From the desk of Jeanne Hambleton
Members of the European Parliament (MEPs) adopt written declaration 69/2008 on fibromyalgia initiated by five deputies and the European Network of Fibromyalgia Associations (ENFA).
Brussels (16.12.2008) – Written Declaration 69/2008 on fibromyalgia has been a success in the European Parliament by finding the necessary quorum of signatories of 393 deputies giving their support. The Written Declaration was initiated by five key MEPs active on health at the European Parliament: Mr. Adamou, Ms. Brepoels, Ms. Dičkuté, Mr. Popa and Ms. Sinnott. These MEPs decided to launch the declaration during the celebratory meeting of the 1st European Fibromyalgia Awareness Day in May 2008, organized by ENFA
The Written Declaration is calling on the European Union to recognize fibromyalgia in Europe as a disease, as WHO did in 1992. It is estimated that 14 million people in Europe suffer from fibromyalgia and the condition is more prevalent with women (87% of total prevalence).
Fibromyalgia is a complex disease with a variety of symptoms in addition to the defining symptom – chronic widespread pain. These include fatigue, non-restorative sleep, morning stiffness, irritable bowel and bladder, restless legs, depression, anxiety and cognitive dysfunction often referred to as “fibro fog.” All of these symptoms cause serious limitations in patients’ ability to perform ordinary daily chores and work and severely affect their quality of life. Some scientists believe that there is an abnormality in how the body responds to pain, and particularly a heightened sensitivity to stimuli.
Fibromyalgia imposes large economic burdens on society as well as on affected individuals. A study shows that an average patient in Europe consults up to 7 physicians and takes multiple medications over 5-7 years before receiving the correct diagnosis. The debilitating symptoms often result in lost work days, lost income and disability payments. Research in the UK has shown that diagnosis and positive management of Fibromyalgia reduce healthcare cost by avoiding unnecessary investigations and consultations
Thus, the European Parliament is calling through this declaration, for the European Commission and the Council, to help raise awareness of the condition and facilitate access to information for health professionals and patients, by supporting European and national awareness campaigns; to encourage Member States to improve access to diagnosis and treatment; to facilitate research on fibromyalgia through the work programmes of the EU 7th Framework Programme for Research and future research programmes; and finally to facilitate the development of programmes for collecting data on fibromyalgia.
Educating healthcare professionals, patients and the public to promote better understanding and management of Fibromyalgia will benefit patients, healthcare providers and the society.
A Written Declaration is a text of up to 200 words on a matter falling within the European Union’s sphere of activities. MEPs can use them in order to launch or relaunch a debate on a subject that comes within the EU’s remit. At the end of the lapsing date (3 months after its launch on 1 September for the declaration 69/2008) the declaration is forwarded to the institutions named in the text, together with the names of the signatories.
European Network of Fibromyalgia Associations (ENFA)
Mr. Robert Boelhouwer
President of ENFA
ENFA is a network of patient association and support groups working in close consultation with the national association in the relevant country. Our joint missions are to conquer the myths and misunderstandings around Fibromyalgia. The network will help collectively push forward the boundaries which currently exist in understanding, experiencing and treatment of Fibromyalgia. Our main goal is to see fibromyalgia receiving the recognition it deserves across Europe as an illness in its own right.
by Jeanne Hambleton © 2007
NFA Leader Against Pain – Advocate
Maybe I should mention that you just might need some kleenex tissues before you start this story but please read it anyway, if only in the spirit of Goodwill to All Children. The men are big enough to look after themselves.
As folks in the UK were getting ready this morning to do some Christmas shopping an email arrived on my desktop with a warning, which said, “This email needs to circulate forever.”
How could I pass up this invitation to inquire within? The email also stated, “This is a real eye opener. A real tear jerker No prerequisites (commitments). Simply, because everyone should be reminded.“
This was sent to me by a lady from Montevideo, Uruguay called Marta. Where the pictures, shown in the email, were taken, it does not say, but I am sure it conveys a worldwide message, especially within the African continent.
Picture 1. shows European students sat at computers working, with the caption, “Does studying annoy you?”
Picture 2. reveals children, possibly from Africa, without shoes, sat on a bench and drawing their lessons in the dirt with their fingers. The caption says, “ Not them!”
Picture 3. is a happy family picture of a father with his daughter enjoying a beef burger roll with the words, “Hate veggies?”
Picture 4. is a picture of a long line of native mothers and starved children, clothed, in rags and waiting in line with a bowl for some food handouts. This caption says, “They starve from hunger!”
Picture 5. reveals the back view of a jolly obese child having fun, with a caption which reads, “On a diet?”
Picture 6. gives a close-up of a painfully thin starved child with a tape measure around the child’s matchstick thin arm. The caption referring to diet says, “They die from it!” Or the lack of any kind of diet.
Picture 7. shows a baby being cuddled by a parent revealing the lovely cuddly cheeks of a child’s bottom. This reads, “Does your parent’s care tire you?”
Picture 8. shows a sibling cuddling a child with the last bone in the baby’s spine clearly visible as she rests in sister’s arms for comfort. This caption tells us these children have no parents to grow tired of. “They don’t have any!”
