Global suicide rates may be reduced if the management of organophosphorus pesticide poisoning (OPP) were improved, according to a Review in an online edition of The Lancet.

Dr Michael Eddleston, Scottish Poisons Information Bureau, New Royal Infirmary, Edinburgh, Scotland, and team examined published articles on OPP during the period 1960-2006. They explained “Organophosphorous pesticide self-poisoning is a major clinical health problem across much of rural Asia. Of the estimated 500 000 deaths from self-harm in the region each year, about 60% are due to pesticide poisoning.”

Furthermore, they say that about 200,000 deaths, 60% of the total, are specifically due to OPP. Deaths as a result of accidental OPP are much less common, and seem to take place only in regions where the most toxic organophosphate pesticides are accessible.

Symptoms of OPP, caused by the over-stimulation of numerous receptors in the body, are:

– vomiting
– diarrhea
– sweating
– confusion
– agitation
– coma
– respiratory failure
– paralysis

There is still a great deal of uncertainty about the best use of common treatments for OPP, even though these treatments have been around for over 50 years. Commonly used treatments, such as atropine, oximes and diazepam have different levels of effectiveness, depending on which specific poison is affecting the patient. “However, consensus exists that early resuscitation with atropine, oxygen, respiratory support, and fluids are needed to improve oxygen delivery to tissues,” the authors say.

The authors believe larger trials are needed to see how effective magnesium sulphate might be – they suggest patients may benefit greatly from it. Gastric lavage (stomach pumping), a commonly used procedure for OPP, is only effective right at the beginning of the onset of symptoms. As the onset of symptoms is rapid the authors wonder how effective gastric lavage might be.

“Medical management of OPP is difficult, especially in resource poor locations where most of these patients present…We expect that in the next decade evidence from continuing research from Asia will finally provide clear guidance on how to treat OPP. Hopefully, this new guidance will include the use of novel antidotes that will reduce the case fatality from pesticide poisoning. However, some organophosphorus pesticides might prove very difficult to treat with current therapies, such that bans on particular pesticides could be the only method to substantially reduce the case fatality after poisoning,” the writers conclude.

lancet

A world-renowned team of experts in biomechanics and physiology from six universities, led by Professor Hugh Herr of the Massachusetts Institute of Technology’s Media Lab, refute scientific claims that the prostheses worn by Oscar Pistorius, a 21-year-old South African bilateral amputee track athlete, provide him with an unfair advantage in the 400-meter race. Their conclusions were based on data collected at the Rice University Locomotion Laboratory, under the direction of Professor Peter Weyand. Pistorius hopes to run in the 400-meter race at the Beijing Olympics this summer.

Based on the team’s findings, the Court of Arbitration for Sports (CAS) in Lausanne, Switzerland, has ruled that Pistorius is eligible to participate in International Association of Athletics Federations (IAAF) sanctioned competitions. If he qualifies for the 2008 Beijing games, Pistorius would be the first disabled athlete ever to run against able-bodied athletes in an Olympic event.

The team’s findings were presented to the CAS April 29-30 by Herr and Professor Rodger Kram of the University of Colorado at Boulder, and provided the foundation for Pistorius’ appeal to overturn the IAAF decision that previously banned him from running against able-bodied athletes in races that are governed by IAAF rules. The team’s findings were presented at the CAS, where Pistorius was represented by the international law firm of Dewey & LeBoeuf on a pro-bono basis.

In addition to Herr, Weyand and Kram, the panel of experts included Professor Matthew Bundle from the University of Wyoming, an expert in the energetics and mechanics of sprinting performance; Craig McGowan, from the University of Texas at Austin, a leading authority on muscle, tendon and joint mechanics; Alena Grabowski, from the Massachusetts Institute of Technology, an expert in human locomotor energetics and biomechanics; and Jean-BenoГ®t Morin from the University of Saint-Etienne, an expert in the mechanics of human running performance.

None received compensation for their research or participation in the hearing. The authors plan to submit the study to a peer-reviewed journal now that the legal case has been settled.

