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Crafty_Dog
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« on: October 13, 2006, 04:01:22 PM »

http://www.technologyreview.com/printer_friendly_article.aspx?id=17597


Nanosolution Halts Bleeding
A biodegradable liquid developed at MIT and the University of Hong Kong offers a new way to quickly treat wounds and promote healing.
By Jenn Director Knudsen
A team of researchers at MIT and the University of Hong Kong have developed a biodegradable liquid that can quickly stop bleeding.


Composed of peptides, the liquid self-assembles into a protective nanofiber gel when applied to a wound. Rutledge Ellis-Behnke, research scientist in the department of brain and cognitive sciences at MIT and Kwok-Fai So, chair of the department of anatomy at the University of Hong Kong, discovered the liquid's ability to stop bleeding while experimenting with it as a matrix for regrowing brain cells in hamsters.


The researchers then conducted a series of experiments on various mammals, including rodents and pigs, applying the clear liquid agent to the brain, skin, liver, spinal cord, and femoral artery to test its ability to halt bleeding and seal wounds.


"It worked every single time," said Ellis-Behnke. They found that it stopped the bleeding in less than 15 seconds, and even worked on animals given blood-thinning medications.


The wound must still be stitched up after the procedure; but unlike other agents designed to stop bleeding, it does not have to be removed from the wound site.


The liquid's only byproduct is amino acids: tissue building blocks that can be used to actually repair the site of the injury, according to the researchers. It is also nontoxic, causes no immune response in the patient, and can be used in a wet environment, according to Ellis-Behnke. A paper outlining the findings is available online and will be published in the December issue of Nanomedicine.


Ellis-Behnke believes that first responders, say, on a battlefield or at a traffic accident, will save more lives with the nanosolution. Yet the most significant application may be in surgery, he says, especially on the liver and brain.


In fact, as much as half of the time during any operation is spent "doing some sort of bleeding control," says Ellis-Behnke. Consequently, such a liquid could "fundamentally change the pace of the operation."


Ram Chuttani, director of endoscopy and chief of interventional gastroenterology at Beth Israel Deaconess Medical Center in Boston and assistant professor of medicine at Harvard Medical School, is familiar with their research. "Where I see huge applications is in patients who present with gastrointestinal bleeding," he says. "[Right now,] there's no ideal agent to endoscopically manage gastrointestinal bleeding."


"Technologically, this would be one of the easiest things for us to use," Chuttani adds. "It's an exciting agent, a very exciting agent...that's still quite far away. I'd definitely be an early adopter."




The researchers don't yet understand how the nanosolution works to stop bleeding, beyond that it doesn't clot the blood. "Maybe it's creating a nanoscale patch and knitting the materials back together," says Ellis-Behnke, adding that "this is just speculation." Clinical trials on humans are at least three years away, he says.


The research was funded by the Deshpande Center for Technological Innovation at MIT as well as the Technology Transfer Seed Fund of the University of Hong Kong and the Research Grant Council of Hong Kong.


The U.S. military already uses several agents to stop bleeding, including ones made by Z-Medica and HemCon. Z-Medica of Wallingford, CT, uses zeolite-based agents in its pourable products, called QuikClot, and bioactive glass. HemCon of Tigard, OR, uses an organic substance called chitosan in its bandages.


Both QuikClot and bioactive glass, a silica- and calcium-based material, are porous, and thus work like a sponge to mop up blood and adhere to tissue at and around the wound site.


The chitosan in HemCon's bandages binds to tissue and seals wounds. (Chitosan is found in shrimp shells, but extensive tests have shown that people with shellfish allergies don't suffer allergic reactions to chitosan, according to HemCon's president and CEO, John Morgan.) HemCon plans to sell a consumer version of its product next year.


"Both [Z-Medica and Hem-Con's products] have saved lives in my hands," says Captain Peter Rhee, a military trauma surgeon based at the Los Angeles County Medical Center, who oversaw the first study using pourable agents to halt bleeding on animals.


The liquid solution made by the MIT and University of Hong Kong researchers could offer several advantages, however. One is speed. In studies, the nanoliquid took only seconds to work, while competing products take around two minutes. The nanoliquid can also be used on a wound of any shape, unlike HemCon's square bandages, which don't fit over oddly shaped gashes. And the nanoscale solution doesn't have to be removed from the patient, unlike Z-Medica's bioactive glass, which cannot remain at the wound site indefinitely.