Picture 9. reveals youngsters sat at a games console and states, “Bored with the same game?”
Picture 10. Shows a young unclothed child playing in the dirt with a bit of stick, next to the human skull of someone who had probably died from starvation. The caption reads, “They have no option!”
Picture 11. shows a smart new trainer with a caption which reads, “Someone got you Adidas instead of Nike?”
Picture 12. pictures the feet of a child with half of a plastic bottle cut to make the sole of a pair of sandals. The picture clearly reveals the screw top of the plastic bottle on the footwear, which is tied onto the foot with rag. This caption states, “They only have one brand?” Maybe it is cola?????
Picture 13. is of a sweet little girl in clean pyjamas snuggled up in her cosy bed. This caption reads, “Aren’t you thankful for a bed to sleep in?”
Picture 14. The final contrast picture shows a child laying in the dirt, half covered with a piece of old rag, trying to sleep, with a caption that reads, “They’d wish not to wake up!”
The closing slide asks, “Are you still complaining? Observe around you and be thankful for all that you have in this transitory lifetime…. We are fortunate to have much more than what we need to be content. Let us try not to feed this endless cycle of consumerism and immortality in which this ‘modern and advanced’ society forgets and ignores the other two thirds of our brothers and sisters. Send this information without any obligation or expectation in receiving good luck. Don’t keep it! Send it and it won’t be in vain. Let us complain less and give more!”
I imagine you feel as I do. I work hard for my dollar and I do not believe in sharing my hard earned cash with large charities who have magnificent offices, managing directors, hundreds of paid staff and devote just a fraction of their donations to their ‘good’ works. You can call me the woman with the long pockets if you like, but I want to know my money is going where it will doing some good and helping those would really need it. How to be confident about that I am not sure? In true Scorpion fashion I hate to be misled or deceived.
Quite how we can help these starving children is the burning question. I have had masses of appeals for all sorts of charities drop on my doormat in recent weeks. At least these ends up in the local hospice waste paper recycling skip and help them a little along with our papers and magazines. I looked on the Internet at our UK BBC Children in Need but could not see children in a similar situation.
SAVE THE CHILDREN
The UK Save the Children organisation has produced a Christmas shopping catalogue, on line, so should you decide to buy Christmas gifts from them you are indirectly donating while shopping, just how much remains to be seen! Perhaps this might be more acceptable – buying and giving at the same time. It is easy to look at this site to see the work they are doing and possibly shop with them. Every Christmas I seem to receive more and more cards printed by charities and sent by to me by friends.
However I should mention that if you telephone their UK number – 0844 557 5425 – instead of ordering on line, it could cost you 40p a minute as you give your details and make your mind up. Some of that money will be going to the charity.
Our doctors’ surgery is using this 0844 prefix number and getting a rake off which is a bit vexing considering how much our GPs are reported to be earning – but that is another story.
No – I am not a sales rep for any charity – just a concerned parent. No, this is not a commercial for children’s charities – it is a wake up call.
The American Save the Children website also appears to have a programme for under privileged children in developing countries, who are suffering from hunger and poverty. It seems you can also purchase festive gifts from them indirectly helping the cause.
What you decide to do is between you and your conscience. I would however like to leave you with these thoughts.
These pictures and words certainly do bring you down to earth especially when you consider the wastage by governments the world over. I am just sorry I could not reproduce the pictures but I am sure you know the kind of scenes I mean – you must have seen them on TV from time to time. Send me your email address with the request for these pictures if you would like them forwarding.
Just consider the money all of the worldwide governments squander… it is time someone added the total figure and gave us some home truths.
These starving children, if they live, may be our next generation – our future leaders. Do you think if they survive they could be future terrorists? I am sure they will have a grudge against the world – surely they will feel the world owes them a living. This is all very sad and really makes you think. Whatever happened to the innocence of childhood?
Just imagine what we spend on consumerism not to mention what we will spend on our own children this Christmas 2007. I wonder what our children would think if we put these pictures under the Christmas tree on Dec.25 instead of a new bike, a new game toy and all the other things children of our modern world expect to receive from their parents aka Father Christmas?
What would it be like if children all over the world went without just one toy from their festive gifts in aid of the starving and poverty stricken children. It would take a lot of organizing to gather in that money and it is a huge task but it could be done – all it needs is a good website supported by reliable well known people…. even if it took until Easter to collect the money – the children would still be starving.
Where are you Bob Geldorf? Can you help us with this? Does someone know his email address? My mind is boggling at the power of the people…… How about Skinny Kids for a campaign title – that rather sums it up!
Just a thought – maybe if that £5 we would be spending on a nonsense stocking gift for someone who has everything, was replaced with a warm note telling them Christmas is for children – starving children in particular – and they would be receiving his gift money with a tax gift aid. Sorry but this has been sent to starving “Skinny Kids” who have nothing.
I would hope we would get a really warm hug for this initiative. This friend really did not need an air freshener toy for his car or a key ring. If we did not get a big hug that receiver is a Christmas Meanie…. Take it from me. We will cross him off our Christmas list in future – so there.
Sorry to be a party pooper – but someone has to do it. I will make up for it and send you some happier stories in the near future.
Take care. Jeanne.
