Stress Makes Your Hair Go Gray

Those pesky graying hairs that tend to crop up with age really are signs of stress, reveals a new report in the June 12 issue of Cell, a Cell Press publication.

Researchers have discovered that the kind of “genotoxic stress” that does damage to DNA depletes the melanocyte stem cells (MSCs) within hair follicles that are responsible for making those pigment-producing cells. Rather than dying off, when the going gets tough, those precious stem cells differentiate, forming fully mature melanocytes themselves. Anything that can limit the stress might stop the graying from happening, the researchers said.

“The DNA in cells is under constant attack by exogenously- and endogenously-arising DNA-damaging agents such as mutagenic chemicals, ultraviolet light and ionizing radiation,” said Emi Nishimura of Tokyo Medical and Dental University. “It is estimated that a single cell in mammals can encounter approximately 100,000 DNA damaging events per day.”

Consequently, she explained, cells have elaborate ways to repair damaged DNA and prevent the lesions from being passed on to their daughter cells.

“Once stem cells are damaged irreversibly, the damaged stem cells need to be eliminated to maintain the quality of the stem cell pools,” Nishimura continued. “We found that excessive genotoxic stress triggers differentiation of melanocyte stem cells.” She says that differentiation might be a more sophisticated way to get rid of those cells than stimulating their death.

Nishimura’s group earlier traced the loss of hair color to the gradual dying off of the stem cells that maintain a continuous supply of new melanocytes, giving hair its youthful color. Those specialized stem cells are not only lost, they also turn into fully committed pigment cells and in the wrong place.

Now, they show in mice that irreparable DNA damage, as caused by ionizing radiation, is responsible. They further found that the “caretaker gene” known as ATM (for ataxia telangiectasia mutated) serves as a so-called stemness checkpoint, protecting against MSCs differentiation. That’s why people with Ataxia-telangiectasia, an aging syndrome caused by a mutation in the ATM gene, go gray prematurely.

The findings lend support to the notion that genome instability is a significant factor underlying aging in general, the researchers said. They also support the “stem cell aging hypothesis,” which proposes that DNA damage to long-lived stem cells can be a major cause for the symptoms that come with age. In addition to the aging-associated stem cell depletion typically seen in melanocyte stem cells, qualitative and quantitative changes to other body stem cells have been reported in blood stem cells, cardiac muscle, and skeletal muscle, the researchers said. Stresses on stem cell pools and genome maintenance failures have also been implicated in the decline of tissue renewal capacity and the accelerated appearance of aging-related characteristics.

“In this study, we discovered that hair graying, the most obvious aging phenotype, can be caused by the genomic damage response through stem cell differentiation, which suggests that physiological hair graying can be triggered by the accumulation of unavoidable DNA damage and DNA-damage response associated with aging through MSC differentiation,” they wrote.

Notes:
The researchers include Ken Inomata, Kanazawa University, Takaramachi, Kanazawa, Ishikawa, Japan, KOSEМЃ Corporation, Tokyo, Japan, Hokkaido University Graduate School of Medicine; Takahiro Aoto, Kanazawa University, Takaramachi, Kanazawa, Ishikawa, Japan, Tokyo Medical and Dental University, Tokyo, Japan; Nguyen Thanh Binh, Kanazawa University, Takaramachi, Kanazawa, Ishikawa, Japan; Natsuko Okamoto, Kanazawa University, Takaramachi, Kanazawa, Ishikawa, Japan, Kyoto University Graduate School of Medicine, Kyoto, Japan; Shintaro Tanimura, Kanazawa University, Takaramachi, Kanazawa, Ishikawa, Japan, Hokkaido University Graduate School of Medicine; Tomohiko Wakayama, Kanazawa University, Ishikawa, Japan; Shoichi Iseki, Kanazawa University, Ishikawa, Japan; Eiji Hara, The Cancer Institute, Japanese Foundation for Cancer Research, Tokyo, Japan; Takuji Masunaga, KOSEМЃ Corporation, Tokyo, Japan; Hiroshi Shimizu, Hokkaido University Graduate School of Medicine; and Emi K. Nishimura, Kanazawa University, Takaramachi, Kanazawa, Ishikawa, Japan, Tokyo Medical and Dental University, Tokyo, Japan.