Copyright Technology Review 2006.
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Crafty_Dog
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« Reply #1 on: October 13, 2006, 04:16:58 PM »

  Posted October 13, 2006 06:32 AM 
http://www.wired.com/news/technology/medtech/1,71925-0.html

Honey Remedy Could Save Limbs



By Brandon Keim
01:00 AM Oct, 11, 2006

When Jennifer Eddy first saw an ulcer on the left foot of her patient, an elderly diabetic man, it was pink and quarter-sized. Fourteen months later, drug-resistant bacteria had made it an unrecognizable black mess.

Doctors tried everything they knew -- and failed. After five hospitalizations, four surgeries and regimens of antibiotics, the man had lost two toes. Doctors wanted to remove his entire foot.

"He preferred death to amputation, and everybody agreed he was going to die if he didn't get an amputation," said Eddy, a professor at the University of Wisconsin School of Medicine and Public Health.

With standard techniques exhausted, Eddy turned to a treatment used by ancient Sumerian physicians, touted in the Talmud and praised by Hippocrates: honey. Eddy dressed the wounds in honey-soaked gauze. In just two weeks, her patient's ulcers started to heal. Pink flesh replaced black. A year later, he could walk again.

"I've used honey in a dozen cases since then," said Eddy. "I've yet to have one that didn't improve."

Eddy is one of many doctors to recently rediscover honey as medicine. Abandoned with the advent of antibiotics in the 1940s and subsequently disregarded as folk quackery, a growing set of clinical literature and dozens of glowing anecdotes now recommend it.

Most tantalizingly, honey seems capable of combating the growing scourge of drug-resistant wound infections, especially methicillin-resistant Staphylococcus aureus, or MRSA, the infamous flesh-eating strain. These have become alarmingly more common in recent years, with MRSA alone responsible for half of all skin infections treated in U.S. emergency rooms. So-called superbugs cause thousands of deaths and disfigurements every year, and public health officials are alarmed.

Though the practice is uncommon in the United States, honey is successfully used elsewhere on wounds and burns that are unresponsive to other treatments. Some of the most promising results come from Germany's Bonn University Children's Hospital, where doctors have used honey to treat wounds in 50 children whose normal healing processes were weakened by chemotherapy.

The children, said pediatric oncologist Arne Simon, fared consistently better than those with the usual applications of iodine, antibiotics and silver-coated dressings. The only adverse effects were pain in 2 percent of the children and one incidence of eczema. These risks, he said, compare favorably to iodine's possible thyroid effects and the unknowns of silver -- and honey is also cheaper.

"We're dealing with chronic wounds, and every intervention which heals a chronic wound is cost effective, because most of those patients have medical histories of months or years," he said.

While Eddy bought honey at a supermarket, Simon used Medihoney, one of several varieties made from species of Leptospermum flowers found in New Zealand and Australia.

Honey, formed when bees swallow, digest and regurgitate nectar, contains approximately 600 compounds, depending on the type of flower and bee. Leptospermum honeys are renowned for their efficacy and dominate the commercial market, though scientists aren't totally sure why they work.

"All honey is antibacterial, because the bees add an enzyme that makes hydrogen peroxide," said Peter Molan, director of the Honey Research Unit at the University of Waikato in New Zealand. "But we still haven't managed to identify the active components. All we know is (the honey) works on an extremely broad spectrum."

Attempts in the lab to induce a bacterial resistance to honey have failed, Molan and Simon said. Honey's complex attack, they said, might make adaptation impossible.

Two dozen German hospitals are experimenting with medical honeys, which are also used in the United Kingdom, Australia and New Zealand. In the United States, however, honey as an antibiotic is nearly unknown. American doctors remain skeptical because studies on honey come from abroad and some are imperfectly designed, Molan said.

In a review published this year, Molan collected positive results from more than 20 studies involving 2,000 people. Supported by extensive animal research, he said, the evidence should sway the medical community -- especially when faced by drug-resistant bacteria.

"In some, antibiotics won't work at all," he said. "People are dying from these infections."

Commercial medical honeys are available online in the United States, and one company has applied for Food and Drug Administration approval. In the meantime, more complete clinical research is imminent. The German hospitals are documenting their cases in a database built by Simon's team in Bonn, while Eddy is conducting the first double-blind study.

"The more we keep giving antibiotics, the more we breed these superbugs. Wounds end up being repositories for them," Eddy said. "By eradicating them, honey could do a great job for society and to improve public health."

 
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Crafty_Dog
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« Reply #2 on: October 19, 2006, 07:39:13 PM »

WASHINGTON (Reuters) -- Hospitals need to step up efforts to prevent infections with drug-resistant "superbugs," which are becoming more and more of a threat to patients, the U.S. Centers for Disease Control and Prevention said Thursday.

Every year, infections caught in U.S. hospitals kill 90,000 people and cost $4.5 billion, the CDC said. Facilities need to keep track of such infections and put into place regular programs to fight them, it said.

