Medical innovations, October 22

October 22, 2010 by  

Bionic legs, long-lasting artificial hearts, and gene X-rays. These are just some of the latest medical innovations we are bringing you this week.

Italian Man Surpasses 1,000 Days of Support with an Artificial Heart
A 54-year-old man was the first in Italy to receive SynCardia’s Total Artificial Heart while waiting for a matching donor. He was also the first to surpass 1000 days on the device while enjoying a normal life at home. He walks 10 km and works out at home for 30 minutes each day. The artificial heart is powered by a The Freedom™ portable driver approved for commercial use in Europe and but is still undergoing an FDA-approved Investigational Device Exemption (IDE) clinical study in the U.S.

Bionic Legs Allow Paraplegics to Get Up and Walk
Initially based on military technology, eLEGS is now geared for consumers. The bionic legs were developed by Berkeley Bionics and can help paraplegic get rid of their wheel chairs and walk.

eLEGS is the latest in a line of “human augmentation robotics systems” that Berkeley Bionics has created with the Robotics and Human Engineering Laboratory at the University of California, Berkeley. It was based on another system called HULC, for the Human Universal Load Carrier, a robotics system licensed to Lockheed Martin that was made for the military to help soldiers carry heavy packs across extreme terrain without risking injury.

The eLEGS device consists of a backpack that holds the battery, and metal leg casings that are secured around a person’s clothed body with velcro straps. A mixture of sensors and robotics creates a natural-seeming gait that can speed up to an excess of 2 miles per hour.

An X-ray for your genes
Researchers at the Tel Aviv University’s Sackler Faculty of Medicine is taking a big step towards personalized medicine. Using a deep sequencer, a machine that reads the human genome and its expression, doctors can more or less predict how a patient reacts to medications. Somewhat like an “X-ray for our genes”, the method enables researchers to look “at how the genetic expression of small regulatory genes, called microRNAs, affects the way a patient reacts to medication. This could mean fewer deaths from adverse drug effects and novel and safe uses for existing medications. “

Long-lasting mechanical heart implanted for the first time in Canada in heart-failure patient
A 61-year old woman was the first in Canada to receive the ventricular assist device (LVAD) for advanced heart failure. The device is called DuraHeart and “is designed for long-term cardiac support and reduces the risk of complications including strokes, infection and device failure – all of which can happen in mechanical heart devices. The device’s central pump is powered by magnetic levitation technology, which means its moving parts are held in place with magnets instead of bearings, eliminating wear and tear on the device. This technology enables blood to flow through the pump smoothly, which extends the life of the device and the life of the patient.”

Folate and lung cancer

July 29, 2010 by  
Filed under CANCER

As scientists continue to unravel the genetics of cancer, other researchers are also discovering ways of using these information in preventing or slowing down cancer.

Take for example lung cancer. Studies have identified a high number of genetic mutations in the lungs of smokers. Furthermore, the carcinogens that cause their mutations vary depending on the cigarettes, their ingredients and how they are manufactured.

But knowing the genetic mechanisms of cancer is not enough. Steven Belinsky of the Lovelace Respiratory Research Institute in New Mexico and his colleagues studied more than 1000 current and former smokers and report possible ways of slowing down  lung cancer even if not being able to beat it completely. And it is something that you can do all by yourself through lifestyle change. The answer lies in your diet. The research results indicate that genetic changes that lead to lung cancer is less severe among those who ate leafy green vegetables , multivitamins and foods rich with folate.

According to Dr. Belinsky:

“These studies do in fact indicate that substances in these food groups and in the multivitamins could potentially retard the processes by which these gene changes occur in the smoker.’’

The researchers identified sputum samples of smokers eight genes  which are commonly “silenced” in lung cancer patients and strongly associated with risk for this disease.

Folate is a vitamin commonly associated with pregnancy to prevent fetal defects such as spina bifida. However, everybody needs folate. According to World’ Healthiest Food, folate

So what are foods that are rich in folate?

