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Technology

Polymer-based filter successfully cleans water, recovers oil in Gulf of Mexico test

PITTSBURGH -- In response to the massive oil leak in the Gulf of Mexico, a University of Pittsburgh engineering professor has developed a technique for separating oil from water via a cotton filter coated in a chemical polymer that blocks oil while allowing water to pass through. The researcher reports that the filter was successfully tested off the coast of Louisiana and shown to simultaneously clean water and preserve the oil. Di Gao, an assistant professor and William Kepler Whiteford Faculty Fellow in the Department of Chemical and Petroleum Engineering in Pitt's Swanson School of Engineering, created his filter as a possible method to help manage the spreading oil slick that resulted from the April 20 explosion of BP's Deepwater Horizon drilling platform. Gao has submitted his idea through the Deepwater Horizon Response Web site managed by the consortium of companies and government agencies overseeing the disaster response. A video of Gao testing his filter with oil and water samples from the Gulf of Mexico spill is available on YouTube at www.youtube.com/watch?v=kfRKjiOXVWE Gao's filter hinges on a polymer that is both hydrophilic -- it bonds with the hydrogen molecules in water -- and oleophobic, meaning that it repels oil. When the polymer is applied to an ordinary cotton filter, it allows water to pass through but not oil. The filter is produced by submerging the cotton in a liquid solution containing the polymer then drying it in an oven or in open air, Gao explained. For the massive slick off the U.S. Gulf Coast, Gao envisions large, trough-shaped filters that could be dragged through the water to capture surface oil. The oil could be recovered and stored and the filter reused. Current cleanup methods range from giant containment booms and absorbent skimmers to controlled fires and chemical dispersants with questionable effects on human health and the environment. Gao focuses his research in the development and application of chemical nanostructures, including liquid-resistant coatings. In 2009, Gao reported in the journal Langmuir his demonstration of a nanoparticle-based solution that can prevent the formation of ice on solid surfaces, from power lines to airport runways and roads. More information is available on Pitt's Web site at www.chronicle.pitt.edu/?p=4206

Jun 7, 2010

Health

Non-melanoma skin cancer may help identify survivors at increased risk for future cancers

Childhood cancer survivors diagnosed later with non-melanoma skin cancer may be at increased risk for having a malignant tumor within 15 years, according to research led by St. Jude Children's Research Hospital investigators. Almost 20 percent of survivors in this Childhood Cancer Survivor Study (CCSS) who were diagnosed with basal or squamous cell skin cancer developed another more aggressive cancer within 15 years, said Gregory Armstrong, M.D., assistant member of the St. Jude Department of Epidemiology and Cancer Control. He presented the results June 7 at the 46th Annual Meeting of the American Society of Clinical Oncology in Chicago. "These findings suggest non-melanoma skin cancers are a potential marker for survivors who are at risk for future invasive malignancies," Armstrong said. The study involved 14,358 childhood cancer survivors whose cancer was diagnosed between 1970 and 1986. All are now participating in the CCSS, which is funded by the National Cancer Institute to track the health outcomes of childhood cancer survivors. Armstrong is project director for CCSS, which includes investigators at 30 institutions in the U.S. and Canada. St. Jude is the central coordinating institution. Les Robison, Ph.D., St. Jude Epidemiology and Cancer Control chair, is the CCSS principal investigator. He is also this study's senior author. Childhood cancer survivors are known to be at increased risk for additional cancers, which remain a leading cause of disability and death among those who beat cancer the first time. "This study is the first to track the risk of multiple malignancies in a large group of aging cancer survivors," Armstrong said. The average survivor in this study was age 36. Nearly 10 percent of study participants, or 1,383 survivors, reported being diagnosed with a second tumor. The group included 231 survivors found to have a third tumor and 153 individuals diagnosed with four or more. The analysis found that nearly 39 percent of childhood survivors diagnosed with one subsequent tumor went on to develop another within 15 years. The study's other authors are Wei Lui, Ph.D., and Deokumar Srivastava, Ph.D., of St. Jude; Sue Hammond, M.D., Nationwide Children's Hospital, Columbus, Ohio; Smita Bhatia, M.D., City of Hope, Duarte, CA.; Joseph Neglia, M.D., University of Minnesota, Minneapolis; Marilyn Stovall, Ph.D., M.D. Anderson Cancer Center, Houston; Wendy Leisenring, Sc.D., Fred Hutchinson Cancer Research Center, Seattle; and Yutaka Yasui, Ph.D., University of Alberta, Edmonton, Canada. St. Jude Children's Research Hospital St. Jude Children's Research Hospital is internationally recognized for its pioneering research and treatment of children with cancer and other catastrophic diseases. Ranked the No. 1 pediatric cancer hospital by Parents magazine and the No. 1 children's cancer hospital by U.S. News & World Report, St. Jude is the first and only National Cancer Institute-designated Comprehensive Cancer Center devoted solely to children. St. Jude has treated children from all 50 states and from around the world, serving as a trusted resource for physicians and researchers. St. Jude has developed research protocols that helped push overall survival rates for childhood cancer from less than 20 percent when the hospital opened to almost 80 percent today. St. Jude is the national coordinating center for the Pediatric Brain Tumor Consortium and the Childhood Cancer Survivor Study. In addition to pediatric cancer research, St. Jude is also a leader in sickle cell disease research and is a globally prominent research center for influenza. Founded in 1962 by the late entertainer Danny Thomas, St. Jude freely shares its discoveries with scientific and medical communities around the world, publishing more research articles than any other pediatric cancer research center in the United States. St. Jude treats more than 5,700 patients each year and is the only pediatric cancer research center where families never pay for treatment not covered by insurance. St. Jude is financially supported by thousands of individual donors, organizations and corporations without which the hospital's work would not be possible. In 2010, St. Jude was ranked the most trusted charity in the nation in a public survey conducted by Harris Interactive, a highly respected international polling and research firm. For more information, go to www.stjude.org.

