Structural features of donor's kidney may predict receipient's compatibility

A donor's kidney structure may predict the success or failure of kidney transplant in the recipient's body, a new study as suggested.

The study may help clinicians as they evaluate the quality of organs at the time of transplantation. The quality of donated kidneys obtained from living donors is often inferred from their age, risk factors and kidney function.

Although living kidney donors are extensively evaluated to ensure that they have good health and that they do not have any medical conditions that would disqualify them from donating, subtle injuries in the donated kidney tissue may not be detected through standard evaluations.

When a team of researchers evaluated 2,293 kidney donor-recipient pairs, the investigators discovered that some very subtle structural features of the donated kidney may influence the longevity of the kidney in the recipient.

For e.g., minimal scarring of the kidney or hardening of its vessels, as well as a larger size of nephrons- the microscopic functional units of the kidney-observed in biopsies at the time of donation were associated with a shorter lifespan of the transplanted kidney in recipients, regardless of other donor or recipient characteristics that are known to affect the longevity of donated kidneys.

We think that these subtle features in the living donor kidney make the recipient more susceptible to lose the kidney transplant over time, said Dr. Issa.

These important findings may provide insights into previously unrecognised predictors of kidney transplant failure in recipients, concluded Dr. Issa.

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Researchers discover new blood test which can detect multiple types of cancer

Researchers have discovered a new kind of blood test in development which is capable of screening for a number of types of cancer.

Moreover, it has a high degree of accuracy, according to the results presented at the recently held seminar.

The test, developed uses next-generation sequencing technology to probe DNA for tiny chemical tags ( methylation) that influence whether genes are active or inactive.

When applied to nearly 3,600 blood samples, some from patients with cancer, some from people who had not been diagnosed with cancer at the time of the blood draw- the test successfully picked up a cancer signal from the cancer patient samples and correctly identified the tissue from where cancer began ( the tissue of origin).

The test's specificity- its ability to return a positive result only when cancer is actually present- was high, as was its ability to pinpoint the organ or tissue of origin researchers found.

The new test looks for DNA, which cancer cells shed into the blood stream when they die. In contrast to ' liquid biopsies', which detest genetic mutations or other cancer-related alterations in DNA, the technology focuses on modifications to DNA known as methyl groups.

Methyl groups are chemical units that can be attached to DNA, in a process called methylation, to control which genes are 'on' and which are ' off'.

Abnormal patterns of methylation turn out to be, in many cases, more indicative of cancer- and cancer type- than mutations are.

The new test zeroes in on portions of the genome where abnormal methylation patterns are found in cancer cells. 

Our previous work indicated that methylation-based assays outperform traditional DNA-sequencing approaches to detecting multiple forms of cancer in blood samples, said the study's lead author.
In the study, investigators analysed cell-free DNA ( DNA that had once been confined to cells but had entered the bloodstream upon the cells' death) in 3,583 blood samples, including 1,530 from patients diagnosed with cancer and 2,053 from people without cancer.

The patients samples comprised more than 20 types of cancer,  including hormone receptor-negative breast, colorectal, esophageal, gallbladder, gastric, head and neck, lung, lymphoid leukemia, multiple myeloma, ovarian and pancreatic cancer.

The overall specificity was 99.4 %, meaning only 0.6% of the results incorrectly indicated that cancer was present.

The sensitivity of the assay for detecting pre-specified high mortality cancer ( the percent of blood samples from these patients that tested positive for cancer) was 76 %.

Within this group, the sensitivity was 32 % for patients with stage 1 cancer, 76 % for those with stage 2 , 85 % for stage 3 and 93 % for stage 4.

Sensitivity across all cancer types was 55%, with similar increases in detection by stage. For the 97 % of samples that returned a tissue of origin result, the test correctly identified the organ or tissue of origin in 89 % of cases.

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Researchers identify gene linked to tooth healing

Researchers have identified the gene called  DIk1 that enhances stem cell activation and tissue regeneration to help in tooth healing.

The study found a mechanism that could offer a potential novel solution for tooth repairing.

Stem cells hold the key to wound healing as they develop into specialised cell types throughout the body - including in the teeth. Stem cells are so important that in the future they could be used in laboratories to regenerate tissues that have been damaged or lost due to disease, said researchers.

"By uncovering both the new stem cells that make the main body of a tooth and establishing their vital use of Dlk1 in regenerating the tissue, we have taken major steps in understanding stem cell regeneration," said the study's lead author.

Researchers identified a new population of mesenchymal stem cells -- the stem cells that make up skeletal tissue such as muscle and bone -- in a continuously growing mouse incisor model. They showed that these cells contribute to the formation of tooth dentin -- the hard tissue that covers the main body of a tooth.