The scientific team was asked to evaluate the IAAF’s initial claim that the Cheetah Flex-Foot prostheses (J-shaped, high-performance prostheses used for running) worn by Pistorius give him an advantage over able-bodied runners. The team concluded that the scientific evidence put forth by the IAAF investigation to ban Pistorius was fundamentally flawed. “While an athlete’s performance in sprints of very short duration is determined almost entirely by mechanical factors, in races of longer duration, such as the 400m, performance depends on both mechanical and metabolic factors,” said Herr, a bilateral amputee who heads the MIT Media Lab’s Biomechatronics research group.

Based on this performance link, the scientists refuted the IAAF findings on two major points: the speed-duration relationship and rates of metabolic energy expenditure.

Specifically, the scientists concluded that:
Pistorius’ ability to maintain speed over the course of longer sprints–his speed-duration relationship–is essentially identical to that of able-bodied runners, indicating that he fatigues in the same manner as able-bodied sprinters.

Pistorius’ rates of metabolic energy expenditure do not differ from elite non-amputee runners. In particular, he has nearly the same running economy, or rate of oxygen consumption at submaximal speeds, and a similar maximal rate of oxygen consumption as elite non-amputee runners.

“Based on the data collected at Rice, the blades do not confer an enhanced ability to hold speed over a 400m race,” Weyand said. “Nor does our research support the IAAF’s claims of how the blades provide some sort of mechanical advantage for sprinting.”

“The study commissioned by the IAAF claimed that Pistorius has a 25 percent energetic advantage at 400m race speeds. That claim is specious because anaerobic energy supply cannot be quantified,” Kram said.

In summary, the team of experts unanimously concluded that the IAAF allegations were not scientifically valid.

###

Source: David Ruth

Rice University

UroToday – Nocturnal enuresis can be defined as nighttime incontinence in children at an age when bladder control is expected. Dysfunctional voiding and nocturnal polyuria are thought to play a role. Hypercalciuria might also be involved in the pathogenesis of enuresis associated with nocturnal polyuria. Raes et al investigated if modifications in renal function are involved in nocturnal enuresis. They assessed circadian variation in natriuresis and tubular sodium handling in polyuric hypercalciuric children.

They had a total of 10 children with proved hypercalciuria and nocturnal polyuria and 10 age matched controls. A 24-hour urine collection was performed in 8 sampling periods for measurement of urinary sodium excretion. Segmental tubular sodium transport was investigated during a daytime oral water load test and calculated according to standardized clearance methodology.

The children with enuresis showed a marked increase in the fractional excretion of sodium during the night (0.93% ± 0.36%), while daytime sodium excretion was decreased (0.84% ± 0.23%). Analysis of segmental tubular sodium transport revealed decreased delivery of sodium to distal tubule (CH2O + CNa = 10.7 ml/100 ml glomerular filtration rate). This indicated that not only was there increased proximal tubular sodium reabsorption but also stimulation of distal sodium reabsorption. It was shown by increased fractional distal sodium reabsorption (92.9% ± 2.2%, controls 90.5% ± 2.9%). Increased distal reabsorption was associated with increased fractional potassium excretion (17.5% ± 2.7%, controls 13.6% ± 6.4%), indicating increased distal tubular sodium/potassium exchange.

The group concluded that there was no intrinsic defect in renal tubular sodium transport, but during the day increased sodium reabsorption in proximal and distal tubules was observed. This suggested that extrarenal factors might be involved in altered circadian variation in solute and water excretion by the kidney.


Raes A, Dehoorne J, Hoebeke P, Van Laecke E, Donckerwolcke R, Vande Walle J
Journal of Urology 176(3): 1147-1151, September 2006.

Reviewed by UroToday Medical Editor Pasquale Casale, MD

UroToday – the only urology website with original content global urology key opinion leaders actively engaged in clinical practice.

To access the latest urology news releases from UroToday, go to:
www.urotoday

Copyright © 2006 – UroToday

The Canadian Food Inspection Agency (CFIA) has confirmed the presence of the emerald ash borer (EAB) in Toronto, Ontario. Located in the vicinity of Sheppard Avenue East and Highway 404, the infested trees were first detected by Ontario Ministry of Natural Resources staff. This is the first find of the pest in the Toronto area.

