Data from a clinical trial of amyotrophic lateral sclerosis (ALS) patients treated with stem cell technology reveals that the therapy has proven safe without causing significant side effects. Patients in the trial were transplanted with stem cells derived from their own bone marrow and treated with BrainStorm Cell Therapeutics’s NurOwn stem cell therapy. The initial phase of the study is designed to establish the safety of NurOwn and will later be expanded to assess efficacy.
Ovarian cancer screening popular despite guidelines
According to a new survey published in the Annals of Internal Medicine, a third of US primary care physicians believe ovarian cancer screening is effective and many would offer it to patients despite expert guidelines and scientific evidence to the contrary. “Currently the evidence suggests that the harms of ovarian cancer screening exceed the benefits,” said Dr. Laura-Mae Baldwin of the University of Washington in Seattle. “That’s why it is not being recommended.” Baldwin and her colleagues surveyed more than 1,000 doctors across the country, asking them questions about a hypothetical case of a woman presenting for her annual exam. Sixty-five percent of doctors said they “sometimes” or “almost always” offered or ordered ovarian cancer screening for women at medium risk and this number dropped to 29% for women at low risk. Screening is done either as an ultrasound scan or a CA-125 blood test.
Talking things through in your head may help autism
British scientists revealed that teaching autistic children how to develop inner speech skills might help them cope with daily tasks later in life. A study that was conducted by researchers at Durham, Bristol and City University London and published in the Development and Psychopathology journal involved 15 adults with high-functioning autism and 16 neurotypical adults for comparison. The volunteers were asked to complete a test of planning ability for which typical people would normally use “thinking in words” strategies. When the two groups were asked to do the task while also repeating outloudacertainword,suchas“Tuesday” or “Thursday” designed to distract them, the control group found the task much harder, while the autistic group were not bothered by the distraction. This study suggests that unlike neurotypical adults, participants with autism do not normally use inner speech to help themselves plan. These results also suggest that children with autism may do better at school if they are encouraged to learn their daily timetable verbally rather than using visualplans,whichiscurrentlyacommon approach.
FDA approves BTG’s drug for cancer toxicity
US health regulators approved a drug called Voraxaze from British specialty drugmaker, BTG Plc that helps cancer patients get rid of toxic levels of methotrexate. Prolonged exposure to methotrexate chemotherapy treatment can cause kidney and liver damage, skin rash and severe mouth sores, damage to the lining of the intestines, and death because of low blood counts. In a clinical trial of 22 methotrexate patients, Voraxaze eliminated 95% of methotrexate from their blood. For ten of the patients, the methotrexate fell to a low level within 15 minutes and stayed that way for eight days, the FDA said. Common side effects included low blood pressure, headaches, nausea, and vomiting.
New DNA reader to offer affordable gene sequencing
A new genome-sequencing machine from IonTorrent,adivisionofLifeTechnologies Corp. located in Connecticut, is 1,000 times more powerful than existing technology and is close to offering a read-out of a person’s complete genetic information for only $1,000. Taking up about as much space as an office printer, it can sequence an entire genome in a single day rather than six to eight weeks required only a few years ago. Ion Torrent will sell the tabletop machine, called the Ion Proton Sequencer, for $99,000 to $149,000, making it affordable for large medical practices or clinics; existing sequencers cost up to $750,000. The company has signed on Baylor College of Medicine, Yale School of Medicine, and the Broad Institute as its first customers.
Bread is a major culprit in high salt intake
About 90% of American adults consume too much salt and the leading culprit is not potato chips or popcorn but slices of bread and dinner rolls, revealed the Centers for Disease Control and Prevention (CDC). The CDC said that 40% of salt consumed can be linked to 10 types of foods: bread and rolls lead the list followed by cold cuts and cured meat, pizza, poultry, soups, sandwiches, cheese, pasta dishes, meat dishes, and snacks such as pretzels and potato chips. Bread may not have much salt in a single serving, but when eaten several times a day, it can significantly contribute to salt intake considering a single slice of white bread may contain as much as 230 mg of salt. The CDC recommended eating more fruits and vegetables and carefully reading the labels on food products to find those with the lowest salt content.
First patients shown to improve with embryonic stem cells
Before treatment, a 51-year-old graphic artist suffering from Stargardt’s disease, the most common form of macular degeneration in young patients was legally blind. Another 78-year old patient suffering from dry macular degeneration, the leading cause of blindness in the elderly could not see well enough to go shopping. After being treated with stem cells from a donated human embryo, both of these patients improved dramatically. A week after treatment, the graphic artist could count fingers, and after one month she could read the top five letters on the eye chart. She can see more color and contrast, has started using her computer, and for the first time in years can read her watch and thread a needle. The macular degeneration patient recently went to the mall for the first time in years. These results represent the first medical use of stem cells taken from human embryos, making them crucial barometers of whether the controversial technique will find widespread therapeutic uses.