The findings showed that when these stem cells are activated, they send signals back to the mother cells of the tissue to control the number of cells produced, through a molecular gene called Dlk1.

During the study, the researchers also showed that Dlk1 can enhance stem cell activation and tissue regeneration in a tooth wound healing model. This mechanism could provide a novel solution for tooth reparation, dealing with problems such as tooth decay, crumbling and trauma treatment.

"The work has taken place in lab models at this stage, and further work needs to be done before we can bring them to human use. But it's a really big breakthrough in regenerative medicine that could have huge implications for patients in future," the author added.

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2 Minute Massage to Ease Foot Pain

It's astounding to think that a whopping 2 million people are treated for the painful heel condition known as plantar fasciitis, according to the Orthopaedic Surgeons. The pain is caused by inflammation of the plantar fascia - the thick band of tissue that supports the arch and joins the toes to the heel bone. The condition can be triggered by a number of activities including running, walking or standing for long periods of time. In addition to being very painful, plantar fasciitis can become chronic if left untreated.

 

If you do suffer from plantar fasciitis pain, then you may already be aware of a number of treatment options. Some of which include wearing podiatrist-recommended shoes, adding insoles to your shoes, sleeping with a night splint, and taking over-the-counter pain relievers.

But should you want to get instant relief after a long day on your feet, giving yourself a quick and easy foot massage is one simple, and non-invasive way to treat plantar fasciitis pain. In fact, a podiatric surgeon,  recommends a technique known as a cross-fiber massage to help treat heel pain. It's very easy to do and is very effective in treating pain. 

What to do: 
1. The ideal time to perform a foot massage is after a bath, shower, or a foot soak, because the foot tissues are already warmed up.
2. To complete the massage think of your foot as a tic-tac-toe board. Use medium-to-firm pressure and massage your foot along the full length of the arch, from the heel to the toes.
3. Then, go across the entire width of the arch, massaging each foot for two minutes.
“Doing this provides fascial release, increasing circulation and reducing tension as well as tightness to the plantar fascia,” the Dr. explains. After you're done massaging each foot, apply ice to the area for about 15 minutes.

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Human eggs developed in a lab for the first time

Scientists have succeeded for the first time in growing human eggs in a laboratory from the earliest stages in ovarian tissue all the way to full maturity - a scientific step that had previously been taken in mice.

Publishing their result the scientists  said it could one day help in developing regenerative medicine therapies and new infertility treatments.

In previous studies, scientists had developed mouse eggs in a laboratory to the stage where they produced live offspring, and had also matured human eggs from a relatively late stage of development.

This latest work, by scientists at two research hospitals, is the first time human eggs have been developed outside the human body from their earliest stage to full maturity.

"Being able to fully develop human eggs in the lab could widen the scope of available fertility treatments. We are now working on optimising the conditions that support egg development in this way and studying how healthy they are," said the researcher.

Independent experts not directly involved in this work praised it as important, but also cautioned that there is much more to do before lab-grown human eggs could be safely be made ready for fertilisation with  sperm.

"This early data suggests this may well be feasible in the future," said  a senior clinical lecturer in Endocrinology.

"(But) the technology remains at an early stage, and much more work is needed to make sure that the technique is safe and optimised before we ascertain whether these eggs remain normal during the process, and can be fertilised to form embryos that could lead to healthy babies."

A genetics professor  said the work was "an impressive technical achievement".

If success and safety rates were improved, he said, it could in future help cancer patients wishing to preserve their fertility while undergoing chemotherapy treatment, improve fertility treatments, and deepen scientific understanding of the biology of the earliest stages of human life.

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Scientists have succeeded for the first time in growing human eggs in a laboratory from the earliest stages in ovarian tissue all the way to full maturity - a scientific step that had previously been taken in mice.

Publishing their result in the journal Molecular Human Reproduction on Friday, scientists from Britain and the United States said it could one day help in developing regenerative medicine therapies and new infertility treatments.

In previous studies, sc ..

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Can Your Hip Replacement Kill You?

When a Dr.'s right hip gave out in 2006, he asked his surgeon to implant an artificial one — specifically, a metal-on-metal hip called the ASR XL, made by a company. He knew what he was talking about: As an orthopedic surgeon, the Dr.  specializes in complex hip replacements. But what he knew wasn’t enough to protect him from a defect in the device.

