Neuroradiologist James Leach, MD, and his UC colleagues are among the first in the United States to combine functional magnetic resonance imaging (MRI) and “diffusion tensor tractography” data to outline important areas of brain function and their connections prior to surgery – and then transfer that data to the operating room to track those areas during actual surgery.

This approach, Leach says, has already been used in 20 cases at Cincinnati’s University Hospital.

“Combining tractography and functional MRI intraoperatively has been in use clinically for only a few years,” says Leach, associate professor of radiology at UC and a neuroradiologist with University Hospital, “but our preliminary data is very promising because it allows us to optimize surgical approaches to treating brain tumors to ultimately improve patient outcomes.”

He says that combining standard visual, sound, and voice-based tests, whose results are measured by MRI, performed on a high-field-strength (3 Tesla) scanner, with a precise intraoperative guidance system will improve patients’ post-operative speech, movement and memory, and also optimize quality of life for those with brain tumors and other neurological conditions.

Leach presented this preliminary research in a special scientific exhibit at the American Society of Neuroradiology’s annual meeting in Chicago.

To combine both functional MRI and diffusion tensor tractography images in the operating room, Leach and his colleagues use a high-tech surgical navigation system known as BrainLAB. The BrainLAB technology incorporates functional MRI data to identify brain areas linked to speech, movement and vision, and diffusion tensor imaging data to map critical “white-matter tracts”- the electrical connections between different parts of the brain that should be avoided during surgery.

Leach says the detailed, easy-to-understand images produced from functional MRI data also help patients understand what is happening in their head and how the surgery will be conducted.

“We can essentially show patients a color-coded picture of their brain and explain to them where their tumor is in relation to areas that control critical functions like expressive speech, movement and vision,” says Leach. “This can help alleviate the patient’s apprehension and help explain what will happen during surgery.”

Although researchers expect this dual-imaging technique to become standard practice across the United States in the next five years, there are still limitations. For example, explains Leach, patients with limited vision may not demonstrate as much activity in the brain in areas linked to vision during functional MRI testing.

“That doesn’t necessarily mean that there’s no function there – it may just be that functional MRI is not sensitive enough to detect it,” says Leach.

###

Collaborators in this study include UC and Neuroscience Institute colleagues Christopher McPherson, MD, Ronald Warnick, MD, Raj Narayan, MD, and John Tew, MD.

Contact: Amanda Harper

University of Cincinnati

Researchers at the 28th Annual Society for Maternal-Fetal Medicine (SMFM) meeting – The Pregnancy Meeting™ – has unveiled a study linking pre-conceptional folate supplementation of at least one year to reduced early premature delivery rates of 50 to 70 percent, regardless of age, race or other factors. Of particular note is the drop in very early premature births, those babies who are at the greatest risk of complications such as cerebral palsy, mental retardation, chronic lung disease, and blindness.

The study is an observational analysis based on the self-reporting of folate supplementation by 38,033 participants in an earlier trial sponsored by the National Institutes of Health (NIH.) The current study only examined singleton pregnancies and excluded pregnancies in which there were medical or obstetrical complications such as preeclampsia, chronic hypertension, and congenital or chromosomal abnormalities.

“Thanks to the depth and breadth of the NIH study, which included an early pregnancy ultrasound of each participant, we had highly accurate evidence of the gestational ages of the preterm deliveries,” said Radek Bukowski, M.D., Ph.D., assistant professor, Obstetrics and Gynecology, at the University of Texas Medical Branch at Galveston, the lead study author and SMFM member. “This evidence enabled us to determine that folate supplementation for at least one year is linked to a 70 percent decrease in very early preterm deliveries (20 to 28 weeks in gestational age) and up to a 50 percent reduction in early preterm deliveries of 28 to 32 weeks.”

“We already knew that folic acid supplementation beginning before pregnancy and continuing into the first trimester helps prevent serious birth defects of the brain and spinal cord, such as spina bifida,” said Alan R. Fleischman, M.D., senior vice president and medical director of the March of Dimes. “Now Dr. Bukowski’s research makes us optimistic that taking folic acid for at least one year before pregnancy also may greatly reduce the risk of premature birth. These findings add even greater weight to March of Dimes support for the U.S. Public Health Service’s long-standing recommendation that every woman of childbearing age consume 400 micrograms of folic acid daily. We hope this new research also will spur more health care professionals to urge their female patients to make folic acid part of their daily routine as a simple step toward having a healthy baby in the future.”

“In addition to its benefits in preventing pregnancy complications, previous studies have suggested that folic acid may also have beneficial effects in preventing stroke and cardiovascular disease in adults,” said Katharine Wenstrom, M.D., president of the SMFM, “That’s why everyone – men and women – should get into the habit of taking it.”