Jun 7, 2010

Health

ASCO data show serum DNA blood tests detect cancers with high sensitivity and specificity

Chicago, IL and San Jose, CA, June 7, 2010 -- Chronix Biomedical today reported new data further demonstrating that its serum DNA blood tests have the potential to accurately detect early stage breast cancer and prostate cancer. Chronix's proprietary technology identifies disease-specific genetic fingerprints based on circulating DNA fragments that are released into the bloodstream by damaged and dying (apoptotic) cells. In this new study of 575 individuals, Chronix's proprietary assays detected and identified DNA fingerprints in the blood that indicated the presence of prostate cancer and breast cancer with 92% sensitivity and 100% specificity, significantly outperforming the published accuracy data for current diagnostic methods. The new study results were presented in an oral session today at the 2010 ASCO Annual Meeting in Chicago. Breast cancer expert, Steven Narod, M.D., F.R.C.P.C., noted, "These new data, although early, provide further evidence that Chronix's proprietary serum DNA assays may represent a new diagnostic and prognostic platform that can identify cancer earlier and more accurately than is currently possible. I am pleased to be working with Chronix to further validate these promising findings." Dr. Narod is Director of the Familial Breast Cancer Research Unit at Women's College Research Institute, an affiliate of the University of Toronto. The tests use proprietary algorithms developed by Chronix researchers to detect, analyze and identify cancer-related fragments of circulating DNA that are released into the bloodstream by apoptotic cells. Chronix researchers consistently find that this apoptotic DNA in the serum is coming from a limited number of regions or "hotspots" on the genome specific to each cancer. According to the data presented today, DNA fragments from any one of the 29 breast cancer "hotspots" and 32 prostate cancer "hotspots" identified by Chronix researchers indicate that cancer is present. "By focusing on these blood-borne genomic 'hotspots,' we can reliably detect the presence of cancer without having to first isolate or analyze the tumor cells," said Howard Urnovitz, Ph.D., Chief Executive Officer of Chronix and a co-author of the study. "If verified by further studies, our Chronix blood-based assays would make it possible to diagnose cancer at its earliest stages, track progress as patients undergo treatment and possibly even optimize treatment using patients' disease-specific genomic fingerprints." The testing involved 575 individuals: 178 with early stage breast cancer, 197 with invasive prostate cancer and 200 healthy controls. The Chronix assays detected breast cancer with a 92% sensitivity and 100% specificity. Although not directly comparable, for reference it is noteworthy that data from a large study of U.S. mammography screening programs reported an overall sensitivity of just 75%, and specificity of 92.3%, with lower figures for some populations such as younger women. The Chronix assays also detected invasive prostate cancer with a 92% sensitivity and 100% specificity. In contrast, the widely used PSA (prostate specific antigen) test has previously demonstrated 85% sensitivity and a specificity of just 25% to 35%. If the Chronix data are confirmed in larger studies, they have the potential to reduce the current rate of false positive and false negative results that contribute to poorer patient outcomes and higher health care costs. Previous published studies have demonstrated that the Chronix approach can identify the presence or absence of active disease in multiple sclerosis patients and that it can accurately detect early stage breast cancer with high diagnostic sensitivity and specificity. Commercial applications for veterinary use are already in development in conjunction with the University of Calgary, including tests for the early detection of BSE, or mad cow disease. Dr. Urnovitz added, "With these encouraging findings, we are launching a 'For Investigative Use Only' testing service that for the first time will enable cancer researchers to monitor the status of patients in their clinical trials with a high level of sensitivity and specificity, potentially accelerating clinical trials and increasing their chances for success." Patient data collected from this new service for clinical researchers along with additional planned clinical studies are expected to expand the database needed to obtain regulatory approval for the use of Chronix assays in ongoing cancer patient care. About Chronix Biomedical (ASCO booth #6052) Chronix Biomedical is pioneering a breakthrough approach to the diagnosis, monitoring and management of a broad range of cancers and other conditions. It has developed proprietary technology that measures and categorizes DNA sequences circulating in the serum that are associated with specific changes in disease and health status. Using advanced genome analysis methodology, proprietary data tools and disease-specific databases, Chronix has demonstrated the utility of its diagnostic and prognostic approach in a chronic neurologic disease, in breast and prostate cancer and in multiple myeloma. It currently is conducting studies in other cancers. The company plans to offer its serum DNA-based assays in as a "For Investigational Use Only" test in its research laboratories. Chronix is headquartered in San Jose, California and has research facilities in Germany. For more information, visit www.chronix-biomedical.com.

Jun 7, 2010

Health

Regular bedtimes linked to better language, reading and math skills in preschool children

WESTCHESTER, IL -- Children in households with bedtime rules and children who get adequate sleep score higher on a range of developmental assessments, according to a research abstract that will be presented Monday, June 7, 2010, in San Antonio, Texas, at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies LLC. Results indicate that among sleep habits, having a regular bedtime was the most consis¬tent predictor of positive developmental outcomes at 4 years of age. Scores for receptive and expressive language, phonological awareness, literacy and early math abilities were higher in children whose parents reported having rules about what time their child goes to bed. Having an earlier bedtime also was predictive of higher scores for most developmental measures. The study also provides a wealth of information about typical sleep patterns in 4-year-old children. According to the American Academy of Sleep Medicine, preschool children should get a minimum of 11 hours of sleep each night. Getting less than this recommended amount of sleep, the study's authors found, was associated with lower scores on phonological awareness, literacy and early math skills. The data show that many children are not getting the recommended amount of sleep, which may have negative consequences for their development and school achievement. "Getting parents to set bedtime routines can be an important way to make a significant impact on children's emergent literacy and language skills," said lead author Erika Gaylor, PhD, early childhood policy researcher for SRI International, an independent, nonprofit research institute in Menlo Park, Calif. "Pediatricians can easily promote regular bedtimes with parents and children, behaviors which in turn lead to healthy sleep." Gaylor recommended that parents can help their preschooler get sufficient sleep by setting an appropriate time for their child to go to bed and interacting with their child at bedtime using routines such as reading books or telling stories. The study involved a nationally representative sample of approximately 8,000 children who completed a direct assessment at 4 years of age as part of the Early Childhood Longitudinal Study -- Birth Cohort. This analysis included information from parent phone interviews when their child was 9 months old and again when their child was 4 years old. Nighttime sleep duration was based on parent-reported usual bedtime and wake time. Developmental outcomes were assessed using a shortened set of items from standardized assessments. Results were controlled for potential confounders such as child and bedtime characteristics. "This is by far the largest study of its kind to date. Previous studies have included up to 500 children in this age group," Gaylor said. "It's fortunate to have this rich dataset available for analysis." Last year a study in the August 2009 issue of Sleep Medicine also emphasized the importance of an early bedtime and consistent bedtime routine for children. It reported that children with a bedtime after 9 p.m. took longer to fall asleep and had a shorter total sleep time. Children without a consistent bedtime routine also were reported to obtain less sleep. The SLEEP 2010 abstract supplement is available for download on the website of the journal Sleep at http://www.journalsleep.org/ViewAbstractSupplement.aspx. About SLEEP 2010 A joint venture of the American Academy of Sleep Medicine and the Sleep Research Society, the annual SLEEP meeting brings together an international body of more than 5,000 leading clinicians and scientists in the fields of sleep medicine and sleep research. At SLEEP 2010 more than 1,100 research abstract presentations will showcase new findings that contribute to the understanding of sleep and the effective diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea. About SRI International Silicon Valley-based SRI International is one of the world's leading independent research and technology development organizations. SRI, which was founded by Stanford University as Stanford Research Institute in 1946 and became independent in 1970, has been meeting the strategic needs of clients and partners for more than 60 years. Perhaps best known for its invention of the computer mouse and interactive computing, SRI has also been responsible for major advances in networking and communications, robotics, drug discovery and development, advanced materials, atmospheric research, education research, economic development, national security, and more. The nonprofit institute performs sponsored research and development for government agencies, businesses, and foundations. SRI also licenses its technologies, forms strategic alliances, and creates spin-off companies. In 2009, SRI's consolidated revenues, including its wholly owned for-profit subsidiary, Sarnoff Corporation, were approximately $470 million.