Five years after his surgery, and in excruciating pain, the Dr. underwent more surgery, this time to have the device replaced. When the surgeon sliced into his hip, what he saw looked like a crankcase full of dirty oil. Tissue surrounding the hip was black. Cobalt leaking from the ASR hip had caused a condition called metallosis, destroying not only local muscle, tendons and ligaments, but harming Dr.'s  heart and brain as well.

Despite Dr.’s repeated efforts to warn his colleagues and the company that the implants were harming patients, the company continued to market metal-on-metal hips. While it withdrew the ASR XL model from the market in 2010, citing slow sales, it continued to sell another, similarly problematic model, the Pinnacle, until 2013.

More than 9,000 patients filed suit against the company, and on Nov. 16, six New York patients won a 247million $ verdict for serious harms caused by the Pinnacle hip implants and for failing to warn doctors and patients about its dangers. These suits and others are pulling back the curtain on what some doctors call the Wild West of medicine: the untested and largely unregulated medical device industry.

About 32 million Americans — or about one in 10 — have at least one medical device implanted, from artificial joints to cardiac stents, surgical mesh, pacemakers, defibrillators, nerve stimulators, replacement lenses in eyes, heart valves and birth control devices.

These devices have helped countless people, and some have saved lives. But many others are harmed — and doctors and patients are at the mercy of manufacturers’ claims about the safety and efficacy of the devices. Medical interventions are now the third-leading cause of death in the United States, and devices play an increasing role in that statistic.

Many people assume that the Food and Drug Administration requires rigorous testing of medical devices before they are approved, the same as the lengthy approval process it requires for new drugs. In fact, most high-risk devices on the market, including implants, have undergone no clinical testing at all.

Although the standard for approval of a new drug usually calls for two randomized, controlled clinical trials, the standard for many medical devices is no standard at all. Since medical devices didn’t come under regulatory control until 1976, the agency simply grandfathered in all devices that were already on the market under a provision known as 510(k), which allows manufacturers to sell most new devices without requiring any clinical testing as long as the manufacturer says its product is “substantially equivalent” to an existing device.

In addition to the 510(k) pathway, medical device companies can avoid clinical testing for the highest risk devices through the supplement pathway by telling the agency, they made a minor change to a previously approved device. The use of these loopholes is widespread: A study published in 2009 found that only 5 percent of high-risk implanted cardiac devices even partly met the standard for drug testing.

Metal hips are far from the only devices with catastrophic consequences. In October 2007,  a leading medical device manufacturer, recalled the lead wires in its defibrillator after they were found to fracture and misfire, harming or even killing patients. The devices had not been clinically tested and were approved for sale by the F.D.A. through the supplement pathway. But in this case, the “minor change” was a fatal one; the new wire was thinner and prone to fracture.

By the time of the recall, 268,000 leads had been implanted in patients worldwide. After the recall, many patients rushed to have the devices removed, but removal posed its own dangers, causing major complications in 15 percent of patients.

Even when devices are subjected to trials, the agency sometimes ignores danger signs detected by those studies. In 1997, during the approval process of the vagus nerve stimulator, a device made by a company to treat epilepsy, an adviser voiced concerns about a high death rate noted in patients with the device. But the agency didn’t stop the device from going to market. Instead, it awarded conditional approval, meaning that the company would have to conduct safety studies after the device was on the market.

The agency didn’t even require the company to inform patients that there was concern about the death rate, or that they were effectively being made unwitting guinea pigs. When the company finally submitted five studies that it said proved the device was safe, it failed to include death data for any of the studies, a move the agency defended, saying the agency hadn’t asked the company to count deaths, only to “characterize” deaths.

How it’s possible to characterize deaths without including any actual data on deaths is anyone’s guess.

With such shockingly lax regulations, it’s no surprise that device recalls have risen over the years; in 2003, there were eight Class 1 device recalls, which the agency defines as indicating “a reasonable probability” that a device will “cause serious adverse health consequences or death.” In 2016, that number rose to 117, affecting hundreds of thousands of patients.

Loose oversight of devices poses a threat to public health. This presumes that such speed and innovation is actually lifesaving or life-enhancing. The number of device-related deaths shows how dangerous that presumption is.

The fact that the agency has allowed lax practices like the 510(k) loophole to continue, despite calls for reform by institutions, poses the question of why the agency would put profits ahead of safety. 

Returning to a system in which the agency commissioners are civil servants is perhaps a first step, but it needs to be the first of many. As a government agency, the agency is supposed to serve as a bulwark between corporate profiteering and the public welfare. Its continued allowance of regulation loopholes like 510(k), despite the significant demonstrated cost to public welfare, calls into serious question the agency’s fulfillment of its stated mission to protect public health by ensuring safety, efficacy and security.

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