Contact: Richard Merritt
Duke University Medical Center
DURHAM, N.C. – Long denigrated as vestigial or useless, the appendix now appears to have a reason to be – as a “safe house” for the beneficial bacteria living in the human gut.
Drawing upon a series of observations and experiments, Duke University Medical Center investigators postulate that the beneficial bacteria in the appendix that aid digestion can ride out a bout of diarrhea that completely evacuates the intestines and emerge afterwards to repopulate the gut. Their theory appears online in the Journal of Theoretical Biology.
“While there is no smoking gun, the abundance of circumstantial evidence makes a strong case for the role of the appendix as a place where the good bacteria can live safe and undisturbed until they are needed,” said William Parker, Ph.D., assistant professor of experimental surgery, who conducted the analysis in collaboration with R. Randal Bollinger, M.D., Ph.D., Duke professor emeritus in general surgery.
The appendix is a slender two- to four-inch pouch located near the juncture of the large and small intestines. While its exact function in humans has been debated by physicians, it is known that there is immune system tissue in the appendix.
The gut is populated with different microbes that help the digestive system break down the foods we eat. In return, the gut provides nourishment and safety to the bacteria. Parker now believes that the immune system cells found in the appendix are there to protect, rather than harm, the good bacteria.
For the past ten years, Parker has been studying the interplay of these bacteria in the bowels, and in the process has documented the existence in the bowel of what is known as a biofilm. This thin and delicate layer is an amalgamation of microbes, mucous and immune system molecules living together atop of the lining the intestines.
“Our studies have indicated that the immune system protects and nourishes the colonies of microbes living in the biofilm,” Parkers explained. “By protecting these good microbes, the harmful microbes have no place to locate. We have also shown that biofilms are most pronounced in the appendix and their prevalence decreases moving away from it.”
This new function of the appendix might be envisioned if conditions in the absence of modern health care and sanitation are considered, Parker said.
“Diseases causing severe diarrhea are endemic in countries without modern health and sanitation practices, which often results in the entire contents of the bowels, including the biofilms, being flushed from the body,” Parker said. He added that the appendix’s location and position is such that it is expected to be relatively difficult for anything to enter it as the contents of the bowels are emptied.
“Once the bowel contents have left the body, the good bacteria hidden away in the appendix can emerge and repopulate the lining of the intestine before more harmful bacteria can take up residence,” Parker continued. “In industrialized societies with modern medical care and sanitation practices, the maintenance of a reserve of beneficial bacteria may not be necessary. This is consistent with the observation that removing the appendix in modern societies has no discernable negative effects.”
Several decades ago, scientists suggested that people in industrialized societies might have such a high rate of appendicitis because of the so-called “hygiene hypothesis,” Parker said. This hypothesis posits that people in “hygienic” societies have higher rates of allergy and perhaps autoimmune disease because they — and hence their immune systems — have not been as challenged during everyday life by the host of parasites or other disease-causing organisms commonly found in the environment. So when these immune systems are challenged, they can over-react.
“This over-reactive immune system may lead to the inflammation associated with appendicitis and could lead to the obstruction of the intestines that causes acute appendicitis,” Parker said. “Thus, our modern health care and sanitation practices may account not only for the lack of a need for an appendix in our society, but also for much of the problems caused by the appendix in our society.”
Parker conducted a deductive study because direct examination the appendix’s function would be difficult. Other than humans, the only mammals known to have appendices are rabbits, opossums and wombats, and their appendices are markedly different than the human appendix.
Parker’s overall research into the existence and function of biofilms is supported by the National Institutes of Health. Other Duke members of the team were Andrew Barbas, Errol Bush, and Shu Lin.
WASHINGTON, Sept. 26 2007 — Consuming large amounts of caffeine while taking acetaminophen, one of the most widely used painkillers in the United States, could potentially cause liver damage, according to a preliminary laboratory study reported in the Oct. 15 print issue of ACS’ Chemical Research in Toxicology, a monthly journal. The toxic interaction could occur not only from drinking caffeinated beverages while taking the painkiller but also from using large amounts of medications that intentionally combine caffeine and acetaminophen for the treatment of migraine headaches, menstrual discomfort and other conditions, the researchers say.
Health experts have warned for years that consuming excess alcohol while taking acetaminophen can trigger toxic interactions and cause liver damage and even death. However, this is the first time scientists have reported a potentially harmful interaction while taking the painkiller with caffeine, the researchers say.
While the studies are preliminary findings conducted in bacteria and laboratory animals, they suggest that consumers may want to limit caffeine intake — including energy drinks and strong coffee — while taking acetaminophen.
Chemist Sid Nelson, Ph.D., and colleagues, of the University of Washington in Seattle, tested the effects of acetaminophen and caffeine on E. coli bacteria genetically engineered to express a key human enzyme in the liver that detoxifies many prescription and nonprescription drugs. The researchers found that caffeine triples the amount of a toxic byproduct, N-acetyl-p-benzoquinone imine (NAPQI), that the enzyme produces while breaking down acetaminophen. This same toxin is responsible for liver damage and failure in toxic alcohol-acetaminophen interactions, they say.