Jun 6, 2010

Health

Study is first to find that CPAP therapy restores brain tissue in adults with sleep apnea

WESTCHESTER, IL -- Obstructive sleep apnea patients had reductions of grey-matter volume at baseline but showed significant grey-matter volume increase after three months of CPAP therapy, according to a research abstract that will be presented Monday, June 7, 2010, in San Antonio, Texas, at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies LLC. Results indicate that obstructive sleep apnea patients showed focal reductions of grey-matter volume at baseline in the left hippocampus, posterior parietal cortex and right superior frontal gyrus. Significant grey-matter volume increases were observed after three months of continuous positive airway pressure therapy in hippocampal and frontal structures. No further improvement in gray-matter volume was observed after one year of CPAP therapy. "OSA patients showed cognitive impairment associated with neurostructural damage affecting specific cerebral regions," said principal investigator Vincenza Castronovo, PhD, clinical psychologist and psychotherapist and sleep laboratory coordinator at the University Vita-Salute San Raffaele and San Raffaele Scientific Institute in Milan, Italy. "In addition, we show that most of the neuropsychological deficits are reversed after three months of treatment with CPAP and, for the first time, that such cognitive improvements parallel an increase of grey-matter volume in specific hippocampal and frontal brain regions. The increase of grey-matter volume in these regions is significantly correlated with the improvement at neuropsychological tests of executive functioning and short-term memory." The study involved 17 patients with an apnea-hypopnea index (AHI) greater than 30 (i.e., more than 30 breathing pauses per hour of sleep), indicating severe obstructive sleep apnea. They were compared with 15 healthy controls. Brain scans were conducted by 3 Tesla magnetic resonance imaging (MRI), and a processing technique called "voxel-based morphometry" (VBM) was used to characterize regional cerebral volume and tissue concentration differences in gray matter by examining the entire brain. VBM increasingly is being used as a tool to examine patterns of brain change in healthy aging or neurodegenerative disease, as well as neuroanatomical correlates of behavioral or cognitive deficits and skills. Castronovo added that measuring neuropsychological performance may help physicians assess OSA patients for treatment effectiveness. "Our results also suggest that specific neuropsychological measures are valuable tools for the assessment of therapy success and can offer to patients and physicians the evidence that adherence to treatment can lead not only to clinical but also to brain-structural recovery," she said. The National Institute of Neurological Disorders and Stroke reports that "gray matter" refers to the cerebral cortex, where the brain does most of its information processing. The cortex is a layer of tissue that has a gray-colored appearance because it lacks the myelin insulation that gives most other parts of the brain a white appearance. According to the American Academy of Sleep Medicine, OSA is a sleep-related breathing disorder that involves a decrease or complete halt in airflow despite an ongoing effort to breathe. It occurs when the muscles relax during sleep, causing soft tissue in the back of the throat to collapse and block the upper airway. This leads to partial reductions (hypopneas) and complete pauses (apneas) in breathing that can produce abrupt reductions in blood oxygen saturation and reduce blood flow to the brain. Most people with OSA snore loudly and frequently, and they often experience excessive daytime sleepiness. The treatment of choice for OSA is CPAP therapy, which provides a steady stream of air through a mask that is worn during sleep. This airflow keeps the airway open to prevent pauses in breathing and restore normal oxygen levels. Help for OSA is available at more than 2,000 AASM-accredited sleep disorders centers across the U.S. Last year Castronovo reported that there was a large overlap in the pattern of brain activity in men with OSA and healthy controls during a working-memory task. But some regions were less active in men with untreated OSA, while additional brain regions such as the hippocampus showed increased activation. Then after three months of CPAP therapy, men with OSA showed decreases in the activation of the left inferior frontal gyrus and anterior cingulate cortex, and bilaterally in the hippocampus. The study, published in the September issue of the journal Sleep, supports the "compensation hypothesis," suggesting that the brain "recruits help" to maintain performance and compensate for the neural dysfunction caused by OSA. A South Korean study published in the February 2010 issue of the journal Sleep found gray matter concentration deficits in multiple brain regions of newly diagnosed men with severe OSA, including limbic structures, prefrontal cortices and the cerebellum. In the March 2009 issue of the Journal of Sleep Research, a French study reported finding gray matter loss in multiple regions, including the thalamus, hippocampus and cerebellum. The study was supported by the Respironics Foundation. The SLEEP 2010 abstract supplement is available for download on the website of the journal Sleep at http://www.journalsleep.org/ViewAbstractSupplement.aspx. A joint venture of the American Academy of Sleep Medicine and the Sleep Research Society, the annual SLEEP meeting brings together an international body of more than 5,000 leading clinicians and scientists in the fields of sleep medicine and sleep research. At SLEEP 2010 more than 1,100 research abstract presentations will showcase new findings that contribute to the understanding of sleep and the effective diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.

