Tag Archives: procedure

In a surprise finding, gene mutation found linked to low-risk bladder cancer

The investigators identified STAG2 as one of the most commonly mutated genes in bladder cancer, particularly in tumors that do not spread. The finding suggests that checking the status of the gene may help identify patients who might do unusually well following cancer treatment, says the study’s senior investigator, cancer geneticist Todd Waldman, MD, PhD, a professor of oncology at Georgetown Lombardi. "Most bladder cancers are superficial tumors that have not spread to other parts of the body, and can therefore be easily treated and cured. However, a small fraction of these superficial tumors will recur and metastasize even after treatment," he says. …

Contralateral prophylactic mastectomy may not increase life expectancy

According to the American Cancer Society, more than 232,000 women are diagnosed with breast cancer in the U.S. every year, making breast cancer the second most common type of cancer in women, after skin cancer. Many women who face this diagnosis worry about cancer recurring in the healthy breast and therefore choose to have both breasts removed, even though the risk of developing cancer in the other breast is very low. Women at high risk include those with a family history of breast or ovarian cancer and women who test positive for the BRCA1 and BRCA2 gene mutations…

Sparing the body, breast cancer treatment via nipple injection

“Local delivery of therapeutic agents into the breast, through intra-nipple injection, could diminish the side effects typically observed with systemic chemotherapy—where the toxic drugs pass through all of the tissues of the body,” said Dr. Silva Krause, one of the researchers behind the experiment, “It also prevents drug breakdown by the liver, for example, which can rapidly reduce effective drug levels.” According to Silva, she and her colleagues have already begun experimentation in applying the method. “The authors have utilized this technique to inject a new nanoparticle-based therapeutic that inhibits a specific gene that drives breast cancer formation,” said Silva, “This targeted treatment was shown to prevent cancer progression in mice that spontaneously develop mammary tumors, [and] is currently in review in Science Translational Medicine.” In order to better communicate their procedure, Silva and her colleagues decided to publish with JoVE. …

Boston hospital to offer hand transplants for kids

A Boston hospital is starting the world's first hand transplant program for children, and doctors say it won't be long until face transplants and other radical operations to improve appearance and quality of life are offered to kids, too. The move shows the growing willingness to do transplants to enhance a patient's life rather than to save it as donated hearts, livers and other organs have done in the past. More than 70 hands and at least 20 faces have been transplanted in adults, and doctors say it's clear these operations are safe enough to offer to children in certain cases, too. “We feel that this is justifiable,” Dr. Amir Taghinia said of the pediatric hand program he will lead at Boston Children's Hospital. “Children will potentially benefit even more from this procedure than adults” because they regrow nerves more quickly and have more problems from prosthetic hands, he said. Only one hand transplant is known to have been done in a child - a baby in Malaysia in 2000. Because the donor was a twin who died at birth, her sister did not need to take drugs to prevent rejection. That's the main risk in offering children hand transplants - the immune-suppressing drugs carry side effects and may raise the risk of cancer over the long term. However, one independent expert thinks the gains may be worth it in certain cases. “We understand so much more about immune suppression” that it's less of a risk to put children on it, said Dr. Simon Horslen, medical director of the liver and intestine transplant program at Seattle Children's Hospital. “This is never going to be done as an emergency procedure, so the families will have plenty of opportunity to weigh the options.” Also, a hand can be removed if rejection occurs, and that would not leave the child worse off than before the transplant, Horslen said. Several types of kids might be candidates - those born without hands, children who lose them in accidents and children with infections that wind up requiring damaged hands to be amputated. Quality of life is a key concern for people missing arms and hands - prosthetics for those limbs are not as advanced as those for feet and legs. In December, doctors at Johns Hopkins Hospital in Baltimore did a double-arm transplant for former soldier Brendan Marrocco, who lost all four limbs while serving in Iraq. It was the seventh double-hand or double-arm transplant performed in the U.S. For a child missing two hands, “the quality-of-life issues are a big deal,” said Dr. Douglas Diekema of the Center for Pediatric Bioethics at Seattle Children's Hospital and a member of the American Board of Pediatrics' ethics committee. “In terms of how we interact with the social world, it's mostly our face and our hands,” so a transplant “is a reasonable thing to offer a family,” he said. Boston Children's Hospital plans to make its first cases healthy children 10 or older who are missing both hands. “Some of them can't feed themselves, they can't go to the bathroom, someone needs to assist them with almost every activity,” Taghinia said. The hospital also will consider children missing one hand who already are taking immune-suppressing drugs because of transplanted organs, or those with only one hand that doesn't work well. The hospital will cover the cost of the operation and care for three months afterward, then ask insurers to pay for immune suppression and follow-up.source : http://www.foxnews.com/health/2013/06/17/boston-hospital-to-offer-hand-transplants-for-kids/

