60 second brain test

Until recently physicians have had to rely on time-consuming and uncertain behavioural examinations to diagnose the onset of brain diseases such as multiple sclerosis, Alzheimer's and schizophrenia.

Research published recently in the Institute of Physics' Journal of Neural Engineering suggests that we could soon be able to diagnose the onset of many brain diseases by analysing the tiny magnetic fields produced by neuron activity in the brain.

This is a significant breakthrough for neurologists and psychiatrists as it could present a fast and simple screening test for brain diseases, while also helping differentiate between different brain diseases that have similar symptoms.

A team of investigators from the University of Minnesota Medical School in Minneapolis, US, led by Professor Apostolos P Georgopoulos, has been analysing the magnetic charges released when neuronal populations in our brains 'couple'. By comparing the patterns of tiny magnetic charges in healthy brains to those afflicted with common diseases such as Alzheimer's, the team has been able to identify the patterns commonly associated with these debilitating diseases.

A process called magnetoencephalography (MEG), a non-invasive measurement of magnetic fields in the brain, has been used to examine a total of 142 volunteers during tests which last between 45- 60 seconds. The team first studied 52 volunteers to find patterns of neural activity that could identify all the different illnesses. They then tested a further 46 patients to see whether the patterns found from the first group could accurately diagnose disease within a second group. Here, many of the predictors found from the first set of participants also correctly diagnosed more than 90% of subjects in the second sample.

Prof Georgopoulos said: “We want to continue and acquire data from a large number of subjects – patients and matched controls. The throughput of this MEG test is large so we can continue a high rate of testing and we hope that clinical applications can become a reality in a year or two.”

Diagnosing illnesses like Alzheimer’s has always been very difficult, particularly in the early stages. Physicians are forced to rely on conversations with patients, memory tests, physical examinations and, occasionally, brain scans. It is sometimes not until post-mortem or after a biopsy that cause of illness can be confirmed.

Novartis challenge fails

In a landmark ruling on 6 August the Indian High Court dismissed drug company Novartis’s petition to patent the generic anti-cancer drug Glivec, produced in India.

According to media reports the Court held as valid a legal provision unique to India, which states that modifications of known medicines cannot be patented unless they make the drug significantly more effective.

The ruling, which came after months of delay, will be welcomed by several groups, including Medicines Sans Frontieres (MSF), who acquire a large proportion of their medications from India’s generic drug manufacturers.

MSF, who organised a major international campaign protesting against Novartis’s challenge, said many Developing Countries around the world rely on the affordable generic drugs produced in India.

They said if the ruling went in favour of Novartis, Glivec would be the first in a long line of generics whose production would be blocked, thus cutting off access to affordable medication for many of the world’s poor.

Siemens acquisition

Siemens has signed a merger agreement with US-based Dade Behring Medical Solutions Group. The acquisition is valued at around US$7 billion and is expected to be finalised in the second quarter of 2008.

Dade Behring, headquartered in Deerfield, Illinois, US, has operations in 35 countries, employs some 6,400 people and serves more than 25,000 customers around the world. The company provides clinical laboratory equipment and integrated solutions for routine chemistry testing, immunodiagnostics (including infectious disease testing), hemostasis testing and microbiology.

Peter Löscher, Chief Executive Officer, Siemens, said: “Complementing last year’s acquisitions of Diagnostic Products Corporation and Bayer Diagnostics, this transaction secures our leading position in the highly attractive healthcare industry.”

Erich R Reinhardt, President of Siemens Medical Solutions, said: “By further strengthening its presence in clinical laboratory diagnostics, Siemens Medical Solutions continues to pursue its vision to become the global leader in full-service diagnostics, offering imaging diagnostics, clinical laboratory diagnostics and healthcare IT solutions – from a single source and along the entire value chain.”

Pencil in brain for 55 years

BBC News reports that a woman in Germany who has had an 8cm pencil embedded in her head for 55 years, has finally had it removed. According to the report Margret Wegner fell over while carrying the pencil when she was four.

It punctured her cheek and part of it went into her brain, above the right eye. She has suffered headaches and nose bleeds for most of her life. Surgeons in Berlin removed most of the pencil, but had to leave behind a 2cm section that was so embedded and encapsulated in soft tissue it as impossible to remove, but was safe to leave.

When the accident occurred, doctors at that time thought it too dangerous to operate, however new medical techniques and technology significantly reduced the danger.

Doctors protest

BBC News online reports (26 July 2007) that 49 doctors in Kazakhstan have resigned to protest against the pressure placed on them following the infection of some 120 toddlers with HIV.

Ten of these toddlers have so far died, according to the report. The virus, discovered in hospitals last September, was spread through blood transfusions. In June, 21 medical workers were tried and found guilty of corruption and negligence which lead to the spread of HIV.

During the trial it emerged that many of these blood transfusions were not necessary. The doctors who resigned in protest said they should not be blamed for the region’s deficient and under-funded healthcare system. In a statement, the Union of Medical Professionals said more would resign unless the government reconsidered its approach to the outbreak.

According to the report the prosecution has begun a criminal investigations into 13 other doctors related to the case.