"Effective and comprehensive programs to prevent drug-resistant infections are essential to improve patient safety," said Dr. Denise Cardo, director of CDC's Division of Healthcare Quality Promotion.

"Preventing these types of infections requires a constant and concerted effort on the part of health-care facilities, but it's important they make this a priority," Cardo added in a statement.

Bacteria have been steadily evolving to evade the action of antibiotics and infections are becoming more difficult to fight.

For instance, the CDC said, in 1972, only 2 percent of Staphylococcus aureus bacteria infections were drug-resistant but in 2004, 63 percent were.

In a few cases, no available antibiotics can cure an infection, and many more resist methicillin, a later-generation type of antibiotic.

The new CDC guidelines advise hospitals, nursing homes and long-term care facilities to track infection rates, ensure that their staff use standard infection control practices and follow guidelines regarding the correct use of antibiotics.

Simple hand-washing is still a problem in some facilities, the CDC has said.

"The main mode of transmission to other patients is through human hands, especially health-care workers' hands," the CDC says in a statement on its Web site at

"Prevention of drug-resistant infections requires a full complement of actions tailored to the local setting," said Dr. Patrick Brennan, chair of the CDC's Healthcare Infection Control Practices Advisory Committee.

The problem is not restricted to the United States.

In Britain, 1,168 people died from methicillin-resistant Staph infections in 2004, according to the Office of National Statistics. Hospital-acquired infections killed 8,500 Canadians last year.

Copyright 2006 Reuters. All rights reserved.
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Crafty_Dog
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« Reply #3 on: October 26, 2006, 08:16:37 AM »

http://www.filipinomartialartsmuseum.com/Articles/deleon/martial_arts/hilot.html

I have experienced some outstanding results from hilot.
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Crafty_Dog
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« Reply #4 on: October 26, 2006, 08:22:47 AM »

Second post of the morning
=============

Study Says Better Scans May Discover Lung Cancer Sooner
             
By GINA KOLATA
Published: October 26, 2006
NY Times
Researchers in New York report that millions of lives could be saved by detecting lung cancer early with annual CT scans and treating it immediately, when it can still be cured.

Survival of Patients with Stage I Lung Cancer Detected on CT Screening (NEJM)The stakes are high: while death rates for other cancers have fallen, lung cancer is the leading cause of cancer deaths in this country, killing more than 160,000 people a year.

For years, doctors have thought there was little they could do for lung cancer, but now with more sensitive scans, many are rethinking that view.

?You could prevent 80 percent of deaths,? said the study?s lead author, Dr. Claudia Henschke, a professor of radiology and cardiothoracic surgery at Weill Cornell Medical College.

But the report is controversial. Some medical experts and a patient advocacy group say that because this study is so much bigger than previous studies and so carefully done, it should change the testing landscape, while others say that it did not include comparison groups to demonstrate clearly that there is any benefit from annual CT exams.

The study, by researchers at NewYork-Presbyterian/Weill Cornell hospital and published today in The New England Journal of Medicine, involved more than 31,000 people in seven countries. The participants included smokers and former smokers, but also included people in Japan who had never smoked but had the scans as part of annual physical exams.

The scans found 484 lung cancers, 412 of which were at a very early stage. Then the researchers tracked those cancer patients for an average of about three years after the cancer was detected. After three years, most patients were still alive. The researchers projected that more than 80 percent of those with early-stage cancer would live at least 10 years after their cancer was diagnosed.

Supporters of the findings include Dr. James Mulshine, a professor of internal medicine at Rush University Medical Center in Chicago. The study design may not have been perfect, he said, and there is more to be learned from other studies that are now under way, but he said the data from this one was convincing.

?This is a profoundly important report,? Dr. Mulshine said. ?It is a remarkable result.?

Members of an advocacy group for lung cancer patients, the Lung Cancer Alliance, agreed. ?This is the most important breakthrough for the lung cancer community,? Laurie Fenton, the group?s president, said in a news release.

And, says Dr. Henschke?s colleague Dr. David Yankelevitz, it makes sense that early detection can save lives. Lung cancer screening is analogous to screening for breast cancer, Dr. Yankelevitz said. In both situations, he added, ?treatment is easier and the outcomes are better when the tumor is small.?

But mammograms are endorsed by many national groups, whereas lung cancer screening is not. And while praising the new study?s careful accumulation of data, representatives of groups like the American Cancer Society, the American Society of Clinical Oncology, the International Association for the Study of Lung Cancer and the U.S. Preventive Services Task Force, say the study is unlikely to persuade them to recommend screening as a public policy.

One reason is that everyone in Dr. Henschke?s study had CT scans. And so, researchers say, with no comparison group of people who did not have scans, they are left wondering: Does screening, in the end, save lives?