Inomata et al.: “Genotoxic Stress Abrogates Renewal of Melanocyte Stem Cells by Triggering Their Differentiation.” Publishing in Cell 137, 1088-1099, June 12, 2009. DOI 10.1016/j.cell.2009.03.037.

Source:
Cathleen Genova

Cell Press

The Young & the Vigorous: Study Explains Aging Stem Cell Behavior

A comprehensive study from Canada’s Robarts Research Institute has pinpointed two genes that shed significant light on
why stem cells divide and develop less vigorously as we age.

This research is the first to provide an explanation of how a range of genes regulates human stem cell behavior — and the
first to suggest that this behavior may be regulated by genetic mechanisms found in most human cells. The study was led by
Robarts Scientist Dr. Mick Bhatia and published in this month’s issue of the journal Developmental Cell, available online as
of May 2.

“The current thinking is that there must be some unique ‘stemness’ gene that no other cell expresses, but what we found is
that what makes stem cells special — their ability to renew themselves and differentiate into other tissue types — may be
attributed to fundamental mechanisms of cell physiology common to all cells,” said Dr. Bhatia, Director of the Krembil Centre
for Stem Cell Biology at Robarts Research Institute and Canada Research Chair in Stem Cell Biology and Regenerative Medicine
at The University of Western Ontario’s Schulich School of Medicine in London, Ontario.

“The difference between those robust, self-replicating young hematopoietic (blood-forming) stem cells and older cells appears
to be the degree of expression of these two regulatory genes governing fundamental cell physiology. This basic biological
understanding is of critical importance as we explore ways to safely and effectively harness the clinical potential of these
cells to repair and regenerate damaged tissue.”

Using leading technology in cell purification, genomics and bioinformatics, Dr. Bhatia’s team compared the genetic profiles
of 112 individual samples of highly purified populations of human blood-forming stem cells found in early gestational blood,
umbilical cord blood and adult bone marrow samples collected and meticulously analyzed over the past seven years.

Among their broad research questions: What it is that gives young stem cells their ability to divide and develop so
vigorously? What causes this activity to drop off over time, such as in the adult bone marrow where blood cells are renewed
more slowly as we age?

The team honed in on two regulatory genes — called HES-1 and HLF — that function in high gear in the developing embryo to
drive the complex cellular processes that form the human blood system. The expression of these genes drops off significantly
as blood-forming stem cells age in adulthood.

Surprisingly, each gene uses a different mechanism to regulate human stem cells: HES-1 activates signals that cause stem
cells to divide more often; HLF turns on other signals that prevent stem cells from dying. The effect of each boosts the
number and activity of stem cells early in human development.

“Up until now I’d say we were merely testing candidate genes and trying to pinpoint which of these could be responsible for
regulating the behavior of human hematopoietic (blood-forming) stem cells,” Dr. Bhatia said. “This study allows us to say:
‘Here’s what genes really impact the stem cells that form the human blood system.’ Now we need to look at what it is that is
turning on these two regulatory genes and what genes they in turn regulate.”

Funding and support for this research was provided by the National Cancer Institute of Canada, Canadian Institutes of Health
Research, the National Centre of Excellence Program, Stem Cell Network-Stem Cell Genomics/Genome Canada, the London Regional
Genomics Centre, the Krembil Foundation, the Canada Research Chair program and a postgraduate scholarship award from the
Ontario Graduate Society.

Robarts Research Institute
P.O. Box 5015, 100 Perth Dr.
London, Ontario N6A 5K8
Canada
robarts

Simbionix To Reveal Two New Products At The Upcoming American Urology Association (AUA) Annual Meeting

Simbionix USA Corporation, the world’s leading provider of medical education and simulation training products for medical professionals and the healthcare industry, is launching two new hands-on training systems- the Lap Nepherctomy simulation module and the VirtaMed TURPSim. Both solutions will be revealed for the first time at the AUA annual meeting in San Francisco next week.