Jun 6, 2010

Brain & Behavior

Nocturnal alertness improves after exposure to milliseconds of bright light flashes

WESTCHESTER, IL - Exposure to extraordinarily brief, millisecond flashes of bright light improves alertness at night, according to a research abstract that will be presented Monday, June 7, 2010, in San Antonio, Texas, at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies LLC. Results indicate that subjective sleepiness decreased and objective nighttime alertness improved after participants received a two-millisecond pulse of bright light once per minute for 60 minutes. Flash exposure, as compared with darkness, elicited significant improvement in self-rated alertness and a significant 57-millisecond improvement in median reaction time on the auditory Psychomotor Vigilance Test, compared with no significant improvement after 60 minutes of darkness. This was accompanied by significant changes in the faster frequencies of the EEG following exposure to the flashes. "We found it shocking that light exposure as brief as a few milliseconds could engender changes in alertness and brain wave activity," said principal investigator Jamie M. Zeitzer, PhD, assistant professor in the department of psychiatry and behavioral sciences at Stanford University in Palo Alto, Calif. "These results change the manner in which we think about the brain's capacity to respond to light." The randomized crossover study involved seven people who were tested two times, with the sessions separated by more than two weeks. In each testing condition they were wakened two hours after their typical bedtime for stimulus administration. Once they were exposed to an hour of darkness, and once they were exposed to a total of 120 milliseconds of bright light pulses during an hour of darkness. Vigilance was measured immediately before and at the end of the 60-minute stimulus. According to the American Academy of Sleep Medicine, the solar light-dark cycle is the primary environmental time cue for synchronizing the circadian system to the 24-hour day. Artificial light absorbed by visual photoreceptors also can affect circadian timing by triggering the suppression of melatonin, a hormone that acts as a "darkness signal." AASM practice parameters indicate that timed light exposure in the work environment can decrease sleepiness and improve alertness during night shift work. However, bright light therapy typically involves exposure to up to 10,000 lux of light for scheduled periods of 20 minutes or more. The study was supported by the Air Force Office of Scientific Research, the U.S. Department of Veterans Affairs and Stanford University. The SLEEP 2010 abstract supplement is available for download on the website of the journal Sleep at http://www.journalsleep.org/ViewAbstractSupplement.aspx. A joint venture of the American Academy of Sleep Medicine and the Sleep Research Society, the annual SLEEP meeting brings together an international body of more than 5,000 leading clinicians and scientists in the fields of sleep medicine and sleep research. At SLEEP 2010 more than 1,100 research abstract presentations will showcase new findings that contribute to the understanding of sleep and the effective diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea.

Jun 6, 2010

Health

Daughters caring for a parent recovering from stroke more prone to depression than sons

Quebec City -- Adult daughters caring for a parent recovering from stroke are more prone to depression than sons, Marina Bastawrous today told the Canadian Stroke Congress, co-hosted by the Canadian Stroke Network, the Heart and Stroke Foundation, and the Canadian Stroke Consortium. Caring for a parent who has experienced a stroke results in a dramatic shift from the usual parent-child relationship. "Stroke can be particularly challenging for families," says Bastawrous, a masters candidate at the University of Toronto. "Taking care of elderly parents can bring out family strengths and family weaknesses." The adult child-to-parent bond can result in excellent care when a senior has a stroke. But not always, she says. The study found that close and secure relationships with parents predicted better mental health and greater satisfaction in adult child caregivers. "But strained relationships before or following the stroke increases depression in daughters," she says. "If the relationship between a parent and adult daughter is already strained, a stroke can make things even worse." The quality of relationships both before and after the stroke had an equally important influence on wellbeing. The study found that adult daughters placed greater importance on family relationships than sons and, in turn, were more negatively impacted by poor relationships with their parent. "When a parent has a stroke, adult children often become their primary caregivers," says Heart and Stroke Foundation spokesperson Dr. Michael Hill. "It's important that as part of the recovery process we examine their experiences because they are obviously vital to the ongoing care of the stroke patient." Sandwich generation spread too thin Study co-author Dr. Jill Cameron says adult children providing stroke care for their parents need help and they need it now. "Adult children are stroke care's forgotten generation," she says. "We can't afford to leave them behind." Sixty two percent of stroke caregivers are adult children. Yet stroke care interventions are overwhelmingly designed for spouses. This imbalance must be addressed, says Dr. Cameron. "We need to make better use of financial resources to enhance the support provided to this growing population of caregivers." She notes that adult children caregivers need to balance the challenges of professional life, family life, and the added responsibility of taking on the care of somebody post-stroke. "Caregivers need more support," she says. "They aren't trained but their role is essential." To remove some of the strain − financial and emotional − innovative thinking is required. "Our healthcare system is not sustainable in the face of rising costs," says Dr. Cameron. "We need to plan." Here's what Dr. Cameron envisions as part of this plan: Create work environments that support family members caring for stroke survivors (e.g., caregiving leave). Recognizing that family members perform many caregiving duties after the stroke survivor returns home but receive little if any training; hospitals must train family members for their caregiving role. To ensure post-hospital care plans incorporate the unique circumstances of the family, caregivers should be recognized as members of the care team. "Family caregivers are critical to stroke recovery and typically assume major care roles that are frequently costly to their financial, social, and emotional well-being," says Dr. Antoine Hakim, spokesperson for the Canadian Stroke Network. "Innovative new ideas to support their balance and quality of life is essential." Statements and conclusions of study authors are solely those of the study authors and do not necessarily reflect Foundation or CSN policy or position. The Heart and Stroke Foundation of Canada and the Canadian Stroke Network make no representation or warranty as to their accuracy or reliability. The Canadian Stroke Network (canadianstrokenetwork.ca) includes more than 100 of Canada's leading scientists and clinicians from 24 universities who work collaboratively on various aspects of stroke. The network, which is headquartered at the University of Ottawa, also includes partners from industry, the non-profit sector, provincial and federal governments. The Canadian Stroke Network, one of Canada's Networks of Centres of Excellence, is committed to reducing the physical, social and economic impact of stroke on the lives of individual Canadians and on society as a whole. The Heart and Stroke Foundation (heartandstroke.ca), a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy. For more information and/or interviews, contact The CSC 2010 MEDIA OFFICE (JUNE 7 and 8) at 418-649-5232 OR contact Hémisphère Relations Publiques Marie-José Bégin 514-994-0802 [email protected] France Gaignard 514-616-7705 Congress information and media registration is at www.strokecongress.ca After June 8, 2010, contact: Jane-Diane Fraser Heart and Stroke Foundation of Canada (613) 569-4361 ext 273, [email protected]

