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From the FDA

IBM and Mayo Clinic Build Database

IBM and the Mayo Clinic recently launched a new technology partnership that they believe will enable more individualized patient treatment. Together, they plan to build a database of patient records that doctors can access and leverage in patient diagnoses and treatment plans. After initially putting the medical records of about 4.4 million patients treated at Mayo's three clinics into a database, IBM and Mayo have spent the past two years developing and testing a methodology for mining the data.

Now they want to analyze information about patients in new ways and compare individual medical records to data about other patients who have similar disease characteristics and genomic makeup's. IBM and Mayo hope to use the results to fine-tune treatments.

For example, a doctor treating a patient for cancer could use the data mining system to discover the results of treatments given to the last 500 patients who had cancers that were located in the same spot and had identical genetic characteristics. The individualized care made possible by such information could one day replace current blanket-treatment approaches based on standard medical protocols. Instead of treating cancer patients with a common stew of chemotherapy, drugs could be tailored to fit specific cases.

itworld.com

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Anticoagulation News

Heart attacks without chest pain more fatal

Patients who report to the hospital with symptoms of heart attack, but without chest pain, or often under-treated. This lack of attention and treatment increases risks that the heart attack will be fatal. Other common symptoms of heart attack include fainting, shortness of breath, excessive sweating, nausea, and vomiting. Cardiac patients presenting to the hospital without chest pain have triple the death rate of other cardiac patients and are less likely to receive medications to slow the progression of a heart attack, according to results from a new study published in the August issue of CHEST, the peer-reviewed journal of the American College of Chest Physicians.

Researchers looked at data collected in 14 countries on 20,881 patients hospitalized for acute coronary syndromes. Of those, 1,763, or 8 percent, did not report chest pain. Older patients, women and diabetics were more likely to fall into this group. The researchers found that the conditions of about a quarter of such patients were initially misdiagnosed, compared with only 2 percent of patients with chest pain.

The study also found a significant difference in death rates during hospitalization: 13 percent for patients without chest pain versus 4 percent for those with chest pain. The authors said that at least some of the difference in survival rates could be explained by differences in health before the heart attacks, and that some might be caused by the delay in diagnosis. But the study also noted that omissions in therapy were not adequately corrected during hospital admission and presumably contributed to the poorer outcome.

Doctors Guide Online

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Innovation

Robot Doctor Monitors Patients

The U.C. Davis Medical Center is currently experimenting with a robot doctor who enables physicians to monitor patients when they are away from the hospital. A robot equipped with a screen, microphone and speakers allows the physician to converse with patients as if they were in the same room. The robot, nicknamed "Rudy," is mobile and can be remotely steered down hospital hallways and in and out of patient rooms. The device allows a doctor many miles away to do "rounds" at the hospital.

Some doctors see "telerounding" as a 21st Century means of visiting patients who are far away. The robot devices could greatly benefit rural communities where doctors travel great distances between offices and hospitals. Rudy and three similar robots are the centerpiece of a study being conducted at four separate hospitals. The aim of the project is to show that robotic medicine can be as safe as making traditional rounds.

After a period of adjustment, early study results show that most patients respond well to the robot. The study should be complete by October or November.

sacbee.com

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New Treatment

Pancreas Stem Cells Show Promise for Diabetes

The pancreas houses two distinctly different tissues. The bulk of its mass is exocrine tissue and associated ducts, which produce an alkaline fluid loaded with digestive enzymes which is delivered to the small intestine to help with digestion. Scattered throughout the exocrine tissue are several hundred thousand clusters of endocrine cells which produce the hormones insulin and glucagon, plus a few other hormones.

Insulin and glucagon are critical participants in glucose homeostasis and serve as acute regulators of blood glucose concentration. From a medical perspective, insulin in particular is enormously important - a deficiency in insulin or deficits in insulin responsiveness lead to the disease diabetes mellitus.

Researchers from the University of Toronto recently found that stem cells taken from the pancreas of adult mice are able to develop into cells that produce insulin. If these same cells exist in humans, it could be possible to cure diabetes among people dependent on insulin injections. So far, no experiment has proved that the pancreas contains stem cells, making the Toronto study an exciting lead in finding an abundant insulin-cell source for transplant into diabetes patients.

Researchers now want to prove that the cells they found in mice are true stem cells- immature cells that can renew themselves and have the potential to become many different types of cells. The immature pancreatic cells were able to develop into cells of the nervous system as well as beta cells. The real test will be whether these cells can actually restore glucose levels in people with diabetes.