The Lap Nephrectomy simulation system is a unique replication of one of the most advanced laparoscopic procedures. While studies show that the laparoscopic nephrectomy procedure offers improved quality of life at lower costs, it is at the same time considered to be a challenging surgery with a steep learning curve. The solution provided by Simbionix will enable urologists to practice the procedure in a virtual clinical environment without risks to patients or recurring training costs. It is expected that the potential for unlimited access to training may reduce intra-operational complications associated with this procedure.

The new VirtaMed TURPSim simulation system is the latest development from VirtaMed who joined forces with Simbionix in 2009 to provide GYN and Urologist surgeons with the most advanced training systems for endoscopic surgery. Trans-Urethral Resection of the Prostate (TURP) is the current gold standard in the treatment of Benign Prostate Hyperplasia (BPH). With a wide range of prostate anatomies, pathologies and operative complications, this technique requires skills training and experience to achieve optimal results. The new VirtaMed TURPSim provides comprehensive training on the skills necessary to perform this procedure and will enable practice of complete TURP procedures using an authentic resectoscope.

Gary Zamler, Simbionix CEO, commented “Simbionix is a pioneer in the field of medical education, and for the past ten years has continuously introduced ground breaking technology that has changed and shaped the face of medical education. Our commitment to the medical community is to provide all medical fields with new and advanced training tools, as demonstrated by these latest developments intended for urologists. Our strong partnership with VirtaMed is based on this same philosophy intended to advance clinical performance.”

“The combination of TURPSim and HystSim provides a realistic platform for full procedural training in both urology and gynaecology. We are excited to continue our collaboration with Simbionix to ensure that every training center has the option to add the TURPSim to its training portfolio,” says VirtaMed CEO Stefan Tuchschmid. “VirtaMed will continue to focus on developing new simulators with the highest possible realism, and Simbionix is a partner who supports us in every possible way.”

About Simbionix USA Corporation

Simbionix is the world’s leading provider of simulation and training products for medical professionals and the healthcare industry. Founded in 1997, the company is committed to delivering high quality products, advancing clinical performance and optimizing procedural outcomes. Simbionix cooperates with physicians on a regular basis to produce the most reliable and effective training and supporting systems

About VirtaMed

VirtaMed is a Swiss based company with an interdisciplinary background in medicine and engineering. The HystSim(TM) and TURPSim(TM) systems are the first VirtaMed product and provide instructional teaching and training of hysteroscopy and the transurethral resection of the prostate. VirtaMed’s mission is to develop state-of-the-art training tools for endoscopic surgery of highest possible realism, all with the ultimate goal to improve the quality of patient care.

Source: Simbionix USA Corporation

Benefits Of Long-Term Exercise, Healthy Eating Habits In Young Adults

Despite mounting public health concerns about obesity and persistent social pressures dictating that slim is beautiful, young women in their ’20s consistently exercise less than young men.

And young black women showed significant declines in exercise between 1984 and 2006, according to a University of Michigan study to be published in the October issue of the American Journal of Public Health.

The study is one of the first to analyze long-term patterns in weight-related activities, and to assess how these patterns vary by gender, race and ethnicity, and socioeconomic status.

The disparities in health behaviors the study reveals are consistent with disparities in the prevalence of obesity, particular among women, according to Philippa Clarke, lead author of the study and a researcher at the U-M Institute for Social Research (ISR).

The study is based on data obtained every two years from 17,314 men and women who were aged 19 to 26 between 1984 and 2006. The participants were part of a follow-up panel drawn from the Monitoring the Future Study, conducted by ISR. The analysis was funded by the Robert Wood Johnson Foundation, as part of the Youth, Education, and Society Project, also based at ISR.

For the study, the researchers looked at trends over a 23-year-period in six different health behaviors. They measured how often participants reported eating breakfast, and eating at least some green vegetables and fruit; how often they exercised vigorously (jogging, swimming, or calisthenics); how often they got at least seven hours of sleep, and how much television they watched on an average weekday.