Today’s abstract, Preconceptional Folate Prevents Preterm Delivery, represents the first and largest U.S. study to look at the effects of pre-conceptional folate supplementation on early preterm delivery. It is the fifth study by SMFM members to be honored by the March of Dimes for honing the tools used in the fight against prematurity. The March of Dimes conducts a National Prematurity Campaign aimed at raising awareness and reducing the growing rate of premature births.

###

The Society for Maternal-Fetal Medicine (est. 1977) is a non-profit membership group for obstetricians/gynecologists who have additional formal education and training in maternal-fetal medicine. The society is devoted to reducing high-risk pregnancy complications by continuously educating its 2000 members on the latest pregnancy assessment and treatment methods. It also serves as an advocate for improving public policy, and expanding research funding and opportunities for maternal-fetal medicine. The group hosts an annual scientific meeting in which new ideas and research in the area of maternal-fetal medicine are unveiled and discussed.

For more information, visit smfm/.

The March of Dimes is the leading nonprofit organization for pregnancy and baby health. With chapters nationwide and its premier event, March for Babies, the March of Dimes works to improve the health of babies. For the latest resources and information, visit marchofdimes/ or mailto:nacersano.

Source: Elizabeth Lynch

March of Dimes Foundation

Even though human Metapneumovirus has been identified as a significant respiratory pathogen for almost a decade, most laboratories do not routinely test for it. According to Steve Ewers, Senior Product Manager at Diagnostic HYBRIDS, “the primary reason for this has been the absence of an FDA-cleared, reliable rapid assay. The D3 DFA Metapneumovirus Identification Kit provides the laboratory with an easy-to-perform, proven methodology utilizing the same protocol as the gold standard D3 Ultra™ DFA Respiratory Virus Screening & Identification Kit. The consistency in methods will allow for easy integration into the lab workflow.”

Ewers added that “metapneumovirus infection is especially prevalent in infants and elderly patients, but is often indistinguishable from RSV infection, making it difficult to prevent cross-infections. The availability of the D3 DFA Metapneumovirus Identification Kit combined with our premier D3 Ultra DFA Respiratory Virus Screening & Identification Kit allows laboratories to identify eight major respiratory viruses in a clinically relevant time frame, allowing physicians to make decisions based on a definitive diagnosis instead of on symptoms alone.”

The D3 DFA Metapneumovirus Identification Kit is a major addition to Diagnostic HYBRIDS’ rapid respiratory virus testing system. The system includes the R-MixTM and R-Mix TooTM mixed cell culture systems which allow for the rapid isolation of MPV in cell culture, and now the D3 DFA Metapneumovirus Identification Kit. The complete respiratory testing system, including additional D3 DFA respiratory testing kits, is available in the U.S., Canada, and select international markets.

About Diagnostic HYBRIDS

Diagnostic HYBRIDS invents, develops, manufactures, and sells innovative diagnostic and analytical products for a wide range of viral respiratory diseases, herpes virus infections, and other specific viral and thyroid diseases. The company also develops and commercializes innovative and genetically engineered cell-based detection products for the pharmaceutical and biotechnology industry, with an initial focus on pharmacology assays and products that measure drug clearance and anti-viral interventions with drugs and vaccines. The company is certified to ISO 13485 standards (2003) and manufactures live continuous and primary cell cultures for clinical diagnostics and pharmacology assays from its headquarters in Athens, OH. Diagnostic HYBRIDS was named one of the 500 Fastest Growing Companies in America in 2004 and 2005 by Inc. Magazine. The company is a pillar member of BioOhio, a statewide organization of bioscience companies accelerating the bioscience and healthcare economy in Ohio.

Diagnostic HYBRIDS

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

“Telehealth programs have been shown to be very helpful in a variety of contexts, but one of the main limitations for delivering these services in the developing world has been a lack of infrastructure,” says lead study author John D. Piette, Ph.D., a senior research scientist with the VA and professor of internal medicine at the U-M Medical School.

For this study, researchers took advantage of the broad penetration of cell phones in Latin America and paired them with low-cost internet-based phone calls. The service used a cloud computing approach so that the program can be provided from a central location to low income countries around the globe that lack a strong technological infrastructure.

To test the service, the researchers enrolled patients with diabetes from a clinic in a semi-rural area of Honduras. Patients received weekly, automated, interactive phone calls and overwhelmingly reported that the program helped them to improve their diabetes management and general health.

Over the six-week study, researchers saw a clinically important improvement in patients’ hemoglobin A1C, a measure of blood sugar control. The results are forthcoming in the June issue of the American Journal of Preventive Medicine.

“We wanted to demonstrate that it was possible to deliver a high-tech program from U-M to very vulnerable patients with diabetes in Honduras who only have local cell phone service,” Piette says.

The developing world faces a cardiovascular disease crisis as fast food becomes ubiquitous and people shift to urban centers and less active modern lifestyles. Worldwide, the number of people with diabetes is expected grow from 285 million to 439 million by 2030.