Study finds no increased risk of heart disease in kidney donors
There is good news for the >27,000 people around the world who donate a kidney each year. A study led by Dr. Amit Garg at Lawson Health Research Institute followed living kidney donors for ten years and found that they were at no greater risk for heart disease than the healthy general population. The study involved 2,028 Ontarians who donated a kidney between 1992 and 2009, and 20,280 healthy non-donors for comparison. “We manually reviewed the medical charts of over 2,000 living kidney donors in Ontario and linked this information to universal healthcare databases to reliably follow major cardiovascular events,” says Dr. Garg. Despite reduced kidney function in the donors, the researchers found that donors had a lower risk of death and heart disease compared to non-donors. According to an accompanying editorial by researchers at the University of Michigan, the study resolves the uncertainty that persists about the full extent of risks assumed by living kidney donors and makes an important contribution to our understanding of the long-term consequences of living kidney donation.
FDA to evaluate ExAblate’s treatment of pain palliation and bone metastases
InSightec Ltd has submitted a premarket approval application (PMA) to the U.S. Food and Drug Administration (FDA) for its ExAblate treatment of pain palliation of bone metastases. Over 60% of cancer patients suffer from painful bone metastases and 30% of these patients will not respond to radiation therapy. ExAblate uses MR guided focused ultrasound (MRgFUS) to treat the pain caused by bone metastases non-invasively and without ionizing radiation. It combines high intensity focused ultrasound to thermally ablate tumors and continuous MRI to visualize the anatomy, plan treatment, and monitor treatment outcomes in real time. The PMA submission was based on a two-arm randomized controlled trial comparing patients undergoing ExAblate’s MR guided focused ultrasound for palliation of painful bone metastases with patients undergoing a sham treatment. Patients who had no response to the sham treatment were later allowedtoundergoanExAblatetreatment. Currently, ExAblate is the only MRgFUS system with FDA approval, which was granted in 2004 for uterine fibroids.
Dr Richard Nahas, md
Dr Richard Nahas, md
Seekers Centre for Integrative Medicine
In downtown Ottawa operates an exceptional facility of integrative medicine, established by the husband and wife team of Dr Shadi Nahas, PhD, Director of Research, and Dr Richard Nahas, MD, Medical Director. Richard’s training and continued commitment as an ER physician may not seem to be a typical path upon which a physician comes to embrace integrative medicine, yet it is precisely this path that the doctor credits with driving his vision of the facility existing today.
Following an undergraduate degree in biochemistry from Ottawa University, Richard attended medical school at the University of Toronto, completing his training in 1998. Typical of conventionally- trained physicians who go on to embrace integrative medicine, Richard felt there were gaps in knowledge during his training. His interest in integrative medicine began in his teen years in relation to application of principles of clinical nutrition in performance enhancement, sports psychology, and the notion of training the mind along with the body. He chose medicine as his path eager to learn the intricacies of the human body and was disappointed with the relative lack of knowledge academia was able to impart. The focus was on describing disease, with very poor understanding of the underlying causes of the diseases being studied.
He found himself gravitating towards emergency medicine, feeling it was what conventional medicine did best. Seeking an opportunity to learn a broader understanding of medicine, Richard began to travel the world delivering his ER skills to areas that seemed to require them most. His travels included elective study in Egypt, clinical rotation in Gaza, as well as service with Doctors Without Borders taking him to Johannesburg, Africa and the Amazon of South America. These travels further spurred his interest in integrative medicine. He found conventional medicines helped people in these settings in the short term, but felt the people were better served by their local medicines in terms of long term feasibility as well as chronic disease management. Travel experiences taught Richard that political/ economic factors are at the heart of healthcare issues in developing nations, as opposed to more medicine serving as a viable solution. Also, the experiences exposed Richard to a wide array of local, traditional healing systems that he found intriguing.
Richard returned to his home town of Ottawa resolved to serve his community with integrated systems of healing. While conventional medicine inarguably offers world- class care in emergency settings, Canada is entrenched in epidemics of chronic illness- the arena where integrative medicine demonstrates its greatest strength. Richard’s opinions and perspective on the integrative versus conventional medicine debate are certainly strong, however shortcomings of conventional models of care are not where he chooses to apply his focus. “I must balance my feelings of how much change is required”, Richard describes.
“There are many challenges that surface in operating an integrative practice, including lack of recognition and understanding from peers, the reality of practicing in isolation and an inability to consult with colleagues for direction on difficult cases, but this is typical of individuals who choose the path of a pioneer”.
So we pose the question to Richard that surely it would be easier to remain in ER practice… “When you believe in what you are doing, you see results, you know in your heart it is a better system of medicine… you don’t have a choice, you can’t go back”, he replied.
Being critical of conventional medicine does not improve the situation, and in fact serves little purpose other than to make things worse. An integrative physician truly hoping to impact the healthcare system must make effort to work with the system around them, regardless of obstacles that may present before them. Richard describes one example that exemplifies the requirement for integrative practitioners to consider efforts of collaboration among their highest priorities:
“The Seekers Centre of Integrative Medicine served as one centre for the TACT trial of chelation in secondary coronary prevention. One patient wanted to join the trial, but their local cardiologist instructed them not to join, stating that he did not believe in chelation. The cardiologist ended up being the chief cardiologist at the Ottawa Heart Institute. I undertook the task of contacting the cardiologist to discuss the role of chelation and the outcomes I had already witnessed it achieve in terms of angina treatment. We have since ended up being collaborators in many areas, he referred 50-60 patients that ended up as participants in the trial, and we are discussing conducting a trial together to assess vascular compliance at the Ottawa Heart Institute”.