“Agreement is growing that the source of the obesity epidemic lies in an environment that produces an energy gap, where energy intake exceeds energy expenditure even by as little as 100 excess calories per day,” wrote Clarke and co-authors Patrick O’Malley, Lloyd Johnston, John Schulenberg and Paula Lantz, all researchers at ISR.

The finding that young women consistently exercised less than young men, suggests that differences in energy expenditure could play a role in gender disparities in obesity and overweight.

The frequency of eating fruit and vegetables remained relatively stable among young adult women but declined significantly among young men. Young men also reported eating breakfast less often than did young women.

Both men and women reported a steady decline in the frequency of getting at least seven hours of sleep each night.

Despite the focus on television viewing as an important determinant of obesity, the researchers found that the amount of time men and women spent watching TV stayed relatively stable.

When the researchers compared behaviors of different racial and ethnic groups, they found some major differences. For example, although white women showed a steady increase in the frequency of eating breakfast, the trajectory for non-Hispanic black women declined until 1996 and only began to increase in 2000.

Although fruit and vegetable consumption changed little among young adults, consumption of both was consistently lower among black and Hispanic men and women in any given year.

And although the frequency of exercise remained relatively stable among young adult women in general, among black women, the frequency of exercising steady declined.

In addition, black and Hispanic women showed greater declines than white women in the frequency of getting at least seven hours of sleep a night. They also were less likely than white women to report eating breakfast, and eating fruits and vegetables.

Among men, those from lower socioeconomic backgrounds reported dramatic declines in sleep, after adjusting for race and ethnicity.

Minority racial and ethnic groups, and women from lower socioeconomic groups, also reported watching television more often than whites and women from more affluent backgrounds.

Source:
Diane Swanbrow

University of Michigan

Preserving Therapeutic And Sustainable Plant Species

Sacred Seeds, a non-profit organization committed to preserving both sacred medicinal plant species and the ancient wisdom about their therapeutic and sustainable use, is pleased to announce that Sri Uma Maheshwara Seva Trust (“Hosagunda”), in the state of Karnataka, India, has become a foundational garden in the international Sacred Seeds movement. Developed to help stem the loss of biodiversity and health practices that depend on biodiversity, Sacred Seeds is helping local communities and institutions create gardens around the world that contain plants traditionally used for primary health care as well as nutritionally important species to improve local diets. These gardens serve as living genetic repositories helping to preserve the diversity of healing plants used by humankind. Sacred Seeds foundational gardens serve as vanguards of integrative ethnobotanical conservation and models for other communities across the globe.

It was also announced that Semillas Sagradas at Finca Luna Nueva in Costa Rica and Hosagunda have become “sister” gardens in the family of Sacred Seeds Sanctuaries. They, along with all of the Sacred Seeds gardens, are united in a shared devotion to the highest principles of plant conservation and traditional botanical wisdom.

Tom Newmark, chairman of Sacred Seeds and co-founder of Semillas Sagradas in Costa Rica, welcomed Hosagunda to “our international family of medicinal plant sanctuaries.” He further noted that “the great Ayurvedic and Sidha medical systems of India have brilliantly appreciated the healing power of medicinal plants for thousands of years, and Sacred Seeds is delighted that Hosagunda will represent those healing traditions in our family of plant sanctuaries.”

CMN Shastry, managing trustee of Hosagunda, expressed his hope that Hosagunda’s programs will inspire similar projects around the world. “Hosagunda,” he observed, “is a Sacred Forest rich with archeological relics of religious and cultural significance. We are reintroducing native herbal species of sacred and medicinal uses to create a living expression of ancient traditional medicine. By joining the international Sacred Seeds movement, we will study best practices from other sanctuaries and we hope inspire other cultures to integrate medicinal gardens with archeological restoration.”

The Sacred Seeds Project is administered by the William L. Brown Center at the Missouri Botanical Garden. Dr. Rainer Bussmann, director and William L. Brown Curator of Economic Botany, expressed his enthusiasm about the addition of Hosagunda to the Sacred Seeds Project. “Hosagunda is one of the few remaining fragments of forest in the densely populated agricultural landscape of Karnataka. With its 600 acres of sacred forest and temples, Hosagunda forms a real Eco-Spiritual Center, and is a wonderful example of conservation by revitalizing local traditions. We are thrilled to have it as part of Sacred Seeds.”