Table 1: Selected Food Sources of Folate and Folic Acid

Food Micrograms (μg) % DV^
*Breakfast cereals fortified with 100% of the DV, ¾ cup 400 100
Beef liver, cooked, braised, 3 ounces 185 45
Cowpeas (blackeyes), immature, cooked, boiled, ½ cup 105 25
*Breakfast cereals, fortified with 25% of the DV, ¾ cup 100 25
Spinach, frozen, cooked, boiled, ½ cup 100 25
Great Northern beans, boiled, ½ cup 90 20
Asparagus, boiled, 4 spears 85 20
*Rice, white, long-grain, parboiled, enriched, cooked, ½ cup 65 15
Vegetarian baked beans, canned, 1 cup 60 15
Spinach, raw, 1 cup 60 15
Green peas, frozen, boiled, ½ cup 50 15
Broccoli, chopped, frozen, cooked, ½ cup 50 15
*Egg noodles, cooked, enriched, ½ cup 50 15
Broccoli, raw, 2 spears (each 5 inches long) 45 10
Avocado, raw, all varieties, sliced, ½ cup sliced 45 10
Peanuts, all types, dry roasted, 1 ounce 40 10
Lettuce, Romaine, shredded, ½ cup 40 10
Wheat germ, crude, 2 Tablespoons 40 10
Tomato Juice, canned, 6 ounces 35 10
Orange juice, chilled, includes concentrate, ¾ cup 35 10
Turnip greens, frozen, cooked, boiled, ½ cup 30 8
Orange, all commercial varieties, fresh, 1 small 30 8
*Bread, white, 1 slice 25 6
*Bread, whole wheat, 1 slice 25 6
Egg, whole, raw, fresh, 1 large 25 6
Cantaloupe, raw, ¼ medium 25 6
Papaya, raw, ½ cup cubes 25 6
Banana, raw, 1 medium 20 6

Source: Office of Dietary Supplement, National Institutes for Health (ODS)

How much folate do we need?

Table 2: Recommended Dietary Allowances for Folate for Children and Adults [10]

Males and Females
1-3 150 N/A N/A
4-8 200 N/A N/A
9-13 300 N/A N/A
14-18 400 600 500
19+ 400 600 500

*1 DFE = 1 μg food folate = 0.6 μg folic acid from supplements and fortified foods

Source: Office of Dietary Supplement, National Institutes for Health (ODS)

Special warning

Folate from natural sources is not linked to any health risks. However, folate supplements in the form of folic acid can be toxic if taken in large amounts.

According to ODS:

Beware of the interaction between vitamin B12 and folic acid.

Intake of supplemental folic acid should not exceed 1,000 micrograms (μg) per day to prevent folic acid from triggering symptoms of vitamin B12 deficiency [10]. Folic acid supplements can correct the anemia associated with vitamin B12 deficiency. Unfortunately, folic acid will not correct changes in the nervous system that result from vitamin B12 deficiency. Permanent nerve damage can occur if vitamin B12 deficiency is not treated.

It is very important for older adults to be aware of the relationship between folic acid and vitamin B12 because they are at greater risk of having a vitamin B12 deficiency. If you are 50 years of age or older, ask your physician to check your B12 status before you take a supplement that contains folic acid. If you are taking a supplement containing folic acid, read the label to make sure it also contains B12 or speak with a physician about the need for a B12 supplement.

Loneliness affects the mind and the body

June 10, 2010 by  
Filed under DEPRESSION

When I decided to become a work-at-home-mom (WAHM) after moving to a strange country, little did I know that the word “loneliness” would take on a new dimension for me. I am not exactly a social butterfly, but the utter isolation of a home office was too much for me. My friends were so far away, my kids at the kindergarten, my husband at the office. There were no colleagues to talk to or even just to bicker with. I became depressed, lost appetite and weight, and couldn’t sleep. That was 3 years ago. Since then I have made new friends and joined some clubs and organizations and gone out regularly. But I have learned how hard social isolation can be – on the mind as well as on the body. No wonder that solitary confinement is used as a punishment for serious misdemeanors in prisons. Yet, one can be lonely even in a crowd of people.

What are the health effects of loneliness?

In recent years, research studies have been conducted to explore the causes of loneliness and how it affects health.  Here are some of the findings:

How does social network affect loneliness?

The current trend of social networking has good and bad effects on loneliness.

In a USA Today report, a cancer survivor got a lot of support through social media to over her depression. According to breast cancer survivor Jody Schoger:

“If any survivor posts something onto Twitter or Facebook that they’re ‘having a hard day,’ I can bet you 10 to 1 that he or she is surrounded by good wishes by day’s end. Yet the survivor, the one who is ill, has to be willing to take that step. Once he or she does, the burden of illness and its perceived isolation fades away.”

However, loneliness is contagious and it can also spread through social networking. There was the case of the so-called suicide pact among lonely young people only connected through the Internet a few years ago.

Dr. John Cacioppo, a social neuroscientist at the University of Chicago conducted several studies on loneliness and summarized his results as follows:

Can a healthy lifestyle alter your genes and treat your cancer?