As well, the researchers suggest that they may not yet have found the perfect lab-dish conditions to determine if their precursor cells do have the power to produce an infinite supply of cells. The next step is for the Toronto researchers to investigate how well their insulin-producing cells perform in the bodies of diabetic mice.

canada.com

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Life Style

Study Shows Food, Not Pills, Best Source of Antioxidants

Because of inadequate evidence, the American Heart Association (AHA) recently decided against recommending antioxidant supplements to prevent heart disease. Instead of taking vitamin pills, the AHA urges Americans to seek antioxidants from foods, such as fruits, vegetables, whole grains, and nuts. Americans should consume five or more servings of fruits and vegetables each day and at least six servings of grain products, including whole grain foods.

Antioxidants, including vitamins C and E and beta-carotene, target a process called oxidation in which cell-damaging substances called free radicals accumulate. Oxidation is suspected of increasing the risk of several diseases, including heart disease. There is some evidence that oxidation plays a role in the development of deposits called plaques that build up in diseased arteries. Some studies have observed lower rates of heart disease in people who take antioxidant supplements, such as vitamin E.

In 1999, the AHA began advising the public to consume foods that are rich in antioxidants, but concluded that there was not enough evidence to recommend the use of antioxidant supplements. For the past 5 years, researchers have studied the link between antioxidant supplements and cardiovascular disease. The AHA maintains that these studies have not provided sufficient evidence to change their recommendations regarding the use of supplements.

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Cholesterol Talk

HDL Levels Correlated with Breast Cancer Risk

In a recent study of nearly 39,000 Norwegian women, researchers identified an association between HDL, or "good" cholesterol, levels and risks for breast cancer. Specifically, overweight women with low HDL levels experienced an increased risk for acquiring breast cancer after menopause. Study participants were followed over a 20-year period, and those with higher HDL levels were one-third less likely to develop breast cancer. The women provided data on lipids, weight, diet, and lifestyle; 708 participants developed invasive breast cancer.

High-density lipoproteins (HDL) carry cholesterol from the blood back to the liver, which processes the cholesterol for elimination from the body. HDL makes it less likely that excess cholesterol in the blood will be deposited in the coronary arteries, which is why HDL cholesterol is often referred to as the "good" cholesterol.

Having an HDL-C level in the lowest quartile was an especially strong marker of breast cancer among postmenopausal women with a Body Mass Index (BMI) of 25 or more with a relative risk of 0.43 for highest versus lowest quartile participants. Writing in the Journal of the National Cancer Institute, researchers suggest that the 25-30% overall reduction in the risk of postmenopausal breast cancer noted in women with HDL levels above 1.64 mmol/l may be because HDL-C is a marker of androgen status, and women with an androgen deficit are believed to have a lower risk of developing breast cancer.

The study was conducted by scientists at the University of Tromso in Norway. Researchers emphasize that follow-up studies are necessary to verify the association between HDL levels and breast cancer risks.

jncicancerspectrum.oupjournals.org

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Fitness Watch

Red Wine Protects Heart

Researchers from Jefferson Medical College recently published results from a new study that demonstrated the benefits of moderate red wine consumption. The study found that red wine is more effective than gin at lowering biochemical inflammatory markers in the blood. These markers are the hallmarks of heart disease and stroke.

Subjects in two groups were given two drinks a day of either wine or gin for 28 days. Those who received red wine the first time were then given gin. Those who had gin first then received red wine. The researchers measured levels of inflammatory biomarkers before and after each half of the trial.

The red wine dramatically lowered, more than the gin, the levels of molecules involved in inflammation. The researchers noted that although evidence points to some heart-protective benefits of alcoholic beverages in general, this evidence is not direct and doesn't necessarily prove that alcohol directly combats the development of atherosclerosis.

Heart Center Online

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Product of the Month

Samaritan AED - Automated External Defibrillator

You can act quickly to help save a life when a sudden cardiac arrest occurs.

The Samaritan® AED portable defibrillator gives the first responder (EMS, Fire, Police and you) the tools to do just that.

Prescription and Training Required

• Easy-to-use: clear, concise, comprehensive, high-fidelity voice prompts guide the user.
• Lightweight - Only 4.2 lbs
• Long-lasting Battery: 12 hrs monitoring or 120 shocks (at full energy).
• Built-in memory - assures data is captured every time.
• LARGE display: allows the rescuer to see patient ECG, heart rate, number of shocks delivered, text prompts (coinciding with voice prompts) elapsed timer and battery fuel gage.

One of the most important features of the Samaritan® AED is the automatic "self-compensating" feature that allows the Samaritan® AED to deliver a low-energy, escalating (100J - 150J - 200J) electric shock to the patient. Call today and find out more.

800.298.4515

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Copyright ©2003 QAS, Inc. All rights reserved. The information provided in this Newsletter and on the Hometestmed site is intended for your general knowledge only and is not a substitute for professional medical advice or treatment for specific medical conditions.