While EAB poses no risk to human health, this beetle is an invasive alien species and poses a significant threat to our forests and forest industries.

The CFIA is surveying to determine the extent of infestation in the area. The pest is currently in its dormant period and will not spread naturally during the winter months.

Tree removal is not considered an effective tool for the control of EAB. However, some trees may be removed in collaboration with Natural Resources Canada – Canadian Forest Service for research purposes. Affected property owners will be eligible for compensation under the Introduced Forest Pest Compensation Regulations.

Restrictions on the movement of all firewood and ash tree materials will be implemented on properties within a five-kilometre radius from where EAB was detected. This is necessary to stop the movement of potentially infested materials that may harbour the insect. EAB is generally spread through the movement of infested firewood, nursery stock and forest products. Affected property owners will be notified of these restrictions by the CFIA.

Trees, nursery stock, logs, lumber, wood packaging, wood or bark, wood chips or bark chips of ash trees (genus Fraxinus), as well as firewood of all species will be regulated for EAB.

EAB has previously been confirmed in the Municipality of Chatham-Kent as well as Essex, Elgin, Lambton, Middlesex and Norfolk counties. Regulated areas have been implemented in these areas to control the movement of potentially infested materials and slow the spread of the pest to new areas.

The CFIA will continue to work with its partners and stakeholders toward the goal of slowing the spread of this destructive pest.

Additional information on EAB and other invasive alien species is available on the CFIA web site at inspection.gc/ or by calling 1 866 463-6017.

Canadian Food Inspection Agency

According to the january issue of the Mayo Clinic Women’s HealthSource, chronic obstructive pulmonary disease is increasingly becoming a problem for women. The most important risk factor for COPD is long term cigarette smoking.

Chronic obstructive pulmonary disease is a broad term that describes any of a group of illnesses that block airflow through the lungs. The most common are emphysema and chronic bronchitis with symptoms often develop gradually, and people don’t realise they have the disease until it’s advanced.

The COPD death rate for women in the United States has increased much faster between 1980 and 2000 than it did for men. In 2000, the number of women dying of COPD surpassed men for the first time. According to recent research, women with the disease experience more breathlessness, higher rates of depression and lower quality of life than men with the disease, even those women reported fewer years of smoking than men.

The increase in female rates of COPD likely reflects the increase in the number of female smokers since the 1940s, when advertisers began promoting smoking as a symbol of independence for women.

Chronic obstructive pulmonary disease can be treated, but not cured. The most important treatment is to stop smoking. For smokers with COPD, quitting smoking reduces subsequent loss of lung function by half and cuts the death rate by nearly half.

ash

Investigators at Children’s Hospital Oakland Research Institute, Oakland, California found a way to obtain large numbers of hematopoietic stem cell from human term placenta. The results, which appear in the July 2009 issue of Experimental Biology and Medicine, describe detailed report on quantification, characterization, engraftment capacity, and most importantly, practical way to obtain hematopoietic stem cells from placenta in numbers that are several-fold higher than could be obtained from cord blood.

The research team, Dr. Vladimir Serikov, MD, PhD, D.Sci, Assistant Staff Scientist, Catherin Hounshell, a research associate, Sandra Larkin, a research associate, Mr. William Green, student, Dr. Hurokazy Ikeda, MD, Visiting Scientist, Dr. Mark Walters, Medical Director of Children’s Hospital Oakland Hematology and Oncology Programs, and Dr. Frans Kuypers, Senior Scientist, performed studies in human term placentas, human cord blood, and immunodeficient mice. Dr. Serikov said, that the fact the human term placenta is a hematopoietic organ was reported by our team for the first time more then a year ago, and this year this finding was confirmed by UCSF scientists headed by Dr. S. Fisher.