In previous studies, the same researchers showed that high doses of caffeine can increase the severity of liver damage in rats with acetaminophen-induced liver damage, thus supporting the current finding.
“People should be informed about this potentially harmful interaction,” Nelson says. “The bottom line is that you don’t have to stop taking acetaminophen or stop taking caffeine products, but you do need to monitor your intake more carefully when taking them together, especially if you drink alcohol.”
Nelson points out that the bacteria used in the study were exposed to ‘megadoses’ of both acetaminophen and caffeine, much higher than most individuals would normally consume on a daily basis. Most people would similarly need to consume unusually high levels of these compounds together to have a dangerous effect, but the toxic threshold has not yet been determined, he says.
Certain groups may be more vulnerable to the potentially toxic interaction than others, Nelson says. This includes people who take certain anti-epileptic medications, including carbamazepine and phenobarbital, and those who take St. John’s Wort, a popular herbal supplement. These products have been shown to boost levels of the enzyme that produces the toxic liver metabolite NAPQI, an effect that will likely be heightened when taking both acetaminophen and caffeine together, he says.
Likewise, people who drink a lot of alcohol may be at increased risk for the toxic interaction, Nelson says. That’s because alcohol can trigger the production of yet another liver enzyme that produces the liver toxin NAPQI. The risks are also higher for those who take large amounts of medications that combine both acetaminophen and caffeine, which are often used together as a remedy for migraine headaches, arthritis and other conditions.
The researchers are currently studying the mechanism by which this toxic interaction occurs and are considering human studies in the future, they say. The National Institutes of Health funded the initial animal and bacterial studies.
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Contents of this release are strictly embargoed by the ACS, which has sole authority to alter the release time. Wire service stories must carry the embargo time, and wire stories on the press release topic may not be distributed more than 24 hours before that time. Solely to solicit expert comment, news media may show relevant parts of this document, and the paper to which it refers, to independent specialists. However, they must ensure in advance the embargo conditions will be honored. The research in this press release is from a copyrighted publication, and stories must credit the journal by name. Anyone using advance information for stocks or securities dealing may be guilty of insider trading under the federal Securities Exchange Act of 1934. For questions or assistance, please use the news media contact, above.
“Cooperative Binding of Acetaminophen and Caffeine within the P450 3A4 Active Site,” tx7000702
Print publication date: Oct. 15, 2007
ASAP (online) date: 9-26-07
Contact: Michael Bernstein
American Chemical Society
PHILADELPHIA — Researchers at the University of Pennsylvania School of Medicine and the Agency for Healthcare Research and Quality (AHRQ) have developed a framework to help hospital managers, physicians, and nurses handle the tough challenges of implementing health information technology (HIT) by directly addressing the unintended consequences that undermine safety and quality.
As documented in a 2005 JAMA article by Penn’s Ross Koppel, PhD, computerized physician order entries, CPOE for short, reduce medication errors due to transcription or hand-writing deficiencies but produce many unintended consequences. For example, in some CPOE systems, physicians must enter the patient’s weight before ordering some types of medications. Physicians will often insert an estimated weight just to order the desired medication, without being able to indicate it as an estimation. That number is then used by subsequent physicians for medications requiring more careful weight measurements. Koppel is the Principal Investigator of an AHRQ-supported study of hospital workplace culture and medication error at Penn’s Center for Clinical Epidemiology and Biostatistics and a faculty member in Penn’s Sociology Department.
In this new paper, co-authors Koppel, AHRQ’s Michael I. Harrison, PhD, and Shirly Bar-Lev, PhD, from the Ruppin Academic Center, Israel, show managers and clinicians how to avoid or catch unintended consequences before they cause lasting harm. This study appears in the September issue of the Journal of American Medical Informatics Association – JAMIA.
Use of sophisticated HIT in hospitals is increasing dramatically. In addition to CPOE, other examples in which unintended consequences can occur are decision support systems and electronic medical records. Health care facilities are investing millions of dollars in health care information technology as they seek to improve patient care, safety, efficiency, and cost savings. Yet the results are often disappointing, say the researchers.
“Managers and clinicians need to prevent more undesirable side effects and recognize unforeseeable consequences early on,” says lead author Harrison. “Then they can take steps to remedy them before damage mounts.”
The authors demonstrate how new HIT changes workplace processes and how practitioners alter these technologies during use. The authors call their new paradigm “Interactive Sociotechnical Analysis.”
“We are strong proponents of HIT,” say Harrison and Koppel. “But introducing HIT is not like adding a fax machine. HIT involves a whole set of activities and interactions with existing IT, people, the built environment, and with other systems. These interactions generate unpredictable developments. We map these developments to inspire greater awareness of IT implementation problems and increased action to improve new IT systems.”
“Decision makers are taking unnecessary risks if they wait for HIT projects to run for a year or two before doing a post-hoc evaluation,” observes Harrison. “Real time evaluations can reveal unintended consequences as they emerge, allowing remedial action to be taken.”
This release can be viewed at http://www.pennhealth.com/news
PENN Medicine is a $3.5 billion enterprise dedicated to the related missions of medical education, biomedical research, and excellence in patient care. PENN Medicine consists of the University of Pennsylvania School of Medicine (founded in 1765 as the nation’s first medical school) and the University of Pennsylvania Health System.