The patients who used the program the most were the ones who had higher blood pressure at the outset, had more severe diabetes and lived farther away from the clinic, says Piette, who is also associate director for global health communications at the U-M Center for Global Health. On average, the patients in the study had only five years of formal education and annual household incomes of $2,500.

Patients also had the option of enrolling in the program with an informal caregiver or CarePartner, who also received calls to their cell phones informing them of how the patient was doing and providing suggestions for how they could help support the patient’s self-care.

The research builds on previous work by Piette and co-author Milton Mendoza, M.D., president of Yojoa International Medical Center in Santa Cruz de Yojoa, Honduras. They found that despite poverty and high levels of unemployment, 78 percent of 624 chronically ill primary care patients surveyed had access to cell phones. More than 80 percent of patients expressed interest in receiving automated calls reminding them about appointments, making sure they were taking their medicine, providing educational information and helping them to self-monitor their health.

Those findings were echoed in their new research: 92 percent of patients who completed follow-up surveys said they would use the service again.

“We believe the work of Dr. Piette and his colleagues represents an important and sustainable milestone in innovative global health strategies for the prevention, diagnosis, and management of non-communicable diseases,” says U-M Global Health Director Sofia D. Merajver, M.D., Ph.D. “This work truly stands the chance to improve the health of millions of people in a relatively short time.”

Piette says future research will examine the program’s success against a control group and extend the study period over a longer time period.

Additional authors: Martha Ganser, M.S., Muhima Mohamed, Nicolle Marinec, M.P.H., Sheila Krishnan, M.P.H., all of U-M.

Funding: U-M School of Public Health Global Health Summer Internship Program, and National Institutes of Health grants via the Michigan Diabetes Research and Training Center, and the Michigan Institute for Clinical and Health Research.

Disclosures: None.

Citation: “A Preliminary Study of a Cloud-Computing Model for Chronic Illness Self-Care Support in an Underdeveloped Country,” American Journal of Preventive Medicine, June 2011.

Source:
University of Michigan Health System

Reprinted with kind permission from kaisernetwork. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at kaisernetwork/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork, a free service of The Henry J. Kaiser Family Foundation.

© 2009 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

“We hope that through iMedicor collaborative resources we will be able to continue to garner awareness of pulmonary hypertension and eventually a cure,” said Rino Aldrighetti, President of PHA.

iMedicorTM is a HIPAA compliant, collaborative online portal designed for and by medical professionals to facilitate the secure exchange of medical records, educational content and ideas in real-time. The portal can also help doctors tap corresponding services from other professionals in the medical industry. Some of iMedicor’s features include:

- An online referral and consultation community to create relationships that drive revenue
- An expansive multi-specialty video and text based CME / CEU catalog
- A voice recognition driven medical documentation system
- Medical association section that promotes regular interaction between associations and constituents. Healthcare groups section that allows healthcare professionals of like interests to identify one another and collaborate.
- Access to healthcare-specific blogs and forums.
- An events section that gives members and participating organizations the ability to publish up coming events to gain exposure and increase attendance.
- A practice improvement section that offers courses and information on better practice management

Only licensed medical professionals are permitted to access the free site at iMedicor.

About the Pulmonary Hypertension Association (PHA)

Founded in 1987, the Pulmonary Hypertension Association’s (PHA) mission is to seek a cure for pulmonary hypertension and provide hope for the pulmonary hypertension community through support, education, advocacy, and awareness. Pulmonary Hypertension (PH) is a simplified name for a complex health problem – continuous high blood pressure in the lungs, resulting in an enlarged heart. PHA aids patients and their families in coping with this devastating disease; provides networking opportunities to end the “aloneness” of a rare illness; assists in locating doctors and medical facilities with expertise in treating pulmonary hypertension; forms support groups to allow patients to network and open contact with others; and publishes a newsletter, Pathlight, that builds a sense of community. www.phassociation/

About Vemics, Inc.

Vemics, Inc. (PINK SHEETS:VMCI) is a leading provider of hosted, real-time learning and productivity solutions. Vemics LiveAccess™ solutions combine multipoint video/voice and data technologies with industry specific content, consulting expertise and deep customer support enabling organizations large and small to work, collaborate and learn face-to-face, online from almost anywhere with little or no capital investment. Vemics is based in New York with offices in Massachusetts, Pennsylvania, Moscow, St. Petersburg (Russia), Toronto (Canada) and Austin, Texas. vemics , imedicor