Bosnians mourn baby who died for lack of ID number

Thousands of Bosnians gathered in front of parliament on Sunday evening to mourn a three-month-old baby who died after failing to get timely surgery because a parliamentary wrangle prevented her getting a passport. Berina Hamidovic was the first victim of politicking over identity numbers, which has united Bosnians in protests against the institutional paralysis that has blocked post-conflict reforms and the country's path towards the European Union. The somber gathering followed days of protests in Sarajevo and other towns over lawmakers' failure to agree new legislation on citizens' identity numbers. The row has left babies born since February unregistered, and therefore denied passports or medical cards. The protesters this time did not carry banners or posters, but encircled parliament with a ring of candles placed on the ground, and stood or walked in silence. The baby's parents said the time they had wasted persuading Serbian border police to let her in without a passport to go to a hospital in Belgrade for surgery had cost her her chance of life. The baby was diagnosed with tracheoesophageal fistula - a hole between her gullet and windpipe - and had already had an unsuccessful operation in Sarajevo. “We practically had to take the child across the border illegally, although she was legally allowed to travel for urgent health reasons,” the baby's father Emir Hamidovic said. When the baby was finally admitted to hospital in Belgrade, Bosnian authorities refused to pay for the surgery. Though the Serbian doctors agreed to carry out the procedure, the baby contracted an infection and died. “She perhaps had a chance to stay alive, but this is an obvious example how the state does not take care of its citizens,” said Hamidovic, 31, who is unemployed. The protests over ID numbers started two weeks ago after another 3-month-old baby was unable to leave for urgent surgery abroad because lawmakers could not agree how to redraw the districts that determine the 13-digit identification number assigned to each citizen. Similar ethnic wrangles have plagued Bosnia since the end of its 1992-95 war, which left it divided along ethnic lines with a weak central government and a system of ethnic quotas that has stifled development. The Serbs are pressing for a new registration arrangement along territorial lines. Muslims, known as Bosniaks, say that would only cement the ethnic divide.source : http://www.foxnews.com/health/2013/06/17/bosnians-mourn-baby-who-died-for-lack-id-number/

New website keeps loved ones informed during surgery

Just mentioning the word surgery can send chills down a person's spine. Whether it’s a simple appendectomy or a more complicated procedure, going under the knife can be frightening for both patients and families alike. Now, a new website, MDconnectME.com, is helping to settle the nerves of friends, significant others and family members all across the globe. The website, which is free to use, was designed to allow family members to stay informed while their loved one undergoes an operation. Before surgery, patients make a list of people to notify during their procedure, which grants their doctor permission to send previously-typed notes like, “Ann is now heading into the operating room for surgery,” throughout the day. These messages can be sent through text or e-mail. MDconnectME.com is now being used throughout the country at centers such as Mount Sinai Hospital, Johns Hopkins, and UCLA. For more information, go to MDconnectME.comsource : http://www.foxnews.com/health/2013/06/12/new-website-keeps-loved-ones-informed-during-surgery/