Penn’s School of Medicine is currently ranked #3 in the nation in U.S.News & World Report’s survey of top research-oriented medical schools; and, according to most recent data from the National Institutes of Health, received over $379 million in NIH research funds in the 2006 fiscal year. Supporting 1,400 fulltime faculty and 700 students, the School of Medicine is recognized worldwide for its superior education and training of the next generation of physician-scientists and leaders of academic medicine.
The University of Pennsylvania Health System includes three hospitals — its flagship hospital, the Hospital of the University of Pennsylvania, rated one of the nation’s “Honor Roll” hospitals by U.S.News & World Report; Pennsylvania Hospital, the nation’s first hospital; and Penn Presbyterian Medical Center — a faculty practice plan; a primary-care provider network; two multispecialty satellite facilities; and home care and hospice.
Contact: Karen Kreeger
University of Pennsylvania School of Medicine
Sept. 13, 2007 ANN ARBOR, Mich.—Using atom-level imaging techniques, University of Michigan researchers have revealed important structural details of an enzyme system known as “Mother Nature’s blowtorch” for its role in helping the body efficiently break down many drugs and toxins.
The research has been detailed in a series of papers, the most recent published online this month in the journal BBA Biomembranes.
The system involves two proteins that work cooperatively. The first, cytochrome P450, does the actual work, but only when it gets a boost from the second protein, cytochrome b5. To complicate matters, the two proteins can interact only when both are bound to a cell membrane. That makes it difficult to use traditional techniques to discern the structural details that are crucial to the interaction, said Ayyalusamy Ramamoorthy, who leads the research group.
For instance, X-ray crystallography, often used to determine protein structures, requires separating the molecules from their membrane environment. Because part of cytochrome b5 sticks to the membrane, such separations involve breaking the molecule at the sticking point, which happens to be the part that controls its interaction with cytochrome P450. So while crystallography can offer some information on structure, it can’t provide insights into exactly what goes on between P450 and b5 during their cozy, membrane-bound encounters, Ramamoorthy said.
However, the technique his lab uses—solid state NMR spectroscopy—can produce detailed images of proteins in the membrane environment, not only revealing molecular structure but also showing how a particular protein nestles into the membrane. Cytochrome b5 presented a challenge even to that versatile method, though, because the molecule has three parts that all behave differently: the rigid, sticky portion that buries into the cell membrane, a highly mobile, water-soluble portion, and a less mobile “linker” that connects the other two parts.
But by tweaking their technique, the researchers were able to get high-resolution images of all three portions.
“The challenge was something like having a room full of people and trying to get good photos of every one of them,” said Ramamoorthy, an associate professor of chemistry and Biophysics. “With one picture, you probably can’t do it. But if you say, ‘Everyone over age 50 stand up,’ and you take one picture, and then you ask for another age group and take another picture, and so on, you have a better chance.”
By spinning their samples (or aligning the molecules in the magnetic field), the researchers were able to differentiate parts of the molecule based not on age group, as in the photo analogy, but by mobility. “With the techniques we designed, we were able to observe the rigid portion separately from the highly mobile and less mobile portions,” Ramamoorthy said.
In the first part of the work, published in the Journal of the American Chemical Society in May, the researchers described the membrane-spanning segment of cytochrome b5, revealing for the first time its helical shape and the way it tilts in relation to the membrane. In the new work published in BBA Biomembranes, they determined that once both molecules are bound in the membrane, cytochrome b5 modulates the motion and the structure of cytochrome P450. More work is in progress to determine the detailed high-resolution structures of these two proteins.
Ramamoorthy’s team also is studying other membrane-associated proteins, a group that includes many biologically important molecules.
“These proteins are involved in all major diseases, everywhere in the body, and are therefore primary targets for pharmaceutical applications,” Ramamoorthy said. “In my opinion, solving the structures of membrane proteins should be the highest priority for structural biologists in the coming years.”
Ramamoorthy collaborated on the most recent work with Lucy Waskell, a professor of anesthesiology and a physician at the Department of Veterans Affairs Medical Center.
A leader in this area of research, Ramamoorthy has organized several major international symposia on the field at the University of Michigan, edited a special issue in the journal BBA-Biomembranes, published a number of papers in leading journals, and brought out a book on NMR Spectroscopy of Biological Solids. Ramamoorthy said that this area of research will grow considerably at U-M from implementing plans to set up a high magnetic field solid-state NMR spectrometer facility and an NIH-funded program.
More information on Ramamoorthy
Contact: Nancy Ross-Flanigan
Phone: (734) 647-1853
Related Categories: Science.
See also: News, Health, University of Michigan, Global News
Finding promise new treatments for tendon injury and disease
Los Angeles, Sept. 7, 2007—Athletes know that damage to a tendon can signal an end to their professional careers. But a consortium of scientists, led in part by University of Southern California (USC) School of Dentistry researcher Songtao Shi, has identified unique cells within the adult tendon that have stem-cell characteristics—including the ability to proliferate and self-renew. The research team was able to isolate these cells and regenerate tendon-like tissue in the animal model. Their findings hold tremendous promise for the treatment of tendon injuries caused by overuse and trauma.