Jun 6, 2010

Health

Non-intense physical activity to reduce depression and boost recovery of stroke patients

Quebec -- You don't always need to build up a big sweat to reap the healing benefits of physical activity. Research has found that even a low-intense exercise program can reduce depression symptoms and boost physical therapy results in recovering stroke patients. "The power of physical activity to raise the spirits of recovering stroke patients is stronger than anyone suspected," Heart and Stroke Foundation researcher Dr. Jocelyn Harris told Canadian Stroke Congress, co-hosted by the Canadian Stroke Network, the Heart and Stroke Foundation, and the Canadian Stroke Consortium. She says that many stroke survivors experience feelings of depression in the weeks and months following stroke, which can interfere with the recovery process. This may be due in part to the fact that depression can cause a lack of motivation, increased fatigue, and trouble concentrating. Intense physical activity has a positive effect on reducing depression for most stroke patients. But some stroke patients undergoing medical treatments have special challenges and can't reach high activity levels, she says. "Many stroke patients could never reach aerobic levels high enough to alleviate depressive symptoms," says Dr. Harris, who works at the Toronto Rehabilitation Institute. Without that fitness boost, depression can become a perpetual, unwelcome guest for stroke patients and their caregivers. This new study shows there is no reason for these patients to miss out on the benefits of physical activity. The study followed 103 recovering stroke patients who were all receiving regular, standard treatment in hospital. Fifty-three -- just over half − of the patients were enrolled in an additional, experimental program for upper limb recovery called Graded Repetitive Arm Supplementary Program (GRASP). The remaining 50 patients carried on with regular treatments. Patients in the GRASP group spent an extra 35 minutes four times a week doing non-intense arm exercises as part of rehabilitation activities, such as pouring water in a glass, buttoning up a shirt, or playing speed and accuracy games. Depressive symptoms were measured by the Center for Epidemiology Depression Rating Scale (CES-D), which measures symptoms of depression. The GRASP treatment program improved stroke-affected arm and hand function by 33 per cent as well as improving the amount that the patient used their arm and hands. "At four weeks, the GRASP patients also reported less depressive symptoms and greater change scores than those in the control group did," says Dr. Harris. "The GRASP patients all did better − much better." The effects lasted up to five months. "Depression and depressive symptoms in the weeks following a stroke are very common. Depression may be a direct result of the damage to a region of brain and in addition, the sudden change in ability and life circumstances," says Heart and Stroke Foundation spokesperson Dr. Michael Hill. "It's important to know that depression is treatable. Patients and caregivers should mention depressive symptoms and seek treatment during follow-up visits with their neurologist, internist, or family physician." Nobody knows for sure how many patients show depressive symptoms after stroke, says Dr. Harris. "In the literature, the rate ranges between 23 and 72 per cent. That is a huge difference." These numbers point to the importance of planning for the needs of the baby boom generation who are currently poised to enter the high stroke risk stage, says Dr. Hill. Dr. Harris wants to take the GRASP program out of the hospital and into the community. "We need to create more meaning and purpose in the lives of stroke survivors," says Canadian Stroke Network spokesperson Dr. Antoine Hakim. "Whether it is gardening, enjoying the grandchildren, or going for a walk in a beautiful park, there are many focuses that can raise mood, alleviate depression, and improve recovery in stroke survivors." Statements and conclusions of study authors are solely those of the study authors and do not necessarily reflect Foundation or CSN policy or position. The Heart and Stroke Foundation of Canada and the Canadian Stroke Network make no representation or warranty as to their accuracy or reliability. The Canadian Stroke Network (canadianstrokenetwork.ca) includes more than 100 of Canada's leading scientists and clinicians from 24 universities who work collaboratively on various aspects of stroke. The network, which is headquartered at the University of Ottawa, also includes partners from industry, the non-profit sector, provincial and federal governments. The Canadian Stroke Network, one of Canada's Networks of Centres of Excellence, is committed to reducing the physical, social and economic impact of stroke on the lives of individual Canadians and on society as a whole. The Heart and Stroke Foundation (heartandstroke.ca), a volunteer-based health charity, leads in eliminating heart disease and stroke and reducing their impact through the advancement of research and its application, the promotion of healthy living, and advocacy. For more information and/or interviews, contact The CSC 2010 MEDIA OFFICE (JUNE 7 and 8) at 418-649-5232 OR contact Hémisphère Relations Publiques Marie-José Bégin 514-994-0802 [email protected] France Gaignard 514-616-7705 Congress information and media registration is at www.strokecongress.ca After June 8, 2010, contact: Jane-Diane Fraser Heart and Stroke Foundation of Canada (613) 569-4361 ext 273, [email protected]

Jun 6, 2010

Health

Childhood parasomnias such as sleepwalking and bedwetting may persist into adolescence