In this report, said Dr. Serikov, we demonstrate for the first time that human placentas could provide abundant amounts of CD34+ CD133+ colony-forming cells, as well as other primitive hematopoietic progenitors, suitable for transplantation in humans. The total amount of live hematopoitic stem cells, or colony-forming units in culture that could be obtained from placentas was an order of magnitude larger than the number of hematopoietic stem cells obtained from cord blood from the same source. Hematopoietic stem cells which maintain their differentiation capacity, as well as stromal stem cells that support long-term culture of hematopoietic cells, can be harvested from perfusate of placenta following CXCR4 receptor blockade, said Dr. F. Kuypers. Importantly, live HPCs can similarly be obtained from whole cryopreserved placentas. Cells derived from placental tissue differentiated into all blood lineages in vitro. Animal experiments further demonstrated successful engraftment of placenta-derived HSC, which reconstituted hematopoiesis in immunodeficient mice.

In summary, said Dr. F. Kuypers, our results indicate for the first time that human term placenta is a high capacity source of live and functional hematopoietic stem cells. By using placental circulation and stem cell receptor blockade an abundant amounts of hematopoietic stem cell could be easily obtained in sterile conditions by non-destructive methods.

Dr. Steven R. Goodman, Editor-in-Chief of Experimental Biology and Medicine said “the outstanding importance of these results for practical hematology is determined by the fact that total number of stem cells that can be harvested from cord blood limits the efficacy of this stem cell source for transplants only to small children. These novel findings demonstrate that placenta may provide a source of autologous stem cells sufficient for reconstitution of hematopoiesis in adult patients. Use of methods to obtain hematopoietic cells from placenta, developed by Dr. Serikov and Dr. Kuypers as augumentation of cord blood-based therapy or replacement of bone marrow for transplantation will dramatically change whole field of transplantology.”

Source:
Dr. Frans Kuypers
Society for Experimental Biology and Medicine

A review of the hormone erythropoietin has called for further trials to be conducted to ascertain its efficacy in improving neuronal damage in stroke patients.

Erythropoietin (EPO) is an endogenous hormone primarily produced by the kidney and works by increasing the production of red blood cells and delivering oxygen to muscles. In the 1980s, the human recombinant EPO (rHuEPO) was developed, which in turn led to key advances in the treatment of patients with chronic renal failure and anaemia.

Writing in the March issue of the Annals of Clinical Biochemistry, Dr Joanne Marsden of Kings College Hospital argues consideration must be given for EPO to be licensed for use in other applications.

“The discovery that EPO is present in other tissues in the body (e.g. endothelial, myocardial and neural cells) has led to suggestions that EPO may have a beneficial effect on these cells and hence function as an anti-inflammatory and neuroprotective agent,” writes Dr Marsden.

“There is increasing evidence that EPO may have a beneficial effect in Parkinson’s disease and other diseases associated with the central nervous system.”

Although the use of rHuEPO is not without side-effects, such as hypertension and thrombosis, the review argues that the clinical benefits of rHuEPO in other applications cannot be ignored.

“There is an increasing amount of evidence-based literature that demonstrates the usefulness of EPO as an neuroprotective agent at the site of injury. Consideration must be given to its use in other clinical areas where research shows there is benefit to patients,” said Dr Marsden.

EPO was banned by the International Olympic Committee in 1990 following its abuse by athletes. However, modern testing procedures can now differentiate between endogenous and recombinant EPO.

Erythropoietin – measurement and clinical applications [PDF 144k]

Annals of Clinical Biochemistry is published bimonthly by The Royal Society of Medicine. Its Editor is Julian Barth.

Erythropoietin – measurement and clinical applications. Annals of Clinical Biochemistry 2006; 43(2): 97-104

rsm.ac

Advancing the minimally invasive treatment of aortic aneurysms, Medtronic, Inc. (NYSE: MDT), today announced approval by the U.S. Food and Drug Administration (FDA) of the Talent Thoracic Stent Graft with Captivia® Delivery System, which features a tip capture mechanism for controlled deployment and precise placement of the implantable medical device.

Now available for clinical practice in the United States, the Talent Captivia System is used in the endovascular repair of thoracic aortic aneurysms (TAA), dangerous bulges in the body’s main artery (near the heart) that can rupture with fatal consequences if left untreated. While an estimated 60,000 people in the United States have a TAA, only about half are ever diagnosed due to lack of symptoms.