“Conventional biodiversity conservation seeks to “circle the wagons” so to speak around critically important but endangered wilderness habitats,” notes ethnobotanist Dr. Michael J. Balick, vice president and director of The New York Botanical Garden Institute of Economic Botany. “However, by identifying local communities that are enthusiastic about ethnomedicine and healing plants, and fostering the development of the Sacred Seeds network, the ‘wagons’ are being loaded with healing species and spreading and safeguarding their treasures around the world. Thankfully, the world’s people now recognize the importance of conserving the biosphere – Sacred Seeds builds on this awareness to preserve and foster traditional practices critical to primary health care delivery, part of the endangered ‘ethnosphere’ – the collective total of human wisdom so essential to our survival.”

Source:
Holly Berthold
Missouri Botanical Garden

Treating Male Infertility With Stem Cells

New research has examined the usefulness of bone marrow stem cells for treating male infertility, with promising results. The related report by Lue et al, “Fate of bone marrow stem cells transplanted into the testis: potential implication for men with testicular failure,” appears in the March issue of The American Journal of Pathology.

When a couple experiences infertility, the man is just as likely as the woman to be the cause. Male infertility may arise from failed proliferation and differentiation of the germ cells (precursors of sperm) or from dysfunction of the supporting cells. New research is looking to stem cells as a means of replacing nonfunctioning cells, whether germ cells or supporting cells.

Researchers, directed by Dr. Ronald S. Swerdloff of the Harbor-UCLA Medical Center, collected bone marrow stem cells from mice expressing the green fluorescent protein (GFP). These green cells, which could be easily tracked in recipient mice, were injected into the testes of infertile mice, in which infertility was induced either chemically or genetically (via mutations in a gene required for sperm production).

The donor GFP-expressing cells took up residence in the testes and survived within the recipient mice for the entire 12-week study period. The donor stem cells displayed the characteristic shape of either germ cells or supporting cells, suggesting that the stem cells had differentiated. These differentiated donor (green) cells were also found near the native recipient cells of the same type, demonstrating that the local cellular environment likely influenced the fate of the donor stem cells.

As further confirmation of the differentiation status of the donor cells, the expression of specific proteins on the cell surface was examined. Both germ and supporting cells expressed marker proteins known to be found only on the differentiated cells, not on stem cells.

These data demonstrate that bone marrow stem cells have the potential to differentiate into cells of the testes involved in sperm production, both germ cells and supporting cells. Interestingly, the germ cells did not differentiate fully into sperm, suggesting that additional factors or cellular signals are needed.

Future studies will characterize the other factors, such as hormones, required to complete sperm production in this transplant model. In addition, since the bone marrow cells used here represent a mixed population of stem cells, further studies will determine which specific stem cell type was able to colonize and differentiate in the testes. The results of future studies could have dramatic implications for treating male infertility or testosterone deficiency.

###

Lue YH, Erkkila K*, Liu PY*, Ma K, Wang C, Hikim AS, Swerdloff RS. Fate of bone marrow stem cells transplanted into the testis: potential implication for men with testicular failure. Am J Pathol 2007 170: 899-908.

*These authors contributed equally to this work as second author.

The American Journal of Pathology, the official journal of the American Society for Investigative Pathology (ASIP), seeks to publish high-quality original papers on the cellular and molecular mechanisms of disease. The editors accept manuscripts which report important findings on disease pathogenesis or basic biological mechanisms that relate to disease, without preference for a specific method of analysis. High priority is given to studies on human disease and relevant experimental models using cellular, molecular, biological, animal, chemical and immunological approaches in conjunction with morphology.

Contact: Audra Cox

American Journal of Pathology

Dynamic Electronic Tracking And Care Coordination Tools Save Lives Of Seniors, Study Finds

Can a patient-centered, care management program utilizing nurse care managers and interdisciplinary teams, supported by electronic tracking and care coordination systems reduce the rate of deaths and hospitalizations among chronically ill older adults? The answer – based on a three-year study involving more than 3,400 chronically ill seniors led by Oregon Health & Science University researcher David A. Dorr, M.D. – appears to be “yes.”