WESTCHESTER, IL -- Although incident parasomnias are uncommon as children enter adolescence, parasomnias present in preadolescents may persist into the teen years, according to a research abstract that will be presented Monday, June 7, 2010, in San Antonio, Texas, at SLEEP 2010, the 24th annual meeting of the Associated Professional Sleep Societies LLC. Results indicate that the rate of persistence after five years was 29 percent for children with bedwetting and 27 percent for children with sleepwalking. The overall prevalence for these parasomnias was 2.6 and 3.1 percent respectively. The study also found that the incidence rate for new cases of sleepwalking was 3.2 percent during the follow-up period, while the incidence rate for new cases of bedwetting was less than one percent. "Current wisdom was that most of these behaviors remitted by adolescence," said principal investigator Stuart F. Quan, MD, professor emeritus of medicine at the University of Arizona in Tucson, Ariz. "Our data indicate that in a number of children, they will persist. Because parasomnias such as sleepwalking can be injurious as children grow older, parents need to be cognizant and be prepared to protect them from injury." Quan added that bedwetting can be an embarrassing problem for adolescents. However, a variety of treatments are available, and in most cases the problem will abate by adulthood. Parents can get help for their child's or teen's sleep problems at an AASM-accredited sleep disorders center. The study involved 310 children in the Tucson Children's Assessment of Sleep Apnea Study (TuCASA), a prospective cohort study that enrolled children between the ages of 6 and 11 years for an initial assessment. The children were studied again after a mean interval of 4.6 years. At both time points parents were asked to complete comprehensive sleep habits surveys. Results also show that all cases of sleep terrors remitted by adolescence. The most common problem was sleep talking, which had a prevalence rate of 22.3 percent and persisted into adolescence in 46 percent of cases. However, Quan noted that sleep talking typically is a minor hindrance that requires no treatment. In The International Classification of Sleep Disorders, Second Edition, published by the American Academy of Sleep Medicine in 2005, sleepwalking, sleep terrors and bedwetting -- also called "sleep enuresis" -- are classified as parasomnias. This group of 12 sleep disorders involves undesirable behaviors that occur while falling asleep, during sleep or while waking up. Children who sleepwalk may walk toward a window or even go outside, which can put the child at risk. During an episode of sleep terrors, a child sits up in bed with a look of intense fear and makes a piercing scream or cry. Bedwetting is considered to be a sleep disorder only when it occurs at least twice a week during sleep after 5 years of age. Sleep talking -- also called "somniloquy" -- is classified as a normal variant. It is often associated with parasomnias and can occur with varying degrees of comprehensibility. The study was supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health. The SLEEP 2010 abstract supplement is available for download on the website of the journal Sleep at http://www.journalsleep.org/ViewAbstractSupplement.aspx. A joint venture of the American Academy of Sleep Medicine and the Sleep Research Society, the annual SLEEP meeting brings together an international body of more than 5,000 leading clinicians and scientists in the fields of sleep medicine and sleep research. At SLEEP 2010 more than 1,100 research abstract presentations will showcase new findings that contribute to the understanding of sleep and the effective diagnosis and treatment of sleep disorders such as insomnia, narcolepsy and sleep apnea. Abstract Title: Prevalence, incidence, and remission of parasomnias among adolescent children in the Tucson Children's Assessment of Sleep Apnea Study (TuCASA) Category: Sleep Disorders -- Parasomnias Abstract ID: 0672 Presentation Date: Monday, June 7, 2010 Presentation Type: Poster - #251 Presentation Time: 10:30 a.m. - 12:30 p.m.

Jun 6, 2010

Health

Second-line CML drug evokes faster response, fewer side effects, pivotal study finds

CHICAGO - Dasatanib, a medication currently approved as treatment for drug-resistant chronic myeloid leukemia (CML), provided patients with quicker, better responses as a first therapy than the existing front-line drug, according to researchers at The University of Texas MD Anderson Cancer Center. The findings were presented at the 46th Annual Meeting of the American Society of Clinical Oncology today, and published in the New England Journal of Medicine. Hagop Kantarjian, M.D., professor and chair of MD Anderson's Department of Leukemia, presented the findings and is the corresponding author on the published study. Currently, imatinib, or Gleevec ®, is the approved initial therapy for CML, which has increased the five-year survival rate for the disease from 50 percent to 90 percent, said Kantarjian. However, 30-40 percent of imatinib patients do not achieve confirmed cytogenic complete response (CCyR), or the absence of the defective chromosome that causes the disease, within a year. This benchmark is clearly associated with improvements in long-term outcome, said Kantarjian. "Previous research conducted at MD Anderson found that more patients taking dasatinib were achieving complete responses more quickly than they do on the current standard of care," said Kantarjian. "In this pivotal Phase III study, we confirmed that dasatinib gets more patients to high-quality remission faster than imatinib, making it a superior front-line therapy. Dasatinib, on average, also has a more favorable side-effect profile." For the multinational Phase III study, known as DASSIN (Dasatinib versus Imatinib Study In treatment-naïve CML patients), 519 newly diagnosed CML patients who had received no prior treatment were randomized to receive either dasatinib, also known as Sprycel ®, 100 milligrams once daily (259 patients), or imatinib, 400 milligrams once daily (260 patients). CCyR, confirmed on two assessments, was the study's primary endpoint. Secondary endpoints included rate of and times to CCyR and major molecular response (MMR), defined as a level of .1 percent or lower of the defective chromosome, as well as safety. After a minimum follow-up of 12 months, the researchers found that the rates of confirmed CCyR and MMR in those taking dasatinib were 77 percent and 46 percent, respectively, compared to 66 percent and 28 percent, on the imatinib arm. Therapy failed in nine patients (3.5 percent) in those taking imatinib, compared to five patients (1.9 percent) taking dasatanib. The dasatanib arm reported fewer side effects - nausea, vomiting, muscle inflammation, rash, fluid retention - with most other toxicities being similar in both arms. "We've learned that in cancer therapy, it's important to use your big guns up front. We know that achieving complete cytogenetic response within a year of starting treatment is associated with more favorable long-term survival; therefore, using this second-generation drug first will likely improve outcomes for patients with chronic myeloid leukemia," said Kantarjian. CML is caused by an abnormality known as the Philadelphia chromosome that produces an aberrant protein, Bcr-Abl, which causes the overproduction of one type of white blood cell that drives the disease. Dasatinib, a tyrosine kinase inhibitor, blocks the action of Bcr-Abl; the drug is currently approved by the U.S. Food and Drug Administration for patients who can't tolerate imatinib or whose CML resists the drug. The study was supported by Bristol-Myers Squibb, makers of dasatinib. Kantarjian receives research funding from the company. In addition to Kantarjian, other authors on the ASCO study include: Jorge Cortes, M.D., Department of Leukemia, MD Anderson; Neil Shah, M.D., Ph.D., San Francisco School of Medicine; Andreas Hochhaus, M.D., Universitaetsklinikum Jena; Sandip Shah, M.D., Vedanta Institute of Medical Sciences; Manuel Ayala, M.D., Centro Medico Nacional La Raza; Beatriz Moiraghi, M.D., Hospital General De Agudos J.M. Ramos; Mejia M. Brigid Bradley-Garelik, M.D, Bristol-Myers Squibb; Chao Zhu, Ph.D., Bristol-Myers Squibb, and Michele Baccarani, M.D., University of Bologna. About M. D. Anderson The University of Texas M. D. Anderson Cancer Center in Houston ranks as one of the world's most respected centers focused on cancer patient care, research, education and prevention. M. D. Anderson is one of only 40 comprehensive cancer centers designated by the National Cancer Institute. For six of the past eight years, including 2009, MD Anderson has ranked No. 1 in cancer care in "America's Best Hospitals," a survey published annually in U.S. News & World Report.