The results of their research will be published in the October 2007 issue of the journal Nature Medicine and will be available online at http://www.nature.com/nm on Sunday, September 9, 2007.
Tendons, the tough band of specialized tissues that connect bone to muscle, are comprised of strong collagen fibrils that transmit force allowing the body to move. Tendon injuries are a common clinical problem as damaged tendon tissue heals slowly and rarely regains the integrity or strength of a normal, undamaged tendon.
“Clinically, tendon injury is a difficult one to treat, not only for athletes but for patients who suffer from tendinopathy such as tendon rupture or ectopic ossification,” Shi says. “This research demonstrates that we can use stem cells to repair tendons. We now know how to collect them from tissue and how to control their formation into tendon cells.”
Prior to this research, little existed on the cellular makeup of tendons and their precursors. By looking at tendons at the molecular level, the research team identified a unique cell population—termed tendon stem/progenitor cells (TSPCs) in both mice and adult humans—that when guided by a certain molecular environment, form into tendon cells. The team included leading scientists from the National Institute of Dental and Craniofacial Research at the National Institutes of Health, Johns Hopkins University and the University of Maryland School of Medicine.
Songtao Shi, a researcher for USC’s Center for Craniofacial Molecular Biology, a Division within the USC School of Dentistry, has published numerous studies on the role of stem cells in regeneration. He was part of an international research team that successfully generated tooth root and supporting periodontal ligaments to restore tooth function in the animal model. Earlier this year, his research was published in the journal Stem Cells after he and his team discovered that mesenchymal stem cells are capable of regenerating facial bone and skin tissue in the mouse and swine models.
Funding for the study came from the USC School of Dentistry and the National Institutes of Health.
Yanming Bi, Driss Ehirchiou, Tina M Kilts, Colette A Inkson, Mildred C Embree, Wataru Sonoyama, Li Li, Arabella I Leet, Byoung-Moo Seo, Li Zhang, Songtao Shi & Marian F Young. “Identification of tendon stem/progenitor cells and the role of the extracellular matrix in their niche.” Nature Medicine, http://www.nature.com/nm
USC’s Center for Craniofacial Molecular Biology
USC’s Center for Craniofacial Molecular Biology is a research laboratory located on the Health Sciences Campus of the University of Southern California in Los Angeles. Administratively, CCMB is part of the USC School of Dentistry. The laboratory is funded through multiple research grants, including several from the National Institutes of Health, under which research is conducted into development, biochemical and molecular biological aspects of human development, with a special emphasis on craniofacial structures in both health and disease. Current investigations include the molecular etiology of cleft palate, the molecular genetics of tooth development and lung development in the premature infant.
Contact: Angelica Urquijo
University of Southern California
Rice method is first to yield cartilage-like cells, engineer human cartilage
HOUSTON, Sept. 6, 2007 – Rice University biomedical engineers have developed a new technique for growing cartilage from human embryonic stem cells, a method that could be used to grow replacement cartilage for the surgical repair of knee, jaw, hip, and other joints.
“Because native cartilage is unable to heal itself, researchers have long looked for ways to grow replacement cartilage in the lab that could be used to surgically repair injuries,” said lead researcher Kyriacos A. Athanasiou, the Karl F. Hasselmann Professor of Bioengineering. “This research offers a novel approach for producing cartilage-like cells from embryonic stem cells, and it also presents the first method to use such cells to engineer cartilage tissue with significant functional properties.”
The results are available online and slated to appear in the September issue of the journal Stem Cells. The study involved cells from an NIH-sanctioned stem cell line.
Using a series of stimuli, the researchers developed a method of converting the stem cells into cartilage cells. Building upon this work, the researchers then developed a process for using the cartilage cells to make cartilage tissue. The results show that cartilages can be generated that mimic the different types of cartilage found in the human body, such as hyaline articular cartilage — the type of cartilage found in all joints — and fibrocartilage — a type found in the knee meniscus and the jaw joint. Athanasiou said the results are exciting, as they suggest that similar methods may be used to convert the stem cell-derived cartilage cells into robust cartilage sections that can be of clinical usefulness.
Tissue engineers, like those in Athanasiou’s research group, are attempting to unlock the secrets of the human body’s regenerative system to find new ways of growing replacement tissues like muscle, skin, bone and cartilage. Athanasiou’s Musculoskeletal Bioengineering Laboratory at Rice University specializes in growing cartilage tissues.
The idea behind using stem cells for tissue engineering is that these primordial cells have the ability to become more than one type of cell. In all people, there are many types of “adult” stem cells at work. Adult stem cells can replace the blood, bone, skin and other tissues in the body. Stem cells become specific cells based upon a complex series of chemical and biomechanical cues, signals that scientists are just now starting to understand.
Unlike adult stem cells, which can become only a limited number of cell types, embryonic stem cells can theoretically become any type of cell in the human body.
Athanasiou’s group has been one of the most successful in the world at studying cartilage cells and, especially, engineering cartilage tissues. He said that for his research the primary advantage that embryonic stem cells have over adult stem cells is their ability to remain malleable.