?Intuitively, it makes sense,? said Dr. Stephen Swensen, a professor of radiology at the Mayo Clinic who conducted a study that was similar to Dr. Henschke?s but smaller.

Dr. Swensen added, ?It makes sense that if you find a cancer earlier you will save lives.?

But ?the science hasn?t backed that up yet,? he said.

Cancer specialists have long known that there are cancers of all types ? and lung cancers are no exception ? that stop growing on their own, or that grow so slowly that they never cause problems. So, some ask, how many of the people said to be cured were never in danger? And how often will people have operations that can involve removing part of a lung, which is risky in itself, when their cancer was not lethal?

The problem, as with other cancer scans, is that science cannot always tell the difference between cancers that will stop and those that will not.

The researchers also ask another question: How often did the scans find cancers early but without affecting the person?s life expectancy?

?Everyone knows we can pick up things better with screening,? said Dr. Elliott Fishman, a professor of radiology and oncology at Johns Hopkins Hospital in Baltimore. ?But is picking up the same thing as curing? If I pick up a tumor that is one centimeter today and you live five years or I pick it up four years later and you live one year, it?s the same thing.?

Even evaluating patients with suspicious CT results can be risky, more dangerous, say, than evaluating women with suspicious lumps on a mammogram, said Dr. David Johnson, deputy director of the cancer center at Vanderbilt University and a past president of the American Society of Clinical Oncology.

In Dr. Henschke?s study, doctors investigated more than 4,000 nodules in patients, finding about 400 early-stage cancers.

?This is not sticking a needle in a breast,? Dr. Johnson said. ?It is sticking a needle in the chest, where it can collapse a lung.? In some cases, that is followed by surgery to further evaluate a lump. ?How many people do we subject to needless evaluations?? Dr. Johnson asked.


Page 2 of 2)



It is not even clear, some researchers said, whether the patients in Dr. Henschke?s study really would survive 10 years on average. The investigators used a statistical model to estimate how long patients would be expected to live after most had survived about three years.

Survival of Patients with Stage I Lung Cancer Detected on CT Screening (NEJM)?Ten years should be 10 years,? Dr. Fishman said. ?It?s being guesstimated out. Let?s look in 10 years and see what happens.?

More definitive answers about the value of CT testing may come in a few years when another study, by the National Cancer Institute, is over. It randomly assigned its nearly 55,000 participants, smokers or former smokers, to have annual CT scans or, for comparison, chest X-rays. Based on previous studies, many researchers consider chest X-rays largely ineffective for early diagnosis of the cancer, so it can serve as a placebo control in this study.

Another institute study is assessing chest X-rays by randomly assigning participants to have an annual X-rays or to have no screening.

In the meantime, cancer specialists say doctors and their patients must decide, on an individual basis, what to do. They could wait for the clinical trials to be completed, or they could decide to have scans now, while the data may not be ideal.

And the scans can be expensive. Dr. Howard Forman, a professor of diagnostic radiology at Yale, says that Yale charges $802.39 for the scan and the doctor?s interpretation.

And while many insurers do not pay for CT lung cancer screening tests, that may change, Dr. Forman said. He said he did not find this study to be convincing ? like others, he said he needed to see control group data. But Dr. Forman, who is on the Medical Policy and Technology Assessment Committee for Wellpoint, an insurance company, said it would be hard to deny paying for the test now that the data were in The New England Journal of Medicine.

?The New England Journal of Medicine is a de facto Good Housekeeping seal of approval,? Dr. Forman said.

?It is not proof that screening saves lives,? he said. But, he added, ?proof for a lot of medicine is not there.?

For now, said Dr. Robert Smith, director of cancer screening at the American Cancer Society, it may make sense for smokers or former smokers to have scans for early lung cancer detection.

Patients, Dr. Smith added, should discuss the test with their doctors first, going over potential benefits and potential dangers. And they should be careful to go to a center that has the expertise and experience to do the scans and any follow-up medical procedures properly.

But, he said, the new study adds to the information that CT scans might save lives.

?There is a lot of promise here,? he said. And so, he said, ?it is not at all unreasonable for individuals at high risk of lung cancer to seek testing on their own.?

Others, like Dr. Ned Patz, a professor of radiology, pharmacology and cancer biology at Duke University Medical Center, say they suspect that patients? desire for the tests may cool once they know of the risks.

?A lot of patients ask about it,? Dr. Patz said. ?We counsel them and tell them what the data are. Then they are not interested.?


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Crafty_Dog
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« Reply #5 on: November 01, 2006, 10:32:15 AM »

Please use thread of same name on Science Culture Humanities forum.
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