Jun 5, 2010

Health

Sleep apnea patients using oral appliance therapy show high efficacy and compliance

WESTCHESTER, Ill. -- According to new research that will be presented on Saturday, June 5, at the 19th Annual Meeting of the American Academy of Dental Sleep Medicine, between 31 and 53 months after beginning oral appliance therapy, the sleep apnea treatment remained effective. Subjective daytime sleepiness, fatigue severity, and quality of life also remained improved. Mandibular advancement appliances (MAA) have been shown to safely and effectively treat mild to moderate obstructive sleep apnea (OSA). The aim of this study was to assess the efficacy of two different MAA over time from a previous comparative study (PCS). This Canada-based study included four women and 10 men who had participated in a PCS that tested two oral appliances in a randomized cross-over design. The participants were 52 years of age on average. Each participant took three polysomnograms (PSG): one baseline from the PCS, a night with the appliance they selected at the end of the PCS, and a follow-up night. Results indicate that respiratory disturbance index (RDI) was significantly reduced from baseline (10.4±1.3) to the night at the end of the PCS (5.7±1.1) and remained low at follow-up (4.5±0.7). Before each PSG, subjects completed the Epworth Sleepiness Scale (ESS), the fatigue severity scale (FSS), and a quality of life questionnaire (FOSQ). Questionnaire results revealed that the ESS, FSS, and FOSQ were all significantly improved from baseline to the night at the end of the PCS and remained improved at follow-up. Participants reported a high compliance, wearing their MAA 7.1 hours a night, 6.4 nights a week. A second arm was added to fit a dorsal harness in an attempt to eliminate positional apnea. The addition of a dorsal harness was effective, although compliance was poor. Five subjects agreed to wear the harness. It was effective for four subjects, but only one agreed to wear it after a one-month trial. "The study showed excellent long-term compliance with oral appliances as well as a high efficiency and a very positive effect on blood pressure and cardiac rhythm," said lead author Luc Gauthier, DMD, MSc. "Efficiency continued to improve even though, on average, the subjects had a higher body mass index during follow-up," said Gauthier. This abstract will receive the Clinical Research Award at the 19th Annual Meeting. This research was supported by FODQ-FRSQ, CIHR & Sogedent. The appliances were provided by Klearway and Silencer in Canada and the harness by Amrein in Switzerland. The AADSM Annual Meeting will bring together almost 700 international clinical and research leaders in dental sleep medicine to present and discuss new findings and developments related to sleep-related breathing disorders, including obstructive sleep apnea (OSA), upper-airway resistance syndrome (UARS), and snoring. The three-day scientific meeting will be held in conjunction with SLEEP 2010, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society in San Antonio, Texas. Learn more at www.aadsm.org. Abstract Title: Follow-Up Study of Two Mandibular Advancement Appliances: Preliminary Results Presentation Date: Saturday, June 5, 2010 Category: Clinical Research Award Abstract ID: 011

Jun 4, 2010

Health

Nasendoscopy proves useful in predicting treatment success in sleep apnea patients

WESTCHESTER, Ill. -- According to new research that will be presented on Saturday, June 5, at the 19th Annual Meeting of the American Academy of Dental Sleep Medicine, nasendoscopy may help dentists predict oral appliance therapy success in sleep apnea patients. Nasendoscopy involves a flexible endoscope being inserted through the nasal cavity. The tip of the scope is placed at the level of the velopharynx and oro-/hypopharynx. OAT has been shown to be a safe and effective treatment for patients with obstructive sleep apnea (OSA). This therapy is indicated for use in patients with mild to moderate OSA on the basis of the apnea-hypopnea index (AHI). However, it has been reported that some patients with severe OSA also benefit from OAT. Such findings suggest that patients should not be selected for OAT based on AHI alone. This Japan-based study included 21 severe OSA patients (AHI>30) comprised of 18 men and three women. OSA severity was diagnosed with overnight polysomnography (PSG). Subjects ranged from 35 to 78 years of age. During the nasendoscopy, patients laid supine in a dental chair. Researchers observed changes in the width of the velopharynx and oro-/hypopharynx. After several weeks of wearing an oral appliance during sleep, each subject took a second PSG with the device. AHI reduction rates from OAT were compared between patients who did and did not show throat widening during the nasendoscopy. All severe OSA patients showed improved AHI following OAT. All subjects experienced oro-/hypopharyngeal widening, but only 16 subjects demonstrated velopharyngeal widening. The AHI reduction rate for patients with velopharyngeal widening was 79 percent. The reduction rate for patients without velopharyngeal widening was 45 percent. The difference between the two groups was significant. The direction of the velopharyngeal widening, 'all-round' or 'lateral dominant,' was independent of patient response. Results indicate that patients who showed velopharyngeal widening during a nasendoscopy responded most effectively to OAT. These findings suggest that velopharyngeal widening observed when advancing the mandible from the centric occlusal position is associated with better OAT outcome. Lead author Yasuhiro Sasao, DDS, PhD, suggests that nasendoscopies can help dentists predict patient response to OAT, reducing waste of resources and time. "In Japan, nasendoscopy is used in dentistry and medicine to diagnose or evaluate oral function such as speech and swallowing -- the system is simple and relatively inexpensive," said Sasao. This abstract will receive the Clinical Research Award at the 19th Annual Meeting. The AADSM Annual Meeting will bring together almost 700 international clinical and research leaders in dental sleep medicine to present and discuss new findings and developments related to sleep-related breathing disorders, including obstructive sleep apnea (OSA), upper-airway resistance syndrome (UARS), and snoring. The three-day scientific meeting will be held in conjunction with SLEEP 2010, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society in San Antonio, Texas. Learn more at www.aadsm.org. Abstract Title: Videondoscopic diagnosis for predicting response to oral appliance therapy in obstructive sleep apnea Presentation Date: Saturday, June 5, 2010 Category: Clinical Research Award Abstract ID: 001