“Identifying a readily available cell source has been a major obstacle in cartilage engineering,” Athanasiou said. “We know how to convert adult stem cells into cartilage-like cells. The more problematic issue comes in trying to maintain a ready stock of adult stem cells to work with. These cells have a strong tendency to convert from stem cells into a more specific type of cell, so the clock is always ticking when we work with them.”
By contrast, Athanasiou said his research group has found it easier to grow and maintain a stock of embryonic stem cells. Nonetheless, he is quick to point out that there is no clear choice about which type of stem cell works best for cartilage engineering.
“We don’t know the answer to that,” Athanasiou said. “It’s extremely important that we study all potential cell candidates, and then compare and contrast those studies to find out which works best and under what conditions. Keep in mind that these processes are very complicated, so it may well be that different types of cells work best in different situations.”
Athanasiou began studying embryonic stem cells in 2005. Since funding for the program was limited, he asked two new graduate students in his group if they were interested in pursuing the work as a secondary project to their primary research. Those students, Eugene Koay and Gwen Hoben, are co-authors of the newly published study. Both are enrolled in the Baylor College of Medicine Medical Scientist Training Program, a joint program that allows students to concurrently earn their medical degree from Baylor while undertaking Ph.D. studies at Rice.
“Eugene and Gwen are both outstanding students,” Athanasiou said. “Each earned their undergraduate degree from Rice and each worked in my laboratory as undergraduate students. They have chosen to do this research because they think this may represent the future of regenerative medicine.”
The research was funded by Rice University.
Contact: Jade Boyd
Study tries new way to rehab fried-food-loving couch dwellers
CHICAGO — For lunch, Joy Hesemann loved to dive into a platter of deep-fried, crunchy chicken tenders with a side of ranch dressing. At night, she’d fry up ground beef for Hamburger Helper or another boxed meal for her family’s dinner. Later, she’d plop in front of the TV or computer screen and rip into a bag of Oreos or potato chips.
“I knew I was constantly overeating and eating the wrong things, and I wasn’t exercising,” admitted Hesemann, 27, an administrative assistant from Streamwood, Ill. “I wanted to change, but I needed some motivation.”
That came in the form of a new research study at Northwestern University investigating innovative ways to rehabilitate people with lousy health habits. The prerequisites: a chummy relationship with saturated fat but no acquaintance with fruits and vegetables; leisure time spent gazing at a TV or computer screen, along with an “allergy” to exercise.
In other words, a typical American lifestyle.
“That was me,” Hesemann said. She signed up.
The study was designed by Bonnie Spring, a professor of preventive medicine at Northwestern’s Feinberg School of Medicine, to make change as easy as possible.
Spring knows it’s overwhelming for someone with a raft of unhealthy habits to overhaul an entire lifestyle. So she wants them to just change two unhealthy behaviors to see if the others will tag along. Sort of a buy two, get two free sale. Her method is based on the Behavioral Economics Theory used by Nobel Prize winner Daniel Kahneman.
She’s also helping these fat-food-loving couch dwellers flip their lifestyles with an arsenal of high-tech tools including a specially programmed Palm Pilot to monitor eating and exercise; virtual visits with a personal coach and an accelerometer which straps around the waist to record the intensity of their movements. (You call that a brisk walk”)
Participants are assigned to eat more veggies and fruits or cut down on saturated fat; and cut back on “screen” time or increase exercise.
“We’re trying to figure out which two behavior changes give you the maximum healthy bang for your buck on all unhealthy behaviors that we’re trying to modify,” Spring said.
“The new behaviors come along for the ride in one of two ways — a complementary behavior or a substitute behavior,” Spring explained. “If watching TV means you also snack when you watch, then eating and snacking are complementary behaviors for you. If I can get you to cut down on your TV, you’ll probably automatically cut down on your snacking. I make your life simpler by just asking you to change one. The complementary behavior is a bonus that comes along for the ride.”
“A substitute behavior replaces or crowds out another behavior,” Spring said. An example would be eating more fruits and vegetables, so you would nibble strawberries instead of being elbow-deep in a bag of Cheetos.
Hesemann’s assignment for the four-month study was to slash most saturated fat from her diet and break a sweat for an hour a day. She also got a crash course on healthier eating and strategies to inject more physical activity into her day such as taking the stairs instead of the elevator.
She recorded every bite of food and minute of exercise in the ever-present Palm Pilot, which had software to monitor her daily progress. With each entry, an image of a thermometer with a rising “temperature” showed her intake of saturated fat so far that day (she was allowed 20 grams) and her minutes of exercise.
“It was dreadful to have to write it down,” Hesemann said about logging in her food. She learned her favorite fried chicken tenders lunch soared past her fat quota as did her beloved Italian sausages. “I said ‘Oh, my god. I’m never eating those again!’ I hated seeing that thermometer rise.”
At the end of each day she’d download the data into her computer and send it to her personal coach. The coach would zip Hesemann encouraging e-mails (“You’re doing a great job!”) or friendly reminders to get off the couch (“You need 30 minutes more of activity each day.”)
As with all participants, Hesemann’s recordings in the Palm Pilot and contact with the personal coach gradually tapered off over the four-month period of the study. This latter period is when it gets interesting for Spring. She’s waiting to see who falls off the wagon.