The study – described in the December 2008 Journal of the American Geriatrics Society – has broad implications for how the care of the more than 130 million Americans with chronic illnesses, two thirds of whom are 65 or older, is managed.

“This study underscores the enormous societal costs of a health care infrastructure that does not adequately support the interdisciplinary services and care coordination needed to prevent adverse outcomes for older adults with multiple chronic illnesses,” said Dorr, the study’s lead investigator and an assistant professor of medical informatics and clinical epidemiology at OHSU.

“Patients coping with two chronic health conditions are eight times as likely to die within a year as peers with one such illness, ” said Dorr. “Someone with three or more chronic illnesses has 40 times higher odds of being hospitalized than a person with a single chronic illness and 91 times higher odds than someone with no such illness. We also know that chronic conditions account for 83 percent of all healthcare spending and that the majority of cost increases in Medicare spending are due to patients with five or more chronic illnesses.”

The study – conducted between January 1, 2002 and June 30, 2005 at 13 primary care clinics at Intermountain Healthcare, a large not-for-profit integrated health care system in Utah – found that deaths among the 1,144 patients in the “intervention” group receiving optimum care, called Care Management Plus (CMP), were significantly lower in the first and second years than among the 2,288 patients in the control group whose members received the usual care.

Seven Intermountain clinics served the CMP patients and six the control group patients. Each CMP patient was matched with two control patients based on age, hospitalization records, comorbidity scores, gender, and specific chronic illnesses. The average age of all patients was 76. Three quarters of them had two or more chronic illnesses. Just over 64 percent were females.

In all, 6.5 percent of CMP patients died in the first year of enrollment versus 9.2 percent of control patients; 13.1 percent of CMP patients and 16.6 percent of controls died in the second year. CMP was a particular benefit for patients with diabetes – who constituted 48.7 percent of all patients in the study and had a significantly higher number of comorbidities. Their mortality rate at one year was 6.2 percent vs. 10.6 percent for controls; at two years it was 12.9 percent vs. 18.2 percent.

Hospitalizations were only slightly lower overall for CMP patients than for controls, but for diabetes patients in the CMP group they were significantly lower – 21.2 percent versus 25.7 percent for controls at one year and 30.5 percent versus 39.2 percent for controls at two years.

Intermountain Healthcare has a long history of innovative use of computers in improving healthcare. At the CMP clinics, computer tools were combined with a registered nurse who received extra training. Physicians referred patients with complex conditions to the nurse care manager who completed a patient assessment focused on self-efficacy, knowledge, readiness to change and patient-directed goal setting. The care manager then created with the patient a detailed care plan supported by specialized computer tools, including structured protocols and guidelines for various conditions and diseases, a care management tracking (CMT) database and detailed electronic patient worksheet. The care manager suggested medication changes or other treatments when indicated, helping physicians respond to patients’ needs more quickly and efficiently. The tools helped organize and prioritize the teams’ work.

“Family practice and internal medicine physicians are drowning in the huge number of things to consider for their patients, especially those with multiple conditions and medications,” said Cherie P. Brunker, M.D., co-principal investigator and Geriatrics Chief, Intermountain LDS Hospital and assistant professor of geriatric medicine, University of Utah Center on Aging. “Computer tools and a specially trained care manager can make all the difference.”

“It is clear,” Dorr concluded, “that to provide the kind of high quality and efficient coordination of care tracked in this study across the nation’s health care system will require the redesign of primary care as well as reform of the payment system and reinforcement from policymakers, but it would be an investment in the future health of the chronically ill patient population.”

###

The Care Management Plus system has been adopted by more than 50 clinics around the country in the past two years. Dorr and Brunker are working to add more to the list.