Man with kidney disease receives first bioengineered vein

A man suffering from end-stage kidney disease became the first U.S. patient to receive a bioengineered blood vessel, Nature World News reported. The 62-year-old from Danville, Va., underwent a two-hour procedure on June 5 during which surgeons at Duke University Hospital implanted the lab-grown vein into his arm. Researchers from Duke University created the vein using human blood cells that were grown in a tubular, scaffold-like device. In clinical tests, the vein performed better than animal-based or synthetic implants, and could be an effective treatment for thousands of dialysis patients, Nature World News reported. “This is a pioneering event in medicine. It's exciting to see something you've worked on for so long become a reality. We talk about translational technology - developing ideas from the laboratory to clinical practice - and this only happens where there is the multi-disciplinary support and collaboration to cultivate it ,” said Dr. Jeffrey H. Lawson, a vascular surgeon and vascular biologist at Duke Medicine. “We hope this sets the groundwork for how these things can be grown, how they can incorporate into the host, and how they can avoid being rejected immunologically,” Lawson said in a news release. “A blood vessel is really an organ - it's complex tissue. We start with this, and one day we may be able to engineer a liver or a kidney or an eye.” Click for more from Nature World News.source : http://www.foxnews.com/health/2013/06/07/man-with-kidney-disease-receives-first-bioengineered-vein/

Medical breakthrough for multiple sclerosis sufferers

In a breakthrough discovery, researchers have discovered a treatment capable of reducing the debilitating autoimmune response that occurs in people suffering from multiple sclerosis (MS). When patients are diagnosed with multiple sclerosis, their bodies begin to attack the protein myelin, which insulates the body’s spinal cord, brain and optic nerves. As a result, MS patients experience symptoms such as numbness in their limbs, paralysis and sometimes blindness. However, during a phase one clinical trial of a new treatment for MS patients, researchers were able to curtail the body’s attacks on myelin by 50 to 75 percent, while sustaining the functionality of the rest of the immune system. Current treatments for MS seek to lessen the body’s autoimmune response to myelin, but this often results in decreased effectiveness of the entire immune system. “Most therapies for autoimmune diseases employ approaches broadly called immunosuppressors – they knock down immune response without specificity,” study co-author Stephen Miller, professor of microbiology-immunology at Northwestern University Feinberg School of Medicine, told FoxNews.com.  “People can become highly susceptible to everyday infections and develop higher rates of cancer.” Miller and his colleagues sought a more targeted ‘tolerance’ treatment that would leave the greater immune system intact while knocking out only the autoimmune response to myelin. “In MS, the idea is to target autoreactive T-cells directed against myelin…which would (reduce) disease progression, but wouldn’t make patient susceptible to higher rates of infection,” Miller said. In a study published in the journal Science Translational Medicine, a small group of MS patients were treated intravenously with an infusion of their own white blood cells, which had been engineered to carry billions of myelin antigens. Researchers hoped the cells would teach the body to stop attacking myelin. Miller and his team needed to determine if the treatment, which was based on 30 years of previous research, could be safely applied in humans – and they were pleased to discover it could be. “It was safe to infuse as many as 3 billion autologous cells that we collected and manipulated back into the same patient and didn’t trigger exacerbations,” Miller said. “Most patients didn’t show any increased signs of disease during the six-month follow up.” Furthermore, the treatment did not seem to impede the larger immune system. Researchers tested this by analyzing whether or not each patient continued to retain their immunity to tetanus, for which all of the patients had previously been vaccinated. “Among four patients receiving the highest doses (of autologous cells),  immune response to myelin antigens had diminished or gone away - but tetanus had not gone away,” Miller said. This indicated that the immune system’s ability to fight other diseases after the procedure remained intact. Though researchers caution that the study was too small to draw any significant conclusions, they are optimistic about the outcomes of larger studies and the ability of this treatment to help halt the progress of MS – particularly among recently-diagnosed patients. “The idea is that if we’re able to intervene early enough in disease process, we can stop the autoimmune destruction and (the patient) will have little or no clinical deficit as result of earlier attacks before being diagnosed,” Miller said. Researchers hope to receive funding to begin a phase two trial soon.source : http://www.foxnews.com/health/2013/06/06/medical-breakthrough-for-multiple-sclerosis-sufferers/