“It’s really hard to maintain a new healthier lifestyle,” Spring said. “At first it’s novel and exciting and then the novelty wears off. You tend to revert back to the old habits. There’s kind of an inertia that pulls you back.”
Spring is anxious to see which two behavior changes best helped people maintain their healthier habits. But she won’t know the results until the study ends in 2008.
In the meantime, Joy Hesemann now races up and down the stairs at work instead of punching elevator buttons and hits the gym three days a week. She bakes skinless chicken for dinner and nibbles strawberries for dessert. She’s lost 40 pounds and dropped three dress sizes. She’s even eliminated high fat foods from her 6-year-old daughter’s meals. Six month after the study, Hesemann’s new healthy ways show no sign of abating.
“This program made me more conscious of the foods I’m eating. And the exercise is a blast. I still have my fallbacks, but if I go to McDonald’s I’ll get the grilled chicken sandwich instead of the comforting, nasty foods. For me this is a new way of life. ”
Contact: Marla Paul
Smoking shortens nap time of breastfed babies
PHILADELPHIA (September 4, 2007) – – A study from the Monell Chemical Senses Center reports that nicotine in the breast milk of lactating mothers who smoke cigarettes disrupts their infants’ sleep patterns.
“Infants spent less time sleeping overall and woke up from naps sooner when their mothers smoked prior to breastfeeding,” says lead author Julie A. Mennella, PhD, a psychobiologist at Monell.
The findings, published in the journal Pediatrics, raise new questions regarding whether nicotine exposure through breast milk affects infant development.
While many women quit or cut down on smoking while pregnant, they often relapse following the birth of the baby. Mennella comments, “Because nicotine is not contraindicated during lactation, mothers may believe that smoking while breastfeeding will not harm their child as long as the child is not exposed to passive smoke. However, there has been very little research on either short- or long-term effects of nicotine delivered through breast milk.”
Nicotine is a pharmacological stimulant that affects the developing brain and has been shown to cause long-term behavioral and learning deficits.
In the Monell study, researchers measured the feeding behavior and sleep patterns of 15 breastfed infants over a 3-1/2 hour observation period on two separate days. The infants were between two and seven months of age. All mothers were current smokers who abstained from smoking for at least 12 hours before each observation period.
Each mother smoked one to three cigarettes immediately prior to the observation period on one day and refrained from smoking on the other. On both occasions, mothers breastfed their infants on demand over the ensuing 3-1/2 hours. Following each feed, mothers laid infants down on their backs in a crib or on the floor.
An actigraph strapped to the infant’s ankle enabled researchers to measure activity and sleep time. Levels of nicotine and cotinine, a major metabolite of nicotine, were measured in breast milk samples provided by the mothers before each feed, allowing researchers to determine the dose of nicotine passed to each infant.
Total sleep time over the 3-1/2 hours declined from an average of 84 minutes when mothers refrained from smoking to 53 minutes on the day they did smoke, a 37% reduction in infant sleep time. This was due to a shortening of the longest sleep bout, or nap, and to reductions in the amount of time spent in both active and quiet sleep.
The level of sleep disruption was directly related to the dose of nicotine infants received from their mothers’ milk, consistent with a role for nicotine in causing the sleep disruptions.
Infants consumed the same amount of breast milk on both days, suggesting that they were accepting of tobacco flavor in breast milk. Previous research from Mennella’s laboratory has shown that infants demonstrate increased enjoyment of flavors experienced through transmission in breast milk.
Noting that children whose mothers smoke are more likely to smoke as teenagers, Mennella speculates that early experiences with tobacco flavor during breastfeeding may increase its appeal later in life.
She comments that additional studies are needed to examine the long-term developmental effects of nicotine delivered through breast milk.
An earlier study from Mennella’s lab demonstrated that breast milk nicotine levels peak 30 – 60 minutes after smoking one or two cigarettes and clear by three hours after the smoking episode. Emphasizing the many benefits of breastfeeding on infant health and development, Mennella notes that lactating mothers who smoke occasionally can time their smoking episodes to minimize nicotine exposure to their child.
The present findings highlight the need for targeted smoking cessation programs that address issues relevant to lactating women. Mennella suggests that concerns about tobacco flavor in their milk and disruptions of their infants’ sleep may help motivate breastfeeding mothers to abstain from smoking.
Lauren M. Yourshaw and Lindsay K. Morgan also contributed to the study.
The Monell Chemical Senses Center is a nonprofit basic research institute based in Philadelphia, Pennsylvania. For 39 years, Monell has been the nation’s leading research center focused on understanding the senses of smell, taste and chemical irritation: how they function and affect lives from before birth through old age. Using a multidisciplinary approach, scientists collaborate in the areas of: sensation and perception, neuroscience and molecular biology, environmental and occupational health, nutrition and appetite, health and well being, and chemical ecology and communication. For more information about Monell, visit http://www.monell.org.
FUNDING: National Institute on Alcohol Abuse and Alcoholism (NIH) and the Pennsylvania Department of Health. The Pennsylvania Department of Health specifically disclaims responsibility for any analyses, interpretations, or conclusions.
Contact: Leslie Stein
Monell Chemical Senses Center
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