During thoracic endovascular aortic repair (TEVAR), the Talent Captivia System is inserted into the femoral artery in the patient’s groin and moved up through blood vessels to the aorta. With the device at the site of the aneurysm, the physician expands the stent graft within the aorta, creating a new path for blood flow that reduces pressure on the bulge and the risk of rupture.

“The Captivia Delivery System’s tip capture mechanism is designed to provide excellent control of the stent graft during deployment to ensure that blood flow isn’t occluded into the nearby arteries,” said Dr. Edward Y. Woo, M.D., vice-chief and program director of vascular surgery and endovascular therapy for the University of Pennsylvania Hospital System. “This improvement to the delivery system also increases my confidence in the device’s deployment accuracy.”

Medtronic now offers the Talent Thoracic Stent Graft in longer lengths (up to 215 mm in total length) to accommodate the aortic anatomies of more patients. In addition to tip capture, the Captivia Delivery System features a hydrophilic coating to ease insertion into the femoral artery and navigation through the iliac arteries (around the pelvis) en route to the aorta.

“In partnership with physicians around the world, Medtronic stent grafts have been used to treat more than 180,000 patients with aortic disease or injury – more than all other manufacturers combined,” said Tony Semedo, vice president and general manager of Medtronic’s Endovascular Innovations business. “FDA approval of the Talent Captivia System builds on this legacy of leadership in the field of endovascular aortic repair.”

The Talent Captivia System is indicated specifically for the endovascular repair of fusiform aneurysms and saccular aneurysms/penetrating ulcers of the descending thoracic aorta in patients having appropriate anatomy. More information about Medtronic stent grafts, including the Talent Captivia System, is available online here.

Medtronic is committed to advancing the treatment of coronary, peripheral, aortic and structural heart disease through collaboration with leading clinicians, researchers and scientists worldwide.

Source:

Medtronic

Stem cell researcher Treena Livingston Arinzeh will discuss current stem cell applications at NJIT, including the regeneration of bone and cartilage for bone fracture and osteoarthritis treatments, spinal cord repair, and liver regeneration at NJIT’s first Research CafГ©.

The event will be held Sept. 29, 2009, at 4:30 PM in the faculty dining area on the third floor of the NJIT Campus Center. The public is invited and refreshments will be served.

Arinzeh, an associate professor and interim chair of the biomedical engineering department at NJIT, has earned national recognition for her commitment to making adult stem cell therapy a future reality. Her research interests include applied biomaterials and tissue engineering; cell-biomaterial interaction; materials processing; surface characterization and modification of biomaterials. Other interests include materials testing; in vivo models; tissue-engineering scaffolds for repair of bone and other related musculoskeletal tissues. She also studies nerve tissue regeneration.

Since the discovery of the embryonic stem cell about a decade ago, stem cells have been of great interest in the medical community because of their ability to turn into any cell type in the body and therefore, their potential to regenerate tissue in the body.

These are not the only stem cells. Stem cells have been used for treating blood disorders in humans for the past several decades. Adult stem cells that come from blood and bone marrow were discovered well before embryonic stem cells. They differ from embryonic stem cells in that they can’t turn into every cell type of the body. They can only turn into certain cell types and therefore, have limited clinical application.

Source:
Sheryl Weinstein

New Jersey Institute of Technology

In a special issue dedicated to prosthetics research, researchers at the Christine Kleinert Institute for Hand and Microsurgery in Louisville, Kentucky, provide an update on five patients to receive hand transplants in the United States.

The update describes a brief history of each patient, why they were transplanted, the immunosuppression they received and complications they encountered, and a summary of how each patient is functioning with their new hand.

Based on these findings, researchers conclude that hand transplants are not only feasible but a clinical option for select patients. Hand transplantation promises patients function and sensation that they could not achieve with a prosthesis.

JRRD is a well-established and respected peer-reviewed journal sponsored by the Department of Veterans Affairs. The journal publishes original research, clinical studies, and reviews covering 25 rehabilitation disciplines. JRRD is widely distributed in print and electronic format to both national and international audiences, reaching more than 500,000 readers across 6 continents in 2007.

Source: Journal of Rehabilitation Research and Development