The CMP study was supported by a grant from the John A. Hartford Foundation. Dorr was also supported through grants from the National Library of Medicine. To access the study, “The Effect of Technology-Supported, Multidisease Care Management on the Mortality and Hospitalization of Seniors,” go to www3.interscience.wiley/journal/121475821

Source: Harry Lenhart

Oregon Health & Science University

New Tool Gives Better Insight Into Effects Of Dementia

Medical professionals will now be able to detect subtle changes in the quality of life of people with mild dementia, thanks to a new self-assessment technique that will help improve the timing of additional help and support.

One of the major problems with dementia is that it is difficult to assess the true impact on the person with the condition, particularly because worsening health does not inevitably lead to a reduction in quality of life.

However those whose quality of life is affected should soon be identified more easily, thanks to new research.

The new technique, developed by researchers from the Research Institute for the Care of the Elderly and the University of Bath, will allow patients to self-report their quality of life, providing valuable information about the experience of dementia from the perspective of the person with the condition.

This will enable medical professionals to help patients manage their condition more effectively, offering advice regarding additional support or care, so that any intervention more closely reflects the true needs of the patient.

The assessment, which has been developed with funding from the Alzheimer’s Society, is carried out as an interview with the patient, in which they answer a series of questions about different aspects of their life, using a simple response scale.

“For medical professionals and family members it can be very difficult trying to understand how a condition like dementia is affecting the quality of life of a person,” said Dr Richard Trigg from the University of Bath who developed the assessment.

“Dementia can affect different people in many different ways and we cannot assume that all people with dementia will have a negative quality of life.

“It is therefore essential that we find ways to assess quality of life, using information obtained directly from the person with dementia, if we are to properly understand the impact of the condition.

“By monitoring quality of life changes, medical professionals can chart the effectiveness of different treatments and therapies and more accurately determine when those interventions should be delivered.

“This is crucial to enabling the effective management of this cruel disease”

Information about the Bath Assessment of Subjective Quality of Life in Dementia (BASQID), is available to download from:
rice/BASQID.html

The University of Bath is one of the UK’s leading universities, with an international reputation for quality research and teaching. In 17 subject areas the University of Bath is rated in the top ten in the country.
View a full list of the University’s press releases:
bath.ac/news/releases

Vitamin D Deficiency Likely Among Some Kidney Disease Patients Starting Dialysis

Vitamin D deficiency is almost universal among kidney disease patients who have low blood protein levels and who start dialysis during the winter, according to a study appearing in an upcoming issue of the Clinical Journal of the American Society Nephrology (CJASN). The research identifies a group of patients who are at extremely high risk of being deficient in vitamin D and provides some clues as to why the deficiency occurs in these individuals.

Vitamin D deficiency is common in patients with end-stage renal disease (ESRD) on dialysis, but it’s not clear which patients are at increased risk. Ishir Bhan, MD, MPH (Massachusetts General Hospital), and his colleagues sought to determine whether routinely measured clinical and demographic characteristics could identify dialysis patients who have a high risk of vitamin D deficiency. The researchers analyzed data from 908 patients in the Accelerated Mortality on Renal Replacement (ArMORR) cohort, a nationally representative group of U.S. dialysis patients. Data from 60% of the patients were used to find potential predictors of vitamin D deficiency, while data from the other 40% of patients were used to validate the predictors.

The investigators found that 79% of the study population was vitamin D deficient. Black race, female sex, winter season, and low blood levels of the protein albumin (≤ 3.1 g/dL) were the strongest predictors of vitamin D deficiency. In the validation set, the presence of low blood albumin levels and winter season increased the likelihood of vitamin D deficiency in black females (from 90% to 100%), black males (from 85% to 100%), white females (from 82% to 94%), and white males (from 66% to 92%).

“This research identifies risk factors for nutritional vitamin D deficiency in the dialysis population and may provide clues to its biology in this population,” said Dr. Bhan. One interpretation of the finding that low blood albumin levels were associated with deficiency is that at-risk patients leak large amounts of protein in their urine. The investigators suspect that vitamin D binding protein, which transports the vitamin through the blood, may also be lost through the urine. Its loss could lead to the loss of vitamin D as well. In addition, while previous studies have suggested that patients on dialysis have an impaired ability to generate vitamin D from sun exposure, these findings emphasize that skin-based production of the vitamin is likely to be important in patients with ESRD.