Brain surgery is an option for patients with severe OCD, study suggests

A type of brain surgery appears to be a relatively effective treatment for people with severe obsessive compulsive disorder (OCD) who have not responded to other treatments, a new study suggests. In the study, nearly half of patients showed at least some improvement in their OCD symptoms, and 15 percent fully recovered seven years after the surgery. The findings suggest surgery may be an effective treatment for patients with very severe OCD who have not been helped by other therapies, the researchers said. Patients in the study had not responded to several medications, including serotonin reuptake inhibitors (SRIs) and antipsychotic medications, as well as psychotherapy. On average, patients had experienced symptoms for 16 years, and one-third had attempted suicide. However, the surgery has significant risks. Two of the 19 patients experienced permanent complications from the surgery, including paralysis on one side of the body and cognitive impairment. Because of this, the procedure should be considered with caution, the researchers said. [See 5 Controversial Mental Health Treatments]. Future studies should examine which patients are most likely to be helped by the surgery, so that only those who stand to gain greatest benefit undergo the procedure, the researchers said. Surgery for OCD OCD is characterized by recurrent, intrusive thoughts and repetitive behaviors that patients feel compelled to carry out. Patients might perform these behaviors (such as hand washing) for hours, and some are unable to leave their homes. About 20 to 30 percent of patients are not helped by medication or behavioral therapies. Brain surgery for mental disorders, called psychosurgery, has been practiced since the 1930s, although it is very controversial. Early surgeries, such as lobotomies practiced in the 1940s and 1950s, had serious side effects, including personality changes. The practice of psychosurgery declined after psychiatric medications became available, although a small number of centers today continue perform psychosurgerical procedures. Today, psychosurgery is much more carefully regulated than it was in the past, and performed only after patients determined to be appropriate candidates for the treatment by a team of psychiatrists and neurologists, said Dr. Michael Schulder, vice chair of neurosurgery at North Shore University Hospital in Manhasset, NY. Brain imaging technology available today helps doctors more carefully select the surgery target, said Schulder, who was not invovled in the new study. The study, conducted by researcher at Universit Laval in Quebec, Canada, involved 19 patients who underwent a type of psychosurgery called bilateral capsulotomy between 1997 and 2009. The surgery damages tissue (by creating lesions) in a part of the brain called the internal capsule. Before the surgery, patients scored an average of 34 out of 40 points (extreme OCD) on a test designed to measure the severity of the condition. After surgery, the average score decreased to 23, which is considered moderate OCD. About 37 percent of patients responded fully to the surgery, meaning their score improved by at least 35 percent, and about 10 percent partially responded to the surgery, meaning their score improved by 25 percent. After seven years, three patients fully recovered from OCD, and three had minimal symptoms, the researchers said. Those who did not respond to the surgery were more likely to have had OCD for a longer time period (an average of 20 years) than those who did respond to surgery (an average of 12 years). Psychosurgery vs. deep brain stimulation The study did not have a control group, or a group of patients who did not undergo the procedure, so it's possible the improvement seen in the study was the result of a placebo effect. However, there is little evidence for spontaneous remission or placebo effect in patients with severe OCD, the researchers said. A more recent surgical procedure for OCD, called deep brain stimulation, involves implanting a device that sends electrical impulses into the brain. Unlike psychosurgery, deep brain stimulation is reversible, and does not permanently damage tissue. In 2009, the Food and Drug Administration approved the use of deep brain stimulation for OCD. However, patients with a deep brain stimulation implant may experience problems with the implant that need to be fixed right away, so they should live close to a health care center. Psychosurgery is less expensive than deep brain stimulation, and does not require that patients live close to a health care center, so there is still a place for the procedure in the field, the researchers said. Schulder said that while psychosurgery tends to have a higher complication rate than DBS, the latter procedure poses risks such as infection and erosion of the device through the skin. “There's still a good rational for doing lesioning in some patients. It's not like DBS is complication free,” Schulder said. The study is published June 3 in the Journal of Neurology, Neurosurgery, & Psychiatry. Copyright 2013 LiveScience, a TechMediaNetwork company. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.source : http://www.foxnews.com/health/2013/06/04/brain-surgery-is-option-for-patients-with-severe-ocd-study-suggests/