May 25, 2009 by  
Filed under CANCER

dna2 We’ve heard this statement of resignation before: “I can’t do anything about it. It’s in my genes.” Indeed, many diseases have been linked to genetics, including heart disease, mental illness, and cancer. However, this study by researchers at the Preventive Medicine Research Institute in Sausalito, California suggests that there might be something we can do after all, and that changing our lifestyle for the better can trigger changes in certain genes that otherwise make us predisposed to disease.

The researchers followed up 30 men diagnosed with low-risk prostate cancer and who decided not to undergo currently available treatments such as removal of the prostate gland, radiation therapy or hormone therapy. However, they opted for a major lifestyle change program which consisted of

eating a diet rich in fruits, vegetables, whole grains, legumes and soy products, moderate exercise such as walking for half an hour a day, and an hour of daily stress management methods such as meditation.

Indeed there were some expected health benefits observed after 3 months of lifestyle change therapy, namely:

  • Weight loss
  • Improved cardiovascular health

However, the researchers found some unexpected but nevertheless beneficial effects in the form of “changes in activity in about 500 genes — including 48 that were turned on and 453 genes that were turned off…The activity of disease-preventing genes increased while a number of disease-promoting genes, including those involved in prostate cancer and breast cancer, shut down.”

The researchers also performed prostate biopsies before and after the 3-month therapy and found observable clinical improvement.

It is incredible to see these changes in such as short period of time but of course the study only looked at patients with a type of prostate cancer that is less likely to be aggressive or malignant. However, the study demonstrates the undeniable health benefits that a healthy lifestyle can bring. The lifestyle change therapy is especially relevant to prostate cancer patients who are faced with a lot of uncertainties concerning the early screening tests (e.g. PSA) and treatments available. Many patients tend to opt of the so-called “watchful waiting” management. If this management approach is coupled with a lifestyle change therapy, the chances of beating prostate cancer will considerably increase.

According to lead researcher Dr. Dean Ornish

“‘In just three months, I can change hundreds of my genes simply by changing what I eat and how I live?’ That’s pretty exciting. The implications of our study are not limited to men with prostate cancer.”

Photo credit: stock.xchng

Can folic acid increase cancer risk?

April 29, 2009 by  
Filed under CANCER

pregnancy-2In the developed world, many food stuffs, especially flour and grain products, are fortified with folate and folic acid. Folic acid fortification has been going on since 1998 and its goal is to make sure that women consume enough folate during pregnancy. Deficiency of this essential vitamin can lead to birth defects, including the much-dreaded spina bifida.

“Folic acid is the synthetic form of folate, which is a B vitamin that occurs naturally in leafy greens and other fruits and vegetables. It has been shown to significantly reduce the chance of neural tube defects, such as spina bifida, and helps produce and maintain healthy cells and is involved in numerous biological functions.”

Now, just over a decade later, there is a growing body of research that questions the benefits and risks of folic acid fortification. There have been indications, for example, that “long-term consumption of folate and folic acid may increase the risk of developing certain cancers in some people.

In a recent study, Canadian researchers at the University of Toronto report that consumption of folic acid consumed during pregnancy can cause changes in gene function of the unborn offspring, changes which can potentially affect its susceptibility to certain diseases, including cancer.

The study is one of many in the relatively new field of epigenetics which looks at how certain genes and gene functions are “turned on” or “turned off” by environmental factors that include diet and lifestyle.

In some cases, genes that protect the body against certain types of cancer can be shut off, while genes that promote tumour formation can be turned on. Changes to genes can also trigger mutations, which explains why epigenetics has been gaining so much attention in the scientific community for its potential ability to help explain the mystery of disease risk.

Many health officials are concerned that the population is consuming excessive amounts of folic acid, leading to the abovementioned gene alternations. The effects of these alterations, however, are not clearly known.

The current study has been performed in rats and can’t conclusively say whether folic acid fortification has detrimental effects on human health, especially that of the unborn child. However several studies in humans have shown that folic acid supplementation does not lower risks for heart disease or cancer.

In fact,

“…it’s becoming harder to ignore the growing debate about folic acid. Despite its clear benefits when taken by pregnant women, the move to fortify food with folic acid means a major portion of the population is consuming a higher level of the supplement than they would otherwise. Now, concern is growing that parts of the population that may be susceptible to colon cancer and other diseases could be put at greater risk due to their inadvertent exposure to folic acid.”

Photo credit: stock.xchng

Patent on breast cancer risk genes: right or wrong?

December 9, 2008 by  
Filed under CANCER

The BRCA1 (breast cancer 1) gene is a gene closely associated with breast cancer. Mutations in the gene increased an individual’s risk to have breast cancer as well as ovarian cancer. Nowadays, it is very common for women to be tested for mutations in the BRCA1 gene as well as in another gene, the BRCA2 gene for breast cancer risk assessment.