Study co-authors include Sherri-Ann Burnett-Bowie, MD, MPH, Jun Ye, PhD, Ravi Thadhani, MD MPH (Massachusetts General Hospital), and Marcello Tonelli, MD (University of Alberta, Edmonton, Canada).

Disclosures: Dr. Thadhani has received research support from Abbott Laboratories. The remaining authors reported no financial disclosures.

The American Society of Nephrology (ASN) does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, the American Society of Nephrology (ASN) is the world’s largest professional society devoted to the study of kidney disease. Comprised of 11,000 physicians and scientists, ASN continues to promote expert patient care, to advance medical research, and to educate the renal community. ASN also informs policymakers about issues of importance to kidney doctors and their patients. ASN funds research, and through its world-renowned meetings and first-class publications, disseminates information and educational tools that empower physicians.

Source: American Society of Nephrology (ASN)

Novavision Presents Vision Restoration Therapy Data At The AAN Annual Meeting

NovaVision today presented data at the American Academy of Neurology (AAN) 59th Annual Meeting showing that more than 70% of study participants – stroke and traumatic brain injury (TBI) survivors with homonymous visual field defects – demonstrated a visual field improvement of greater than three percent following a standard six-module course of NovaVision VRT™ Vision Restoration Therapy™. A visual field improvement of three percent or greater has been shown previously in earlier studies to correlate with subjective improvement.

NovaVision VRT™ is the first and only FDA-cleared medical device or rehabilitative therapy clinically proven to improve visual field defects in stroke and TBI survivors who have been left partially blind due to their condition. Patients receive a customized program designed for their visual field deficits to use at home daily. Through a specific pattern of visual stimuli that gauge the user’s ability to identify and react, users can gradually expand their visual fields and restore lost vision. NovaVision VRT is based on the science of neuroplasticity the brain’s ability to adapt and form new connections to compensate for injury.

The data indicate that over 70% of study participants from 16 U.S. centers who underwent a six-module (six month) course of therapy showed a three percent or greater improvement in stimulus detection on visual field testing. The average improvement in stimulus detection was 12 percent. Previous studies suggest that people who regain three percent or more of their visual field have functional improvements that may include enhanced quality of life, better reading, watching television and athletics, although functional outcomes were not measured in this study. Age, type of visual field defect, or the amount time since the injury had no impact on the results.

“These results further validate our previous clinical studies showing the true benefits of NovaVision VRT for helping stroke and TBI patients improve their visual field loss,” said Jose Romano, M.D., Associate Professor Neurology, Cerebrovascular Division at the University of Miami, who is the presenter of the study results at the AAN.

Data supports that regardless of how much time has elapsed since a stroke or brain injury, therapeutic interventions such as VRT can improve visual field loss; this improvement can result in functional gains that were once believed lost forever.

There are approximately 1.5 million stroke and traumatic brain injury (TBI) survivors in the U.S. with visual field deficits. This number is increasing by 90,000 each year, according to the American Heart Association.

About NovaVision, Inc.

NovaVision, Inc., headquartered in Boca Raton, Fla., develops and provides scientifically based, innovative medical devices and comprehensive solutions to restore the vision of patients with neurological visual impairments. Nova Vision’s FDA-cleared NovaVisionVRT™ Vision Restoration Therapy™ (VRT) is based on neuroplasticity — the brain’s ability to adapt and form new connections to compensate for injury. NovaVision diagnostic testing maps areas where vision may be improved, and therapy targets and stimulates regions within the brain’s vision-processing areas.

VRT is based on more than 10 years of research with clinical studies published in leading journals including Nature Medicine, Neurology, and The Journal of Cognitive Neuroscience. Data from a recent retrospective study identified that more than 70 percent of U.S. patients who underwent VRT for an initial six-month treatment period showed significant improvements in their vision.

More than 1,000 patients have been treated with VRT and clinical results are positive. VRT is currently offered at leading neurological, eye and rehabilitation centers nationwide

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New York, NY
United States
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