varying acceleration and velocity stimuli caused by our movement in the outside world (such as those experienced while riding in a car that moves from a stationary position to 50 km per hour). These neurons transmit detailed information about these stimuli to the brain (i.e. information that allows one to reconstruct how these stimuli vary over time) in the form of nerve impulses.

Scientists had previously believed that the brain decoded this information linearly and therefore actually attempted to reconstruct the time course of velocity and acceleration stimuli. But by combining electrophysiological and computational approaches, Kathleen Cullen and Maurice Chacron, two professors in McGill University’s Department of Physiology, have been able to show for the first time that the neurons in the vestibular nuclei in the brain instead decode incoming information nonlinearly as they respond preferentially to unexpected, sudden changes in stimuli.

It is known that representations of the outside world change at each stage in this sensory pathway. For example, in the visual system neurons located closer to the periphery of the sensory system (e.g. ganglion cells in the retina) tend to respond to a wide range of sensory stimuli (a “dense” code), whereas central neurons (e.g. in the primary visual cortex at the back of the head tend to respond much more selectively (a “sparse” code). Chacron and Cullen have discovered that the selective transmission of vestibular information they were able to document for the first time occurs as early as the first synapse in the brain. “We were able to show that the brain has developed this very sophisticated computational strategy to represent sudden changes in movement in order to generate quick accurate responses and maintain balance,” explained Prof. Cullen. “I keep describing it as elegant, because that’s really how it strikes me.”

This kind of selectivity in response is important for everyday life, since it enhances the brain’s perception of sudden changes in body posture. So that if you step off an unseen curb, within milliseconds, your brain has both received the essential information and performed the sophisticated computation needed to help you readjust your position. This discovery is expected to apply to other sensory systems and eventually to the development of better treatments for patients who suffer from vertigo, dizziness, and disorientation during their daily activities. It should also lead to treatments that will help alleviate the symptoms that accompany motion and/or space sickness produced in more challenging environments.

The research was conducted by Corentin Massot a Postdoctoral fellow in the Department of Physiology, and Adam Schneider a Ph.D. Student in the Department of Physics.

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The above story is reprinted from materials provided by McGill University.

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Journal Reference:

  1. Corentin Massot, Adam D. Schneider, Maurice J. Chacron, Kathleen E. Cullen. The Vestibular System Implements a Linear–Nonlinear Transformation In Order to Encode Self-Motion. PLoS Biology, 2012; 10 (7): e1001365 DOI: 10.1371/journal.pbio.1001365

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