What you probably don’t know is that for every BRCA1 testing in the US, a certain amount is probably paid to somebody. You see, the BRCA1 gene is one of the genes whose sequence has been patented. And not only one patent but many.

The original holder of the BRCA1 gene sequence in question was Myriad Genetics but it was transferred to the University of Utah in 2004.

In Europe, resistance to the patent was strong and it took 7 years to finally resolve the issue. And the patent owners won their case in the European Patent Office last November. “Between 10% and 15% of all heritable breast and ovarian cancers have a mutation in BRCA1 or BRCA2, another gene linked to breast cancer, leading to as many as 5,000 new cases of both cancers in the European Union every year…The ruling means that the patent owners now have the right to collect royalties on tests carried out on tens of thousands of women across Europe every year”, according to this Nature report.

European scientists are dismayed about the ruling.

“Clinical geneticists do not agree with monopolies on diagnostic testing of genes for such diseases because they believe they block the competition that could lead to the development of better, cheaper products.”

Paying royalties would mean increased cost for the tests. Currently, it costs more than $US 3000 to test for each BRCA gene in the US. In the EU, it costs much less when testing for both. With the patent in place, it is expected that the price of the test will skyrocket, adding to the burden of the European health care system.

In addition, it might hinder further research since using the gene in the lab might mean infringement of the patent owner’s rights. There have been many cases of gene and biological patents hindering scientific research, including patents on hepatitis C, haemophilus influenza, and SARS.

Some claims the ruling on BRCA1 is confusing and doesn’t clearly define what constitute infringement of the patent.

Granting gene patents have been severely criticized but this didn’t stop the process. In this article in the New York Times, the late Michael Crichton, doctor, science fiction writer, film maker and cancer victim brought up the following food for thought regarding biological patents:

Two Genes Related to Ankylosing Spondylitis, Discovered

October 25, 2007 by  
Filed under ARTHRITIS

A disabling form of arthritis, ankylosing spondylitis is a painful and progressive disease in which some or all of the spine’s vertebrae fuse together.

Ankylosing spondylitis is a type of arthritis that not only affects the spine but also can attack other joints and organs, including the heart, lungs and eyes. The condition afflicts an estimated one in 200 males and one in 500 females and typically strikes during adolescence and young adulthood.

Now, an international team of researchers (led by a Fred Hutchinson Cancer Research Center geneticist) has discovered two genes associated to ankylosing spondylitis.

The study revealed two genes linked to ankylosing spondylitis: ARTS1 and IL23R, both of which influence immune function. Together with the previously known gene HLA-B27, the new findings increase to three the number of genes known to be involved in the disease. A person who carries all three genetic variants would be expected to have a one-in-four chance of developing the disease.

What does finding a gene associated to a disease mean actually? It means that anybody can get tested for said genes to determine their risk of a certain disease — such as ankylosing spondylitis and the genes associated with it as recently discovered. In the long run, this disease may be treated or prevented by gene therapy, once research become successful in this department.

Indeed, genes are important, as my friend Hsien always tells us.

According to principal investigator and corresponding author Lon Cardon, Ph.D (a member of the Hutchinson Center’s Human Biology Division, a statistical methodologist who last year came to the Hutchinson Center’s Human Biology Division from the University of Oxford, where he conducted the research and retains an academic post, also a professor of biostatistics at the University of Washington):

“Clinically these diseases tend to occur together — people with inflammatory-bowel disease also tend to have a higher probability of having ankylosing spondylitis and psoriasis. The IL23R gene provides a genetic link that sheds new light on their co-occurrence.

This is an exciting time for genetics. The Wellcome Trust Case Consortium has yielded more genetic discoveries for common diseases in 2007 than have been made in the entire history of the field.”

Do not get tired ever of hearing about genetics and stuff in any other disease or health condition, because the breakthroughs are admirable, not to mention awesome. Not all people (not even me!) may understand it and the research involved, but it is paving the way to prevention and cure of serious diseases. Yes, including arthritis and its many forms such as ankylosing spondylitis.

Ankylosing spondylitis. What a mouthful! But now we know that it is a form of arthritis.

Find more details from the Fred Hutchinson Cancer Research Center press release.

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NOTE: The contents in this blog are for informational purposes only, and should not be construed as medical advice, diagnosis, treatment or a substitute for professional care. Always seek the advice of your physician or other qualified health professional before making changes to any existing treatment or program. Some of the information presented in this blog may already be out of date.