Jun 4, 2010

Health

Tongue measurements may help dentists determine oral appliance therapy success for sleep apnea

WESTCHESTER, Ill. -- According to new research that will receive the Graduate Student Research Award on Saturday, June 5, at the 19th Annual Meeting of the American Academy of Dental Sleep Medicine, the ratio between tongue volume and bony enclosure size in patients with obstructive sleep apnea (OSA) may help dentists calculate oral appliance treatment success. Although mandibular advancement splints (MAS) have been shown to be a safe and effective treatment for OSA, predicting efficacy in individual patients is problematic. The researchers assessed whether anatomical factors such as craniofacial size, upper-airway soft tissue volume, and/or the anatomical balance between them, were associated with MAS treatment outcome. The study included 49 OSA patients. Patients were at least 18 years of age and had mild to severe sleep apnea. They were without other sleep disorders or serious comorbid medical or psychiatric disorders. Each patient was fitted for a custom two-piece MAS, which was worn during sleep. Treatment outcome was assessed by polysomnography after approximately six weeks of oral appliance therapy. Of the 49 patients, 24 responded to the treatment, demonstrating an apnea-hypopnea index (AHI) reduction of 50 percent or more. Body mass index and age did not differ between responders and non-responders, but responders did have a lower baseline AHI, indicating that their sleep apnea was less severe before treatment. Tongue cross-sectional area (CSA) was measured in a subset of 28 patients, including 12 responders and 16 non-responders. The measurements were taken using cephalometric soft-tissue imaging. Responders had a larger tongue CSA than non-responders, but there was no difference in the bony oral enclosure CSA. The ratio of tongue to bony enclosure CSA significantly differed between responders and non-responders, indicating the ratio as a significant predictor of response to treatment. Because patients who responded to MAS treatment had a larger tongue volume for a given oral cavity size, the researchers suggest that determining this ratio may help predict MAS treatment success. "While this study re-affirms the difficulties in predicting OSA treatment response to mandibular advancement splints, responders seem to have a larger tongue volume for a given oral cavity site, suggesting that MAS may help correct anatomical imbalances," said lead author Whitney Mostafiz. The AADSM Annual Meeting will bring together almost 700 international clinical and research leaders in dental sleep medicine to present and discuss new findings and developments related to sleep-related breathing disorders, including obstructive sleep apnea (OSA), upper-airway resistance syndrome (UARS), and snoring. The three-day scientific meeting will be held in conjunction with SLEEP 2010, a joint venture of the American Academy of Sleep Medicine and the Sleep Research Society in San Antonio, Texas. Learn more at www.aadsm.org. Abstract Title: Influence of Oral Dimensions on Mandibular Advancement Splint Treatment Outcome in Obstructive Sleep Apnea Presentation Date: Saturday, June 5, 2010 Category: Graduate Student Research Award Abstract ID: 021

Jun 4, 2010

Blog Entry

Hip exercises found effective at reducing, eliminating common knee pain in runners

A twice weekly hip strengthening regimen performed for six weeks proved surprisingly effective at reducing -- and in some cases eliminating -- knee pain referred to as patellofemoral pain (PFP) in female runners. The study by Tracy Dierks, assistant professor in the Department of Physical Therapy at Indiana University-Purdue University Indianapolis, was based on the theory that stronger hips would correct running form errors that contribute to PFP, even though study participants were given no instruction in gait training. The study used a pain scale of 0 to 10, with 3 representing the onset of pain and 7 representing very strong pain -- the point at which the runners normally stop running because the pain is too great. The injured runners began the six-week trial registering pain of 7 when they ran on a treadmill and finished the study period registering pain levels of 2 or lower; i.e. no onset of pain. "I wasn't expecting such huge reductions, to be honest," Dierks said. "We've had a couple of runners who have been at level 2, but the overwhelming majority have been a 2 or below." PFP, one of the most common running injuries, is caused when the thigh bone rubs against the back of the knee cap. Runners with PFP typically do not feel pain when they begin running, but once the pain begins, it gets increasingly worse. Once they stop running, the pain goes away almost immediately. Dierks said studies indicate PFP essentially wears away cartilage and can have the same effect as osteoarthritis. His study participants showed many of the classic signs of PFP, the most prominent being their knees collapsing inward when running or doing a squat exercise move. The pilot study thus far involved five runners and a control group that comprised another four runners. Hip strength measurements were taken before and after the runners in the control group maintained their normal running schedule for six weeks. Hip strength measurements were taken for all of the runners before and after the next six-week period in which they all performed the hip-strengthening exercises. The exercises, performed twice a week for around 30 to 45 minutes, involved single-leg squats and exercises with a resistance band, all exercises that can be performed at home. This study is part of an ongoing study involving hip exercises and PFP pain, with 11 runners successfully using the intervention. Dierks said he plans to seek funding to test the exercises on a larger group of runners. Earlier research had focused on the feet as a possible root of PFP, with studies only recently looking more closely at the hips. Dierks said studies have found an association between PFP in women and weak hips, but his study is the first to test a possible treatment. He noted that PFP is considered "multi-factorial," so his study is examining one of several possible causes of the pain. Dierks will present the findings of his study, "The effect of hip muscle strengthening on pain when running in females with patellofemoral pain," on Friday, June 4, at 4:15 p.m. during the gait analysis II session. Co-investigators are Zachary H. Gergory, Rebecca L. Phipps and Peter A. Altenburger, all of IUPUI. Dierks can be reached at [email protected] and 317-274-3147.

Jun 4, 2010