This release includes forward-looking statements within the meaning of Section 27A of the Securities Act of 1933, as amended, and Section 21E of the Securities Exchange Act of 1934, as amended. All statements regarding our expected future financial position, results of operations, cash flows, financing plans, business strategy ,integration of NuScribe’s business into ours, products and services, competitive positions, growth opportunities, plans and objectives of management for future operations, as well as statements that include words such as “anticipate,” “if,” “believe,” “plan,” “estimate,” “expect,” “intend,” “may,” “could,” “should,” “will,” and other similar expressions are forward-looking statements. All forward-looking statements involve risks, uncertainties and contingencies, many of which are beyond our control, which may cause actual results, performance, or achievements to differ materially from anticipated results, performance, or achievements. Factors that may cause actual results to differ materially from those in the forward-looking statements include those set forth in our filings with pinksheets. We are under no obligation to (and expressly disclaim any such obligation to) update or alter our forward-looking statements, whether as a result of new information, future events or otherwise.

vemics

Chief Executive Officer of PSA, Liesel Wett, said it could be hard to talk about death and dying, but it was very important people understood your wishes before it was too late.

Ms Wett said while many people would prefer to die at home, often it was just not feasible.

“We know that the number of people who die at home in Australia has actually decreased over the past 50 years. Now only about 16% of people die at home, 20% die in hospices and 10% in nursing homes. The rest die in hospitals,” Ms Wett said.

“So if people want to die at home, or they want to have a say about the end stage of their lives, they need to do some basic planning.”

This included:

– Speaking to loved ones and/or caregivers about their preferences

– Finding out about support services – there are excellent palliative care services available right around Australia

– Preparing a simple Advance Care Plan, covering the type of care they wished for and where they’d like to be at the end of life.

“Pharmacists as health professionals can often provide advice, particularly in areas cornering the quality use of medicines,” Ms Wett said. “There is no doubt that when someone you love is dying, it can be a very emotional and stressful time. Talking about it beforehand, and doing some basic planning, can help to ease the burden. After all, it’s all about making people comfortable at the end of their lives.”
PSA will be circulating and displaying new information materials from Palliative Care Australia, all based around the theme “Let’s chat about dying”.

“There’s no escaping that we will all die eventually, and everyone deserves quality care at that time. To make that a reality, we need to chat about dying and make our preferences clear.

“In having these conversations, we have a great opportunity to make a positive impact on our lives, the lives of our loved ones, and those in our communities – the opportunity to choose to maximise our life experience when we have certain knowledge that our life’s end is near; the opportunity to make choices that minimise our suffering; and the opportunity to make choices that make the journey easier for our loved ones, leading to good grieving,” Ms Wett said.

Source:

Pharmaceutical Society of Australia

Over 700 patients attending eight hospital emergency care departments and another eight walk-in centres located in hospital grounds were quizzed by the researchers. They were asked about their treatment preferences and how they rated the treatment they had received.

Here are some of the findings:

– Most of the patients went to an emergency care department first, even if there was a walk-in centre in the hospital grounds

– Nearly four-fifths of those who were in the walk-in centres had been redirected from emergency care departments

– Approximately one in every three patients treated at a walk-in centre would have preferred to go to a hospital emergency care department, compared to just about 12% of those at emergency care department who would have preferred a walk-in centre

– Half of the patients questioned in walk-in centres did not even realize they were being treated in this kind of facility

– Those who opted to go into a walk-in centre thought they would be seen more quickly than if they had got an appointment with their GP (family doctor)

The authors said “The policy aim of establishing walk-in centres to improve access to care appears to have been lost or subsumed by a more immediate demand to reduce A&E workload and waiting times. There is no evidence from the data available that walk-in centres co-located with A&E departments have achieved the aim of increasing patient choice, preferences or satisfaction with care received.”

“Comparing care at walk-in centres and at accident and emergency departments: an exploration of patient choice, preferences and satisfaction”
Emerg Med J 2007; 24: 260-4
emj.bmj

Edited by: Christian

“While yielding to temptation can certainly be harmful, this article argues that overcontrol and excessive farsightedness (‘hyperopia’) can also have negative long-term consequences,” say Ran Kivetz and Anat Keinan.

As with many mid-life (and quarter-life) crises, we tend to experience especially strong regret if pleasure is constantly delayed. According to the study – one of the first to compare indulgence regret to self-control regret – the greater temporal perspective gleaned with age helps us let go of guilt for, say, transgressions at a long-ago spring break. Instead, we begin to experience wistful feelings for delayed pleasures – for not taking that around-the-world trip sooner or for constantly dieting and not eating dessert.

“In the short run, vice is regretted more than virtue, but in the long run virtue is regretted more,” conclude the authors. “Consumers sometimes suffer from excessive farsightedness and future-biased preferences, consistently delaying pleasure and overweighing necessity and virtue in local decisions.”

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Ran Kivetz and Anat Keinan. “Repenting Hyperopia: An Analysis of Self-Control Regrets” Journal of Consumer Research. September 2006.

Contact: Suzanne Wu

University of Chicago Press Journals