Libya frees Bulgarian nurses

Six Bulgarian nurses who were serving life sentences in Libya were freed after eight years in jail and flew to Bulgaria in late July. Their freedom follows years of negotiations between the European Commission and the Libyan authorities.

The five nurses and a Palestinian-born doctor were convicted of deliberately infecting Libyan children with HIV – charges they denied.

The Libyan High Judicial Council had a week earlier commuted their death sentences to life after the families of the 438 children infected with HIV agreed a compensation deal reportedly worth US$1 million per child.

The report says foreign experts believe the infections started before the medics arrived at the hospital in Libya, and are more likely to have been a result of poor hygiene.

Gadolinium warning

New research has shown a possible link between Gadolinium, a popular magnetic resonance imaging (MRI) contrast agent, and the incidence of a rare disease called nephrogenic systemic fibrosis (NSF) in patients with kidney disease.

The warning was first issued in an editorial in the March issue of Radiology. Phillip H Kuo, MD, PhD, assistant clinical professor of diagnostic radiology at Yale University School of Medicine in New Haven, Connecticut, United States, said: “We recommend avoiding the use of gadodiamide (Omniscan) [and other gadolinium-based MRI contrast agents] in patients with any degree of renal disease.

At this point, the data clearly show the vast majority of NSF cases are associated with the use of gadodiamide.” NSF, an emerging systemic disorder characterised by widespread tissue fibrosis, has been diagnosed in patients who were previously administered gadodiamide (Omniscan) and other gadolinium-based MRI contrast agents.

While the precise cause of NSF is unknown, the disorder has only been observed in patients with kidney disease, especially those requiring dialysis. NSF is characterised by thickening and hardening of the skin and immobility or tightening of the joints.

NSF can develop rapidly and may result in patients becoming wheelchair-bound within just a few weeks. In some cases, there is involvement of other tissues, including the lungs, heart, diaphragm, esophagus and skeletal muscle. No consistently effective therapy exists.

Robot navigates heart

St Mary’s Hospital in London is pioneering the world’s first robot able to navigate the human heart during a popular procedure to eliminate heart rhythm disorders – catheter ablation.

The robotic device, used to treat the world’s most common heart rhythm disorder – atrial fibrillation (AF), could dramatically reduce clinical risk for patients. The advancement has the potential to simplify complex procedures and not only increase patient safety but also the availability of the procedure.

The Sensei Robotic Catheter system, by Hansen Medical, was launched globally in May with St Mary’s announced as the World’s first centre for training and development.

More than 20 St Mary’s patients have already been operated on by the robotic surgical hand, which is controlled by a doctor from a nearby console station. Catheter ablation, a noninvasive procedure, involves inserting several thin wires and tubes into the heart through veins and arteries.

When carefully placed at target sites, various energies are delivered to destroy the tiny areas of heart muscle, identified as the cause of the rhythm abnormality. The robot enables the stable positioning and control of these thin wires, often in locations that are difficult to reach and stabilise.

Electrodes wake man from coma

The United Kingdom’s Daily Mail newspaper reports that a man was brought back to life after being in a coma for six years, following the implantation of electrodes in his brain.

Doctors inserted the electrodes into the man's thalamus, the region believed to control consciousness, to boost its speech and movement signals. He can now talk, chew and swallow, according to the report.

Vit D deficiency

A review article in the 19 July issue of the New England Journal of Medicine discusses the important role vitamin D plays in a wide variety of chronic health conditions, as well as suggesting strategies for the prevention and treatment of vitamin D deficiency.

Humans attain vitamin D from exposure to sunlight, diet and supplements. Vitamin D deficiency is common in children and adults. In utero and childhood vitamin D deficiency may cause growth retardation, skeletal deformities and increase risk of hip fractures later in life.

In adults, vitamin D deficiency may precipitate or exacerbate osteopenia, osteoporosis, muscle weakness, fractures, common cancers, autoimmune diseases, infectious diseases and cardiovascular diseases.

Dr Michael Holick, an internationally recognized expert in vitamin D and a professor of medicine, physiology, and biophysics, and director of the General Clinical Research Center at Boston University School of Medicine and Director of the Bone Healthcare Clinic at Boston Medical Center says it is estimated that 1 billion people world-wide are vitamin D deficient or insufficient.

Without vitamin D only about 10-15% of dietary calcium and about 60 percent of phosphorus is absorbed by the body. This is directly related to bone mineral density which is responsible for osteoporosis and fractures, as well as muscle strength and falls in adults.

In utero and childhood, calcium and vitamin D deficiency prevents the maximum deposition of calcium in the skeleton. Studies have shown people living at higher latitudes (where the angle of the sun’s rays are unable to sufficiently produce adequate amounts of vitamin D in the skin) are more likely to develop and die of Hodgkin’s lymphoma, colon, pancreatic, prostate, ovarian, breast and other cancers.

Holick believes the current recommended Adequate Intakes for vitamin D need to be increased to 800 – 1000 IU vitaminD3/d. “However, one can not obtain these amounts from most dietary sources unless one is eating oily fish frequently,” says Holick.

“Thus, sensible sun exposure (or UVB irradiation) and/or supplements are required to satisfy the body’s vitamin D requirement,” he adds.


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